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Abstract Background Since effective education is one of the main concerns of every society and, in nursing, can lead to the education of successful people, the development of learning and teaching methods with greater effectiveness is one of the educational priorities in every country. The present study aimed to compare the effect of education using the flipped class, gamification and gamification in the flipped learning environment on the performance of nursing students in a client health assessment. Methods The present study was a Parallel randomized clinical trial study. The participants were 166 nursing students. The clinical trial data was collected from December 14, 2023, to February 20, 2024. The inclusion criteria were nursing students who had passed the first semester, who were willing to participate and install the app on their mobile devices, and who had no experience with the designed application for this study. The participants were allocated to four groups with colored carts. In the first group, teaching was performed via gamification in a flipped learning environment; in the second group, teaching was performed via the gamification method. A flipped class was implemented in the third group. In the fourth group, the usual lecture method was used. The practical performance to assess the physical health assessment with 10 questions using the key-feature questions, along with the satisfaction and self-efficacy of the students, was also checked with questionnaires. Results In this study, 166 nursing students, (99 female and 67 male), with an average (standard deviation) age of 21.29 (1.45) years, participated. There was no statistically significant difference in the demographic characteristics of the participants in the four intervention groups (P > 0.05). Comparing the results before and after the intervention, the results of the paired t test indicated a significant difference in the satisfaction, learning and self-efficacy of the learners (P

Professional ethics are important to support the ethical decision making of nurses and to respond to the current challenges in healthcare. This study was to explore professional ethical challenges and the strategies to address the ethical challenges in clinical in a Muslim country. This study used an exploratory descriptive qualitative approach. Two focus groups and semi-structured individual interviews were conducted, and data were analyzed using thematic analysis. Participants shared their experiences and perceptions of professional ethical challenges and suggested strategies. Nine ethical challenges were identified: 1) Less patient-centered care; 2) Giving bad news to the patient and family; 3) Ethical decision making about no treatment, no mechanical ventilation, and no resuscitation; 4) Not considering patients’ culture in nursing care; 5) New technologies and challenges related to overuse; 6) Health information as an ethical challenge for managing and using large patient datasets; 7) Nursing in disasters or crises and the challenge of respecting ethical principles; 8) Palliative care for patients; and 9) Fear created moral distress. Study findings highlight ethical challenges that nurses have in clinical practical and the strategies that can be used.moral distress. The findings underscore the ethical challenges faced by nurses in clinical practice and suggest strategies for addressing each challenge in Iran.

Abstract Background Nurses’ professional competencies play a significant role in providing safe care to patients. Identifying the acquired and expected competencies in nursing education and the gaps between them can be a good guide for nursing education institutions to improve their educational practices. Methods In a descriptive-comparative study, students’ perception of acquired competencies and expected competencies from the perspective of the Iranian nursing faculties were collected with two equivalent questionnaires consisting of 85 items covering 17 competencies across 5 domains. A cluster sampling technique was employed on 721 final-year nursing students and 365 Iranian nursing faculties. The data were analyzed using descriptive statistics and independent t-tests. Results The results of the study showed that the highest scores for students’ acquired competencies and nursing faculties’ expected competencies were work readiness and professional development, with mean of 3.54 (SD = 0.39) and 4.30 (SD = 0.45), respectively. Also, the lowest score for both groups was evidence-based nursing care with mean of 2.74 (SD = 0.55) and 3.74 (SD = 0.57), respectively. The comparison of competencies, as viewed by both groups of the students and the faculties, showed that the difference between the two groups’ mean scores was significant in all 5 core-competencies and 17 sub-core competencies (P

Background: Uncertainty is a common challenge for nurses in clinical decision-making, which can compromise patient care quality and safety. To address this issue, it is essential to understand how nurses perceive and cope with uncertainty in their practice. Aim: This study aimed to explore nurses’ perceptions of uncertainty in clinical decision-making using a qualitative approach. Methods: This study was conducted with a qualitative approach and conventional content analysis in 2020. Participants consisted of 17 nurses from different wards of teaching hospitals in Northwestern Iran, recruited using the purposive sampling method. Data were collected through semi-structured interviews and analyzed simultaneously with data collection (June to December 2020). The data were analyzed using the content analysis approach suggested by Wildemuth. Data were managed with MAXQDA10 software. The analysis revealed four main themes and ten subthemes that described the nurses' experiences of uncertainty in clinical decision-making. Results: The main themes were: difficult choice, difficult situation, insufficient judgment, and emotional burden. Conclusions: The study participants defined uncertainty in clinical decision-making as a difficult choice that occurs in difficult situations, which influenced their clinical judgment and emotional well-being. These findings provide valuable insights for developing interventions to help nurses manage uncertainty and improve their decision-making skills and safety.

Abstract Background The TPSN model is an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. This model is done to reduce the theoretical-practical gap in nursing. The present study aimed to explore the experiences of nursing students. Methods In a conventional content analysis, 11 undergraduate nursing students, 7 graduate nursing students, and 4 doctoral students were selected. Data was collected through focus group discussions and individual interviews. Results The findings from analyzing the students’ experiences who had received education using this model resulted in four main categories: the feeling of being a nurse, an integrated and collaborative clinical education platform, the development of nursing clinical education, and educational challenges. Conclusion The TPSN model provides a suitable platform for nursing clinical education. This model helps students integrate theoretical knowledge with clinical practice and helps them act as professional nurses in the future.

Abstract Background Donabedian conceptual and multidimensional framework has been used in several studies in an educational context. In this study, we aimed to adapt the Donabedian three-component model (structure, process, and outcome) in undergraduate nursing education. This conceptual framework provides a comprehensive image of nursing education institutions and can help to evaluate institutions by measuring different aspects of their performance. A comprehensive understanding of the various elements of an educational institution helps to develop a complete, appropriate relevant set of performance indicators. Methods This was a modified Delphi study. It had three rounds. The expert panel consisted of nursing faculty members and nursing Ph.D. students. In the first round, a questionnaire was designed based on interviews, focus groups, and a literature review. Experts rated their agreement with each element on a 5-point Likert scale in rounds two and three. The consensus level was set as 75%. The stability between rounds was also determined by calculating kappa coefficients. One Sample T-Test was also calculated for new items in round three. Results All 55 items of the questionnaire were confirmed in the second round based on the consensus percentage of 75. Five new items were added to the third round based on comments in round two. Eventually, all elements except one were confirmed according to the consensus level, kappa values, means, and One-Sample T-Test in round three. The structure's key elements include staff (academic and non-academic); equipment; guidelines; resources and facilities; and students’ demographics and characteristics. Process key elements include communication; education; evaluation; cooperation; and consultation. Outcome key elements include knowledge development; nursing image; alumni’s outcome; students’ outcome; related medical centers’ performance; accreditation and evaluation results; and satisfaction. Conclusions Different elements of a nursing education institution at the bachelor's level were determined. The results of this study can help related bodies to develop and implement a comprehensive and systematic evaluation. These results can also be a basis for making this model useful in other nursing courses or education in other fields.

