---

Introduction: Infertility and depression are major problems of today&aposs societies. Although depression is one of the most prevalent diseases in primary care practice, consult for receiving help is carried out much less than true prevalence of the disease. Therefore gathering information about prevalence and risk factors of depression is very valuable. Beck Depression Inventory (BDI) which is a screening tool for depression can be used in Iranian patients because of availability of a validated translation. The objective of this study was to estimate the prevalence of depression in infertile subjects in an infertility center.

Materials and Methods: In this study, 681 infertile women were evaluated in Shariati Hospital, Tehran. Demographic information’s including age, duration, type and cause of infertility, level of education, previous treatments and smoking habits were recorded. BDI was completed by patients and score was estimated. Score of 16 and higher was assumed positive.

Results: There was no relationship between age and prevalence of positive BDI score, but prevalence of positive BDI score was higher in infertilities of longer duration, infertilities caused by both male and female factors and in patients with low level of education and history of previous treatment or surgical therapy.

Conclusion: Infertile patients are at risk of depression. Rate of consulting with psychiatrists and getting help is low in our country due to cultural aspects, so screening of high risk subgroups in infertile patients and referring them to psychiatrist would be very helpful.

---

Introduction: Nurses as the main members of treatment-and-care team play an important role in improvement and promotion of health in society. Job stress is a recognized and integral part of modern nursing which has destructive effects on both nurses and patients.

Materials and Methods: The present descriptive and analytical study aims to determine the level of nurses&apos job stress in Tehran in 2004. It also tries to identify factors affecting job stress from nurses&apos point of view. A total of 111 nurses working in two educational and non-educational hospitals in Tehran were studied. The sampling was simple, i.e. the subjects volunteered to participate in the study. A questionnaire with 2 sections was developed. In the first section we asked about personal and professional characteristics and the second section was designed to evaluate job stress in following 5 categories: management, economy and welfare, mentality and social affairs, occupational health and ergonomics. There was also an open-ended question asking about nurses&apos attitude toward job stress. The questionnaire items were to be answered on a scale ranging from 0 to 4. We used descriptive statistics and Chi square statistical test to analyze the collected data.

Results: The results showed that 44.1% of samples had high levels of job stress while 54.1% suffered from medium and 1.8% from low levels of job stress. There was a significant relationship between hospital type and job stress job stress in the educational hospital was higher compared to the noneducational hospital. There was also an inverse relationship between years of experience and job stress.

Conclusion: Due to high percentage of the subjects with high to medium levels of job stress, employment of preventive and precautionary procedures regarding job stress is recommended.

---

Introduction: A variety of maladies, sometimes disabling, beset many ovulatory women in a recurrent manner during the luteal phase of each ovarian cycle. These problems can deteriorate interpersonal relationships and/or interfere with normal activities of life. Present research was performed to evaluate effects of hypericum perforatum for treatment of physical symptoms of premenstrual syndrome.

Materials and Methods: This study was a randomized, double-blind, placebo-controlled, parallel group compassion study performed over two menstrual cycles on student of Tehran University of Medical Sciences and Tehran University. Volunteers underwent a preliminary screening interview, completed Beck questionnaire as a screening test for depression and attended a medical screening visit before being diagnosed as having premenstrual syndrome. Participants administrated hypericum or placebo, 30 drops BD, for two complete cycles. Premenstrual symptoms were evaluated by a daily symptom report form. Data analysis performed by Chi square, Fisher exact, Wilcoxon and t tests.

Results: Premenstrual daily hypericum caused a significant improvement in mean daily score of severity of premenstrual problems compared to placebo (p<0.05). Premenstrual administration of hypericum, 30 drop BD, showed significant advantage over placebo for physical disorders (%49, p=000).

Conclusion: Daily premenstrual administration of hypericum perforatum treats physical symptoms of premenstrual syndrome. It seems that hypericum perforatum can improve symptoms of premenstrual syndrome.

