Search

Background Continuing medical education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and nurses’ vital role in improving health care. It is, therefore, imperative to explore the nurses’ experience of CME courses and the extent to which such programs are effective. Objective The present qualitative study aimed to explore and describe nurses’ experiences of the effect of CE programs in promoting their competencies toward non-communicable diseases. Methods This qualitative content analysis study was conducted from December 2019 to April 2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran) and based on the principles of conventional content analysis. The target population was nurses who actively worked in the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including nine nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews guided by an interview guide, and data collection continued until data saturation was achieved. Each interview took about 30–45 min. Follow up questions were used for clarification when needed. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln. Results Analysis of the interview data resulted in 230 primary codes, based on 8 categories, and three themes were identified. The extracted themes were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. The associated categories were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. Conclusion Professional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning, and implementation of training programs based on professional needs and effective assessment of the teaching/learning process.

The prevalence of hookah smoking in the Islamic Republic of Iran is increasing among females, especially in the southern cities.The aim of this study was to investigate the factors influencing hookah tobacco smoking among females in the Islamic Republic of Iran.In this qualitative study, 52 females who use hookah were selected (25-71 years old) from the cities of Evaz and Gerash and were interviewed. The participants were selected using purposive sampling and the data were gathered using semi-structured interviews. Data analysis was performed using the conventional approach of qualitative content analysis.Most participants were aged between 25 and 35 years old and 55.8% were married. Three main themes were identified from the qualitative data including: personal factors, family factors and social factors.The findings of this study indicate that the reasons for hookah smoking were based on complex interactions between individual, family, and social factors. In order to successfully reduce hookah smoking in females it is necessary to consider an approach that uses these social factors.العوامل المؤثّرة في تدخين تبغ الشيشة بين الإناث في جمهورية إيران الإسلامية: دراسة نوعيّة.محمد بذرافشان، أمير المنصوري، حامد دلام، بهنام مسموعی، نسرين شكربور.يتزايد معدّل انتشار تدخين الشيشة في جمهورية إيران الإسلامية بين الإناث، لا سيّما في المدن الجنوبية.هدفت هذه الدراسة إلى استقصاء العوامل التي تؤثّر على تدخين تبغ الشيشة بين الإناث في جمهورية إيران الإسلامية.في هذه الدراسة النوعيّة، اختيرت 52 امرأة يدخّن الشيشة (في عمر 25–71 عامًا) من مدينتي إيفاز وجيراش، وأُجريَت مقابلات معهن. واختيرت المشاركات عن طريق أخذ عيّنات هادفة، وجُعت البيانات بمقابلات شبه منظّمة. وحُلِّلت البيانات بالنهج التقليدي لتحليل المحتوى النوعي.تراوحت أعمار معظم المشاركات بين 25 و 35 عامًا، وكان ٪55.8 منهن متزوجات. وحُدّدت ثلاثة مواضيع رئيسية من البيانات النوعيّة اشتملت على: العوامل الشخصية، والعوامل العائلية، والعوامل الاجتماعية.تشير نتائج الدراسة إلى أن أسباب تدخين الشيشة اعتمد على تفاعلات معقّدة بين العوامل الفردية والأسرية والاجتماعية. ويستلزم النجاح في الحدّ من تدخين الشيشة لدى الإناث التفكير في نَجٍ يستخدم هذه العوامل الاجتماعية.Étude qualitative sur les facteurs influençant le tabagisme par houka chez les femmes en République islamique d’Iran.La prévalence du tabagisme par houka en République islamique d’Iran augmente chez les femmes, en particulier dans les villes du sud.l’objectif de la présente étude était d’étudier les facteurs influencant le tabagisme par houka chez les femmes en République islamique d’Iran.Dans cette étude qualitative, 52 femmes sélectionnées qui fumaient la houka (âgées de 25 à 71 ans) dans les villes d’Evaz et de Gerash ont été interrogées. Les participantes ont été sélectionnées sur la base d’un échantillonnage ciblé et les données ont été recueillies dans le cadre d’entretiens semi-structurés. L’analyse des données a été réalisée selon l’approche conventionnelle d’analyse qualitative du contenu.La plupart des femmes avaient entre 25 et 35 ans. En termes de statut marital, 55,8% étaient mariées. Trois thèmes principaux ont été identifiés à partir des données qualitatives, à savoir : les facteurs personnels, les facteurs familiaux et les facteurs sociaux.Les résultats de cette étude indiquent que les raisons de l’utilisation de la houka étaient les interactions complexes entre les facteurs individuels, familiaux et sociaux. Pour réussir à réduire le tabagisme par houka chez les femmes, il est nécessaire de tenir compte les facteurs sociaux.

