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Abstract Background The global phenomena of an increasing older population within the total population and the rise in urban older residents have prompted numerous studies on the indicators of an age-friendly city in various Iranian cities. The insights obtained from these studies can aid policymakers in promoting social justice for older adults. Thus, this study aimed to investigate the status of age-friendly city indicators across different cities in Iran. Method/design A systematic review was conducted by searching for studies in Persian and English databases until March 2024, including Pubmed, Web of Science, Scopus, Cochrane, Google Scholar, and ScienceDirect, using keywords such as “age-friendly”, “elderly-friendly”, “cities”, “older adults”, “aging”, “elderly”, “indicators”, “components”, “criteria”, “features”, “characteristics”, “indexes”, “Iran”, and “urban space”, along with their MeSH equivalents, employing “AND” and “OR” operators. Additionally, Persian databases such as Magiran and SID were extensively searched using keywords like “elderly-friendly”, “city”, “urban spaces”, “Iran”, “indicators”, “components”, “features”, and “criteria”. The references of the final articles were also examined to ensure search accuracy. The results from the studies on the indicators of an age-friendly city were reviewed, summarized, and ultimately reported. Results The initial search yielded 2857 articles, of which 34 were included in the systematic review. Only two studies addressed the indicators based on the needs of the older adults, with the majority reporting unfavorable urban conditions for the older adults. Despite these unfavorable conditions, the index of open spaces and buildings received the highest rank among the examined indicators. However, two indicators—respect for older adults, social acceptance, civic participation, and employment— did not perform well in any study. Conclusion The findings indicated that Iran failed to meet the required standards for age-friendly cities. Therefore, it is recommended that policymakers in the field of geriatric health take measures to identify and mitigate environmental risk factors for older adults. Trial Registration This systematic review was registered on the Prospero database with the number CRD42023475657 on date 8 November 2023.

Objectives: This study aimed to assess the age-friendly indicators in Kashan City, Iran in 2022.Methods: This cross-sectional study was conducted in four districts of Kashan City, Iran. Researchers randomly selected 80 locations and used a specific checklist for observation. Data analysis was performed using descriptive statistics.Results: Outdoor buildings and offices scored a mean of 8.95±2.25 out of 20 (range 5-14, 95% CI: 8-10.05), indicating an average condition. Urban roads and transportation scored 6.10±2.34 out of 20 (range 5-10, 95% CI: 5.8-7.0), also showing an average condition. Parks and public spaces received a score of 7.57±1.5 out of 16 (range 6-11, 95% CI: 6.8–8.1), reflecting an average condition. Religious places scored 10.09±2.6 out of 12 (range 7-11, 95% CI: 9.2–10.3), indicating a good condition.Conclusion: The majority of outdoor buildings and offices, urban roads and transportation, as well as recreational and religious spaces in Kashan City do not meet the necessary standards for an age-friendly environment. These findings highlight areas that require improvement to enhance the health, activity, and quality of life for the elderly population.

Abstract Background Losing a child at an old age while also facing health problems and physical limitations can have significant negative impacts on parents’ lives such as anxiety, depression, and impairment in social functions. The process of coping with the death of a child is particularly unknown among older adults. Therefore, this study aimed to explore how older adults cope with the death of their child. Method This qualitative study was conducted in 2020–2021, using Corbin and Strauss (2015) approach to the grounded theory method. The sampling began purposefully and continued theoretically until theoretical saturation was achieved. Semi-structured interviews were conducted to collect data from Iranian older adults who had experienced the death of their child. To ensure data trustworthiness, the Guba and Lincoln (1985) criteria were utilized. A qualitative data analysis software, MAXQDA2020, was used to manage the data. Findings The results of this study were obtained from 27 participants. The main concern of older adults was the fear of their lives collapsing following the death of their child. Participants utilized three main strategies to address their concerns: attempting to rebuild themselves, connecting to a higher power, and searching for positivity amidst grief. The central category that emerged from the analysis was “improving physical, mental, and spiritual capacities,” resulting in personal growth and improved social relationships. Conclusions Through the use of the three aforementioned strategies, older adults were able to overcome their primary concern of the fear of their lives collapsing following the death of their child. Further development of the theory is suggested in order to design a model that can facilitate older adults’ coping with this difficult life event.

