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Abstract Background Considering the values and preferences of individuals who attempt to quit smoking is a crucial step in the development of smoking cessation technologies. This study aimed to explore preferences regarding smart smoking cessation technologies. Methods This parallel convergent mixed-methods study was conducted in two phases: quantitative and qualitative. In the quantitative phase, a cross-sectional study was conducted with 360 participants selected through stratified random sampling from technology-based smoking cessation clinics in Tabriz, Tehran, and Karaj cities in Iran. Data on demographic characteristics and preferences for smart smoking cessation technologies were collected using questionnaires and analyzed using descriptive statistics. In the qualitative phase, 25 users of these technologies were selected through purposeful and snowball sampling. The data were gathered through in-depth semistructured interviews and analyzed using qualitative content analysis with a conventional approach. Quantitative and qualitative data were integrated using the merging strategy and convergence model. Results The quantitative phase results indicated that the highest preference was related to wearing and using a smartwatch for smoking cessation and using mobile apps. In the qualitative phase, 17 subcategories were extracted and classified into 8 main categories: high effectiveness, better management of the smoking cessation process, personalized technology, safe and uncomplicated technologies, attractiveness and innovative design, scientific basis, mobile applications, and smart monitoring devices. Conclusion By combining and integrating quantitative and qualitative results, it can be concluded that users are more interested in wearable technologies and interactive mobile applications. The findings of this study can assist smoking cessation technology developers in designing and improving their tools based on user needs and preferences to enhance their effectiveness and acceptability.

Abstract Screening is a key component of breast cancer early detection programs that can considerably reduce relevant mortality rates. The purpose of this study was to determine the breast cancer screening behavioral patterns and associated factors in women over 40 years of age. In this descriptive‑analytical cross‑sectional study, 372 over 40 years of age women visiting health centers in Tabriz, Iran, in 2023 were enrolled using cluster sampling. The data were collected using the sociodemographic characteristics questionnaire, breast cancer perception scale, health literacy for Iranian adults scale, and the Breast Cancer Screening Behavior Checklist. The obtained data were analyzed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (univariate and multivariate logistic regression analyses). In total, 68.3% of all participants performed breast self‑examination (BSE) (9.9% regularly, once per month), 60.2% underwent clinical breast examination (CBE) (8.9% regularly, twice per year), 51.3% underwent mammography (12.3% regularly, once per year), and 36.2% underwent sonography (3.8% regularly, twice per year). The findings also showed that women with benign breast diseases were more likely to undergo CBE (OR = 8.49; 95% CI 2.55 to 28.21; P < 0.001), mammography (OR = 8.84; 95% CI 2.98 to 10; P < 0.001), and sonography (OR = 18.84; 95% CI 6.40 to 53.33; P < 0.001) than others. Participants with low and moderate breast cancer perception scores were more likely to perform BSE than women with high breast cancer perception scores (OR = 2.20; 95% CI 1.21 to 4.00; P = 0.009) and women who had a history of benign breast disease were more likely to perform screening behaviors than others (OR = 2.47; 95% CI 1.27 to 4.80; P = 0.008). Women between the ages of 50 and 59 were more likely to undergo mammography (OR = 2.33; 95% CI 1.29 to 4.77; P = 0.008) and CBE (OR = 2.40; 95% CI 1.347 to 4.20; P = 0.003) than those ≥ 60 years. Given the low participation of women in regular breast cancer screening, it is suggested that health care providers highlight the need for screening at the specified intervals in their training programs. In addition, health authorities are recommended to use reminder systems to remind women, especially those over 40 years of age, of the best time for breast screening. Moreover, health care providers must seek to improve breast cancer knowledge, attitudes, and perceptions of women who visit health centers, which are the first level of contact with the healthcare system for the general population.

Abstract Background Breast cancer is a prevalent cancer characterized by its aggressive nature and potential to cause mortality among women. The rising mortality rates and women’s inadequate perception of the disease’s severity in developing countries highlight the importance of screening using conventional methods and reliable scales. Since the validity and reliability of the breast cancer perception scale (BCPS) have not been established in the Iranian context. Therefore, this study aimed to determine the measurement properties of the BCPS in women residing in Tabriz, Iran. Methods The present study comprised a cross-sectional design, encompassing a sample of 372 Iranian women. The participants were selected through a multi-stage cluster random sampling technique conducted over a period spanning from November 2022 to February 2023. The measurement properties of the Iranian version of BCPS were assessed following the guidelines outlined in the COSMIN checklist. This involved conducting various steps, including the translation process, reliability testing (internal consistency, test-retest reliability, and measurement error), and methodological tests for validity (content validity, face validity, construct validity, and hypothesis testing). The study also investigated the factors of responsiveness and interpretability. The presence of floor and ceiling effects was assessed. Results The internal consistency of the scale was assessed using Cronbach’s alpha, yielding a satisfactory value of 0.68. Additionally, McDonald’s omega (95% CI) was computed, resulting in a value of 0.70 (0.66 to 0.74). Furthermore, the test-retest reliability was evaluated, revealing a high intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94 to 0.99). The CVI, CVR, and impact scores of the BCPS were determined to be 0.98, 0.95, and 3.70, respectively, indicating favorable levels of content and face validity. To assess construct validity, an examination of the Exploratory Factor Analysis (EFA) was conducted on a set of 24 items. This analysis revealed the presence of six distinct factors, which collectively accounted for 52% of the cumulative variance. The fit indices of the validity model (CFI = 0.91, NFI = 0.96, RFI = 0.94, TLI = 0.90, χ2/df = 2.03, RMSEA = 0.055 and SRMR = 0.055) were confirmed during the confirmatory factor analysis (CFA). The overall score of BCPS exhibited a ceiling effect of 0.3%. The floor effect observed in the overall score (BCPS) was found to be 0.5%. Concerning the validation of the hypothesis, Spearman’s correlation coefficient of 0.55 was obtained between the BCPS and the QLICP-BR V2.0. This correlation value signifies a statistically significant association. Furthermore, it is worth noting that the minimum important change (MIC) of 3.92 exhibited a higher value compared to the smallest detectable change (SDC) of 3.70, thus suggesting a satisfactory level of response. Conclusions The obtained findings suggest that the Iranian version of the BCPS demonstrates satisfactory psychometric properties for assessing the perception of breast cancer among Iranian women. Furthermore, it exhibits favorable responsiveness to clinical variations. Consequently, it can serve as a screening instrument for healthcare professionals to comprehend breast cancer and as a reliable tool in research endeavors.