Objective This study explored the consequences of COVID-19 on the occupational safety and health of nurses.Design Qualitative conventional content analysis.Participants 14 nurses selected by purposeful sampling method.Setting Five educational and non-educational hospitals in the Northwest of Iran.Data collection and analysis Semistructured interviews were used for data collection and analysed using conventional content analysis.Results Two main categories have emerged from the data: reduced quality of professional life and post-traumatic growth. Reduced quality of professional life, which has two subcategories including job dissatisfaction and burnout, has a negative nature, and has had many negative effects on the physical, mental and well-being of nursing personnel during the coronavirus era. On the other hand, post-traumatic growth, with two subcategories that include promoting safe behaviour and gaining a positive self-concept, has a positive nature.Conclusions Maintaining the occupational health and safety of nurses plays an important role in providing quality services to patients. Therefore, it is necessary for managers and policymakers to use the experiences related to the COVID-19 crisis, to prevent negative factors and strengthen positive factors, to maintain the safety and occupational health of nurses, and increase the quality of care.

Abstract Aim Nursing competencies are crucial indicators for providing quality and safe care. The lack of international agreement in this field has caused problems in the generalization and application of findings. The purpose of this review is to identify the core competencies necessary for undergraduate nursing students to enter nursing work. Data Sources We conducted a structured search using Scopus, MEDLINE (PubMed), Science Direct, CINAHL, Web of Science, and Google Scholar. Review Methods We conducted a scoping review using the methodology recommended by the Joanna Briggs Institute, supported by the PAGER framework, and guided by the PRISMA‐ScR Checklist. Inclusion criteria included full‐text articles in English, quantitative and qualitative research related to competencies for undergraduate students or newly graduated nurses, competency assessment, and tool development from 1970 to 2022. We excluded articles related to specific nursing roles, specific contexts, Master's and Ph.D. curricula, hospital work environment competencies, and editorial. Results Out of 15,875 articles, we selected 43 studies, and data analysis with summative content analysis identified five themes named individualized care, professional nursing process, nursing administration, readiness, and professional development. Conclusion Considering the dynamics of competencies and their change with time, experience, and setting, it is necessary to update, localize, and levelling of the proposed competencies based on the culture of each country. Impact These competencies provide a guide for undergraduate nursing curriculum development and offer a framework for both clinical instruction and the evaluation of nursing students.

Abstract Aim To assess the barriers to the implementation of virtual care for patients with chronic wounds from wound therapists' perspective. Design A qualitative study. Methods The study was conducted in two consecutive phases: (1) literature review, (2) descriptive qualitative study. In the first phase, texts published in English until 2023 were identified using international databases. The entire text of the selected studies was evaluated independently by two reviewers. Data analysis was carried out using textual content analysis. In the second phase of the study, twelve participants from Iranian wound care clinics participated. Data were collected through focus group discussion and analysed using conventional content analysis. Integration of both phases was conducted in the data analysis stage. Results The most important barriers in providing virtual care to patients with chronic wounds were identified into five categories including lack of policymaking in virtual care, ethical challenges in virtual information and communication technology, social, economic and cultural issues, IT users' insufficient knowledge and limitation of virtual care scope of practice. Conclusion The findings of the present study identified different barriers in the implementation of virtual care for patients with chronic wounds. In order to successfully develop a virtual care programme, it is necessary to adopt suitable policies regarding information and communication technology, provide the necessary legal frameworks, assign an adequate budget and consider the ethical, cultural, social and social issues. Implications for the Profession and/or Patient Care Identifying barriers to developing a virtual care programme will help manage patients with chronic wounds at home. Impact This study accurately identifies barriers to providing virtual care for patients with chronic wounds and helps plan to address these barriers and facilitate the development of a virtual care programme for these patients at home. Reporting Method This research has adhered to the SRQR reporting guideline. No Patient or Public Contribution The involvement of patients or the public in the design, or conduct, or reporting, or dissemination plans of this research was not suitable.

Abstract Background Improvements in nurses’ and midwives’ education will increase workforce quantity and quality. Continual improvement of organization performance is based on continual measuring; Appropriate indicators must be selected to measure and appraise the performances. This study aimed to recognize and categorize key performance indicators (KPIs) for baccalaureate nursing education institutions’ performance measurement. Methods This study had two phases: (1) Interview: Seven semi-structured interviews were conducted with faculty members and nurses. (2) Narrative Literature review: schools’ and universities’ reports and web pages were assessed to recognize KPIs. The data analysis method was directed content analysis. The Donabedian Model components were used to guide the data analysis. Results The total number of indicators retrieved was 468; 75 were from interviews with faculty members and nurses and 393 were from the literature review. Indicators were categorized into: Structure (staff; equipment, resources, and facilities; guidelines), Process (education; communication and collaboration; evaluation), and Outcome (survey and accreditation; national and international recognition; satisfaction; sustainability and financial efficiency; students; alumni; knowledge related to the field). Conclusions A number of indicators were identified that were categorized into various groups related to the performance of nursing schools. Further investigations are needed with different groups of stakeholders including students, professional associations, healthcare institutions, alumni, and clients. As well in some areas, new or composite indicators may need to be developed. Also, each institution needs to select appropriate indicators based on its context, policy goals, and infrastructure.

Abstract Aim The objective of this study was to validate the Iranian translation and cross‐cultural adaptation of the Student Survey on Writing Nursing Care Plan (SSW‐NCP). Background To provide supporting evidence about the nursing students' skill in planning and documenting nursing care plans based on nursing process, Salvador et al. developed the SSW‐NCP to measure the extent to which nursing students are qualified in writing nursing care plans. However, an Iranian version of the SSW‐NCP is presently not available. Method The cross‐cultural adaptation and linguistic translation of the SSW‐NCP adhered to World Health Organization (WHO) guidelines. The reliability and validity process followed the COSMIN checklist. Results The survey was well translated to Persian language and culturally adapted through confirming the relevancy, appropriateness and logical representation of all aspects on nursing process by bilingual experts and pre‐tested on Persian‐speaking nursing students. The Cronbach's Alpha coefficient (α) and test–retest stability assessing affirmed the reliability, and convergent validity of the adapted survey was confirmed through comparison to Influencing Factors of Nursing Students' Clinical Judgment (IFNSCJ). The adaptation process of the SSW‐NCP resulted in a conceptually equivalent translated version, which is comparable to the original version and is acceptably valid and reliable. Implications for Nursing Management Knowing the proficiency of nursing students as future nurses in writing nursing care plans can provide accurate professional information for better educational and practical level programming and management that can enhance nursing practice. Patient or Public Contribution The target group of survey was nursing students who contributed and participated in the current study.