In the new era, many people seek their health-related information through the Internet due to the increasing access to this technology. Searching online health information can affect the health behavior. This study aimed to investigate the correlation between online health information-seeking behavior and a healthy lifestyle during pregnancy in a sample of Iranian pregnant women. This cross-sectional study was conducted among pregnant women admitted to health centers of Eghlid city, Fars province, Iran in 2019. A total of 193 women participated in the study. The required data were gathered using two validated questionnaires to measure the online health information-seeking behavior and the healthy lifestyle practices of the participants. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 22. Online health information experience and its subscales showed no statistical correlation with a healthy lifestyle. Age and education did not correlate with online health information-seeking behavior. Age had a statistical correlation with a healthy lifestyle, but education had the same correlation only with some subscales of a healthy lifestyle. The findings were surprising, suggesting that online health information-seeking behavior does not affect the lifestyle of pregnant women. These finding and probable explanations are discussed, but due to the limited literature on the subject, further studies are recommended to be conducted.

Background The current corona virus pandemic is acting as a stressor or trauma, which not only threats physical health status, but also threats mental health status and well-being of people. Currently, COVID-19 pandemic is a life-threatening unpredictable condition accompanied with a large number of uncertainties. The present study has mainly aimed to assess mental health and the relevant social factors during this pandemic in Fars province. Methods This cross-sectional study was performed on 922 participants in Fars province, Iran, using internet-based data collection technique. All the included participants filled out the General Health Questionnaire (GHQ-28). Moreover, demographic variables and some social factors were evaluated by asking some questions. All the participants were ensured of the confidentiality of the collected data, and willingly completed the questionnaire. Results Among the participants, there were 629 women (68.2%) and 293 men (31.2%). The mean age of the participants was 36.98 ± 11.08 years old. Four hundred twenty-five subjects (46.1%) obtained GHQ-28 scores above the cut-off point, and accordingly, they were suspected of having poor mental health statuses. Women, in comparison to men (OR = 2.034, 95%:1.62–3.28), and individuals aged 50 years old (OR: 4.01 95%:2.15–7.50), have poorer mental health statuses. Trusting on media, health authorities, and cooperation with policy makers, as well as having uncertainty on information about Coronavirus pandemic were also shown to be associated with poor mental health condition (P Conclusion The present study revealed that the number of those people with suspected poor mental health in Fars province significantly increased compared to a previous study using the same questionnaire. Furthermore, the participants who had less trust in media and policymakers were more prone to mental health problems. Therefore, it can be concluded that supporting people in these life-threatening pandemic crises is of great importance, so the policy makers and media must present reliable and valid information to people as soon as possible.

Background: Malaria is one of the major human health problems that have become increasingly important in recent decades. Objective: The present study aimed to identify the epidemiological status of malaria in the years 2006–2018 in the southern region of Fars province in southern Iran. Methods: This is a cross-sectional descriptive-analytical study. The study population consisted of all persons with malaria referred to the Center for Disease Control in the four cities of Larestan, Gerash, Evaz and Khonj in the south of Fars province, Southern Iran, between 2006 and 2018. Frequency (%) was used to report descriptive statistics and mean and standard deviation for quantitative variables. The trend of malaria incidence during these years was analyzed using the Cochran Armitage Test. The significance level was considered 5%. Findings: A total of 190 cases of malaria in the period of 2006 to 2018 occurred in the southern region of Fars province; 77.9% were men, more than 95% were Afghans, and most of them were workers. The incidence of malaria in one hundred thousand people per month showed that most of the new malaria cases were in the months of July to October. The peak incidence was in August, with 19.88 cases per 100,000 people. Cochran-Armitage test results showed that this trend was not statistically significant (P = 0.399), despite an almost upward trend in malaria incidence in the south of Fars province. Conclusion: The results of this study showed that the trend of malaria in the south of Fars province was ascending; therefore, increasing surveillance activities to prevent and control malaria in such area is of utmost importance.

