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Background and objectives: Health-related procrastination refers to a delay in the performance of health-related activities, which is a rather neglected subject despite being critical. Due to the adverse effects of procrastination on the care and treatment of patients with type-2 diabetes, it is necessary to explore procrastination among this group of patients through in-depth studies. The present research was conducted to explain different types of health-related procrastination in patients with type-2 diabetes. Materials and methods: This qualitative study applied content analysis with 13 patients with type-2 diabetes selected via purposive sampling. Data were collected through individual and semi-structured interviews. The data were then analyzed using Lundman and Graneheim content analysis method. Findings: Based on the analysis of the data, instances of health-related procrastination in patients with type-2 diabetes were classified into six main categories, including minimizing self-care, poor adherence to treatment, poor nutritional habits, poor adherence to drug regimen, disregard for disease monitoring, and a sedentary lifestyle. Conclusions: The results of this study provide an in-depth understanding of the various forms of health-related procrastination in patients with type-2 diabetes. These findings can be employed in the design, implementation, and monitoring of treatment and care programs targeting these patients. [ABSTRACT FROM AUTHOR]

Background: The theory-practice gap can be described as a lack of ability to relate the knowledge acquired in academics and research work with practice. This study aims to assess the knowledge and the perception of Nigerian nurses on the theory-practice gap in Nursing. Materials and Methods: This cross-sectional correlational study was carried out with a sample of 196 nurses who were working in the Federal Medical Centre Keffi and Aminu Kano Teaching hospital in Kano, all from the northern part of Nigeria, from April to June 2019. The participants were selected using a convenient sampling technique, where a self-administered questionnaire was utilized to collect the data and analysis was undertaken using SPSS. Results: The results of this study showed that 83.80% of respondents had good knowledge and 89.10% of the respondents had good perceptions. The levels of knowledge were significantly different in correlation with the educational level of respondents (χ2 = 13.88, df = 6, p = 0.022), which was determined using a Fischer exact test. Also, the level of perception was significantly different when considering the nature of work participants undertook (X2 = 7.65, df = 2, p = 0.022). Conclusions: Given the participants' awareness and perceptions in this study, it is clear that they are well informed of the theory-practice gap. This is a call for all professionals at an individual and organizational level to work, as it will translate into gap minimization, thereby increasing the quality of health care delivery as nurses constitute the largest part of the health care team in Nigeria. [ABSTRACT FROM AUTHOR]

Background: Myocardial infarction is a start for many heart problems that can make a patient refer to treatment centers long after discharge the objective of this study was to investigate the effect of nutritional counseling on nutritional behavior. Materials and Methods: 120 patients who were admitted to cardiac intensive care units of selected after stroke were selected and were randomly assigned into two groups. If the total MEDFICS score in each group is higher than or equal to 70, nutritional behavior will need to be modified, if it is less than 40, the diet will be TLC, and if it is between 40-70, it will be heart-healthy diet. Subjects whose score was above 70 were referred to nutrition counseling classes. Results: After two months, the mean MEDFICS score in the experimental group (62.4 ± 07.6) was significantly lower than that of the control group (4.22 ± 3.65). The results of the independent t-test after the intervention showed a significant difference between the experimental and control groups (P <0.001). It showed an improvement in nutritional behavior in the experimental group after the intervention. Conclusion: the research hypothesis that states the nutritional behavior of patients improves after implementation of the nutritional counseling program is accepted with a 95% confidence interval. [ABSTRACT FROM AUTHOR]

Background: Therapeutic communication (TC) between nursing students and patients is essential for providing high-quality care. Purpose: This study aimed to introduce a questionnaire for the assessment of TC among Iranian nursing students and to examine its psychometric properties. Methods: This mixed-method research was conducted in two phases of developing tool content and validation of the scale. Results: Five factors were specified, explaining 42.89% of the total variance. The confirmatory factor analysis confirmed the structure of the scale. Cronbach's alpha coefficient of the scale was 0.83. Conclusions: The final questionnaire was a valid and reliable scale for the self-assessment of TC among nursing students. Furthermore, scholars can use this instrument to compare students' TC before and after educational interventions. Impact statement: Nursing students' TC questionnaire is a suitable instrument for assessing nursing trainees' TC and enhancing their engagement in learning. [ABSTRACT FROM AUTHOR]