Abstract Aim Nursing diagnosis is the basis of applying nursing process and evidence‐based care in nursing. This issue has been affected by the gap between theory‐practice in nursing. The attending nursing teachers Project aims to create an organizational link between health care centres and nursing schools, reducing the gap between theory‐practice and empowering nurses to apply nursing diagnosis. Design The present study was part of the second cycle of an action research study conducted in the cardiology ward in 2019–2020. Methods Interventions were performed in the form of Teacher, Patient, Student, Nurse Model to empower nurses in quantity and quality of nursing diagnosis. Results The results indicated a significant increase in the number of nursing diagnoses recorded. Moreover, the qualitative criteria based on PES components were found to have changed significantly after the interventions. Empowering nurses in the form of this Project could suggest that creating proper structures between nursing schools and health care centres, full‐time presence of faculty members in hospitals, and enhancing their roles in these institutes will lead to improvements in educational as well as health care systems.

Abstract Background Maintaining patient safety is a practical standard that is a priority in nursing education. One of the main roles of clinical instructors is to evaluate students and identify if students exhibit unsafe clinical practice early to support their remediation. This study was conducted to identify self-presentation components among nursing students with unsafe clinical practice. Methods This qualitative study was conducted with 18 faculty members, nursing students, and supervisors of medical centers. Data collection was done through purposive sampling and semi-structured interviews. Data analysis was done using conventional qualitative content analysis using MAXQDA10 software. Results One main category labelled self-presentation emerged from the data along with three subcategories of defensive/protective behaviors, assertive behaviors, and aggressive behaviors. Conclusion In various clinical situations, students use defensive, assertive, and aggressive tactics to maintain their professional identity and present a positive image of themselves when they make a mistake or predict that they will be evaluated on their performance. Therefore, it seems that the first vital step to preventing unsafe behaviors and reporting medical errors is to create appropriate structures for identification, learning, guidance, and evaluation based on progress and fostering a growth mindset among students and clinical educators.

Abstract Aim This study was conducted to describe the perceptions of nursing applicants about their chosen profession and to explore the factors which influenced their understanding. Design A qualitative study with a conventional content analysis design. Methods Participants were 19 nursing applicants enrolling in nursing schools in three provinces of western Iran. Data were collected using semi‐structured interviews. The content analysis of the interviews was done according to the steps proposed by Zhang and Wildemuth. Results The mean age of participants was 20 years (SD = 2.5), and 11 of them (57.9%) were females. Participants understood the nature of nursing work to encompass only a limited level of independence; they viewed it as a feminine profession, and as a job with spiritual rewards. The perceived content of nursing work included providing help and patient care in the hospital with a focus on performing procedural tasks. Applicants' perceptions of nurses' characteristics included strong physical endurance, communication skills, emotional strength and low intellectual skills. The professional status of nursing was perceived simultaneously as having high job security but limited potential for career advancement and professional growth. The factors reported to influence applicants' perceptions were related to the media, academic–career counsellors, personal factors, and family and friends.

Abstract Background Ethics-based nursing practice can transform health care practices. As the biggest human capital in the health care system, nurses are obliged to follow ethical principles in this field. One of these ethical principles; is beneficence, which is considered the core of nursing care. This study aimed to investigate clarification of the principle of beneficence in nursing care and its related challenges. Methods This integrative review was conducted using the Whittemore & Knafl method in 5 stages, including problem identification, searching the literature, evaluating primary sources, analyzing data, and presenting the results. Databases like SID, Irandoc, Magiran, Google Scholar, Web of Science, PubMed, and Scopus were searched using the keywords; “beneficence”, “ethic”, “nursing” and “care” in English and Persian in the time range of 2010 to 10 February, 2023. After applying inclusion criteria and assessing the articles using Bowling’s Quality Assessment Tool, finally, 16 papers were included from 984. Results After reviewing and evaluating the qualified articles, the findings were classified into four main categories: (1) nature, (2) applicability, (3) Relevant and influential factors, and (4) challenges related to the ethical principle of beneficence in nursing care. Conclusion Based on the results of this review it seems that paying attention to clarification the principle of beneficence in nursing care can provide positive outcomes for patients to benefit from this principle and finally, it leads to increasing the well-being and health of patients, reducing their mortality rate, increasing satisfaction and maintaining the respect and human dignity of patients.

Abstract Background To facilitate the development of clinical reasoning skills in nursing students, educators must possess the ability to teach and evaluate them. This study aimed to describe the development and validation process of an analytic rubric of clinical reasoning skills based on the nursing process in undergraduate nursing students. Methods A seven-step method was used for rubric development. The initial validation process of the rubric of clinical reasoning was performed with the participation of key stakeholders to assess its face and content validity as well as applicability in the classroom and bedside. An initial pilot test was performed based on scenario-based examinations in the nursing process training course so that convergent validity was used to show how closely the new scale is related to the previous measure for evaluating students’ tasks. Internal consistency and inter-rater correlation coefficient measurement for reliability were assessed. Results The rubric to assess clinical reasoning skills was developed into eight categories according to the five stages of the nursing process. Content and face validity of the rubric were done qualitatively and resulted in a clear, simple rubric relevant to clinical reasoning skills assessment. The convergent validity was confirmed by the conventional method. The reliability was approved by a high inter-rater correlation coefficient based on the assessment by two random independent raters. Conclusion The clinical reasoning meta-rubric developed in this study meets the purpose of the study. This analytical rubric can be applied to guide teaching and learning as well as evaluate clinical reasoning based on the findings. Testing the applicability confirmed its validity and reliability for assessing clinical reasoning skills in nursing process education during the undergraduate nursing program.

Abstract Aim There is a lack of clarity about the components which would signify appropriate psychological strengths among nursing student candidates. This study was conducted to identify such components from the viewpoint of the clinical nurses and nursing instructors. Design A qualitative study. Methods This study comprised qualitative research using a conventional content analysis approach. Participants were 25 nurses and nursing instructors. Data were collected in audio‐recorded and transcribed semi‐structured interviews and were analysed using MAXQDA10 software. Results Analysis revealed four main categories including "anger management," "Stress/distress management," "self‐belief" and "aptitude for hard work." Conclusions This study identified core components for future investigations into the psychological strengths of nursing applicants. This study provides specific testable hypotheses for future research endeavours. It is recommended that the researchers investigate the appropriateness of the components identified in this study to assess the psychological strength of the applicants in the longitudinal studies.

