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This study investigates the barriers and promoters of caring for older adults living with Alzheimer's Dementia (AD) in families. This was a qualitative study through content analysis (based on the Granheim and Lundman method), and the participants were selected using purposive sampling from the families of older adults living with AD who were receiving care in the community. We used semi-structured interviews to collect data from 32 family members. The validity and reliability of the data were assessed using the Lincoln and Guba criteria. In this study, 70.58% of primary caregivers were women. Caregiving facilitators included "Efficient family," "Capable caregiver," and "Motivated caregiver." Caregiving barriers included "Lacking awareness and knowledge," "Vulnerable family," "Older person with complex/multiple needs," and "Lack of care infrastructures." Training families and caregivers and developing care infrastructures for older adults with AD can help reduce caring barriers in older adults.

Background: Work and family life are the two basic components of the individuals’ life and each one affects the other. Objective: This study aimed to investigate the relationship between occupational stress, mental health and marital satisfaction among Iranian nurses. Methods: A cross-sectional study was conducted on 200 randomly selected nurses. The 35 items hospital stress scale, Enrich Marital Satisfaction questionnaire and Scl-25 mental health questionnaire were used. Descriptive statistics, Pearson correlation coefficient, independent sample t-test and analysis of variance and regression analysis were used. Results: Inverse correlations were observed between the scores of job stress and mental health (r = –0.468, p = 0.001) and marital satisfaction (r = –0.517, p = 0.001). More than 0.74% of variation in marital satisfaction is explained by the components of occupational stress. Conclusion: The results revealed that occupational stress plays a decisive role in nurses’ marital satisfaction and mental health. Due to the destructive effects of occupational stress on the people’s mental health, interpersonal relationships and on their efficacy in their job, establishment of some counseling services for nurses to be used by them periodically or by need, can help them to manage their stress level and better management of their family life problems. Moreover, in-service courses or workshops on stress management may help nurses to possess appropriate knowledge and skills on stress management.

Background: Drug-Drug Interaction (DDI) among the elderly is one of the major healthcare challenges worldwide. The present study assessed the rates of DDI and inappropriate drug prescription among the elderly in Kashan City, Iran. Methods: This descriptive-analytical study was designed, conducted, and reported according to the guideline of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). A random sample of 368 elderly who lived in Kashan City, Iran, was selected through cluster sampling technique. Data collection tools were a demographic questionnaire and a drug checklist. The obtained data were analyzed by the Chi-squared test, logistic regression analysis, and Odds Ratio (OR) in SPSS. Results: In total, 308 (88%) participants used at least one drug. The Mean±SD scores of daily consumed drugs and the number of inappropriate drugs taken daily by the study participants were 6.21±3.52 and 0.28±0.62, respectively. Most of the study participants were taking more than two drugs (n=267, 86.68%) and more than four drugs (n=200, 64.9%) per day. The OR of DDI among the study participants who were taking ≥2 drugs per day was 2.49 times greater than those who were taking one or two drugs (OR=2.49, 95% confidence interval=1.20-5.18). The most frequent DDIs were between non-steroidal anti-inflammatory drugs and beta-blocker agents (n=84, 18.22%) and between non-steroidal anti-inflammatory drugs and nitrates (n=46, 9.9%). Conclusion: The rate of inappropriate drug use among the elderly living in Kashan, Iran, is low, however, polypharmacy and DDIs are highly prevalent among them. To reduce the rates of DDI and polypharmacy, educational programs for different healthcare providers are required to improve their knowledge. Moreover, further studies are needed to assess the effects of polypharmacy and DDI preventive measures, like drug history cards.

The aim of this study was to develop and psychometrically validate the Iranian scale of patient privacy and confidentiality. This methodological study was conducted in two stages: first, a conventional content analysis was used to qualitatively identify concepts of privacy and confidentiality. Then, the face validity, content validity, and construct validity were assessed. Internal consistency coefficient and total consistency were checked. KMO and Bartlett’s test were used to examine thequestionnaire for factor analysis. EFA identified seven factors that accounted for 55.25% of the total variance in the questionnaire score. The total Cronbach’s α coefficient was 0.84 for the whole instrument. The Spearman reliability coefficient of the instrument was 0.91 using the test–retest method.The final Iranian version of the Patient Privacy and Confidentiality Scale can be used as a valid and reliable instrument to measure the rate of observation of patient privacy and confidentiality.

