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Abstract Background Daily activities have been recommended to minimize the long-term complications of coronary artery bypass as one of the strategies to return to the normal activity level, the effectiveness of which needs further investigation. This study aims to determine the quality of life and activities of daily living one year after CABG. Methods This cross-sectional study was performed on 206 patients who had undergone CABG for more than one year in 2018 in the north of Iran. The research instrument was a questionnaire including five sections, Data were analyzed using descriptive statistics and Chi2, Mann–Whitney U, Kruskal–Wallis tests, and a Logistic regression model. Result The mean score of quality of life was 31.7 ± 2.04 of 12 to 48 possible scores. About Activities of Daily Living results showed 99.5% and 84.7% of the samples needed help with many of these activities respectively. The mean score of quality of life was significantly different based on sex (p

Abstract Background People who have coronary artery disease are more likely to develop signs and symptoms of COVID-19 due to their special circumstances. Coronary artery bypass grafting surgery (CABG)does not cure the disease but reduces the signs and symptoms, therefore, there is a possibility of severe complications of Covid-19 after it. Materials and methods This study is a descriptive and cross-sectional study conducted from June to July 2020 on 200 patients who underwent CABG from February 2018 to February 2020. The instrument consisted of socio-demographic variables and COVID’s signs and symptoms checklist. Data were collected by census method by telephone. Data were analyzed using descriptive statistics, Fisher’s exact test, Mann Whitney U test, and logistic regression model. Results The results showed that the majority of the samples were male (67%). The mean age of them was 62.02 ± 9.06 years and 10% of the m had signs and symptoms of Covid 19. Having the symptoms of COVID-19 is significant in terms of the variables of decreased sense of smell (p

Abstract Background and objective Heart rhythm disorder is one of the most common problems after coronary artery bypass graft surgery. Various factors, such as the history of sleep apnoea before the operation, may aggravate the occurrence of this disorder. The present study was conducted to determine the relationship between sleep apnoea before surgery and heart rhythm disorder after surgery in patients undergoing coronary Artery Bypass Grafting in 2019. Methods This analytical cross-sectional study was conducted on 192 patients who were selected by sequential sampling. The research tool included demographic information, a checklist of heart rhythm disorders, and the Berlin sleep apnoea questionnaire. Descriptive statistics and the Chi-square test, Fisher's exact test, Mann–Whitney’s U-test, and logistic regression were used to analyze the data. Results A total of 71.35% of the samples were male, and the mean age of the participants was 57.8 ± 7.5 years. Also, 46.0% of the samples had sleep pane and 21.35% had rhythm disorder. The most frequent heart rhythm disorder in patients with obstructive sleep apnoea was atrial fibrillation. There was a significant relationship between the occurrence of rhythm disorder and a history of smoking (P = 0.021), and the regression model showed that a history of smoking is the only variable related to the occurrence of rhythm disorder after coronary Artery Bypass Grafting (P = 0.005, CI 95%: 6.566–1.386, OR = 3.017). Conclusions The results showed that there is no statistically significant relationship between sleep apnea and rhythm disorder after coronary artery bypass surgery.

Abstract Introduction: A fall is a sudden descent on the ground or other lower levels. It is a serious safety threat for hospitalized patients. Coronary artery bypass graft (CABG) surgery as an open heart surgery has complications such as cardiac arrhythmias and delirium that can increase the risk of fall. Objective: This study aims to determine the risk of falls in patients after CABG surgery and investigate its associated factors. Matetials and Methods: This cross-sectional study was conducted on 302 patients undergoing CABG surgery in a specialized hospital in Rasht City, Iran, from November 2019 to July 2020. They were selected by a sequential sampling method. The data collection instrument included demographic information, disease-related factors, surgery-related factors (before, during, after), and the Morse fall scale (MFS) checklist. The study data were collected after the patient's surgery and transfer from the intensive care unit to the surgical ward. Descriptive statistics, as well as the Kolmogorov Smirnov, Wilcoxon, Mann-Whitney U, Kruskal-Wallis, and Spearman correlation, were used to analyze the collected data. A rank regression model was used to determine the factors related to the risk of falls in patients. Results: The mean ±SD age of participants was 59.35 ±8.37 years. About 70.53% of the patients were male, and 46.03% were overweight (Body Mass Index ranged 25-29.9 kg/m2). The majority of patients at the time of admission to the surgical ward and before surgery (92.72%) had no risk of falls. After surgery and transfer to the surgical ward, 82.12% had a low risk of falls. The mean risk of falling was higher in patients over 60 years (P