---

Introduction: It has been estimated that 335 million elderly, about 13 percent of general population, live in developing countries. It has been predicted that in 2040, this percentage will rise to 20 percent. Psychophysical complains are common in elderly and investigation of quality of life (QOL) in these samples of population is very important.

Materials and Methods: This research is a descriptive analytical study carried out to investigate the QOL of elderly residents of Zahedan city. In this study a short form questionnaire (SE 36) of QOL was used. Estimated required number of the samples was 200 that were selected with random cluster sampling.

Results: Average age of studied population was 72.3 years and their mean number of children was 6.7. Mean scores of the general health perception, physical activity, physical role function, bodily pain, social function, emotional role function, vitality and mental health were 38.6, 42.7, 36.8, 37.8, 43.9, 45,46.7 and 42.7, respectively.

Conclusion: Since currently there are no sound data for elderly QOL in Iran, considering mean QOL score of 50 and standard deviation of 10, all observed QOL scores (in eight dimensions) were low. These findings show importance of attention to QOL in elderly clients.

---

Background & Aim: One of the cause of anxiety for most patients is hospitalization. Once the patients are hospitalized for cardiac catheterization, the anxiety would be augmented. The anxiety raises body physiological and psychological activities such as: heart rate and respiratory rate. This research, as clinical trial study, has the objective to determine the influence of applying two methods of relaxation and premeditation on respiratory rate and pulse rate in hospitalized patients, experiencing coronary angiography, in heart and postangio wards of Shahid Beheshti Hospital in Zanjan, at 2003.

Methods & Materials: 40 patients who were candidates for CA, has been studied, in regard to existing conditions and methods of sampling and random allocation to two groups of relaxation, and premedication. Data collection tool included demographic and disease related information sheet, as well as record sheets for respiratory rate and pulse rate at intervals of 8-12 and ½ hrs before, during and after the angiography. For relaxation group, the researcher would speak individually about the influence of relaxation, the day before angiography then with the aid of client himself/herself, performed relaxation instances in a single bout, and eventually asked client to perform relaxation technique 2-3 times before going for angiography. In premedication group, patients received regular preangiographic medications including diazepam, chlorpheniramine, metoclopramid, and hydrocortisone. Respiratory rate and pulse rate were measured in both groups 8-12 and ½ hrs, before during and after CA. Afterward, resulted data were analyzed statistically by (SPSS) software for windows.

Results: Pulse rate at 8-12 hours before, during and after the angiography showed no significant difference between two groups (p>0.05). Thus our research hypothesis that “alterations of respiratory rate and pulse rate in patients under coronary angiography, who get relaxation, are identical to those in premedicaton group”, would be confirmed

Conclusion: These results show that the premeditation method can be substituted by relaxation before practicing invasive procedures.

---

Background & Aim: Nurses have the major role at care continuity and health promotion. They frequently affect total productivity in a organization. However, the nurses believe that due to several barriers they have not desire productivity, therefore the health care have been left at level of quality. The aim of this research are assessing nurses&apos view about productivity and role of human resource on it.

Methods & Materials: This study has been done based on grounded theory method. Open interviews has been used for gathering of data. Sampling was purposive in beginning study but so that study was proceeding and categories were completed, it changes to theoretic sampling. Constant comparative analysis was method of data analyses.

Results: Essential themes emerged from the data in human resource category. These are: systemic calculating number of staff, accurate staff select and use criteria for them, provide adequate staff from various categories in total year&aposs day, accept patient when as coordinate to in charge nurse and well communication. These make necessary groundwork for productivity. Then accidents that emerged from inappropriate quantity and quality of human resource will be decreased. These enhance nursing productivity the biggest group of health care services. Model of Productivity and human resource effects on it’s, from nurses&apos view, has concluded of this research.

Conclusion: In nurses&apos view that participates in this research, human resource can affect on productivity process and improve it, then it lead to develop quality care- health care vision and goal.

