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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 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 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 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 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 One of the areas that need attention in the nursing profession, which can affect various fields of work, professional, care, etc., are temperament and character. Various factors can affect the temperament and character. One of these factors is the circadian rhythms in which most nurses experience disturbances. Considering the importance of examining and evaluating temperament and character in nurses and the effects of circadian rhythm disturbances on them, and given that less attention has been paid to it, this study aims to determine the relationship between circadian rhythm and temperament/character of nurses working in selected teaching hospitals in Tehran, Iran. Materials & Methods This is a descriptive-correlational study with a cross-sectional design. The study population consists of all nurses working in teaching hospitals affiliated to Iran University of Medical Sciences. The study samples were 200 eligible nurses who were selected randomly (by lottery method) from different departments of four hospitals. A demographic form, the morningness-eveningness questionnaire (MEQ), and Cloninger’s temperament and character inventory (TCI) were used to collect data. Data analysis was conducted in SPSS software, version 16. Results Most of the participants (64%) were neither-type nurses in terms of circadian rhythm. The circadian rhythm in overall had a negative significant correlation with persistence (P=0.039) and self-transcendence (P=0.047). Also, circadian rhythm had a significant relationship with age (P<0.001), sex (P=0.044), employment status (P=0.003), and work experience P<0.001). The dimensions of TCI, including novelty seeking, reward dependence, persistence, self-directedness, cooperativeness, and self-transcendence, had a statistically significant relationship with the demographic characteristics of nurses. Conclusion The circadian rhythm of nurses has a significant negative correlation with some components of TCI. Considering the impact of circadian rhythm on the quality of nursing care, the officials and hospital managers should gain sufficient knowledge of circadian rhythms, identify evening-type nurses, provide training, facilities, and special privileges to nurses, and determine their work shifts according to their circadian rhythms, so that they can improve the quality of patient care and increase patient satisfaction. [ABSTRACT FROM AUTHOR]

Background & Aims The numerous problems of children with congenital heart disease (CHD) and their care burden can reduce the quality of life of parents, especially mothers. Compliance with treatment after discharge from the hospital is crucial. It is necessary to provide home care educational programs for them. Given the advance of technology and the popularity of mobile phone use, this study aims to design an educational mobile application for home care after surgery to improve the quality of life and adherence to treatment in mothers of children with CHD in Iran. Materials & Methods This is a study protocol on 72 mothers of children with CHD referred to the Children’s Medical Center of a hospital (affiliated to Tehran University of Medical Sciences) for surgery. The data collection tools will be a demographic form, the 36-Item Short Form Health Survey (SF-36), and Fatemi et al.’s Adherence to Treatment Questionnaire. Data collection will be done before and one month after the intervention. The collected data will be analyzed using mean and standard deviation, independent t-test, paired t-test, chi-square test, Fisher’s exact test, and Mann-Whitney U test. Results The results will be analyzed to assess the effectiveness of the mobile-based educational intervention in improving the quality of life and adherence to treatment of mothers of children with CHD. Conclusion This is the protocol of a study that examines the effect of a mobile-based post-surgery home care training application on the quality of life and adherence to treatment of mothers. The results of such studies can help identify the faster, easier and more effective methods of patient education. [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 & Aim: Attempting to improve the quality is an important issue in the nursing service and care system. The COVID-19 pandemic has created great challenges for healthcare systems, especially for the intensive care units, which can affect the quality of nursing care provided to these patients. The aim of this study was to determine the quality of nursing care in nurses working in the intensive care unit of COVID-19. Methods & Materials: In this descriptive-cross-sectional conducted in 2021- 22, 142 nurses from Valiasr, Amir Kabir, Amir al-Momenin and Khansari hospitals affiliated to Arak University of Medical Sciences were selected by the census method. The Martins’ nursing care quality questionnaire (including 25 items in 7 domains) was completed by the participants. The SPSS software version 16 and independent t-tests, analysis of variance and the Pearson's