Background: Therapeutic Communication (TC) is the process of purposeful and understandable communication between patients and caregivers, which helps facilitate optimized care. Here, we assessed nursing students' interaction with patients and its related factors. Materials and Methods: In this descriptive-analytical study, a convenience sample of 240 undergraduate nursing students from Tehran University of Medical Sciences, Tehran, Iran, completed consent forms, a demographic information questionnaire, and a TC questionnaire in 2018. Data were analyzed using descriptive and inferential statistics. Results: TC score of most students was moderate and good, with the mean (SD) of 143.07 (12.86). Factors, including gender (χ² = 8.02, p ≤ 0.01), semester (χ² = 4.01, p ≤ 0.05), employment (r = 0.49, p ≤ 0.01), and workshop attendance (r = 0.80, p ≤ 0.01), influenced the students' TC knowledge and skills. Conclusions: Future nurses' TC can be improved by part-time employment and practical training. Conducting more research with a larger sample size from all nursing faculties is suggested. [ABSTRACT FROM AUTHOR]

Background: Health communication (HC) is considered an important task of nurses to provide high quality and holistic care as well as to improve patient health. The nursing student--patient HC is an abstract concept and needs to be clarified. Therefore, this study was conducted to increase the knowledge about nursing students' HC with patients by considering various participants' viewpoints. Materials and Methods: In this conventional qualitative content analysis, 18 semi-structured interviews were conducted with six nursing students, six nursing instructors, and six patients in educational hospitals affiliated to the University of Medical Sciences. Credibility, confirmability, dependability, and transferability were established to validate the trustworthiness of the data. The process of data collection and analysis lasted 9 months. Results: After data analysis, two categories were generated: (A) "junior nursing student--patient communication," with two subcategories of "performing social communication with patients" and "failure to build therapeutic relationships with patients," and (B) "senior nursing student--patient communication" with two subcategories of "establishing effective communication with patients" and "performing one"way communication with patients." Conclusions: More attention should be paid to improve HC through shifting towards student-centered approaches in nursing curriculum. Further, role model nurses and clinical educators should guide nursing students for institutionalizing HC in future nurses. [ABSTRACT FROM AUTHOR]

In recent years, particular attention has been paid to nursing students’ therapeutic communication (TC) with patients, due to a strong emphasis on patient-centered education in the Iranian healthcare reform. However, various studies have highlighted the poor communication of future nurses. Therefore, researchers have used qualitative methodology to shed light on the antecedents and consequences of nursing students’ TC and promote it. We carried out a conventional content analysis using semistructured interviews with a purposefully selected sample of 18 participants, including nursing instructors, students, and patients in hospitals affiliated to Tehran University of Medical Sciences. “Communication readiness,” “predisposing factors,” and “continuity of care” were identified as the three major themes. “Communication readiness” consisted of “physical readiness,” “academic readiness,” and “developmental readiness.” “Predisposing factors” included “contextual factors” and “educational condition.” “Continuity of care” included “patient satisfaction” and “improving nursing student’s motivation to communicate with patients.” “Communication readiness” and “predisposing factors” constitute the antecedents of nursing student’s TC with patients, and “continuity of care” is considered as its consequence. More attention needs to be paid by the regulators to TC instruction in both theoretical and clinical educational curriculum. Furthermore, all nurses must be informed about the importance of TC in promoting patient outcomes and quality of care. [ABSTRACT FROM AUTHOR]

Background and aim: Therapeutic communication, the fundamental component of nursing, is a complex concept. Furthermore, the poor encounters between nursing student and patient demonstrate the necessity of instruction regarding therapeutic communication. The aim of this study was to define and clarify this important concept for including this subject in the nursing curriculum with more emphasis. Methods: A literature search was conducted using keywords such as “nursing student”, “patient” and “therapeutic communication” and Persian-equivalent words in Persian databases (including Magiran and Medlib) and English databases (including PubMed, ScienceDirect, Scopus and ProQuest) without time limitation. After extracting concept definitions and determining characteristic features, therapeutic communication in nursing students was defined. Then, sample cases, antecedents, consequences and empirical referents of concept were determined. Results: After assessing 30 articles, therapeutic communication defining attributes were as follows: “an important means in building interpersonal relationships”, “a process of information transmission”, “an important clinical competency”, “a structure with two different sections” and “a significant tool in patient centered care”. Furthermore, theoretical and clinical education and receiving educators’ feedback regarding therapeutic communication were considered as antecedents of the concept. Improving physical and psychological health status of patient as well as professional development of nursing students were identified as consequences of the concept. Conclusion: Nursing instructors can use these results in order to teach and evaluate therapeutic communication in nursing students and train qualified nurses. Also, nursing students may apply the results to improve the quality of their interactions with patients, perform their various duties and meet patients’ diverse needs. [ABSTRACT FROM AUTHOR]

