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Background: Pediatric nurses are responsible for caring for children and their families; thus, investigating missed care in the pediatric ward is important and helps to improve the quality of care. Accordingly, this study aimed to explain the perceptions of pediatric nurses about missed care.Methods: This study was conducted using content analysis on 15 pediatric nurses selected by purposive sampling. The data were collected through in-depth semi-structured interviews. After obtaining informed consent, interviews were audio-recorded and transcribed verbatim. MAXQDA software (version 10) was used to facilitate coding and thematic analysis.Results: Four main categories emerged from the data analysis, including missed family-centered care, unsafe care, predisposing factors, and adverse outcomes.Conclusion: The findings showed that from the perspective of pediatric nurses, missed care occurs in different dimensions, including psychological support, communication, education, assessment, drug treatment, and infection control, and it can ultimately lead to mother’s dissatisfaction and bring about adverse effects on the child’s recovery besides harming the nurse.

Introduction: Although many studies have been conducted on allergic diseases, their risk factors including allergic rhinitis have not yet been fully understood. The present study aims to investigate the relationship between house type, floor, and frequency of truck traffic on the street of residences with allergic rhinitis in adolescents in Yazd. Materials and Methods: This cross-sectional study was conducted on 5141 adolescents aged 13-14 years, from February 2020 to June 2020, using the large-scale Global Asthma Network (GAN) survey data in Yazd. The data were collected electronically using the GAN standard questionnaire, and analyzed in SPSS software version 23 using descriptive and analytical statistics (Chi-square and logistic regression). The value of P < 0.05 was considered significant. Results: In this study, 11.2% of boys and 13.3% of girls had allergic rhinitis, indicating a significant difference by gender (P = 0.025). The prevalence of allergic rhinitis did not differ significantly according to the type of house (apartment or detached house with a yard) and the floor (P > 0.05). However, the prevalence of allergic rhinitis showed a significant correlation with the frequency of truck traffic on the street of residence (P = 0.001). If the truck passed through the street near the house almost all day, the chance of developing allergic rhinitis would be 2.4 times higher. Conclusion: The risk of allergic rhinitis increases with the frequent truck traffic from the street near the house, but the type of house and floor do not have a significant effect.

BACKGROUND: A newborn with an untreatable genetic disorder could disrupt a family and affect parents’ mental health, psycho-social interaction, and parent–child relationships. This study was conducted to explore the psychological problems of mothers having the children with untreatable genetic disorders. MATERIALS AND METHODS: This qualitative study was performed using the conventional content analysis method on 15 mothers having the children with untreatable genetic disorders selected by purposeful sampling. In-depth and semi-structured interviews were used to collect data. The recorded interviews were transcribed verbatim immediately and imported into MAXQDA10 software. Lundman and Granheim’s content analysis method and Guba and Lincoln’s proposed criteria for assessing rigor of the results were used. RESULTS: Overall, 1067 primary codes were extracted from the interviews and after the integration of similarities grouped into 19 sub-categories and three major categories including psychological reactions before diagnosis, after determined diagnosis, and after the child’s death. CONCLUSIONS: The results showed that having the child with untreatable genetic disorder is considered as a notable psychological trauma and causes painful psychological reactions in parents. In this regard, the following approaches are recommended to health professionals: continuous monitoring of mental health of these families, developing a family education program, emotional and psychological support, and genetic counseling.

BackgroundNurses and researchers emphasize the importance of adding educational content of palliative care to nursing curricula in Iran as a means to improve the quality of care at the end of life and self-efficacy is considered as an important determinant in palliative care nursing. However, undergraduate nursing students are not sufficiently trained to achieve the qualifications required in palliative care. The aim of this study was to determine the effect of combined training (theoretical-practical) of palliative care on the perceived self-efficacy of nursing students.MethodsThis is a semi-experimental study with a pretest-posttest design. Sampling was nonrandomized with convenience method and included 23 seventh-semester students. The intervention consisted of palliative care training for ten theoretical sessions and three practical sessions. Data were collected using demographic and the perceived self-efficacy questionnaires completed before and after the intervention. Data were then analyzed in the statistical SPSS 23 software using descriptive and analytical statistics.ResultsThe mean age of the samples was 22.78 (SD1.17). Most of the participants were male (56.5%) and single(91.3%). The findings showed that, perceived self-efficacy, psycho-social support and symptom management improved significantly after the intervention (pConclusionPalliative care training can increase the nursing students perceived self-efficacy. Since nursing students are the future nurses of the care system, therefore, managers and planners can take a step towards improving the quality of nursing care by using palliative care training programs. Since nursing students will be future nurses in health care system, therefore, managers and planners can take steps to improve the quality of nursing care by using palliative care education programs.

