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Background & Aims Nurses on the frontline of fight against COVID-19 faced with many stressors. The unpredictability of the situation and the seriousness of the risk can lead to intolerance of uncertainty (IU) in them. Nurses with IU perceive uncertainties about COVID-19 as distressing and stressful, and experience severe anxiety and worry. Anxiety in such situations leads to cognitive avoidance, rumination or other maladaptive coping strategies. The present study aims to determine the IU status during the COVID-19 pandemic in nurses working in teaching hospitals in Tehran, Iran. Materials & Methods This descriptive cross-sectional study was conducted in 2020 on 240 nurses working in the coronavirus wards of teaching hospitals affiliated to Iran University of Medical Sciences, whowere selected by a census sampling method and based on the inclusion criteria. A demographic form and Freeston et al.’s intolerance of uncertainty scale (IUS) were completed by them. Data analysis was performed in SPSS software, version 16, using descriptive and inferential statistics. Results The mean score of IU was 62.58±20.36. The stress dimension of IUS showed the highest score (2.49±0.78) while the dimension of inability to take action showed the lowest score (2.15±0.80). The COVID-19 infection was significantly associated with IU (P=0.048). Conclusion The nurses working in the coronavirus wards of selected teaching hospitals had IU during the COVID-19 pandemic such that they had more IU regarding stress, but the amount of IU was not so high that can make them unable to perform their duties. Providing education to nurses on how to break the cycle of anxiety and IU, changing their beliefs about IU, reducing their negative orientation to problems, controlling and monitoring their performance, and facilitating the provision of care can help optimize nursing care and achieve quality patient care during health-related crises. [ABSTRACT FROM AUTHOR]

Background & Aims Some studies have reported a high risk of metabolic syndrome among women and night shift workers. This study aims to determine the status of metabolic syndrome laboratory indicators and thyroid function tests in nurses working in Rajaei Cardiovascular, Medical, & Research Center (RCMRC) in Tehran, Iran, in 2020-2021. Materials & Methods This is a descriptive cross-sectional study on the health records of nurses working in RCMRC. The sampling was done using a census method. Records with incomplete information were excluded. A form containing demographic characteristics, thyroid function indicators, and metabolic syndrome laboratory indicators was used to collect data from the health records. Data analysis was performed in SPSS software, version 26. Results Out of 401 reviewed records, 339 cases (84.5%) were for female nurses. The mean age of nurses was 37.47±8.68 years, and their mean work experience was 13.17±8.07 years. According to the criteria of the American Heart Association and the National Heart, Lung, and Blood Institute, the prevalence of abnormalities in metabolic syndrome laboratory tests was 5.21%, while according to the National Cholesterol Education Program III criteria, it was 2.99%. The prevalence of clinical hypothyroidism was 0.2%; subclinical hypothyroidism, 12.0%; and subclinical hyperthyroidism, 1.5%. Conclusion The prevalence of metabolic syndrome and thyroid disorders among nurses working in RCMRC is not considerable. Further large-scale studies (cohort or longitudinal) are recommended. [ABSTRACT FROM AUTHOR]

Background & Aims One of the consequences of the COVID-19 pandemic was its impact on marital relations. In health workers, including midwives, who have longer and more contact with mothers who may be infected with COVID-19, the fear of transmitting the virus to their partners is more. This fear can affect their personal lives, including sexual relationships and sexual health. This study aims to determine the relationship of the fear of COVID-19 with sexual function and sexual satisfaction in midwives working in teaching hospitals in Tehran, Iran. Materials & Methods This cross-sectional study was conducted on 122 midwives working in teaching affiliated to Iran University of Medical Sciences. They were selected using a census method from May 13 to August 6, 2022. Data collection tools included a demographic/ COVID-19-related form, Ahurso’s fear of COVID-19 scale, female sexual function index (FSFI) and sexual satisfaction index. Data were analyzed in SPSS software, version 24. Results The mean age of participants was 32.21±6.27 years. Most of them had a bachelor’s degree. Sexual satisfaction had no significant relationship with any demographic factors (P>0.05). There was a negative and significant correlation (weak) between fear of COVID-19 and sexual satisfaction (r=-0.214, P=0.019). Also, there was a negative and significant correlation (moderate) between the fear of COVID-19 and sexual function (r=-0.450, P<0.001). Conclusion It seems that the fear of COVID-19 is related to sexual function and sexual satisfaction of Iranian married midwives. Therefore, during similar pandemics in the future, midwives need support such as receiving more personal protective equipment and stress management and resilience training workshops . [ABSTRACT FROM AUTHOR]

Background & Aims Providing quality nursing care has always been the main concern of nurses. Clinical competence and moral courage are effective factors in providing quality nursing care. The present study aims to determine the relationship between clinical competency and moral courage in Iranian nurses. Materials & Methods This is a descriptive-correlational study with a cross-sectional design that was conducted in 2022 on 123 nurses working in teaching hospitals affiliated to Hamadan University of Medical Sciences, who were selected using a simple random sampling method. Data collection tools were Sekarka et al.’s moral courage questionnaire, Liu et al.’s competency inventory for registered nurses, and a demographic form. Data analysis was done using descriptive statistics, independent t-test, one-way analysis of variance and Pearson’s correlation test in SPSS software, version 16. Results The mean scores of clinical competency and moral courage scores were 151.18±22.32 and 59.56±7.47, respectively, indicating a moderate clinical competency and high moral courage. There was a significant and positive (weak) relationship between moral courage and clinical competency (r=0.272, P=0.001). Conclusion Due to the moderate clinical competency of nurses, educational workshops are recommended to improve their clinical competence. Moreover, since there is a weak relationship between clinical competency and moral courage of nurses, factors other than clinical competence may be related to moral courage, which requires further studies. [ABSTRACT FROM AUTHOR]

Background & Aims Patients with leukemia face mental distress that can affect their hope. One of the effective components in measuring psychological well-being is illness perception, which refers to the cognitive evaluation and understanding of a medical condition. This study aims to determine the relationship between illness perception and hope in patients with leukemia hospitalized in selected hospitals in Tehran, Iran. Materials & Methods This is a descriptive-correlational study conducted on 200 patients with leukemia hospitalized in selected hospitals affiliated to Tehran University of Medical Sciences in 2023. Data collection tools were a demographic form, Broadbent et al.’s brief illness perception questionnaire (BIPQ) and Snyder’s adult hope scale (AHS). The collected data were analyzed in SPSS software, version 16 using descriptive and inferential statistics such as Pearson’s correlation test, independent t-test, and analysis of variance. Results The mean total score of BIPQ was 37.45±9.10 and the mean total score of AHS was 32.39±1.88. There was negative and significant correlation between illness perception and hope (r=-0.489, P<0.001). Conclusion A more positive perception of leukemia can improve the hope of patients. It is recommended to implement interventions to create a positive illness perception in these patients to increase their hope. [ABSTRACT FROM AUTHOR]

Background & Aims The spread of COVID-19 pandemic caused anxiety in the medical staff, especially nurses, which contributed to many physical and mental problems in them. The relationship between cognitive flexibility and COVID-19-related anxiety is still unknown. This study aims to measure the relationship between cognitive flexibility and COVID-19-related anxiety in nurses, and find the related factors. Materials & Methods This is a descriptive-analytical study with a cross-sectional design that was conducted in 2021 on 120 male and female nurses working in one of the hospitals affiliated to Arak University of Medical Sciences. Sampling was done using a stratified and random sampling method for three months. The cognitive flexibility inventory (CFI) and the corona disease anxiety scale (CDAS) were employed to collect data. Data analysis was performed in SPSS software, version 23, using independent t-test, analysis of variance (ANOVA), and Pearson correlation test. Results The mean total score of CDAS was 21.09±3.96, ranged from 12 to 32. The mean total score of CFI was 52.78±9.97, ranged from 30 to 81. Based on Pearson’s correlation test results, there was no significant relationship between cognitive flexibility and COVID-19-related anxiety (P>0.05). The mean scores of CFI and CDAS were not significantly different based on age, number of children, work experience, physical activity level, and educational level; however, nurses with permanent employment (P=0.007) and female nurses (P=0.03) had higher cognitive flexibility, and married nurses had lower anxiety (P=0.021). Conclusion There is no significant relationship between cognitive flexibility and COVID-19-related anxiety in nurses. The personality traits such as cognitive flexibility is not enough to reduce the high level of anxiety caused the pandemics such as COVID-19 and it requires multiple measures and strategies. [ABSTRACT FROM AUTHOR]