Abstract Background Aesthetics of everyday life are associated with the physical, mental, and social health of older adults, leading them to experience a successful old age. This study aimed to examine the aesthetics of everyday life and its related factors among older adults in Kashan from 2021 to 2022. Methods This cross-sectional study consisted of 350 older adults who were referred to Urban Comprehensive Health Service Centers (UCHSC) in Kashan. Sampling was done by a two-stage method (cluster, random). The data collection was performed with a background information questionnaire and the Elderly’s Perception of Everyday Aesthetics scale (EPEA-S). Data were analyzed using an independent t-test, analysis of variance, Pearson’s correlation coefficient, and multiple linear regression tests in the SPSS software. Results The mean age of the participants was 69.56 ± 6.63 years. The mean score of aesthetics of everyday life in older adults was 133.02 ± 14.73, with the family and others subscale receiving the highest score. The univariate test indicated a statistically significant correlation between age, employment status, education, income, smoking, social activities, physical activities, interest in artistic works, and the aesthetics of everyday life in older adults (P

Background: Compassion fatigue (CF) is a progressive process of absorbing patients’ pain and suffering resulting from caring interactions between caregivers and patients. Since compassion fatigue is strongly influenced by cultural and ethnic differences, the question arose, "How do Iranian deal with CF?”Objectives: This study aimed to obtain a deep understanding of Iranian nurses’ strategies in dealing with CF.Methods: The study was conducted using the conventional content analysis method. Purposive sampling was conducted to select clinical nurses working in hospitals of Tehran and Kashan Universities of Medical Sciences, Iran. Using semi-structured face-to-face interviews, data were collected from 13 nurses who had experienced CF. Data analysis was performed according to the steps proposed by Graneheim and Lundman. To prove the trustworthiness of the data, the four criteria of credibility, dependability, confirmability, and transferability were used.Results: Participants included 13 nurses whose average age was 31 years. Three categories emerged from the participants' experiences, namely "creating a work-life balance," "trying to ignore," and "use of support circle." All categories were placed under the theme of “struggling to survive in a turbulent workplace”.Conclusion: Nurses make lots of effort to deal with CF in personal and social levels. Healthcare managers can help nurses by providing them with more support, such as spiritual and organizational ones.

Many articles published in this esteemed journal are related to aging issues such as physical resilience,[1] fear of falling,[2] functional independence and life satisfaction,[3] and social health[4] of older adults. These issues, which greatly affect the social participation and health of older adults, are largely related to city conditions and structures.Sociality is one of the inherent human characteristics. Active participation in society and human relationships necessitate being part of a community. Nowadays, most people live in cities. It is crucial to uphold principles of justice within urban spaces to fulfill people's social needs.[5] Numerous theories have proposed in this field. One such theory is the "right to the city". The right to the city theory refers to the entitlement of every individual residing in a city to enjoy citizenship rights within the framework of urban spaces. This theory encompasses various social, economic, and political dimensions. This idea initially introduced by Henri Lefebvre in 1968, based on collective urban demands.[6] The components of the right to the city theory include the right to utilize urban spaces (such as physical access, control, and ownership of space, and urban vitality) and the right to participate (including urban decision-making, urban organization, and the production of space/right to urban citizenship). Implementing the theory of the right to the city can lead to significant outcomes such as security, employment, justice, social participation, and the preservation of human dignity for all individuals.[7]This theory aims to address social inequalities within cities under the influence of capitalism. According to this theory, the city is a social structure in which citizens possess rights. Therefore, cities should designed in a way that enables all members of society, regardless of their gender, age, social or economic status, to access available facilities and resources, including urban services, housing, and public spaces. The theory emphasizes the inclusion of all members of society, particularly vulnerable groups. Upholding civil, social, and human rights serves as the central theme of this theory. Latin American urban planners were the first to legalize this concept.[8] Among the vulnerable groups that make up a significant portion of urban populations today are older adults.In response to the growing population of older adults, primarily residing in cities, the concept of age-friendly cities introduced by the World Health Organization (WHO) in 2007. According to the WHO, an age-friendly city encompasses open spaces and public buildings, transportation, housing, social participation, social respect and acceptance, civic participation and employment, communication and information, social support, and health services.[9] The components of an age-friendly city overlap with those of the right to the city theory. However, age-friendly cities specifically focus on older adults and address their unique needs and limitations. Geriatric nursing aims to provide nursing services in various physical, psychological, and social aspects to older adults, supporting their overall well-being. Increasing social participation is a vital indicator of social health among the older adults, as it can significantly affect their resilience and self-esteem.[10] From the perspective of geriatric nursing, achieving cities with age-friendly standards can viewed as part of realizing the goals set forth by the right to the city theory. Both concepts strive to reform cities to achieve social justice, equitable access, and non-discrimination, thereby combatting ageism.[7] However, it is important to note that the right to the city theory encompasses a broader range of individuals in society, pursuing broader political and social goals. Justice, autonomy, and dignity are among the most important ethical principles for older adults, which can significantly influence their quality of life.[11] Environmental characteristics of a city, including physical accessibility to essential locations, environmental safety, adequate recreational and welfare facilities, and affordability, are key requirements that contribute to active aging. If older adults perceive the city environment as unsafe or unsuitable, or if they have negative experiences of community engagement, they may gradually withdraw and become socially isolated, preferring to stay at home.[12]Despite several decades having passed since the introduction of the right to the city theory and the concept of age-friendly cities, these ideas have not thoroughly discussed in an interdisciplinary manner within urban studies. Many of their associated goals have not yet fully realized. Consequently, there appears to be a significant gap between theory and practice, reflecting the persistence of urban disparities and social inequalities affecting the older adults and other age groups.[7]What is clear is that both the right to the city and age-friendly city concepts necessitate the implementation of interdisciplinary policies and actions. Reforming cities to align with these concepts requires the active participation of stakeholders in decision-making processes, interdisciplinary consensus among researchers, and governmental support. Geriatric nurses can play a pivotal role in facilitating successful aging by providing guidance to entities responsible for older adults’ affairs, such as municipalities and welfare organizations. Additionally, establishing dedicated associations for older adults and promoting their active participation in artistic, cultural, and sports activities can contribute to creating a suitable platform for achieving age-friendly cities. Raising awareness about citizenship rights and generating public demand can also expedite the realization of positive changes.

