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Background: Pediatric nurses are responsible for caring for children and their families; thus, investigating missed care in the pediatric ward is important and helps to improve the quality of care. Accordingly, this study aimed to explain the perceptions of pediatric nurses about missed care.Methods: This study was conducted using content analysis on 15 pediatric nurses selected by purposive sampling. The data were collected through in-depth semi-structured interviews. After obtaining informed consent, interviews were audio-recorded and transcribed verbatim. MAXQDA software (version 10) was used to facilitate coding and thematic analysis.Results: Four main categories emerged from the data analysis, including missed family-centered care, unsafe care, predisposing factors, and adverse outcomes.Conclusion: The findings showed that from the perspective of pediatric nurses, missed care occurs in different dimensions, including psychological support, communication, education, assessment, drug treatment, and infection control, and it can ultimately lead to mother’s dissatisfaction and bring about adverse effects on the child’s recovery besides harming the nurse.

Introduction: Although many studies have been conducted on allergic diseases, their risk factors including allergic rhinitis have not yet been fully understood. The present study aims to investigate the relationship between house type, floor, and frequency of truck traffic on the street of residences with allergic rhinitis in adolescents in Yazd. Materials and Methods: This cross-sectional study was conducted on 5141 adolescents aged 13-14 years, from February 2020 to June 2020, using the large-scale Global Asthma Network (GAN) survey data in Yazd. The data were collected electronically using the GAN standard questionnaire, and analyzed in SPSS software version 23 using descriptive and analytical statistics (Chi-square and logistic regression). The value of P < 0.05 was considered significant. Results: In this study, 11.2% of boys and 13.3% of girls had allergic rhinitis, indicating a significant difference by gender (P = 0.025). The prevalence of allergic rhinitis did not differ significantly according to the type of house (apartment or detached house with a yard) and the floor (P > 0.05). However, the prevalence of allergic rhinitis showed a significant correlation with the frequency of truck traffic on the street of residence (P = 0.001). If the truck passed through the street near the house almost all day, the chance of developing allergic rhinitis would be 2.4 times higher. Conclusion: The risk of allergic rhinitis increases with the frequent truck traffic from the street near the house, but the type of house and floor do not have a significant effect.

BACKGROUND: A newborn with an untreatable genetic disorder could disrupt a family and affect parents’ mental health, psycho-social interaction, and parent–child relationships. This study was conducted to explore the psychological problems of mothers having the children with untreatable genetic disorders. MATERIALS AND METHODS: This qualitative study was performed using the conventional content analysis method on 15 mothers having the children with untreatable genetic disorders selected by purposeful sampling. In-depth and semi-structured interviews were used to collect data. The recorded interviews were transcribed verbatim immediately and imported into MAXQDA10 software. Lundman and Granheim’s content analysis method and Guba and Lincoln’s proposed criteria for assessing rigor of the results were used. RESULTS: Overall, 1067 primary codes were extracted from the interviews and after the integration of similarities grouped into 19 sub-categories and three major categories including psychological reactions before diagnosis, after determined diagnosis, and after the child’s death. CONCLUSIONS: The results showed that having the child with untreatable genetic disorder is considered as a notable psychological trauma and causes painful psychological reactions in parents. In this regard, the following approaches are recommended to health professionals: continuous monitoring of mental health of these families, developing a family education program, emotional and psychological support, and genetic counseling.

BackgroundNurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students.MethodsThis is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics.ResultsThe mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (pConclusionPalliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.

[This corrects the article DOI: 10.1371/journal.pone.0302938.].

Objective: The use of medicinal plants in diabetic patients is rising, it is essential to increase knowledge about the effects of medicinal plants and subsequently perform evidence-based action, so, review studies are a helpful way for the present purpose. Current study was conducted to investigate the clinical trials of medicinal plants used in the treatment of diabetes in Iran. Materials and Methods: Articles published online between 2010 - 2020 were googled in Magiran, SID, Scopus, and, Iran Medex with Persian keywords such as “type 2 diabetes”, “medicinal herbs”, “healing herbs” “herbs”, “medicinal plants” and “clinical trial”. The inclusion criteria for articles were conducting in the form of a clinical trial, conducting in Iran, publishing in Persian language and having at least a score of 3 based on the Jadad scale. Results: 20 clinical trial studies were extracted. Five studies were conducted on cinnamon and two studies on cumin and the rest of the plants were examined just in one study. Although some trials showed positive effects of the medicinal plants on reducing fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c), some others demonstrated that medicinal plants had no effect on important variables in diabetes control. Conclusion: Conclusions about the benefits of plants should be made with caution, safety and efficacy of plants in the treatment of diabetes should be investigated further. It is essential that patients take any herbal supplements under physician’s supervision and after receiving the necessary advice.