Introduction: Life satisfaction reflects an individualchr('39')s overall feelings about life, influenced by various factors. Objective: This study aimed to identify and introduce the indices related to the living environment that affect life satisfaction. Materials and Methods: This study was performed on 1000 residents of 55 neighborhoods of Rasht City (north of Iran) by an analytical cross-sectional method. The participants were chosen with a multistage cluster sampling method. The study data were collected using questionnaires, including the residentschr('39') characteristics, indicators of the living environment, and the satisfaction with life scale. The obtained data were analyzed using descriptive statistics, and inferential statistics, including the Pearson correlation coefficient, independent t test, analysis of variance, and linear regression. Results: Based on the present study results, the mean±SD age of the subjects in the study was 43.73 ±15.55 years. The analysis showed that their level of life satisfaction was average mean ±SD: 19.41 ±7.63, range: 5-35). The regression analysis identified dissatisfaction of facilities (B= -0.366; 95%Cl : -0.434, -0.298; P= 0.001), satisfaction with living in the local area (B= 0.248; Cl: 0.123, 0.373; P= 0.001), duration of residence (B: -0.364;95% Cl: -0.625, -0.102; P= 0.006) and gender (women compared to men) (B: 0.896; Cl: 0.011, 1.781; P=0.047) as the predictors of life satisfaction. Conclusions: According to the results, the life satisfaction of our study participants was at a moderate level and was affected by living environment indicators, especially facilities.

Introduction: Standard cardiopulmonary resuscitation (STD-CPR) is successful in only 10-15% of cases in emergency department (ED). This study aimed to determine the effect of interposed abdominal compression (IAC) during resuscitation on outcomes of ED cardiac arrests. Methods: In this randomized clinical trial study, non-trauma patients aged 18-85 years, patients with in-hospital cardiac arrest hospitalized in the ED were randomly assigned into two either STD-CPR or IAC-CPR group on a 1:1 basis and using computer-generated random numbers. Participants in the intervention group, received abdominal compression during the diastole phase of STD-CPR. The rate of return of spontaneous circulation (ROSC), heart rate (HR), respiratory rate (RR), arterial blood gas (ABG) indicators, and survival rate were compared between the two groups. Results: Ninety patients were enrolled (45 in each group). There were no differences between the two groups regarding age (p = 0.76), sex (p = 0.39), employment status (p = 0.62) and Charlson comorbidity scale (p = 0.46). Abdominal compression had a positive effect on heart rate (p < 0.001), mean arterial pressure (p = 0.003), arterial blood oxygen pressure (p = 0.001), and arterial blood carbon dioxide pressure (p = 0.001) as well as a negative effect on arterial blood oxygen saturation (p = 0.029) 30 minutes after resuscitation. Out of the 90 CPR cases, 8 (17.7%) cases in intervention group and 8 (17.7%) cases in control group were successful, among which all of the 8 patients in the intervention group and 5 of the patients in the control group had been discharged from hospital without any complications. Conclusion: The results showed that abdominal compression during CPR can improve resuscitation outcomes in patients with cardiac arrest. Therefore, in order to use this technique, further research is recommended.

Objective (s): Body mass index (BMI) is one of the major contributors to the spread of non-communicable diseases that it is affected by various factors such as demographic variables and living environment. The aim of this study was to investigate body mass index and its predictors in Rash, Iran. Methods: This was a cross sectional study that performed on 1,000 residents of 5 neighborhoods in Rasht, 2017. Data were collected using a questionnaire including residents’ characteristics and living environment indicators derived from the Foxton and Jones Social Capital questionnaire. Every participants’ height and weight were measured. Simple and multivariate linear regression using SPSS v.20 was used for data analysis. Results: The prevalence of overweight and obesity in the study population was %55.5 and the results showed that age (B = -0.031, P

Abstract Introduction: To determine predictors of length of stay (LOS) in the intensive care unit (ICU) after coronary artery bypass grafting (CABG) and to develop a risk scoring system were the objectives of this study. Methods: In this retrospective study, 1202 patients' medical records after CABG were evaluated by a research-made checklist. Tarone-Ware test was used to determine the predictors of patients' LOS in the ICU. Cox regression model was used to determine the risk factors and risk ratios associated with ICU LOS. Results: The mean ICU LOS after CABG was 55.27±17.33 hours. Cox regression model showed that having more than two chest tubes (95% confidence interval [CI] 1.005-1.287, Relative Risk [RR]=1.138), occurrence of atelectasis (95% CI 1.000-3.007, RR=1.734), and occurrence of atrial fibrillation after CABG (95% CI 1.428-2.424, RR=1.861) were risk factors associated with longer ICU LOS. The discrimination power of this set of predictors was demonstrated with an area under the receiver operating characteristic curve and it was 0.69. A simple risk scoring system was developed based on three identified predictors that can raise ICU LOS. Conclusion: The simple risk scoring system developed based on three identified predictors can help to plan more accurately a patient's LOS in hospital for CABG and can be useful in managing human and financial resources.

