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Background: Providing care for patients in Persistent Vegetative State (PVS) by family caregivers without enough training and knowledge may be problematic both for the patients and for the caregivers. Therefore, the present study tries to explain the experiences of family caregivers of patients with PVS of seeking information needed to provide adequate care. Materials and Methods: Twenty two participants, including 17 family caregivers and 5 professional caregivers were enrolled by purposive sampling into this qualitative content analysis study, carried out between 2013 and 2015. Unstructured interviews and field notes were used to gather the data. Data collection was stopped when data saturation was achieved. Data analysis was performed by content analysis based on Graneheim and Lundman's approach. Results: As a result of the analysis of the collected data a main theme emerged labeled as “Seeking constructive education” with three categories including “Neglected requisite education,” “Greedy search for useful education” and “Dynamic independence in care.” Conclusions: In this study, information seeking by family caregivers of patients with PVS was constructive. Family caregivers insistently sought needed information from various sources. Ultimately, they found these insistent efforts beneficial and fruitful, because their efforts made them independent in providing care for their patients.

Background: Family is one of the early systems of human societies. Inappropriate performance of family in taking care of children, especially nutritional care, leads to irreparable damages to their development and growth. Accordingly, the present study aimed to investigate the nutrition care of children under the age of six in Abadan. Methods: This descriptive-analytic study was carried out on 406 families with children under the age of six in Abadan city. The families were selected using the cluster sampling method. The data collection tools were a researcher-made questionnaire and direct interview. Furthermore, descriptive and analytical tests such as single sample t-test were used using the SPSS. Results: The results of this study showed that 60 percent of children under one year of age and 32.7 percent of 1-3 year old children were breastfed. Conclusion: The family care function was not satisfactory in regarding the nutrition status of 1-3 year old children. This suggests the necessity of education on breastfeeding by the end of the 2-year period.

Background: To respond to the growing and emerging needs of the people in the health sector, the nurses need to develop their working domain from the hospitals to the community and be prepared to provide entrepreneurial roles at different care levels. Thus, to discover how to identify entrepreneurial opportunities in the field of nursing entrepreneurship, a study was conducted with the aim of describing the experiences of Iranian entrepreneurs on the identification of proper opportunities in entrepreneurship. Materials and Methods: This study was a qualitative research in which the Graneheim and Lundman's content analysis was used to collect and analyze the data. Thirteen entrepreneurial nurses were purposefully selected, and the data were collected by unstructured interviews. Results: As a result of data analysis, three main themes were obtained including the resources for opportunity identification and opportunity assessment and identification of proper opportunities. Conclusion: The findings indicate how to identify entrepreneurial opportunities in the field of health by entrepreneurial nurses which is the first step in the entrepreneurial process. Therefore, the findings of this study can be used to educate nurses who are interested in entering the field of nursing entrepreneurship.

Reliability and validity of measurement tools in master dissertations is essential in flawless evaluation of research result. It ensures that collected data by these tools help in achieving results of study. Therefore, this study was conducted to investigate the properties of measuring tools used in nursing dissertations in Isfahan in 2015. this research is descriptive type of study. For this purpose, 237 dissertations of Medical Science University and 125 dissertations of Islamic Azad University were selected and analyzed using census sampling method. Data on properties of measuring tools used in them were collected by researcher-made information recording form. To analyze the collected data, descriptive statistics using SPSS software was used.in this study, the most common measuring tool at the dissertations was questionnaire and 50.5% of them made by researcher. In the majority of dissertations, the validity and reliability of researcher-made and standard tool had been evaluated. Researchermade tools in most cases investigated using content validity and test-retest reliability. In 54.3% of the cases, validity had been examined by referring to reference, while reliability had been examined by Cronbach's reliability. Among the standard tools used in the dissertations examined, the validity and reliability for the tools for the available sample had not been re-examined in majority of dissertations. In studies where physiological measurement tools have been used, properties of these tools have not been considered in the majority of cases. the findings suggest there are some problems in the process of proving the validity and reliability of measuring tools used in dissertations, requiring that researchers, supervisors, and referees to pay enough attention for this issue.

