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Aim: This study aimed to determine the effects of acupressure on the intestinal function of patients undergoing Coronary Artery Bypass Graft (CABG) surgery. Background: Studies indicated that cardiovascular patients are prone to constipation. Acupressure is one of the therapeutic and palliative approaches that can be used by doctors, nurses, and even patients themselves. Methods: The present three-group randomized clinical trial study was conducted on 90 patients undergoing CABG surgery. In the intervention group, 48 hours after surgery the patients received acupressure points LI4 and ST25 twice a day (10 am and 6 pm) for three sequential days. In the sham group, the patients received acupressure at a 1.5 cm distance from the LI4-ST25 points, and the patients in the control group received only the usual care. This research used a demographic and medical information questionnaire, Rome IV scale, Bristol stool scale, symptom registration checklist, and daily excretion assessment checklist. The intestinal function indices were completed 24 hours after surgery (before intervention), 48, 72, 96, and 120 hours after surgery. Results: All three intervention, sham, and control groups were without defecation in 24 hours (before intervention) and 48 hours after surgery. There was a significant difference between the three intervention, sham, and control groups in the number of stools after 72 hours, 96 hours, and 120 hours after the intervention (p<0.001). Also, a significant difference was observed among the three groups in terms of stool consistency 96 hours after the start of the intervention (p=0.032) and 120 hours after the start of the intervention (p<0.001). Conclusion: The results showed that patients had a significant improvement in the number of bowel movements and stool consistency in the intervention group. In acute conditions, acupressure on LI4-ST25 points can positively affect intestinal function when patients are hospitalized in the intensive care unit. [ABSTRACT FROM AUTHOR]

Background and Objectives: High workload, insufficient resources, and many stressors in the workplace have led to the imposition of physical and psychological pressures on nurses, which exposes them to Death Anxiety (DA). This systematic review aimed to assess the DA and factors associated with its in nurses during the COVID-19 pandemic. Material and Methods: An extensive search was conducted on Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) databases via keywords including "Death", "Death Anxiety", "Nurses", and "COVID-19", from December 2019 to November 10, 2021. Results: 818 nurses were enrolled in four papers. Nurses' mean age and work experiences were 31.21 (SD=5.43) and 7.60 (SD=6.73) years, respectively. The mean DA of nurses during the COVID-19 pandemic was 7.30 (SD=2.23). Also, 31.05% of nurses had a high DA level during the COVID-19 pandemic. Age, sex, work experience, working hours per week, childbearing, several patients needing end-of-life care, direct participation in resuscitation operations, patient death, depression, mental health status, and life satisfaction were influential factors in DA nurses during the COVID-19 pandemic. Conclusion: Thus, nursing policymakers should pay special attention to these factors related to nurses' health maintenance and promotion programs to increase the quality of nursing care for COVID-19 patients. Also, it is recommended that psychological and communication support be provided to nurses during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Purpose: Forensic nursing is a specialty in the nursing profession based on legal procedures. This study aimed to assess the effect of a forensic nursing virtual education course on knowledge and clinical decision-making among master's nursing students. Methods: In a quasi-experimental study with a pre- and post-test, 106 master's nursing students at Guilan (n=65) and Mazandaran (n=41) Universities of Medical Sciences, Iran were enrolled. Data were collected using census sampling from March to April 2021. Participants in the intervention group received a forensic nursing virtual education course in three 90-minute sessions for 2 days. Results: A total of 88 out of 106 master's nursing students were enrolled in this study. The mean post-education score for knowledge in the intervention group was significantly higher than in the control group (12.52 vs. 7.67, P<0.001). The mean post-education score for clinical decision-making in the intervention group was significantly higher than in the control group (16.96 vs. 13.64, P<0.001). Conclusion: The level of knowledge and clinical decision-making of master's nursing students regarding forensic evidence improved after the forensic nursing virtual education course in the intervention group compared to the control group. Nursing managers and policy-makers can develop appropriate strategies to improve the knowledge and clinical decision-making of nursing students by using forensic nursing education courses in the curricula of nursing programs, especially in postgraduate education as an elective or mandatory course. [ABSTRACT FROM AUTHOR]

