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Introduction and objective: Uremic pruritus is a common symptom in patients under hemodialysis. The exact cause of uremic pruritus is not yet known. Although effective treatments are available, there is not still a commonly accepted treatment for this disorder. The present study was aimed at examining the effects of thermotherapy on the quality of life (QOL) and biochemical parameters in hemodialysis patients with uremic pruritus. Patients and methods: In this experimental study, a total of 40 men under hemodialysis suffering from uremic pruritus were randomly selected and divided into an experimental group (thermotherapy) and a control group (no exposure to heat). The experimental group were exposed to far-infrared radiation (FIR) at 40 °C in 15-minute sessions, three times a week, in total for 18 sessions. The Severity of Pruritus Scale (SPS), the Kidney Disease Quality of Life Instrument (KDQOL), and the ItchyQoL were completed by the participants before the start of intervention, one month after the start of intervention, and at the end of intervention. The data were analyzed using SPSS22. Results: Significant differences were observed between the intervention and control groups in all the criteria for assessing uremic pruritus, including history of symptoms, daily activities, QOL, effects on sleep, emotional aspects, and severity of pruritus (p

Objective (s): Fear of falling is the main fear among older adults and is an independent risk factor for decreased mobility and quality of life. Therefore, a standard tool is needed to assess the fear of falling. The Geriatric Fear of Falling Measure is one of the common tools that used for this purpose. The present study aimed to translate and initially validate the Persian version of the questionnaire in Iran. Methods: This was a methodological study and was conducted on 200 elderly people. After translating and obtaining opinions of experts, the content and face validity of the questionnaire were determined qualitatively. Then, the validity of the GFFM was assessed through convergent validity (correlation test between the Persian version of the GFFM and the Activities Specific Balance Confidence Scale-ABC questionnaire) and known group comparison. Reliability was evaluated using internal consistency (Cronbachchr('39')s alpha). Results: The results obtained from known groups comparison indicated that the questionnaire well differentiated among participants who were differed in self-reported health condition. The convergent validity showed a significant correlation between the Persian version of the GFFM and the ABC questionnaires. The Cronbachchr('39')s alpha coefficient for the dimensions and the total questionnaire was between 0.75 and 0.89. Conclusion: The findings indicated that the Persian version of the GFFM is a valid instrument and can be used in a variety of situations, including clinical and research environments. It is suggested that the future studies assess the structural validity of the GFFM using factor analysis with a bigger sample size.

Background During various infectious pandemics, phobia or panic has been suggested as one of the most common mental disorders. The current study reports on the psychometric properties of the Persian version of the COVID‐19 Phobia Scale (C19P-S) in Iran. Methods The forward–backward translation procedure was applied to translate the English version of the C19P-S into Persian. Then, content and face validity, structural validity (exploratory and confirmatory factor analyses), convergent and discriminant validity, concurrent validity, reliability, and stability were performed to evaluate the Persian version. Results In all, 660 people participated in the study. The mean age of patients was 35.55 (SD = 12.24) years. Exploratory factor analysis confirmed a four-factor structure for the scale. Confirmatory factor analysis showed that almost all fitness indices for the model were satisfactory (RMSEA = 0.06, CFI = 0.96, TLI = 0.96, IFI = 0.97). The Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC) for the questionnaire were 0.95 and 0.96, respectively. Conclusion The Persian version of C19P-S showed good psychometric properties and a good fit for the four-factor structure. It can now be used to assess panic disorder in therapeutic settings and identify candidates needing clinical intervention.

Objective (s): Assessing the disability of the elderly requires a specific instrument. The Groningen Frailty Inventory is one of the known instruments that used to measure the ability of the elderly. The present study aimed to translate and initially validate the Persian version of the GFI questionnaire. Methods: The present study was a methodological study which was performed on 139 elderly people. The questionnaire was translated from English into Persian and face and content validity were determined qualitatively. The quantitative validation was performed using construct validity (known groups comparison and concurrent validity). The General Anxiety Inventory was used for concurrent validity. Reliability was assessed by estimating internal consistency and test-retest analyses. Results: The results of the known groups analysis showed that the questionnaire well differentiated disability score in older men versus women as hypothesized. Older people with lower education also had lower score as compared to well-educated older participants. Concurrent validity indicated a significant correlation between the Persian version of the Groningen Frailty and the General Anxiety Inventory. The internal consistency (Kuder- Richardson) was 0.762. Test-retest reliability (ICC) of the questionnaire with a two-weeks interval was 0.61. Conclusion: The findings indicated that the Persian version of Groningen Frailty Indicator is a valid instrument and now could be used for measuring in research and clinical practice. It is suggested that the future studies assess the structural validity of the GFI using factor analysis with a bigger sample size.

Background and Objective: Angina pectoris is one of the most common among heart diseases. Low health literacy is associated with a high prevalence of chronic diseases, including cardiovascular disease. Considering the significant burden of heart disease, improving the level of health literacy of individuals can play a decisive role in the prevention and treatment of these diseases and saving resources. The aim of this study was to investigate the level of health in patients to Angina pectoris, who referred to selected hospitals in Tehran. Materials and Methods:This study is a descriptive-analytical study that was performed on 405 patients with angina referred to the heart clinics of selected hospitals in Tehran in 2017. Patients were selected by convenience sampling. Data were collected using demographic questionnaires, Health Literacy of Iranian Adults (HELIA) and analyzed by descriptive and inferential statistics and Anova with SPSS software version 20. Results:: The mean age of the patients was 53.08. The average score of health literacy of patients with angina pectoris (63.77 ± 15.44) is based on the fact that it can be said that the subjects in terms of health literacy were not at a sufficient level. The results of Anova statistical test showed There is a statistically significant relationship between health literacy level and age variables, education level, employment status, income level, duration of heart disease and heart disease and ways of obtaining medical information (p

This study aimed to compare the effects of reflexology and aromatherapy massage on the severity of restless legs syndrome (RLS) in 105 female patients undergoing hemodialysis. A randomized placebo-controlled clinical trial was conducted in a hemodialysis center with 48 beds in a high turnover hospital in an urban area of Iran. Intervention groups received reflexology (n = 35) and aromatherapy massage using lavender essential oil (n = 35) for 24 sessions, and the placebo group (n = 35) received simple foot massage. The restless legs syndrome rating scale was used to assess RLS severity in the groups before the intervention and after 4 and 8 weeks of the interventions. Results obtained by the mixed model analysis 3 * 3 (3 groups * 3 times) revealed the significant effect of time, group, and the time–group interrelationship (p = 0.001). Aromatherapy massage reduced the RLS severity, but reflexology did not appear to cause any significant reduction in it. Therefore, we suggest that aromatherapy massage be incorporated into routine care for relieving the ailment and suffering of patients undergoing hemodialysis.