[This corrects the article DOI: 10.1371/journal.pone.0302938.].

Introduction: The birth of a premature baby shocks parents a lot. Although fathers also experience high levels of anxiety, they have received little attention and research. In order to focus on family care, this study was conducted to determine the effect of the first skin contact of fathers with premature infants hospitalized on their anxiety in the neonatal intensive care unit. Methods: This study was a randomized clinical trial with two experimental and control groups. 72 fathers of premature infants admitted to the neonatal intensive care unit of Shohada-e-Kargar Hospital were selected. In the experimental group, fathers made skin-to-skin contact with their infants for half an hour. In the control group, no intervention was performed. The level of anxiety in the experimental and control groups before and after the intervention was determined using the Spielberger Anxiety Questionnaire. The collected data were analyzed using t-test and Chi-square statistical tests in SPSS 16 software. Results: The results showed that before the intervention in the experimental group, the mean scores of trait and state anxiety were 54.28±16.26 and 50.36±14.66, respectively, these mean scores in the control group, were 59.81±14.48 and 58.86±15.41, respectively, which was not statistically significant. However, after the intervention, the mean scores of trait (47.92±10.1) and state anxiety (48.47±9.7) of the experimental group compared to the mean scores of trait (57.72±14.65) and state anxiety (62.47±14.16) of the control group decreased, which showed a statistically significant difference (p

Objective: The use of medicinal plants in diabetic patients is rising, it is essential to increase knowledge about the effects of medicinal plants and subsequently perform evidence-based action, so, review studies are a helpful way for the present purpose. Current study was conducted to investigate the clinical trials of medicinal plants used in the treatment of diabetes in Iran. Materials and Methods: Articles published online between 2010 - 2020 were googled in Magiran, SID, Scopus, and, Iran Medex with Persian keywords such as “type 2 diabetes”, “medicinal herbs”, “healing herbs” “herbs”, “medicinal plants” and “clinical trial”. The inclusion criteria for articles were conducting in the form of a clinical trial, conducting in Iran, publishing in Persian language and having at least a score of 3 based on the Jadad scale. Results: 20 clinical trial studies were extracted. Five studies were conducted on cinnamon and two studies on cumin and the rest of the plants were examined just in one study. Although some trials showed positive effects of the medicinal plants on reducing fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c), some others demonstrated that medicinal plants had no effect on important variables in diabetes control. Conclusion: Conclusions about the benefits of plants should be made with caution, safety and efficacy of plants in the treatment of diabetes should be investigated further. It is essential that patients take any herbal supplements under physician’s supervision and after receiving the necessary advice.

Introduction: The spread of COVID-19 rapidly affected the daily lives of individuals, including students. It has led to changes in students' usual curricula and nursing students' lifestyles. It has affected not only on the personal life and health of nursing students but also the lifestyle and health of other people in the community. Therefore, this study aimed to determine the lifestyle of nursing students of Shahid Sadoughi University of Medical Sciences and Health Services during the COVID-19 epidemic in 2020. Methods: This was a cross sectional study in 2020 on 171 nursing students of Shahid Sadoughi University of Medical Sciences and Health Services using the convenience sampling method. To collect the required data, demographic information form and lifestyle questionnaire during the COVID-19 epidemic were used. The collected data were then analyzed by SPSS software version 16 using descriptive and inferential statistics methods (independent t-test and ANOVA). Results: The mean and deviation score of students' general lifestyle was at a moderate level, 38.08 ± 16.8. Mean and deviation scores of both happy and healthy lifestyles were at a low level, 21.66 ± 9.4 and 16.42 ± 8.5, respectively. There was no significant relationship between demographic characteristics and mean lifestyle score (P≥0.05). Conclusion: Due to the fact that students' lifestyle are at a moderate level and the score of lifestyle components (both happy and healthy) was at a poor level, and given that the end of the COVID-19 pandemic is uncertain, therefore, it is necessary for managers and officials of universities and the Ministry of Health to plan timely and effective interventions to improve the lifestyle of nursing students.