Introduction: Human immunodeficiency virus infection /acquired immunodeficiency syndrome has grown to be one of the world's most momentous pandemics. The present study aimed to explore the effects of stigma on people living with HIV/AIDS (PLWHA) and recommend coping strategies to reduce this phenomenon. Materials and Methods: Using a narrative literature review, the related articles were searched, retrieved, and selected from the databases of Noor Specialized Magazines (Noormags), Elmnet, Scientific Information Database of Academic Center for Education, Culture, and Research (SID), IranMedex, and Magiran via the keywords of "Stigma, Social Stigma, Labeling, Acquired Immunodeficiency Syndrome, AIDS, Human Immunodeficiency Virus, and HIV" in Persian and in the databases of PubMed and Scopus in English. The same procedure was further performed in Google Scholar in both languages. The inclusion criteria were the full-text articles in Persian and English and the exclusion criteria were no access to the full-text articles, while review articles were removed. Results: Considering the inclusion and exclusion criteria and excluding the duplicate studies, 16 articles were recruited in total for review purposes. The effects of stigma on PLWHA consisted of individual and social consequences. As well, the most appropriate coping strategies to reduce stigma were acknowledged as "providing psychosocial support for infected people", "raising awareness in the public and medical staff", "cultivating spirituality and a close relationship with God", "developing and implementing counseling strategies", and "establishing specialty clinics for PLWHA". Conclusion: Given the study findings, it can be suggested that policy-makers and community healthcare managers pay much more attention to the individual and social consequences of HIV/AIDS and make further efforts to increase awareness in the public and medical staffs, strengthen spirituality in PLWHA, and set up specialty clinics for such individuals to cope with stigma. [ABSTRACT FROM AUTHOR]

Depression can lead to increased medical costs, impaired individual and social functioning, nonadherence to therapeutic proceeding, and even suicide and ultimately affect quality of life. It is important to know the extent of its prevalence for successful planning in this regard. This study was conducted to determine the prevalence of depression in the Iranian elderly. This systematic review and meta-analysis study was done through Medline via PubMed, SCOPUS, Web of Science, ProQuest, SID, Embase, and Magiran with determined keywords. Screening was done on the basis of relevance to the purpose of the study, titles, abstracts, full text, and inclusion and exclusion criteria. The quality of the articles was assessed using the Newcastle-Ottawa standard scale. After primary and secondary screening, 30 articles were finally included in the study. According to the 30 articles reviewed, the prevalence of depression in the Iranian elderly was 52 percent based on the random-effects model (CI 95%: 46–58). According to the results of the present study, depression in the Iranian elderly was moderate to high. Therefore, more exact assessment in terms of depression screening in elderly people seems necessary. Coherent and systematic programs, including psychosocial empowerment counselling for the elderly and workshops for their families, are also needed. Researchers can also use the results of this study for future research. [ABSTRACT FROM AUTHOR]

This descriptive correlational study was aimed at determining the relationship of hemodialysis shift with sleep quality and depression in 310 hemodialysis patients. Demographic and Clinical Questionnaires, the Pittsburgh sleep quality index, and Beck's Depression Inventory were used to ascertain the aforementioned relationship. Among the patients, 59.6% reported poor sleep quality and 44.8% reported experiencing depression. Results show that these conditions were significantly related to many factors. Although dialysis shift was not significantly related to sleep quality and depression, sleep quality was found significantly associated with age, female gender, illiteracy, unemployment, residence in rural areas, diabetes, addiction to sedatives, and phosphorus levels. A significant relationship was also found between depression and phosphorus levels. Logistic regression predicted age, gender, illiteracy, unemployment, residence in rural areas, and addiction to sedatives as factors for poor sleep quality. A body mass index (BMI) above 30, decreased urea, and increased phosphorus were predicted as factors for increased depression. [ABSTRACT FROM AUTHOR]

