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Abstract Background During epidemics, the number of individuals whose mental health is affected is greater than those affected by the infection itself. This is because psychological factors have a direct relationship with the primary causes of the disease and mortality worldwide. Therefore, an increasing investment in research and strategic actions for mental health is essential globally, given the prevalence of infectious diseases. The aim of this study was to elucidate and describe the strategies for mental health preparedness and response during epidemics, with a focus on the COVID-19 pandemic in Iran. Methods A qualitative study was conducted in Iran from 2022 to 2023. Purposeful Sampling was employed, continuing until data saturation was achieved. Data collection involved semi-structured interviews and observational notes with 20 managers and experts possessing expertise, experience, and knowledge in mental health. Ultimately, the participants' opinions, based on their experiences, were analyzed using the qualitative content analysis method with a conventional approach, resulting in the categorization of data into codes, subcategories, and categories. Results The study revealed participants' opinions and experiences, categorized into two overarching categories: Preparedness, Policy-Making, and Planning Strategies (with four subcategories), and Response Strategies (comprising thirteen subcategories). Conclusion The opinions and experiences of managers and experts in this study revealed that an appropriate mental health response during pandemics requires preparedness before the occurrence of such crises and the implementation of suitable response strategies after the occurrence. Managers, policymakers, and decision-makers in this field should pay attention to the solutions derived from the experiences of such crises to respond more preparedly in the future.

Abstract Background Intimate partner violence (IPV) is the most common form of violence against women. Postpartum IPV refers to any type of IPV that occurs up to one year after childbirth and has many adverse impacts on mothers and their children. Considering the lack of sufficient information on the prevalence and factors related to IPV after childbirth in Iran, this study aimed to evaluate the frequency and severity of IPV, its different forms, and psychosocial factors related to IPV, as well as to explore how IPV is perceived among mothers one year after childbirth. Methods An explanatory sequential mixed-methods design was used to conduct this study in two phases. The first phase is a cross-sectional study that will be performed on postpartum mothers who have a one-year-old child referred to health care centers in the southern region of Tehran, Iran, with the aim of determining the prevalence of IPV and its related factors. The second phase is a qualitative conventional content analysis study with the purpose of exploring women’s experiences and perceptions of IPV and its preventive or protective factors. Purposive sampling will be used. Based on the results of the quantitative phase, mothers who are at the two ends of the IPV spectrum (based on their total Conflict Tactics Scale (CTS-2) scores) will be selected, and in-depth and semistructured interviews will be conducted with them. Finally, the researchers will provide an interpretation of the quantitative results using qualitative data. Discussion This is the first study that uses a mixed methods approach to explain different dimensions of IPV, its related factors, and mothers' perceptions of it. By providing a better understanding of this phenomenon, it is hoped that the results of this research will be used by policymakers and officials of educational and cultural systems to plan and provide effective interventions, enact laws, and present educational and cultural programs to prevent IPV after childbirth. Ethical code IR.TUMS.FNM.REC1400.200.

Abstract Nurses may experience burnout more than other professions. Occupational burnout is a serious concern considering the importance of nurses' jobs in patient care. This study was carried out with the aim of designing and validating the questionnaire of burnout factors in the operating room nurses. Mixed method study was done in two qualitative and quantitative phases in 2022 on Iranian operating room nurses. In the first stage, the concept of operating room nurses' burnout was explained using interviews and literature review, and items were generated. In the second stage, the face validity, content and construct validity of the questionnaire was examined with 342 operating room nurses, and also the reliability of the questionnaire was tested using internal consistency (Cronbach's alpha) and stability (test–retest). After conducting the interview and literature review, 65 questions were extracted. Based on face validity, 4 items were modified. After content validity, 40 items remained. In construct validity, after exploratory factor analysis, 34 items with 5 dimensions were extracted. These dimensions included Organizational, Individual, Interpersonal, Occupational Nature and Managerial factors. Cronbach's alpha and intra-class correlation coefficient were equal to 0.937 and 0.946, respectively. The designed tool based on understanding the concept of burnout in operating room nurses has appropriate and acceptable validity and reliability. Therefore, it can be used to measure burnout in operating room nurses.