Background & Aims One of the reasons for leaving the job among nurses can be the lack of career adaptability, which refers to ability to cope with changes in working conditions. This study aims to determine the relationship between career adaptability and the intention to stay in job among nurses working in critical care units of teaching hospitals in Tehran, Iran. Materials & Methods This is a descriptive-correlational study with a cross-sectional design that was conducted in 2022-2023 in critical care units of seven hospitals affiliated to Iran University of Medical Sciences. Participants were 220 nurses working in these units with at least 6 months of work experience, who selected by a stratified sampling method from different working shifts. Data collection was done online using a demographic form, the career adapt-abilities scale (with four dimensions of concern, control, curiosity, confidence), and an intention to stay in job questionnaire (with three dimensions of adaptation, sacrifice, communication). Descriptive statistics (Mean±SD, frequency, percentage) were used to describe the data, while Pearson’s correlation test and regression analysis were used to assess the relationships between the study variables. Results The mean total score of career adaptability was 2.98±0.98 and the mean total score of intention to stay was 3.02±1. Among the dimensions of career adaptability, the highest average was related to concern (3.05±1.14) and the lowest score was related to curiosity (2.92±1.09). Among the dimensions of intention to stay, the highest score was related to sacrifice (3.06±1.09) and the lowest score was related to adaptability (2.98±1.1). A positive and significant relationship was found between career adaptability and the intention to stay in job (r=0.43, P<0.05). Conclusion Career adaptability, especially its curiosity dimension, has a significant relationship the intention to stay in job among nurses working in critical care units. By addressing different dimensions of career adaptability in nurses, hospital managers can be able to safeguard nurse retention in hospitals and mitigate nurse turnover. [ABSTRACT FROM AUTHOR]

Background & Aims Despite the significant impact of immunosuppressive drugs on controlling and treating certain diseases, their continued use can predispose patients to infectious diseases such as COVID-19, leading to anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms. This study aims to determine the levels of anxiety, depression, and PTSD symptoms in patients treated with immunosuppressive drug during the COVID-19 pandemic. Materials & Methods This descriptive cross-sectional study was conducted on 330 individuals treated with immunosuppressive drug such as those with autoimmune diseases, cancer, and transplant recipients in Firoozgar and Rasoul-e-Akram hospitals in Tehran, Iran, from July to December 2022. They were selected using a continuous sampling method. The instruments were a demographic/disease related questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Impact of Event Scale-Revised (IES-R). Data analysis was done in SPSS software, version 16 using descriptive (frequency, percentage, mean, standard deviation) and inferential (Independent t-test, analysis of variance, and Pearson’s correlation test) statistics. Results In this study, the mean age of participants was 51.35±12.95 years, and 148 (44.8%) were female. The majority of the patients had normal levels of anxiety and depression (91.2% and 92.1%, respectively). The mean total IES-R score was 27.71 out of 88. The anxiety and depression scores did not have a significant relationship with any demographic, disease-related, and COVID-related characteristics of the study participants, but a significant correlation between income level and total score of IES-R was observed (P=0.043). Conclusion The individuals receiving immunosuppressive drugs in this study, despite being susceptible to COVID-19, had normal levels of anxiety and depression and obtained lower than average score in the IES-R. This finding can reduce the concerns about the mental health of these patients. Further studies using other questionnaires or a qualitative study on the experiences of these patients during the COVID-19 pandemic are recommended. [ABSTRACT FROM AUTHOR]

Background & Aims Evidence has shown that the inability to regulate and understand emotions causes various behavioral problems in children with autism spectrum disorder (ASD). This study aims to investigate the effect of an emotion labeling (EL)-based training on the behavioral disorders of children with ASD. Materials & Methods This is a quasi-experimental single-subject study ABA method. Five boys with high functioning autism were purposefully included in the study after one week of sampling in 2022. For each child, the Let’s Face It software was used individually to recognize basic emotion expressions (6 types) in three sessions followed by teaching EL at 8 sessions for 4 weeks, two sessions per week. The data collection tool was a demographic form and the test of behavioral disorders of children with ASD. The collected data at five phases were analyzed in SPSS software, using descriptive statistics, and Friedman’s test. Results According to the result of Friedman test, there was a significant difference between the first and third phases (P=0.037) and the third and fourth phases (P=0.019) of behavioral disorders measurement. The EL training significantly reduced the behavioral disorders of patients (P=0.030). Conclusion It seems that the EL-based training can reduce the behavioral disorders of children with ASD. [ABSTRACT FROM AUTHOR]

Background & Aims Due to the effects of COVID-9, health care workers, including nurses, faced many psychological challenges, including death anxiety. This study aims to determine the death anxiety level of nurses working in the intensive care units (ICUs) for COVID-19 patients in hospitals affiliated to Tehran University of Medical Sciences in 2020. Materials & Methods This is a descriptive cross-sectional study that was conducted on 179 nurses working in the ICUs for COVID-19 patients in two hospitals located in Tehran and Qom cities. Continuous sampling method was used for their selection. Data collection was done using a demographic form and Templer's 15-item death anxiety scale. Results The mean death anxiety score of nurses was 8.74±2.007 out of 15, which is higher than the median score (i.e., 7.5). The results of one-way analysis of variance showed that the death anxiety score was significantly different between nurses only in terms of age (P=0.000). Tukey's post hoc test showed that the mean DAS score in nurses aged 30-39 was lower than in nurses aged ≥40 years and <30 years. There was no statistically significant difference in death anxiety between nurses in terms of other demographic factors (P>0.05). Conclusion The nurses working in ICUs experienced a high level of death anxiety during the COVID-19 in Iran. It is necessary that the policy makers and educational, medical or hospital managers develop educational and interventional programs including online in-service programs or educational booklets to help nurses overcome the COVID-19-related conditions [ABSTRACT FROM AUTHOR]

Background & Aims During the COVID-19 pandemic, vaccination is necessary for pregnant or lactating women which can prevent them from infection to severe case of disease. The present study aims to determine the factors related to the acceptance of COVID-19 vaccination among pregnant or lactating women in Zahedan, Iran using the health belief model (HBM). Materials & Methods This is a cross-sectional study. Participants were 260 pregnant or lactating women referred to comprehensive health service centers in Zahedan city in 2022. Sampling method was done as a convenience sampling method. Data collection was done using a demographic form and a HBM-based questionnaire. The reliability of the questionnaire was confirmed based on Cronbach’s alpha value of 0.7. Moreover, the content validity index value was 0.81 and the content validity ratio was 0.77. The data were analyzed using non-parametric Wilcoxon test, Mann-Whitney U test, Spearman correlation test, and regression analysis in SPSS software, version 22. Results The results of the regression analysis showed that the demographic variables explained 12.6% of the variance in vaccine acceptance behavior, where only the effect of age and educational level was significant, (P<0.05). The BM constructs along with age and educational level predicted 26.3% of the variance in vaccine acceptance behavior, where only age, self-efficacy and perceived benefits had a significant effect (P<0.05). Overall, the mentioned variables predicted 38.9% of the variance in vaccine acceptance behavior. Conclusion The factors of young age, high educational level, and the HBM constructs of self-efficacy and perceived benefits can predict the COVID-19 vaccine acceptance behavior of pregnant or lactating women in the South East of Iran. These findings can help policymakers and health care providers to use this model in designing program for improving vaccination acceptance of these high-risk groups. [ABSTRACT FROM AUTHOR]

Background & Aims Chronic obstructive pulmonary disease (COPD) is a debilitating respiratory disease and one of the main causes of death and disability in the world. Respiratory support treatments are among the methods for the recovery of these patients. The present study aims to assess the effect of breathing exercises and chest physiotherapy on the fatigue of patients with COPD. Materials & Methods This is a quasi-experimental study on 45 patients COPD who were selected by convenience sampling method and randomly assigned to two experimental groups of breathing exercises (n=15) and chest physiotherapy (n=15) and one control group (n=15). Before and 6 weeks after the intervention, Krupp’s Fatigue Severity Scale was completed by the patient. Data analysis was done using paired t-test, one-way analysis of variance and chi-square in SPSS software, version 26. Results The mean scores of fatigue severity were significantly different in all groups between pretest and post-test phases (P<0.001). The fatigue severity in the intervention groups was reduced, while it increased in the control group, after intervention. There was no significant difference in fatigue severity among the three groups at baseline, but the difference was significant after the intervention (P<0.001). Conclusion Considering the reduction in fatigue severity after two supportive treatments, it is recommended that breathing exercises and chest physiotherapy should be used along with drug treatments for patients with COPD to improve their respiratory conditions. [ABSTRACT FROM AUTHOR]

Background & Aims Suicide and suicidal thoughts among adolescents have become a worrying psychosocial problem. This study aims to evaluate suicidal ideation among adolescents from the west of Tehran, Iran. Materials & Methods In this descriptive cross-sectional study, 256 boys and girls were selected from second-grade high schools in the west of Tehran by a convenience sampling method in 2022. The data collection tools were a sociodemographic form and the Beck scale for suicidal ideation (BSSI), which were completed using a self-report method. The collected data were analyzed in SPSS software, version 16 using descriptive and inferential statistics (independent t-test, analysis of variance). Results The mean age of the participants was 17.33±0.67 years. The mean score of BSSI was 3.19±5.66 out of 5. Among the sociodemographic factors, suicidal ideation had a statistically significant relationship only with the grade point average (P=0.004). Conclusion It is recommended to design and implement programs to educate and provide psychiatric services to high school students in Iran to reduce their suicidal ideation. [ABSTRACT FROM AUTHOR]