It is essential to better understand the caregiving burden and its determinants to support caregivers. The aim of this study was to test the validity and reliability (internal consistency) of the caregiver burden inventory (CBI) in Iranian caregivers of elderly patients with Alzheimer.A cross sectional study was conducted to translate and validate the CBI in Iran. The structural validity of the scale was evaluated by exploratory factor analysis. The concurrent validity was tested correlating the CBI scores with the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) scores. The internal consistency reliability was assessed using the Cronbach's alpha coefficient.In total, we enrolled 315 caregivers of elderly patients with Alzheimer disease (79% women, mean age 56.5 ± 13.9). The structural validity of the CBI as assessed by exploratory factor analysis indicated three factors (emotional/psychological, time-dependence and physical burden) that jointly explained 45.21% of the total variance observed. The Pearson correlation coefficient for the relationship between the scores obtained on the Caregiver Burden Inventory and the BAI and the BDI were 0.69 and 0.49 respectively, confirming the concurrent validity. The Cronbach's alpha for the CBI was 0.91 ranging from 0.78 to 0.92 for its subscales.Used in clinical practice and research, the CBI was verified to be a proper multidimensional instrument for evaluating the burden in caregivers of elderly patients with Alzheimer disease.

Background Population aging is an important phenomenon for many countries worldwide. Considering the growing trend of aging population in Iran, it is very important to consider beliefs and perceptions of old people about aging. The Aging Perception Questionnaire (APQ) is one of the most common instruments that used to measure aging comprehension. The present study was a methodological inquiry that aimed to examine validity and reliability of the Persian version of the Aging Perception Questionnaire (APQ). Methods Forward-backward procedure was used for translation. Content validity and face validity were evaluated qualitatively. In order to evaluate construct validity a cross section study was conducted and both exploratory and confirmatory factor analyses were performed. In order to determine reliability, internal consistency (the Cronbach’s alpha) and stability (Intraclass Correlation Coefficient -ICC) were estimated. Results A total of 500 elderly people attending the community centers in Tehran, Iran were entered in other study and completed the Persian version of the questionnaire. Most elderly were female (52.8%).The mean age of participants was 68.33 (SD ± 6.10) years. The results obtained from exploratory factor analysis showed a four-factors solution (consequences negative, emotional representation, control positive and consequences positive) that jointly explained 52.8% of the total variance observed. In addition the confirmatory factory analysis showed a good fit for the data. Finally, the Cronbach’s alpha coefficient of 0.83 ranging from 0.80 to 0.87 was obtained for the whole scale and the subscales. The ICC value of 0.96 ranging from 0.90 to 0.98 was found for the whole scale and the subscales. Conclusion The results indicated that the Persian version of APQ is valid and can be used to measure aging perception in Iran.

Objective (s): Caring for elderly with Alzheimer can lead to the development or exacerbation of many physical and psychological problems for caregivers. The purpose of this study was to assess the anxiety and depression in caregivers of elderly with Alzheimer. Methods: This was a cross-sectional study of 315 caregivers of elderly people with Alzheimer in Tehran, Iran. Data were collected by demographic questionnaire, the Beck Anxiety Inventory and the Beck Depression Inventory. Descriptive statistics were used for data analysis. Results: The mean and standard deviation of caregivers’ anxiety was 12.61± 10.48 which was significantly higher in women than men (p = 0.004). The mean and standard deviation of caregivers’ depression was 13.23 ± 9.52 which was significantly higher in women than men (p = 0.001). The results of t-test and one-way analysis of variance showed that there was a significant difference between total anxiety score by gender, caregiver-to-elderly ratio, health status and caregivers’ income status (p = 0.001). There was also a significant difference between the overall score of depression and marital status, gender, income and caregivers health status (p = 0.001). Conclusion: The study showed that Alzheimerchr('39')s caregivers experience mild to moderate levels of anxiety and depression. The findings suggest strategic planning to increase social support among Alzheimerchr('39')s caregivers is essential.

Background: Patients with cardiovascular diseases usually suffer from hospital anxiety and depression. Aim: This study aimed to investigate the effect of foot reflexology massage on anxiety and depression in female older adults suffering from acute coronary syndrome.Participants: Ninety older women with acute coronary syndrome were randomly assigned into intervention and control groups (n=45 in each group).Research Design: A randomized controlled trial.Intervention: The intervention and control groups received foot reflexology massage and routine care, respectively.Main Outcomes Measures: The levels of anxiety and depression were evaluated using the hospital’s anxiety and depression scale (HADS) before and immediately after foot reflexology massage.Results: Foot reflexology massage reduced both anxiety (F(1.44)=19.11, p = .001) and depression (F(1.44)=16.76, p = .001) in acute coronary patients relative to control patients. The intervention had a large effect on hospital anxiety and depression.Conclusions: Foot reflexology massage is an efficient and safe intervention for alleviating psychological responses among female older adults suffering from acute coronary syndrome during hospitalization.