Background: Promoting self-efficacy behaviors in self-care and people's true understanding of these behaviors are effective in controlling the disease, reducing the rate of transmission, and empowering patients. The aim of this study was to determine the effect of telephone counseling on self-efficacy in self-care behaviors of patients with coronavirus disease 2019 (COVID-19). Methods: This experimental study was conducted on patients with COVID-19 who had been referred to Shahid Beheshti hospital in Kashan, Iran, from May 2020 to August 2020. Eligible patients were recruited through convenience sampling and then allocated into an experimental (n=30) and a control (n=30) group using block randomization. In the experimental group, patients were trained through telephone counseling one, five, and 10 days after discharge. The control group received the usual training in the hospital. Data were gathered using a self-care questionnaire at different time intervals. The collected data were analyzed with SPSS software (version 11.5) using the Chi-square, one-way analysis of variance (ANOVA), and t-test. The significance level was set at 0.05. Results: The mean score of self-care at time of discharge and two and four weeks later were 47.86±6.84, 62.23±5.24 and 78.46±3.38, respectively. There was a significant difference in self-efficacy scores between the study groups at time of discharge (P=0.29). In addition, there was a significant difference in self-efficacy scores two weeks (P=0.01) and four weeks (P=0.001) after discharge from the hospital. The self-efficacy score in the experimental group increased significantly over time. Furthermore, group and time had significant effects on the self-efficacy score (P

Background: One strategy that parents use to achieve peace and recovery following the death of a child is to continue bonding with their dead children. Older adults with the death of a child are a vulnerable group, but no study has been conducted on them in Iran. Objectives: The current study aimed to explore the relationship between older adults and their dead children. Methods: This qualitative study utilized the grounded theory method. The data were gathered through purposive sampling during 2020–2021. Semi-structured interviews were conducted with 13 older adults who had experienced a child death. The method of Corbin and Strauss (2015) was used to analyze the data. The Guba and Lincoln criteria were used to ensure the data trustworthiness. The data were managed using MAXQDA12. Results: The participants' mean age was 68.30 ± 7.39 years, and 76.9% of them were female. The findings were categorized into three major categories and nine subcategories. The three major categories of “staying connected with the dead child,” “attempting to seek peace for the dead child,” and “keeping the child's memories alive” emerged from the participants' experiences, along with the theme of “unbreakable bond with the child.” Conclusion: As a protective strategy, the continuing bond between the older parents and their dead children aided in their adjustment. It is suggested that health-care providers facilitate the acceptance of child death in these older adults through providing group counseling and reminiscence sessions.

Background: Despite the vulnerability of older adults and the importance of social support following the death of a child, little research has been conducted on the Iranian older population. This study aimed to explore perceived support among older adults after the death of a child. Materials and Methods: This study was carried out in Iran in 2020-2021 using a qualitative content analysis method. Semi-structured interviews with older adults who had experienced child death were used to collect data. To ensure the data's trustworthiness, Guba and Lincoln's criteria were applied. The Graneheim and Lundman method was used to analyze the data. Results: The participants' mean age was 70.41 years. The findings were organized into one theme, two main categories, and five subcategories based on 352 initial codes. Two main categories emerged from the participants' experiences: “supporting networks” and “giving support to others” with the theme of “healing emotional pain.” Following the death of a child, the older parents perceived support as recuperation from their hurt feelings. Conclusions: Receiving support from family, entourages, and society, as well as providing support to the family and parents with the same experience were protective factors against the effects of child death among older parents. To reduce the consequences of child death, older parents' health should be monitored through home care provided by nurses.