Background & Aims Caring for a patient undergoing hemodialysis is a stressful experience that causes a heavy care burden. With the outbreak of COVID-19, family caregivers of these patients had increased worry about the risk of infection in the dialysis centers. This fear can make their care burden heavier. This study aims to investigate the impact of coping skills training on the care burden experienced by family caregivers of patients undergoing hemodialysis. Materials & Methods This quasi-experimental study was conducted in 2020 on 60 family caregivers of patients undergoing hemodialysis at the Comprehensive Treatment Center for Special Diseases in Birjand, Iran. Participants were randomly assigned to intervention and control groups. The intervention group received coping skills training in six sessions. All participants completed the Zarit burden interview before, immediately after, and one month after the intervention. The data were analyzed in SPSSsoftware, version 19. Results The two groups were homogeneous regarding demographic information (P>0.05). Both groups had a moderate to severe care burden before the intervention. A significant difference was reported in the care burden score of the intervention group after training (P<0.001). Conclusion Coping skills training can reduce the care burden of the family caregivers of patients undergoing hemodialysis. Therefore, coping skills training can be used by nursing managers to reduce the care burden of family caregivers of patients with hemodialysis. [ABSTRACT FROM AUTHOR]

Background & Aims The ethical challenges of pediatric nurses in the work environment is inevitable. One of these challenges for nurses is related to euthanasia, which is affected by extensive legal, religious, and cultural issues. This study aims to determine the relationship between ethical reasoning and attitudes towards euthanasia in nurses working in children’s hospitals. Materials & Methods This descriptive-analytical study was conducted on 194 pediatric nurses working in two children’s hospitals affiliated to Tehran University of Medical Sciences. Data were collected electronically and in person using three questionnaires, including a demographic form, the nursing dilemma test (NDT), and the euthanasia attitude survey (EAS). The collected data were analyzed in SPSS software, version 26. Results The mean score of ethical reasoning was 42.92±10.33, and the mean score of EAS was 2.65±0.12. The ethical reasoning score had no significant correlation with age, work experience, sex, marital status, education level, and history of participation in nursing ethics courses, except for the department, which was significantly related to ethical reasoning. The EAS score had no significant correlation with any of the demographic variables, except for the department. The Pearson correlation test results indicated a significant negative correlation between ethical reasoning and attitudes toward euthanasia (r=-0.60, P<0.001). Conclusion The ethical reasoning of pediatric nurses in the study hospitals is at a moderate level, and they have a negative attitude toward euthanasia. The nurses with higher ethical reasoning have a more negative attitude toward euthanasia. Nurses from special care units and emergency departments have lower ethical reasoning but a more positive attitude toward euthanasia. Participation in nursing ethics workshops has no significant relationship with ethical reasoning scores and attitudes toward euthanasia. Based on the findings of this study, it is recommended that comprehensive educational programs should be held to strengthen the ethical reasoning of pediatric nurses and enhance their perception of euthanasia. [ABSTRACT FROM AUTHOR]

Background & Aims One of the goals of providing training to the anesthesia care team is to train staff with theoretical and functional abilities to deal with clinical challenges. However, there is a gap between the existing and desired performance levels of personnel in anesthesia procedures. This study aims to assess the competence of anesthesia personnel in Kashan, Iran, and find its related factors. Materials & Methods This descriptive-analytical study was conducted on 95 anesthesia personnel of hospitals in Kashan, Iran, in 2023, who were selected using a census method. The data collection tools were a demographic form and the Anesthesia Nursing Competence Scale. Data were analyzed in SPSS v.22 software using descriptive statistics (frequency, mean, standard deviation), Mann-Whitney U test, Kruskal-Wallis test, Spearman’s correlation test, Point-Biserial correlation test, and regression analysis. Results The mean age of the participants was 34.57±10.1 years. The overall competence level of anesthesia personnel was at a high level (84.84±53.11). Their competence had a significant relationship with their sex and marital status (P<0.05). Conclusion The competencee of anesthesia personnel in Kashan is at a high level in all fields, except for the patient’s risk care. It is recommended to empower personnel in this area to prevent adverse events and improve the quality of medical services. [ABSTRACT FROM AUTHOR]

Background & Aims Tracheostomy is often performed for people hospitalized in intensive care units (ICUs), but it can cause larynx damage and discomfort in the patient. Given that the final outcome and possible complications of tracheostomy are directly related to the quality of nursing care, this study aims to evaluate the effect of tracheostomy care training on the performance of nurses working in the ICUs of selected hospitals affiliated to Iran University of Medical Sciences. Materials & Methods This quasi-experimental study was conducted on 64 nurses working in the ICUs of Rasul Akram and Firouzgar hospitals in 2021. The data collection tools were a demographic form and the tracheostomy patient care evaluation questionnaire of Atashzadeh et al. (2015). data analysis was performed in SPSS software, version 16 using descriptive and inferential statistics (paired t-test, and analysis of variance). P<0.05 was considered statistically significant. Results The mean age of nurses was 31.49±6.02 years. Most of them were female (70.3%) with a bachelor's degree (90.6%). Their mean overall work experience was 6.74±5.13 years, and their average work experience in the ICU was 4.92±4.66 years. Most of the nurses (43.8%) had permanent employment. Most of the nurses had rotating shift (89.1%), and had not completed the course of tracheostomy care (93.8%). The results of the paired t-test showed a statistically significant difference in the mean performance score of nurses before training (45.85±8.87) and after training (93.3±42.33) (P<0.001). Conclusion Considering that the performance of nurses in caring for patients with tracheostomy in the ICUs of selected hospitals is not satisfactory, educating nurses and providing sufficient facilities based on guidelines and opinions of experts are recommended to improve the quality of services to these patients by nurses in the hospitals. [ABSTRACT FROM AUTHOR]

Background & Aims One of the concerns of nurses and physicians is the adherence to treatment in patients with heart diseases. In Iran, there are no accurate statistics on the treatment adherence of patients with coronary artery stents, and the risk of cardiovascular diseases (CVDs) in these patients has not been investigated. Therefore, this study aims to determine the relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents. Materials & Methods This descriptive cross-sectional study was conducted from June to August 2021 in Shahid Madani Hospital in Tabriz, Iran. Participants were 200 patients who underwent coronary angioplasty in the past year and had coronary artery stents. They were selected by a simple random sampling method. To collect data, a demographic form, the treatment adherence questionnaire, and the Framingham risk score (FRS) were used. The collected data were analyzed in SPSS software, version 22 using descriptive statistics, Pearson correlation test, t-test, and one-way analysis of variance. Results The mean age of the patients was 61.6±10.62 years. Most of them were male (60.5%) and married (68%). The overall mean score of treatment adherence was 41.50±8.48, indicating moderate adherence. Patients had poor adherence in domains of dietary regimen and regular physical activity such that most of them used high-fat food (87%) and had the least amount of physical activity per week (92.4%), but they used prescribed medicines on time (70.3%). Based on the FRS, men were twice as likely to have CVDs as women. There was a significant association between treatment adherence and the risk of CVDs, such that the risk of CVDs in the next 10 years among patients decreased with increasing their adherence to treatment (r=-0.25, P<0.001). Conclusion Given that there is a significant relationship between treatment adherence and the risk of CVDs in patients with coronary artery stents, and considering that these patients have poor adherence to a low-fat diet and regular physical activity, it is recommended that nurses in their patient education programs emphasize adherence to having a low-fat diet and regular physical activity and identify the barriers to achieving it, so that, by increasing patients’ adherence to treatment, the risk of CVDs in the next 10 years can be reduced in these patients. [ABSTRACT FROM AUTHOR]

Background & Aims During the COVID-19 pandemic, nurses working in psychiatric departments were also involved, which affected their mental health. The present study aims to determine the effect of psychological immunization on perceived stress and anxiety caused by COVID-19 in nurses working in the psychiatry department of a hospital in Zahedan, Iran. Materials & Methods This is a quasi-experimental study that was conducted from February to June 2022. Participants were 50 nurses from the psychiatry department of Baharan Hospital in Zahedan city who were selected by a census method, and were assigned to intervention and control groups. Data collection tools included a demographic form, the perceived stress scale, and the corona disease anxiety scale. The psychological immunization was provided in two four-hour workshops. Data analysis was done in SPSS software, version 16 using mean, standard deviation and chi-square test, independent t-test, paired t-test, and Fisher’s exact test. P<0.05 was considered statistically significant. Results Most of the nurses had an infection with COVID-19 and were vaccinated. The mean and score of anxiety decreased from 11.96±10.05 to 8.12±6.92 in the intervention group (P=0.004) and decreased from 11.84±10.26 to 8.40±6.51 in the control group (P=0.07). The mean score of perceived stress changed from 27.45±5.56 to 27.20±4.20 after intervention in the intervention group (P=0.8) and from 27.48±4.71 to 28.32±4.87 in the control group (P=0.43). Conclusion The psychological immunization program has no significant effect on anxiety and stress caused by COVID-19 in nurses of psychiatric departments in Zahedan, Iran. It is recommended that psychiatric hospital managers should pay attention to the psychological problems of nurses at the beginning of the pandemic. [ABSTRACT FROM AUTHOR]