One of the fundamental steps in the intensive care unit is maintaining an open airway, and if the procedure is not done properly for patients, it is accompanied with many complications. Thus the aim of this study was to evaluate compliance with the standard care of tracheostomy and endotracheal tube in nurses working in intensive care units in Golestan hospital in Ahvaz. in this descriptive cross-sectional study, by the completion of observational checklist containing 31 questions relating to the care standards of endotracheal tube and tracheostomy and a questionnaire, demographic information of 72 nurses working in the intensive care unit in Ahwaz Golestan hospital in 2015 were asked. To verify the validity of the questionnaire, the viewpoints of professors of nursing were used and the reliability of the questionnaire was verified by agreement between the present observers. Eventually, the data collected was analyzed using descriptive statistics and Kruskal-Wallis test, Mann Whitney U and Pearson correlation coefficients using SPSS version 20.the mean score of nurses in standard care of endotracheal tube and tracheostomy was 51/10 ± 45/78 respectively. Also significant positive relationship was observed between age and occupational characteristics of nurses and their performance in the care of the airways (05/0> P). According to the results, despite of optimal performance of personnel, some nursing practices in the care of artificial airway are not done properly which need more control and supervision. Therefore, it is necessary to provide regular training programs in the field of artificial airway and optimal care in critically ill patients is crucial.

The concept of care is entirely complex and subjective so that there can be no treatments without care and more than half of health services are including care. Nursing is one of the most important components of hospital services and nurses group is very important group and after doctors, forms the largest group of technical staff employing in the field of the care of patients. The population of the study includes the employed nurses and the samples (specialist nurses, nurses and nursing assistances) were selected with simple convenience sampling method. In this study, 40 patient caregivers were asked to write all the activities done during their shifts in a form of story, and then their daily stories were recorded and analyzed by the researcher. Also, the services were classified by nominal group (the group of experts and professors of nursing). the results showed that 41.9% of services which the nurses were doing during working shift were basic services that could be also done by nursing assistances. 39.2 % of the services done by nurses were public services and only 18.9% of the services done by nurses were placed in the category of skilled nursing services. In relation to the first objective of study, i.e. determining the types of care services provided by nursing assistances, the results showed that 41.9% of care services done by nurses were basic services that were also done by nursing assistances.

The growth of the elderly and middle-aged population, and the life expectancy have changed the attitudes towards the seniors; Meanwhile, the importance of caring for the self-esteem among the seniors required to do this study in the field; which, its results can help to improve the seniors’ mental health. This study has been carried out aiming to measure the elderly’s self-esteem dwelling in Ahwaz Nursing Homes in 2014. This is a descriptive-comparative study carried out on 190 people of the seniors dwelling in Ahwaz nursing homes. For the eligible seniors, two questioners of Rosenberg’s Measuring Scale, and Cooper Smith’s Measuring Scale were filled out. The variables regression was determined by using SPSS statistical software, version 18. About 44% of participants in the study were aged from 60 to 65 years old. 68% were men, and 61% were married. Some 50% had 3 to 5 children. More than 43% received higher education. Some 53% were financially dependent. About 50% were self-employed. There was no significant difference between self-esteem among the male and female seniors. Also, there was no significant difference among the elderly’s self-esteem based on their marital status. But, there was a significant negative correlation between the total scores of self-esteem, and the marital status, the financial independence, and dwelling in the nursing homes. As, for the effect of the self-esteem on the elderly’s mental health, and their being highly affected by the life conditions, and with respect to the cultural, religious, and social position of Iran, as much as possible, the backgrounds should be provided for the seniors to dwell with their families; and, if dwelling in the nursing homes is the best choice, providing necessary services with high quality should be employed with grater attempts.

Diabetes is one of the chronic diseases causing the deaths in human societies. Since the patients suffering diabetes are prone to many complications, self-care will be one of the most effective ways to prevent these complications. The current study aimed at evaluating the effect of implementation of hospital discharge planning on the self-care ability of the patients suffering type-2 diabetes in the hospitals supervised by Shiraz Medical University in 2013. The current study is a semi-experimental study of clinical trial type. The participants were 66 patients with typediabetes which were divided into case (33 patients) and control (33 patients) groups. For the case group, the discharge plan was performed using oral instructions, booklet, and telephone counseling while the patients in the control group received routine care. The self-caring abilities of the patients were measured using a standard questionnaire pre- and post-intervention. The descriptive and analytical statistics tests through SPSS16 were used for data analysis. The average score of the self-care in the control group was 23/17 ± 48/69 pre-test and 17/12 ± 72/47 post-test which were statistically significant. The average score of the self-care in the case group was 23/17 ± 48/69 pre-test which was increased to 17/12 ± 72/47 post-test (p

