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Background: Nowadays, grandparents have a major role in taking care of their grandchildren. Also, caring for grandchildren is a common and normative experience for many Iranian grandparents. The present study aimed to compare the quality of life of physically active and inactive grandmothers caring and non-caring for grandchildren., Methods: This analytical cross-sectional study was conducted on 300 grandmothers at the age range of 50 to 70 years old, who lived in Bojnurd, northeastern Iran (2018). Data were collected using the questionnaires of 36-Item Short Form Health Survey (SF-36) and Baecke Physical Activity, and demographic information., Results: The total scores of quality of life in caring physically active, physically inactive, non-caring physically active and non-caring physically inactive grandmothers were 76.95±6.33, 71.74±9.41, 75.56±5.9, and 56.06±11.23, respectively. There was a significant difference in the comparison of the quality of life score in caring grandmothers in two active and inactive groups (P<0.001). In addition, the quality of life score of non-caring grandmothers indicated a significant difference in physically active and inactive grandmothers (P<0.001)., Conclusion: According to the results of this study, it seems that caring physically active grandmothers have higher quality of life. It can be suggested that the grandmothers who care for their grandchildren may improve their health and quality of life by incorporating the programs to increase physical activities in their daily life., (© 2023 Hemmati H., et al.)

Purpose: This review investigated medical students’ satisfaction level with e-learning during the coronavirus disease 2019 (COVID-19) pandemic and its related factors., Methods: A comprehensive systematic search was performed of international literature databases, including Scopus, PubMed, Web of Science, and Persian databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as “Distance learning,” “Distance education,” “Online learning,” “Online education,” and “COVID-19” from the earliest date to July 10, 2022. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool)., Results: A total of 15,473 medical science students were enrolled in 24 studies. The level of satisfaction with e-learning during the COVID-19 pandemic among medical science students was 51.8%. Factors such as age, gender, clinical year, experience with e-learning before COVID-19, level of study, adaptation content of course materials, interactivity, understanding of the content, active participation of the instructor in the discussion, multimedia use in teaching sessions, adequate time dedicated to the e-learning, stress perception, and convenience had significant relationships with the satisfaction of medical students with e-learning during the COVID-19 pandemic., Conclusion: Therefore, due to the inevitability of online education and e-learning, it is suggested that educational managers and policymakers choose the best online education method for medical students by examining various studies in this field to increase their satisfaction with e-learning.

Background: Individualized patient education can help older people with diabetes to improve their self-care behaviors and effectively manage their disease. Identifying patients' preferred learning style can be a useful way to optimize learning opportunities. The aim of this study was to investigate the effect of education based on Kolb's learning style on selfcare behaviors of older people with type II diabetes., Methods: This randomized clinical trial was conducted on 62 older adults with type II diabetes referred to the diabetes center of Imam Reza Hospital in Bojnourd, Iran, from May to November 2020. Participants who met the inclusion criteria were randomly allocated into two groups of intervention (n=34) and control (n=28). Participants in intervention group received the educational intervention based on their learning style (described by Kolb as accommodating, diverging, converging and assimilating) in four 45 minutes-sessions (two sessions per week). In the control group, the same educational content was presented with a lecture and a booklet. Participants in both groups completed the self-care questionnaires before and one month after the intervention., Results: The mean self-care scores of the older adult patients with type II diabetes based on Kolb's learning style after the educational intervention in the intervention and control groups were 58.15 (SD=10.71) and 44.7 (SD=12.12), respectively (P<0.001). Accommodating Kolb's learning style-based education was most effective in improving self-care practice in older adult patients with type II diabetes (P<0.001)., Conclusion: Education based on Kolb's learning style is effective in improving self-care behaviors of older people with type II diabetes. Therefore, it is suggested to consider Kolb's learning style in the educational process of older adults with type II diabetes to improve self-care practice in these patients., (© 2021 Bagchegi O. et al.)

