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Background & Aim: Nutrition is a very important factor in toddler age growth. Getting started the first steps of the children with family in this period shows the necessity of paying attention to the correct nutritional behaviors. Therefore this research has been conducted for assessing the effect of nutritional behavior model on the quality of toddler&aposs nutrition and performance of their mothers.

Methods & Materials: This research is a semi-experimental study, in which sixty six children (12-36 months old) were selected from two health care centers in the southern part of Tehran. The subjects were selected using non probability-convenient sampling method. The data gathering tool was 3 questionnaires: 1. Mother and child demographic characteristics 2. Mother&aposs function assessment tool about toddler&aposs behavior during feeding 3. Reminding tool of 24 hours food. The tools were filled in using interviews. Then nutritional behavior model was instructed in a workshop during 2 days, 3 hours a day. After the intervention data were recollected again and were analyzed by descriptive and inferential statistics.

Results: The results showed a significant difference in mother&aposs function about toddlers nutritional behavior during nutrition before and after the intervention (P<0.001). Also a significant difference was seen in the toddlers nutrition pattern before and after the intervention (P<0.05).

Conclusion: Based on the research findings it can be concluded that nutritional behavior model is effective in improving the pattern of toddler&aposs nutrition and in increasing mothers&apos knowledge related to a correct function on toddler&aposs behavior during feeding. Therefore educational plan to mothers on correct nutritional behaviors is suggested in order to improving the quality of toddler&aposs nutrition.

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Background & Aim: Due to the fact that family centered care have a crucial role in pediatric nursing, it seems compatibility of nurses&apos and parents&apos perception about parents&apos needs can lead to deliver higher quality care. The aim of this study was to compare parents&apos and nurses&apos perceptions about needs of hospitalized children&aposs parents.

Methods & Materials: This is a cross-sectional survey. One hundred and fifty parents and 80 nurses were selected using convenient sampling method. Data was gathered using Kristjánsdóttir&aposs "parental needs of hospitalized children" questionnaire. Data were analyzed using descriptive and analytical (Chi-squared & Mann-Whitney U tests) methods.

Results: Research findings showed that there was significant difference between both parents&apos and nurses&apos perceptions about parents&apos needs (P=0.012). Both groups believed that parents&apos needs are met partially in hospitals. There was not meaningful difference between the parents&apos and nurses&apos perceptions concerning meeting parental needs (P=0.666). Based on their perceptions, understanding of parents&apos needs help them to meet their requirements in health care facilities. There was a significant difference between parents&apos and nurses&apos perceptions regarding parents&apos need (P=0.018).

Conclusion: Parents and nurses recognized all of the parents&apos needs to be important there were also deficits in meeting these needs. Therefore, parents&apos cooperation with health care team is necessary to facilitate the recovery of sick children as well as meeting parents&apos needs.

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Background & Aim: While patient education promotes compliance to treatment and self-care ability, short hospital length of stay, anxiety, illness, and sleep disorders can interfere with this approach. It is not clear how realistic is to learn during the short hospitalization period, from nurses' and patients' perspectives. This study aimed to compare perspectives of patients and nurses on the reality of learning cardiac heart failure educational content in Shahid Rajaee heart hospital.

Methods & Materials: In this cross-sectional study, two hundred and fifty one patients and 181 nurses were selected using convenience sampling. Data were collected using the reality part of CHFPLNI and were analyzed in SPSS-11.

Results: Most of the patients were male (82.4%) most of the nurses were female (85.6%). The mean ages of patients and nurses were 55.18 and 35.15, respectively. The mean hospitalization period was 4.26 days and the mean duration of heart failure was 10.70 years. The majority of nurses had not participated in advanced preparation courses. Patients and nurses had agreement on the reality of medication learning. Patients rated medication (P<0.001), diet information (P<0.001), other information (P<0.001) and the total scale (P<0.001) as more realistic than the nurses did. Female nurses (P=0.012) and nurses with advanced preparation (P<0.001) perceived learning needs as more realistic than the other nurses.

Conclusion: Regarding discordance between patients' and nurses' perspectives on the reality of learning, nurses may postpone to implement educational program. Patients' perspectives should be considered in the establishment of heart failure educational programs.

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Background & Aim: Using illicit drugs such as Ecstasy is a deviant behavior in adolescents. Attitude toward using illicit drugs can predict its usage. This study was carried out in order to determine the adolescents' attitude toward using Ecstasy in 2006.

Methods & Materials: In this cross-sectional study, eight hundred adolescents aged 16-18 years who lived in the west of Tehran recruited from public regions of municipality. Data was gathered using authors-structured questionnaire. After filling in informed consents, the questionnaires were completed by the respondents.

Results: Findings revealed that 78.9 % of the adolescents had negative attitudes and 17.5% had positive attitudes toward using Ecstasy. Boys and girls attitudes were not significantly different.

Conclusion: Regarding relatively high negative attitudes among the adolescents toward Ecstasy using, it seems that investments in health promoting programs were appropriate. Nevertheless, along with these programs, parents and teachers should pay more attention to the issue.