Introduction: Cognitive status of patients before Coronary Artery Bypass Grafting (CABG) affects their activities of daily living. Evaluation of cognition status and its related factors can help caregivers to plan suitable care programs. Objective: This study aimed to evaluate the patient’s cognition status and its related factors before CABG. Materials and Methods: This cross-sectional study was done in 2016 on 139 patients before CABG who were selected by convenience sampling method. The study data were collected by Cognition Failure Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. CFQ scores range from 0-100, and higher score shows the weaker status of cognition. The obtained data were analyzed by descriptive and inferential statistics of the Man-Whitney U test, the Chi-squared test, and logistic regression. Results: The Mean±SD score of cognitive status of the samples was 12.92±12.73. The findings showed significant relationship between cognitive status and age (P=0.002) and anxiety (P

Fatigue is the commonest symptom in cancer patients; despite high levels of clinically significant persistent cancer-related fatigue, few treatments are currently available. The aim of this study was to evaluate the efficacy of acupressure on fatigue in patients with cancer who underwent chemotherapy. The study was designed as a randomized and controlled trial. Ninety samples were selected using the convenience sampling method, and random block sampling was used for allocation of groups (30 for each group). The three groups were similar by age and gender. The experimental group underwent acupressure at the Zusanli (ST-36), Hegu (LI-4), and Sanyingjiao (SP-6), whereas sham pressure was used in the placebo group and no intervention was applied in the control group; the level of fatigue of participants in three groups was calculated in three phases, before, during, and after chemotherapy. Data were analyzed using SPSS, version 22. The results showed that the mean of visual analog score of fatigue is significantly different in three groups at the end of chemotherapy (p = 0.021). The mean visual analog score of fatigue in the acupressure group was meaningfully lower than that in the control group after chemotherapy (p = 0.028). Results of this investigation showed that acupressure has short-term effectiveness on the cancer-related fatigue of patients undergoing chemotherapy. Keywords: acupressure, cancer patients, cancer-related fatigue, complementary and alternative medicine

Introduction: Peripheral Intravenous catheterization is the most commonly used invasive treatment method in patients admitted to the hospitals, but it has some complications. The indwell time of catheter is one of the factors associated with the occurrence of complications, especially phlebitis. In spite of the instructions for replacing the catheters after 72 hours, sometimes the complications occur sooner. Thus early catheter replacement becomes necessary, and sometimes the catheter is replaced after 72 hours without any complication. Objective: This study aimed to determine the incidence of complications and related factors using Peripheral Intravenous (PI) catheters during 72 hours after insertion. Materials and Methods: This is an analytical cross-sectional study conducted on 154 patients of cardiac surgical wards selected using convenience sampling technique. The study instruments were phlebitis assessment and infiltration rate scale developed by the Infusion Nurses Society (INS). All Intravenous pathways were evaluated for data collection using these tools. The collected data were analyzed using descriptive statistics and statistical tests (Fisher’s exact-test and the Chi-squared test). Results: About 48.7% of the study patients did not have any complications during 72 hours of catheter placement, and the reason for the replacement of catheters after 72 hours was the hospital’s instructions. Complications that lead to catheter replacement before 72 h were phlebitis (24.7%), obstruction (14.3%), drug leakage outside of the catheter (2.6%), and drug leakage into the patient’s tissue (2.6%). Complications were significantly higher in women (P=0.013), and on the second day of catheterization compared to other days (P=0.0001). Conclusion: Since nearly half of the patients with catheters in this study had no complications after 72 hours, it seems that further studies should be done to reassess replacing uncomplicated catheters after 72 hours. In addition, complications of catheter insertion are more common in women than in men. This finding calls for more attention and care in this area.

Background: Anxiety and depression are among the most common psychological symptoms in patients with life-threatening illnesses, and have a close relationship with hospitalization in specialized care units. Objectives: This study aimed at evaluating anxiety and depression and their related factors in patients admitted to Intensive Care Units (ICUs). Materials & Methods: This is an analytical cross-sectional study conducted on 135 patients hospitalized in ICUs (neuro ICU and general ICU) of Poursina Medical Education Center in Rasht City, Iran. The patients were selected by convenience sampling method. The study data were collected using a checklist surveying demographic, clinical and psychosocial characteristics of the patients, and Hospital Anxiety and Depression Scale (HADS). Then, the obtained data were analyzed by Mann-Whitney U and Kruskal-Wallis tests in SPSS V. 18. Results: The Mean±SD anxiety and depression scores of the study patients were 6.12±9.3 and 7.10±2.3, respectively. There was a significant relationship between short-term hospitalization and anxiety (P=0.03), and a high score of depression was observed in those with middle-school education (P=0.03) and non-invasive ventilation (P=0.01). Moreover, administration of sedatives (P=0.001) and tracheostomy ventilation (P=0.04), showed a significant correlation with depression. Conclusion: Anxiety and depression (symptoms of mood disorders) among ICU patients were relatively high and the duration of hospitalization was significantly associated with anxiety. Moreover, the administration of sedative drugs had significant correlation with depression. In addition, the type of received mechanical ventilation was associated with both disorders. Routine screening of anxiety and depression by nurses in ICUs is useful for early treatment, and can prevent long-term complications of these disorders.