Abstract Background Breast cancer and genital cancer are known as cancers that affect people’s relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. Methods To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients’ marital adjustment, patients’ marital satisfaction, patients’ marital intimacy, and patients’ marital relationships. The secondary outcomes were partners’ marital adjustment, partners’ marital satisfaction, partners’ marital intimacy, and partners’ marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. Results From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient’s marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner’s marital satisfaction, the patient’s and partner’s marital adjustment, and the patient’s and partner’s marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient’s marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner’s marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient’s marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner’s marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. Conclusions The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

Abstract Background Premature infants need to be hospitalized in the neonatal intensive care unit (NICU) for long periods of time, which can increase anxiety and stress in their mothers. Additionally, the breastfeeding rate is lower among preterm infants. This study aimed to determine stress levels and emotional intelligence in mothers of preterm infants and their relationship with breastfeeding self-efficacy. Methods This descriptive-correlational study was performed with a convenience sampling of 210 mothers of premature infants admitted to the neonatal intensive care unit in Tabriz, Iran in 2021. Data collection tools included socio-demographic checklist, perceived stress scale (PSS14), Dennis’ breastfeeding self-efficacy scale, and the Schering emotional intelligence questionnaire. Data were analyzed using SPSS software version 16 via descriptive and inferential statistics (Pearson correlation and one-way ANOVA and modified general linear model). Results Study findings demonstrated that most of the mothers had low stress (75.2%) and high breastfeeding self-efficacy (61.9%). The mean (SD) of emotional intelligence of the participants was 88.18 (16.60), ranging from 33 to 165. The results of the general linear model by modifying the demographic characteristics showed that the variables of emotional intelligence (B = 0.23, P = 0.03), stress (B=-0.56, P = 0.01), gestational age (B = 2.81, P < 0.001) and number of deliveries (B = 9.41, P < 0.001) were predictors of breastfeeding self-efficacy. Conclusion The findings showed that mothers of preterm infants had low emotional intelligence, and the majority of them had low perceived stress and high breastfeeding self-efficacy. Findings highlight the importance of addressing maternal stress and enhancing emotional intelligence to promote successful breastfeeding in mothers of preterm infants. Healthcare providers and managers are encouraged to offer support and educational programs to mothers of preterm infants, aiming to enhance their emotional intelligence. Further research and interventions focusing on these factors are warranted to improve the overall well-being of both mothers and infants in the neonatal intensive care unit.

Abstract Aim To develop the general population knowledge, attitudes and practices (KAP) questionnaire towards the COVID‐19 outbreak. Design A methodological study. Methods The general population KAP questionnaire items were designed using a literature review. A panel of experts was used to calculate content validity ratio (CVR) and content validity index (CVI). Construct validity was examined using exploratory factor analysis (EFA) and hypothesis testing. Internal consistency of the questionnaire was measured using Cronbach's α coefficient. Eight hundred forty‐seven patients referred to health centres in Tabriz, Iran completed the questionnaire in 2021. Results The developed questionnaire consisted of three parts, including knowledge, attitudes and practices. EFA identified three dimensions for the knowledge (ways of transmission and prevention, high‐risk groups, and symptoms and treatment), three dimensions for the attitudes (hope, fear and view of the vaccine) and three for the practices (adherence to personal and public hygiene, limiting their presence in society and protecting yourself in the community). The Kaiser–Meyer–Olkin index for knowledge, attitudes and practices was 0.733, 0.725 and 0.886, respectively, with a significant Bartlett's test of sphericity (p

