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Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Methods: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after the intervention. Data were analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.

Sense of humor constitutes a part of everyday life and work and an indispensable part of healthcare. However, the relationship between sense of humor and nursing occupational health and stress is yet to be studied in Iran. This study aimed to analyze the interplay of demographic factors, occupational stress, sense of humor, and health status of nurses working at the hospitals affiliated with the Ahvaz Jundishapur University of Medical Sciences, Iran. In this descriptive-analytical study, the statistical population consisted of 203 nurses. Occupational stress was assessed using the Iranian version of the Effort-Reward-Imbalance (ERI) Questionnaire. The Sense of Humor Questionnaire (SHQ) and the Iranian version of the 12-item General Health Questionnaire (GHQ-12) were employed to assess the sense of humor and physio-psychological health, respectively. Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) software. 81% (n=164) of the participants had an “external effort” (E) and “reward” (R) ratio greater than 1, indicating very high occupational stress. 39% (n=79) nurses with high occupational stress displayed their commitment to the workplace. Approximately 42% (n=85) of nurses were suffering from health problems. The mean humor score of participants was 2.90±0.41. Major life events over the past 3 months (p

Objective: Spiritual intelligence is manifested when a person spends his life in complete spirituality. Anxiety and test anxiety are among the most common psychological and emotional problems during student life that have a negative impact on students' mental health and academic performance. Therefore, this study was conducted to explain the role and relationship between spiritual intelligence and hidden anxiety and test anxiety. Methods: This analytical study was performed on 503 nursing and midwifery students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (2018) using the available sampling method. King spiritual intelligence scale, Sarason's test anxiety scale, and Spielberger Anxiety Questionnaire were used to collect data. To analyze the data, statistical methods of path analysis and correlation coefficients were used. Results: The overall effect of test anxiety variable on spiritual intelligence variable is 0.1632 and the overall effect of hidden anxiety variable on spiritual intelligence variable is -0.07. Spiritual intelligence has a significant relationship with test anxiety, so that with increasing mental intelligence, test anxiety is decreased. While in the case of significant relationship between spiritual intelligence and hidden anxiety, with increasing spiritual intelligence, hidden anxiety is also increased. There was no significant relationship between hidden anxiety and test anxiety. The two variables of hidden anxiety and test anxiety have a very weak effect on spiritual intelligence. The effect of hidden anxiety is not significant at all, and the effect of test anxiety is very weak, although being significant. Conclusion: High spiritual intelligence indicates lower test anxiety, while it is inversely related to hidden anxiety. As a result, high spiritual intelligence does not indicate less hidden anxiety in individuals. So it cannot be said for sure that spiritual intelligence plays an important role in reducing anxiety.

Background Managing the amount of use of sedatives due to their high side effects in the intensive care unit is essential. Sedation-agitation protocols may play an important role in this regard. However, they have not been practically applied in Iran. Aims This study aimed to evaluate the effect of using the Richmond agitation and sedation scale on hospital stay duration and dependency rate on the intensive care unit ventilator system in Ahwaz City, Iran, in 2016–2017. Methods This randomised clinical trial was conducted on 74 patients. The subjects were selected by a stratified sampling method and divided into the experimental ( n = 32) and control ( n = 32) groups. Sedation and agitation levels were managed by the Richmond agitation and sedation scale as soon as the samples were anxious and agitated, and every 6 hours in the intervention group. However, the control group received routine care. The data obtained were analysed by the Statistical Package for the Social Sciences (SPSS). Results There was no significant difference between the two groups in terms of demographic variables, such as age, gender, admission diagnosis and Glasgow coma scale scores on admission. However, they differed in terms of hospital stay duration and ventilator connection ( P Conclusions Based on the results of this study, as well as the approval of validation and reliability of the Richmond agitation and sedation scale in different studies, this protocol can be very effective in optimising the use of sedatives in the intensive care unit.

Background End-of-life care education is required for nurses to acquire the clinical competence necessary for the improvement of the quality of end-of-life nursing care. The aim of this study was to determine the effect of nursing care education based on End-of-Life Nursing Education Consortium (ELNEC) on the knowledge and performance of nurses working in the intensive care unit (ICU). Materials and Methods This quasi-experimental, randomized, controlled trial was conducted with a pretest-posttest design. From among nurses working in the ICU of Golestan and Imam Khomeini hospitals in Ahvaz, Iran, 80 nurses were selected bsed on the inclusion criteria. They were randomly assigned to the intervention and control groups (40 people in each group) using a table of random numbers. Data were collected using a demographic characteristics form, the ELNEC Knowledge Assessment Test (ELNEC-KAT), ‎and the Program in Palliative Care Education and Practice Questionnaire (German Revised Version; PCEP-GR‎). Results A significant difference was observed between the study groups in terms of the average knowledge score in all 9 modules including nursing care, pain management and control, disease symptom management, ethical/legal issues, culture, communication with the patient and his/her family, loss and grief, death, and quality of life (QOL) (P < 0.001). Moreover, the average performance score of nurses in the fields of preparation for providing palliative care, self-assessment of ability to communicate with dying patients and their relatives, self-assessment of knowledge and skills in palliative care increased significantly in the intervention group compared to the control group (P < 0.001). Conclusions End-of-life nursing education is recommended as an effective method for promoting knowledge, attitude, performance, and clinical competence among all nurses involved in end-of-life care.