Introduction: The advances in the field of burn treatment resulted in increased survival of burn patients, which led to increased attention to the issues associated with the quality of life. The assessment of the quality of life and the associated factors might help in identifying the needs of affected patients and designing suitable therapeutic and supportive programs. Objective: The present study aimed to determine the quality of life and the associated factors in patients suffering from burns hospitalized at the subspecialty burn and plastic surgery center in Rasht city. Materials and Methods: The present cross-sectional analytical study consisted of 60 burns patients collected through systematic random sampling. The instrument used included Burn-Specific Health Scale-Brief (BSHS-B) along with a questionnaire for recording the demographic information as well as the complications and problems after the burn (itching, hypertrophic scar, colloid, hypopigmentation, and hyperpigmentation). The data were analyzed by descriptive statistics (frequency estimation, mean, and standard deviation) and inferential statistical tests (Friedman and linear regression tests). Results: The mean post-burn quality-of-life total score was 76.9±20.74; the patients presented substantial problems regarding heat sensitivity of the burnt site (61.75%), and the extent of burns was a predictive factor of the quality of life [P=0.0001, 95% Confidence Interval (CI)=-1.65 to -0.6, B=-1.133]. Conclusion: Despite the advances achieved in treating patients with burns, the subsequent problems and complications are yet challenging. Also, the low-degree burns can be considered as a factor affecting the quality of life of these patients.

Introduction: Coronary Artery Bypass Graft (CABG) surgery is one of the main treatment methods for coronary artery disease. The change in hemodynamic indices after CABG surgery is a common but serious complication. Objective: This study aimed to determine the effect of aromatherapy using lavender essential oil on the hemodynamic indices of patients after undergoing CABG surgery. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial included 98 patients who were assigned into an experimental or a placebo group 3 days after undergoing CABG surgery. The experimental group inhaled five drops of lavender essential oil, whereas the placebo group inhaled five drops of distilled water for 30 min. Before and after the intervention, hemodynamic indices (systolic blood pressure, diastolic blood pressure, pulse rate, and respiratory rate) of patients were measured and recorded. The intervention in both groups was performed every 24 h for three consecutive days. The data were analyzed using the chi-square test, independent t-test, Mann–Whitney U test, repeated measures ANOVA, and regression analysis. Results: The results revealed significant differences between the two groups in terms of the mean systolic blood pressure after the second day of intervention and the mean diastolic blood pressure after the first day of intervention (P=0.046 and 0.029, respectively), with the blood pressure significantly lower in the treatment group than in the placebo group. Conclusion: Among the hemodynamic indices tested, only the blood pressure of the patients was reduced by aromatherapy with lavender essential oil after CABG surgery; therefore, it can be used as a simple, complementary, and low-cost therapeutic intervention after CABG surgery to stabilize a patient s blood pressure.

Abstract Introduction: The experiences of learners in the educational system are not just limited to the overt curriculum. Other factors also play a significant role in shaping student learning in the form of hidden curriculum. Students views on this issue can help design a suitable curriculum. Objectives: The purpose of this study was to determine the viewpoint of nursing students about the hidden curriculum on learning. Materials and Methods: This is a descriptive-analytic cross-sectional study. The sample size of this study comprised 300 nursing students of the Guilan University of Medical Sciences Faculty of Nursing (students of the 2nd to the 8th semesters) who were selected using the random sampling method. The research instrument included a researcher-made questionnaire consisting of two parts of the socio-demographic characteristics and 34 statements about students views regarding the effect of hidden curriculum on learning. Data analysis was performed using descriptive statistics and the binomial test. Results: The results of this study on the effect of the hidden curriculum on learning showed that the subjects agreed on the impact of the program in 25 statements (P=0.038) and selected disagreement options only in nine statements. According to responses of the research subjects, the reasons why the hidden curriculum was effective on learning based on students viewpoints are: Good student-professor relationship (88%), a chance to interact with experienced professors (82%), student humiliation (80%), equipping classes with up-to-date electronic teaching aids (80%) and attention to the peer group as a model of behavior (53%). Conclusion: The findings of this study confirm the profound effect of the hidden curriculum on learning. Considering the importance of the formal curriculum, more attention to the hidden curriculum can boost knowledge among students.