Objective: The failure to detect PDG and lack of providing essential interventions accordingly can disrupt the lives of survivors of natural disasters years after the death of their loved ones. The present study aims to investigate PGD after natural disasters using a systematic review and meta-analysis. Study design: This study was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Methods: With the focus on the prevalence of PGD after natural disasters, studies conducted until the end of 2021 were collected without a time limit. To do this, reputable databases such as PubMed, Web of Science, Scopus, Embase, Google Scholar, and Science Direct were used. The random effects model was used to perform a meta-analysis of the studies. To check the heterogeneity between the studies, the I2 index was used. The publication bias of the study was evaluated using Begg's test. Data were analyzed using the STATA software. Results: Primarily, 2566 studies were collected based on the initial search, from which 12 final studies were entered into the analysis. The results showed that the prevalence of PGD after natural disasters was 38.81 % (95 % CI: 24.12–53.50, I2 = 99.7 %, p = 0

Abstract Background In recent years, Iran has encountered a growing frequency of earthquake disasters. Given that nurses constitute the largest group of healthcare providers, it is imperative that they possess adequate disaster preparedness skills, irrespective of the location or time. Despite the operating room nurses’ roles in disasters, their experiences and challenges in disaster preparedness have been overlooked. Consequently, this study aimed to investigate the experiences, challenges, perspectives, and factors influencing the disaster preparedness of operating room nurses during the 2017 earthquake in Kermanshah, Iran. Methods The present qualitative research was carried out in Iran In 2022 utilizing conventional content analysis. The study involved conducting semi-structured interviews with 16 operating room nurses who had participated in disaster preparedness during the Kermanshah earthquake. The participants were selected using a purposive sampling approach that aimed to achieve maximum diversity. The interviews were continued until the point of data saturation was reached, and the verbatim transcripts were analyzed using conventional content analysis in MAXQDA software. To ensure the rigor of the research, Guba and Lincoln’s criteria were employed. Results The study conducted data analysis to identify the main theme as “insufficient disaster preparedness due to a faded preparedness”, along with six major categories and eighteen subcategories related to earthquake disaster preparedness. The major categories included: knowledge and perception of preparedness for disasters; educational and training programs for disaster preparedness; equipment preparedness for disasters; managerial-organizational preparedness for disasters; clinical skills for responding to disasters; and resilient ability in disaster response situations. Conclusion The findings of the study provide valuable insights into the dimensions of disaster preparedness in earthquake disasters among operating room nurses. Nursing managers can utilize these findings to develop effective strategies and provide support in areas such as improving knowledge and educational level, equipment preparedness, strengthening plans and managerial structures, enhancing skills, and explaining resilience strategies to improve the disaster preparedness of operating room nurses and medical organizations’ disaster response teams.

Abstract Background To determine the health needs and promote women's health, their quality of life should be investigated. For this purpose, a valid tool is needed, that has credible validity and reliability, and its concepts are clearly defined and culturally appropriate. This study aimed to develop and assess the psychometric properties of “Iranian Women’s Quality of Life Instrument (IWQOLI)”. Methods The items of “IWQOLI” were generated from themes extracted (150 items) from a content analysis approach with the participation of 40 women. Face validity of the questionnaire with the participation of 10 women and content validity by 10 experts was approved. To determine the domains of the questionnaire, exploratory factor analysis (principal component extraction method) was performed. Internal consistency and test—retest reliability methods with 14-day intervals (30 women) were used to assess the reliability of WQOLI. Results After performing the face and content validity, 32 items were deleted. S-CVI/Ave was obtained for the instrument (0.93). The factor structure of the inventory was identified by undertaking a principal component analysis in a sample of 590 women. Five factors were extracted with a total variance account of 56.24% and 28 items dropped at this point. The IWQOLI score was significantly correlated with the SF-36 (r = 0.717, p