Background & Aims Aging is associated with decreased physical and psychological functions. This study aims to investigate the ability to perform basic and instrumental activities of daily living (ADL) in elderly women with osteoporosis in Tehran, Iran. Materials & Methods This is a cross-sectional study conducted on 130 elderly women over 60 years of age referred to selected hospitals affiliated to Iran University of Medical Sciences in 2019-2020, who were selected by a consecutive sampling method. The data collection tools were a demographic form, the Barthel index for ADL, and the Lawton-Brody Instrumental ADL scale. The data was statistically analyzed in SPSS software, version 20. Results The mean age of the women was 67.5±5.7 years. None of them had dependency for performing ADLs such as eating. The highest dependence was for urination (54.62%). Regarding instrumental ADLs, the highest inability was related to shopping (60.77%), and the lowest inability was related to managing one's own medication use (0.77%). The scores of basic and instrumental ADLs were significantly related to age and educational level (P<0.001). Conclusion More governmental, family and social support is needed for elderly women with osteoporosis (with older age and educational level) who have lower ability to perform their basic and instrumental ADLs. [ABSTRACT FROM AUTHOR]

Background & Aims safe nursing care is the use of knowledge and skills by nurses to provide quality patient care and it is considered one of the health goals in intensive care units. The feeling of being supported by the hospital play a key role in achieving this goal; it can lead to job satisfaction, good job performance, and patient satisfaction. This study aims to determine the relationship between perceived organizational support and safe nursing care in nurses working in the intensive care units (ICUs) of public hospitals in Tabriz, Iran. Materials & Methods This is a descriptive-correlational study with a cross-sectional design that was conducted on 200 nurses working in the ICUs of hospitals affiliated to Tabriz University of Medical Sciences in 2021-2022, who were selected using a quota sampling method. Eisenberger et al.’s perceived organizational support scale and Rashvand et al.’s safe nursing care questionaire were used to collect data. Data analysis was done in SPSS v.16 software using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, analysis of variance, and Pearson correlation test). Results The mean score of perceived organizational support was 23.20±9.57, which was lower than the cutoff point. Safe nursing care was at a favorable level with a mean score of 322.89±34.1. The perceived organizational support had no statistically significant correlation with safe nursing care and its dimensions. Conclusion Despite the unfavorable perceived organizational support of ICU nurses in Tabriz, their safe nursing care is favorable. There is no statistically significant relationship between their perceived organizational support and safe nursing care. This finding is probably due to the prevailing rules and professional beliefs in the work of nurses, which has caused the care provided to be safe despite the perception of low organizational support. [ABSTRACT FROM AUTHOR]

Background & Aims Breast cancer (BC) is one of the important challenges of the health system due to its impact on marital relationships. This study aims to compare sexual function and sexual distress of women with and without BC. Materials & Methods In this case-control study, 75 women with BC and 75 healthy women from Zanjan, Iran participated. Data were collected using a demographic form, the female sexual distress scale-revised (FSDS-R), and the female sexual function index (FSFI). Data analysis was done in SPSS software, version 20 using the Mann-Whitney test and multivariate analysis of covariance. Results The mean age of patients was 36.49±6.53 years and the mean age of controls was 36±0.72 years. There was no statistically significant difference between the two groups in terms of some demographic variables such as age, educational level of women and their husbands, occupation of women and their husbands, place of residence, and number of children (P>0.05). The mean score of FSFI in all subscales in the patient group was lower than in the control group. This difference was statistically significant only in the dimension of desire (P=0.003). regarding the sexual distress variable, the mean FSDS-R score of healthy women was lower than that of women with breast cancer, but this difference was not statistically significant (P>0.05). Conclusion The difference between women with and without breast cancer is significant only in the desire domain of sexual function. There is no statistically significant difference between the two groups in sexual distress and in other domains of sexual function. The sexual problems of women with BC require consideration and support, and provding counseling in terms of sexual function. [ABSTRACT FROM AUTHOR]

Background & Aims The present study aims to determine the fear of COVID-19 in the elderly newly diagnosed with cancer referred to selected hospitals affiliated to Alborz University of Medical Sciences. Materials & Methods In this longitudinal study, 174 elderly people newly diagnosed with cancer referred to the selected hospitals participated, who were selected using a continus sampling method. To collect data, a demographic form, the Abbreviated Mental Test, and the 7-item fear of COVID-19 scale were used before diagnosis, one month after, and two months after. The data were analyzed in SPSS software, version 22. Results Fear of COVID-19 level at the time of cancer diagnosis was moderate (mean score: 17.69±4.74). In the second stage (one month after the diagnosis), the mean score was 14.26±4.09. In the third stage (two months after diagnosis), the mean score was 11.81±4.13. Fear of COVID-19 at the time of cancer diagnosis was significantly different based on marital status (P=0.049), underlying diseases (P=0.014), and perception of health (P=0.004). Conclusion Fear of COVID-19 can disrupt the process of treatment and chemotherapy in elderly patients with cancer. It is recommended to develop interventions to improve the mental health of the elderly with cancer during the pandemic. [ABSTRACT FROM AUTHOR]

Background & Aims Admitting a child to a pediatric intensive care unit (PICU) brings various physical, psychological and social consequences for parents. Supporting parental self-efficacy is a step to ensure successful implementation of pediatric care. Therefore, it is necessary to provide appropriate interventions to reduce anxiety and stress and improve self-efficacy of parents. Although mobile-based education has been used for patients in many studies, its use for family caregivers of children admitted to PICU is limited. This study aims to assess the effect of a mobile-based educational program on the anxiety and self-efficacy of mothers with children admitted to PICUs in Iran. Materials & Methods In this quasi-experimental study, participants were 60 mothers of children admitted to the PICUs of hospitals in Shahrekord, Iran from April to August 2022. They were selected using a convenience sampling method and were divided into two intervention and control groups. The intervention group received a mobile-based educational program for four days, one session per day, each for 60 minutes. For the control group, routine education was given by the ward nurses. Data were collected by Spielberger’s state-trait anxiety inventory and Schwarzer & Jerusalem’s general self-efficacy scale. Data were analyzed using descriptive and inferential statistics. Results The mean self-efficacy score in the intervention group increased significantly compared to the pre-intervention score (from 19.60±4.01 to 21.87±5.13; P<0.001), but no significant difference was observed in the control group (from 18.53±4.23 to 19.30±5.40; P=0.393). In the intervention group, the mean anxiety score decreased significantly compared to the pre-intervention score (from 47.33±5.52 to 43.63±5.27; P=0.001) but no significant difference was observed in the control group (from 48.30±6.88 to 46.43±9.02; P=0.131). There was no significant difference between the two groups in anxiety and self-efficacy scores before and after the intervention (P>0.05). Conclusion Nurses can reduce anxiety and increase the self-efficacy of mothers of children admitted to PICUs by using other measures along with virtual education, which requires more research in this field. [ABSTRACT FROM AUTHOR]

Background & Aims Healthcare providers are responsible for providing services to mothers and infants during disasters. The purpose of this study is to determine their educational needs for maternal and newborn care during disasters in Iran. Materials & Methods This is a cross-sectional study that was conducted in 2017 on 208 healthcare providers (nurses, practical nurses, and midwives) from nine armed forces hospitals in Tehran, Iran who were selected by a census method. The data collection tool was a researcher-made questionnaire with acceptable face validity, content validity, and structure, with a Cronbach’s alpha of 0.94. The data were analyzed using descriptive and inferential statistics in SPSS software, version 16. Results The mean score on the educational needs assessment scale was higher in the fields of sexual violence management (4.30±0.01) and information management (4.28±0.01), indicating the high need for education in these areas. The lowest scores were in the fields of postpartum care in newborns (2.19±0.96) and responsiveness (2.98±0.89). In total, the educational needs of healthcare providers were high (3.3±0.43). Conclusion The readiness of healthcare providers in Iran to provide maternal and newborn care during disasters is low and needs more attention. Therefore, it is recommended to compile and revise university educational programs and implement continuous education programs based on the results of this study in the proposed areas (especially sexual violence management and information management) in a regular, periodic, and continuous manner. [ABSTRACT FROM AUTHOR]

Background & Aims One of the challenges in accurate and macro planning for the future is the uncertainty involved in estimating the future and rapid changes in various health-related fields. A powerful tool that can predict future competitive environments is the scenario planning tool. The current research aims to provide scenarios for the future of nursing education in Iran. Materials & Methods This exploratory research was conducted in 2022. In the first stage, the drivers and trends of nursing education were identified using meta-synthesis, interviews, and the Delphi method. Then, the influence and uncertainty of the identified trends were rated using the opinions of a panel of experts. In the next step, using influence/uncertainty diagrams, the key factors for writing the scenario were identified. Scenarios were then designed by Scenario Wizard software, version 4.11, and strategies were presented. Results The experts agreed on 6 drivers and 31 trends. With five key uncertainties, the scenarios were designed with three optimistic, realistic, and pessimistic assumptions. According to the size of the matrix and its dimensions (15×15), four problem-oriented, ethics-oriented, maintaining the status quo, and limited educational system scenarios were designed. The validity of the scenarios was examined according to feasibility, internal consistency, usefulness, and differentiability. Conclusion Each of the four designed scenarios has the potential to be realized, but their occurrence depends on the current plans. The use of future planning methods, such as the scenario planning tool, can be used as a warning system for awareness of opportunities and threats in Iran's health system before a crisis. [ABSTRACT FROM AUTHOR]