Abstract Introduction: Cancer is a major health issue in Iran and in the rest of the world. Fatigue is one of the most complex and the most prevalent cancer-related problems that can affect various aspects of life for cancer patients. It can cause numerous problems. Objective: The aim of this study was to determine the level of fatigue and its associated factors in patients with cancer. Materials and Methods: In this descriptive-analytical study, 90 cancer patients referred to the oncology department in one of the teaching hospitals were assessed. The data collection tool was a questionnaire based on demographic information and the fatigue severity scale (FSS). This questionnaire consisted of nine questions with a numeric scale for answers ranging from 0 to 7. A score of 7 indicates the highest level of fatigue and 1 indicates no fatigue. The patients with above-average scores were considered to have fatigue and those with lower scores were considered to have no fatigue. To analyse the data, descriptive and inferential statistics (chi-square test, one-way ANOVA, and logistic regression) were used. Results: The mean age of the patients was 52.1 ± 14.4 years. The majority of the subjects were women (58.9%), married (91.1%), and with an educational level below diploma (40%). The average score of fatigue was 5.8 ± 0.54 out of 7. The results of the logistic regression model showed that the factors influencing cancer-related fatigue were the variable of unemployment (p =0.034, β= 1.1) and haemoglobin levels (p=0.049, β= 0.33). Conclusion: The results showed that in addition to providing physical care and nursing interventions, it is important to consider demographic factors and psychological interventions for the comprehensive management of problems in cancer patients, particularly fatigue.

Introduction: The prevalence of human papilloma virus (HPV) is growing in the world. According to the precancerous role and the importance of prevention, human papilloma virus vaccination is considered in all countries. The knowledge and attitude of patients have a considerable effect on HPV injection. It seems that higher knowledge level of physicians can have significant effect on justification and informing target group for vaccination. Objective: The aim of this study was to determine the level of knowledge and attitude of medical students regarding human papilloma virus vaccination and associated factors in Guilan University of Medical Sciences. Methods: This analytic cross-sectional study was carried out on 90 medical students who entered in 2005 and 2006 by census method. Inclusion criteria were studying in final year and would like to participate in the study. In 2012 Data were gathered by a questionnaire including three sections: demographic characteristics (6 questions), knowledge (20 questions) and attitude (26 questions). In scoring knowledge questionnaire, correct, don t know and incorrect answers received 1, 0 and -1 respectively. 1-3 likert scale was used to score the attitude questions. Agree, don t know and disagree received 3, 2 and 1 respectively. The level of knowledge score was -20 to 20 points and the attitude included 26-78 points. For data analysis, descriptive statistics including mean, standard deviation, frequency and analytic statistics including T-test and Pearson correlation coefficient were used. Results: Findings indicated that most participants (82.2%) were female and 66.7% aged less than 25 years. The main source of information about HPV was from courses taken during medical school (57%). Mean of knowledge score was 5.17±3.24 (answers ranging 5-13) and mean of attitude score was 52.16±5.04 (answers in ranging 38-63). There was no significant difference between knowledge and attitude about HPV and sex, age groups, marital status and medical student s source of information. Also, no correlation was noted between knowledge and attitude about HPV (P=0.28, r=0.11). Conclusion: Based on study results, the level of Knowledge and attitude of medical students about HPV vaccination was low. Also in attention to the source of students' information, special attention to educational contents for knowledge and attitude promotion is important for future physicians. Therefore educational programs are needed to increase students' knowledge during study especially during clinical education on HPV and vaccination. On the other hand with attention to the role of physicians in giving information to society, better knowledge and understanding of students regarding role of vaccination and decreasing mortality of cervical cancer can take a step to promote the condition of societal health.

Abstract Introduction: The professional socialization is the process of which the individual gain values ​​, norms, behaviors and social skills relevant to a profession and internalize a sense of identity to a specialized field. Therefore, the process begins at the first step of the nursing education program and continues with completion of nursing education till entering into the work place. Thus, the formation of nursing as a occupation takes place through professional socialization of individuals Objective: This study is done with the aim of assessment of professional socialization level among nursing students at Guilan University of Medical Sciences. Methods: A cross sectional descriptive analytical approach was adopted. Participants were all nursing students at the faculty of Shahid Beheshti in Rasht. In total 211 students were chosen. Sampling was conducted with census. The instrument used was a Researcher made questionnaire that from the statements contained in the instruments by Shahim, and some of the items offered by Chao et al were given to samples. The data was analyzed with descriptive and inferential statistics (Independent T test, correlation Pearson coefficient, one way ANOVA, post Hoc Tukey) Results: The finding of the study showed weak level (0%) and 40 students (19%) were in moderate level and most of the samples (81%) were in good level of professional socialization. In general, professional socialization had a statistically significant relationship with factors such as marital status (p=0.045), age (p=0.029,r=0.151), family residence (p=0.04), maternal education (p=0.023), student work (p=0.031), theoretical instructor (p=0.0001), clinical lecturer (p=0.032), having information about the nursing profession before entering the field (p=0.0001),compliance between previous image and existing realities (p=0.0001 ), interest in the course (p=0.0001). Conclusion: From the research findings, the level of professional socialization of nursing students is acceptable. Recognition of the professional status can drew authorities attention to provide opportunities for greater autonomy in practice and systematic holistic nursing care situations