Recognition of the factors affecting the medical students’ academic success is one of the most important challenges and concerns in medical schools. Hence, this study aimed to investigate the mediating effects of metacognitive learning strategies and learning-related emotions in the relationship between academic self-efficacy with academic performance in medical students.MethodsThe present study was carried out on 279 students of medicine studying at Shiraz University of Medical Sciences. The students filled out three questionnaires: academic emotions (AEQ), metacognitive learning strategies, and academic self-efficacy questionnaires. The data were analyzed using SPSS and Smart PLS3.ResultsThe results of structural equation modeling revealed that the students’ self-efficacy has an impact on their learning-related emotions and metacognitive learning strategies, and these, in turn, affect the students’ academic performance. Moreover, learning-related emotions influence the metacognitive learning strategies, which in turn mediate the effect of emotions on academic performance.DiscussionThe results of this study revealed that metacognitive strategies and learning-related emotions could play a mediating role in the relationship between students’ self-efficacy and academic performance.

This study aimed to develop and test a research model that examined 7effective factors on the effectiveness of laboratory information system (LIS) through strategic planning. This research was carried out on total laboratory staff, information technology staff, and laboratory managers in Shiraz (a city in the south of Iran) teaching hospitals by structural equation modeling approach in 2015. The results revealed that there was no significant positive relationship between decisions based on cost-benefit analysis and LIS functionality with LIS effectiveness, but there was a significant positive relationship between other factors and LIS effectiveness. As expected, high levels of strategic information system planning result in increasing LIS effectiveness. The results also showed that the relationship between cost-benefit analysis, LIS functionality, end-user involvement, and information technology-business alignment with strategic information system planning was significant and positive.

It is expected that the number of people living with diabetes rise especially in low- and middle-income countries. In Iran, more than four million adults have diabetes mellitus, and self-management education is essential for effective diabetes self-care. This study aimed to investigate the effect of self-management education with telephone follow-up in diabetic patients of rural areas of Fars province in Lamerd city, Iran. In this experimental study, 64 participants were randomly assigned to intervention and control groups (32 patients for each group). In the intervention group, the participants attended four educational sessions, each lasting 90 minutes. The control group received the usual care. Outcome measures were clinical variables and the patients' scores in Diabetes Self-Management Questionnaire (DSMQ) in the preintervention and postintervention phases. Effects of the intervention were analyzed using Mann-Whitney U test and analysis of covariance. Data of 60 patients (30 in each group) were analyzed. There were significant differences between the two groups in fasting blood sugar after 3 months of intervention. There was a significant difference between the intervention and control groups in DSMQ sum scale after adjusting for baseline value. In subscales of DSMQ, there were significant differences between the intervention and control groups in glucose management, dietary control, and physical activity, whereas no significant difference was found in health care use between the intervention and control groups. Self-management education with telephone follow-up in diabetic patients in rural areas is effective, especially in improving fasting blood sugar level and increasing scores of patients based on DSMQ.