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Background & Aim: Nausea and vomiting is one of the major side-effects of chemotherapy. Due to complex nature of its management, both medical and non-medical therapies are recommended. This study aimed to investigate the effect of music therapy on chemotherapy nausea and vomiting in children with malignancy.

Methods & Materials: In this quasi-experimental study, 30 children aged 8-12 who were under chemotherapy were recruited. After getting the current treatments, the children listened to a kind of music for 45 minutes at 6, 9, and 12 hours after the beginning of the chemotherapy. Nausea and vomiting was measured using both numerical and descriptive scales every 8 hours for 24 hours after beginning of the chemotherapy. Data were analyzed using Willcoxon and Mcnemar statistical tests in the SPSS, version 11.5.

Results: The rate of nausea was declined significantly at the 16^th and 24^th hours after music therapy. Assessment of nausea by descriptive scale showed a decline only at 24^th hours after music therapy. The rate of vomiting did not show any significant difference between two stages.

Conclusion: Music therapy could decrease the amount of nausea in children with malignancy under chemotherapy however, it does not any effect on the rate of vomiting.

 

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Background & Aim: Despite the advancement of medical science, readmission of the heart failure patient remains a serous problem. The aim of this study was to assess the effect of continuous care and educational intervention on the rate of readmissions, refers to physician, and health costs in patients discharged from hospital.
Methods & Materials: This study was a randomized clinical trial in which 110 patients were studied. The participants were allocated in two experimental and control groups. Data were gathered using questionnaires. Home visits were carried out in the experimental group during six months. At the end of the intervention, the rate of readmissions, referrals, and health care costs were compared in the two groups. Data were analyzed using independent t-test, Fisher&aposs exact test, and Chi-square test.
Results: Results indicated that the rate of readmissions (1.65±1.01 vs. 2.74±1.07, respectively), and refers to physicians (2.73±1.24 vs. 3.32±0.94, respectively) were lower in the experiment group than the control group (P<0.05) after the intervention. The average health care cost in the intervention group (2494000±172150 Rials) did not differ significantly with the control group (2736800±167360 Rials) (P>0.05).
Conclusion: The results of this study indicated that the nursing interventions such as home visits are effective in lowering readmissions and refers to physicians in patients with heart failure. It seems that home visits are necessary in promoting the patients health. 

 

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Background & Objective: Invasive procedures are severe stressors for
in-patient children. The stress result in sleep disorder, reduced concentration, and increased pain. Nowadays, pharmacologic and nonpharmacologic interventions are used to control stress. We aimed to assess the effect of massage on children&aposs anxiety level before intensive procedures.

Methods & Materials: In this clinical trial, 70 children aged 7-11 were recruited from a children hospital. The participants were randomly allocated to the intervention and control groups. The intervention group received massage therapy in the Yeen tang point and palms for five minutes. The control group received the usual care. Anxiety was measured using OSBD-R. Data were analyzed using Mann-Wittny and Willcoxon statistical tests.

Results: The anxiety level was not significantly different between two groups before the intervention (Control group: 3.24±0.48 Intervention group: 3.24±0.56) (P=0.472). Following the massage, the anxiety level decreased significantly in the intervention group (Intervention group: 1.57±0.54 Control group: 3.37±0.46) (P<0.001).

Conclusion: Massage in the Yeen tang point and palms can reduce the anxiety level in hospitalized children prior to invasive procedures. It is recommended to use this massage technique in pediatric wards to reduce anxiety level.

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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.