Objectives: Futile medical care is considered as the care or treatment that does not benefit the patient. Staff of intensive care units experience moral distress when they perceive the futility of care. Therefore, this study aimed to determine the relationship between perceptions of nurses regarding futile medical care and their caring behaviors toward patients in the final stages of life admitted to intensive care units. Method: This correlation, analytical study was conducted with 181 nursing staff of the intensive care units of health centers affiliated to Mazandaran University of Medical Sciences, Mazandaran, Iran. The data collection tool included a three-part questionnaire containing demographic characteristics form, perception of futile care questionnaire, and caring behaviors inventory. To analyze the data, statistical tests and central indices of tendency and dispersion were investigated using SPSS, version 19. Pearson's correlation coefficient, partial correlation, t-test, and analysis of variance tests were performed to assess the relationship between the variables. Ethical considerations: The study was reviewed by the ethics committee of the Mazandaran University of Medical Sciences. Informed consent was obtained from participants. Results: Our findings illustrated that the majority of nurses (65.7%) had a moderate perception of futile care, and most of them (98.9%) had desirable caring behaviors in taking care of patients in the final stages of life. The nurses believed that psychosocial aspects of care were of utmost importance. There was a significant negative relationship between perception of futile care and caring behavior. Conclusion: Given the moderate perception of nurses concerning futile care, and its negative impact on caring behaviors toward patients, implementing suitable interventions for minimizing the frequency of futile care and its resulting tension seems to be mandatory. It is imperative to train nurses on adjustment mechanisms and raise their awareness as to situations resulting in futile care. [ABSTRACT FROM AUTHOR]

Background: Many patients undergoing hematopoietic stem cell transplant (HSCT) experience fatigue due to their disease process and its long period of treatment. Using nonpharmacological methods to help reduce their fatigue is a reasonable endeavor. The present study was conducted to investigate the effect of Benson's relaxation technique on fatigue levels in patients after HSCT. Materials and Methods: Thirty-seven patients were randomly selected to the intervention (n = 19) and control group (n = 18). In the intervention group, the participants performed Benson's relaxation exercises for 20 min twice per day over a period of 15 days. The data collection tools used included a demographic and medical information form and the Brief Fatigue Inventory, completed by both groups on three different occasions (upon admission and days 8 and 14 after the HSCT). The data obtained were analyzed in Statistical Package for the Social Sciences version-20 using statistical tests. Results: The results of the independent t-test showed no significant preintervention differences in fatigue levels between the two groups. On days 8 (t = 11.21, p < 0.001) and 14 after the transplant (t = 15.62, p < 0.001), a significant difference was observed in the mean level of fatigue between the two groups. Conclusions: These findings indicate that Benson's relaxation technique would improve fatigue in HSCT patients. [ABSTRACT FROM AUTHOR]

Fatigue is one of the main complaints of patients undergoing allogeneic and autologous hematopoietic stem cell transplantation (HSCT). Since nonpharmacological interventions are cost-effective and causes fewer complications, this study aimed to review the studies performed on the effects of nonpharmacological interventions on fatigue in patients undergoing HSCT during September 2016. MEDLINE, CINAHL, Scientific Information Database, IranMedex, PubMed, ScienceDirect, Scopus, Magiran, and IRANDOC databases were searched using Persian and English keywords. A total of 1217 articles were retrieved, 21 of which were used in this study. Exercise is known as an effective intervention in alleviating physical and mental problems of patients undergoing stem cell transplant. This review-based study showed that nonpharmacological methods such as exercise might be effective in decreasing fatigue in patients undergoing stem cell transplant. There is a multitude of studies on some of the complementary and alternative therapy methods, such as music therapy, yoga, relaxation, and therapeutic massage. These studies demonstrated the positive effects of the aforementioned therapies on reduction of fatigue in patients undergoing stem cell transplantation. All the investigated methods in this study were nonaggressive, safe, and cost-effective and could be used along with common treatments or even as an alternative for pharmacological treatments for the reduction, or elimination of fatigue in patients undergoing stem cell transplantation. Given the advantages of complementary and alternative medicine, conducting further studies on this issue is recommended to reduce fatigue in patients after stem cell transplantation. [ABSTRACT FROM AUTHOR]