Background Anxiety is one of the most common mental health problems experienced by the elderly that affects quality of life. This study aimed to assess the psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-P) in order to provide a valid instrument for measuring anxiety in this population. Methods Forward-backward translation was used to translate the Geriatric Anxiety Inventory from English into Persian and was tested by 10 elderly to assess its face validity. Then a sample of elderly people attending health centers in Dezful, Iran completed the questionnaire. Validity was assessed using both exploratory and confirmatory factors analysis, known-groups comparison (abused and non-abused elderly) also was administered. The internal consistency of the instrument was assessed using Kuder-Richardson 20 coefficients (KR-20). Afterwards, the reliability and validity through assessing the correlation between the Persian version of the GAI-P and the SF-36, were measured. Results In all 720 elderly completed the questionnaire. Of these data from 420 elderly were used for exploratory factor analysis and the data from the remaining 300 elderly were used for confirmatory factor analysis. The exploratory factor analysis showed a three-factor solution (cognitive, arousal and somatic) for the questionnaire that jointly explained 59.48% of the overall variance observed. The confirmatory factor analysis supported the three-factor solution and the second-order latent factor model. The findings indicated a positive and significant correlation between the two measures lending support to its concurrent validity (r = 0.67, p

Purpose This study examined the effect of the eye movement desensitization and reprocessing intervention on depression and anxiety in patients undergoing hemodialysis. Design and methods In this randomized controlled trial, 90 patients were enrolled. The intervention group received six sessions of the eye movement desensitization and reprocessing intervention. Data were collected before and 2 weeks after the intervention using the Hospital Anxiety and Depression Scale. Findings Measured levels of anxiety and depression were significantly reduced in the intervention group compared with preintervention levels and to the control group. Practice implications Nurses can use the eye movement desensitization and reprocessing intervention in clinical practice in combination with psychotropic drugs for the reduction of depression and anxiety in patients undergoing hemodialysis.

Objective (s): The Heart Failure Knowledge Scale: (HFKS) is an instrument for measuring the knowledge of patients with heart failure disease. This study aimed to translate and validate the questionnaire in Iran. Methods: This was a methodological study. After translation from English into Persian and obtaining the views of experts, the content and face validity of the questionnaire were determined qualitatively. In order to determine the validity known groups comparison and criterion validity (correlation coefficient between Persian version of HFKS and European Heart Failure Self-Care Behavior and Minnesota Living with Heart Failure Questionnaire-MLHF) were performed. Reliability was examined using internal consistency analysis and test re test. Results: In all 150 patients with coronary hear disease completed the questionnaire. The results of known groups comparison showed that the mean knowledge of patients with heart failure with moderate economic level was significantly higher than other patients (p = 0.0001). Criterion validity showed a significant correlation between Persian version of the HFKS and the European Heart Failure Self-Care Behavior (r = 0.83) and Minnesota Living with Heart Failure Questionnaire-MLHF (r = 0.175). The internal consistency (Cronbach’s alpha) was 0.84. Test-retest reliability (ICC) of the questionnaire with interval time of two weeks was 0.88 (p < 0.001). Conclusion: The findings indicated that the Iranian version of the HFKS is a valid instrument and could be used to measure the knowledge of patients with heart failure in research and treatment departments. It is suggested that in the future studies the construct validity of the HFKS questionnaire should be investigated using a factor analysis in a more representative sample.

Background Nurses have a vital role in the healthcare system. One of the basic steps to increase their happiness is to recognize factors such as job satisfaction and quality of working life. Therefore, the goal of the present study was to examine the relationship between happiness and quality of working life and job satisfaction among nursing personnel. Methods This descriptive study was carried out on 270 hospital nurses who worked in emergency departments in Iran. Nurses were recruited through the census method. Data collection instruments included the Oxford Happiness Inventory (OHI), the Quality of Work Life Questionnaire (QWL), and the Job Satisfaction Questionnaire (JSQ). Data were explored using descriptive statistics, and stepwise multiple linear regression analysis. Results The mean age of participants was 30.1 ± 6.26 years. The mean happiness score was 38.5 ± 16.22, the mean Quality of Working Life (QWL) score was 84.3 ± 17.62, and the mean job satisfaction score was found to be 45.5 ± 13.57); corresponding to moderate levels of attributes. The results obtained from the ordinary least-square (OLS) regression indicated that happiness significantly was associated with economic status and satisfaction with closure (R2: 0.38). Conclusion Overall the current study found that nurses who work in emergency departments did not feel happy. Additionally, the findings suggest that their happiness were associated with their economic status, and closure over their duties.

Pain associated with fistula cannulation is a challenge for nurses who provide care to older patients undergoing hemodialysis. Several non-pharmacological methods have been suggested for relieving fistula cannulation pain, but the benefits of visual and auditory distraction methods among older patients undergoing hemodialysis have not been investigated yet. Therefore, this study aimed to compare the effects of visual and auditory distractions on fistula cannulation pain among older patients undergoing hemodialysis. This randomized controlled clinical trial was conducted on 120 older patients undergoing hemodialysis. They were randomly assigned to three groups of visual distraction, auditory distraction, and the control (n = 40 in each group) using a simple random assignment method. The distraction interventions continued for three consecutive sessions and the numeric rating scale of pain severity was used for data collection. Descriptive and inferential statistics were used for data analysis using SPSS. It was found that pain severity significantly reduced after the distraction interventions in either the auditory or visual distraction groups and also after all three distraction sessions (p = 0.001). However, visual distraction had a better effect on the reduction of pain severity. Therefore, while both visual and auditory distractions reduced pain severity in older patients undergoing hemodialysis, visual distraction was more effective. Nurses are encouraged to incorporate visual distraction as a safe and non-pharmacologic technique into routine nursing care for reducing older patients&rsquo, suffering and improving their wellbeing when fistula cannulation is performed.