---

Background & Aim: Blended E-Learning is an educational method which has been used recently in higher education worldwide. So, it seems that it is crucial for the Iranian academic members to accept it as a new educational method. This study was conducted to investigate attitudes of the faculty of Nursing and Midwifery School at Tehran University of Medical Sciences toward blended E-learning.

Methods & Materials: In this cross-sectional study, all faculty members of Tehran University of Medical Science (n=60) were recruited to the study. Data were gathered using validated and reliable self-designed questionnaires. The collected data were analyzed using SPSS software.

Results: The response rate was 93.33% (n=56). Most of the respondents (85.7%) were female. The mean age was 44.88 (SD=5.6). The years of teaching ranged from 5-30 years (mean=16.75). The majority of the respondents (66%) had positive attitude toward blended e-learning thirty four per cent had completely positive attitude and none of them had negative attitudes. About 41% reported that they were eager to provide their course syllabuses according to this approach and 87.5% said that they were willing to attend the blended e-learning education workshops. There were no significant relationships between demographic variables and the attitudes. There was a significant relationship between willing to attend the workshops and positive attitude toward blended e-learning (P=0.012).

Conclusion: According to the positive attitude of the respondents toward blended e-learning, it is recommended that further studies take place in order to design and implement the approach in formal education in the school of Nursing and Midwifery of Tehran University of Medical Science.

 

---

Background & Aim: Parents participation in management of diabetes has been recognized to be beneficent. Recognizing parents&apos worries should be addressed to plan effective health promoting programs. This study aimed to explore parents&apos worries about life problems of adolescent girls with diabetes.

Methods & Materials: In this qualitative study, 26 parents (16 mothers and 10 fathers) of adolescent girls with type 1 diabetes were recruited using purposive sampling from the Diabetes Society in west Azerbaijan. Data were collected using in-depth and semi-structured interviews. Analysis of the transcripts was guided by qualitative content analysis.

Results: Qualitative content analysis demonstrated three original categories from parents&apos worries: 1) worries about the future 2) worries about the treatments and 3) worries about the society.

Conclusion: Better perception of parents&apos concerns may promote effective communication between health professionals and parents. Modification of parents&apos personal control and perceived threat through appropriate educational programs that acknowledge and address their concerns may be a means of empowering parents.

---

Background & Aim: Healthcare classification systems help to gather information and process health data. Nursing management focus on developing computerized records to answer legal, managerial and clinical needs. The Classification systems help organizations to use nursing data. This study investigated informational and structural needs of nursing data classification.

Methods & Materials: This descriptive-comparative study was carried out in 2009. Current classification systems for nursing were investigated and their specifications were gathered in a questionnaire. The items were prioritized by experts in four degrees. Using statistical analysis items with a priority over 80 percent (average 2.4) were selected.

Results: Findings about nursing diagnosis, intervention and outcomes showed that diagnosis item (average 2.93 out of 3), intervention item (average 2.52 out of 3), and outcome item (average 2.84 out of 3) should be presented in the system. Structure of nursing data classification was identified as a hierarchical and combinational classification. The computerized terminology (average 1.86 out of 3) had no priority.

Conclusion: It is suggested to make decisions for standardizing nursing data to use in computerized systems. Since, nursing system in Iran is moving toward defining tariff for nursing services, coding nursing care components will help this plan to be developed.

---

Background & Aim: Quality of health care services shows the degree of achievement of health outcomes. From ethical and legal perspectives, nurses should be responsible for quality of presented care. Retired nurses can help to elaborate real and valuable concepts related to effective factors on quality of nursing care due to their experiences. The aim of this study was to explore the perspectives of retired nurses on factors that affect quality of nursing care in Semnan.

Methods & Materials: In this qualitative content analysis method, 20 retired nurses were invited to the study using purposeful sampling. Data were collected mainly using semi-structured interviews. The analysis was carried out using content analysis.

Results: Findings of the study yielded to three significant themes including: 1) necessity of humanistic relationships 2) suitable selection and education (3) planning and organizing nursing cares related to quality of nursing cares.