Ethical Climate is an important aspect in organizational climate and a positive ethical climate is required for supporting the nurses' professional actions. Therefore, it seems essential to do studies across the country in order to know about the hospitals climate. Hence, the aim of the present study was to survey the nurses' perception of the ethical climate of the educational hospitals in Sari. This descriptive-analytical study was conducted on 151 randomly selected nurses in educational hospitals of Sari in 2016. A two-part questionnaire was used for data collection which the first part was related to demographic features and the second part was a standard ethical climate questionnaire. The collected data was analyzed in SPSS 19 software by using descriptive statistical tests, variance analysis and t-test. The participants' average age was 31.56 ± 5.63. There were 60 male among the participants, 6 associated nurses, and 124 bachelors of nursing as well as 21 MSc. in nursing. Also 65 nurses had 1-5, 45 individuals had 5-10 as well as 41 of them had more than 10 years' work experience. The relationship between perceived ethical climate of the nurses and participants' demographic features was not significant. The results of this study indicated that the ethical climate of the educational hospitals of Sari was favorable. [ABSTRACT FROM AUTHOR]

Introduction: The staff who have safe work environment, do their best to make their work environment better and more efficient. These staff act more successful and most probably have high job involvement. The aim of this study was to investigate the relationship between ethical climate and job involvement among the nurses working in educational hospitals of Sari. Implementation method: This study is a descriptive-analytical one which was conducted on 151 nurses of educational hospitals of Sari in 2016. For data collection a three-part questionnaire was used, the first part of which was related to demographic features. The second part was a Kanungu standard job involvement questionnaire while the third part was related to the Olson's ethical climate questionnaire. Finally the collected data were analyzed by SPSS19 software using t-test statistical tests and variance analysis. Findings: The participants of this study were the nurses working in educational hospitals of Sari whose average age was 31.56 ± 5.63, 91 individuals were female and 96 of them were passed the ethics courses. The relationship between the gender and ethical climate was not significant while its relationship with job involvement was significant. Also the relationship of age and ethics course passing was not significant with ethical climate and job involvement. The ethical climate mean score was 93.72 ± 13.41 while job involvement's was 29.51 ± 6.35 and their relationship was significant. Conclusion: The results indicated that although the staff had a good perception of ethical climate but they had low job involvement and the relationship between ethical climate and job involvement was significant. [ABSTRACT FROM AUTHOR]

Background: Pain is a common phenomenon after surgery. Cardiac surgeries are no exception and patients generally experience acute pain after these surgeries. Inadequate pain management after cardiac surgery predisposes patients to many complications. Therefore, the aim of this study was to determine the effects of listening to preferred music on pain intensity after open heart surgery. Materials and Methods: This study was a randomized clinical trial (RCT) conducted in open heart intensive care unit (ICU) of a university hospital in Sari, Iran. A total of 60 patients who were scheduled to undergo open heart surgery were randomly allocated in two groups. Patients in the intervention group (n = 30) listened to their preferred music by headphones for 30 minutes, whereas those in the control group (n = 30) did not listen to music. Using a Numerical Rating Scale (NRS), pain intensity was measured among the patients before the intervention, and immediately, 30 minutes and one hour after the intervention. Data was analyzed by Chi-square test, student's t-test and repeated measures analysis of variance (ANOVA). Findings: Mean pain intensity in the intervention group before, immediately after, 30 minutes and one hour after the intervention were 5.8, 3.1, 2.5 and 2.4, respectively. Corresponding numbers in the control group were 4.7, 4.7, 4.8 and 4.9, respectively. Repeated measures ANOVA showed music to significantly reduce pain intensity (p = 0.0001) Conclusions: Music can be effective as a non-pharmacological, inexpensive, non-invasive and side effect free method for pain management after open heart surgery. [ABSTRACT FROM AUTHOR]