Abstract Background After losing their child, elderly parents look for a meaning in this phenomenon. This meaning comes out from their experiences, and their responses to and actions in life are shaped based on this meaning. Therefore, this study was conducted with the aim of “understanding the meaning of losing a child in older adults.” Methods This qualitative study was conducted using conventional content analysis method. Using semi-structured face-to-face interviews, data were collected from 15 older adults who had experienced of losing their adult child. Data analysis was performed according to the steps proposed by Graneheim and Lundman, 2004. To prove the trustworthiness of the data, credibility, dependability, confirmability and transferability were used. Results The age range of participants was between 61 and 83 years and 73.3% of them were female. The two main categories of “tasting the bitter flavor of life” and “searching for a positive meaning in losing a child” together with the theme of “finding hope in the heart of darkness” were extracted from the participants’ experiences. Conclusions Despite the grief of losing a child, which had cast a dark shadow over the parents’ lives, the child’s liberation from worldly sufferings, his/her presence in a better world, and being hopeful about the grace of God had caused the elderly parents to find hope in the heart of darkness. After identifying the parents with a deceased child, they should be helped through psychological counseling and care of the healthcare team so that they can adapt to this situation by finding a positive meaning in losing their child.

Background: Nurses are the key members of the health-care team and play an important role in the assessment of the patients’ problems. Objectives: This study aimed to investigate Iranian nurses’ self-reported mastery and use of musculoskeletal assessment skills. Methods: This cross-sectional study was conducted from October 2018 to January 2019 on 200 nurses in Shahid Beheshti Hospital of Kashan, Iran. Data were collected using a two-part questionnaire including a demographic data form and 16 self-report items on nurses’ mastery in the assessment of the musculoskeletal system. The levels of self-reported mastery and use of the musculoskeletal assessment skills in patient care were assessed. Data analysis was done using descriptive statistics, independent samples t-tests, analysis of variance, and the Pearson correlation analysis. Results: Nurses obtained 83.25% of the score in the area of using health history taking skills, while they obtained 86.94% of the score of mastery in this field. Furthermore, nurses gained 33.77% of the score in the area of using physical examination skills, while they gained 44.53% of the score of mastery in this area. The most commonly used musculoskeletal assessment skills were “checking the range of motion of the joints” and “checking muscle strength” that were used in 20.5% of cases. However, nurses rarely used specific tests such as the Patrick’s, ballottement, and Lasègue tests. A significant direct correlation was found between nurses’ self-reported mastery in musculoskeletal assessment skills and the use of these skills (r = 0.44, P = 0.001). Conclusion: Despite the desirable levels of nurses’ self-reported mastery and use of history taking skills, the level of their self-reported mastery and use of musculoskeletal assessment skills are not satisfactory.

Background: There are inconsistencies about the best clinical teaching method for strengthening nursing students’ critical thinking (CT). Objective: This study is aimed to compare the effects of the one-min preceptor (OMP) and problem-based learning (PBL) clinical education on nursing students’ CT. Methods: This was a randomized controlled trial. All forty 3rd-year nursing students who had taken the Medical-Surgical Nursing III clinical course were recruited to the study through the census method in 2016 in Kashan University of Medical Sciences, Kashan, Iran. The students were randomly allocated into three groups of 13 to pass their clinical course via the OMP, the PBL, or the conventional clinical education methods, respectively. In the first session and at the end of the last session, the students completed the California CT Skills Test Form B. The one-way analysis of variance and the Kruskal–Wallis and Mann–Whitney tests were used to analyze the data. Results: Students’ mean age was 21.77 ± 1.32 years. There were no significant differences in baseline CT score among the conventional (11.17 ± 1.64), OMP (10.58 ± 1.34), and PBL (10.79 ± 1.18) groups (P = 0.894). However, at the end of the study, the difference among the groups regarding CT score was significant (12.17 ± 1.89, 13.69 ± 1.10, and 13.64 ± 1.44; P = 0.049). Conclusion: OMP and PBL can be potentially effective in improving students’ CT ability. Therefore, these methods can be used in clinical nursing education to improve students’ CT ability.