Background: Temporary medical centers can properly compensate for the shortage of hospitals during biological emergencies. They bolster the capacity of medical centers regarding patient admissions, provide efficient care, and mitigate the progression of critical situations. This study aims to identify the advantages of setting up temporary medical centers in responding to the COVID-19 pandemic. Materials and Methods: This qualitative study engaged 25 people involved in managing temporary medical centers during the COVID-19 pandemic. The participants included patients, construction experts, and specialists who equipped and set up temporary medical centers in Tehran City, Iran. All had possessed a history of responding to biological agents. Considering the maximal diversity, the participants were selected based on work experience, age, gender, education level, and managerial background. The inclusion criteria comprised willingness to participate, ability to communicate with the interviewer, and informed consent. The exclusion criterion included the inability to continue the research. The study data were analyzed by MAXQDA-2020 software using the Graneheim and Lundman method. The results were validated against the Guba and Lincoln criteria. Results: Based on the results, the advantages of temporary medical centers were classified into 8 sub-themes: human-centered care, quick performance and response, helping the health system, preventing the burnout of treatment staff, saving the costs, justice and equality, leveling and providing classified services at various levels, and timely patient transfer. Conclusion: With specific criteria for accepting patients, temporary medical centers ensure their safety in care, help to break internal transmission, and pay attention to patients’ social and emotional needs. As a rapid response mechanism, they can answer to the current COVID-19 pandemic and other epidemics in future disasters. The result of this study can help manage biological emergencies in the future, as it presents a clear picture of the advantages of temporary treatment centers.

Abstract Background The evaluation of spiritual requirements in patients can facilitate the delivery of spiritual care as an essential element of holistic healthcare. The objective of this research was to develop and evaluate the psychometric properties of a questionnaire on patients’ spiritual needs in medical-surgical hospital settings. Methods This research utilized an exploratory sequential design, involving the creation of a pool of items through both inductive and deductive methods. The questionnaire’s psychometric properties were then assessed using various techniques, such as face and content validity, item analysis, construct validity, internal consistency, stability, confirmatory factor analysis, and the Gradual Response Model of Samejima. The data analysis was conducted using MPLUS software, version 5.1. Results The study’s results showed that a four-factor structure (interpersonal connectedness, relationship with God, transcendence, and peaceful environment) with 43 items was successfully extracted through exploratory factor analysis. The confirmatory factor analysis supported the findings of the exploratory factor analysis. The Cronbach’s alpha coefficients for the scale and factors ranged between 0.83 and 0.95. Furthermore, the interclass correlation coefficients for the scale and factors were between 0.89 and 0.96. Conclusions The questionnaire designed in this study is a reliable and valid instrument that can be utilized by healthcare, educational, and research institutions to evaluate the spiritual needs of patients in medical-surgical hospital settings.

Introduction Nurses’ innovative behaviours play a crucial role in addressing the challenges including adapting to emerging technologies, resource limitations and social realities such as population ageing that are intricately tied to today’s healthcare landscape. Innovative behaviours improve healthcare quality, patient safety and satisfaction. Organisational factors and individual attributes influence nurses’ inclination to innovate. With the rise of artificial intelligence and novel technology, healthcare institutions are actively engaged in the pursuit of identifying nurses who demonstrate innovative qualities. Developing a comprehensive protocol to elucidate the various dimensions of nurses’ innovative behaviours and constructing a valid measuring instrument, rooted in this protocol represents a significant step in operationalising this concept.Methods and analysis The study encompasses two phases: a qualitative study combined with a literature review, followed by the design and psychometric evaluation of the instrument. To ensure diversity, a maximum variation purposive sampling method will be used during the qualitative phase to select clinical nurses. In-depth semistructured interviews will be conducted and analysed using conventional content analysis. Additionally, a comprehensive literature review will supplement any missing features not captured in the qualitative phase, ensuring their inclusion in the primary tool. The subsequent quantitative phase will focus on evaluating the questionnaire’s psychometric properties, including face, content and construct validity through exploratory factor analyses (including at least 300 samples) and confirmatory factor analyses (including at least 200 samples). Internal consistency (Cronbach’s alpha), reliability (test–retest), responsiveness, interpretability and scoring will also be assessed.Ethics and dissemination This study originates from a doctoral dissertation in nursing. Permission and ethical approval from Semnan University of Medical Sciences has been obtained with reference code IR.SEMUMS.1401.226. The study’s findings will ultimately be submitted as a research paper to a peer-reviewed journal.