Background: Reaching geriatric period is one of the greatest successes in human Beings.The older adults are predisposed to risk of many diseases and disabilities, and physical activity is one of the most efficient methods to prevent geriatric period disorders. Therefore, the present study aimed define the effect of an empowerment program on physical activity of the elderly residing in Shahid Rezaian health care center in 2014. Materials and Methods: This quasi-experimental study was conducted on 70 older adults, age 65 years and over, selected through convenient sampling and assigned to groups of study and control. Study group was divided into 5 seven-member subgroups and a one-hour session of physical exercises was administrated for them once a week for eight sequential weeks. All subjects evaluated before and after intervention by International Physical Activity Questionnaire. Subjects’ physical activity was scored, based on the personal activity protocol,and the results were compared. Significance level was considered as P

In this work we applied a recently developed ionic liquid assisted in-situ solvent formation microextraction coupled with magnetic nano-particle based dispersive micro-solid phase extraction following by HPLC diode array detector (IL-ISFME/D-µ-SPE/HPLC-DAD) for preconcentration and measurment of cannabinoid compounds (THC-9, CBN, CBD) in urine samples. The extraction involved a primary extraction based on IL-ISFME technique followed by a D-µ-SPE step. In the final, the extracted analytes introduced to HPLC-DAD by means of methanol. The condition of the technique were optimized regarding to six effective factors including IL amount, ion pairing salt amount, magnetic nano-particle amount, organic solvent volume, ionic strength and organic solvent type. The whole optimization procedure was done within 159 experimental runs. Optimization procedure was performed by a full factorial central composite design (CCD). This new technique provided up to 98-113 fold preconcentration of the analytes under the optimized conditions. Good repeatabilities (with RSDs 1.8-2.1%) were obtained. Detection limits were in the range of 0.2–1.4 ng/ml.

Background: To respond efficiently to the increasing and new needs of people in health issues, it is necessary for nurses to develop their knowledge from hospital to society and to be equipped to play entrepreneur role in different levels of care. The present study was conducted to describe Iranian entrepreneur nurses’ perceived barriers to entrepreneurship, in order to identify the existing barriers. Materials and Methods: This is a qualitative study in which Graneheim and Lundman’s content analysis method was employed. Thirteen entrepreneur nurses were chosen purposively, and data were gathered by unstructured interviews. Results: As a result of the data analysis, five major themes were extracted: Traditional nursing structure, legal limitations, traditional attitudes of governmental managers, unprofessional behaviors of colleagues, and immoral business. Conclusions: The findings of the present study show that Iranian nurses are confronted with various problems and barriers to enter entrepreneur nursing and keep going in this area. By focusing on such barriers and applying appropriate changes, policymakers and planners in health can facilitate nurses entering into this activity.

Quiescent leadership cannot last long time. When the environment is constant and unchanged, firms will have little mobility Human is subject to organizational changes and numerous factors. Removing the rust from the mirror of the soul of man enhances his development towards his capabilities. Purpose: This study aimed to examine change management capabilities of nurse managers (Head nurses). This research is a descriptive study, which examines the change management capabilities in 50 different supervisors from the perspective of 187 nurses in hospitals under the supervision of head nurses in Qazvin, and it is conducted by Census method. The tools of this research are Bass and Avolio's Transformational leadership questionnaire that its validity and reliability were confirmed. To analyze the data, the software ѕрѕѕ version 22 statistical tests of Pearson, T, Nava, KS, and Chi-square exact was used. The findings showed that, according to the results of t-test, a statistically significant difference was not seen between the scores on all subscales obtained from the questionnaire of management capabilities in change management from nurses, demographic characteristics of nurses. (All p>0/5). However, scores in terms of individual consideration was (p=0/44) and Mental stimulation was (p=0/035) and only statistically significant difference was observed in the education of nurses. Given that nursing managers (supervisors) in the field of change management have a poor and average performance, it seems the higher the level of education is for nurse managers, their ability to apply change management is higher. Also supervisors' performance within individual consideration with an error probability equal to 0/012 is at an optimum level and hence was able to win the trust of staff. To advance the goals of excellence in medical care, training the managers towards change, establishing physical and mental health and confidence in them by their involvement, is considered an important factor in order to improve the quality of health systems.

Background: The use of long-term care services has risen and this trend is expected to continue as the population reaches old age. Objectives: This study was performed to assess the caring conditions in nursing homes. Patients and Methods: This study was conducted with a qualitative approach using conventional qualitative content analysis. The study was conducted on 23 Iranian participants including 14 elders and 9 caregivers. Data was collected with unstructured interviews and continued to the point of data saturation. Analysis of data was performed continually and concurrently with data collection through a comparative method. Results: Three themes emerged from 595 open codes including care as unpleasant task, sustained care and insufficient resources. Ten subthemes indicated participants’ experiences and understanding of caring conditions in a nursing home. Conclusions: The prevailing given care was the routine one with a focus on physical aspects, although there was some psychological care given to the older people. The findings of this research are guidelines for managers and care planners in nursing homes who should pay attention to physical and psychological care needs of older people. In addition, it is important to pay close attention to the needs of caregivers and provision of instructions for treatment, supervision and education of caregivers and medical students to provide a better care.