Aim To evaluate nursing students’ professionalism attitude, it is necessary to use a validated and reliable instrument. Design This study aimed to develop the Persian version of the eight‐dimensional professionalism attitude questionnaire for student nurses (Instrument of Professional Attitude for Student Nurses). Methods In this cross‐sectional study during March to April 2017, after being translated into Persian and receiving experts’ comments face, content, and construct validity of the questionnaire were sought among nursing students. Internal consistency reliability was examined by estimating the Cronbach's alpha coefficient and stability was estimated by calculating intraclass correlation coefficinet. Results A total of 750 students with an average age of 24.15 (SD = 1.32) years participated in the study. Both exploratory and confirmatory factor analyses confirmed the construct of the questionnaire. Cronbach's alpha coefficient for the entire instrument was 0.89 and more than 0.70 for all dimensions. Also the intraclass correlation coefficient for the questionnaire was found to be 0.92, well above acceptable threshold. The findings approved that the Iranian version of Instrument of Professional Attitude for Student Nurses is a reliable and valid questionnaire. Hence, using this questionnaire to conduct studies is recommended.

Background Evaluating knowledge in patients with coronary artery disease requires a specific measure. The aim of the present study was to translate and evaluate the CADE-Q in patients with coronary artery disease in Iran. Methods Forward-backward procedure was applied to translate the questionnaire from English into Persian. Then a cross-sectional study was conducted to evaluate psychometric properties of the questionnaire. A sample of patients with coronary artery disease attending to cardiac departments of teaching hospitals affiliated to medical universities in Tehran, Iran completed the 19-item CADE-Q from April to December 2017. Structural validity of CADE-Q was assessed using both exploratory and confirmatory factor analyses. Reliability was examined using Cronbach’s alpha coefficient. Stability was evaluated by estimation intraclass correlation coefficient. Results In all 500 patients participated in the study. The mean age of patients was 53.63. (SD = 14.36) years, and 57% were male. The results obtained from the exploratory factor analysis showed a four factor solution (lifestyle habits and exercise, risk factors, diagnosis and treatment, signals & symptoms and medicine) that jointly explained 48.9% of the total variance observed. However, the second-order confirmatory factor analysis supported the three-factor solution while convergent and divergent validity were not confirmed. Finally, the Cronbach’s alpha coefficient of 0.84 ranging from 0.50 to 0.82 was obtained for the scale and its subscales. In addition, the ICC value of 0.88 showed satisfactory stability for the questionnaire. Conclusion The Coronary Artery Disease Education Questionnaire was found to be a multidimensional instrument. The results confirmed the factor structure of the questionnaire with a second-order analysis. Since the convergent and divergent validity of the scale were not confirmed, further assessment is essential to establish fitness of the questionnaire in Iran.

Background It is essential to better understand the caregiving burden and its determinants to support caregivers. The aim of this study was to test the validity and reliability (internal consistency) of the caregiver burden inventory (CBI) in Iranian caregivers of elderly patients with Alzheimer. Methods A cross sectional study was conducted to translate and validate the CBI in Iran. The structural validity of the scale was evaluated by exploratory factor analysis. The concurrent validity was tested correlating the CBI scores with the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) scores. The internal consistency reliability was assessed using the Cronbach’s alpha coefficient. Results In total, we enrolled 315 caregivers of elderly patients with Alzheimer disease (79% women, mean age 56.5 ± 13.9). The structural validity of the CBI as assessed by exploratory factor analysis indicated three factors (emotional/psychological, time-dependence and physical burden) that jointly explained 45.21% of the total variance observed. The Pearson correlation coefficient for the relationship between the scores obtained on the Caregiver Burden Inventory and the BAI and the BDI were 0.69 and 0.49 respectively, confirming the concurrent validity. The Cronbach’s alpha for the CBI was 0.91 ranging from 0.78 to 0.92 for its subscales. Conclusion Used in clinical practice and research, the CBI was verified to be a proper multidimensional instrument for evaluating the burden in caregivers of elderly patients with Alzheimer disease.

Background and purpose Physical activity can improve the mental and physical functioning of older people. This study investigated the impact of Tai Chi exercise on the quality of life of older men. Materials and methods This randomized controlled clinical trial was conducted on 132 older men in an urban area of Iran. The subjects were randomly assigned into two groups: a Tai Chi intervention group and a control group (n = 66 per group). Quality of life was evaluated using the Leiden-Padua quality of life questionnaire before and after the intervention. Data analysis was performed using analytical statistics via the SPSS software. Results After eight weeks of Tai Chi exercise, the mean scores of quality of life in different areas demonstrated a statistically significant difference between the two groups (p < 0 0.05). Conclusion This study illustrated that the 8-week Tai Chi intervention had a positive effect on the quality of life in older men.

objective (s): The study aimed to assess the effectiveness of Pilates on patients with type 2 diabetes Methods: A randomized controlled trial was carried out in forty patients with a diagnosis of diabetes type 2. Patients were randomly assigned to one of two groups: experimental group (EG) that in addition to the usual care performed eight weeks of pilates exercises and the control group (CG) that continued to receive the usual care and did not undergo any other intervention. Participants evaluated before and one week after the intervention completed. The quality of life questionnaire (CASP-19) and the short-term test (AMTs) were used to collect data. Results: The groups were homogeneous at baseline. According to the statistical analysis, no significant improvement was observed in the EG. Conclusion: The study did not show benefit for pilates group compared to control group. It is suggested that in the future, this study should be carried out with bigger sample size, increasing the intervention time and a specific questionnaire for assessing the quality of life of the elderly.

Objective (s): Aging perception is recognized as one of the important circles associated with the problems of the elderly. Aging perception Questionnaire (APQ) is one of the common tools that measures agin perception. The purpose of this study was to validate the Persian version of the APQ. Methods: This was a methodological study and was conducted on 200 elderly people. After translating and obtaining opinions of Persian literature and gerentologist experts, the content and face validity of the questionnaire were determined qualitatively. Then, the validity of the aging perception questionnaire was assessed through convergent validity (correlation test between the Persian version of the APQ and CASP-19 questionnaire) and known group comparison (comparing male and female perception). Reliability was evaluated using internal consistency (Cronbachchr('39')s alpha) and stability (ICC). Results: The known group comparison showed that the instrument discriminated well between men and women where men significantly scored higher than women. Convergent validity showed a significant correlation between the Persian version of the APQ and CASP-19 questionnaires. Cronbachchr('39')s alpha coefficient for the dimensions and total questionnaire was between 0.64 and 0.81. Test-retest reliability (ICC) of the questionnaire with a two-week interval was between 0.65 and 0.96. Conclusion: The findings indicated that the Persian version of the APQ Questionnaire is a valid instrument and can be used in a variety of situations, including clinical and research environments.