Conclusion: The electronic version of the IAPAT-C was valid and reliable. COVID-19 significantly affected various aspects of Iranian adolescents’ daily lives. Accordingly, it is necessary to provide appropriate interventions and policies for this sensitive class.

Abstract Aim The aim of this study was to identify the defining characteristics of spiritual distress (00066). Design This study was conducted by integrated review method using Broom method. Methods PubMed, ProQuest, Web of Science, Embase, Scopus, and Cochran Library, and Persian scientific databases were searched from January 2010 to December 2020. Results Twenty‐one article and 74 defining characteristics were identified. 33 of these defining characteristics was mentioned in NANDA. The criteria with the highest frequency and repetition in articles were lack of peace, lack of hope, change in anger behaviour, lack of meaning in life, change in fear and crying behaviour, Concern about belief and values system and/or God. Conclusion Some of the spiritual distress defining characteristics overlap with other nursing diagnoses, including anxiety and hopelessness. Clinical and content validation studies need to be conducted and the main criteria for diagnosing spiritual distress in different cultures and religions need to be identified.

Background: Spiritual distress negatively affects well-being, and its effects are much stronger and more permanent than the positive aspects of spirituality. Since spiritual distress has destructive effects, the introduction and validation of defining characteristics, which are most likely expressive of spiritual distress in the client, can be applied in the daily use of this nursing diagnosis for the quick identification of individuals with spiritual distress, designing targeted and culture-based nursing care, and cost reduction.Aim: The present study was performed with aim to assess the content validity of the defining characteristics of nursing diagnosis of "spiritual distress".Method: This methodological study was performed based on the six steps of Fehring's diagnostic content validity model. A total of 40 nursing experts participated in the study to validate 74 defining characteristics. Descriptive statistics and Fehring's diagnostic content validity model were used for data analysis.Results: Contents validity of 74 defining characteristics was assessed. Six defining characteristics were identified as primary that four were introduced by North American Nursing Diagnosis Association (NANDA), four were considered as irrelevant and 64 were identified as secondary that 29 were introduced by NANDA. The total score of diagnostic content validity was 0.68.Implications for Practice: Validation and identification of defining characteristics as representative of nursing diagnosis of spiritual distress can be effectively applied to help quick and correct identification and provide targeted and optimal nursing care.

Abstract Background Proper human resource management in military health centers leads to long-term development and improved health-care quality. As a result, the purpose of this research is to identify the key performance indicators of human resource management for military hospital managers, and the unique indicators of military hospitals were obtained. Methods This cross-sectional study was performed by the TOPSIS method in the fall of 2021. This study used a checklist consisting of 20 performance indicators of human resource management, which were scored by 20 senior military hospital managers based on two criteria: "importance" and "measurability in military hospitals". The Shannon entropy method was used to weight the indicators, and the BT-TOPSIS Solver software was used to analyze and prioritize them. Results Among the 20 indicators in human resource management, the staff satisfaction index in military hospitals, the competitiveness rate of salaries in military hospitals relative to the national sector, the number of permanent staff in military hospitals, and the percentage of contract labor costs in military hospitals have the highest coefficient, respectively. Conclusions The importance of human resource management and organizational performance is due to their influence on each other. As a result, human resource management should pay special attention to the professional and personal development of human resources, as this has an impact on the performance of the organization in the long run. In light of the sensitive nature of human resource management and its crucial role in achieving any organization's strategic goals, selecting appropriate indicators is essential. The Department of Military Health requires indicators unique to the military sector to assess the human resource management of the military hospital, since according to the existing circumstances, the indicators of the military sector and those of the civilian sector are different.