Background & Aims The present study aims to compare the effects of emotion regulation training and mindfulness-based cognitive therapy (MBCT) on the resilience and self-compassion of women with irritable bowel syndrome (IBS). Materials & Methods This is a quasi-experimental study with a pre-test/post-test/follow-up design. The study population consists of 300 women with IBS who visited the clinics of internal medicine physicians in Ilam, Iran, in 2018-2019. The sample size was determined 20 for each group based on the Fleiss method. Therefore, 60 were selected by a simple cluster sampling method and based on the entry criteria. They were divided into three groups of emotion regulation (n=20), MBCT (n=20), and control (n=20). After the interventions, the post-test and follow-up assessments were conducted for the groups. The instruments were the Connor-Davidson resilience scale and the self-compassion scale of Neff (2003). For data analysis, SPSS software, version 23 and repeated measures analysis of variance were used. Results Both emotion regulation training and MBCT had a significant effect on the resilience and self-compassion of women (P=0.001), where MBCT had a greater effect compared to emotional regulation training. Conclusion The MBCT can be used as an effective method to increase resilience and self-compassion of women with IBS. [ABSTRACT FROM AUTHOR]

Background & Aims Nurses are the largest group of healthcare providers, especially during the COVID-19 pandemic. Patients with COVID-19 are in dire need of spiritual care due to being alone in quarantine, away from their families. The present study aims to assess the spiritual care competence of nurses in the special care units for COVID-19 in teaching hospitals in Arak, Iran Materials & Methods This is a descriptive cross-sectional study. Participants were 142 nurses working in the special care units for COVID-19 in hospitals affiliated to Arak University of Medical Sciences in 2022, who were selected by a census method. The data collection tool was the spiritual care competence scale. The data were analyzed in SPSS software, version 16. Results The mean total score of spiritual care competence was 100.71±14.45, which was higher than the median score of 81. The spiritual care competence had a significant relationship with marital status (P=0.044), willingness to work overtime (P<0.001), age (P=0.011), total work experience (P=0.03), and work experience in the special care unit (P=0.025), such that spiritual care competence was higher in older married nurses with a willingness to work overtime and a higher work experience. Conclusion The spiritual care competence of nurses in the study hospitals is at a favorable level. The results of this study can help future studies in improving the quality of nursing care and the competence of nurses in spiritual care. [ABSTRACT FROM AUTHOR]

Background & Aims Infant hospitalization in the neonatal intensive care unit (NICU) causes loss or delay in mother-infant attachment. On the other hand, quarantine and social distancing during the COVID-19 epidemic had psychological consequences, such as increased fear of infection. This study aims to determine the relationship between mother-infant attachment and fear of COVID-19 in mothers with neonates admitted to the NICUs of selected hospitals in Tehran, Iran, during the COVID-19 pandemic. Materials & Methods In this descriptive-correlational study, participants were 195 mothers with neonates admitted to the NICUs of selected teaching hospitals affiliated to Iran University of Medical Sciences in 2021. Data collection tools were a demographic form, the fear of COVID-19 scale (FCoV-19S), and Avant’s mother-infant attachment behaviors questionnaire, which were completed by the researcher. Data were analyzed in SPSS software using independent t-test, Kruskal-Wallis test, Mann-Whitney U test, and ANOVA. Results The mean score of FCoV-19S was 19.04±5.40, and the mean score of mother-infant attachment was 70.12±50.65. No significant relationship was observed between the fear of COVID-19 and motherinfant attachment (P>0.05). Fear of COVID-19 had a significant relationship with the interest in the baby’s gender (P=0.001) and the mother’s education level (P=0.041). Mother-infant attachment had a significant relationship with interest in the baby’s gender (P=0.01) and infant hospitalization due to jaundice (P=0.049). Conclusion Mother-infant attachment of the mothers in this study is low, and their fear of COVID-19 is almost high. There is no significant correlation between the fear of COVID-19 and mother-infant attachment. It is necessary to pay attention to effective factors in promoting emotional attachment between mothers and neonates hospitalized in the NICUs. It is also recommended that the medical staff and nurses pay attention to this group of mothers during pandemics such as COVID-19 and use some techniques to reduce their fear of infection. [ABSTRACT FROM AUTHOR]

Background & Aims The early mobility of a patient hospitalized in the intensive care unit (ICU) is a very complicated issue and requires coordination between the departments and between all ICU staff, including physicians, nurses, and physiotherapists. Early mobilization program is safe and feasible and has positive results for the patient, medical staff, families, and health system. The present study aims to determine the barriers to early mobility of patients admitted to the ICUs of hospitals in Kohgiluyeh and Boyer-Ahmad Province, Iran. Materials & Methods This is a descriptive cross-sectional study conducted in 2020-2022. The study population consists of the ICU staff of hospitals in Kohgiluyeh and Boyer-Ahmad Province, including physicians, nurses, and physiotherapists. Sampling was done by a census method. The data were collected using a demographic form and a researcher-made questionnaire of early mobility barriers of ICU patients and analyzed in SPSS software, version 18 using descriptive and inferential statistics. Results In the present study, 174 nurses, physicians, and physiotherapists answered the questionnaire, where 57.8% were female and 59.8% were single. Among the barriers to early mobility, the patient-related barriers had the lowest mean (0.411±0.108) and cultural barriers had the highest mean (0.478±0.146). Conclusion It is necessary to investigate the barriers to early mobility of patients admitted to the ICU of study hospitals, especially the cultural barriers. In this regard, there is a need to design a clinical protocol to manage and reduce these barriers. [ABSTRACT FROM AUTHOR]

Background & Aims Due to having multiple tasks in ensuring the health of patients, primary healthcare workers are under many stresses that may lead to job burnout. The present study aims to determine the relationship between occupational stress and job burnout of primary healthcare workers. Materials & Methods This descriptive, correlational study was conducted in 2019 on 128 primary healthcare workers in Saveh and Zarandieh cities, who were selected by a census method. Data was collected by a demographic form, the Maslach Burnout Inventory (MBI), and Spielberger’s job stress survey (JSS). Descriptive statistics were used to describe the data, and independent t-test, analysis of variance, and Pearson correlation test were used to analyze data in SPSS software, version 18. Results The mean score of JSS was 140.7±48.6, which was lower the median score (150). The mean frequency score was 23.43±8.3 for the MBI dimension of emotional exhaustion, 17±4.78 for depersonalization, and 14.43±6.74 for personal accomplishment. Occupational stress had a positive and significant relationship with the frequency of emotional exhaustion (r=0.59, P<0.001) and depersonalization (r=0.22, P<0.001), and a negative and significant relationship with the frequency of personal accomplishment (r=-0.47, P<0.001). This indicates that with the increase of occupational stress, the frequency of job burnout in two dimensions of emotional exhaustion and depersonalization increases, while the frequency of personal accomplishment decreases. Conclusion Primary healthcare workers in the study region have moderate occupational stress and a high level of job burnout in the areas of depersonalization and personal accomplishment. Considering the high level of job burnout and its relationship with occupational stress in these healthcare workers, and the fact that these factors can have a negative impact on the quality of healthcare services, it is necessary to carry out necessary interventions to reduce and manage occupational stress and job burnout of primary healthcare workers. [ABSTRACT FROM AUTHOR]

Background & Aims Special attention should be paid to empowering healthcare providers, including nurses. Empowerment as the clinical skill is an important goal of nursing education. The present study aims to determine the effect of a nursing manager psychological empowerment program on the management skills of nursing students. Materials & Methods This interventional study was conducted in Imam Khomeini Hospital in Tehran, Iran. Participants were 84 students in nursing management internship from Tehran University of Medical Sciences and 19 nursing managers. The nursing students were divided into two control (n=42) and intervention (n=42) groups. The intervention was a psychological empowerment program for nursing managers. After intervention, the management skills of students was assessed using a checklist completed by observation and interviewing ward supervisors. Data were analyzed in SPSS software, version 16. Results The management skills of students in the intervention group significantly increased after receiving the empowerment program by 0.274 units. Conclusion Psychological empowerment of nursing managers can improve the management skills of nursing students. The results of this study can be used to persuade nursing managers to receive psychological empowerment training, which can lead to psychological improvement of the work environment, nurses and nursing students. [ABSTRACT FROM AUTHOR]