The use of mobile phone text messaging has been suggested as a potential method for the modification of health-related behavior. There is limited data on the effectiveness of this method in respect of occupational health. Thus, the present study was conducted to evaluate the effect of text messaging on the improvement of occupational health in terms of quality of work life (QWL) and occupational stress and burnout. This experimental and clinical trial was conducted in the intensive care units (ICU) of how many hospitals in Babol, Iran, in 2015–2016. The study population consisted of all ICU nurses who had the inclusion criteria. After homogenization, the subjects were randomly divided into intervention and control groups (n = 40). The data collection tools used in this study consisted of a demographic characteristics form and the Quality of Work Life Questionnaire, Occupational Stress Inventory (Osipow), and the Geldard Burnout Questionnaire (GBI). The nurses in the intervention group received two text messages on occupational health each week for 3 months. The nurses in the control group received no intervention. QWL and occupational stress and burnout were evaluated in the two groups before the intervention, after the 3 months of intervention, and in the fourth month of intervention. The collected data were first analyzed in terms of the normality of distribution using the Shapiro-Wilk test and then using Mann-Whitney U test and the Friedman test. The participants consisted of 80 nurses in two groups. The two groups were homogeneous in terms of demographic characteristics before the intervention. No significant difference was observed between the groups in terms of QWL and occupational stress and burnout at the same time in the study. Mean QWL in the intervention group increased significantly compared to the control group 1 day and 1 month after the intervention (P

Objective (s): Cardiovascular diseases are the main cause of death in developed and developing countries. The aim of this study was to investigate the effect of a family-centered empowerment model (FCEM) on quality of life in elderly patients with angina. Methods: This was a randomized trial on a convenient sample of patients 60 years and older with angina hospitalized in cardiology clinics of a teaching hospital in Qazvin, Iran. Patients were randomized to receive intervention or the usual care. The intervention group received a four dimensions program (perceived threat with group discussion method, self-efficacy with problem solving methods, self-esteem with educational partnership and outcome and process evaluations). To collect data we used an specific FCEM instrument, and the Seattle Angina Questionnaire. Results: Following the implementation of the program the intervention in group showed better quality of life in all dimensions compared to their own baseline score and the control group (p

SUMMARYBackground Fatigue and abnormalities in cardiovascular parameters are recognized as major problems for patients with acute coronary syndrome. Non-pharmacological nursing interventions are useful for controlling this fatigue and reducing patients' suffering during hospitalization. Aim The present study compared the effects of aromatherapy massage and reflexology on fatigue and cardiovascular parameters in older female patients with acute coronary syndrome. Design This study was a randomized clinical trial. Methods The study was conducted with 135 older female patients with acute coronary syndrome who were hospitalized in a cardiac care unit in 2014. They were invited to participate in the study and then were randomly divided into three groups: ‘aromatherapy massage’, ‘reflexology’ and ‘control’. The fatigue severity and cardiovascular parameters were assessed using the Rhoten fatigue scale and a checklist. Measurements in the groups were performed before and immediately after the intervention. Data analysis was performed using descriptive and analytical statistics via the SPSS software. Results Aromatherapy massage significantly decreased fatigue, systolic blood pressure, mean arterial pressure and O2 saturation more than the reflexology intervention. However, reflexology reduced patients' heart rates more than an aromatherapy massage (P

Objective (s): Due to the increasing elderly population in the world, need to access accurate data for planning and action to protect and promote the health of the elderly is more attention. Choosing right tools with good psychometrics properties is a prerequisite for access accurate data. The aim of this systematic review was to assess the common tool used measuring quality of life. Methods: A comprehensive search of databases of Pubmed, Medline, and Science Direct was conducted, using the related keywords to development and psychometrics of older quality of life instruments. Results: In all a total of 342 papers were included in this review. Most commonly used quality of life measures in elderly were generic instruments (81.3%). Among generic measures the 36-Item Short Form Health Survey (SF-36) was widely used (26.8%), while only specific tools to measure quality of life in elderly people accounted for 18.7%. Among specific measures the World Health Organization Quality of Life - OLD was widely used (9.6%). Conclusion: The results revealed that CASP-19, OPQOL-BRIEF and WHOQOL-AGE are the best specific measures that can be recommended for measuring quality of life in elderly populations.

Introduction: Coronary artery disease is the most common type of cardiovascular disease. Despite the increasing number of patients with coronary artery disease, the lived experiences of these patients have remained unknown. The purpose of the study was to understand the lived experiences of elderly patients with coronary artery disease. Methods: This qualitative research was conducted using an interpretive phenomenological approach. Participants included thirteen elderly patients (9 males and 4 females) with coronary artery disease selective of purposive sampling method from Coronary Care Unit of Shahid Beheshti Hospital in Qom, 2016. Data were collected through semi-structured interviews between 55 - 80 minutes. The interviews were recorded and transcribed. The Van Manen's proposed six steps was used to analyze the data. Results: The main theme of study was "living with ups and downs". It included sub-themes of 1) losing calmness,2) trying to achieve calmness through spirituality, 3) losing health, 4) trying to promote health through modification of lifestyle, 5) perceiving family support, 6) living in fear, 7) living with a damaged heart". Conclusion: Findings of the research indicated that the coronary artery disease led patients to experience ups and downs for the participations. After the disease, they were trying to achieve calmness through some strategies. Members of the treatment team, especially nurses should provide self-care education for to make them be have successfully in this field.&nbsp