Abstract Background The exclusive breastfeeding (EBF) is undeniably proven significant in mothers’ health and infants’ growth and survival. Its persistence has many familial, social, and economical benefits. Social support is known to be an effective factor in EBF’s success and sustainability. However, Exclusive breastfeeding social support (EBFSS) scale validity and reliability is not evaluated in Iran. This study aimed to determine the psychometric properties of EBFSS during postpartum period in Tabriz city, Iran. Methods It is a cross-sectional study with descriptive survey method performed between March 2021 and August 2022. Psychometric properties were determined for the Persian version of EBFSS in six stages: translation process, evaluating content validity, face validity, construct validity, discriminant validity, and reliability. A group of experts (n = 10), followed by a group of women with EBF (n = 10), evaluated the instrument’s items based on content and face validities, respectively. A cross-sectional study using the multi-stage cluster random sampling method on 348 women with EBF in the first four months after delivery was conducted to determine the construct validity. The internal consistency and repeatability (test-retest on 30 women, 2 weeks apart) were used to find out the reliability. Results Content validity ratio (CVR), content validity index (CVI), and impact score were 0.98, 0.98, and 3.54 for EBFSS, respectively. This indicates a good content and face validity. Exploratory factor analysis (EFA) was performed on 16 items to examine the construct validity identified emotional, instrumental, and informational factors. These factors explained 59.26% of the cumulative variance. The fit indices (CFI = 0.98، TLI = 0.95، χ2/df = 4.20، RMSEA = 0.07 and SRMSEA = 0.05) confirmed the validity of the model in a confirmatory factor analysis (CFA). The internal consistency was examined through Cronbach’s alpha and McDonald’s omega coefficients that were 0.90 and 0.92, respectively. Finally, Repeatability and reproducibility were found 0.97 (95% CI: 0.92 to 0.99) using Intra-class correlation. This shows an appropriate reliability of the instrument. Conclusions The research findings indicate that the Persian version of the EBFSS has appropriate psychometric properties for evaluating the social support in Iranian women with EBF. This means healthcare providers can use it for screening social support in EBF. Researchers also can use it as a valid instrument.

Objectives: This study investigates the prevalence and risk factors of child-to-parent violence (CPV) among university students in Tabriz. Methods: Using a cross-sectional design, 500 first-year students from Tabriz University of Medical Sciences were surveyed with questionnaires. Data analysis was conducted using SPSS version 16. Results: The findings revealed a concerning prevalence of controlling and psychological violence towards both mothers (48 %) and fathers (44 %). Boys demonstrated a lower likelihood of violence against their father (aOR=0.44; 95 % CI: 0.30 to 0.64) and mother (aOR=0.41; 95 % CI: 0.28 to 0.60) compared to girls. Students in the paramedical group exhibited a 54 % and 77 % lower probability of violence against their father (aOR=0.46; 95 % CI: 0.17 to 0.65) and mother (aOR=0.33; 95 % CI: 0.25 to 0.84) respectively, compared to those in the medical group. Spiritual well-being did not show a significant association with CPV towards fathers (p = 0.379) and mothers (p = 0.186). Discussion: These findings underscore the need for multi-pronged interventions. Equipping students with healthy communication skills, expanding mental health services, and implementing preventive programs targeting adolescents could be crucial in addressing CPV. For nursing practice, this research provides a basis for developing care strategies that incorporate mental health support and communication skill enhancement.

Abstract Background The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. Methods This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. Results A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. Conclusion Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.

Abstract Background Covid-19 has had significant effects on the quality of life of individuals around the world. Research highlights many negative impacts related to Covid-19; however, there are also potential positive impacts. The current study aimed to identify both the perceived negative and positive effects of Covid-19 among the residents of Tabriz, Iran. Materials & methods The descriptive cross-sectional study was conducted in 10 health centers in Tabriz city in 2021. Cluster random sampling was used to select the 861 study participants. A questionnaire was developed to collect demographic and Covid-19 impacts. Data were analyzed with descriptive and inferential statistics using SPSS 16 software. Results The mean (SD) of negative and positive impacts of Covid-19 was 37.7 (5.10) and 36.35 (5.31), respectively. Significant negative impacts included restriction in participation in cultural (90.4%) and religious (88.9%) activities. Positive impacts were increased attention to personal hygiene (88.7%) and attention to elders (87.6%). Gender (p = 0.006), work status (p = 0.004) and age (p = 0. 01) had significant association with the mean of negative impacts and work status (p = 0.01), age (p

Background: Donated milk is the best choice for infants who cannot receive breast milk from their mothers. Researchers in this study evaluated the knowledge and attitude of healthcare providers regarding milk-donation and examined their socio-demographic predictors in Tabriz-Iran, 2021.Methods: In this cross-sectional analytic study, the total sample size consisted of 535 healthcare providers including 272 nurses and midwives working at maternal hospitals and 263 healthcare providers working at healthcare-centers. Census-sampling method was used during October 2020 to February 2021, and data collection tools included socio-demographic, knowledge and attitude questionnaires. Pearson-correlation test, independent t-test, one-way analysis of variance, and adjusted general linear model were used to analyze the data using SPSS version 16.Results: The mean (SD) of the knowledge score was 12.04±4.30 (score range of 0-22) and that of the attitude score was 134.27±20.23 (score range of 42-210). Results of general linear model was adjusted for socio-demographic characteristics and showed that predictors of knowledge variable were associated with having prior experience of breastfeeding another infant (P=0.006) and encouraging others to breastfeed (P=0.008); also, the predictor of attitude variable was aligned with encouraging others to breastfeed (P