Background & Aims Resilience is defined as a person’s ability to maintain psychological balance and recover from challenging conditions. Due to the very important role of family caregivers in the treatment of older patients with COVID-19, attention to their health and well-being has been increased. This study aims to determine the resilience level of the family caregivers of older people during COVID-19 pandemic in Mashahd, Iran. Materials & Methods This descriptive-analytical study was conducted on 120 family caregivers of older people who referred to urban health centers in Mashhad, Iran. Sampling was done in using cluster random sampling method from April to June 2022. The instrument was a two-part questionnaire included demographic form (surveying age of the elderly and caregiver, gender of caregiver, educational level of caregiver, employment status of caregiver, marital status of caregiver, and the relation of caregiver with the elderly) and the Connor-Davidson resilience scale. Data analysis was done in SPSS v.23 software using descriptive and inferential statistics. Results The mean age of family caregivers and elderly were 39.94±1.32 and 74.44±3.17 years, respectively. The age of caregivers ranged 20-74 years and the age of the elderly ranged 60-89 years. The mean resilience score of caregivers was 49.40±13.07, which is low. There was a significant relationship between resilience score and educational level (P<0.05), marital status (P<0.001) and employment status of family caregivers (P<0.05). The correlation between resilience and caregiver’s age (r=0.17) and elderly’s age (r=0.13) was positive, but weak. Conclusion Family caregivers of the elderly in Mashhad city have low resilience. Their educational level, employment status, and marital status are related to their resilience level. Attention to these factors can help health care providers to develop plans for increasing their resilience and improving the quality of life of the elderly. [ABSTRACT FROM AUTHOR]

Background & Aims Interpersonal cognitive distortion (ICD) is one of the psychological problems in old age that causes a person not to have a correct and logical understanding of relations. Its continuation can lead to anxiety and depression. This study aims to determine the ICDs among the community-dwelling elderly in Tehran, Iran. Materials & Methods In this descriptive-correlational study, participants were 200 older people dwelling in the urban parks in Tehran, Iran who were selected using a cluster sampling method from December 2020 to October 2021. Data collection tools included a demographic form, abbreviated mental test score (AMTS), and interpersonal cognitive distortion scale (ICDS). The collected data were analyzed in SPSS software, version 16 software using descriptive statistics (Mean±SD, No. (%)) and inferential statistics (Pearson correlation test, independent t-test, analysis of variance). Results The mean total score of ICD was 52.53±8.29 out of 95, which indicates the moderate level of ICD among the elderly. In terms of the dimensions of ICDS, the unrealistic relationship expectations had the highest mean score (2.91±0.57), while the dimension of interpersonal rejection had the lowest score (2.64±0.52). There was a significant relationship between the age of the elderly and their ICD (P=0.03). Conclusion Considering the existence of a significant relationship between ageing and cognitive distortions, The nurses working in healthcare centers in Mashhad should take it into account in interventions for the elderly. [ABSTRACT FROM AUTHOR]

Background & Aims Considering the benefits that a welcoming environment can have for the patients and their families, and specifically for people with mental disorders, this study aims to launch a welcoming program in the Iran psychiatric Hospital and assess its effectiveness in improving the quality of and satisfaction with the services for patients with mental disorders. Materials & Methods The welcoming unit of the hospital was officially launched and began to operate since September 2017. In the welcoming program, the nurse first introduced herself to the patients and their families, and if needed, made them familiar with the hospital and its goals and environment, how to reach psychiatrists, and regulations during hospitalization. This program continued by acquainting patients with their rights, the hospital's rules, treatment team, welfare amenities, inpatient wards, electroconvulsive therapy unit, clinics, support center, and by handling complaints and criticisms. For internal evaluation, a survey form with 5 open-ended questions was designed without including demographic characteristics and distributed among the hospital departments. The responses were collected and analyzed using the content analysis method. Results The results of internal evaluation showed that 92% of the patients and their families were satisfied with the welcoming program and perceived it as very good and excellent. Half of the patients and their families (50%) believed that some nurses were caring and some were careless and did not take care of problems well. They perceived that psychiatrists and psychologists did not spend much time with the patient, and their visits were done very late. Conclusion Based on the perceptions of the patients and their families about the welcoming program, it seems that they are satisfied with the program in overall. The result can motivate other psychiatric and non-psychiatric centers in Iran for the implementation of a welcoming program. [ABSTRACT FROM AUTHOR]

Background & Aims Although COVID-19 can affect people in different age groups, the conditions and severity of symptoms are worse in people with diabetes. This aims to determine the knowledge, attitude and practice (KAP) regarding COVID-19 in people with diabetes in Tehran, Iran. Materials & Methods This is a descriptive cross-sectional study on 384 patients with type 1 and type 2 diabetes referred to Firozgar and Hazrat Rasool-e Akram hospitals affiliated to Iran University of Medical Sciences from December 2021 to June 2022. They were selected using a continuous sampling method. The instruments were a demographic form and the KAP questionnaire designed by Honarvar et al. (2020). Data analysis was done in SPSS v.16 using descriptive and inferential statistics. Results The mean age of the participants was 40.11±15.20 years. It was reported that 94.8% had moderate and sufficient knowledge of COVID-19. The mean attitude score was 30.90±4.89 which is a moderateto-high level. Only 1.3% had poor practice regarding COVID-19. A statistically significant relationship was observed between the average knowledge of patients and their marital status (P=0.006), employment status, and duration of disease (P<0.001). In addition, there was a statistically significant relationship between the attitude of patients and their educational level (P=0.015) and duration of disease (P=0.027). Their practice level had a significant relationship with gender (P=0.010), marital status (P=0.001), and type of diabetes (P<0.001). Conclusion The KAP of people with diabetes in Tehran regarding COVID-19 is at a favorable level. This indicates the success of the measures taken to educate this category of patients by health centers and media, and reveals the necessity of increasing the health literacy of people in pandemics. Background & Aims Although COVID-19 can affect people in different age groups, the conditions and severity of symptoms are worse in people with diabetes. This aims to determine the knowledge, attitude and practice (KAP) regarding COVID-19 in people with diabetes in Tehran, Iran. Materials & Methods This is a descriptive cross-sectional study on 384 patients with type 1 and type 2 diabetes referred to Firozgar and Hazrat Rasool-e Akram hospitals affiliated to Iran University of Medical Sciences from December 2021 to June 2022. They were selected using a continuous sampling method. The instruments were a demographic form and the KAP questionnaire designed by Honarvar et al. (2020). Data analysis was done in SPSS v.16 using descriptive and inferential statistics. Results The mean age of the participants was 40.11±15.20 years. It was reported that 94.8% had moderate and sufficient knowledge of COVID-19. The mean attitude score was 30.90±4.89 which is a moderateto-high level. Only 1.3% had poor practice regarding COVID-19. A statistically significant relationship was observed between the average knowledge of patients and their marital status (P=0.006), employment status, and duration of disease (P<0.001). In addition, there was a statistically significant relationship between the attitude of patients and their educational level (P=0.015) and duration of disease (P=0.027). Their practice level had a significant relationship with gender (P=0.010), marital status (P=0.001), and type of diabetes (P<0.001). Conclusion The KAP of people with diabetes in Tehran regarding COVID-19 is at a favorable level. This indicates the success of the measures taken to educate this category of patients by health centers and media, and reveals the necessity of increasing the health literacy of people in pandemics. [ABSTRACT FROM AUTHOR]

Background & Aims The most important factors for the development of any society are human resources. The intensive care units (ICUs) are the most important departments in the hospitals. Considering the importance of time management for patient care, lack of human resources in this profession, and the fact that nurses spend a lot of time on indirect and non-nursing works, this study aims to investigate the time and type of indirect patient care provided by nurses in the ICU of a hospital in Iran during the COVID-19 pandemic. Materials & Methods This is a descriptive, cross-sectional, and observational study that was conducted for 6 months. Participants were 42 nurses working in the ICU of Hafte Tir Hospital in Rey, Iran who were randomly selected from different shifts. Their activities were observed and their spent time was recorded by the researcher using the stopwatch mobile application. The data collection tool was the Persian version of the International Classification for Nursing Practice (ICNP) checklist with acceptable face and content validity according to opinions of a panel of experts (5 faculty members and 10 nurses). descriptive statistics (frequency, mean, standard deviation, minimum, and maximum) were used for data analysis by SPSS software, version 22. Results Most of nurses (60%) were in the age group of 30-39 years and 72% of them had a work experience of 11-20 years. Most of the nurses were female (85%) and married (80%). In each shift, nurses spent an average time of 247 minutes providing indirect care. The longest time in indirect care was related to writing nursing reports (34.9 ± 10.5 min per shift) and the shortest time were related to removing personal protective equipment (6.11±3.19 min per shift), consulting with a colleague, and wearing personal protective equipment (both with 7±3.55 min per shift). Conclusion Although patients need direct care and continuous presence of the nurse more during the COVID-19 pandemic and there are advanced equipment. To provide proper nursing care, it is important to increase the number of nurses and reduce their non-nursing activities. [ABSTRACT FROM AUTHOR]

Background & Aims Aging is associated with declined health. To maintain the health of the elderly, it is necessary to develop preventive health measures. Social well-being is an important dimension of health in the elderly. The present study aims to determine the effect of group reminiscence therapy on the social well-being of retired older men in Zahedan, Iran. Materials & Methods This is a quasi-experimental study that was conducted in 2018. Participants were 90 retired older men aged 60-75 years in Zahedan, Iran who were selected by a convenience method and were randomly divided into intervention and control groups. Data collection tools were a demographic form and Keyes’ social well-being scale-short form. Data analysis was performed using descriptive and inferential statistics in SPSS software, version 16. Results The Mean±SD age was 68.02±3.46 in the intervention group and 68.64±4.60 years in the control group. The results of independent t-test showed that the mean score of social well-being after reminiscence intervention was significantly different between the two groups (P=0.002). Conclusion Group reminiscence therapy has a positive effect on the social well-being of retired older men. Since the elderly are interested in sharing memories and considering that reminiscence therapy is an attractive, simple and cost-effective intervention, it can be used to improve their social well-being. [ABSTRACT FROM AUTHOR]