Objective (s): Assessing quality of life in elderly needed specific instrument. The Older People’s Quality of Life Questionnaire (OPQOL-35) is one of the common measure used for assessing quality of life of the elderly. This study aimed to translate and validate the Persian version of OPQOL-35, in Iran. This questionnaire consists of 35 items measuring life overall, health, social relationships and participation, independence, control over life and freedom, home and neighborhood, psychological and emotional well-being, financial circumstances, leisure, activities and religion. Methods: Forward-backward procedure was used to translate the questionnaire into Persian. Then, face validity and content validity was performed. Data were collected from 200 older people. In order to evaluate the construct validity, known-groups comparison (elders living alone vs. elder living with family or someone) was performed. The correlation between the OPQOL-35 and SF-36 was tested to establish criterion validity. Reliability was evaluated using intraclass correlation coefficients (ICC) using test- retest analysis. Results: The result of known- groups comparisons showed that quality of life in elders living alone was significantly lower than other elders (P< 0.001). Criterion validity represented a significant correlation between Persian version of the OPQOL-35 and the SF-36 (P

Introduction: High incidence rates of childhood cancer and the consequent deaths in the Middle East is one of the major reasons for the need for palliative care in these countries. Using the experiences and innovations of the other countries can provide a pattern for the countries of the region and lead to the development of palliative care in children. Therefore, the aim of this study is to compare the status of pediatric palliative care in Egypt, Lebanon, Jordan, Turkey, and Iran. Materials and Methods: This is a comparative study in which the information related to pediatric palliative care system in the target countries (from 2000 to 2016) has been collected, summarized, and classified by searching in databases, such as “PubMed, Scopus, Google scholar, Ovid, and science direct.” Results: Palliative care in children in the Middle East is still in its early stages and there are many obstacles to its development, namely, lack of professional knowledge, inadequate support of policy-makers, and lack of access to opioids and financial resources. Despite these challenges, providing services at the community level, support of nongovernmental organizations (NGOs), using trained specialists and multi-disciplinary approach is an opportunity in some countries. Conclusion: Considering the necessity of the development of pediatric palliative care in the region, solutions such as training the human resources, integrating palliative care programs into the curriculum of the related fields, establishing facilitating policies in prescription and accessibility of opioids, providing the necessary support by policy-makers, doing research on assessment of palliative care quality, as well as NGOs' participation and public education are suggested.

Objective This study aimed to investigate the impact of listening to pleasant natural sounds on anxiety and physiological parameters in patients undergoing coronary angiography. Methods The present pragmatic quasi-randomized controlled clinical trial was conducted on 130 patients undergone elective angiography. The participants were randomly divided into two groups, including a pleasant natural sounds group, and a control group (n1/2 65 per group). Spielberger's state/trait anxiety inventory was used to assess levels of anxiety. The patients' anxiety level and physiological parameters were measured at baseline, before, during, immediately after, and 20 min after coronary angiography. Results The mean level of anxiety was similar in both arms at baseline (t = 1.317, df = 128, p = 0.190). The intervention arm displayed significantly lower anxiety levels than the control arm during the intervention (Wilks' lambda 0.11, Pillai's trace 0.89, P 0.001, F 2.05). The physiological parameters (systolic and diastolic blood pressure, mean arterial pressure, heart rate, and oxygen saturation) of both groups showed statistically significant differences ( p 0.05) over time and in group-by time interactions. Conclusion As an effective nursing intervention presenting no side-effects, listening to pleasant natural sounds can be helpful in the management of anxiety.

Objective (s): Heart failure is a severe chronic disease and has a negative impact on the quality of life (QoL). The aim of this study was to assess quality of life and its related factors in patients with heart failure using an specfic measure.. Methods: A cross-sectional study of 210 patients with heart failure was conducted using convenience sampling methods. The Minnesota Living with Heart Failure (MLHF) and socioeconomic questionnaires were used to collect data. The data analysis was performed using descriptive statistical tests, Pearson correlation coefficient, independent t-test, and regression analysis. Results: The mean age of patients was 57.90±13.54. Higher and lower scores were observed for the treatment satisfaction with mean and standard deviation of 66.34±17.32, and angina stability with mean and standard deviation of 38.92±24.02. The results of multiple liner regression showed that there was significant difference between quality of life and NYHA class (β =0.13; p=0.04). Conclusion: The finding indicated that quality of life was low in patients with Heart Failure. Higher NYHA class was independent predictors of poor QoL in patients hospitalized with heart failure. It seems necessary to put more focus on nursing care to enhance and improve quality of life for these patients.

Objective (s): To translate and validate a Persian version of the AAQ in Iran. The AAQ consists of 24 items which cover three theoretical domains: physical change, psychological growth, and psychosocial loss. Methods: The existing AAQ (English version) was translated into Persian according to process of translation and adaptation of instruments of The World Health Organization protocol. Data were then collected from 200 older people. Reliability (internal consistency, test- retest reliability) face validity, content validity, known-groups comparison and criterion validity of the AAQ, with the SF-36, and the WHOQOL, were examined. Results: The mean age of participants was 67.66 ±6.28, and more than half (50.5%) were female. There was satisfactory internal consistency (Cronbach’s a 0.80–0.89) for the subscales. Test-retest reliability (ICC) of the questionnaire with interval time of two weeks was 0.97(p < 0.001). The result of known-groups comparison showed that the questionnaire discriminated between subgroups of elderly people differing in gender, and education. Criterion validity was assessed by comparing scores for the eight dimensions of the SF-36, four factors of the WHOQOL and four factors of the AAQ (Persian version). The AAQ showed significant correlation with SF-36, and WHOQOL in most dimensions. Conclusion: We tested and validated a Persian version of the AAQ with 24 items. It appears to be a promising tool, providing reliable and valid data helping for measuring Attitudes to Ageing among elders in different settings such as clinics, homes and research environments. It is recommended in the future studies that structural validity of the Persian version AAQ in larger sample factor analysis be examined.