PURPOSE: Comparison of two safe complementary medicine methods to treat cancer-related pain and fatigue in adult patients with acute leukemia during active treatment with chemotherapy. METHODS: A randomized trial with three groups (light massage, music therapy, and standard care) in Ahvaz, Iran, between 2018 and 2019. A total of 104 participants of the massage and music therapy groups received 15-minute intervention sessions, thrice weekly for 4 weeks, and participants of the control group received standard care. Cancer-related pain and fatigue intensity were measured by numeric self-report rating scales. During the 4 weeks of the interventions, pain and fatigue intensity were measured weekly. All the groups were followed up for 2 weeks after the end of the intervention. RESULTS: Pain and fatigue intensity decreased significantly over time between the intervention groups compared with the standard care group. In the massage and music therapy groups, a progressive reduction of pain and fatigue intensity over time (from the baseline to the fourth week) was observed. Fatigue intensity did not differ between the two intervention groups. Pain intensity decreased more in the massage group compared with the music therapy group. The durable effects of the massage therapy were greater compared with the music therapy 2 weeks after the intervention was completed. CONCLUSION: Light massage was more effective and persisted longer than the music therapy for controlling leukemia-related pain and fatigue in adult patients with acute leukemia.

Background cancer is one of the most common causes of death around the world. The process of this disease and the resulting complications reduce the quality of life of cancer patients. Taking the necessary measures for improving the quality of life of these patients seems to be essential. This study was performed to investigate the effect of integrated educational program on the quality of life of cancer patients. Method in this clinical trial study, 64 patients hospitalized in the specialized cancer hospital affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran, were selected according to the inclusion criteria. Then, through blocked randomization method, they were assigned into intervention and control groups. The intervention group received the necessary trainings over four 60-min sessions (one session per week). The data collection in this study included demographic questionnaire and quality-of-life questionnaire of cancer patients (QLQ-C30). The quality of life was examined before the training as well as one and two months after the training. The data were analyzed by SPSS 20. Independent t-test was used to compare the means of the life quality dimensions of the studied groups. Results all of the functional dimensions [physical , role function , emotional , cognitive , social(P≤0.05)] and symptomatic [fatigue , nausea and vomiting, pain , dyspnea , sleep disorders, diminished appetite, constipation, and diarrhea (P≤0.05)] of the quality of life of the intervention group increased significantly one and two months after running the integrated educational program. Conclusion integrated training causes improved symptoms and enhanced quality of life in cancer patients. Thus, it is recommended that integrated training be conducted alongside the routine care of cancer patients. This can improve the therapeutic outcomes, and also highlights the important role of nurses as well as nursing cares.

Background: The effective design and implementation of the nursing interventions to evaluate the patients' readiness for ventilator weaning will reduce their connection time to the ventilator and the complications of their connection to it. This study was conducted to examine the effect of nursing interventions based on the Burns Wean Assessment Program (BWAP) on successful weaning from Mechanical Ventilation (MV). Materials and Methods: In this clinical trial, 70 patients undergoing MV in the Intensive Care Units (ICUs) of Golestan Hospital (Ahvaz, Iran) in 2018 were randomly assigned to intervention and control groups. The nursing interventions designed based on BWAP were implemented on the patients in the intervention group, who were later weaned from the device according to this program. The recorded data included demographic information, BWAP score, vital signs, and laboratory values, which were analyzed using the Pearson correlation coefficient, Chi-Square, Fisher, and Mann-Whitney U tests. Results: There was a statistically significant and inverse correlation between the BWAP score and the MV duration such that a high BWAP score was associated with a shorter MV time (p = 0.041). Also, the mean number of re-intubation (p = 0.001) and the number of re-connection to the ventilator in the intervention group were significantly lower (p = 0.005). Conclusions: The results showed that nurses' assessment of patient's readiness for weaning from MV based on this tool and designed nursing care reduced the duration of MV, re-intubation, and re-connection.

Introduction: The aim of this paper is to evaluate the awareness of ordinary people about relief operations and accurate cardiopulmonary resuscitation when facing out-of-hospital cardiac arrest. Methods: This was a cross-sectional study including 500 ordinary people who were randomly selected over a 3-month period in Ahvaz County, Ahvaz, Iran, and then asked to perform resuscitation operation on medical moulages. Their performance was then evaluated using a 21-item checklist. Results: The awareness of participants about relief operations were only acceptable in 9 cases. Only 1 (0.2%) of them was able to detect a pulse and blood circulation as well as to relieve any airway obstruction. 7 (1.4%) were able to correctly find the position on the chest where external cardiac massage (ECM) should be performed. And only 1 could perform ECM at a rate of 100-120 compressions/min. Conclusion: Results obtained from the present study does not confirm the awareness of ordinary people when encountering OHCA. Hence, it is essential to hold related training courses at appropriate intervals to improve their skills and knowledge.

Introduction: The optimal performance of a healthcare organization is one of the effective factors in increasing the efficiency and productivity of nurses and thus reducing their burnout. The aim of this study was to investigate the role of organizational management on nurse burnout based on experiences from Iranian nurses working in psychiatric wards. Materials and Methods: This qualitative study was conducted on 15 nurses working in psychiatric wards selected through purposive sampling. Data collection was done through in-depth semi-structured interviews in psychiatric wards in Ahvaz (southwest of Iran) and Tehran. Data analysis was done through conventional content analysis. Results: The findings included one main category and three subcategories. The main category was “Providing care at an inadequate organization,” and the three sub-classes namely “Shortages of human resources,” “Shortage of physical resources,” and “Impact of management approaches to care provision” were extracted. Conclusion: The results of this study showed that inadequate supply of equipment and human resources along with ineffective managerial approaches in the organization could lead to mental and emotional exhaustion, negative attitudes toward the profession, decreased and poor service quality, employee turnover, and early retirement of nurses in psychiatric wards. Therefore, by adopting appropriate policies in their programs, paying special attention to the physical and mental health of nurses, and addressing their problems, managers of healthcare organizations can motivate and sustain the human resources within the organization.