Introduction: Assertiveness, is one of the life skills that effects on increasing self-esteem, logical expression of thoughts and feelings, reducing anxiety, improving social communication skills and supporting human rights and finally increasing life satisfaction and happiness Introduction: Assertiveness, is one of the life skills that effects on increasing self-esteem, logical expression of thoughts and feelings, reducing anxiety, improving social communication skills and supporting human rights and finally increasing life satisfaction and happiness Methods: The pilot of study is situated on clinical trial research experiment, for two groups before and after intervention. Among 80 nursing students enrolled in Nursing and Midwifery school of Islamic Azad University Najaf Abad in 2013-2014 who trained in the field, all those who had poor expression were 36 subjects which measured with Adolescence Self-Assertiveness (ASA) scale and 24 subjects who want to enter to the research were separated randomly into experimental and control group. Experimental group consisting of Gestalt therapy, two-hours per session for 8 weeks, were trained. The control group did not receive the interventions. Therefore data analysis performed using the mean scores, paired t- test and intervention. Results:In experimental group, the mean scores of assertiveness after intervention increased significantly (P

Introduction: Nursing as a clinical discipline is developing daily in emergency wards and health care system managers should assess and prioritize clinical competence indicators in these wards continuously. Lack of clear clinical competence indicators challenges evaluation Objective: This study aimed to determine general clinical competence indicators from nurses viewpoint working in emergency wards Methods: This is a assessment study using Delphi method in three phases: the first phase (determine the General Clinical competence indicators), Phase II (classifying general clinical competence indicators by members of the expert panel) third phase (prioritizing general clinical competence indicators using exploratory factor analysis) through which 710 nurses were chosen by convenience random sampling working in emergency wards affiliated to Guilan Therapeutic Educational Centers during a two month period. Finally, exploratory factor analysis was used Results:In prioritizing phase of general clinical competence indicators, five factors statements were classified by the expert panel and provided a structured model in three domains which were divided as communication (10 items), disaster and emergency management (8 items) and personality characteristics (12 items) Conclusion: A present alternative to reduce the gap between theory and practice in nursing is through determination and prioritization of clinical competence criteria in emergency wards. Factor analysis can be used to prioritize these indicators. Further research in health care system is ed in order to achieve reliable and valid instrument

Introduction: Violence at work is considered an important risk factor worldwide. Nurses due to their presence and practice in treatment centers, direct contact with patients and also many stresses are at risk of various types of violence. Objective: The aim of this study was to determine the incidence of violence against nurses working in educational-medical centers in Rasht city. Methods: This is a descriptive-analytical cross sectional study which its population consists of nurses employed in educational-medical centers in Rasht city and 442 nurses were selected by stratified randomize sampling methods. Data collection instrument was extracted from Nachreiner and Rahmany tools used to survey incidence of violence against nurses in the educational-medical centers in Rasht. The findings were analyzed by descriptive and inferential statistics such as T and Chi square tests. Result: Findings showed that 54.1% and 11.1% of nurses experienced verbal and physical violence respectively. Verbal violence in most cases occurred by visitors and physical violence often occurred by patients and in most cases who did not report violence was because it was considered useless. In addition results indicated a significant relationship between verbal violence and level of education (P= 0.02) and physical violence and work condition (P=0.02) and marital status (P=0.02). Conclusion: Results indicated high frequency of verbal and physical abuse toward nurses in health centers in Rasht and different measures are needed to decrease its incidence.

Abstract Introduction: Quality of life and improving it has a significant role in the health of social and personal life. As regards to students as future managers of communities, it is essential to review the factors that can endanger their health and quality of life. Objective: This study aimed to determine health related quality of life in dormitory and non-dormitory students. Methods: This study was a cross-sectional research conducted in Guilan University of Medical Sciences in 2010. Data needed to determine health-related quality of life were collected via convenience sampling using SF-36 questionnaire from 50 dormitory and 150 non-dormitory students. Data collected were analyzed using statistical T- test, chi square, linear regression and Kolmogorov-Smirnov). Results: Mean total score of health-related quality of life in dormitory students (62.74±14.35) was significantly less than non-dormitory students (72.25±10.95) (p