Background: Miss nursing care, as an important hidden problem, can disrupt nursing function. Hence, it has been identified as a quality index for nursing care and patient safety recently. Therefore, amounts and types of miss nursing care as well as its reasons have to be explored using a quantitative tool. The present study aimed to investigate the features of the localized miss nursing care tool in 2020.Methods: In this methodological study, miss nursing care tool was translated and back-translated and its face and content validity was assessed by a panel of experts. Then, the tool was distributed electronically among 300 nurses with various experiences working in healthcare centers. The construct validity was evaluated via exploratory factor analysis. Its reliability was also explored using Cronbach’s alpha and Intra-class Correlation Coefficient (ICC).Results: This study was conducted on 300 nurses. The exploratory factor analysis, which resulted in the identification of three factors in the second part of the tool, namely relations, financial resources, and human resources, explaining 79.6% of the total variance. The reliability of the first and second parts of the tool was 0.912 and 0.901, respectively. Additionally, the ICC was found to be 0.687 for the first part and 0.706 for the second part of the tool.Conclusion: The Persian version of the miss care tool benefitted from appropriate validity and reliability. Thus, it could be used as an index for evaluation of clinical nursing care.

Aim Screening is one of the most important ways for early frailty detection that contributes to its prevention and timely treatment. The aim of this study was to determine the diagnostic value of the Persian version of the Tilburg Frailty Indicator (P-TFI) in the frailty screening. Method This is a diagnostic test accuracy study that uses known group method. It was designed based on a STARD statement and performed on 175 elderly people in the City of Kashan, Iran. The subjects were selected among older people available in health centers affiliated to Kashan University of Medical Sciences using purposive sampling. Data analysis was carried out using SPSS v16. Descriptive statistics were used to describe the characteristics of the research subjects. Independent t-test was used to determine the ability of the P-TFI to discriminate frail and non-frail individuals, and to evaluate the cut-off point and instrument accuracy, the receiver operating characteristic (ROC) curve was used. The best cut-off point was determined among the proposed points using Youden index. At the determined cut-off point, the diagnostic value parameters of the P-TFI (sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, accuracy, and diagnostic odds ratio) were calculated and their range was estimated with 95 % confidence interval. Findings A total of 74.3 % of the sample was male and their mean age was 68.6 ± 54.44 years. The area under the ROC curve was calculated 0.922, indicating high accuracy of the instrument. The sensitivity and specificity of this instrument at the cut-off point of 4.5 were 0.95 and 0.86, respectively. Positive and negative predictive values were calculated 0.68 and 0.98, respectively, and the accuracy of the instrument was reported to be 0.88. Conclusion The P-TFI can be used as a sensitive and accurate instrument, which is highly applicable to screen frailty in older people.

Aim: This study was made to analyze the concept of treatment adherence among war veterans who suffer posttraumatic stress disorder.Methods: This concept analysis was done using Walker and Avant’s c...

Introduction Few studies are available on complementary medicine used in the Middle East and particularly from Iran. Therefore, this study aimed to investigate the prevalence of using traditional and complementary medicine (T&CM) by people in Kashan, Iran, in 2014. Methods A cross-sectional study was conducted on 541 subjects using cluster sampling from the general population of Kashan, Iran. The participants answered a questionnaire on knowledge, attitude and application of T&CM. Descriptive statistics and Chi-Square tests were used to analyze the data. Results Of the 541 subjects, 56.9% were male, 73.8% had a history of using T&CM methods, 66.5% reported that using T&CM was effective in improving their diseases and 42.1% had recommended T&CM to others. Respectively, 38.6% and 9.6% of the subjects have frequently used herbs and cupping. Moreover, 52.7% believed that herbs were very effective in the treatment of their health problems. T&CM methods were mostly used for headaches and dizziness (20%), common cold (19%) and digestive problems (17%). Conclusions T&CM was prevalent among the participants and herbal products were the most common. Due to the people’s enthusiasm toward T&CM, measures and policies must be implemented promptly to increase the public awareness and endorse the appropriate use of T&CM.