Background: Aromatherapy as an alternative and complementary medicine is a well-known method for reducing the symptoms of various physiological processes such as labor experience. The aim of this study was to systematically review the currently available evidences evaluating the use of aromatherapy for management of labor pain and anxiety., Methods: In a systematic review, 5 databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific Information Database [SID]) were searched, from database inception up to December 2019. Keywords used included (aromatherapy OR ""essential oil" OR "aroma*") AND (pain OR anxiety) AND (labor OR delivery). Using the Cochrane Collaboration's 'Risk of bias' method; the risk of bias in the included studies was evaluated., Results: A total of 33 studies were verified to meet our inclusion criteria. Most of the included studies were conducted in Iran. Aromatherapy was applied using inhalation, massage, footbath, birthing pool, acupressure, and compress. The most popularly used essential oil in the studies was lavender (13 studies), either as a single essential oil or in a combination with other essential oils. Most of included studies confirmed the positive effect of aromatherapy in reducing labor pain and anxiety., Conclusion: The evidences from this study suggest that aromatherapy, as a complementary and alternative modality, can help in relieving maternal anxiety and pain during labor., (© 2020 Muhbubeh T., et al.)

Background: The sexual desire in the middle-aged and senior women is one of the factors affecting their quality of life and psychological well-being., Aim: The present study was aimed to assess the sexual desire and related factors among married women aged 50-70 years., Materials and Methods: In this descriptive-analytical study, 210 married menopausal women aged 50-70 years were selected by cluster sampling method. Data were collected using a demographic profile questionnaire and Sexual Desire Inventory (SDI), and analysed by SPSS version 22 software using descriptive statistics and independent t-test, ANOVA and Pearson correlation coefficient tests., Results: The mean age of women was 59.40 ± 5.93 years, and the mean sexual desire score was 22.66 ± 17.78 (out of 112). There was a significant relationship between sexual desire score and age, educational level, occupation of women and spouses, age of menopause, marital history, number of pregnancies and children, individual health and pain level (P < 0.001). The sexual desire score had a significant association with diabetes, hypertension, heart disease, high cholesterol, chronic pain, gastrointestinal problems, chronic ulcers, bladder and intestinal problems, joint and bone disorders, taking cardiac medications, antihypertensive, anticoagulant, insulin, cholesterol-lowering drugs (P < 0.001)., Conclusion: The low sexual desire score and its reduction with age and the presence of various diseases and factors affecting sexual desire highlight the importance of diagnostic screening, family related educational planning and the role of health care providers in the health status of the older adults.

Background: Osteoarthritis is one of the chronic diseases that greatly affect the health and life quality of individuals., Aim: This study aimed to determine the effect of self-management educational program on the pain intensity of the elderly patients with knee osteoarthritis., Methods: In a randomised clinical trial, a total of 82 elderly patients with knee osteoarthritis were randomly divided into intervention and control groups. The intervention group received six sessions of self-management group education, while the control group received only the routine care during this period. In both groups, patients' pain intensity, with a visual analogue scale (VAS), were assessed before, immediately after and eight weeks after the start of the study., Results: The mean pain intensity scores of the intervention and control groups were not significantly different before the intervention (P = 0.9), but after the intervention, the mean pain intensity score in the intervention group (3.61 ± 2.36) was significantly lower than that of the control group (4.93 ± 2.00), (P < 0.0001)., Conclusion: Implementation of a self-management program for the patients with knee osteoarthritis is useful in reducing their pain intensity and can be used as one of the effective methods for their empowerment.

Introduction: Falls and fear of falling are considered as the major factors affecting the elderly's disabilities, so that most of these individuals often find their homes as a safe environment., Aim: The aim of this study was to evaluate the relationship between home safety and prevalence of falls and fear of falling among older adults., Materials and Methods: This cross-sectional study was conducted on 450 elderly people who lived in Bojnrud, Northeast of Iran, from December 2016 to July 2017 using cluster sampling method. A demographic characteristics questionnaire, Fall Efficiency Scale-International (FES-I)questionnaire, and Home Safety Checklist were employed as research instruments., Results: Out of the study population, 157 individuals (35.7%) had a history of falls in the past one year. The mean score for fear of falling in the elderly people examined was 29.14±11.07 and the same value for home safety status was equal to 11.31±4.17. The mean score for fear of falling was significantly correlated with history of falls in older adults (p<0.0001). There was also a statistically significant relationship between home safety status and prevalence of falls and fear of falling in the elderly (p<0.0001). Besides, the results of logistic regression analysis showed that fear of falling could be estimated by 29-51%, taking the history of falls in the last 12 months and home safety mean score into account (p<0.0001)., Conclusion: Home safety status and demographic variables could have effects on falls and fear of falling in elderly individuals. Therefore, putting these factors together, older adults at the risk of further falls can be identified and provided with trainings through planning and appropriate interventions to prevent the incidence of falls and their negative consequences among them.