Background: Nurses have a crucial role in identifying spiritual needs and providing spiritual care to patients living with cancer. Aim: This study evaluated Iranian oncology nurses' spiritual care competence and its relationship with job satisfaction and moral distress. Method: This cross-sectional study was conducted on 280 Iranian oncology nurses in 2020 using four questionnaires: demographic questionnaires, the Spiritual Care Competence Questionnaire (SCCQ), the Minnesota Job Satisfaction Questionnaire (MSQ) and the nurses' Moral Distress Questionnaire (MDS-R). Findings: The mean scores indicated a medium to high Spiritual Care Competence (SCC), mild to moderate moral distress and high job satisfaction. There was a positive correlation between SCC and external job satisfaction (r=184, p<0.05) and a negative correlation between SCC and moral distress (r=-0.356, p<0.05). Conclusions: SCC diminishes with decreasing external job satisfaction and increasing moral distress. To improve the SCC of nurses working with patients living with cancer, it is recommended that nursing managers and policymakers revise the organisational policies to tackle the obstacles and consider the related factors to provide an ethical climate, implement quality spiritual care and increase job satisfaction. [ABSTRACT FROM AUTHOR]

Background: The consequences of a corneal transplant are evaluated and classified by care providers, but understanding and interpretation of the results varies between patients, and creates different views for them and influences their lives in different ways while these influences are largely unknown. Aim: This study aimed to explore understanding of new life in patients after corneal transplantation. Methods: This qualitative study was conducted using a hermeneutic phenomenological approach in Tehran in 2016. Twelve corneal transplant recipients (7 men, 5 women) who were chosen purposefully from penetrating corneal transplant recipients, participated in this study. Semi-structured interviews were used to collect data. The content of the interviews was transcribed and analyzed using Van Manen’s methodology. Results: Data analysis led to the emergence of several main themes, among which "having a new sense" and "fear and hope" were two of the most important themes. Conclusion: It can be inferred from the overall participants' experiences that corneal transplant has brought about a new look at life for patients. However, transplant-related issues are endless and continuous, and a sense of fear and hope has always surrounded them. [ABSTRACT FROM AUTHOR]

Introduction: Mothers, who often serve as primary care-givers for their offspring, play a crucial role in the development of children. Understanding the parenting experiences of mothers who are blind can be valuable and beneficial for professional educators and health care workers who wish to provide holistic and appropriate services to both mothers who are blind and their children. This study aimed to explore the experience of mother-child integration by mothers who are blind living in Iran. Methods: A hermeneutic phenomenology approach was adopted to conduct the study. Congruent with this approach, Van Manen's (1990) method consisted of six interplay activities that helped the researchers in the process of the study. Semistructured in-depth interviews were performed to produce qualitative data with nine mothers who are blind. The thematic analysis introduced by Van Manen was used to isolate and extract the meaning units, subthemes, and the main theme hidden in the lived stories of the participants. Results: "Close nurturers" was the overarching theme extracted from the experience of mothers who are blind, which emerged from six themes: monitoring by alternative senses, monitoring by careful calls and staying vigilant, loving by heart and imagining in mind, discovering the child's intentions, parenting anxiety, and deficits in communication. Discussion: Blindness changes the mothering behaviors of women who are blind to the extent that they often adopt a close-mothering approach in caring for their children. This approach helps them to cope with their limitations and thereby decrease their level of child-related anxiety. Health professionals should consider the concept of close nurturers to better understand the behaviors of mothers who are blind. Implications for practitioners: Understanding the lived experiences of mothers with blindness can generate valuable knowledge that can be used to provide appropriate health care and other support services for these women and their children. [ABSTRACT FROM AUTHOR]