Abstract Background Current study was conducted with the aim of explaining domains of clinical competence in undergraduate midwifery students so that it addresses the challenges in midwifery curriculum and improving clinical assessment methods in Iranian undergraduate midwifery students. Methods Qualitative approach and conventional content analysis were used in the design of the present study. The research setting included midwifery and nursing schools and hospitals and health centers affiliated to Tehran and Guilan universities of medical sciences in Iran. The target population consisted of undergraduate midwifery students in the fourth to eighth semesters of school, midwives working in hospitals and health centers, midwifery faculty members, and obstetricians. The participants were selected through purposive maximum variation sampling, which continued until data saturation. After in-depth semi-structured interviews, the content of the interviews was analyzed according to the steps proposed by Zhang & Wildemuth. Results Twenty-four people participated in this study, including seven midwifery students, seven midwives, nine midwifery and reproductive and sexual health faculty members, and one obstetrician. The participants were aged 20–56 years and their mean age was 39.75 years. Their level of education varied from midwifery student to PhD. The mean work experience of the participants was 13.62 years and the mean duration of the interviews was 48 min. The analysis of the data obtained from the experiences of the participants led to the formation of the four categories of ethical and professional function in midwifery, holistic midwifery care, effective interaction, and personal and professional development, along with ten subcategories. Conclusion The findings of the present study showed that clinical competence in midwifery students involves different domains that correspond well overall to the general definitions of clinical competence in different sources. These findings can be used as a basis for the design and psychometric assessment of a clinical competence assessment tool for undergraduate midwifery students.

Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.

BackgroundBreast cancer is the most common cancer among women and is the second leading cause of cancer death. This disease affects all aspects of the patient's life and family, especially the patient's spouse, which confirms the need to adapt to these changes. The common instruments used for the investigation of adaptation among husbands of women with breast cancer are mainly outdated, one-dimensional, or non-concordant with the Iranian culture. Therefore, the present study aimed to design and validate an adaptation scale among the husbands of Iranian Muslim women suffering from breast cancer.MethodsThis exploratory sequential mixed study was conducted in two qualitative and quantitative stages. In the qualitative stage, semi-structured interviews were performed with 21 participants. Then, items were developed through content analysis using the approach proposed by Elo and Kyngas on the basis of Roy's adaptation model. In the quantitative stage, the extracted items were reduced and psychometric properties such as face, content, and construct validity as well as reliability were explored. To investigate the construct validity, a cross-sectional descriptive study was conducted on 300 husbands of women with breast cancer selected via cluster sampling.ResultsThe initial questionnaire contained 79 items. After the assessment of face and content validity, 59 items were evaluated regarding construct validity using exploratory factor analysis. At this stage, six adaptation dimensions were observed among the women's husbands, with the variance of 51.71. The Cronbach's alpha and correlation coefficient of the questionnaire were 0.912 and 0.701, respectively.ConclusionThe developed 51-item adaptation scale had an appropriate validity and reliability and could be used for the assessment of adaptation in the target group.