The prevalence of depression and anxiety is increasing among the elderly around the world. It is believed that lavender can stabilize the people's mood, so this study was designed to evaluate the effect of lavender on anxiety and depression of the elderly.This study was a single blind clinical trial with a control group. The participants in the study consisted of 60 elderly subjects (30 in each group) who referred to the Health Center of Larestan city in the south of Iran in 2019. The intervention consisted of using 2 g of lavender teabag, which was prescribed to be used 2 times as decoction in the morning and night. The duration of the intervention was 2 weeks. The eligible participants were randomly assigned to the intervention and control groups using balanced block randomization with a block size of ten. The control group did not receive any placebo. Data collection tools in this study included demographic information questionnaire, Beck Depression and Spiel Berger Anxiety Inventory. Chi-square test and independent t-test were used to analyze the data. The significance level was considered 5 %.The two groups were similar in terms of age, gender, educational level and marital status and there was no significant difference. The mean score of depression in the intervention group before and after drinking lavender herbal tea was 17.80 ± 1.49 and 16.33 ± 1.49, respectively. The mean score of depression between intervention and control groups after drinking herbal tea were 16.33 ± 1.49 and 18.33 ± 1.84, respectively. This indicated the effect of herbal tea on reducing depression (P 0.001). Also, mean difference of intervention and control groups after drinking herbal tea in terms of depression and anxiety (state and trait) were (-2.00, 95 % CI (-2.86, -1.13)), (-6.40, 95 % CI (-9.43, -3.36)) and (-4.13, 95 % CI (-7.66, -0.60)), respectively.The results of the present study showed that consumption of lavender herbal tea can reduce depression and anxiety scores and since it is inexpensive and accessible, it is suggested to be used as a complementary treatment in reducing anxiety and depression.

Hospital employees' turnover is one of the problems with which both public and private organizations have been faced for many years. Employees' turnover can cause many organization's investments in employees to be wasted and the stability and continuity of the organizational activities to be undermined. The present study aimed to investigate the effects of social support and mediating factors on the turnover intention of administrative and financial employees working in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Iran, using structural equation modeling in 2017. This was an applied, cross-sectional, and descriptive-analytic study conducted on the administrative and financial employees working in the teaching hospitals affiliated to Shiraz University of Medical Sciences in 2017. The results showed that the proposed model remarkably explained "turnover intention," and the overall validity of the model was confirmed. Accordingly, 15 of 21 study hypotheses were supported. Moreover, the results showed that social support had an indirect significant association with the hospital employees' turnover intention and could decrease it through increasing the employees' organizational commitment, psychological empowerment, and core self-evaluation and reducing their job stress and job burnout (P < .05). To reduce the hospital employees' turnover intention in hospitals, employ suitable and qualified individuals for the positions, provide training courses such as stress management, improve better interactions and mutual cooperation among managers and employees, provide job security and job enrichment, and create a comfortable and relaxed working environment.

The status of public resources in health has a positive and direct impact on this sector's outcomes because of its effect on the increase of social services. The government's ability to manage health expenditures greatly depends on identifying the determinants of these expenditures. Therefore, this study aimed to determine factors affecting the government health expenditures and estimate the related function in Iran during 2006-2011 using panel data. This was a cross-sectional and time-series study that was conducted using panel data analysis. In this study, the data were collected and categorized separately for each province from documents in the Ministry of Health and the Statistical Center of Iran. The results showed that there were positive associations between health expenditures and some factors including age group of 20 to 39 years (P = .04), the number of women (P = .001), the number of physicians, the number of hospital beds, and annual budget (P < .001). According to the results, it seems that allocating a part of health subsidies for increasing the insurance coverage of the age group of 20 to 39 years and also starting saving accounts can have an important effect on reducing health expenditures of this age group.

Today, postgraduate students experience a variety of stresses and anxiety in different situations of academic cycle. Stress and anxiety have been defined as a syndrome shown by emotional exhaustion and reduced personal goal achievement. This article addresses the causes and different strategies of coping with this phenomena by PhD students at Iranian Universities of Medical Sciences. The study was conducted by a qualitative method using conventional content analysis approach. Through purposive sampling, 16 postgraduate medical sciences PhD students were selected on the basis of theoretical sampling. Data were gathered through semistructured interviews and field observations. Six hundred fifty-four initial codes were summarized and classified into 4 main categories and 11 subcategories on the thematic coding stage dependent on conceptual similarities and differences. The obtained codes were categorized under 4 themes including "thesis as a major source of stress," "supervisor relationship," "socioeconomic problem," and "coping with stress and anxiety." It was concluded that PhD students experience stress and anxiety from a variety of sources and apply different methods of coping in effective and ineffective ways. Purposeful supervision and guidance can reduce the cause of stress and anxiety; in addition, coping strategy must be in a thoughtful approach, as recommended in this study.