Objective Nursing students’ attainment of patient safety (PS) competency has always been a global concern among health and educational organisations. Therefore, this study was conducted to determine senior nursing students’ confidence of their PS competencies, and associated predictive factors.Design Cross-sectional study.Setting Four faculties from the nursing faculties of East Azerbaijan province.Participants 253 senior nursing students in Iran.Primary and secondary outcome measures Using the modified version of the Health Professional Education Patient Safety Survey, data related to the level of confidence of nursing students in acquired competencies in seven sociocultural dimensions of PS in classroom learning and clinical settings were collected. In addition, the predictors of the patient’s safety competencies were identified by linear regression statistics.Results Mean scores of all dimensions of PS competencies both in the classroom and in clinical settings were higher than 3.11 (out of 5). The nursing students were most confident in their learning of ‘understanding human and environmental factors’ in the classroom and the clinical setting. Nursing students displayed the least confidence in learning ‘work in teams with other health professionals’ in both the classroom and the clinical settings. Type of university, prior experience with PS competencies education, and coverage of PS competency issues in the curriculum predicted the students’ perceived competency scores in the classroom (R2=0.53, p

Abstract Background There are still concerns about the effectiveness of clinical education models which are done with the aim of reducing the theoretical-practical gap in nursing. In this article, we intend to describe an innovative model to create an integration and structured relationship between educational and healthcare provider institutions. The basis of this work is the full-time presence of nursing teacher in the clinical settings and the development of their role to improve the education of students and nurses and the quality of nursing services. Methods This was a participatory action research. This action research was implemented in four steps of problem identification, planning, action and reflection. Interviews, focus groups and observation were used for the qualitative part. Clinical Learning Environment Inventory (CLEI), Job Satisfaction in Nursing Instrument questionnaires and Patient Satisfaction with Nursing Care Quality Questionnaire were completed before and after the study. Qualitative content analysis, paired and independent t test were used for data analysis. Results The academic-practice integration Model of TPSN is a dynamic and interactive model for accountability in nursing Discipline. Unlike the medical education model that includes patients, students, and physicians as the three points of a triangle, this model, which is shaped like a large triangle, places the person in need of care and treatment (patient, client, family, or society) in the center of the triangle, aiming to focus on the healthcare receiver. The model consists of three components (Mentoring component, Preceptorship component, and integrated clinical education component). Each of the components of this model alone will not be able to eliminate the ultimate goal of bridging the theory-practice gap. Conclusions A new and innovative model was proposed to reduce the theory-practice gap in the present study. This model increases the collaboration between educational institutions and healthcare settings compared with the previous models. The TPSN model helps students, nurses, and nursing instructors integrate theoretical knowledge with clinical practice and act as professional nurses.

Background & Objective: Simulation is one of the new learning methods in medical and nursing education that can lead to useful learning outcomes. This study aims to explain the lived experiences of senior nursing students about education in simulated learning environments. Materials & Methods: This qualitative research was based on the phenomenological approach. To collect data, senior nursing students of both genders were purposefully selected and surveyed using in-depth and semistructured interviews lasting from 40 to 60 min. The interviews continued until theoretical saturation after 15 interviews with the participants. Data were analyzed using Colaizzi’s seven-step method. Data reliability and validity were assessed using the reliability criteria proposed by Lincoln and Guba (1985). Results: In this study, the main themes include learning, support and technical factors, human factors, and advantages. As a new learning method, simulation encounters support, technical, and human barriers that can be overcome to achieve goals such as learning clinical skills, clinical judgment skills, increasing critical thinking, and improving patient safety. Conclusion: Simulation is one of the methods that can develop and improve students' basic skills and help in deepening their learning. Nursing schools can provide the necessary provisions and facilities to improve the quality of curricula by expanding and integrating simulations into nursing curricula.

Purpose: Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences. Methods: This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion. Results: Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The “Stress Management Protocol for Nurses Working in COVID-19 Wards” was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items. Conclusion: This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.

Abstract Background Knowing of perception of the illness, and cardiovascular risk factors in patients with myocardial infarction is crucial in engaging in effective secondary prevention. This study aimed to examine illness perception and cardiovascular risk factors in patients with myocardial infarction undergoing percutaneous coronary intervention. Methods The participants comprised 131 patients undergoing a first-time percutaneous coronary intervention at a metropolitan, tertiary referral hospital in Tabriz, Iran. The convenience sampling method was employed to select the research sample within a six-month period. The instruments used were as follows: (1) Demographic and health information form, (2) The Brief Illness Perception Questionnaire (3) The Health Risk Assessment framework developed by the Centers for Disease Control and Prevention. The design of the study was descriptive, cross sectional. The continuous variables were analyzed using Independent t-test and analysis of variance (ANOVA); and categorical variables were compared using the chi-square test. Results Most participants had a positive family history of cardiovascular disease (54.2%), with 66.4% of participants having at least one cardiovascular risk factor such as diabetes (36.6%) hypertension (32.8%) and dyslipidemia (16%). Most participants were physically inactive (78.6%), about 48.9% were overweight, 34.4% suffered from obesity and 26% were smokers. Illness perception in this study was seen to be high (6.21), with highest scores occurring in the illness control dimension (6.83) and lowest scores occurring in the understanding dimension (3.77). There was a significant relationship between illness perception and physical activity, nutrition, sleep and general health. Direct significant relationships between biometric values (cholesterol, glucose, blood pressure); psychological factors (depression, anxiety and stress) and illness perception were also found to exist. Conclusions Low scores in two dimensions of illness perception may lead to psychological consequences such as stress, anxiety, and depression. The relationship between illness perception and some risk factors of cardiovascular disease such as physical activity, diet and biometric values, reveal the need for more attention to patient education and counselling.

Abstract Background Innovative and student-centered teaching methods are required to improve critical thinking and clinical reasoning skills. The objective of this study was to determine the impact of an oncology internship training on learning outcomes of nursing students using an integrated teaching-learning method. Methods A pre- and post-test quasi-experimental study was conducted among 107 undergraduate nursing students in fourth year who were allocated to two groups (intervention group = 51 and control group = 55) to receive an integrated teaching-learning method and routine method respectively. Data was collected using the Clinical Decision Making in Nursing Scale (CDMNS) and the students’ cognitive learning test. Results Difference in mean scores of cognitive learning test post-intervention was significant between the two groups (p < 0.001). Total CDMNS scores and its dimensions increased significantly for the intervention group post-intervention (p < 0.001). Analysis of covariance (ANCOVA) showed that when the effect of confounding variables, such as the student’s Grade Point Average (GPA) and the pre-test scores of cognitive learning and decision-making scale were held constant, the effect of the independent variable (group) on students’ cognitive learning test (p = 0.002) and CDMNS (p = 0.004) was significant. Conclusions Nursing students’ cognitive learning and clinical decision-making scores were improved as a result of the integrated teaching-learning method. Nursing educators can use this method in clinical education to improve students’ cognitive and meta-cognitive skills, thereby improving nursing care quality.