Background Psoriasis is a chronic mental and physical disease that leads to many challenges for people along their lives so that its compatibility and acceptance by the patient is hardly possible. Objectives The objective of the present study was to describe and explain the experienced coping strategies by patients with Psoriasis. Methods The present study was a qualitative phenomenological interpretation, which was conducted on people with psoriasis, who had referred to Imam Khomeini hospital of Ahvaz during June and March 2014. In this study, 15 people with psoriasis were selected based on purposive sampling and they were asked to express their life experiences regarding coping strategies. Data were collected through a deep and unstructured interview, and the method of Diekelmann et al. (1989) was used for data analysis. Results After analysis of the texts of interviews, the main theme, which was attempt to cope with disease and four sub-themes namely “disease, the reason for spiritual promotion”, “intellectual insight”, “supporting behavior” and “concealing disease” were extracted, which indicated the patients’ experiences when coping with psoriasis. Conclusions The results of the present study showed that people with psoriasis experienced many challenges in order to cope with this disease, and accurate identification of these challenges and real understanding of their experiences by health professionals, and reflecting positive experiences such as spiritual promotion via their disease to other patients are recommended.

Background: Psoriasis is a common, chronic skin disease that causes challenges such as stigma and labeling from both the community and individuals due to its effects on appearance. Objectives: The objective of this study was to describe and explain the social stigma and rejection experienced by patients with psoriasis. Patients and Methods: The present research is a qualitative study with a hermeneutic phenomenological approach conducted among psoriasis patients referring to the dermatology clinic and ward of Imam Khomeini hospital in Ahvaz, Iran between June and December 2014. In this study, 15 patients with psoriasis were selected by purposeful sampling, and they were asked to express their experience of stigma and rejection. The data were collected through in-depth semi-structured interviews, and Diekelmann and colleagues’ method was used for data analysis. Results: After analysis of interviews, four themes were extracted: lack of social support, unrealistic and inappropriate labeling, rejection and isolation, and feeling of absurdity and futility. These can be indicative of the patients’ experience from social stigma and rejection phenomena. Conclusions: Patients’ experiences of stigma and rejection phenomena indicated that all aspects of their lives are affected. Moreover, these findings highlight the significance of stigma and rejection concepts in providing better care to these patients.

Objectives: Within the context of Health-Related Quality of Life studies, it was necessary to translate and evaluate the psychometric properties of the SF-12 Health Survey version 2. The aim of this study was to investigate the factorial structure, convergent validity and reliability of this instrument in a healthy Iranian sample, following translation and establishment of content and face validity. Methods: In this cross-sectional study the translated instrument was administered together with the Sense of Coherence Scale and Health Index in a convenience sample of healthy people (n=289) aged 18 to 76 years old between June and September 2006. A test-retest was conducted one month later. Results: Content Validity Index for Scale (85.6%) and face validity of the instrument were acceptable. The results of Exploratory Factor Analysis and Structural Equation Modeling by four models verified the existing two-factor structure, a physical and a mental component summary. All models exceeded the goodness of fit indices and showed a resemblance with the original instrument, except for models 3 and 4 (allowing cross-loadings). Although in these two models the General Health item and scale was loaded to the mental component rather than the physical component, construct validity of the instrument was confirmed. Also, physical and mental component summaries were significantly (P

Background In our previous study, we found that the degree of sense of coherence (SOC) and baseline ratings of several dimensions of health-related quality of life (HRQoL) were the most important predictors of HRQoL changes 6 months after the pre-diagnosis period of breast cancer. To find a way to explain these findings, the aim of this study was to explore the mediating effect of the SOC between ratings of HRQoL dimensions before final diagnosis, and ratings of the same dimensions at the 6 months follow up, within a sample of women with breast cancer. Methods A longitudinal study with a prospective design at baseline (T1) and 6 months later (T2) was conducted on 162 women with breast cancer. To measure HRQoL dimensions three different questionnaires, the European Organization for Research and Treatment of Cancer QLQ-30, the SF-12 Health Survey version 2 and the Health Index were applied at T1 and T2 to cover both diagnostic-specific and generic dimensions. Measurement of the SOC as a mediator was done by the SOC-13 scale. Results Mediational analyses on eight significant pairs of HRQoL dimensions showed that the degree of SOC totally mediated variations of global quality of life (p

