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To describe the experiences of nurses regarding strategies to prevent missed nursing care.One of the global challenges is missed nursing care, which includes missed or delayed care. This problem puts patients' clinical outcome at risk, so understanding nurses' experiences of how to prevent or reduce it can help the health care policymakers.In this qualitative descriptive study, 14 nurses were selected by purposive sampling. In-depth semi-structured interviews were conducted to collect data. The Graneheim and Lundman's approach of qualitative content analysis was used for data analysis. MAXQDA (version 10) software was used for data management.The extracted codes were summarized into seven categories and one theme. The categories included "empowering nurses," "manpower supply," "supervision," "specializing the activities," "providing resources and facilities," "encouraging teamwork," and "resolving dissatisfaction." The main theme was "missed nursing care prevention strategies."The frequency of missed nursing care can be reduced or prevented using management strategies such as paying attention to nurses "empowerment, increasing nurses" job satisfaction, normalizing nurses' salaries, providing equipment and facilities, and monitoring nurses' performance. Experimental studies are recommended to evaluate the effectiveness of these strategies.Nursing managers can take steps such as workplace improvement, reducing nurses' workload, and empowering nurses to reduce or eliminate missed care.

Background and Aim. Internet abuse use among students is a common phenomenon that can have many negative effects on their academic and social life. This study was aimed at investigating the correlation of Internet abuse use with academic performance and academic burnout in nursing students. Materials and Methods. A total of 184 nursing students were recruited by simple random sampling. Data collection tools included a demographic information form, the Internet Abusive Use Questionnaire and Maslach Burnout Inventory-Student Survey. Data were analyzed by the SPSS-18 software using descriptive and inferential statistics. Results. The abusive use of the Internet in nursing students was lower than the average level. There was a positive correlation between Internet abusive use and academic burnout ( r = 0.305 , p < 0.001 ), but there was a negative correlation between Internet abusive use and academic performance ( r = − 0.478 , p < 0.001 ). The results of multiple regression analysis showed that Internet abusive use could predict the variance of academic burnout and academic performance. Conclusions. Internet abusive use was correlated with increased academic burnout and decreased academic performance in nursing students. Educational interventions are required to increase students’ awareness of the consequences of Internet abusive use.

Background. One of the most important psychosocial issues related to the nursing profession is moral distress (MD), which has devastating effects on student performance as well as patient care. The current study was conducted to determine the frequency, severity, rate, and causes of MD in nursing students. Methods. During this cross-sectional study, 86 samples were last year undergraduate nursing students of Kermanshah University of Medical Sciences, who were entered into the study by the census method. Data gathering instruments were personal information form, Moral Distress Scale-revised (MDS-r), and Moral Distress Thermometer (MDT). Results. The mean frequency, severity, and rate of MD, according to the MDS-r questionnaire, were 1.3 ± 0.7 out of 4, 1.8 ± 0.8 out of 4, and 3.3 ± 2.3 out of 16, respectively. The average MDT score was 2.6 ± 2.5 out of 10. The most common causes of MD were working in unsafe conditions (6.8 ± 6.0), observing impaired patients health servicing (5.4 ± 5.6), and the low quality of patient care (5.1 ± 4.6). There was a statistically significant relationship between the gender, work experience, and participation in the professional ethics workshop variables and mean MDS-total and MDT. Conclusion. The rate and mean severity of MD were reported at a moderate level. Also, the MDT average was reported at a mild to an uncomfortable level, and the overall MD was equal to moderate. Therefore, student administrators should take steps to eliminate or reduce the causes of MD. In this regard, the need for teaching preventive methods against MD to nursing students before their clinical courses seems crucial. Also, students with MD must be referred to the psychiatric/psychologist.

Background. Self-directed learning plays an important role in nursing education and is associated with academic achievement, communication self-efficacy, assertiveness, responsibility, and students’ clinical competencies. This study was conducted to analyze the existing research on the level of self-directed learning in nursing students. Methods. In this systematic review and meta-analysis, all studies that had examined the level of self-directed learning in nursing students until March 2, 2020, were searched in Science Direct, Ovid, Scopus, PubMed, ProQuest, Web of Science, and Google Scholar databases. In the meta-analysis section, I2 index and the random effects model were used. Comprehensive Meta-Analysis software (version 2) was used for data analysis. Results. The mean score of self-directed learning in 12 articles with 3830 samples was 156.73 ± 1.47 out of 200 (95% CI: 153.3–160.1). These scores were 153.50 ± 2.71 (95% CI: 148.18–158.82) and 154.67 ± 1.32 (95% CI: 157.50–159.32) in the male and female students, respectively. There was a significant relationship between self-directed learning and sample size, year of study, and semester ( p < 0.05 ). Conclusion. The mean self-directed learning in nursing students was at a moderate level, which does not seem to be sufficient. Given the positive role of self-directed learning in nursing education, it is essential that nursing professors teach self-directed learning skills to students via training courses.