Introduction: Breast cancer is an important issue in chronic disease studies. Breast cancer is the most common cancer among women.Life expectancy is long in patients with breast cancer and in result they suffer longer from cancer and its complications.Therefore it seems necessary to determine QOL and its related-factors in these patients. Objective: The purpose of the study isto determine Quality of Life and its related factors among women with breast cancer. Methods:This analytical descriptive study was conducted on 170 women with breast cancer referred to Educational-therapeutic hospitals in Rasht in 2011-2012. Data were collected by questionnaire including demographics and Health-related Quality of Life (WHOQOL-BREF) questionnaires. Data were analyzed using SPSS software version 16, and descriptive statistics and t-test, ANOVA, Pearson correlation coefficients and linear regression. Results: Findings indicated that samples mean age was 50.67±10.04and mean Health-relatedQOLscore was 48.65±9.7, physical domain 53.86±12.45, psychological 41.05±12.06, social 55.36±10.52 and environment 50.26±9.16. In assessing related factors with quality of life using multiple regression indicated significant differences between maritalstatus, occupation, type of breast surgery (p

Introduction: Heart failure is considered to be one of the most common chronic diseases in the ‎world which puts high expenses on health care systems. In order to control heart failure there are a ‎lot of ways self care is one of them. ‎ Objective: This survey has been conducted with the aim of studying self-care behaviors and related ‎factors in patients with CHF. ‎ Methods: This cross sectional study assessed the associations between self- care behaviors and ‎demographic variables in ‎‏33‏‎ patients who referred to medical & educational center of heart in Rasht ‎city. Data collection instrument included questionnaire covering demographic characteristics and ‎European questionnaire of EHFSCB. Data collected were analyzed using one – way ANOVA, ‎Kruskal Wallis and independent t- tests in SPSS (version ‎‏15‏‎).‎ Results: The mean age of individuals was ‎‏69.9‏‎ ‎‏±‏‎ ‎‏19.9‏‎, of which ‎‏%60.6‏‎ were woman, ‎‏%57.6‏‎ were ‎married, ‎‏%57.6‏‎ were illiterate, ‎‏%66.7‏‎ had poor financial conditions and ‎‏%90.9‏‎ suffered from other ‎chronic diseases that had the highest percentages such as hypertension ‎‏%25‏‎, diabetes ‎‏%18.7‏‎. Also ‎the mean of disease duration was ‎‏2.5‏‎ ‎‏± 1.6‏‎ month. The mean of self-care score was ‎‏37.9‏‎ ‎‏± 5.4‏‎ and ‎only ‎‏%6.1‏‎ of individuals had good self-care. The best self-care behavior was related to taking drugs ‎according to doctor s recommendation, going on low-salt diet & taking enough rest. The least self-‎care behavior taken was daily weighing, regular exercise and injecting flu vaccination. No ‎significant correlation was found between demographic variables and self-care behaviors .‎ Conclusion: Considering a low percent of individuals who had good self-care behavior, it is ‎recommended that more assessed and proper intervention be taken to confront these factors.‎

Introduction: Despite the impact of increased abdominal hypertension on organ dysfunction and ‎increased mortality, data on the frequency and its related risk factors in critical care unit does not ‎seem enough. While studies have shown that patients intra-abdominal pressure measured at ‎admission to intensive care unit can serve as an independent prognostic factor for mortality and ‎assess impacts of IAH on organ function.‎ Objective: This study aims to determine the frequency of increased abdominal hypertension and its ‎related factors in patients hospitalized in ICUs.‎ Methods: This cross-sectional, descriptive –analytical study was conducted on ‎‏76‏‎ intensive care unit ‎patients in one o f the teaching hospitals in city of Rasht. Intra-abdominal pressure was measured ‎every ‎‏8‏‎ hours for a ‎‏24‏‎-hour period through a Foley catheter (Korn method). Instrument used ‎consisted of three parts: first part covered personal data (age, gender, Body Mass Index, disease ‎diagnosis), second part included continuous assessment of organ dysfunction scale (respiratory ‎condition, liver, kidney, hemodynamic, and level of conscious) and third part covered data related ‎to IAH and accompanying variables(mean arterial pressure, abdominal perfusion pressure, peak ‎airway pressure, maximum airway pressure, plateau pressure and positive end expiratory pressure) ‎and demographic data, type of diagnosis, SOFA score, central venous pressure, mean airway ‎pressure was recorded.‎ Result: Findings showed that the frequency of intra-abdominal hypertension was ‎‏18.42‏percent. ‎Also Step wise regression method showed that the mean arterial pressure of ‎‏1.02‏‎ times can increase ‎intra abdominal pressure. ‎ Conclusion: Intra-abdominal pressure as a factor affecting the performance of other organs in ‎patients in intensive care units is important and it's recommended that intra-abdominal pressure to be ‎measured routinely in critically ill patients and through this prevent abdominal compartment ‎syndrome and its complications.‎