correlation coefficient were used for the data analysis. Results: The result showed that the mean score of the nursing care quality was 83.83±7.74, which was considered favorable due to being higher than the median score of the tool (62.5). Among the individual characteristics of nurses, the nursing care quality had a statistically significant relationship with the type of employment (P=0.003), age, work experience and work experience in the intensive care unit (P<0.001). Conclusion: Considering the significant relationship of the nursing care quality with the type of employment, age and work experience, it is recommended that health managers take an effective step in formulating the necessary policies to improve the quality of nursing care by taking into account the experience of skilled nurses in intensive care units. [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 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]

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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 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 Cardiovascular diseases are responsible for 30% of all deaths worldwide. The present study aims to evaluate the effect of education through online social media (WhatsApp) on the anxiety and satisfaction of candidates for coronary angiography. Materials & Methods In this study, participants were candidates for elective coronary angiography referred to Imam Khomeini Hospital in Ahvaz, Iran from May to July 2021. They were assigned to the intervention (n=43) and control (n=43) groups. Data were collected using a demographic form, the Beck anxiety inventory (BAI) and the visual analog scale (VAS) for measuring satisfaction. Data analysis was performed in SPSS software, version 16 using independent t-test, paired t-test, chi-square test, and Fisher's exact test. Results Both groups were homogeneous in terms of demographic characteristics at baseline, and there was no significant difference in BAI scores between the intervention and control groups before the intervention (P=0.229). The results of independent t-test showed a significant difference in the mean BAI score before and after intervention in two groups (P<0.001), indicating the effect of intervention on reducing anxiety. The results of independent t-test showed that the satisfaction in the intervention group was significantly higher than in the control group (P<0.001). The results of the paired t-test showed that in both intervention (P<0.001) and control (P=0.005) groups, the BAI score decreased significantly after the intervention compared to the pre-intervention phase. The effect size of education on anxiety was 0.9 and the effect size on satisfaction was 1.88, which shows the high effect of the educational intervention. Conclusion The use of mobile social networks for education is effective in reducing anxiety and improving satisfaction in patients undergoing coronary angiography. Therefore, this interventional method can be used by nurses as an effective method in medical centers. [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 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 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 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 and Aim: Fractures and dislocations of the femur are a common and disruptive public health problem worldwide. One of the most common ways is to identify the factors associated with common outcomes that increase mortality, length of hospital stay, and postoperative complications. By identifying these factors, the adverse outcomes of elderly hip fractures can be prevented. Therefore, the aim of this study was to determine the relationship between factors affecting hip fracture and its consequences. Materials and Methods: The present study was a descriptive cross-sectional observational study. The study population in this study included patients with hip fractures. Patients’ information was examined between 2017-2020 years. Data were analyzed by SPSS applying descriptive statistics, Fisher Exact test, chi-square, independent t-tests, and analytical regression. Results: The results showed that in this study, the majority of patients with hip fracture had an underlying disease (73.9%). The most common underlying diseases in patients included high blood pressure (20.7%), diabetes (13.2%) and heart diseases (10.5%). The most common causes of death was include old age (40.4%), prevalence of covid-19 (20.2%), heart attack (11.7%), pulmonary embolism (10.6%) and surgical wound infection (10.6%). The most common cause of hip fracture was osteoporosis (26.3%) and falling from a height (24.7%). Also level of education (P=0.0001), causes of fracture (P=0.001), type of anesthesia (P=0.001), history of hospitalization in special wards (P=0.001), readmission (P=0.0001), age (P=0.001) and level of self-care (P=0.001) were significantly associated with elderly mortality. There was a significant relation between type of surgery (P=0.038), history of hospitalization in intensive care units (P=0.001), history of blood transfusion (P=0.021) and level of self-care (P=0.001) with length of hospital stay of fractured elderly hip. Conclusion: It can be concluded that by identifying the factors affecting the length of hospital stay, surgical wound infection and mortality of the patients with hip fractures, witness better surgery results, shorter hospital stay, less postoperative complications and reduced death. Some factors such as osteoporosis are preventable, which can be prevented with timely education. [ABSTRACT FROM AUTHOR]