Background. To promote oral health in society, medical and nursing students are required to have acceptable knowledge, attitude, and practice with respect to correct maintenance and use of a toothbrush. This study explored the knowledge, attitude, and practice of Iranian medical and nursing students about the correct maintenance and use of a toothbrush. Methods. A total of 260 nursing students and 320 medical students were randomly recruited. Data were collected by a researcher-made questionnaire on the knowledge, attitude, and practice about toothbrush maintenance and use. Data were analyzed using descriptive and inferential statistics. Results. The mean scores of knowledge, attitude, and practice were 54.53 ± 17.18, 49.67 ± 19.17, and 19 ± 51.50 in the nursing students and 54.17 ± 21.42, 51.18 ± 87.28, and 49.87 ± 17.52 out of 100 in the medical students, respectively. There was no significant difference between the medical and nursing students in the mean score of knowledge. The medical and nursing students had a similar attitude and practice in most items of toothbrush maintenance and use. Conclusion. The medical and nursing students had average knowledge, attitude, and practice regarding toothbrush maintenance and use, which is not acceptable considering their job nature. Hence, interventional measures should be taken to enhance their knowledge, attitude, and practice.

Background. One of the most common surgical complications is nausea. Regarding the contradictory findings on the effect of aromatherapy with peppermint on the severity of nausea, in the present study, we aimed at comparing the effect of aromatherapy with 10% and 30% peppermint essential oils on the severity of nausea in surgical patients. Methods. This single-blind randomized controlled trial was conducted at the surgical ward of Imam Reza Hospital in Kermanshah, Iran. A total of 120 patients undergoing abdominal surgery were randomly divided into three groups of 10% peppermint, 30% peppermint, and control (40 patients in each group) using a random number table. In each of the intervention groups, 0.2 ml of 10% and 30% peppermint essential oil was inhaled. In the control group, the same amount of distilled water colored with green food coloring was inhaled. The severity of nausea was measured by nausea visual analog scale (NVAS) before and 10 minutes after the intervention. Results. In the 10% peppermint group, the mean severity of nausea before the intervention was 52.3 ± 13.7 out of 100, which reduced to 40.5 ± 13.5 after the intervention (p<0.001). In the 30% peppermint group, the mean severity scores of nausea before and after the intervention were 60.2 ± 15.0 and 39.7 ± 12.4, respectively (p<0.001). In the control group, the mean severity scores of nausea before and after the intervention was not statistically significant. There was no significant difference between the two intervention groups in terms of the mean severity of nausea after the intervention. Conclusions. It can be concluded that 10% and 30% peppermint essential oils are equally effective on the severity of nausea.

Background. Critical thinking is one of the most important missions of the educational planning system of medical sciences universities around the world. Hence, identifying the level of critical thinking skills and tendency of medical sciences students to think critically is of great importance. Therefore, the aim of this systematic review was to examine the critical thinking level in medical sciences students in Iran. Methods. To extract published studies in the field of critical thinking in Iran, a search was conducted in the databases of PubMed, Web of Science, Scopus, ERIC, and Magiran. The keywords of critical thinking, medical sciences, and Iran were used for the purpose of the search in the two languages of Persian and English and without any time limit. The PRISMA flow diagram was applied for the selection of articles, and the Newcastle–Ottawa Scale was used for the evaluation of these papers. Results. After evaluating the quality of searched articles, 80 articles were finally selected for the final analysis. The total sample of the articles included 12,578 students. The results indicated that out of 51 articles conducted in the field of critical thinking skills, 48 articles reported these skills at a low level, 2 papers at a medium level, and only 1 paper at a high level in the medical sciences students. Among 29 articles in the field of the level of critical thinking disposition, 13 articles reported their tendency level at a low level, 11 articles at a medium level, and 5 articles at a high level. Conclusion. In general, based on most articles, the level of critical thinking skills in the medical sciences students in Iran was reported to be at a low level and their tendency to critical thinking at a moderate level and low level. Therefore, given the importance of critical thinking for medical sciences students, future studies should consider factors influencing the increase of the critical thinking level in these students. In this regard, formation of some training workshops can also be promising. Furthermore, reviewing the medical sciences curriculum should be taken into consideration by the policymakers and educational planners so as to strengthen the level of critical thinking in the medical sciences students.

Background. Providing an organ for donation is a major problem worldwide and nurses play an important role in facilitating the process of organ donation. This study is aimed at investigating the knowledge, attitude, and performance of nurses working in the ICU, CCU, and emergency wards regarding organ donation. Methods. In this descriptive-analytical study, 185 nurses working in ICU, CCU, and emergency wards were studied through systematic random sampling. The data collection was done by a self-administered questionnaire. Results. The mean knowledge of nurses was 8.9 ± 1.4 out of 10. There was a significant relationship between knowledge of nurses regarding donation and religion and having organ donation card (P<0.001). The mean attitude of nurses was 7.8 ± 2.2 out of 8. The variables, including “having a donation card and marriage,” were associated with attitude of nurses toward organ donation. The mean performance of nurses was 0.4 ± 0.7 out of 3. There was a significant relationship between performance of nurses and having a donation card (P<0.001). Knowledge was the strongest predictor of nurses’ performance (P<0.01). Conclusion. The studied nurses showed sufficient knowledge and favorable attitude toward organ donation; however, they had poor performance. It is suggested to hold training courses to improve performance of nurses. The revision of the nursing students’ curriculum as future nurses should also be considered.