Introduction: Heart transplantation is considered as a golden standard of treatment for advanced heart failure. After - transplantation health of patients is influenced by numerous issues which many of them are unknown to the treatment team including nurses. This research - with the aim of describing the life experiences of heart transplant patients - help us to get close to the patients private life and gain comprehensive and a general understanding of all aspects of their life. Methods: This study applied qualitative approach using phenomenology method. The purposive sampling was conducted and continued with 9 participants until information reached saturation point. The participants are the heart transplant recipients who had surgery in Esfahan's Heart Surgery Center of Shahid Chamran. Results: The extracted interviews were analyzed through Colaizzi method: The eleven extracted main concepts were included: Belief, tendencies of the recipient and family of donor, bewilderment, moment of facing with transplantation, satisfaction, vital organ, support, temperament, physical effects of transplantation, mental changes, paradox of life and death. Conclusion: In heart transplant patients, being in touch with peers and family support have an important role in putting up with the transplantation issue. Lack of social situation and social support were among the patients distresses. Lack of the necessary information about transplantation made patients dissatisfied with the heart transplantation. Regarding the research findings, training received by patients would not be suffice and lack of information has been made them face with problems; therefore, the nurse team of transplantation should play more an active role in training the patients.

Background Complications and diabetes-related difficulties such as fatigue are among the major hindrances in improving health behaviors such as the participation in diabetes self-care programs. Objectives This study investigates the factors influencing fatigue levels in type two diabetes patients given the significance of fatigue and its consequences on controlling diabetes as well as regarding the significant role of the community health nurses in treating and educating patients. Patients and Methods The present study is a quantitative research with a descriptive design. The participants of the study were 195 patients with type two diabetes supported by Isfahan Endocrine and Metabolism Research Centre. They were selected via available sampling method. The instrument of data collection was a written questionnaire that consists of two-part demographic information section and a short form of the Multidimensional Fatigue Symptom Inventory (MFSI-SF). The collected data were analyzed using SPSS (ver 16). The significance value for all the tests in the study was P ˂ 0.05. Results There were significant statistical differences (P ˂ 0.05) between the mean fatigue scores for females (23.22 ± 17.49) and males (13.24 ± 17.73). Among the investigated factors, there was a significant statistical association among the fatigue mean total score and body mass index, (F = 9.521, df = 2, P ˂ 0.05), physical activity (t = 3.90, df = 190, P ˂ 0.05), and complications such as nephropathy, neuropathy, and foot ulcer history. Conclusions Fatigue in diabetes is a complex and multifaceted phenomenon, which can be controlled and treated effectively, if it is evaluated appropriately, and the factors that cause it are investigated.

Background This study reports the results of the qualitative process evaluation (PE) of the Isfahan Healthy Heart Program (IHHP), an integrated community-based trial for prevention and control of non-communicable diseases in Iran. Methods The study explored the overall quality of program implementation. The participants, including designers of IHHP, stakeholders and community members (n = 60) were purposefully recruited from the intervention areas. Data collected from semi-structured interviews and field notes were analyzed using a modified thematic analysis. Results Four main themes were identified. Our findings highlighted the key role of the resources as both facilitating and hindering factors. IHHP directors faced incompatibilities arising from negative perceptions/attitudes which resulted in decreased adherence to the program. Hence various strategies were used to motivate, strengthen and organize the human workforce implementing the program. Conclusion Recommendations arising from evaluation of the program were used in subsequent stages of implementation. Qualitative research is an important component of community trials which can improve their implementation.

Background Until the last 2 decades, spiritual care was a vital, but invisible, aspect of nursing care. Spirituality and spiritual care have entered the mainstream, and the literature in this area has burgeoned. In addition, there is minimal information in the literature documenting the expressed spiritual needs of patients in general and specific subgroups of patients in particular, thus this article aimed to present spiritual needs of Iranian Muslim patients. Therefore, this study is of significance to nursing in general and to transcultural nursing in particular because of the high priority associated with increasing the nursing knowledge through research that investigates and describes care practices in diverse cultures.

Address: 1Lorestan Medical Sciences University, Lorestan, Iran, 2Faculty of Nursing & Midwifery, Islamic Azad University, Khorasgan Branch And Medical Education Research Centre (MERC) of Isfahan University of Medical Sciences, Iran, 3School of Nursing and midwifery, Esfahan Medical Sciences University, Iran and 4School of Nursing and midwifery, Ardabil Medical Sciences University, Iran * Corresponding author