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Background & Objective: Osteoporosis is a serious metabolic bone disorder and a major health concern in women. Osteoporosis affects the quality of life of women. Studying the osteoporosis related food habits and behaviors can promote health promotion program planning. It seems that female teachers are the best models and educational sources for female students. This study was carried out to determine the osteoporosis related food habits and behaviors among female teachers.

Methods & Materials: This study was a cross-sectional study in which 308 female teachers were randomly selected using stratified sampling method from the schools of the 6^th district of Tehran. Data were collected using a questionnaire and analyzed using student t-test, one-way analysis of variance and Tukey test.

Results: Mean score of osteoporosis related food habits and behaviors was 14.9±4.2 (out of a possible 24 maximum attainable score). Osteoporosis related food habits and behaviors score was significantly higher in the teachers who had higher knowledge score, aged more than 50 years old, had worked for more than 25 years , had used educational books and booklets as the first informational source, and among the post- menopausal teachers (P<0.03).

Conclusion: According to the findings, the teachers demonstrated average level of osteoporosis related food habits and behaviors, whereas their mean calcium intake was relatively adequate, but their other food habits and behaviors were relatively inappropriate. It seems developing and implementation of educational programs and offering educational booklets to teacher can help to promote their food habits and behavior which may be helpful in enhancing students&apos food habits.

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  Background & Aim: Transparent and appropriate reporting of studies facilitates critical appraisal, application and combination of findings. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement, is a relatively new statement in order to improve the quality of reporting of observational studies. The present study aimed to assess the quality of reporting nursing and midwifery cohort studies according to the STROBE statement published in the Iranian electronic databases .

  Methods & Materials: In this cross-sectional study, we conducted a literature search in the SID, Magiran, Irandoc, Iranmedex databases and Google Scholar using the "cohort" keyword. It produced 1951 articles. After excluding duplicates and irrelevant articles, 241 papers were remained. We included: papers that were published after publishing of the STROBE statement, papers with cohort designs, and papers which their first author or corresponding author were nurse or midwife. Finally, we included 33 papers in our study. We evaluated the papers with the extended STROBE statement. Data were analyzed using the Kruskal Wallis, Mann Whitney and Spearman tests . 

  Results: About half (48.5%) of the papers had a prospective design others were historical cohort. The compliance with the STROBE statement was 56%. The title, abstract and introductions had generally good quality. The missing data, loss to follow-up and sensitivity analyses had poor quality. There were no associations between the papers' reporting quality with the year of publications, authors' specialty, design of the study, and the time of reviewing process .

  Conclusion: The quality of reporting in nursing and midwifery cohort studies was moderate. Reporting the essential elements of cohort studies according to the STROBE statement is recommended .

  

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  Background & Aim: Medication errors are known as the most common preventable and life threatening medical errors. This study aimed to explore perceptions of nurses on medication errors .

  Methods & Materials: This was a qualitative study with content analysis approach. Seventeen nurses were selected purposefully from the intensive care units of Shohada hospital in khoramabad in 2012. Data were gathered using semi structural interviews with the nurses. Data were analyzed using the Lundman and Graneheim method. We used the Linclon and Gouba method to ensure a ccuracy and trustworthiness of the data . 

  Results: Four main categories and six subcategories were recognized including: 1) Management factors (inefficiency in recruitment of human power, poor physical condition and workload) 2) Inefficiency in professionalism (lack of commitment among nurses, insufficient knowledge and inefficiency in the inter professional relationship) 3) Failure in the process of drug prescription by physicians and 4) Failure in production and packaging drugs by drug companies .

  Conclusion: Training and recruiting professional and committed nurses, using electronic medical files, supervision on pharmacy companies to produce and package proper medication can reduce medication errors .

  

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The World Health Organization (WHO) has introduced palliative care as a way to improve the quality of life of patients with incurable diseases and their families. This care begins with the diagnosis of the disease, and continues throughout the illness (1). Palliative care improves the quality of life of patients with life-threatening diseases and their families. Its purpose is to relieve suffering through the identification, evaluation, and relief of pain and other physical, psychosocial and spiritual problems (2).
Palliative care is required for many diseases. According to reports, every year about 40 million people in the world need palliative care, but only 14% of them receive it, of whom 78% live in low-income or middle-income countries. According to the World Health Organization, patients who require palliative care services, suffer from cardiovascular diseases (38.5%), cancer (34%), chronic pulmonary diseases (10.3%), AIDS (5.7%), and diabetes (4.6%). Other patients with diseases, such as dementia, kidney failure, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological diseases, congenital anomalies, and resistant tuberculosis may also need palliative care services (1). Palliative care can be offered to patients through various models, including hospital-based palliative care, hospice-based palliative care and home-based palliative care (3). Studies have shown that home-based palliative care has a very beneficial effect on the physical, mental, psychological, social and economic dimensions of patient’s life, and reduces the cost of health system, shortens the length of hospitalization, reduces hospital complications and prevents hospital readmission (4-6). This type of care also facilitates the continuity of post-discharge care and helps patient to easily benefit from the facilities of different centers (7). On the other hand, most people prefer to receive care at their homes with their families (8). Studies have shown that home-based palliative care is clinically and economically effective and leads to the satisfaction of patients and their families. Also, the World Health Organization in 2014 has introduced home-based palliative care as one of the main elements of the health systems all around the world (1). However, reports indicate that many countries in the world do not have palliative care programs in their health care system (7), and the lack of government support for palliative care services, lack of prepared professional staff to provide palliative services, limitation in access to narcotic analgesics, resource constraints, lack of policy-makers’ familiarity with palliative medicine, the negative attitude of society towards palliative care and socio-cultural issues have been mentioned as barriers to palliative care in the world (1, 9,10).
Iran’s health system is faced with increasing number of chronic patients and shortages of manpower and ICU beds in health centers. Most patients with life-threatening diseases in Iran are frequently admitted to hospital during the last days of their lives. Despite the shortage of hospital beds, especially in the critical care units, these patients occupy these beds and receive specialized medications until the end of their lives and eventually many of these patients die on ICU beds in hospital (11). While in many cases, hospitalization of incurable patients in critical care units does not have any positive effects on patients’ recovery, and is considered a futile care (12), which increases the costs of health system, poses financial burden on patient’s family, and leads to dissatisfaction and work burnout in healthcare staff (13). On the other hand, many of these patients prefer to spend the last days of their lives at home with their family and be in close contact with their relatives. Evidence suggests that palliative care in Iran is only offered in isolated and limited centers. Most patients are deprived of this kind of care, and home-based palliative care does not have any place in Iran’s health system (14). Patients with incurable conditions who require palliative care services are lost in the system, and in most cases do not receive proper and timely services they need (15). Also, the traditional attitude of healthcare staff towards the management of incurable conditions, the lack of transparency in the protection of healthcare staff against discontinuation of unnecessary treatments or unreasonable expectations of patients and their families, as well as social and cultural differences are barriers to the promotion of palliative care in Iranian society. Another problem in providing home-based palliative care services is the defect in the payment process and insurance coverage of end-of-life patients (16,17). Therefore, given the high prevalence of chronic and incurable illnesses, the increasing number of elderly population, limited critical care beds, shortages of human resources, limited financial resources and equipment in health centers, and taking into account the benefits of home-based palliative care, healthcare system authorities should consider this care method to be one of the important priorities of the health system so that patients can maintain their quality of life and also experience peace during the last days of their lives. Considering the limited research in this field, further research is required on the management of various dimensions of home-based palliative care in order to provide suitable models for the provision of home-based palliative care services in Iran.
 