Background and Purpose: The present study is aimed at evaluating the effects of the COVID‐19 pandemic on Iranian adolescents' participation in various domains of life. The electronic version of the Iranian Adolescent Participation Assessment Tool‐COVID‐19 (IAPAT‐C) was developed and validated for this purpose. Methods: This study was conducted in two phases. In the first phase, the electronic version of the IAPAT‐C was developed and validated through a methodological study involving five stages: content validity review, cognitive interviews, item analysis, structural validity assessment using confirmatory factor analysis, and reliability analysis. The tool was adapted from the previously validated IAPAT and revalidated for this study. In the second phase, the effects of COVID‐19 on adolescents' participation were evaluated using a longitudinal one group before and after comparative design. The study involved 654 adolescents aged 13–18, and the data were analyzed using SPSS19 and G ∗Power 3 software. Results: The IAPAT‐C evaluates the participation of Iranian adolescents in 54 daily life activities before and after the COVID‐19 pandemic. It utilizes a 5‐point Likert scale and was validated through an expert panel review for content validity. Additionally, cognitive interviews with six adolescents confirmed its comprehensibility, relevance, and comprehensiveness. Item analysis, based on data from 38 participants, demonstrated strong interitem correlations (0.6–0.94) and excellent internal consistency (Cronbach's alpha > 0.7). The tool's structural validity was supported by confirmatory factor analysis, which showed that the measurement model was a good fit. Convergent and discriminant validity of model constructs were also confirmed. Notably, COVID‐19 significantly impacted all aspects of adolescents' lives, except for work. Conclusion: The electronic version of the IAPAT‐C was valid and reliable. COVID‐19 significantly affected various aspects of Iranian adolescents' daily lives. Accordingly, it is necessary to provide appropriate interventions and policies for this sensitive class. [ABSTRACT FROM AUTHOR]

Background: Improving the quality of maternal care is considered a key strategy for improving maternal and neonatal outcomes. However, available definitions do not clearly define this concept. Objective: The aim of this study was to clarify the concept of maternal care quality (MCQ) for women with low-risk pregnancy in the maternity ward and to determine its attributes. Methods: This integrative review was conducted using Whitmore and Knafl's method. An online literature search was done in Medline, Embase, Web of Sciences, Scopus, SID, Magiran, and IranMedex databases as well as the websites of health-care and midwifery organizations and associations. Data were analyzed in the four steps of data reduction, data display, data comparison, and conclusion drawing and verification. Results: The two main attributes of MCQ are effective communication and interaction and professional care. Effective communication and interaction between the care provider and pregnant women in the maternity ward is the most important attribute of MCQ. The first category included three subcategories, namely informational interaction, human interaction, and participatory interaction. The two subcategories of the second category were adherence to standards during care delivery and delivering accessible care. Conclusion: MCQ in maternity ward is defined as “the process of delivering safe, fair, accessible, and standard professional care to women during childbirth through human, informational, and participatory interactions.”

Abstract Introduction There is a considerable dearth of official metrics for women empowerment, which is pivotal to observe universal progress towards Sustainable Development Goals 5, targeting "achieve gender equality and empower all women and girls.” This study aimed to introduce, critically appraise, and summarize the measurement properties of women empowerment scales in sexual and reproductive health. Methods A comprehensive systematic literature search through several international electronic databases, including PubMed, Scopus, Embase, ProQuest, and Science Direct was performed on September 2020, without a time limit. All studies aimed to develop and validate a measurement of women empowerment in sexual and reproductive health were included. The quality assessment was performed through a rating scale addressing the six criteria, including: a priori explicit theoretical framework, evaluating content validity, internal consistency, and factor analysis to assess structural validity. Results Of 5234 identified studies, fifteen were included. The majority of the studies were conducted in the United States. All studies but one used a standardized measure. Total items of each scale ranged from 8 to 23. The most common domains investigated were decision-making, freedom of coercion, and communication with the partner. Four studies did not use any conceptual framework. The individual agency followed by immediate relational agency were the main focus of included studies. Of the included studies, seven applied either literature review, expert panels, or empirical methods to develop the item pool. Cronbach's alpha coefficient reported in nine studies ranged from α = 0.56 to 0.87. Most of the studies but three lack reporting test–retest reliability ranging r = 0.69–0.87. Nine studies proved content validity. Six criteria were applied to scoring the scales, by which nine of fifteen articles were rated as medium quality, two rated as poor quality, and four rated as high quality. Conclusion Most scales assessed various types of validity and Internal consistency for the reliability. Applying a theoretical framework, more rigorous validation of scales, and assessing the various dimensions of women empowerment in diverse contexts and different levels, namely structural agency, are needed to develop effective and representing scales.