IntroductionWith the emergence of the COVID-19 pandemic, universities immediately responded to protect students' lives by implementing e-learning in order to stop the spread of the communicable disease within the academic population. This study aimed to describe iranian nursing students' experiences of e-learning during the COVID-19 pandemic.Materials and methodsThe current study used a qualitative descriptive study. Ten nursing undergraduate students from a single Iranian university identified using purposive sampling methods. Face-to-face semi-structured interview conducted from May to July 2021 and analyzed through thematic analysis. Lincoln and Goba criteria were used to obtain data validity and reliability.ResultsFour themes emerged including"novelty of e-learning","advantages of e-learning", "disadvantages of e-learning"and"passage of time and the desire to return to face education". Participants evaluated e-learning as a novel method without proper infrastructure, it was initially confusing but became the new normal as their knowledge of the way to use it improved. Advantages included self-centered flexible learning and reduction in their concerns experienced with face-to-face learning. Disadvantages including changing the way they interact with teachers, decreasing interactions with classmates, problems with education files, superficial learning, hardware problems, family members' perceptions of the student role, interference of home affairs with e-learning, cheating on exams and assignments and being far away from the clinical context.ConclusionThe findings revealed that e-learning has been introduced as a new method for the current research participants and despite the perceived benefits, these students believed that e-learning could supplement face education but not replace it.

Background: Jaundice is one of the most common health problems among neonates, involving almost 60% of full-term newborns, therefore requiring consequent phototherapy. Since phototherapy has several complications, considering alternative treatments has long been of pivotal importance. Therefore, the present study aimed at comparing the effectiveness of bath and massage in bilirubin levels in neonates. Methods: This was a randomized clinical trial conducted on neonates who were born in Zeyaei Hospital in Ardakan, Iran, in 2018. A total of 90 neonates were selected using the convenience sampling method and then assigned into two intervention groups (i.e., bath group and massage group) and a control group through random allocation method. In the bath group, the neonates were bathed immediately after birth. In the massage group, the neonates received field massage twice a day each lasting 15 min for 5 consecutive days. The neonates belonging to the control group were served with routine care. The jaundice meter China 800 (jk) device was used to measure the skin bilirubin levels of the neonates in the three groups in a scheduled manner (i.e., days 1, 3, 5, and 7) at 9 a.m. The data were analyzed using the ANOVA, Chi-square test, Tukey's post hoc test, and repeated measures ANOVA in SPSS software (version 18). Results: There was no significant difference between the mean bilirubin scores of the three groups over the first, third, and fifth days. A significant difference was found between the mean bilirubin scores of the bath and massage groups compared with that of the control group on the seventh day (P=0.001). Also, no significant difference was seen between the mean bilirubin levels of the bath and massage groups on the seventh day. Conclusion: The findings revealed that there was no difference between the bath and massage techniques in reducing neonatal jaundice. Therefore, both techniques can be utilized in this regard.

Background: The sudden exposure of premature newborns to a cold and dry environment can lead to hypothermia. This study aimed at comparing the effectiveness of two polyethylene covers on the body temperature and oxygen saturation of premature neonates. Methods: This experimental study was conducted on 72 premature newborns in the neonatal intensive care unit (NICU) of Shahid Sadoughi Hospital in Yazd, Iran. The study subjects were randomly assigned into three groups, including the neonates with polyethylene head cap, polyethylene body bag, and routine care. The data were collected using a thermometer and a pulse oximeter. The data analysis was performed through descriptive statistics, Chi-square test, analysis of variance (ANOVA), repeated measures ANOVA, and Tukey test using SPSS (version 18) software. Results: There was a significant difference in the mean body temperature of control and intervention groups immediately after their NICU admission and 1 h later. Other significant differences were found in the mean of oxygen saturation belonging to the control group and the hat group upon admission and 1 h later. Also, the mean scores of oxygen saturation belonging to the control group were compared with those of the bag group, and the differences were significantly different 1 h after the admission. Conclusion: In the light of these findings, the application of both polyethylene head cap and body bag can maintain the body temperature and oxygen saturation in the premature neonates transferring to the NICU. In particular, the head cap seems to better improve than oxygen saturation.

Palliative care is a series of actions aiming to offer support to parents and their infants in order to improve their quality of life. Despite optimal outcomes, the provision of palliative care for infants and achieving these outcomes may be hardly feasible. The present study aimed to investigate the barriers to palliative care and gain insight into the solutions. Accordingly, the obstacles were identified and classified into three categories of parent-related barriers (parental request for continuing treatment, cultural background, and religious beliefs), barriers concerning healthcare providers (attitude toward palliative care, death, and life values, religious beliefs, knowledge and skills in palliative care, and ethical distress), and barriers within the healthcare system (unclear policies regarding the implementation of palliative care, inadequate support from caretakers, lack of educational programs, insufficient personnel, unprepared environment, lack of technological requirements, and lack of access to consultants). Each category was discussed, and relevant solutions were provided.