Conclusion: Findings of this study explored perspectives of retired nurses on the effective factors on quality of nursing care. The three themes emerged in the study should be mentioned in planning programs.

---

Background & Aim: Physiologic signs of anxiety usually change hemodynamic variables in patients undergoing heart catheterization. This study carried out to determine the effect of Orientation Program on hemodynamic variables in patient undergoing heart catheterization.

Methods & Materials: In this experimental study, 60 patients undergoing heart catheterization were randomly assigned to either the test or control group. Data were collected using the demographic checklist and a hemodynamic variables checklist for recording hemodynamic variables. The collected data were analyzed using the Chi-square, repeated measurement, and independent t test in the SPSS.

Results: According to the results, there were significant reductions in the systolic and diastolic blood pressures, pulse rate, respiratory rate and systolic left ventricle pressure in the intervention group after the intervention (P<0.05). There were no significant statistical difference between the two groups in systolic aorta pressure (P=0.173), diastolic aorta pressure (P=0.104), and end diastolic left ventricle pressure (P=0.886).

Conclusion: Orientation program had positive effects on most of the hemodynamic variables in the intervention group. The Orientation program is recommended to be used during invasive diagnostic procedures in order to prohibit anxiety&aposs physiologic complications.

---

Background & Objective: Hospitals and healthcare centers, like any other organizations, have some common norms and beliefs called as organizational culture. Organizational culture plays a key role in organization&aposs and staffs&apos performances. Nurses&apos perspectives on the organizational culture affect the way they play their role in. This study aimed to investigate the role of organizational culture from perspectives of nurses working in selected hospitals at Tehran University of Medical Sciences.

Methods & Materials: In this cross-sectional study, 230 nurses working in different wards of selected hospitals of Tehran University of Medical Sciences were recruited to the study. Data were collected using a demographic characteristics checklist as well as the nurse and organizational culture questionnaire extracted from the Robbins criteria. Data were analyzed using descriptive statistical indexes, independent t-test, Pearson correlation coefficient and regression in the SPSS v.17.

Results: Results showed that the existing organizational culture in the selected hospitals was in a moderately good level from nurses&apos perspectives. From the scores obtained for various dimensions of the organizational culture, the highest and lowest scores were for control (44.2%) and conflict tolerance (31.8%), respectively.

Conclusion: The level of the organizational culture from the nurses&apos perspectives might lead them to decrease the quality of their performance. Optimizing the organizational culture can improve nurses&apos performance and motivate them to increase their quality of work.

---

Background & Aim: Increase in cancer prevalence results in feeling fear of being diagnosed with cancer among individuals. Understanding concerns of patients diagnosed with cancer helps health care professionals to provide appropriate caring plans. This study aimed to understand main concerns of patients who confront cancer diagnosis.

Methods & Materials: This was a qualitative study with content analysis approach. Fifteen patients with cancer were selected from a specialized hospital, an oncology clinic, and Emdad Center of Cancer patients in Sari using a purposeful sampling method during May 2011 to June 2012. The sample size was completed regarding data saturation. Data were collected using interviews, observations and recording field notes. All interviews were tape-recorded and transcribed verbatim. Data were analyzed using descriptive content analysis and the Granhim and Landmann method.

Results: Three categories including 485 primary codes were emerged. The derived codes were as follows: 1) sever personal and family disturbance 2) imagination of despair and 3) unclear imagination of future. The main code included in all derived codes was life threatening nature of cancer.

Conclusion: The findings showed that life threatening nature of cancer is a source of fear that makes the disease frightening. Clinical staff and nurses should pay more attention to concerns of patients with cancer and design their care plan accordingly.

---

  Background & Aim: An important goal of nursing care in the Neonatal Intensive Care Unit (NICU) is to provide holistic care as well as the best possible outcome. Understanding perceived needs of mothers is valuable to achieve these goals. This study aimed to compare perceptions of nurses and premature infants’ mothers about mothers’ needs in the NICUs.