The concept of blended learning in the field of nursing and medicine has been accepted. Blended learning has been extensively used thanks to the development of communication technologies and the availability of Internet services. Meanwhile, experiences-based research, by all accounts, can help the expansion of such a learning modality. Therefore, this study was designed to explain nursing doctoral students' experiences of blended learning. To attain this goal, a descriptive phenomenology method was used to illustrate experiences as they are experienced by the participants in the study. With regard to the nature of the investigated phenomena and the existing methods for the inductive analysis, Colaizzi's method of data analysis was used. The findings of the study led to the discovery of three main themes: "failure", "synergy" and "specific interaction". Each of the themes has been further divided into some sub-themes. [ABSTRACT FROM AUTHOR]

Around the world there is a growing consensus that students' rights must be protected, regardless of race, creed, color, sex, religion, and socioeconomic status. One of these rights is the educational equity. However, little is known about these phenomena in nursing education. The aim of this study was to explore the educational equity from the perspective of nursing students. A qualitative study was conducted. Thus, we purposefully recruited for in-depth interviews 13 nursing students (8 female and 5 male). All interviews were transcribed verbatim and analyzed by thematic analysis approach to identify categories and themes. Four main themes emerged from the data: Fair Educational Opportunity, fair evaluation, attempts to combat discrimination, and employing qualified teachers. It is argued that educational equity should be developed in higher education. Principles of equity and students' rights may form the most basic rationale for all formal and informal efforts to extend the right of equal access to education. [ABSTRACT FROM AUTHOR]

Background: While palliative care for patients with heart failure has gained global attention, in Iran most palliative care interventions have focused only on cancer patients. The purpose of this study is to determine the feasibility and acceptability of a telehealth palliative care intervention to improve the quality of life in patients with heart failure in Iran. Methods: This single-site, pilot randomized controlled trial of a telehealth palliative care intervention versus usual care was conducted on patients with New York Heart Association class II/III heart failure recruited from a heart failure clinic in Iran. Under the supervision of a nurse interventionist, intervention participants received 6 weekly educational webinars and concurrent WhatsApp® group activities, with 6 weeks of follow-up. Feasibility was assessed by measuring recruitment, attrition, and questionnaire completion rates; acceptability was assessed via telephone interviews asking about satisfaction and attitudes. Secondary outcomes measured at baseline and 6 weeks included quality of life (PKCCQ and FACIT-Pal-14), anxiety and depression (HADS), and emergency department visits. Results: We recruited and randomized 50 patients (mean age 47.5 years, 60% men). Among those approached for consent, 66% of patients agreed to participate and total study attrition was 10%. Also 68% of patients successfully completed at least 4 out of the 6 webinar sessions. Acceptability: 78% of patient participants expressed willingness to participate in the present study again or recommend other patients to participate. There was a trend towards improvement in anxiety and depression scores in the intervention group though the study was not powered to detect a statistical difference. Conclusion: This nurse-led, early telehealth-palliative care intervention demonstrated evidence of feasibility, acceptability, and potential improvement on quality of life in patients with heart failure in Iran. Trial registration: The study was registered at the Iranian Registry of Clinical Trials (IRCT) at 14 November, 2021, and can be found on the Iranian Registry of Clinical Trials Platform. IRCT registration number: IRCT20100725004443N29. [ABSTRACT FROM AUTHOR]

Background: Hematopoetic stem cell transplantation is considered as a standard treatment for cancer patients to stay hopeful toward treatment outcome. However, these patients experience many complications which might affect different aspects of their life. The aim of this study was to investigate the lived experience of patients after hematopoetic stem cell transplantation and introduce supportive care strategies. Materials and Methods: In this study, Van Manen's Hermeneutic phenomenological approach was used. Eleven patients (7 males and 4 females) were chosen by targeted sampling from visitors of Shariati Hospital's outpatient clinic. Semi-structured interviews were conducted and the final data were analyzed by MAXQDA 10 software. Results: Data analysis revealed that the main theme was resiliency with two sub-themes of "not surrendering to disease" and "feeling closer to God". Conclusion: Participants declared that transplantation was like a second chance for life and considered this opportunity as a gift from God to overcome their disease. According to our findings, spirituality aids can help patients control the disturbances following HSCT and health professionals can use constructive strategies to support patients with spiritual needs. [ABSTRACT FROM AUTHOR]