Background & Aims Pregnancy is associated with physiological and psychological changes. Pregnancy in adolescence may affect the quality of life (QoL) of young women. This study aims to investigate the QoL of adolescent pregnant women in Arak, Iran. Materials & Methods This cross-sectional study was conducted on 217 adolescent pregnant women referred to comprehensive health centers in urban areas of Arak city in 2020 who were selected by a multi-stage sampling method. A demographic form and the QoL gravidarum questionnaire (QoL-GRAV) were used to collect information. Descriptive statistics were used to describe the data and independent t-test, analysis of variance, and Pearson correlation test were used to examine the relationship between the study variables in SPSS software, version 22. Significance level was set at 0.05. Results The mean age of participants was 17.86±1.42 years. Their mean total score of QoL was 1.83±0.56, which was higher than average. They had the highest score in the psychological health domain (Mean=2.01) and the lowest score in the social functioning domain (Mean=1.5). Mother's educational level, husband's educational level, economic status, and pregnancy status (unplanned/ planned) according to women and their husbands had a statistically significant relationship with the QoL. Conclusion The QoL of adolescent pregnant women in Arak is higher than the average. Those with higher educational level, those with husbands having higher educational level, those with better economic status, and those with planned pregnancy have better QoL. [ABSTRACT FROM AUTHOR]

Background & Aims Heart failure is one of the important cardiovascular diseases, affecting 1% of people in their 50s and 10% of people in their 80s. People with heart failure, in addition to physical pain, often experience stress, anxiety, depression, and poor quality of life (QoL). Considering the importance of illness-related worries and spiritual intelligence (SI) in these people, this study aims to determine the relationship between SI and illness-related worries in people with heart failure in Mazandaran, Iran. Materials & Methods This is a descriptive-correlational study. Participants were 247 patients with heart failure admitted to Fatemeh Al-Zahra Hospital affiliated to Mazandaran University of Medical Sciences. To measure the variables, a demographic form, the spiritual intelligence scale of King & Decicco (2009), and the illness-related worries questionnaire. Descriptive statistics (No.[%], Mean±SD) and inferential statistics (Pearson correlation test, independent t-test) were used to analyze the data in SPSS software, version 16. Significance level was set at 0.05. Results The mean total scores of SI and illness-related worries were 61.20 ±16.10 and 86.70 ±19.97, respectively. Pearson correlation test results showed a negative significant relationship between illness-related worries and SI (r=-0.608, P=0.001). Cognitive independence domain of illness-related worries was strongly correlated with all SI domains, including critical existential thinking, personal meaning production, transcendental awareness, and conscious state expansion. The SI had a significant relationship with gender (P=0.001), marital status (P=0.014), economic status (P=0.002), employment status (P=0.018), education status (P=0.001), insurance coverage (P=0.001). The illness-related worries had a significant relationship with gender (P=0.001), history of diabetes (P=0.04), marital status (P=0.001), educational level (P=0.044), and insurance coverage (P=0.01). Conclusion To reduce the illness-related worries of people with heart failure, their SI should be improved using related interventions such as SI training programs. [ABSTRACT FROM AUTHOR]

Background & Aims Error is considered as a part of reality and an integral part of human life. Error reporting is defined as a strategic indicator for error prevention. Nursing managers use management measures and strategies to create an climate in the workplace that nurses increase the rate of reporting errors. The purpose of this study was to determine of the components of nursing errors reporting in selected hospitals of Tehran University of Medical Sciences in 2020. Materials & Methods This research is a descriptive study. The research population includes nurses working in selected hospitals of Tehran University of Medical Sciences. The number of samples was determined using the cochran formula, 336 were determined. Samples were selected by relative stratified random sampling method in July 2020.The tools used in the present study include Made Questionnaire the components of nursing errors reporting. Content validity of both questionnaires was confirmed by content validity method based on the view of 10 faculty members in the field of nursing care and nursing management. Cronbach's alpha coefficient for the components of nursing errors reporting questionnaire (0.78) were measured. Data were analyzed using descriptive analysis and inferential tests such as Kolmogorov-Smirnov, Cramer's v and Mann-Whitney U using SPSS software, version 16. Results According to the results,the mean scores of nursing errors were 80.3% and 32.64% of nurses revealed errors after observing them. Despite the positive nurses’ attitudes toward nursing errors reporting,"fear" and "Managerial barriers" is the most prominent barrier contributing to underreporting. There were significant relationships between nursing errors reporting and hospital ward type, education, nursing error experience, errors reporting method and job experience(P˂0.001). Conclusion Based on the results of the study, creating an anonymous, effective and efficient system for reporting and recording nursing errors, in order to prevent errors, is a necessity in nursing management. Managers have a systematic perspective to identify the factors affecting the occurrence of errors along with their positive reaction and supportive behaviors to the reported errors of nurses can create a culture of fearless learning at the department and organization level and overcome Barriers to reporting nursing errors. [ABSTRACT FROM AUTHOR]

Background & Aims Coronavirus disease 2019 (COVID-19) caused many psychological and social problems in people around the world, especially nurses. The present study aims to investigate and compare post-traumatic stress disorder (PTSD), burnout, and psychological disorders in nurses with and without COVID-19. Materials & Methods This is a causal-comparative study. The study population includes all male and female nurses of non-government hospitals in Tehran from July to September 2021. Of these, 220 nurses (110 without COVID-19 infection and 110 with COVID-19) voluntarily participated in the study. The questionnaires were the Mississippi Scale for Combat-Related Post-Traumatic Stress Disorder, the Maslach Burnout Inventory, and the Depression, Anxiety, Stress Scale. Finally, data analysis was performed using multivariate and univariate analysis of variance in SPSS software, version 16. Results There was a significant difference between the two groups in terms of PTSD, burnout, and psychological disorders (P<0.05). Nurses with COVID-19 had higher scores in PTSD (F=96.38, P<0.001), emotional exhaustion (P<0.001, F=12.45), depersonalization (F=15.49, P<0.001), depression (F=92.97, P<0.001), anxiety (F=37.94, P<0.001) and stress (F=47.6, P<0.001). The nurses with no COVID-19 had higher score in personal accomplishment. Conclusion Nurses who were infected with COVID-19 had lower psychological health compared to noninfected nurses. For this purpose, it is necessary to take measures to identify and provide psychological treatments to improve the mental health of vulnerable nurses. [ABSTRACT FROM AUTHOR]

Background & Aims Job burnout can leads absenteeism, leaving the job or having the intention to leave, reduced quality of life, reduced performance, and reduced quality of patient care and commitment to the organization. Organizational climate has always been important in the nursing profession and in the hospital environment where the nurse’ performance is known as an important component in improving the quality of treatment. This study aims to determine the relationship of job burnout with organizational climate in nurses. Materials & Methods This descriptive correlational study with cross-sectional design was performed in 2020 in the internal surgical wards of four teaching hospitals affiliated to Iran University of Medical Sciences. The sampling was done by a cluster sampling method. The sample size was determined 200 at a 95% confidence level and considering a 80% test power. To collect data, a demographic form, the Maslach burnout inventory, and Halpin and Croft’s organizational climate description questionnaire were used. Data analysis was performed in SPSS v. 24 software using descriptive and inferential statistics. Results Emotional exhaustion domain of job burnout had a statistically significant correlation with all dimensions of organizational climate except for group spirit and disengagement; it had a negative significant correlation with the hindrance dimension and a positive significant correlation with other dimensions. With the increase of organizational climate, emotional exhaustion increases, resulting in more job burnout. Conclusion Health workers, especially nurses and managers, should take measures to reduce job burnout and improve organizational climate and patient satisfaction according to the existing conditions and resources. It is recommended that the educational supervisors of the hospitals develop and implement in-service training focusing on the components of job burnout and organizational climate. [ABSTRACT FROM AUTHOR]

Background & Aims Knee osteoarthritis (KO) is one of the most common causes of pain, reduced function and disability in the elderly. Exercise is one of the methods suggested to manage the pain caused by KO. This study aims to determine the effectiveness of a home workout program on reducing pain in the elderly with KO. Materials & Methods In this randomized controlled clinical trial conducted in March 2021 for three months, 70 older adults with KO were selected using a convenience sampling method and randomly assigned to exercise and control groups. The workout program was first implemented twice a day for 4 weeks in the clinic as a trial. Then, it was performed twice a day at home for another 4 weeks. Before and after the exercise, the patients were evaluated by the pain subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The collected data were analyzed in SPSS software, version 18 using independent t, paired t test, chi-square test, and Fisher’s exact test. The significance level was set at 0.05. Results There was no statistically significant difference between the two groups in terms of demographic and clinical variables and in the mean pain score before the intervention (P=0.587). After the intervention, a significant reduction in pain intensity was reported in the exercise group (P= 0.009). Conclusion The home workout program is effective in reducing the pain of the elderly with KO. It is recommended to use it as a simple and cost-effective intervention to rehabilitate patients with KO along with other treatment methods. [ABSTRACT FROM AUTHOR]