Background: Many nurses are uncertain when making clinical decisions, and this can lead to burnout and professional dissatisfaction. However, no study has addressed facilitators of uncertainty in clinical decision-making among Iranian nurses. Objectives: This study aimed to explore Iranian nurses' experiences of facilitators of uncertainty in decision-making. Methods: This qualitative content analysis study was conducted from June to December 2020. Participants were 17 nurses with bachelor's or higher degrees who were purposively recruited from three hospitals affiliated with Tabriz University of Medical Sciences. Data were collected through semi-structured interviews and analyzed through a content analysis method. Results: Participants' experiences were categorized into three main categories, namely, an unconfident nurse, complex situations, and unclear guidelines and policies. Each category included three to four subcategories. Conclusion: Nurses may experience uncertainty in clinical decision-making when confronted with ambiguous clinical situations or lack sufficient decision-making skills. Nurse leaders are suggested to develop educational programs and support interventions to promote nurses' decision-making skills and help them manage ambiguous situations.

Abstract Background Nurses are at the forefront of patient care during infectious disease pandemics and they play a key role in treating and preventing the upward trend of the disease. Hence, it is crucial to consider their experiences in designing action plans to combat coronavirus disease 2019 (COVID-19). Since there is not enough data in this regard, the current study aimed to investigate the nurses’ experiences in caring for patients with COVID-19 in Iran. Methods In this descriptive qualitative study, a total of 20 nurses were selected by purposive sampling. Semi-structured interviews were conducted and analyzed using qualitative content analysis to collect data. Results Data analysis revealed four main themes, including ‘duality in the form of care,’ ‘confusion and ambiguity in care planning’, ‘workload’, and ‘social isolation in spite of positive image.’ Conclusion Our findings indicated that the nurses experienced a range of paradoxes during the COVID-19 pandemic; these paradoxes included distraction from providing care due to focus on marginal factors in spite of empathy and cooperation in nurses, the presence of volunteer support staff despite the lack of equipment, lack of scientific information and the unreliability of online information, overload in the hospital due to insufficient facilities and equipment, and the physical avoidance of people in the community in spite of social support for nurses in the media. The results of this study can lead to a clear understanding for managers and healthcare policymakers in the country and aid them in taking optimal measures to support nurses and improve the quality of nursing care against COVID-19.

Objectives In this qualitative study, we specify important domains of a nursing education institution that need to be measured to represent its performance via students’ perspectives, one of the most important stakeholders in higher education.Setting This study was conducted in a nursing and midwifery faculty.Participants Participants were bachelor’s, master’s and Ph.D. students in nursing. Convenience sampling was used. The aim and methods of the study were explained to the students, and they were invited to participate in the focus groups. Four focus groups (n=27) were held.Results Thirteen categories emerged that were assigned to three components of the Donabedian model. The structure component contained three categories: learning fields, equipment and facilities and human resources standards. The process component contained five categories: workshops for students and staff, student familiarity with the institution’s rules and plans, teaching, students evaluation and evaluation of teaching staff by students and peers. And outcome components contained five categories: results of self-evaluation by students, graduates’ outcomes, students’ outcomes, students surveys results and related medical centres performance.Conclusion(s) Based on the needs and ideas of this important group of stakeholders, we can proceed further. Once we specify what is important to be measured, then it is appropriate to develop or choose suitable and measurable performance indicators for each of the recognised categories.

Abstract Aim To explore the concept of assertiveness in the patients with thalassaemia major. Design It was a qualitative study with a conventional content analysis design. Method Data were collected using a semi‐structured interview. The research sample included 16 patients with thalassaemia major who were selected using purposeful sampling method from among such patients at educational and therapeutic centres. Then, they were analysed using MAXQDA10 software. Results During the analysis of data for the concept of assertiveness, three sub‐concepts of "courage to self‐presentation," "demonstrating the abilities" and "attendance in groups" were developed.

Abstract Aim To develop the caring model and utilize and evaluate the effect of the model in the nursing student's learning process in burn wards. Design A longitudinal multiphase study. Methods In the first phase, "Coming back to existence caring model" was developed, in the second phase, to evaluate the program, 35 students in the first semester and 31 students in the second semester of the 2017–2018 academic year were selected randomly, and their logbooks were analysed. Results Components of the nursing process, based on the model, were wound management, care and documentation, early mobilization, discharge planning and patient education. The lowest nursing process utilization in both semesters was in the sexuality domain. The most nursing diagnosis was a risk for infection. In the discharge plan, education about how the patient communicates with others in the second semester was less than other educational content (61/3%). However, empowering students was remarkable.

Background and Objective: Women with breast cancer often experience alterations in their mothering roles both because of the disease and the reduced ability for child care. However, many women with breast cancer try to play their mothering roles as they did before the disease. This study aimed to discover the strategies used by Iranian women with breast cancer to manage their mothering roles in the process of the disease and survival. Material and Methods: A qualitative content analysis study was conducted on 23 mothers with breast cancer. Semi-structured interviews were used to collect data and a conventional content analysis method was used to analyze the data simultaneously with data collection. Results: Totally 1200 non-duplicate codes were extracted from the data and were categorized into four categories. Self-preparation was the first category and included three subcategories, namely, self-awareness for regaining the role, psychological mobilization to continue the role, and seeking informational support. Role reorganizing was the second category and had two subcategories, namely assigning to alternate people, and modifications of maternal duties. Self- and family-reconstruction was the third category and included three subcategories of energy conservation, communication development, and child protection. Playing a participatory-supervisory role was the fourth category and had two subcategories of participation and supervision. Conclusion: Identifying the strategies used to play the mothering role can help health care professionals to support, provide advice, and train the mothers with breast cancer and their families. It also helps mothers to play their mothering role during the disease.