Background. The concept of age-friendly cities has been introduced by the World Health Organization (WHO) in an attempt to pay more attention to the elderly. In Iran, this issue is more important due to demographic changes and age conditions. This study aimed to investigate the views of the elderly people living in Tabriz about the indicators of age-friendly cities. Methods. In this cross-sectional descriptive-analytical study, 351 elderly people were selected from six age-friendly centers in Tabriz by simple random sampling method. The data collection tool was the standard questionnaire of the WHO in an age- friendly city. To analyze the data, both descriptive statistics (frequency, frequency percentage, mean, and standard deviation) and analytical statistics (analysis of variance and t-test) were used. Also, the Statistical Package for the Social Sciences (SPSS) software version 16 was used and significance level was considered as 0.05. Results. Among the four studied indicators, the health component had the highest average (44.57 (11.81)), followed by the components of social respect (38.5 (11.5)), participation in social relations (34.8 (9.12)), and the cultural and recreational index (32.86 (10.54; range 1-100)). We also observed a significant relationship between gender and marriage with cultural and recreational component (P = 0.002). Conclusion. Since none of the four indicators of age-friendly cities in Tabriz were standard, the managers of aging-related organizations should plan to standardize these indicators to achieve the desired conditions.

Introduction: Nurses of the emergency department experience stressful events that affect their mental health and reduce the quality of their work life. Career adaptability is considered a personal capability that enables employees to adapt to changes and avoid the negative consequences of job mismatch. This study was conducted to study career adaptability and its correlation with the quality of work life in the emergency department. Material and Methods: This descriptive-correlational study was conducted on 104 nurses in the emergency department of teaching–therapeutic hospitals in Tabriz who were selected using random stratified sampling. Data was collected using a demographic checklist, the Career Adapt-Abilities Scale (CAAS) by Savickas, and the Quality of Nursing Work Life (QNWL) scale by Brooks & Anderson. Data were analyzed in SPSS using descriptive statistics (frequency, mean and standard deviation) and inferential statistics (independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and linear regression analysis). Results: The total scores of career adaptability and the quality of nursing work life were 88.55±25.01 from the achievable range of 24-120 and 141.15±22.56 from the achievable range of 42-252, respectively, which were moderate. In this study, 85.6% of nurses enjoyed a moderate quality of work life. Furthermore, the results of Pearson’s correlation indicated a significant positive correlation between career adaptability and scopes with the quality of work life score (p=0.05). Regression analysis results indicated that career adaptability significantly predicts the quality of nursing work life (p=0.000). Conclusion: In this study, nurses experienced moderate career adaptability and quality of work life. Given the above factors, and considering adaptability as a variable predicting quality of work life, it is suggested to take measures to increase career adaptability in nurses through training or consulting interventions to improve the quality of nursing work life.

Abstract Introduction With rising age, the incidence of physical and mental problems increases. Physiological and social changes occur across the lifespan that can affect an individual’s health and ability. The present study was aimed to determine older adult’s ability to recognize cognitive changes and its relation with mental health status. Materials and Methods A descriptive correlational design was used to recruit 423 older adults who were referred to health centers in Tabriz, Iran in 2019 to receive primary health care. A systematic random sampling method was used for selecting participants. Data collection tools included a demographic-social questionnaire, General Health Questionnaire for assessing mental health (with 4 subscales) and a questionnaire of ability to recognize cognitive changes (with 8 sub-scales). Data were analyzed using descriptive statistics and inferential statistics. Results The mean score of mental health of the older adults was 56.35 (8.40) which shows moderately impaired mental health. The most impaired aspect of mental health detected was the social function dimension 13.20 (2.67). The average of the total ability score was 41.19 (4.78) and the physical strength dimension had the highest average of 9.08 (1.80) and the empowerment obligation dimension had the lowest average of 3.06 (1.08). There was significant relationship between dimensions of depression (r = 0.21, p

Abstract Background The problem of students’ gaming addiction has been related to the individual student’s characteristics and the influence of family environment. Researchers aimed to investigate if and how internet gaming disorder (IGD) of the elementary school boys and girls is related to behavioral disorder and their mother’s parenting style in Iran. Methods This is a descriptive correlational study, involving 657 fifth and sixth-grade elementary school students in 2019. Researchers used a multistage stratified random sampling of students, their parents and their teachers. Data were collected using internet gaming disorder questionnaire (IGD 20), Rutter teacher behavioral disorder questionnaire and Baumrind Parenting Styles questionnaire (PSI). Obtained data were analyzed using SPSS version16 for descriptive statistics and Pearson correlation coefficient test. Results Findings showed that IGD prevalence was 5.9% among primary school students with significant relationship between IGD and behavioral disorder among all participants (r = 0.23, p = 0.04); although it was insignificant among boys (r = 0.13, p = 0.11). Also the relationship between IGD and mother’s parenting style was significant in the total sample (r = 0.12, p = 0.03), in particular for girls and their mothers (r = 0.2, p = 0.001). Conclusions The results of this study indicate the importance of family and parental involvement in prevention and management of IGD chiefly among girls. Healthcare professionals will benefit from knowing the problematic consequences of online gaming among school-age children and try to promote safe and healthy online behavior supported by a supervised family environment.