Background: Chemical incidents are among the most frequent technological disasters that have occurred frequently in recent years. Among the organizations operating in disaster response, hospitals, as the primary unit of care, play the greatest and most critical role. Hence, providing appropriate measures that lead to minimizing the effects of these events is raised as one of the health system's priorities, so this study was carried out with the aim of systematic review on hospital preparedness instruments in chemical incidents Methods: This systematic review was carried out according to the Systematic Reviews and Meta-Analyses guidelines . In this aim, through December 2020, 6 electronic databases were searched in MEDLINE (PubMed, Scopus, ISI Web of Science, ProQuest, Embase, and Cochrane) for the following key words: hospital, preparedness, chemical incidents, instrument. Results: Out of 7794 articles that were screened, 13 articles meet the inclusion criteria for entering the process of final analysis. Most studies were cross-sectional, two were cohort, and three studies were conducted by a qualitative method. The result showed that none of the evaluated checklists and tools included all dimensions required for an appropriate hospital preparedness evaluation in chemical incidents. Conclusion: Based on the results of this investigation, there is no comprehensive tool for assessing hospital preparedness in chemical incidents. The data of this survey can be employed as a guideline for policymakers and managers of medical centers for planning in dealing with chemical incidents.

Abstract Background Disasters may result in mass casualties and an imbalance between health care demands and supplies. This imbalance necessitates the prioritization of the victims based on the severity of their condition. Contributing factors and their effect on decision-making is a challenging issue in disaster triage. The present study seeks to address criteria for ethical decision-making in the prioritization of patients in disaster triage. Methods This conventional content analysis study was conducted in 2017. Subjects were selected from among Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis. Results Efficient and effective triage and priority-oriented triage were the main categories. These categories summarized a number of medical and nonmedical factors that should be considered in the prioritization of the victims in disaster triage. Conclusion A combination of measures should be considered to maximize the benefits of the prioritization of causalities in disasters. None of these measures alone would suffice to explain all aspects of ethical decision-making in disaster triage. Further investigations are needed to elaborate on these criteria in decision-making.

BackgroundOccupational burnout is a mental health problem that among nurses may lead not only to physical and psychological complications, but also to a decrease in the quality of patient care. Considering the stressful nature of surgery, operating room nurses may be at a greater risk. Therefore, the present study aimed to identifying factors associated with the occupational burnout from the perspective of operating room nurses.Materials and methodsThis qualitative study was conducted in Iran in 2021 using conventional content analysis. Sampling was performed using purposeful sampling method with maximum variation. In order to collect data, individual, semi-structured interviews were performed with 18 operating room nurses. Interviews continued until data saturation. Data were recorded, transcribed and analyzed using steps proposed by Graneheim and Lundman. Data management was performed using MAXQDA-2020 software. Four criteria provided by Guba and Lincoln were used to improve the study’s trustworthiness and rigor.ResultsA main theme, 4 categories and 15 subcategories were extracted from the data. The main theme is “gradual burnout due to job tension” and categories and subcategories include organizational factors (manager incompetence, organizational indifference, ambiguity in organizational role, organizational inconsistency), interpersonal factors (surgeon aggression, surgeon authoritarianism, surgeon failure to manage stress, unprofessional behavior of nurses), Occupational nature factors (psychological factors and occupational hazards) as well as individual factors (occupational attitude, unprofessional behavior, emotional involvement, demographic factors, physical factors).ConclusionNumerous factors associated with burnout in operating room nurses, which may put the personnel under more pressure. According to these factors, nursing managers and operating room nurses can consider effective strategies to prevent or coping with burnout.