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Nurses are a major part of the health system workforce. Also, this group of healthcare workers has an important role in providing direct care to the patients. Therefore, nurses are considered an important pillar in any health system (1). However, during recent years, the shortage of nursing staff and high rate of job leaving have become a serious concern in many countries (2). To properly and timely deal with this challenge, it is necessary to have accurate information about all its relative factors such as number, age status, years of service, employment of nursing graduates, the number of active beds, their geographical distribution and the prediction of the number of nursing graduates in the next years.
While some studies have recently emphasized the issue that Iran, similar to many other countries, is facing nursing staff shortage (3), no clear picture is available of the current and future needs for nursing workforce due to the poor infrastructures of health information system in our country. Nejatian has stated that “there is still no accurate statistics on the shortage of nursing staff and the required nursing workforce” (4). However, some health ministry officials have suggested that there is a shortage of 200 thousand nursing staff (5).
Currently, if we accept that the country is facing the challenge of nursing shortage, it will be necessary to comprehensively consider all the factors related to supply and demand. One of the efforts made in recent years was to increase the capacity of nursing schools and establish new nursing schools for training a higher number of nurses. But some believe that a number of graduated nurses are not interested in working in the nursing field (6). For example, according to a governmental report, in 2013, about 1.6 million licensed nurses in the United States did not work in nursing (7). Therefore, further workforce training will not necessarily resolve the shortage of staff and it is necessary to consider other important factors influencing the recruitment and retention of nursing workforce. Among these factors, job satisfaction has a great role in the nurses’ intention to leave their profession (8) or decrease their working hours (9). Occupational burnout, social support (10) and the salaries and bonuses system (11) are other important factors that should be considered for resolving the problem of nursing shortage.
Considering the current situation, if the current shortage is caused by the lack of interest in working in nursing field or leaving nursing career, as Florence Nightingale proved that caring for the injured soldiers is less costly for the British army than letting them die and recruiting new soldiers (12), increasing the capacity for training nurses is not a cost-effective approach for resolving the problem of nursing shortage.
Despite what was mentioned above, the policy makers’ main strategy is still to increase the number of graduated nurses. In this regard, there are various experiences about developing and implementing nursing education programs in the world that could be an appropriate choice for resolving the problem of nursing staff shortage. One of these programs is “Accelerated Nursing Program” which has been developed for the graduates of non-nursing bachelor’s degree to be trained as a nurse. The first Accelerated Nursing Programs was developed in the early 1970s which gradually grew over the next years (13). These accelerated programs are based on the previous experiences of the students and provide an opportunity for individuals with a bachelor’s degree in other disciplines to enter the field of nursing (14). Accelerated nursing programs would provide the fastest way for issuing a nursing license to non-nursing graduates and last from 12 to 18 months (15). These programs are intense with courses offered full-time and there is no break between the courses; the students would pass the same hours of clinical internship as their counterparts in traditional nursing programs. Nursing staff value to the graduates of accelerated nursing programs because they would bring a great amount of skill and education to the workplace; they claim that these graduates are more mature and have stronger clinical skills and also are quick in learning the necessities of the job (14). Results of the study by Ouellet showed that accelerated programs would train qualified nurses who could be successfully prepared for clinical activities (16). Results of a retrospective study by Raines revealed that most graduates of accelerated nursing programs were working in nursing field and a great percentage of them were either studying or a higher degree graduates in nursing (15). Studies on the evaluation of accelerated nursing programs revealed positive results and outcomes in implementing these programs (17, 18).
Iran has high rates of unemployment among university graduates in many fields (19). Considering this important issue and our country’s priority in creating employment for them, it seems that applying the accelerated nursing programs rather than untested programs such as nurse training plan using the capacity of hospital, which has no clear structure, process and results, can be appropriate for the current situation in the country. Therefore, in order to find an answer to this challenge, it is recommended that nursing shortage area should be determined and these programs be launched in those areas. In such a framework, the required nursing staff can be provided in a shorter duration of time and with less cost.
 

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Background & Aim: Nurses play an important role in the health system and their turnover disrupts its performance. The aim of this study was to investigate intention to turnover and its relationship with healthy work environment among nursing staff.
Methods & Materials: This cross-sectional study was conducted on 295 nursing staff from Imam Khomeini hospital complex in Tehran in 2016. Nurses were selected by the stratified random sampling with a proportional allocation, and completed a demographic data form, the Healthy Work Environment questionnaire and the Anticipated Turnover Scale (ATS). Data were analyzed by descriptive statistics, independent t-test, one-way ANOVA, Pearson/Spearman correlation coefficient and multiple linear regression tests using the SPSS software version 20.
Results: The mean score for the intention to turnover was 36.21 (SD=4.38) ranged from 12 to 60. “Authentic leadership” and “skilled communication” domains obtained the highest (9.60±3) and lowest (8.97±2.74) scores respectively. There was poor correlation between the meaningful recognition domain and the anticipated turnover score (r=-0.135, P=0.024). In addition, the anticipated turnover score was significantly higher in male nurses than in female nurses (P=0.023).
Conclusion: Although there was no relationship between anticipated turnover and healthy work environment in this study, considering the importance of nurses’ recruitment and retention, there is a need to investigate the reasons for turnover, including characteristics of work environment, and take necessary measures.
 
 

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Background & Aim: Perimenopause is associated with severe changes in reproduction and hormones. The aim of this study was to determine the effect of group counseling on the severity of menopausal symptoms in the transition to menopause.
Methods & Materials: This clinical trial study was performed on ninety perimenopausal women in Javanrood city in 2019. Women were randomly assigned into the intervention or control groups using the block randomization method. Counseling was conducted for the intervention group in groups of 11 to 12 people in four 60-minute sessions for four consecutive weeks. After 8 weeks, the severity of menopausal symptoms was measured using the Menopause Symptoms Scale. Data were analyzed using the SPSS software version 21.
Results: There was no statistically significant difference between the two groups in terms of menopausal symptoms scores before the intervention (P=0.86). After the group counseling, the median (Q1, Q3) of menopausal symptoms, physical, mental and genitourinary symptoms in the intervention and control groups were 17.0 (15.0, 21.5) and 21.0 (17.0, 30.5) (P<0.001), 6.0 (5.0, 8.0) and 9.0 (6.5, 11.0) (P<0.001), 6.0 (5.0, 8.0) and 8.0 (5.0, 10.0) (P=0.004), and 5.0 (4.0, 6.0) and 6.0 (5.0, 8.5) (P<0.001), respectively. These values for the intervention group were significantly lower than those in the control group.
Conclusion: Providing group counseling for four sessions was effective in reducing the severity of menopausal symptoms in perimenopausal women. Therefore, it is suggested that this strategy be used to promote women's health in the premenopausal period.
Clinical trial registry: IRCT20120215009014N320