Background and Purpose COVID-19 is a new infectious-disease first identified in December 2019 in China, and since it spread globally, it resulted in a Pandemic. Much research is needed to understand the disease, and especially its clinical characteristics. The aim of present study was to explore the clinical features, diagnosis, and treatment of COVID-19 in Tabriz, Iran. Materials and Methods This was a case series single center study that focused retrospectively on the clinical characteristics of 140 early consecutive cases with confirmed COVID-19, who were hospitalized at one of the referral hospitals for COVID-19 patients of Tabriz, from March 20 to May 3, 2020. We used patients’ records to obtain the data, which were analyzed by SPSS Version 16 using descriptive and analytic statistics (Student’s t-test, Mann-Whitney’s, and Chi-square test). Results Findings showed that 34 out of 140 patients deceased. The highest percentage of patients were in the age range of 65 years and over. The most common symptom on admission was dry-cough (67.9%), followed by shortness of breath (55.7%), and fever (51.5%). During hospitalization, 27.1% showed an increase in white-blood-cell count. Only 20% were ventilated and others received oxygen by cannula, and/or mask. Recovered patients reported significant lower rates of pre-existing comorbid conditions than patients who died (p= .02). Conclusion This single center study with a relatively small sample size showed that the most common symptom on admission among patients with COVID-19 was dry-cough, shortness of breath, and fever. The finding is mostly in accordance with the current evidence seen around the World.

Background: Internet dependency has become one of the 21st century dilemmas affecting different aspects of married life such as sexual relationships. Considering the importance of family in the Iranian society, this study aimed to determine how internet dependency is related to sexual desires and satisfaction among married clients of healthcare centers. Materials and Methods: This cross-sectional study was conducted on 326 married clients referred to healthcare centers in Tabriz City, Iran, between February and August 2019. Proportionate stratified random sampling was used based on the health complexes and the healthcare centers covered by them. One of the healthcare centers covered by each complex was selected randomly. The data collection tools included a demographic characteristics checklist, the Internet Addiction Test (IAT), the Index of Sexual Satisfaction (ISS), and the Hurlbert Index of Sexual Desire (HISD). The collected data were analyzed using the Pearson correlation coefficient test and multiple linear regression model. Results: The mean (SD) was 37.33 (15.37) for of internet dependency, 59.20 (17.27) for sexual desire, and 104.45 (22.81) for sexual satisfaction. There was a negative correlation between internet dependency and sexual satisfaction (r = -0.47, p < 0.001). This correlation remained significant (B = -0.41, df = 9, p < 0.001,) even when occupation (B = 3.66, p = 0.01), satisfaction with married life (B = 15.34, p < 0.001), and sexual desire (B = 0.60, p < 0.001) were adjusted as potential confounding factors. Conclusions: Internet dependency can cause a reduction in sexual desire and sexual satisfaction. Designing educational interventions in healthcare centers is recommended to manage the use of internet and to inform clients about the effects that internet dependency may have.

Background: Healthcare is changing from a focus on acute care health issues to one of managing chronic conditions. This change has resulted in the development of home health-care systems as a way of managing chronic conditions outside the hospital. The aim of this study was to analyze the concept of home healthcare using a hybrid model. Materials and Methods: This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical. Science Direct, PubMed, ProQuest, and Scopus were searched with related terms in the theoretical phase. In the fieldwork phase, six professionals with experience in home healthcare were interviewed and after each interview, qualitative content analysis was conducted. During the final phase, descriptions and themes from the first two phases were combined. Results: In the theoretical phase, the definition of home healthcare included descriptions answering the Who, What, When, Where, and Why questions. In the fieldwork phase, the results were divided into three areas: 1-comprehensive care; 2-extent of services; and 3-outcomes. The final analysis phase of this study indicated that the home health-care concept is a comprehensive, professional, and holistic care system accompanied by medical services and professionals whose goals are to support an individual's health and provide care in their home. Healthcare provided in one's home was found to preserve a patient's dignity and reduce health-care costs. Conclusions: The definition of the home healthcare concept establishes a foundation for developing a comprehensive home health-care system. This concept analysis for home healthcare could be a guide for future studies.

Introduction: As a major cause of mortality, coronary artery diseases (CAD) have become an important health priority in recent years. They can affect physical, mental, and social aspects of health and one's perception of wellness and general health. The present study is aimed at determining and comparing the general health status of coronary artery patients in two age groups: Under 45 and 45 and older. Methods: This descriptive–analytical study was conducted with 368 participants. The subjects were selected from March to June 2018 using convenience sampling from Tabriz's Madani Heart Center and Shohada Hospital and then divided equally into four groups: Under 45 CAD patients; under 45 non-CAD patients; 45 and older CAD patients; and 45 and older non-CAD patients. The non-CAD patients were matched to the CAD patients regarding age (±3 years) and sex. The data collection instrument was a 28-item General Health Questionnaire that was administered in interviews with the participants. The data were analyzed using descriptive and analytical statistics. Results: The general health mean scores of the participants were as follows: under 45 CAD patients (41.75 ± 8.80) and their counterpart control group (61.35 ± 7.65); 45 and older CAD patients (40.02 ± 11.22) and their counterpart control group (65.40 ± 6.45). There was a significant difference between the scores of the case and control groups in both age groups (P < 0.001). Conclusion: The results showed that disruption of general health is one of the influential factors in the incidence of CAD. To prevent such diseases, special attention should be given to the instruction of the factors that affect general health and its improvement.