Objective (s): This study aimed to translate and validitethe 20-item Geriatric Anxiety Inventory (GAI) in Iran. Methods: After receiving permission from the designer, the Persian version of the GAI wa provided. Then face and content validity، construct validity were performed. Known group cpmaprsion and by using the SF-36, criterion validity also was performed. Internal consistency was used to examine reliability. Results: In all 100 elderly participated in the study. Significant differences between none-abused and abused groups observed ((P = 0.0001). The criterion validity showed high and significant correlation between most GAI and SF-36 subscales. Cronbachchr('39')s alpha for the total scale was 0.957. Conclusion: The findings revealed that the Persian version of GAI is a valid instrument to measure anxiety in eldrly populations in Iran. We recommend that the future studies examine factors structure of the questionnaire in a larger sample size.

Objective (s): This study aimed to translate and validate a Persian version of the CASP-19, in Iran. Methods: The existing CASP-19 (English version) was translated into Persian version according to the World Health Organization protocol for translation and adaptation of instruments. The operational measure (CASP-19) consists of 19 Likert-scaled items that cover four theoretical domains: control, autonomy, self-realization and pleasure. Data were collected from 100 older people. Reliability (internal consistency, test- retest reliability) face validity, content validity, known groups comparisons and criterion validity of the CASP-19 and the SF-36, were examined. Results: The mean age of the participants was 69.6 (standard deviation± 7.32) years, and more than half (54%) were female. We observed satisfactory internal consistency (Cronbach’s a 0.70–0.88) for the subscales. Test-retest reliability (ICC) of the questionnaire with two weeks interval was 0.96(p < 0.001). The result of known- groups comparisons showed that the questionnaire discriminated subgroups of elderly people who differed in neglect. Criterion validity was assessed by comparing SF-36 and CASP-19 (Persian version). Relationship between translated scale and the SF-36 subscales showed significant correlation in most dimensions. Conclusion: The findings suggest that the CASP-10 is a valid measure for assessing quality of life in elderly populations in different settings.

Hospitalization in the cardiac care unit can increase anxiety in patients. This study aimed to compare hand reflexology versus acupressure on anxiety and vital signs in female patients with coronary artery diseases. This double-blinded randomized placebo-controlled trial with a pre- and post-intervention design was conducted on 135 female patients with coronary artery diseases. Female patients hospitalized in a cardiac care unit were randomly divided into three groups of hand reflexology, acupressure and placebo (n = 45 patients in each group) using blocking and a table of random numbers. Data was collected using the Spielberger anxiety inventory. Also, their vital signs were measured before, immediately after and half an hour after the intervention. Data analysis was performed using descriptive and analytical statistics. Before the intervention, there was no statistically significant difference in anxiety levels between the groups (p &gt, 0.05). Also, the effects of hand reflexology and acupressure immediately and half an hour later on the reduction of anxiety and vital signs were equal (p &lt, 0.05). Implementation of hand reflexology and acupressure can have positive effects on anxiety and vital signs in patients with coronary artery diseases. They can reduce patients&rsquo, anxiety with an equal effectiveness.

Background Assessing quality of life (QOL) in elderly needs specific instruments. The Older People’s Quality of Life Questionnaire (OPQOL-35) is one of the common tools that used for measuring quality of life in elderly populations. The questionnaires contains 35 items tapping into eight domains including life overall, health, social relationships and participation, independence, control over life and freedom, home and neighborhood, psychological and emotional well-being, financial circumstances, culture and religion. This study aimed to translate and validate the OPQOL-35 in Iran. Methods Forward-backward procedure was applied to translate the original questionnaire from English into Persian. Then following qualitative face and content validity, a sample of elderly people completed the questionnaire. In order to evaluate the construct validity, exploratory and confirmatory factor analyses was performed. Subsequently, convergent and divergent validity of the factors were evaluated. Reliability was evaluated by performing internal consistency analysis and Intraclass Correlation Coefficients (ICC). Results In all 500 older people completed the questionnaire. The mean age of participant was 68.92 (SD = 6.97) years, and mostly were males (66.6%). The result of exploratory factor analysis showed 8 factors with Eigen values of greater than one, which explained 67.4% of the variance observed. Confirmatory factor analysis showed acceptable fit indexes for the data [Comparative Fit Index (CFI) = 0.92, Minimum Discrepancy Function by Degrees of Freedom divided (CMIN/DF) = 2.832, Root Mean Square Error of Approximation (RMSEA) = 0.067]. The convergent and divergent validity did not support three latent factors (Life overall, Independence, control over life, freedom and Psychological and emotional well-being). Convergent and divergent validity shown that construct fulfilled for the health, social relationships and participation, home and neighborhood, financial circumstances, culture and religion latent factors, however the results did not support the convergent and divergent validity for three latent factors (Life overall, Independence, control over life, freedom and Psychological and emotional well-being). Cronbach’s alpha coefficient for the subscales ranged from 0.65–0.95. Test-retest reliability (ICC) of the questionnaire with two weeks interval were ranged from 0.88–0.95 indicating a good range of reliability. Conclusion The findings suggest that the Iranian version of OPQOL-35 is a valid measure for assessing quality of life in elderly populations in different settings. Electronic supplementary material The online version of this article (10.1186/s12955-018-1002-z) contains supplementary material, which is available to authorized users.

Background and purpose Patients on hemodialysis experience anxiety and depression. This study aimed to investigate the effect of guided imagery on anxiety, depression, and vital signs in patients on hemodialysis. Materials and methods This randomized controlled clinical trial was conducted on 80 patients undergoing hemodialysis. The subjects were randomly assigned into two groups: a guided intervention group and a control group. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Results After the intervention, the level of anxiety and depression were significantly lower in the intervention group compared with the control group (p = 0.030, p = 0.001, respectively). A statistically significant reduction in the respiratory rate and heart rate was reported in the intervention group (p Conclusion Nurses are suggested to use guided imagery along with other interventions for the management of anxiety and depression. It can alleviate adverse psychological responses among patients on hemodialysis.