Background & Aims Risk management in academic research, courses, and degrees is crucial in universities. However, there is no evidence for risk management in most aspects of university management. This study was conducted to determine the risk management Evaluation from the Staff's Perspective of Iran University Medical Sciences In 2021. Materials & Methods This is a descriptive cross-sectional study. The research samples were 224 staff of the Iran University of Medical Sciences selected by the available sampling method. The data collection tool was a risk management questionnaire. Risk management was classified into six dimensions. The first dimension is related to the level of employees' knowledge of risk management. The second dimension of risk management status. The third dimension includes policies and procedures. The fourth dimension is related to training status. The fifth dimension was the position of risk management, and finally, the sixth one was monitoring, analysis, evaluation, and risk control. In total, the questionnaire was examined in 45 questions on a 5-point Likert scale and was classified into three levels: poor (score less than 3), moderate (score 3 to 4), and good (score more than 4). The data were analyzed using SPSS software, version 26. The numerical indices of minimum, maximum, Mean±SD for the quantitative variables of the research were used. Friedman test was used to examine the relationship between domains and independent t-test, and analysis of variance and Pearson correlation coefficient was used to investigate the relationship between individual variables and risk management. Results The results showed that most employees (59.4%) were women and the majority (48.7%) were 45- 36 years old. The majority of employees (72.8%) were married. Most of the participants (54.4%) worked in administrative headquarters. More than half of the employees (53.1%) had a university degree at the undergraduate level, and only 12.5% of them had completed risk management courses. The results showed that the total score of risk management was 2.44±0/82. The Friedman test result showed a statistically significant relationship between employees' knowledge of risk management and all areas of risk management (p = 0.00). Statistical tests showed that risk management had a statistically significant relationship with the variables of gender (P = 0.02), risk management (P<0.001), and education (P=0.02). The mean score was higher in men than women, and also in employees who had passed the risk management course was higher than other employees. Two-to-two Tukey comparison also showed that the average score obtained by employees with master's degree education was significantly higher than an associate degree (P=0.03). At other levels, this difference was insignificant. Conclusion The results showed that, generally, from the perspective of the Iran University of Medical Sciences staff, risk management at this university is poor. In this regard, the development of educational programs, the adoption of policies and procedures, and the establishment of monitoring programs to implement risk management should be seriously pursued at the university. [ABSTRACT FROM AUTHOR]

Background & Aims Patient safety is an important component and one of the main elements of quality in health care systems. The patient safety status among the pre-hospital Emergency Medical Staff (EMS) in Iran is unclear and there is almost no information about adverse complications. Assessing the current patient safety culture can be a starting point for improving safety attitudes among health care workers, including pre-hospital EMS who are at the forefront of managing patients in critical conditions. This study aims to survey the attitude towards patient safety among pre-hospital EMS in Mashhad, Iran. Materials & Methods This descriptive cross-sectional study was conducted on 438 full-time pre-hospital EMS with at least 6 months of operational work experience in Mashhad city in 2019, who were selected by a census method. The assessment tool was the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ). The collected data were analyzed in SPSS v. 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t test, analysis of variance, and Pearson correlation test). The significance level was set at 0.05. Results It was reported that 13.75% had a positive attitude towards patient safety. The mean total score of EMS-SAQ was 53.55±10.60. The most positive attitude was related to stress recognition (34.2%) and the lowest positive attitude was related to safety climate and perception of management (5.7%). There was no statistically significant relationship between any demographic characteristics and overall attitude towards patient safety (P>0.05). Conclusion The patient safety culture of the pre-hospital EMS in Mashhad is not positive. This requires further research and also taking measures such as holding briefing sessions for managers and staff, increasing the number of staff, setting up an error reporting system, and including topics related to patient safety in the in-service training courses for the staff. [ABSTRACT FROM AUTHOR]

Background & Aims Due to the increasing number of older women with anxiety sensitivity, attention to this condition in this vulnerable group is of particular importance. Spiritual wellbeing can promote the mental health of the elderly, especially older women. this study aims to determine the relationship between spiritual wellbeing and anxiety sensitivity of older women in Ashtian, Iran. Materials & Methods This is a descriptive-correlational study. The study population includs all older women referred to urban and rural health centers in Ashtian city. Of these, 160 were selected by a continuous sampling method. A demographic form, the Spiritual Wellbeing Scale and the Anxiety Sensitivity Index-Revised were used to collect information. The collected data were analyzed using descriptive and inferential statistics in SPSS software, version 16. Results The Mean±SD total scores of spiritual wellbeing and anxiety sensitivity were 96.1±19.86 and 48.25±31.93, respectively. Spiritual wellbeing had a significant association with anxiety sensitivity in older women (r=-0.734, P<0.001). Conclusion There is a negative and significant relationship between spiritual wellbeing and anxiety sensitivity in older women in Iran, such that their anxiety sensitivity decreases with the increase of their spiritual wellbeing Attentio. [ABSTRACT FROM AUTHOR]

Background & Aims Obesity is a global public health problem. The discriminatory behavior of medical staff, including physicians and nurses, towards obese patients can affect their quality of care to these people. This study aims to determine the attitudes of nurses towords obesity and providing care to obese patients its predictors in northern Iran. Materials & Methods In this descriptive-analytical study, 162 nurses working in one of hospitals in Guilan province participated. The data collection tool was a questionnaire consisted of two parts: demographic form, and nurses’ attitudes towards obesity and obese patients scale. Data were collected and analyzed using descriptive statistics (frequency, mean, and standard deviation) and inferential statistics (independent t-test, one-way analysis of variance) in SPSS software, version 16. Multiple linear regression by Backward method was also used to determine the predictors of nurses’ attitudes. Significance level was set at 0.05. Results The Mean±SD age of nurses was 34.08±7.9 years. Most of them were female (97.5%). Their mean clinical work experience was 8.65±7.01 years. Regarding attitudes toward obesity and obese patients, a significant difference was observed between nurses in terms of working department (P=0.001), educational level (P=0.042), and type of employment (P=0.004). The results of linear regression analysis showed that the variables of age, educational level, and type of employment in nurses the significant predictors of their attitude. Conclusion Nurses in northern Iran have a low attitude towards obesity and obese patients. There is a need for nursing managers to reduce the workload of nurses, especially those in special care units, and provide necessary education to nurses about providing care to obese patients. [ABSTRACT FROM AUTHOR]

Background & Aims Mental disorders are associated with a complex self-centered experience of negative emotions such as despair and lack of mental pain. This study aims to determine the mental pain of people with bipolar disorder (BD) hospitalized in a psychiatric hospital in Tehran, Iran. Materials & Methods This is a cross-sectional study. Participants were 153 patients with BD admitted to Iran Psychiatric hospital, who were selected by continuous sampling. Data collection tools were a demographic form and Orbach Mikulincer Mental Pain (OMMP) Scale. Data were analyzed in SPSS software, version 16 software using descriptive and inferential statistics. Results The mean score of OMMP scale in patients was 109.56±36.93. The variables of suicide attempt (P<0.001), economic status (P=0.002), and employment status (P=0.02) status had a significant relation with the mental pain of patients. Conclusion The mental pain of hospitalized patients with BD in Tehran is at a moderate level. Patients with poor financial status, unemployed patients, and those with a history of suicide attempt have higher mental pain. [ABSTRACT FROM AUTHOR]

Background & Aims Childbearing is important for the increase of population; for countries where fertility rate is low, it is important for sustainable development. The present study aims to evaluate the relationship of accountability and religious orientation with childbearing intention in women referred to comprehensive health centers in Yasouj, Iran. Materials & Methods This descriptive and correlational study was conducted in 2019-2020 on 240 fertile married women aged 18-45 years referred to comprehensive health centers in Yasouj city, who were selected by a continuous sampling method. Inclusion criteria were no debilitating diseases, mental illnesses, or contraindication for pregnancy. A sociodemographic form, Harrison-Goff Accountability Scale, and Golriz and Baraheni’s Religious Attitude Scale were used to collect data. Data analysis was done in SPSS software, version 20 using chi-square test, independent t-test, and one-way analysis of variance. P<0.05 was statistically significant. Results There was a negative and significant relationship between accountability and childbearing intention (P=0.036); the intention to have children was significantly lower in women with a higher accountability score. Religious orientation and its two dimensions (intrinsic and extrinsic orientation) had no significant relationship with childbearing intention. Age (P=0.001), length of marriage (P=0.001), and number of male children (P=0.011) had significant correlation with childbearing intention. Conclusion In Yasuj city, the fertile women’s intention to have children decreases with the increase in their responsibilities, age, length of marriage, and number of male children. Therefore, it is recommended that these women be encouraged to have children at a younger age. It may be possible to encourage women with higher accountability to have children by teaching childbearing skills to them. Further studies are needed in this field. [ABSTRACT FROM AUTHOR]