Abstract Aim Considering the wide impact of endometriosis on various aspects of health, this study aimed to explore the impact of endometriosis on Iranian women's lives. Design The present study used a qualitative approach and conventional content analysis. Methods Twenty patients suffering from endometriosis referring to Imam Khomeini Hospital in Tehran took part in this study. The sampling was done purposefully until data saturation. After deep 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 the participants was 34.53 (SD: 5.81) years (range: 23–43) with duration of illness of 6.30 ± 5.86 years. Their educational level varied from high school to university, and most of them were employed. Analysis of the data from participants' experiences led to the formation of 5 categories under the titles "Physical suffering, instability of marital life, mental disorder, disruption in social life and self‐care" and 11 subcategories. Conclusion The findings of the present study showed that endometriosis can adversely affect women's lives including physical, sexual, psychological and social problems. Although in some cases patients adopt different strategies for self‐care, the need for more support is felt.

Abstract Background Health-promoting lifestyle (HPL) is any measure taken to maintain a person’s health. The most important and influential factor in maintaining and enhancing health are health-promoting behaviors (HPB). This study aimed to determine HPB and their predictors among Iranian men. Methods In this cross-sectional study, 783 Iranian men, living in Tehran, were selected, using multistage cluster sampling. The employed questionnaires, namely the sociodemographic questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), and the second part of the Personal Resource Questionnaire (PRQ 85-Part 2), were completed through interviews. The relationship between the dependent variables (HPLP-II and its subdomains) and independent variables (sociodemographic characteristics and social support) was investigated using the adjusted General Linear Model (GLM). Results The mean ± standard deviation of the total HPLP-II score was 2.72 ± 0.44 in the range of 1–4. Among the six dimensions of the HPB, the participants achieved the highest score (3.00 ± 0.52) and lowest score (1.96 ± 0.56) in spiritual growth and physical activity, respectively. The Pearson test showed that the perceived social support was significantly correlated with HPLP-II (r = 0.23; p

Abstract Introduction Sex addiction is a major psychiatric disorder in which a person is compelled to participate in sexual activities despite negative consequences. This study was conducted to localize a brief sex addiction screening instrument (PATHOS) for use in the Iranian population and to determine variables predictive of sex addiction in the general Iranian population. Methods In this study, we evaluated the psychometric properties of PATHOS in a sample of 443 Iranians in 2018. Data were analyzed using exploratory factor analysis (Factor 10.8.04 software). Simple and multiple linear regression analyses were used to investigate construct validity and variables predictive of addiction. Results Exploratory factor analysis identified two factors in this dichotomous questionnaire and reported the questionnaire’s test-retest reliability in the target population. Prognostic variables for sexual addiction in the Iranian population were determined to be female gender, higher education, viewing pornographic videos, having multiple sex partners, having difficulty interacting in sex, and history of masturbation. Conclusion The Persian version of the brief sex addiction screening instrument (PATHOS) has sufficient reliability and validity in the Iranian population. The predictive variables of sex addiction are indicative of the presence of risk of this disorder in Iranian samples and more studies are needed in order to enable prevention and treatment.

Objectives: Generally, adolescents who are interested in performing activities experience positive emotions and report high levels of well-being. However, adolescents with Cerebral Palsy (CP) encounter various issues affecting their interests. The present research was planned to investigate the predictor factors that affect the interest in performing activities in Iranian adolescents with CP. Methods: In total, 312 adolescents with CP (10-19-year-olds, Mean±SD age: 14.08±2.34 y) participated in this cross-sectional study. Their gross motor function was assessed by the Gross Motor Function Classification System (GMFCS), and their manual ability was evaluated by the Manual Ability Classification System (MACS) in random order by an occupational therapist. All study participants also completed the Adolescent Interest Inventory-Cerebral Palsy (AII-CP). The predictive model was analyzed using a multiple linear regression model by the enter method. Results: The multiple linear regression analysis data presented that the highest independence in motor performance, personal values, social environment support, and age appeared to be the strongest predictors of interest in performing activities in the explored adolescents with CP (R2: 0.475). Discussion: Interest as a significant factor for participation and motivation in conducting daily living activities is associated with the highest independence in motor performance, personal values, social environment support, and the age of adolescents with CP.