Abstract Background Adverse attitudes and insufficient knowledge about organ donation after Circulatory Determined Death (DCD) among emergency staff can have important consequences for the proper identification of potential DCD donors. This is aided by the constant application of donation after Circulatory Determined Death policies, and the relative strength of support for this type of donation. Therefore, this study was conducted to investigate the awareness and attitude of emergency personnel about organ donation after Circulatory Determined Death. Methods This descriptive study was carried out with the participation of 49 physicians and 145 nurses working in the emergency departments of educational and medical centers of Tabriz University of Medical Sciences. Nurses were selected by simple random sampling, and all physicians working in the emergency departments were included in the study. The questionnaire of Knowledge and Attitude regarding Organ Donation after Circulatory Determined Death designed by Rodrigue et al. was used. Data were analyzed using descriptive statistics and independent samples t-test, one-way ANOVA, and chi-square test. Results Most of the nurses (62.8%) and physicians (66.7%) had a high level of knowledge about organ donation after circulatory determined death. The mean attitude score was 101.84 (SD: 9.88) out of 170 for nurses and 106.53 (SD: 11.77) for physicians. Physicians who carried organ donation cards had a more positive attitude toward organ donation after circulatory determined death. Conclusion According to this study findings, knowledge and attitude of the emergency staff about organ donation was both high and positive. It is recommended to devise necessary guidelines for organ donation in Iranian emergency departments to assist in the training of colleagues in organ donation ensuring no necessary measures are missed. The results of this study would support the development of guidelines for the successful introduction of DCD in Iran.

Abstract Background Nurses as the majority of the health care workforce help in the health systems strengthening. Nurses’ involvement in health policy making is clear; however, still few are involved in policy-making processes, even in the clinical context. The aim of the present systematic review was to identify factors influencing nurses participation in the health policy-making process. Methods The present systematic review was designed on studies conducted between 2000 and 2019. Four online databases including PubMed, EMBASE, SCOPUS and Science Direct were searched using comprehensive terms. Study selection, quality assessment, data extraction, and data analysis were independently done by two reviewers. Inclusion criteria included published studies in English language and between 2000 to 2019, participants such as nurses and the healthcare managers, mentioned influential factors, types of participants were included nurses and the healthcare managers, study designs and methods clearly defined. The methodological quality of included article was appraised using the checklists of CASP and MMAT. Finally the data were analyzed using content analysis. Results After quality assessment, 11 studies, according to inclusion criteria, were retrieved. Nine studies had a good, 2 a medium, and non-articles was poor methodological quality. Three main themes include nursing-related factors (4 sub- themes), management and organizational factors (8 sub-themes) and creating a positive work environment (3 sub-themes) identified as affecting factors on nurses participation in health policy. Conclusion Nurses can utilize this finding to develop empowering programs to play efficient roles and increase their participation in health policy making. Also, the extracted factors in this review can place nurses in suitable position and make them potential agents in changing the ways of policy-making. Further studies are required to survey the relation between these factors and nursing participation in health policy making.

Abstract Background Defining the disrupted mothering would contribute to developing strategies to support mothers with breast cancer. The aim of this study was to analyze the concept of mothering disruption using a hybrid model. Methods The Hybrid method for concept analysis was implemented consisting of three phases: theoretical, fieldwork, and final analysis. In the theoretical phase, the literature was searched using electronic databases including PubMed, ScienceDirect, Scopus, ProQuest, Google Scholar, CINAHL, Wiley, Ovid, Magiran, and SID from 2000 to 2020. Any quantitative or qualitative studies published in English or Persian, which were focused on mothering disruption in mothers with breast cancer were included in the study. In the phase of fieldwork, 20 mothers were interviewed to explore the aspects of mothering disruption. The interviews were transcribed and analyzed with conventional content analysis. In the final phase, an overall analysis of the two previous phases was performed. Results In the theoretical phase, the following attributes were determined: “disturbance in maternal identity and roles”, “maternal insensitivity and unresponsiveness: disconnection physically and psychologically”, “the career disruption process” and “biographical disruption”. The fieldwork phase explored three themes including “the unbalance between multiple roles”, “role failure”, and “reduced maternal sensitivity”. The final synthesis yielded that the main integrated elements of mothering disruption are “disease as threating maternal role and identity”, “inability to interpret and respond to child behaviors and needs”, and “support for transitioning from being patient toward maternal competency”. Conclusion With a deeper understanding of the term ‘disrupted mothering’ or ‘mothering disruption’, healthcare providers will have a foundation to improve cancer care, deliver effective communication and help such mothers cross this disruption and achieve restoration of their mothering role. Future research is needed to validate this concept and explore connections with health outcomes.

Abstract Introduction:Developing new training methods for improving the health of diabetic patients has always been a concern for nurses. The present study aims to investigate the effects of empowerment-based interventions with or without telenursing on self-efficacy and HbA1c level in diabetic patients. Methods:In this randomized clinical trial, 156 patients with type-2 diabetes were randomly assigned into two intervention groups (empowerment with/without telenursing) and one control group. All subjects in the intervention groups participated in two sessions of the empowerment program. However, only the group of empowerment with telenursing received telephone counseling for 12 weeks. The patients in the control group did not receive any intervention programs. Self-efficacy was measured by diabetes-specific self-efficacy scale. The HbA1c level was measured using Bionic kit. Data were analyzed using SPSS Statistics for Windows, version 13.0 (SPSS Inc., Chicago, Ill., USA). Results:After 14 weeks, while the changes in self-efficacy scores of the control group were not statistically significant, they were significant in the two intervention groups. Comparison of the two intervention groups showed that self-efficacy was higher in the group of empowerment with telenursing. It was only in the empowerment with telenursing group that the reduction of HbA1 c was significant. Conclusion:Training based on empowerment models and emphasis on the strengths of clients in solving their own problems can play a major role in increasing self-efficacy and reduction of HbA1c level. In addition, a continuous training program, along with telephone follow-ups can result in higher self-efficacy and lower HbA1c level.

Background: The short course of baccalaureate nursing program and overcrowding of clinical settings restrict the development of pediatric peripheral venous catheter (PVC) insertion skill among nursing students. Therefore, better teaching strategies are needed. Objectives: The aim of this study was to compare the effects of role play simulation and demonstration on pediatric PVC insertion skill among nursing students. Methods: In this three-group experimental study, 46 nursing students were selected from Tabriz University of Medical Sciences, Tabriz, Iran, randomly allocated to a control, a role play simulation, or a demonstration group. Initially, all students received information about pediatric PVC insertion through lecture. Then, their skill was assessed using a child mannequin in a skill lab by a thirty-item rating scale. Then, participants in the simulation and the demonstration groups received training about this skill through simulation or demonstration teaching methods. After 3 weeks, their skill was reassessed. Data were analyzed using the Wilcoxon and Kruskal–Wallis tests. Results: The baseline total scores of PVC insertion skill were 17.66 ± 7.46, 14.93 ± 6.64, and 16.92 ± 10.38 and after intervention changed to 20.66 ± 5.65, 33.81 ± 6.86, and 41.14 ± 7.67 in the control, role play simulation, and demonstration groups, respectively. There was a statistically significant increase of skill in simulation and demonstration groups (P < 0.001), whereas the increase in the control group was insignificant (P = 0.09). There was no significant difference between role play simulation and demonstration groups (P > 0.05). Conclusion: Both role play simulation and demonstration significantly improve pediatric PVC insertion skill among nursing students. These teaching methods are recommended for developing nursing skills.