Introduction: Colorectal cancer is one of the most common invasive cancers, and is ‎responsible for physical and psychosocial morbidity. Therefore, Quality of Life (QOL) is an ‎important outcome for these patients. Although extensive research has examined QOL in ‎patients with colorectal cancer, less research has examined factors that predict QOL. ‎ Objective: The aim of the present study was to determine the predictive factors of QOL in ‎patients with colorectal cancer.‎ Methods: In this cross-sectional study,‎‏ ‏we assessed ‎‏110‏‎ patients with colorectal cancer who ‎referred to Razi hospital. Data were collected by interview with patients and review of ‎medical records. Health related QOL was evaluated by SF‏-36‏‎. The Data were analyzed with ‎descriptive and deductive statistic methods (Generalized Linear Models) at α‏ ‏‎

Introduction: Post traffic accident depression is one of the most prevelant mental disorders ‎which increased in recent years and its occurance in early years of life affects daily living ‎productivity and also family and society. Therefore it s important to promptly detect it and ‎refers them to psychiatrist for diagnosis and treatment. ‎ Objevtive: The goal of this study was to determine the level of depression one week and also ‎two months after traffic accidents. ‎ Methods: This study had descriptive-cross stional design.‎‏ ‏Participants were chosen from ‎orthopaedic and trauma wards in Poursina hospital in Rasht city. Data were collected in two ‎time periods (one week and two months after the traffic accident ) from ‎‏89‏‎ patients using ‎demographic and Beck Depression Inventory questionnaires. Data were collected in ‎‏2010‏‎ and ‎T- test was used as statistical test for analysis.‎ Results: Findings showed that the majority(‎‏37‏‎.‎‏1‏‎%) had mild depression one week after the ‎accident but the level of depression significantly increased two months after as ‎‏38‏‎.‎‏5‏‎% of ‎samples had severe depression. ‎ Conclusion: Study results indicated that a significant percent of patients experience ‎depression after traffic accident which is related to symptoms two months after. Health care ‎personnel in emergency and other wards need to assess patients for these symptoms. Early ‎detection and referring patients for depression treatment can prevent it from becoming ‎chronic.‎

Introduction: In elderly, autonomy is threatened due to physical and mental disability. This ‎disability in activity of daily living is a chronic condition that causes cost disbursement in ‎society and reduce older people s quality of life. ‎ Objective: The aim of this study is to determine and compare retired elderly s ability in ‎activity of daily living based on demographic characteristics in Rasht.‎ Methods: This study is a cross- sectional descriptive study that includes ‎‏194‏‎ retired elders in ‎governmental organizations. Data collection is done by Katz questionnaire and for assessment ‎of activity of daily‏ ‏living (ADL) ability and instrumental activity of daily living (IADL) ‎Lawton questionnaire was used. Collected data were analyzed using SPSS version ‎‏16‏‎.‎ Results:‎‏ ‏Study results showed that although elderly needed help in activity of daily living ‎such as bathing, walking and appearance conditions but‏ ‏none were in completely dependent ‎group after scoring. In independency domain in instrumental ADL, ‎‏86‏‎.‎‏6‏‎% of them were ‎independent, ‎‏10‏‎.‎‏3‏‎% of them needed help and ‎‏3‏‎.‎‏1‏‎% of them were completely dependent. In ‎demographic characteristics, autonomy in activity of daily living correlates with age, marital ‎status, education and illness.‎ Conclusion: Because of significant correlation between disability in activity of daily living by ‎increasing age, female gender and morbidity, planning for education classes, providing posters ‎and pamphlet based on life style correction and prevention of musculoskeletal diseases is an ‎important step in getting elders to effective and healthy life.‎

Introduction: Electroconvulsive therapy is the most common and also unique method in ‎psychiatry that is used for treatment of many mental disorders such as major depression, ‎schizophrenia and etc. Despite of safety and usefulness of this method, the patients and ‎families have a great deal of stress about it. This stressful approach caused negative attitudes ‎and difficulties in treatment and following up care .Since reactions of the patients and their ‎families can be effective for reforming the medical programs, so considering their knowledge, ‎opinion, experiences and attitudes about ECT is very important.‎ Objective: The goal was to determine the knowledge and attitude of the mental patients, ‎families about the electroconvulsive therapy at the Ebn-e- Sina psychiatry center of Mashad Methods: This research is a descriptive study and its samples consist of ‎‏71‏member of the ‎families whose patients previously experienced ECT at least once. The means for collecting ‎data was a questionnaire, which was filled by the researcher through structured interviewing ‎in three sections including demographic data, knowledge questions and attitudes questions. ‎For data analysis, descriptive statistics (mean, standard deviation) and inferential statistic(x‏2‏‎, ‎spearman correlation coefficient) were used. ‎ Result: Findings totally showed that most of members (‎‏71/8%‏‎) had a poor knowledge and ‎‏70/4%‏‎ of them had a negative attitude about ECT. The result also indicated a significant ‎statistical relation between knowledge about ECT with level of education (P