  Methods & Materials : This was a cross-sectional study in which 63 nurses and 63 mothers with premature infants were selected from the NICUs of four educational hospitals affiliated to the Mashhad University of Medical Sciences through stratified sampling method in two months. Data were gathered using the NICU Family Needs Inventory of Ward and were analyzed using descriptive-analytical statistical methods in the SPSS v.16.

  Results: Among the subscales related to family needs, the following items were reported to be important by mothers: Proximity (95.3%), Assurance (94.1%), Information (91.1%), Support (79.7%) and Comfort (72.8%). On the other hand, nurses believed that the following items were the most important needs of the mothers: Assurance (80.3%), Proximity (75.2%), Information (70.8%), Comfort (66.3%) and Support (64.8%).

  Conclusion : According to study findings, nurses should periodically assess needs of the mothers in the NICUs to be aware of the actual needs instead of placing subjective assumptions on mothers needs. This can improve effective communication and interaction with mothers and enhance satisfaction of the mothers with care.

---

  Background & Aim: The HIV infection is a serious health problem with major effects on various aspects of life. It is essential to understand the lived experiences of patients living with HIV/AIDS. The present study was conducted to investigate affected patients' lived experiences .

  Methods & Materials: This qualitative study was carried out using an interpretative, phenomenological approach. Nineteen patients with HIV/AIDS were selected using purposive sampling method. Field notes, in-depth and semi-structured interviews were used to collect data. The interviews were transcribed verbatim and were analyzed using the hermeneutic approach developed by Diekelmann (1989) . 

  Results: From 19 participants, 57.9% were males. Mean age was 39 years 42.1% were single 47.4% had CD4 counts less than 200 cells/mm3. The main emerged themes were as follows: 1) death way 2) halo of worries 3) hope to cure. Based on the final step of the Diekelmann approach, "being in state of hope and fear" was emerged as a constitutive pattern in patients living with HIV/AIDS .

  Conclusion: Patients with HIV/AIDS experienced fears, doubts, worries, hopes and many emotional challenges in different aspects of their lives. Caregivers should understand and comprehend the emotional states of the patients. Health care providers should design effective interventions to help individuals to cope with HIV/AIDS .

  

---

  Background & Aim: Several studies have indicated that hospitalizing infants causes disruption on mother-infant attachment. The aim of this study was to assess the effect of infant massage by mothers on maternal attachment behavior in infants hospitalized in the neonatal care units .

  Methods & Materials: In this clinical trial, 42 mothers and their neonates were recruited and randomly allocated to the intervention and control groups. Mothers in the intervention group received training by means of educational movies about practical exercises on how to massage the infants. The trained mothers used massage techniques on their infants for five days. The process lasted 15 minutes. The attachment of the mothers on their infants was assessed before and on the day 5 after the massage. Data were collected using the scale of mother-to-infant attachment. Data were analyzed using the Chi-squared test, Fisher’s exact test and the t-test in the SPSS-19 . 

  Results: There were no differences between the two groups in terms of demographic variables and the mean of maternal attachment at baseline (P>0.05). Five days after the massage, there were statistically significant differences between the two groups in the mean maternal attachment (P<0.001) .

  Conclusion: According to the role of massage in attachment behavior, this traditional care is recommended to be used in neonatal units .

  

---

  Background & Aim: The major problem with mechanically ventilated patients receiving enteral nutrition hospitalized in the intensive care units is delayed gastric emptying. Acupressure can increase gastric motility. This study aimed to determine the effect of acupressure on the amount of gastric emptying in mechanically ventilated patients hospitalized in the intensive care units .

  Methods & Materials: In this clinical trial, 78 mechanically ventilated patients were recruited using convenience sampling method and were randomly divided into two control and experimental groups. Acupressure was applied on the Neiguan point for four days in the experimental group. The control group patients received no intervention. Gastric residual volume was measured in the admission time and before the gavages. The mean gastric residual volume of the admission time and the 1-4 days after the admission were compared in the two groups. Data were analyzed using the independent t-test, Chi-squared test, covariance analysis and repeated measured tests in the SPSS-16. 