This study was undertaken to determine the effects of transformational leadership (TL) and mediating factors on organizational success (OS) from the administrative, financial, and support employees' perspective in teaching hospitals affiliated with Shiraz University of Medical Sciences using structural equation modeling. Three hundred administrative and financial employees were selected, using stratified sampling proportional to size and simple random sampling. Data were collected using 5 questionnaires and analyzed using SPSS 21.0 and Lisrel 8.5 through Pearson correlation coefficient and path analysis and confirmatory factor analysis methods. Results showed that TL had significant positive effects on the 3 mediating factors, including organizational culture (t = 15.31), organizational citizenship behavior (OCB) (t = 10.06), and social capital (t = 10.25). Also, the organizational culture (t = 2.26), OCB (t = 3.48), and social capital (t = 7.41) had significant positive effects on OS. According to the results, TL had an indirect effect on OS. Therefore, organizations can achieve more success by strengthening organizational culture, OCB, and social capital through using transformational leadership style. Therefore, in order to increase OS, the following recommendations are made: supporting and encouraging new ideas in the organization, promoting teamwork, strengthening intergroup and intragroup relationships, planning to strengthen and enrich the social and organizational culture, considering the promotion of social capital in the employee training, establishing a system to give rewards to the employees performing extra-role activities, providing a suitable environment for creative employees, and so on.

Wolcott-Rallison syndrome is a rare disease presenting with insulin-dependent diabetes mellitus (DM) before 6 months old, skeletal dysplasia after 6 months old, and liver failure. Other manifestations are renal failure, microcephaly, epilepsy, central hypothyroidism, neutropenia, and dental and dermal problems. The cases were 2 patients from 2 different states of Iran (Khoozestan and Fars) who had developed DM before 6 months old. The first one was a 7-month-old infant who was healthy; in the genetic study (screening), autosomal recessive pattern and novel deletion in EIF2AK3 were reported; her sister had died at 5.5 years old due to diabetic ketoacidosis (DKA) that was associated with liver and renal failure. The second patient had developed DKA at 45 days old, which was associated with mild acute tubular necrosis and abnormal coagulation tests at onset clinical presentation, which were then resolved. He was treated with insulin, and at follow-up, the laboratory data are normal; in the genetic study, EIF2AK3 nonsense homozygous mutation was diagnosed. Genetic study of patients with insulin-dependent DM before 6 months old, especially those with DKA and associated with or without other disorders; attention to novel deletion of in EIF2AK3 gene; screening for skeletal dysplasia after 1 year old; and renal, liver, pancreatic, and thyroid function tests are recommended.

Problem-based learning (PBL) has become a distinct approach in learning. To assess the effectiveness of PBL in teaching ethics to medical students and the effect it has on their ethical reasoning, we decided to hold a PBL ethics workshop and then evaluate them based on pretest and posttest. This quasi-experimental comparative study in Shiraz University of Medical Sciences was designed based on pretest-posttest nonequivalent groups. After obtaining their consent, 120 health care providers were randomly selected and assigned in 4 groups and then asked to attend the ethics workshop. For measuring the participants' ethical reasoning through pretesting and posttesting, a case study consisting of 21 multiple-choice questions (cognitive domain-apply level) was performed. Data were then collected using a questionnaire, which was completed by the participants and analyzed using SPSS software (version 17). The comparison between the participants' attitude and knowledge toward ethics before and after the workshop revealed that all indices in the cognitive domain were changed (P < .001). The scores of pretest and posttest were significantly different. As to the results of our study, the PBL groups showed a more positive learning attitude and higher motivation in comparison with the control group who were subjected to traditional-based method of learning. The result of our study suggests that PBL can and should be used as an alternative method in teaching ethics in medical students because it is more effective and motivates the students.