Background and Objective: Premature birth is an unexpected event that causes a lot of stress for parents as they are not psychologically and emotionally prepared to face it. Therefore, this study aimed to determine the effect of multi-sensory stimulation of neonates by mothers on the stress level of mothers with premature neonates hospitalized in the Neonatal Intensive Care Unit (NICU). Materials and Methods: This quasi-experimental study was performed on 80 mothers (in experimental and control groups) who were selected using the census method in the NICU of Shahid Sadoughi Hospital, in Yazd, Iran. The infants in the experimental group were stimulated twice a day from the third to the sixth day. Data were collected using demographic characteristics form and Parental Stress Scale that were completed before and after the intervention. Data were analyzed in SPSS software (version 20) through statistical tests. Results: There was no significant difference between the mean stress levels in the two study groups before intervention; however, there were significant differences in intervention and control groups post-intervention in the mean±SD score of stress (P

Background & Aim: Performing daily activities is a major element of quality of life in heart failure patients. The Duke Activity Status Index (DASI) is a tool to measure factional capacity. We aimed to examine the psychometric properties of the DASI in patients with heart failure. Methods & Materials: In this methodological study using convenience sampling, we included 120 patients with heart failure referred to the heart clinic of Afshar hospital, Yazd in 2018. We first translated the original DASI to Farsi using forward and backward translation method. Then, we evaluated its face validity, content validity, criterion-related validity, construct validity (Exploratory Factor Analysis), and reliability (internal consistency). Results: In quantitative content validity, the content validity index and content validity ratio were confirmed. The criterion-related validity was confirmed using the Spearman correlation coefficient between the New York Heart Association functional classification scores and the DASI score (r=-0.77, P

Introduction: Medication error is one of the most common errors in the medical context which has a great importance in the ICUs due to the patients’ inability and vulnerability in participating in the medication therapy. The aim of this study was to determine frequency, types, and reasons of medication errors in the ICUs. Methods: This was a cross-sectional descriptive study, which was conducted on 105 nurses working in the ICUs located in hospitals of Yazd City in 2017 on the basis of census sampling method. The data were collected by means of the demographic and occupational questionnaire and the medication errors questionnaire whose content validity and reliability (Alpha Cronbachchr('39')s coefficient) have been approved The data were analyzed using descriptive statistics and the Chi-square statistical test through SPSS software V.16. Results: The findings revealed that %66.7 of the nurses had medication errors. %40.6 of the nurses had made medication error only once, and 58.7% of the errors occurred during the night shift. As to the injectable medications, administrating nonprescription medications, making mistakes in dosage calculation, and giving medication after discontinuation were reported with higher frequencies. Regarding the injectable medications, paying no attention to interactions of concomitant drugs, making calculation mistakes, and administrating nonprescription medications were more frequent. Also, the nurses’ fatigue was reported as the first main cause of medication errors in this study. Conclusion: Given the high frequency of medication errors) 66.7% in the last six months( particularly during the night shift as well as the nurses’ fatigue as the most important cause of the error incidences, it appears important that healthcare authorities and nursing managers take account of the approaches that enhance the nurses’ working conditions.

Background: Breastfeeding is a two-way interaction between mother and infant, the sustainability of which requires the presence of both parts given their complementary roles. Aim: The present study was conducted to investigate the effect of breast milk expression during kangaroo mother care (KMC) on milkvolume in mothers with premature neonates. Method: This quasi-experimental study was performed on 40 mothers with premature newborns admitted to a neonatal intensive care unit in a city in the west of Iran in 2019. The participants were randomly assigned into two groups of intervention and control. Breast milk in both groups was expressed 8 times a day from day 4 to day 6 after birth using a 20-cc syringe and recorded in a checklist. In the intervention group, two milking sessions were performed during the KMC. However, in the control group, milking was conducted according to the ward routine. Data were analyzed in SPSS software (version 23) using repeated-measures ANOVA. Results: The mean ages of the participants in the intervention and control groups were 29.05±4.09 and 27.85±3.58 years, respectively. There was a statistically significant difference between the milkvolume of the intervention and control groups on days 4 (P=0.04), 5 (P=0.02), and 6 (P=0.007) and between the total volume of milkduring the three days (P=0.01). Implications for Practice: Breast milk expression duringKMC could have a positive effect on increasing milkvolume. Therefore, can be recommended as an intervention to support mothers with insufficient milk.