Background: Happiness is a positive feeling that is vital and significant to maintain health. Nursesare working in difficult conditions which may heavily affect their level of happiness and ability toprovide care. Job burnout is a mental reaction against some persistent source of workplace stress. Thepurpose of this study was to identify happiness and its relationship with job burnout in nurses workingat Tabriz’s educational hospitals.Methods: This descriptive-correlational study was conducted on 344 nurses working at Tabriz’s hospitalsin 2018. The subjects were selected by means of proportionate stratified random sampling. Data werecollected using three questionnaires (demographic information, job burnout with 22 items and threesubscales and Oxford happiness with 29 items) and analyzed in SPSS version16 using descriptive statistics.Statistical tests such as Pearson correlation coefficient, independent t-test, one-way ANOVA, and multiplelinear regression analysis were used to analyze the data.Results: The age range of the participants was 23–57 years with a mean of 35.9±7.5. The mean score ofhappiness was 64.2±11.5, (score range 35 to 116), which suggests an average level of happiness amongthe nurses. There was a negative correlation between happiness and total job burnout (r=-0.29, p This negative correlation remained significant (B=-0.15, p health status (B=-5.24, P=0.01), history of illness (B=-4.47, P=0.04), job position (B=-6.61, P=0.001),and type of employment (B=3.56, P=0.03) as potential confounding factors were adjusted.Conclusion: Considering the reverse relationship between job burnout and happiness, it is suggestedthat managers try to improve the workplace by managing condition which could lead to job burnout,and therefore use the results to increase the happiness of nurs.

Objectives: Cardiovascular diseases (CVDs), especially ischemic heart diseases (IHDs) are one of the most important health-related issues in the world. Lifestyle plays a remarkable role in preventing or developing such diseases. Therefore, given the importance of lifestyle as an influential factor in the incidence of coronary artery disease (CAD) and the rise of these diseases in younger ages, the aim of the current research was to investigate and compare various aspects of patients’ lifestyles on developing CAD and subsequently to contrast them with non-affected patients. Materials and Methods: This study included 368 people who were equally divided into four groups of under 45-years-old coronary and non-coronary disease, as well as 45-years and older coronary and non-coronary disease. The participants were selected by means of the convenience sampling method from Madani heart center and Shohada hospital of Tabriz from March to June 2018. Non-coronary and coronary patients were matched in terms of gender and age (±3 years) and data were collected using a 65-item lifestyle questionnaire through interviews. Results: The mean lifestyle scores were obtained as 103.02±12.11, 123.83±10.35, 99.25±0.27, and 129.02±10.65 for under 45-years-old coronary patients and their counterpart control group, as well as 45-years-old and older patients and their counterpart control group, respectively. Based on the results, there was a significant difference between coronary patients and non-coronary groups in both age categories (P

Objectives: This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia and their determinants. Methods: This was a descriptive correlational study. Participants were 225 family caregivers of patients with schizophrenia who were referred to the psychiatric clinic at one large teaching referral hospital in Iran. They were selected through purposive sampling method. Data collection tools were demographic and clinical data form, the Zarit Burden Interview (ZBI) and the Family Coping Questionnaire (FCQ). Results: The score of caregiver burden was 65.14 ± 9.17. Of 225 family caregivers, 23.11% used an avoiding coping strategy. There was a significant relationship between caregiver burden and coping strategies (P

Introduction: Hypertension is a common chronic disease with multiple systemic complications. Reducing dietary salt intake is one of the most effective and economical methods for managing hypertension. The aim of this study was to investigate self-care agency and self-care behaviors of patients with hypertension in reducing dietary salt and its related factors in Tabriz. Methods: In a cross-sectional study, 250 hypertensive adults were selected in June 2016–2017 from a pool of referred patients to the general clinic at one large teaching hospitals in Iran. They were selected through purposive sampling method. The data collection tools included a demographic questionnaire, self-care agency scale, and self-care behaviors scale. Statistical analysis included simple and multiple (multivariable) linear regression. Results: For dietary sodium reduction, the mean scores (standard deviation) of self-care agency and self-care behaviors were 37.4 ± 10.04 and 36.5 ± 7.8, respectively. Variables with a significant correlation with self-care agency were marital status, age, and the years of hypertension diagnosis (P < 0.001), and for self-care behaviors were marital status and self-care agency (P < 0.001). Conclusion: The findings of this study showed that single and older patients with a recent diagnosis of hypertension had a low score in self-care agency and self-care behavior. Therefore, health-care providers can focus their educational activities on these individuals to enhance their self-care behaviors and agency.

