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Background: The elderly health care services provided in public health centers neglect the care and education of the healthy elderly. Aim: This qualitative study aimed to improve the quality of public health services for the healthy elderly. Method: This participatory action research was conducted on 11 health care workers, 54 elderly participants, and 54 family members in Motahhari Comprehensive Health Services Center of Mashhad, Iran, within 2016-2019. Data collection tools were the SERVQUAL questionnaire, interview, focus group discussion, and field note-taking. After the identification of the problems through interviews with participants, the sessions of focus group discussions were held to design the program. After executing the change programs, evaluations were repeated to compare pre-change and post-change situations. Qualitative content analysis was performed using the reality description method, and quantitative content analysis was conducted by descriptive statistics and paired t-test. Results: The mean values of age and work experience of the health care workers were reported as 32.4±2.7 and 8.1±1.7 years, respectively. Using the developed care files, the non-specialist routine care was transformed into standardized organized care based on the needs of the healthy elderly. In the pre-intervention phase, the mean scores of service quality from the perspective of the elderly participants and their families were 63.0±9.4 and 61.8±9.0, respectively. In the post-intervention phase, the aforementioned figures statistically increased (P=0.001) to 130.1±14.7 and 122.6±13.5, respectively. Implications for Practice: The quality of health care services for the healthy elderly improved by encouraging the participation of the elderly and their families in the care process. This approach can be used in other public health centers.

Background: The provision of optimal care is the most important goal in nursing, the fulfillment of which requires the identification of clients’ problems and needs. However, based on the review of the literature, no review study has investigated the problems and needs of the infertile patients in Iran. Aim: The purpose of the present study was to investigate the problems and needs of the infertile patients referring to the assisted reproduction centers. Method: This review study was based on the traditional review procedure developed by Cronin et al., which entails five steps including: 1) choosing the topic of the review, 2) searching the manuscripts, 3) collecting, reading, and analyzing the texts, 4) writing the review, and 5) providing references. The articles published within 2003-2017 were searched in such valid databases as Google Scholar, Pub Med, Science Direct, Ovid, and Cochran. The inclusion criteria in this study were articles in Persian and English with the keywords referring to problems and needs of clients. Out of the 350 original articles, 31 cases were finally selected for this review study. Results: In general, the infertile patients’ problems were placed under four domains of mental-psychological, social, marital, and financial factors. The needs of the infertile individuals were grouped into six domains of physical, care, informational, financial, mental-psychological, and spiritual factors. Implications for Practice: The identification of the patients’ problems and needs can lead to the conceptualization of strategic points targeted toward the delivery of effective interventions facilitating the provision of patient-centered infertility care. This can enhance the quality of life and lower the levels of stress during the course of treatment.

Background: Regarding nurses' significant role in improving quality of marital life in mastectomy patients and their families, implication of the adaptation model can help nurses reaching this goal. Aim: This study aimed to determine Effect of an educational-supportive program based on Roy This quasi-experimental study was performed on 69 mastectomy patients receiving chemotherapy in 2013 in clinical services in Tehran, Iran. The samples were randomly allocated to two groups. The data collection instrument was ENRICH Marital Satisfaction scale (2011). In the experimental group, maladaptive behaviors and their stimuli were determined by the questionnaire, and then adaptive strategies were implemented in 45 days. The program was based on support (patients instruction), peer group, weblog, meeting with the participants’ spouses, and three-month follow-up using behaviors checklist. Control group patients received the regular treatment sessions. T-test, Pearson’s correlation coefficient, Spearman's rank correlation coefficient, and Chi-square tests were run, using SPSS version 19. Results: In experimental group, paired sample t-test reflected an increase in marital satisfaction from 24.7±2.6 before to 32.9±3.5 after the intervention (P=0.03). However, no significant differences were observed in the control group from 26/7±4/6 before to 26/5±4/8 after the intervention in this regard (P=0/63). Implications for Practice: Roy Adaptation Model can be used as a framework for designing educational-supportive programs to improve quality of marital life in mastectomy patients receiving chemotherapy.