Background: Falling and fear of falling are among the most common problems of the elderly, which can cause illness, isolation, dependency and reduced quality of life in elderly. Exercise is recommended to prevent falling injuries in the elderly., Aim: This study aimed to examine the effect of Tai Chi exercise on the risk and fear of falling in older adults., Materials and Methods: In this randomized clinical trial, a total of 60 male and female elderly were randomly divided into two groups: Tai Chi exercise and control (daily activities) groups. Tai Chi exercise protocol in the intervention group consisted of 3 sessions per week for 10 weeks. The risk and fear of falling were assessed in subjects by using standardized questionnaires, including Berg's Balance Scale and Fall Efficacy Scale-International (FES-I) before initiating the protocol, at the end of 4 th , 8 th weeks and at the end of exercise period., Results: Two groups were matched in terms of age, gender, education, and body mass index. Baseline values of risk of falling and fear of falling were not significantly different between the two groups (P>0.05). The score of fear of falling at the end of 4 th , 8 th weeks and at the end of exercise period was significantly different between the two groups (P<0.05) and it decreased in the intervention group, but the risk of falling reduced after 8 and 10 weeks in the intervention group (P<0.001)., Conclusion: Performing Tai Chi exercises for at least four weeks could reduce fear of falling and reduce the risk of falls in older adults after 8 weeks.

Introduction: Understanding the development and distribution of disruptive behaviour among members of a health-care team is critical to the safety and quality of patient care in high-risk environments such as operating rooms. The present study identified disruptive behaviour and its effect on the treatment of patients in the operating room environment., Subjects and Methods: This cross-sectional study used the convenience sampling method to select 144 operating room physicians and nurses (91 women and 53 men). The study was conducted in the operating rooms of four academic hospitals with different specialties in North Khorasan province in Iran from December 2013 to September 2014. The data were collected using a translated, modified, and validated questionnaire to investigate the prevalence and consequences of disruptive behaviour, the response of the health care system to the behaviour, factors affecting the creation of conflict and the spread of disruptive behaviour. Statistical analysis of the data was performed using SPSS 18., Results: Disruptive behaviour was reported by 82.95% physicians and nurses. On average, 39% of physicians and 21% of operating room nurses exhibited disruptive behaviour. Disruptive behaviour is associated with psychological and clinical consequences. Factors such as fear of retaliation (8%), lack of change (43.8%), lack of security (18.1%) and attitude of the organization (14.6%) are significant reasons for the failure to report these behaviours., Conclusions: The findings suggest that disruptive behaviour occurs and affects treatment and workflow of treatment teams in the operating room. Interpersonal conflict contributes to the growth of such behaviour; thus, more research should focus on this subject in the future., Competing Interests: There are no conflicts of interest.

Introduction: Disruptive behaviors cause many problems in the workplace, especially in the emergency department (ED).This study was conducted to assess the physician's and nurse's perspective toward disruptive behaviors in the emergency department. Methods: In this cross-sectional study a total of 45 physicians and 110 nurses working in the emergency department of five general hospitals in Bojnurd participated. Data were collected using a translated, changed, and validated questionnaire (25 item). The collected data were analyzed by SPSS ver.13 software. Results: Findings showed that physicians gave more importance to nurse-physician relationships in the ED when compared to nurses' perspective (90% vs. 70%). In this study, 81% of physicians and 52% of nurses exhibited disruptive behaviors. According to the participants these behaviors could result in adverse outcomes, such as stress (97%), job dissatisfaction and can compromise patient safety (53%), quality of care (72%), and errors (70%). Conclusion: Disruptive behaviors could have a negative effects on relationships and collaboration among medical staffs, and on patients' quality of care as well. It is essential to provide some practical strategies for prevention of these behaviors.