Social participation is a criterion for successful aging. Research has shown that social participation decreases in older adults. However, the role of social support on older adults’ social participation has received little attention, especially in eastern countries, such as Iran. Using the Social Participation Questionnaire, the relationship between social support and social participation was investigated in 525 Iranian older adults. A correlation was found between social support and social participation of older adults. Older adult women were found to have less social support and social participation compared with men. [ Journal of Gerontological Nursing, 41 (6), 39–47.]

Background Injuries with sharps are common occupational hazards for healthcare workers. Such injuries predispose the staff to dangerous infections such as hepatitis B, C and HIV. Objectives The present study was conducted to investigate the behaviors of healthcare workers in Kashan healthcare centers after needle sticks and injuries with sharps in 2012. Materials and Methods A cross-sectional study was conducted on 298 healthcare workers of medical centers governed by Kashan University of Medical Sciences. A questionnaire was used in this study. The first part included questions about demographic characteristics. The second part of the questionnaire consisted of 16 items related to the sharp instrument injuries. For data analysis, descriptive and analytical statistics (chi-square, ANOVA and Pearson correlation coefficient) SPSS version 16.0 software was used. Results From a total of 298 healthcare workers, 114 (38.3%) had a history of injury from needles and sharp instruments in the last six months. Most needle stick and sharp instrument injuries had occurred among the operating room nurses and midwifes; 32.5% of injuries from sharp instruments occurred in the morning shift. Needles were responsible for 46.5% of injuries. The most common actions taken after needle stick injuries were compression (27.2%) and washing the area with soap and water (15.8%). Only 44.6% of the injured personnel pursued follow-up measures after a needle stick or sharp instrument injury. Conclusions More than a half of the healthcare workers with needle stick or sharp instrument injury had refused follow-up for various reasons. The authorities should implement education programs along with protocols to be implemented after needle stick injuries or sharps.

Background An absolute prerequisite to the effective management of dementia is its early diagnosis. Successful dementia screening requires precise and sensitive instruments that can be completed even by illiterate elderly people. Objectives The aim of this study was to evaluate the psychometric properties of the Persian version of the cognitive state test (COST). Materials and Methods This methodologic study was conducted in Kashan, Iran, during 2013 - 2014. A purposeful sample of 150 healthy elderly people and 50 elderly patients with dementia was recruited. After translating the instrument by using the standard forward-backward technique, we assessed its qualitative and quantitative face and content validity. The validity of the test was assessed by using the concurrent validity and the exploratory factor analysis. We also calculated Cronbach’s alpha and employed the test-retest method for evaluating the internal consistency and the stability of the test, respectively. Study data were analyzed by using the SPSS v16.0, the Spearman-Brown, and the intraclass correlation coefficient tests and the principal components factor analysis with varimax rotation. Results The Persian COST consists of nineteen items. The impact scores, the content validity ratios and the content validity indices of all test items were greater than 4.5, 0.69, and 0.84, respectively. The COST had a significant correlation with the clinical dementia rating (rS = -0.76, P value < 0.001), indicating an acceptable concurrent validity for the test. The exploratory factor analysis revealed a five-factor structure that explained 60.59% of the total variance of the total cognitive state score. The Cronbach’s alpha, Spearman-Brown, and interclass correlation coefficients were 0.82, 0.95, and 0.88, respectively (P value < 0.001). Conclusions The Persian version of the COST can be used as a valid and reliable instrument for assessing cognitive state and screening dementia in literate and illiterate elderly people.

Dementia screening tests need to have acceptable sensitivity and specificity. The current study aimed to determine the cutoff point of the Persian Cognitive State Test (P-COST) and test its diagnostic accuracy. The study was conducted using the known-groups method. A purposive sample of 50 patients with dementia and 150 older adults without dementia was recruited in Kashan, Iran. The reference standard included clinical interviewing and findings of a computerized tomography scan. The P-COST was the index test. Mean P-COST scores of the two groups differed significantly ( p < 0.001). The P-COST is a sensitive and precise test for assessing cognitive state and thus can be used for dementia screening and monitoring of older adults' health. [Res Gerontol Nurs. 2015; 8(6):293–299.]