  Results: The results revealed that there were no differences between the two groups in the admission time and the first day (P>0.05). There were statistically significant differences between the two groups in the admission time and 2-4 days after the admission (P<0.05). The difference of mean scores of gastric residual volume were significantly different between the two groups during the four days of post intervention constantly (Repeated measured ANOVA P=0.011) .

  Conclusion: The acupressure increased the gastric emptying in mechanically ventilated patients hospitalized in the intensive care units. Since the acupressure wristband was an easy to use, non-expensive, available procedure, it can be used to improve gastric emptying and prevent delayed gastric emptying complications .

  

---

Background & Aim: Anxiety is one of the most important mental problems in patients who are candidate for coronary angiography, which can have negative physiological and psychological consequences and ultimately lead to the increased hospital stay, increased patient need for analgesics, increased costs and increased incidence of angiographic complications. Therefore, the aim of this study was to determine the effect of aromatherapy on anxiety in patients undergoing coronary angiography.
Methods & Materials: In this randomized clinical trial, 80 patients undergoing coronary angiography referred to the post-cath. ward of Shahid Mohammadi hospital in Bandar Abbas in 2018 were selected and allocated into two groups of intervention and control through the random numbers table. In the intervention group, the eye pads impregnated with 0.2 ml of peppermint oil were used, and in the control group, the pads impregnated with 0.2 ml of placebo were placed on their chest for 20 minutes. Patient’s anxiety levels were recorded before and after the intervention. A demographic characteristics questionnaire and the Spielberger standard questionnaire were used for the data collection. The   data were analyzed by the SPSS software version 24 using the descriptive and inferential statistical methods in accordance with the objectives of the study.
Results: The results of data analysis showed that aromatherapy reduced the anxiety of patients in the intervention group, which was significantly different from the control group (P=0.006). Paired t-test also showed that in the intervention group, the mean score of anxiety after the intervention was significantly lower than that of before the intervention (P<0.001), however this difference was not significant in the control group (P=0.90).
Conclusion: Based on the findings of the study, we can conclude that aromatherapy with the inhalation of peppermint aroma has been effective in reducing anxiety in patients undergoing coronary angiography. It is recommended that nurses use aromatherapy as a non-pharmacological approach to reduce the patients' anxiety.
Clinical trial registry: IRCT20190225042844N1
 

---

Background & Aim: Stress and anxiety are one of the major problems in patients undergoing semi-invasive and invasive procedures such as endoscopy. Different methods to reduce anxiety do not have the same effects. The aim of this study is to compare the effect of thought distraction by music therapy and the presence of caregiver on anxiety level of patients undergoing endoscopy.
Methods & Materials: In this randomized clinical trial, 105 patients referred to endoscopy ward of Shahid Mohammadi hospital and Persian Gulf Bandar Abbas hospital in 2018 were selected by the convenience sampling method and assigned into three groups of music therapy, presence of caregiver and control using the random allocation (35 in each group). The demographic information form and the Spielberger anxiety questionnaire (STAL) were completed before and after the intervention. In the music therapy group, patients received natural sounds through headphones. In the caregiver’s presence group, endoscopy was performed with the presence of caregiver, and the control group only received routine pre-endoscopic care. Data were analyzed using descriptive and inferential statistics through the SPSS software version 24 at a significance level of 0.05.
Results: The result of analysis of variance showed that there was no significant difference in the anxiety mean score between the three groups before the intervention (P=0.77), but a significant difference was observed after the intervention (P<0.005). The decrease in scores in the music therapy group was significant (P=0.044), but in the caregiver’s presence group (P=0.571) and the control group (P=0.663), no significant change was observed before and after endoscopy.
Conclusion: The results of this study showed that distraction with music therapy is an effective way to help patients undergoing endoscopy, and the use of this method can help the procedure to be performed better and enhance patient satisfaction.
Clinical trial registry: IRCT20190715044215N1