IntroductionWith the emergence of the COVID-19 pandemic, universities immediately responded to protect students' lives by implementing e-learning in order to stop the spread of the communicable disease within the academic population. This study aimed to describe iranian nursing students' experiences of e-learning during the COVID-19 pandemic.Materials and methodsThe current study used a qualitative descriptive study. Ten nursing undergraduate students from a single Iranian university identified using purposive sampling methods. Face-to-face semi-structured interview conducted from May to July 2021 and analyzed through thematic analysis. Lincoln and Goba criteria were used to obtain data validity and reliability.ResultsFour themes emerged including"novelty of e-learning","advantages of e-learning", "disadvantages of e-learning"and"passage of time and the desire to return to face education". Participants evaluated e-learning as a novel method without proper infrastructure, it was initially confusing but became the new normal as their knowledge of the way to use it improved. Advantages included self-centered flexible learning and reduction in their concerns experienced with face-to-face learning. Disadvantages including changing the way they interact with teachers, decreasing interactions with classmates, problems with education files, superficial learning, hardware problems, family members' perceptions of the student role, interference of home affairs with e-learning, cheating on exams and assignments and being far away from the clinical context.ConclusionThe findings revealed that e-learning has been introduced as a new method for the current research participants and despite the perceived benefits, these students believed that e-learning could supplement face education but not replace it.

Introdution: Newborn individualized developmental care and assessment program (NIDCAP) is emphasized. This study aimed to determining the barriers to implementation of NIDCAP from nurses' perspectives in neonatal intensive care units in Shahid Sadoughi Hospital in Yazd. Methods: This descriptive study was conducted using a census sampling method. The samples were54 nurses working in the intensive care unit of Shahid Sadoughi and Afshar Hospitals in Yazd. Data were gathered using two questionnaires,( demographic and barrier assessment questionnaires) . Data analysis was performed in SPSS version 24 using descriptive statistics, Chi-square, independent t-test and fisher test. Results: Results showed that in terms of mean and standard deviation, in the area barriers of sleep care, lack of skill (3.08± 1.28 ), In the area of pain and stress assessment management, lack of skill (2.86. ±1.31), in the area of activities of daily living and family-centered care, lack of effective communication with parents respectively (2.83 ± 1.39) and ( 2.86± 1.32), in the area of provision of healing environment, lack of standard light and sound in unit (2.76 ± 1.81) and in the area of organizational barriers, the disproportionate number of nurses to the patients (3.47±0.84) were identified as the most important barriers Conclusion: Based on the findings, lack of skill, lack of effective communication with parents, lack of standard environment and disproportionate number of nurses and patients are the most important barriers to the implementation of NIDCAP in NICUs that managers need to plan appropriate design for addressing them.

Background: Jaundice is one of the most common health problems among neonates, involving almost 60% of full-term newborns, therefore requiring consequent phototherapy. Since phototherapy has several complications, considering alternative treatments has long been of pivotal importance. Therefore, the present study aimed at comparing the effectiveness of bath and massage in bilirubin levels in neonates. Methods: This was a randomized clinical trial conducted on neonates who were born in Zeyaei Hospital in Ardakan, Iran, in 2018. A total of 90 neonates were selected using the convenience sampling method and then assigned into two intervention groups (i.e., bath group and massage group) and a control group through random allocation method. In the bath group, the neonates were bathed immediately after birth. In the massage group, the neonates received field massage twice a day each lasting 15 min for 5 consecutive days. The neonates belonging to the control group were served with routine care. The jaundice meter China 800 (jk) device was used to measure the skin bilirubin levels of the neonates in the three groups in a scheduled manner (i.e., days 1, 3, 5, and 7) at 9 a.m. The data were analyzed using the ANOVA, Chi-square test, Tukey's post hoc test, and repeated measures ANOVA in SPSS software (version 18). Results: There was no significant difference between the mean bilirubin scores of the three groups over the first, third, and fifth days. A significant difference was found between the mean bilirubin scores of the bath and massage groups compared with that of the control group on the seventh day (P=0.001). Also, no significant difference was seen between the mean bilirubin levels of the bath and massage groups on the seventh day. Conclusion: The findings revealed that there was no difference between the bath and massage techniques in reducing neonatal jaundice. Therefore, both techniques can be utilized in this regard.