Nurses are the largest group and an important part of the providers in the health care systems that who a key role in hospitals. Any defect and deficiency in their work can result in irreversible outcomes. This study aimed to determine the effect of supervisors' support and mediating factors on the job performance (JOBPER) of 400 nurses working in the teaching hospitals affiliated to Shiraz University of Medical Sciences, using structural equation modeling. The results showed that the supervisor's support had a significant negative effect on work-family conflict (t = -2.57) and a positive effect on organizational commitment (t = 4.03); Work-family conflict had a significant positive effect on job stress (t = 11.24) and a negative effect on organizational commitment (t = -3.35) and JOBPER (t = -2.29). Family-work conflict had a positive effect on job stress (t = 4.48) and a negative effect on organizational commitment (t = -2.54). Finally, job stress had a negative effect (t = -3.30), and organizational commitment showed a positive effect (t = 5.96) on the studied nurses' JOBPER. According to the results, supervisor's support could influence JOBPER through reducing work-family conflict and increasing organizational commitment. Therefore, to improve the nurses' JOBPER in the hospitals, some strategies are recommended.

Childbirth is a great moment in a woman's life and is inevitably influenced by emotional, social, and psychological stress. This study aimed to assess the anxiety and pain level of nulliparous women giving birth using physiological methods (without doula support) during labor and those women supported by a doula at Towhid Hospital of Jam, Bushehr, Iran in 2015. In this interventional study, 150 women were randomly assigned to either an intervention (with doula support) or a control group (with no doula support). The intrapartum, postpartum, and hidden anxiety levels were measured using Spielberger standard questionnaire used for assessing anxiety. The labor pain rate was evaluated using McGill questionnaire. Results showed that the average rate of obvious anxiety during labor was 57.76 ± 9.57 in physiological delivery (without doula) and 48.04 ± 9.61 in doula-supported delivery. The difference between mean scores of obvious anxiety during labor was significant. The mean anxiety of the control group (who did not receive doula support) was higher (P = .000). Also, the difference between the mean labor pain scores of the 2 groups was statistically significant. The results of the study showed that doula's presence has positive significant effects on labor pain and anxiety reduction; also, doula-supported mothers reported considerably lower pain and anxiety compared with those experiencing physiological delivery (without doula). Thus, the increased use of doula in hospitals all over the country is recommended.

Service quality is the most important factor in the success of health care organizations; because of their vital and important services, even very small errors can be followed by great and irreparable harm and damage. This study aimed to assess the quality of services provided in the teaching hospitals affiliated to Shiraz University of Medical Sciences in 2015. This is an applied, cross-sectional, and descriptive-analytical study conducted in 2015 in the teaching hospitals affiliated to Shiraz University of Medical Sciences. A sample of 290 inpatients with at least 2 days of admission to hospital was selected using stratified sampling proportional to size and simple random sampling methods. The results showed that there were significant negative gaps in all dimensions (P > .001), and the highest and lowest means and SD of negative gaps were related to empathy (-1.35 ± 1.4) and assurance (-0.52 ± 0.95). Moreover, the results showed that there was a significant negative correlation between the patients' age and the total mean of the patients' expectations. According to the results, the studied hospitals had not been able to meet the expectations of their patients in any of the service quality dimensions. Therefore, to improve the service quality dimensions, the authors recommend holding training courses on how to interact with patients and meet their needs, providing adequate and proper information about the diseases and their treatment for the patients, having adequate medical staff, and so on.

Nowadays burnout is a common issue in all health systems and therapeutic professions. Burnout is caused by job stressors and results in reduction in output, increase in absenteeism and health expenses, behavioral changes, and sometimes drugs abuse. Nonetheless, people who have hardy personalities experience less exhaustion. The present research aimed to present a causal model of antecedents with burnout to emphasize the intermediate role of hardy personality in the nurses working in the public hospitals of Shiraz, Iran. The study data were collected using the Nursing Burnout Scale questionnaire (Int J Nurs Stud. 2008;45(3):418-427). In addition, the structural equation method was used as a model in order to determine the relationship between the variables. The suggested pattern in this research was checked by Leasrel software, version 8.5. The study results showed that antecedents, such as incorrect supervision, responsibility, and workload, have a significant effect on burnout. However, mediated hardy personality had no effect on burnout. The results also showed that the people who had hardy personality could manage the stressful situations well and, consequently, rarely experience burnout. Overall, if the job stressors are existent in the job environment and the individuals cannot eradicate them, they will cause burnout outbreak.