Introduction: The novel coronavirus disease (COVID-19) has spread globally. Early and dynamic detection of prognostic factors is essential to improve the ability to treat COVID-19. The present study aimed to determine clinical characteristics and risk factors associated with the length of hospital stay and disease severity in hospitalized COVID-19 patients in Tabriz, Iran. Methods: This retrospective cohort study included 260 early diagnosed cases with COVID-19 hospitalized at two COVID-19 specialized hospitals in Tabriz, Iran, from April 20 to June 20, 2020. Patients’ medical records were used to collect the data. Severe COVID-19 outcomes included need for intubation, admission to the intensive care unit, or death. The data were analyzed using descriptive and analytical statistics, including chi-squared test, Mann-Whitney U test, and logistic regression analysis in SPSS 16. Results: The need for O2 therapy (adjusted odds ratio [AOR]=4.23; 95% CI: 1.15‒15.51; P=0.03), the increased creatinine levels (AOR=2.71; 95% CI: 1.25‒5.88; P=0.01), and the white blood cell counts (AOR=2.44; 95% CI: 1.12‒5.33; P=0.02) were the main risk factors associated with prolonged hospital stay. Also, having kidney diseases (AOR=7.33; 95% CI=1.94‒27.70; P=0.01), elevated the white blood cell counts (AOR=4.52; 95% CI=1.67‒12.26; P=0.003), and lung diseases (AOR=3.97; 95% CI: 1.18‒13.29; P=0.03) were significant among the predictors of the disease severity. Conclusion: According to the results, hypoxia and underlying diseases might lead to unwanted outcomes. The risk factors identified here confirm previous information and could be helpful to guide early clinical decision-making to reduce the mortality rates and improve the clinical outcomes of COVID-19.

Objectives: Breastfeeding mothers returning to work undertake multiple conflicting roles at home and work that can result in high levels of stress. Exploring coping skills amongst these mothers can help in planning useful programmes to promote family wellbeing. This study aims to explore the experiences of working breastfeeding mothers and their coping mechanism against high levels of daily stress. Methods: In this qualitative study, we described the experiences of 20 Iranian breastfeeding mothers through in-depth and semi-structured interviews. All interviews were recorded, transcribed and analysed using thematic analysis. Results: Two main themes emerged as follows: 1) self-management with subthemes of a) attitude reconstruction, b) order and planning, c) creating a boundary between work and family and d) reprioritising life affairs; and 2) seeking help with subthemes of a) family member support, b) childcare facilities and c) spirituality. Conclusions: Findings suggest that women need support from family members and family-friendly policies at the workplace. Breastfeeding mothers may benefit from educational programmes that focus on effective coping strategies. Keywords: Breastfeeding, Coping, Employment, Iran, Stress, Women's health

Background: Child abuse is a widespread social phenomenon with serious life-time consequences. Since parents bring their children to healthcare centers for growth screening and vaccinations, Community Health Workers play an important role in identifying and reporting child abuse cases. Thus, the current study aimed to investigate knowledge, attitude and performance of Community Health Workers regarding child abuse in Tabriz. Methods: This is a descriptive (cross-sectional) study; census method was used for sampling. Study population consists of 265 people, employed at units of family health and vaccination in Tabriz healthcare centers in 2015-2016. A questionnaire was used to collect the data. Data analysis was carried out using SPSS, version 23 through descriptive (mean and standard deviation) and analytical (Two Independent Samples T-test and analysis of variance) statistics. Results: Findings indicate that 58.5 percent of Community Health Workers had good knowledge about causes of child abuse and 45 percent had good knowledge of the signs, symptoms and complications of child abuse. Their total knowledge was good (57%). The mean score of awareness (knowledge) was significant according to the variable of training participation (P=0.04). The participants had a favorable attitude toward dealing with child abuse (91.3 %); the mean score of attitude was significant according to the educational field (P

Purpose: This study aimed to determine factors associated with caregiver burden among primary caregivers of women with breast cancer in Iran. Methods: This was a descriptive correlation study conducted in 2012 on 150 main caregivers of patients with breast cancer who came to the oncology clinic of Shahid Ghazi hospital in Tabriz, Iran. A questionnaire which included caregiving-related factors and the Zarit Burden Interview was used for data collection after its validity and reliability were determined. Data was analyzed using SPSS 13.0 software with descriptive and analytic statistics. The association between significant variables and the dependent variable with an observation of the effects of other variables was assessed using the multiple linear regression model. Results: The mean age of caregivers was 39.60 ± 13.80 years old, and 77 (51.3%) of them were men. The mean score of the Zarit Burden Interview was 30.55 ± 19.18. In the regression model, the mean score of activities of daily living, level of education, gender, and financial status were identified as the determining factors of the burden of caregivers. Conclusions: Primary caregivers need to be financially supported by the relevant organizations. Care skills training and providing palliative care seem helpful in reducing the pain and the burden of family caregivers for patients with breast cancer.