Background: Breast cancer is the most common cancer and the 5th leading cause of death in Iranian women. Many of these women are at the age of fertility and have dependent children. Objectives: This study aimed to explore the experiences of mothers with breast cancer of the support they receive for playing and rebalancing their mothering role. Methods: This qualitative content analysis study was conducted from 2018 to 2019. Participants were 22 mothers with breast cancer purposively recruited from Shahid Ghazi Tabatabaee Hospital in Tabriz, Iran. Data were collected through semi-structured interviews and analyzed through a conventional content analysis method. Results: Participants’ experiences were categorized into three main categories, namely, perceived difficulties, being with and for mother, and rebalancing family functions. The four subcategories of the first category were the physical limitations in performing the mothering role, the psychological burden of the disease, role strain in playing the mothering role, and children’s social difficulties. The second category included five subcategories, namely, assistance with the mothering role, emotional attachment to the mother, provision of family expenses and medical costs, normalization of appearance following cancer-induced changes, and social support resources. Finally, the third category included two subcategories, namely, the stability of the mother’s roles and promoting a health-oriented perspective in the family. Conclusion: Mothers with breast cancer face difficulties in performing their role as mothers. Identifying and providing supportive interventions for them by the health-care providers not only can be effective in achieving role stability for the mother but also in rebalancing family functions.

Abstract Background Nursing education institutions are required to select and train applicants who have appropriate characteristics for delivering effective healthcare. Unlike other healthcare professions and despite the need to attract and select a competent workforce, there has been no comprehensive analysis of the selection criteria and methods used to recruit nursing students. As there is relatively limited prior research available, we conducted a scoping review to explore and synthesise the existing evidence regarding admission criteria and selection methods of nursing students and for the purpose of identifying an agenda for future research in this field. Methods Our scoping review follows the Arksey and O’Malley five-step proposition including identifying the research question and relevant studies, study selection, tabulation of data, and summarizing and reporting the results. Seven databases (PubMed, CINAHL, Scopus, ERIC, SID, Irandoc and PsycINFO) were searched systematically using relevant keywords. Articles on admission of undergraduate nursing students published in both English and/or Persian from 2006 to 2019 were retrieved. Results Existing research evidence suggests that nursing students are largely selected on the basis of two criteria - “cognitive-academic abilities” and “non-cognitive abilities.” Cognitive-academic abilities were assessed in four main dimensions of mathematics, language, natural sciences and reasoning skills mainly through standardized tests and academic records. Our review shows a wide range of non-cognitive characteristics are evaluated in nursing applicants including: morality, interpersonal communication skills and psychological strength. The selection method most commonly used to assess characteristics was through interviews (panel interviews or multiple mini interviews). Other methods included references, personal statements and personality assessment tools. Conclusions This is the first scoping review of literature regarding nursing education selection and recruitment. Results can be used to inform nursing education policymakers and institutions in the design of their selection practices. Future research should concentrate on the evaluation and improvement methods of student selection including content and predictive validity analysis of multiple mini interview and standardized tests, development of cost-effective selection methods and job analysis studies to identify specific non-cognitive characteristics for nursing.

Abstract Aim After the discharge of patients with burns, quality of life, psychological and social adjustment, performance and their follow‐up are ambiguous. Therefore, we decided to improve the status of family‐based care programmes in patients with the burn. Design Participatory action research. Methods The participatory action research was conducted between the Faculty of Nursing, Sina Hospital's managers and multidisciplinary burn teams from 2017–2018. The procedure for data collection included focus group meetings with key informants, interviews, observation, and questionnaire. Qualitative data were analysed using the qualitative content analysis and qualitative data were analysed by SPSSv.24. Results The study, comprised of four phases, started in May 2017 and completed in 9 months. The results of quantitative showed that quality of life has a statistically significant difference before and after the action. The qualitative data resulted were grouped into 3 categories and 28 subcategories and were analysed in the SWOT Matrix. All the multidisciplinary burn teams together with the managers as a team working of the care providers and the academic researcher resulted in enablers the changes in providing health education and services as well as improving the quality of life of patients and their families.

Abstract Aim To identify and document patients' care needs, it is vital to provide quality care services. This study was aimed to describe care needs derived from records of patients with burn and to evaluate whether nurses employed the North American Nursing Diagnosis Association classification to formulate patients' care needs. Design A descriptive cross‐sectional study. Methods In this study using the convenient sampling method, 430 nursing records reviewed in the burn wards. Data were collected using Gordon's checklist. The validity of the checklist assessed by content validity and the reliability of them calculated with inter‐rater and internal consistency. Data analysed by SPSSv.24. Results The mean number of diagnoses per record was 1.94. The most frequent diagnosis was in the domain of Safety/Protection and the top two prevalent nursing diagnoses in Sina hospital were a risk for infection and risk for falls. From all of the detected diagnostic, about 83% were determinedly not related to one of 247 labels of the North American Nursing Diagnosis Association. Given that nurses provide nursing care as requested by physicians and patient care needs are not assessed and recorded by them, it can be concluded that there was no nursing thinking behind their nursing care.

Objective: In cancer care management, patients or their family are usually responsible for continuing health care. Achieving this goal requires identification of their self-care needs. The purpose of this study is to explore the perception of self-care needs of adolescent cancer survivors. Methods: This study was conducted by the qualitative content analysis method. Participants were 19 adolescent childhood cancer survivors and six parents, nurses, physicians, and charity institution staff from children teaching hospitals in Iran. Participants were selected through purposeful sampling, and individual semistructured interviews were used for data collection. Graneheim and Lundman stages of content analysis were employed for data analysis. Data were managed with the MAXQDA10 software. Results: Content analysis revealed nine subcategories as follows: (1) nutritional protection, (2) prevention from infection, (3) prevention from physical damage, (4) control over cancer recurrence, (5) informational needs, (6) pain management, (7) releasing positive thoughts, (8) continuing routine life, and (9) family protection. The first six subthemes were related to protection against physical distress, and the final three ones were related to protection against psychological distress. These two categories form one theme: “protective self-care need” as an essential self-care need in adolescent cancer survivors. Conclusions: Pediatric and school health nurses can prepare strategies to meet these needs by providing effective informational and psychosocial supports, and healthcare providers are able to check periodically the status of survivors care to provide second or third level of care to prevent escalation and incidence of the adverse outcomes of the disease.