This cross-sectional and descriptive-analytic study aimed to estimate the demands for the use of dental services by Shirazi inhabitants in Iran from June 2013 to October 2013. Six hundred eighty subjects older than 18 years were selected from among the people living in Shiraz, using a multistage sampling method. The collected data were analyzed using SPSS 16.0 and Stata 11.0. The results showed that the factors affecting the number of referrals to the dental services centers and the use of these services included the age groups of 28 to 37 and 38 to 47 years, household expenses per month, and having supplementary health insurance coverage (P < .05). According to the results, in order to improve access to dental services and increase the probability of utilizing such services by people in need, the researchers recommend that the authorities should design and develop basic and supplementary health insurance plans to cover different types of dental services, allocate subsidies to dental health services, and increase the knowledge of all the people in different age groups about adherence to dental health principles and prevention of oral and dental diseases.

Adherence to fluid restrictions and dietary and medication guidelines is important for adequate management of hemodialysis (HD) patients. This study aimed at assessing the factors suggestive of adherence in uremic patients on HD. Two hundred HD patients were recruited by census method. Data on blood urea nitrogen (BUN), serum potassium and phosphate levels, and interdialytic weight gain (IWG) were collected from medical records and analyzed. Most of the patients (56%) did not adhere to fluid restrictions. Nonadherence to phosphate, potassium, and BUN levels was 25.5%, 5.5%, and 4.5%, respectively. In addition, there was a relationship between BUN, serum potassium and phosphate levels, and IWG with educational status (p ≤ .05). However, there was no correlation between BUN, serum potassium and phosphate levels, and IWG with sex, age, financial status, marital status, and duration of dialysis (p > .05). Based on the results, most of the patients adhered to dietary and medication regimens. Educational level of the patients was associated with adherence to fluid restriction. It was concluded that dietary compliance may be improved by using dietary counseling techniques and that education motivates patients to change and comply with dietary recommendations.

A study was undertaken to determine the effect of educational intervention on parents' knowledge and performance of the social needs of the healthy siblings of the pediatric leukemia patients. Inadequate care and attention to siblings of pediatric leukemia patients might result in psychosomatic disorders. Parents' knowledge on prevention of such disorders is of great importance. The study proposed to determine the effects of educational intervention concerning parents. Sixty parents of pediatric leukemia patients entered this study. The subjects were selected using convenient sampling method and were randomly categorized into 2 groups: experimental and control. Data were collected before, 1 hour after, and 2 months after the intervention, using a questionnaire. The educational program was arranged in 3 sessions, each lasting 45 to 60 minutes using group discussion and lectures for the parents of the experimental group. Then, the parents were instructed individually, if necessary. The mean scores of the parents' knowledge in the experimental and control groups before the intervention were 5.8 and 6.2, respectively. One hour after instruction, the mean rose to 12.8 and 6.4, and 2 months later to 13.3 and 6.5 (p < .00l). The family performance of 87.2% of the parents in the experimental group and 36.4% of the control group toward the siblings of the sick child was appropriate 2 months after the intervention. Therefore, educational intervention increased the knowledge of the parents of pediatric leukemia patients about the needs of the healthy siblings and how to meet them. It is recommended that educational programs be arranged for parents so that the quality of life in the healthy children can be improved.

AIM To measure the relationship between job satisfaction and the 3 components of organizational commitment. BACKGROUND Most of the research conducted in the West has shown a positive relationship between organizational commitment and job satisfaction of nurses; however, the relationship between the components of organizational commitment and job satisfaction is not well established in Iranian samples. This study aimed to investigate the level of organizational commitment and job satisfaction of the hospital nurses in Iran and the interrelationship between the 3 components of commitment and job satisfaction among them. METHOD Using the organizational commitment questionnaire developed by Meyer et al (J Appl Psychol. 1993;78:538-551), the 3 components of commitment were measured through a descriptive correlational design. Seven hundred eighty-six licensed nurses working in 12 hospitals participated in the study. One hundred ninety-eight of 220 returned questionnaires were identified as appropriate for the analysis. RESULTS Affective commitment was positively related to job satisfaction, normative commitment, and experience in nursing, but it was negatively related to continuance commitment. Continuance commitment was negatively related to job satisfaction and affective commitment. Normative commitment was positively related to job satisfaction and affective commitment. CONCLUSION AND IMPLICATION The 3 components of commitment are variously related to job satisfaction. Nursing managers should pay attention to different components of commitment variously to promote the appropriate type of commitment needed for specific situation in which they work.