Introduction: Family members often play a vital role as caregivers in the lives of individuals with schizophrenia. Results of the studies showed that family invironment is the most important determinint of patients outcomes like as quality of life, relapse, adherence. This study aimed to determine the effect of group psychoeducational programme on attitude towards mental illness in families of patients with schizophrenia. Methods: In this quasi-experimental study, 74 families who have schizophrenic patients hospitalized in psychiatric wards during sampling were selected by convenience sampling method. Then the sample was randomly assigned to experimental and control groups. The families of experimental group received 8 continuous 90-minute 3 times a week psychoeducational sessions. Family attitude towards mental illness was measured using the questionnaire of Opinion about Mental Illnesses (OMI) before and after intervention. Data analysis was conducted using 2 test, independent t-test, and paired t-test on SPSS software version 13. Results: The results showed that majority of the families had negative attitude towards mental illness (88.90%). In addition, the results showed that there was significant difference between different dimensions of attitude towards mental illness before and after psychoeducation in the experimental group. The mean score of families' post-test in the experimental group increased compared to control group 108.86 (14.9), vs. 88.86 (7.5). Conclusion: The results of this study indicate that psychoeducation improves family attitude towards mental illness. Training methods like group psych education for the families of mental patients can be effective on their attitudes towards mental illness.

Seclusion is one of the methods in controlling violent behavior of inpatients in psychiatric wards. In current descriptive analytic study, data collection instrument included the seclusion list of inpatients by considering individual, social and clinical characteristics in one of the psychiatry wards In the Razi teaching hospital of Tabriz in the first six months of 2012. Among 264 admitted patients, 24 patients (9.1%) had been secluded and a total of 29 isolated incidents were recorded. Most of secluded incidents occurred on weekdays (75.9%), first week of inpatient (87.7%), and during the evening shifts (48.3%). The results obtained in this study demonstrate that in 55.2% cases, the duration of isolation was two hours and the most common cause of seclusion was aggressive behaviors. Most of secluded patients (66.7%) were diagnosed with mood disorders.

Introduction: Considering the factors that affect academic achievement is particularly important. Emotional Intelligence mentioned as an important factor in many researches and is defined as set of knowledgeandsocio-emotionalabilitiesthataffectour overall ability to respond to environmental requirements. The aim of this study was to determine the relationship between emotional intelligence and academic achievement of students in Iranian universities. Methods: In this Meta-analysis, databases such as SID, Magiran,Medlib, Irandoc, Pubmed, Scopus and all medical and psychological journals were searched with keywords like “Emotional Intelligence", “Academic achievement" and " students". After discardingduplicatearticles, 36 articled were reviewed, among them 17 articles were irrelevant and discarded. Finally given thepurpose ofthe study, 19 articles included in the study and combination Fisher method were used to analyze the data. Results: According to the combination Fisher method the product of p-values were calculated and then the logarithm were taken and multiplied by -2. Sum of them was equal to 147.03. Sum of Pvalues in 38 degree of freedom (n = 19) were lower than expected so calculated Chi-Square value were significant at a significance level of less than 0.01, it means that there is a significant relationship between emotional intelligence and academic achievement of students in Iran. Conclusion: Results of this study indicates there is a significant relationship between emotional intelligenceand academic achievements in Iranian students. Given that emotional intelligencecan be learned and acquired to some extent, so it is recommended that in academic environments besides teaching intelligence and cognitive talents, emotional intelligence consider in educational programs to help students to cope better with the pressures of studying and community and less fall.

Background & Aim: Administration of medications is an important part of treatment and care provided by nurses. Medication errors can create serious problems to patients and health system. The aim of this study was to determine the reasons of medication errors and the barriers of error reporting from nurses&apos viewpoints. Methods & Materials: In this study, we randomly selected five hospitals in Tabriz and Maragheh. Then, 200 nurses who were randomly selected for the study completed the study questionnaire. The questionnaire included 21 items about medication errors and 19 items about the barriers of error reporting, based on five degree Likert scale. Collected data were analyzed using SPSS-15. Results: In this study, from the viewpoint of nurses, the most important reasons of medication errors were hospital units (3.70±0.84), shortages of nursing staff, nuring burn-out and high workload. Regarding barriers of error reporting, the most cited barriers were management factors (3.78±0.89), fear of legal issues, inappropriate definition of medication error and inappropriate reactions of authorities. Conclusion: We recommend increasing the number of nursing staff, adjusting the workload of nursing staff, using special forms for reporting errors and providing an atmosphere of intimacy between authorities and staffs.

Background & Aim: Administration of medications is an important part of treatment and care provided by nurses. Medication errors can create serious problems to patients and health system. The aim of this study was to determine the reasons of medication errors and the barriers of error reporting from nurses' viewpoints.Methods & Materials: In this study, we randomly selected five hospitals in Tabriz and Maragheh. Then, 200 nurses who were randomly selected for the study completed the study questionnaire. The questionnaire included 21 items about medication errors and 19 items about the barriers of error reporting, based on five degree Likert scale. Collected data were analyzed using SPSS-15.Results: In this study, from the viewpoint of nurses, the most important reasons of medication errors were hospital units (3.70±0.84), shortages of nursing staff, nuring burn-out and high workload. Regarding barriers of error reporting, the most cited barriers were management factors (3.78±0.89), fear of legal issues, inappropriate definition of medication error and inappropriate reactions of authorities.Conclusion: We recommend increasing the number of nursing staff, adjusting the workload of nursing staff, using special forms for reporting errors and providing an atmosphere of intimacy between authorities and staffs.