Patients with heart failure experience high hospitalization. However, patients cannot recognize symptoms according to current approaches, which needs to be improved by new self-monitoring instruments and strategies. Thus, we aimed to assess a self-monitoring traffic light diary on outcomes of patients with heart failure. This was a single-blind, two-arm parallel group randomized controlled trial at the heart failure clinic of Tehran Heart Center (Tehran, Iran). Adult patients with a definitive diagnosis of heart failure with reduced ejection fraction (i.e., ejection fraction of less than 40 %), and New York Heart Association functional classes II–IV were included. A block-balanced randomization method was used to assign eligible subjects to the intervention or control group. Baseline data were collected before random allocation. Participants in the intervention group received a comprehensive intervention consisting of (1) self-care education by an Australian Heart Foundation booklet on heart failure, (2) regular self-monitoring of weight and shortness of breath at home, and (3) scheduled call follow-ups for three months. Patients in the control group received usual care. The primary outcome was heart failure self-care; the secondary outcomes were heart failure quality of life, knowledge, and all-cause hospitalization. From June to August 2017, 68 patients were included in the study. The overall age of participants was 55 (13.6) years old, and 71 % of patients were male. A significant association between the intervention and self-care maintenance (β 5.1; 95 % CI 2.50 to 7.70, P < 0.001), self-care management (β 10.6; 95 % CI 6.50 to 14.8, P < 0.001), self-care confidence (β 8.0; 95 % CI 5.0 to 11.0, P < 0.001) and heart failure knowledge (β 1.7; 95 % CI 1.30, 2.04; P < 0.001) was found. However, there was no association between the intervention and quality of life (β 2.5; 95 % CI − 0.79, 5.88, P 0.135) and hospitalization-free survival of the two groups (Log-Rank P 0.540). A self-monitoring traffic light diary can improve self-care behaviors and heart failure knowledge in patients with heart failure with reduced ejection fraction. Iranian Registry of Clinical Trials IRCT2017021032476N1. PMCID: PMC6262204. [ABSTRACT FROM AUTHOR]

This study aimed to describe the expectations of Bachelor of Science nursing students regarding what constitutes an effective clinical education. In this study, a semistructured interview process was utilized with 17 nursing students studying in sophomore, junior and senior years in training units of hospitals affiliated with Tehran University of Medical Sciences. Content analysis was employed to analyse the data. Data analysis led to identification of three main themes: (i) appropriate communication and interaction between instructors and students; (ii) incorporation of both theory and practice in clinical education, with two subthemes, one being the presence of the instructor as a factor for reducing the gap between theory and practice and the other being evaluation based on appropriate criteria; and (iii) having specialized instructors, with a specific emphasis on the instructor's knowledge and motivation as important factors in learning. The findings reveal the significant role of mentors in providing effective educational and clinical experiences. Therefore, mentors must strive to develop their knowledge and clinical behaviours according to students' needs in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Nurses' influence on health policy protects the quality of care by access to required recourses and opportunities. This is a new and important concept for nursing; however, research studies on policy influence of nurses in health care sector are lacking a basic conceptual understanding of what this concept represents. The aim of this paper is to clarify the concept of nurses' policy influence and to propose the definition of this concept, considering the context of Iran. Materials and Methods: The eight stages of Walker and Avant approach was used to guide this concept analysis. Various databases and internet engines were searched to find all related information about the concept. Textbooks were also searched manually. English language literature reports published between 1990 and 2012 were reviewed. Results: Based on the analysis undertaken, nurses' policy influence is nurses' ability in influencing decisions and affairs related to health through political knowledge, effective communication, and collaboration with other members of the health team, which results in the improvement of nurses' job environment and increases patient outcomes. This is a dynamic process situated on a spectrum and is accompanied with nurses' knowledge, competency, power, and advocacy, and also their ability to change. Conclusions: Nurses have individual views on health care issues and influence health care policies in different ways. With a common understanding of nurses' policy influence as a concept, nurses will recognize the importance of policy making in the health sector and their influence on this process and also on patients' outcomes. [ABSTRACT FROM AUTHOR]

An abstract of the article "First Encounters With Instructors: The Experiences and Perceptions of Nursing Students in Iran," by Hooman Shahsavari and colleagues is presented.