Background & Aims A direct relationship between infertility in women and their exposure to domestic violence has been reported, and several interventions have been suggested to reduce the exposure to violence in infertile women. The current study aims to assess the effect of problem-solving skill training (PSST) on the exposure of Iranian infertile women to domestic violence. Materials & Methods This is a quasi-experimental study with a pre-test/post-test/follow-up design using a control group, which was conducted in the infertility clinic of Shahid Akbarabadi Hospital affiliated to Iran University of Medical Sciences, Tehran, Iran. A total of 80 infertile women who had experienced domestic violence participated in this study. The samples were selected using a convenience sampling method and were divided into two groups of intervention (n=40) and control (n=40) by the block randomization method. The intervention group received PSST online at 4 sessions per week each for 2 hours. The samples were followed up two months after training. To collect data, a demographic and obstetric form and the Revised Conflict Tactics Scale (CST2) were used. Data analysis was done in SPSS v.16 software by using t-test, chi-square test, Fisher's exact test, Mann-Whitney U test, and Wilcoxon test. Results Totally, 38 participants in the control group and 34 in the intervention group were followed up. Physical assault, psychological aggression, sexual coercion, sustained injury, and the negotiation did not show significant differences between the two groups before and after intervention (P>0.05). The mean of psychological aggression significantly increased after the intervention in both control (P=0.001) and intervention (P=0.026) groups. Conclusion PSST do not cause a significant difference in exposure to domestic violence between intervention and control groups of infertile women. The increase in exposure to psychological aggression in both groups after PSST can be due to the coincidence of the study with the COVID-19 pandemic. Further studies are recommended to provide PSST by face-to-face method along with exercises and group activities and teaching other skills such as communication skills. [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]

Background & Aims Maintaining patient safety (PS) is one of professional and ethical duties of health care providers. Nurses, as the largest professional group in the health system, have a potential and significant power in influencing the health care quality. Their competency in PS is essential to ensure quality and safe care. Education plays a vital role in improving PS and providing high quality nursing care. Due to the prevalence of COVID-19 and the need to observe social distancing, it is not possible to hold face-to-face courses. Hence, e-learning is a valuable option during this pandemic. This study aims to evaluate the effectiveness of online PS education on the competence of nurses in intensive care units (ICUs). Materials & Methods This is a single-group quasi-experimental study with a pre-test/post-test design that was conducted in 2020 in Tehran, Iran. Participants were 50 nurses working in the ICUs of Hazrate Rasoole Akram Hospital and Firoozgar Hospital affiliated to Iran University of Medical Sciences, who were by a proportional stratified sampling method. The content of the educational program was prepared using clinical guidelines and the literature which included materials about (1) PS and its different aspects (medication error, hemovigilance, pressure ulcer, fall, nosocomial infections, hand hygiene, surface and equipment disinfection, and waste management), (2) PS culture, (3) the effects of human factors and teamwork on error incidence, (4) importance of communication with patients before and after the occurrence of errors and giving appropriate feedback on errors, (5) root cause analysis of errors, (6) activity analysis after an adverse event, and (7) risk management. The program was prepared using Storyline version 3 software. Educational content was provided to participants on Telegram application. Before and three months after the intervention, data were collected using the Patient Safety Competency Self-evaluation (PSCSE) questionnaire. Data were analyzed by descriptive statistics (frequency, mean, and standard deviation) and inferential statistics (paired t-test) in SPSS software, version 22. Results The mean scores of PS knowledge (21.75±3.28), attitude (61.52±4.19) and skill (84.66±53.7) after the intervention were significantly higher compared to their pretest scores (P<0.001). The mean of total competency score (167.93±11.61) was also significantly higher after the intervention. Results showed that the educational program improved the nurses' competence by 17.86%. The education had the highest effect on PS knowledge, followed by PS skills and attitudes. Conclusion Online education can increase PS knowledge, skills, and attitudes in ICU nurses and can ultimately promote their