This study developed and tested a research model that examined the effects of supervisor support (SUPPORT), work-family conflict (W-FCON), family-work conflict (F-WCON), and job stress (JSTRESS) on a number of selected consequences using data collected from nurses and nurse axillaries in Shiraz University of Medical Sciences hospitals in Fars province (south of Iran). The results demonstrated that W-FCON and F-WCON exerted a significant positive influence on JSTRESS. Contrary to the study hypothesis, the results did not provide any empirical support for the significant negative relationship between W-FCON, F-WCON, and JSTRESS with family satisfaction (FSAT). The findings further revealed that higher JSTRESS led to lower life satisfaction (LSAT). As expected, high levels of FSAT resulted in increased LSAT. However, this study failed to find significant negative relationships between conflicts in the work-family interface and LSAT. The results also revealed that JSTRESS was not significantly associated with LSAT. Consonant with the study hypotheses, W-FCON, F-WCON, and JSTRESS were found to be significant for turnover intentions, whereas LSAT did not. Implications for managers and future research directions are presented.

The quality of life of patients with end-stage renal disease is an important indicator of disease burden. To achieve a better quality of life, some medical treatment might be replaced by other approaches. The aim of this study was to compare the quality of life of renal-transplanted and hemodialysis patients in Iran. Two hundred hemodialysis and 200 renal transplantation patients were recruited from 5 major hospitals and renal patients' support society in Tehran, Iran. The data were collected using the Persian versions of the Ferrans and Powers Quality of Life Index-Dialysis and Transplantation Version. The quality-of-life mean scores of renal transplantation patients were significantly better compared with those of the hemodialysis patients (21.36 [SD, 4.06] vs 20.35 [SD, 5.14]; P = .03). The questionnaire demonstrated significant differences in health/functioning and familial subscale of quality of life between the transplanted and hemodialysis patients (p < .05). The better quality of life of transplant patients, in comparison with hemodialysis patients, is an important reason for advising kidney transplants in renal failure patients. To improve the patients' quality of life, kidney transplantation might be effective for the end-stage renal disease. With regard to socioeconomic problem in most of the patients with renal failure, comprehensive insurance and referral to renal and transplanted patients' support society are suggested for those who have undergone different renal replacement therapies.

This cross-sectional study evaluated the prevalence of major depressive disorder and depressive symptoms in children and adolescents after renal transplantation. A total of 71 patients who had undergone renal transplantation were interviewed in person using the Farsi (Persian) version of the Kiddie Schedule for Affective Disorders and Schizophrenia and Diagnostic and Statistical Manual of Mental Disorders diagnostic criteria. Major depressive disorder, depressive symptoms, and suicidal behaviors were assessed. The rate of major depressive disorder was 2.8%; two-thirds of the patients had irritability; and approximately 40% had recurrent thoughts of death and suicidal ideation. The rate of major depressive disorder was lower than in other chronic diseases such as thallasemia or hemophilia; however, the rate of suicidal behaviors was high.

Team-based learning is designed to provide students with both conceptual and procedural knowledge, aiming to enhance active learning and critical thinking. In the present study, team-based learning and lecture methods in teaching the “hospital organization and management” course among hospital management students were compared. This quasi-experimental study was conducted on 25 undergraduate students of management. Teaching sessions were divided into two parts. The first part was taught with interactive lectures and the second part with team-based learning method. The students' knowledge was measured before, immediately and two months (late post-test) after teaching. Finally, the mean scores of the final exam and students' satisfaction towards the methods of teaching were measured. There was an improvement in test scores of the students after the TBL sessions when compared to the test scores after lecture sessions (P