Objective: Standards of care and treatment of premenstrual syndrome (PMS) vary. Non-drug ‎psychosocial intervention therapy is recommended for women with any kind of ‎discomfort or distress caused by PMS. The current study examined the effectiveness of ‎group cognitive-behavioral therapy on the symptoms of PMS at a girls' dormitory of ‎North Khorasan University of Medical Sciences., Method: In this quasi-experimental study, 32 female students with PMS who were majoring in ‎nursing and midwifery and residing in the dormitory were selected using the ‎convenience sampling method and were assigned to experimental and control groups. ‎The Standardized Premenstrual Symptoms Screening Tool was used as the research ‎tool. Eight sessions of cognitive-behavioral group therapy were held for the students Results: There was a significant difference in psychological symptoms before and after ‎cognitive-behavioral therapy (p=0.012). Furthermore, cognitive-behavioral therapy was ‎effective on social interferences caused by PMS symptoms (p=0.012).‎, Conclusion: Group cognitive-behavioral therapy effectively alleviates PMS symptoms in female ‎college students.‎.

Background: Labor is a stressful situation that may have an adverse impact. Aromatherapy is a method to control anxiety and stress of women. This study was conducted to investigate the effect of aromatherapy using essential oil of orange on women's anxiety during labor., Materials and Methods: In this clinical trial study, 100 women during labor were randomly assigned to two groups: intervention group and control group. The women in the intervention group were exposed to orange essential oil, but the women in the control group were exposed to distilled water. The women's anxiety was assessed using the Spielberger inventory. Moreover, physiological parameters such as systolic and diastolic blood pressure, respiration and pulse rates were assessed in all the women before and 20 min after the intervention. The data were analyzed by Chi-square, Wilcoxon, paired t-test, and Mann-Whitney U test. Data were evaluated with the SPSS 16 program. The significance level of P < 0.05 was considered., Results: The level of anxiety of women in both intervention (P = 0.03) and control (P = 0.003) groups reduced after the intervention. However, the reduction was more in the intervention group (difference in anxiety scores after the intervention in comparison to before intervention = -3.08) in comparison to the control group (score = -1.14). No significant change was found in the physiological parameters of women in the intervention group after the intervention., Conclusions: Aromatherapy is a noninvasive and effective method to help women overcome their anxiety during labor. Orange scent can be useful in childbirth units to help women who are experiencing stress in labor.

Introduction: Anxiety increases significantly during labor, especially among nulliparous women. Such anxiety may affect the progress of labor and physiological parameters. The use of essential oils of aromatic plants, or aromatherapy, is a non-invasive procedure that can decrease childbirth anxiety. This study examined the effect of inhalation of the aroma of geranium essential oil on the level of anxiety and physiological parameters of nulliparous women in the first stage of labor., Methods: In study, was carried out on 100 nulliparous women admitted to Bent al-Hoda Hospital in the city of Bojnord in North Khorasan province of Iran during 2012-2013. The women were randomly assigned to two groups of equal size, one experimental group (geranium essential oil) and one control (placebo) group. Anxiety levels were measured using Spielberger' questionnaire before and after intervention. Physiological parameters (systolic and diastolic blood pressure, respiratory rate, pulse rate) were also measured before and after intervention in both groups. Data analysis was conducted using the x2 test, paired t-test, Mann-Whitney U test, and Wilcox on test on SPSS 11.5., Results: The mean anxiety score decreased significantly after inhalation of the aroma of geranium essential oil. There was also a significant decrease in diastolic blood pressure., Conclusion: Aroma of essential oil of geraniums can effectively reduce anxiety during labor and can be recommended as a non-invasive anti-anxiety aid during childbirth.

Primary dysmenorrhea is common among young women and results in their incapacitation; it can be accompanied by various symptoms that can disrupt their lives. The aim of this randomized trial was to compare the effect of ginger, zinc sulfate, and placebo on the severity of primary dysmenorrhea in young women. One hundred and fifty high school students were recruited. The participants were divided into three groups. The first group received ginger capsules, the second group received zinc sulfate capsules, and the third group received placebo capsules. All participants took the medications for four days, from the day before the commencement of menstruation to the third day of their menstrual bleeding. The severity of dysmenorrhea was assessed every 24 hours by the pain visual analog scale. The severity of pain was significantly different between, before, and after the intervention in both the ginger and the zinc sulfate groups (p < .001). Compared with the placebo receiving group, participants receiving ginger and zinc sulfate reported more alleviation of pain during the intervention (p < .05). Ginger and zinc sulfate had similar positive effects on the improvement of primary dysmenorrheal pain in young women., (Copyright © 2014 American Society for Pain Management Nursing. All rights reserved.)