competence in PS. Nursing managers can use e-learning method to provide in-service training and retraining courses on familiarity with PS concepts, which can help manage medical errors caused by nurses. This learning method is recommended for nurses working in ICUs, especially during the COVID-19 pandemic. [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 Most parents of children with cancer experience a care burden. Increasing their resilience can help reduce their care burden. This study aims to determine the effect of online resilience educational intervention on the resilience and care burden of parents of children with cancer. Materials & Methods This is a single-group study with a pre-test/post-test design. Fifty parents of children with cancer referred to selected medical centers in Tehran, Iran were selected using a continuous sampling method from July 2020 to February 2021 . The data collection tools were a demographic form, Connor-Davidson resilience scale and Novak and Guest’s caregiver burden inventory. Resilience education was presented for 4 weeks online. One month after the intervention, post-test assessments were conducted. Data analysis was done using descriptive and inferential statistics (paired t-test) in SPSS software, version 26 software. Results The Mean±SD resilience score before the intervention was 50.32±21.84 and increased to 78.24±9.16 after the intervention (P<0.001). The Mean±SD total score of care burden before the intervention was 57.18±18.17 and reduced to 24.02±7.45 after the intervention (P<0.001). Conclusion The online resilience educational program can increase the resilience and reduce the care burden of the parents of children with cancer. It can be used by nursing managers to increase resilience and reduce the care burden of these parents. [ABSTRACT FROM AUTHOR]

Background & Aim: Caring for children with congenital heart disease is very challenging for their parents, and the mothers of these children have a low quality of life. The aim of this study was to evaluate the effect of discharge planning on quality of life among mothers of children with congenital heart disease undergoing surgery. Methods & Materials: In this quasi-experimental study, 72 mothers of children with congenital heart disease referred to Shahid Rajaie Cardiovascular center in Tehran in 2019 were included in the study using the continuous sampling method and non-randomly allocated to experimental or control groups (36 in each group). Data collection tool included demographic questions and the SF-36 questionnaire, which was completed before and two months after the intervention. The intervention was performed in six thirtyminute training sessions at the time of admission, during hospitalization and discharge. The training follow-up continued for two months after discharge. Data was analyzed by the SPSS software version 20 using Chi-Square test, independent t-test and Fisher's exact test. Results: The mean score of quality of life before the intervention was 58.93±19.35 in the experimental group and 64.93±16.78 in the control group, and there was no significant difference between groups (P=0.165). Two months after the intervention, the mean score of quality of life was 73.44±17.81 in the experimental group and 73.67±16.49 in the control group, and there was no statistically significant difference between groups (P=0.956). Conclusion: The discharge planning did not improve the mothers' quality of life. It is suggested that in addition to educating about proper care of the child, psychological support be provided for mothers while implementing discharge planning. Clinical trial registry: IRCT20180501039489N3. [ABSTRACT FROM AUTHOR]

Background & Aim: Anxiety is one of the most common complications in cancer patients that can affect the physical and mental health of patients and disrupt the treatment process. For this reason, cancer patients undergoing chemotherapy need education about the disease and ways to cope with its complications and problems. The aim of this study was to compare the effects of video and written training methods on anxiety in patients with gastric and esophageal cancer undergoing outpatient chemotherapy. Methods & Materials: This study is a randomized clinical trial that was conducted on 58 patients with gastric and esophageal cancer who underwent outpatient chemotherapy in Shariati and Imam Khomeini hospitals in Tehran. Participants were randomly assigned to either the video training group (n=28) or the written training group (n=30). Data was collected using the Spielberger State Anxiety Inventory (STAI), at the beginning of the study and then weekly for 12 weeks. The SPSS software version 20 was used to analyze the data. Results: The results showed that the level of anxiety in both groups was significantly lower compared to before the intervention (P<0.05). There was no statistically significant difference in the anxiety mean score between the video group (56.07±9.85) and the written group (56.40±8.13) after the intervention (P=0.89). Conclusion: In general, the results of this study showed that self-care education using video and written methods reduces the anxiety of cancer patients undergoing chemotherapy and both methods can be effective in reducing patients' anxiety. [ABSTRACT FROM AUTHOR]