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Background & Aim: Postoperative pain is one of the clinical challenges for nurses who care for patients. The objective of this review was to evaluate the effect of preoperative education on postoperative pain after elective surgery.
Methods & Materials: A literature search was done on PubMed, CINAHL, Cochrane Library, Web of Science, Scopus and EMBASE to find the articles published in English on clinical trials from January 2012 to June 2018.
Results: Out of 153 studies retrieved, 13 studies (2482 people) were reviewed. Generally, most studies indicated the effectiveness of preoperative education on postoperative pain relief (7 studies, n=1678). In other studies, there was no significant difference between education and the degree of pain reduction in the patient. Also, the results of some studies (n=204) showed that education with empathy could reduce anxiety in half of the cases.
Conclusion: Preoperative education as a complex intervention can reduce postoperative pain. Interactive education with empathy reduces patient’s anxiety and the need for postoperative analgesics. Therefore, training skilled nurses and the providers of such education is suggested for managing pain in patients.
 

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Background & Aim: The caregivers of Alzheimer's patients frequently experience more psychological illness, depression, stress, and discomfort than their peers who do not care for Alzheimer's patients or care for physically ill patients. The aim of this study was to determine the effect of problem-oriented coping strategies training on perceived stress in the family caregivers of the elderly with Alzheimer.
Methods & Materials: The present study was a randomized field trial. The study population consisted of the family caregivers of the elderly with Alzheimer's disease living in Kerman in 2017. The samples were 72 people who were randomly assigned into the control or intervention groups. The caregivers in the intervention group received eight 45-minute sessions about the problem-focused coping strategies based on the specified content, once a week. Data were collected using a 14-item version of the Cohen’s Perceived Stress Scale before and two weeks after the intervention, and were analyzed using independent t-test, paired t-test and chi-square tests through the SPSS software version 18.
Results: Due to the significant difference in the perceived stress score between the intervention and control groups in the pre-intervention stage (P=0.030), and the lack of significant difference between the two groups after the intervention (P=0.06), in order to determine the effect of the intervention, the mean of changes between the two groups were compared and a significant difference was observed in the intervention group compared to the control group (P=0.02).
Conclusion: Considering the positive effect of the problem-focused coping strategy training on reducing perceived stress in the caregivers of the elderly with Alzheimer, designing and implementing interventions with an educational approach can promote the health of caregivers and in turn improve the quality of care for Alzheimer's patients.
Clinical trial registry: IRCT2016050327736N1
 

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Background & Aim: Today, ageing is a challenge for health and care systems, and one of its main consequences is an increase in the readmission rates. Therefore, in all countries, efforts are being made to reduce the readmission rate. The Readiness for Hospital Discharge Scale was designed to understand patients' readiness levels for discharge. This study was conducted to translate and evaluate the psychometric properties of the Readiness for Hospital Discharge Scale.
Methods & Materials: In this methodological study, a convenience sample of 500 elderly patients admitted to hospitals affiliated with Mashhad University of Medical Sciences was selected in 2020-2021. The instrument was translated using the forward-backwards method. The psychometric properties of the final version of the instrument were assessed by employing exploratory and confirmatory factor analysis (validity) and Cronbach's alpha and the Guttman's split-half coefficient (reliability).
Results: In the factor analysis, all items had a factor loading above 0.3 and, all of them were retained. The goodness of fit indices confirmed the model and a good fit of the model. The Cronbach's alpha coefficient for the whole scale and the Guttman's split-half coefficient were 0.92 and 0.86, respectively.
Conclusion: The results of our study supported the four-dimensional structure of this instrument and indicated that this instrument has adequate validity and reliability. Therefore, nurses and doctors can use this tool as a suitable method to measure the elderly patients' readiness for discharge and to achieve a safe transfer from the hospital to home.