Background: Today, improving the quality of life for the elderly is of great importance. In addition, creating a favorable environment for the elderly has become a common concern worldwide. Objectives: The aim of this study was to assess the psychometric properties of the Persian version of quality of life (CASP- 19) in older people. Methods: The study included 200 participants. The CASP-19 quality of life instrument for older people was adapted to Persian language through a translation and translation-back procedure. Afterwards, the reliability (internal consistency and test-retest) and validity (including face validity, content validity, factor analysis, known groups, and criterion validity), through assessing the correlation between the Persian version of the CASP-19 and the SF-36, were measured. Results: Based on internal consistency (Cronbach > s α), the reliability for CASP-19 was 0.97 and for the four subscales varied from 0.93 to 0.97. Test-retest reliability (Pearson’s correlation coefficient) for the Farsi version of the CASP-19 ranged from 0.87 to 0.94. Evaluation of discriminant validity indicated the discriminant power of the CASP-19 in terms of the presence or absence of curtailment of personal autonomy. Criterion validity indicated a significant correlation between many dimensions of the CASP-19 and the SF-36. Conclusions: This study confirmed the validity of the CASP-19 in terms of construct, convergent, known groups, and face validity. Besides, it showed an acceptable internal consistency. The CASP-19 is valid for investigating the needs of the Iranian elderly.

Objectives: Elder abuse is a social and psychological problem of the community that has a significantimpact in reducing mental health of the elderly. It can be considered as one of the factors predisposingto aging depression. The purpose of this study was to evaluate the relationship between age and depressionin the elderly abused in Kashan, Iran, in 2014. Methods & Materials: This descriptive, cross-sectional study was conducted on 500 people aged.60 yearsold in Kashan City, Iran, in 2014. Subjects were randomly selected from 10 healthcare centers of Kashan.The study instruments were demographic information, elder abuse questionnaire in the family (α=0.97),and geriatric depression scale (α=0.90). Results: Results of the current study showed that 80% of subjects have experienced at least one typeof abuse during the last year. The highest rate of abuse was financial abuse (45.6%), and 79.2% hadsome sort of depression. Linear regression analysis showed that emotional neglect (P=0.001, β=0.20), financialneglect (P=0.036, β=0.117) and ostracizing (P=0.001, β=0.241) were significantly associated withdepression. According to the test, a correlation was observed between the elder abuse and depression(r=0.490, P=0.001). Conclusion: The study results indicate the importance and necessity of providing health care services andsupport for the identification of depressed elderly victims of abuse and prevention to solve this problemand improve their situation.

Nurses are required to be knowledgeable about the needs of family members of patients hospitalised in the intensive care unit. The identification of the importance and priority of family members’ needs enables nurses to provide appropriate information and support for family members. The aim of this study was to describe the needs of family members of patients hospitalised in the intensive care unit. A descriptive cross-sectional study using survey methods was conducted. Family members of patients hospitalised for 24–72 hours in the intensive care units of 27 public and teaching hospitals in an urban area of Iran were chosen using the random sampling method. The 45-item Persian version of the Critical Care Family Needs Inventory was used to collect numerical data. Four hundred and fifty family members participated. The mean score for each of the 45 items ranged from 2.45 to 3.72. Ten items were rated by responders as very important, with 93.13% of the sample rating ‘Giving an honest answer to questions’ as having the highest level of importance. ‘To have the pastor visit’ was reported to be the least important need. Age, family relations, marital status and level of education related to the importance level of some of the perceived needs. It is concluded that the most important needs consist of five items relating to the ‘assurance dimension’, while the least important ones are related to the ‘support dimension’. The incorporation of the needs of family members into the nursing education programme is suggested. The findings will help with the preparation of nurses, as future healthcare policy makers, to plan for meeting these needs and will reduce the psychological burden on family members of patients hospitalised in the intensive care unit.

Objective (s): To translate and evaluate the the myocardial infarction dimensional assessment scale (MIDAS), as a disease-specific quality of life scale in patients with myocardial infarction in Iran. Methods: After permission, the questionnaire was translated. Then face validity, content validity, concurrent validity and criterion validity were assessed. In order to evaluate the construct validity, known-groups comparison (patients with and without smoking) was performed. For criterion validity the Short Form 36 (SF-36) was used. Cronbachchr('39')s alpha coefficients and the test retest were used to assess the scale reliability. Results: One hundred patients with myocardial infarction participated in the study. The criterion validity showed high and significant correlation between most the MIDAS and the SF-36 scores. The Cronbach’s alpha for the scale ranged from 0.74 to 0.887 and test-retest reliability (ICC) within 2 weeks, in all dimensions was greater than 0. 90. Conclusion: The findings suggest that the MIDAS is a valid and reliable disease-specific scale and can be considered for measuring health outcomes in research and clinical settings.

Cronbachâ s alpha coefficients for the OPQOl-35 if item deleted. (DOC 92 kb)

Item-domain correlation matrix for the OPQOL-35. (DOC 185 kb)

Spiritual wellbeing harmonises several dimensions of human life and is essential for coping with diseases. Acute coronary syndromes (ACS) cause crisis in physical, psychological aspects and spiritual dimensions of patients’ lives. The purpose of this study was to determine the level of spiritual wellbeing and its dimensions in patients with ACS. For this, a cross-sectional descriptive study was conducted. For data collection, Paloutzian and Ellison’s Spiritual Wellbeing Self-report Questionnaire was filled in by 364 patients with ACS. Patients referred to the cardiac wards of five teaching hospitals in Tehran between August 2011 and April 2012 were recruited using the convenience sampling method. The data were analysed using descriptive and inferential statistics. The findings revealed that the majority of patients (97.9%) benefited from moderate spiritual wellbeing, although religious wellbeing was higher than existential wellbeing in the patients. It is concluded that nurses are required to improve their cultural and contextual knowledge of patients’ spiritual wellbeing to meet patients’ needs in nursing care. Spiritual beliefs can influence coping with diseases, help patients to find meaning and purpose in life to deal with problems resulting from physical and mental illnesses. These findings can be used to suggest the incorporation of religious aspects of spirituality into care programmes designed to improve the quality of life of patients with ACS.