Background & Aim: Patient participation is an important component of the patient-centered care approach and part of patients’ rights, with positive outcomes for the health care system. The aim of this study was to explore the nurseschr('39') experiences of patient participation in nursing care and its related factors. Methods & Materials: This qualitative study was carried out with the participation of 18 nurses working in educational hospitals of Tabriz in 2019. The purposeful sampling through semi-structured interviews and focus group sessions was used to collect the data. Data analysis was performed using conventional content analysis. To achieve the accuracy of the data, the Lincoln and Guba criteria were used. Results: Analysis of the data resulted in four main categories "giving information, decision-making, collaboration and respect". The patient’s participation from the nurses’ perspectives was: an interactive process of decision-making and collaboration between the nurse and the patient with the exchange of information, respect, and permission from the patient. The results also included the prerequisites, domains, outcomes, barriers, and solutions for patient participation in nursing care. Conclusion: Patient participation today is considered the legal right of the patient and also the gold standard of international health care systems. So nurses, health system policy makers, patients and academic centers can use these results to improve patient participation in the care.

Abstract Aim Health service providers are appreciated among the vital components in a society wherein nurses are also considered as the main human resources. Thus, examining the existing challenges in managing these human resources through taking correct measures can contribute to identifying the priorities and consequently influence the quality of services provided. This study aims to investigate the challenges of human resources management in nursing from the perspective of professionals in Iran. Design Qualitative content analyses. Methods Present study is carried out using purposive sampling conducted on 12 nurses involved in different professional nursing positions. To this end, the participants' perceptions, opinions, beliefs and attitudes were collected via two focus group sessions. Data were collected during Febuary and March 2018. Results From the perspective of the professionals, the challenges could be observed in a wide variety of human resources management dimensions in nursing such as job analysis, recruitment, as well as development and retention of workforce.

Abstract Aims This review study aimed to investigate the strategies for implementing the nursing process in the clinical practice and the assessment of the implementation rate of this process in clinical settings of lower‐income countries. Design An integrative review. Method The search was conducted of EMBASE, MEDLINE, CINAHL, Scopus and ISI databases from 1975–July 2018. Following the formation of the research team, two researchers independently selected the eligible studies; finally, 39 articles were approved by the research team for this study. Results The researchers identified three themes: Effects of implementing the NP in clinical settings, Development and application of electronic software in the NP and Factors affecting the implementation of the NP. This review revealed that nurses and nursing managers in hospitals are interested in implementing the nursing process in the form of widely and continuously. But the necessary infrastructure, such as manpower, electronically or manually tools, has not yet been provided, and the implementation of the nursing process is done either imperfectly or not done.

BACKGROUND: The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care. MATERIALS AND METHODS: The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive–comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases. RESULTS: The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation. CONCLUSION: It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.

BACKGROUND: One of the main issues related to the inefficiency of the health system is the lack of sufficient communication between researchers and health policymakers regarding the exchange of the latest findings and the use of inappropriate evidence to manage cases. The knowledge translation removes this disconnect. MATERIALS AND METHODS: In this comparative study, to obtain appropriate data on the status of knowledge translation, refer to the databases of reputable centers and governments and the knowledge translation models were reviewed in the title of main articles, abstracts, guidelines, and reports of reputable international organizations between 2005 and 2020. The origin of the models was determined, then the countries with the largest number of models were selected and analyzed using Walt and Gilson's “Policy Triangle framework in four dimensions: context, content, process, and actors.” RESULTS: All the three countries have politically, socially, and economically made knowledge translation one of their policy priorities. Iran's centralized health system is a major obstacle. The USA and Canada have clear strategies and coherent and practical infrastructures that implement the knowledge translation in the form of operational plans. In contrast, in Iran, it has been enough to establish the knowledge translation centers at the level of universities and knowledge translation websites. In Iran, the Ministry of Health and universities of medical sciences play a direct role, but in Canada, they also use knowledge broker to apply knowledge. CONCLUSION: Iran is building capacity in the field of knowledge translation. That the implementation of interventions with the cooperation of macro policymakers can strengthen it.

Introduction: Coming back into existence is a concept coined relatively recently in a grounded nursing theory of post-burn patients. However, the nature of this concept has not been thoroughly clarified. In order to improve nurses’ and others’ understanding of and communication about coming back to existence, this study aimed to clarify the concept.Methods: This study was performed qualitatively using Rodgers’ evolutionary concept analysis to clarify the concept of coming back to existence. Multiple computerized databases (PubMed, Scopus, ProQuest, Google Scholar, Iran Mede, and SID) were searched for their titles and abstracts to select full-text English papers published without time limit. A total of 20 articles were selected to be reviewed.Results: The key attributes of coming back into existence identified in this study were providing opportunities for thinking and self-reflection on living affairs, releasing the mind to focus on the inner life, and making conscious efforts to explore and discover the original dimensions of one’s being. Antecedents included the bitter and unforgettable experience of physical pain, psychological suffering, failure and hopelessness in interactions, and doubts about one’s self-identity and philosophy of being. Consequences included self-acceptance, a sense of liberation and freedom, and positive and creative development in life to achieve more transcendent goals. Conclusion: The results of this study can be helpful in identifying the needs and problems of clients and developing appropriate care plans and nursing interventions.

Abstract Aim Professional communication between nurse and patient has a significant role in patient satisfaction with nursing care. The aim of this study was to assess nurse–patient communication and patient's satisfaction from nursing services in the burn wards of women and men. Design Participants were all patients admitted to the Burn wards at the Sina Hospital of Tabriz between September–December 2018. Nurse–patient communication and patient's satisfaction were assessed using at the time of discharge. Data were analysed by SPSS applying descriptive and inferential statistics. Results The results show that most patients were dissatisfied with nursing care. More than 80% did not know their nurse. There was a correlation between nurse‐patient communication and patient satisfaction with nursing care and the sex variable was found to be significantly correlated with patients’ satisfaction level. The weakness of nurses 'communication with patients was evident in our study and patients were dissatisfied from this kind of communication, and consequently, patients' satisfaction was reported very low. Improving the satisfaction of patients in the hospital should be the priorities of the hospital managers. Therefore, by educating staff, especially nurses, identifying motivating factors as well as identifying dissatisfaction factors, improved patient satisfaction.