Background: The sudden exposure of premature newborns to a cold and dry environment can lead to hypothermia. This study aimed at comparing the effectiveness of two polyethylene covers on the body temperature and oxygen saturation of premature neonates. Methods: This experimental study was conducted on 72 premature newborns in the neonatal intensive care unit (NICU) of Shahid Sadoughi Hospital in Yazd, Iran. The study subjects were randomly assigned into three groups, including the neonates with polyethylene head cap, polyethylene body bag, and routine care. The data were collected using a thermometer and a pulse oximeter. The data analysis was performed through descriptive statistics, Chi-square test, analysis of variance (ANOVA), repeated measures ANOVA, and Tukey test using SPSS (version 18) software. Results: There was a significant difference in the mean body temperature of control and intervention groups immediately after their NICU admission and 1 h later. Other significant differences were found in the mean of oxygen saturation belonging to the control group and the hat group upon admission and 1 h later. Also, the mean scores of oxygen saturation belonging to the control group were compared with those of the bag group, and the differences were significantly different 1 h after the admission. Conclusion: In the light of these findings, the application of both polyethylene head cap and body bag can maintain the body temperature and oxygen saturation in the premature neonates transferring to the NICU. In particular, the head cap seems to better improve than oxygen saturation.

Palliative care is a series of actions aiming to offer support to parents and their infants in order to improve their quality of life. Despite optimal outcomes, the provision of palliative care for infants and achieving these outcomes may be hardly feasible. The present study aimed to investigate the barriers to palliative care and gain insight into the solutions. Accordingly, the obstacles were identified and classified into three categories of parent-related barriers (parental request for continuing treatment, cultural background, and religious beliefs), barriers concerning healthcare providers (attitude toward palliative care, death, and life values, religious beliefs, knowledge and skills in palliative care, and ethical distress), and barriers within the healthcare system (unclear policies regarding the implementation of palliative care, inadequate support from caretakers, lack of educational programs, insufficient personnel, unprepared environment, lack of technological requirements, and lack of access to consultants). Each category was discussed, and relevant solutions were provided.

Background & Aim: Nowadays in the NICU, family-centered care is the foundation of care, and communication is at the core of family-centered care. This study aimed to compare the perceptions of nurse-mother communication between neonatal intensive care nurses and mothers of hospitalized neonates. Methods & Materials: This is a cross-sectional study. 70 mothers of hospitalized newborns and 70 nurses working in the NICU ward of university hospitals and social security hospitals in Yazd, were selected by convenience sampling in 2015. The study questionnaires included the mothers’ and nurses’ demographic characteristics questionnaire, “nurses’ perceptions of nurse-mother communication” questionnaire and “mothers’ perceptions of nurse-mother communication” questionnaire. The data were analyzed using descriptive statistical tests and independent t-test on SPSS software version 19. Results: The mean age for nurses was 33.36±6.99 years and for mothers was 29.77±6.40 years. Mean score and standard deviation of perception of “nurse-mother communication” for nurses was 69±6.92 and for mothers was 57.66±11.99. Independent t-test showed statistically significant differences between mean scores (P

Background & Aim: Medication errors are one of the most common medical errors and these errors have a double importance in neonatal intensive care unit. The aim of this study was to determine the frequency and type of medication prescribing errors in neonatal intensive care unit. Methods & Materials: This study is a descriptive-analytical research. A census sample of 71 nurses from the neonatal intensive care unit of 5 hospitals in Yazd was included in study in 2015. The tools of data collection were the demographic and occupational data questionnaire and “medication errors” questionnaire. Data were analyzed by descriptive statistics and the Chi-square statistical test, using SPSS software v.18. Results: 47.9% of nurses (34 persons) had made medication errors. 35.2% of samples had made 1-2 errors, and 51.51% of errors had occurred on the night shift. The most frequent nonparenteral medication errors were errors in drug calculation, drug dosage, the drug route of administration, and incorrect medication. In parenteral medications, errors in the drug infusion rate, drug calculation, drug dosage, and the Lack of attention to drug-drug interactions were frequently reported. Nurses declared that the large number of patients was the first main cause of medication errors. Conclusion: Given the high frequency of medication prescribing errors particularly on the night shift, as well as considering the disproportionate nurse-to-patient ratio as a major cause of the errors, future research is needed to further evaluate the causes and prevention strategies of the medication errors.