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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.

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Background & Aim: Urinary tract infection is one of the most prevalent complains among elderly in primary care centers. The purpose of this study was to assess urinary tract disorders and prevalence of urinary tract infection in residents of Kahrizak elderly House.

Methods & Materials: In this cross-sectional study, 142 men and 114 women (mean age: 76.03±8.32 years) were randomly selected for the study. Data were gathered using a questionnaire. Weight and height of the participants was measured and urine cultures were ordered. Data were analyzed using c² and Fisher‘s exact test. The P<0.05 denoted statistical significance.

Results: Findings showed that 34% of elderly had urinary tract infection. Of those, 55% (46 cases) were women and 45% (41 cases) were men. Prostate hypertrophy (32.5%) and gyneacologic disorders (16.9%) were the most diagnosed disorders (P<0.05).

Conclusion: The prevalence of urine tract infection in elderly with urinary system disorders is high. Recognizing at risk elderly and referring them to the health care centers can prevent urinary tract infection and its complications.

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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.

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Background & Aim: Diet rich in fruits and vegetables is shown to be an important factor in prevention of chronic diseases. Adolescence is a critical period in adopting eating behaviors. Schools are important social environments in adolescents' lives and are important settings for interventions that aim to improve eating behaviors, including fruit and vegetable intake. This study aimed to assess effectiveness of a school-based intervention based on social cognitive theory on fruit and vegetable (F&V) intake of female adolescents in Tehran.

Methods & Materials: This experimental school based field trial was conducted on 296 female students aged 10-13 years old (157 in the intervention and 139 in the control groups). The intervention included classroom nutrition education on F&V and increasing availability of F&V through school buffet. Psychosocial characteristics of the students were assessed using a questionnaire and F&V intake were measured using 24-hr recall method, at baseline and after three months intervention. Descriptive and inferential statistics were used for data analysis.

Results: After the intervention, vegetable and fruit intake were 0.6 and 0.63 servings higher in the intervention group compared to the controls. Knowledge and self-efficacy scores were significantly higher in the intervention group compared to the control group. Home availability and observational learning scores were significantly decreased in the intervention group.

Conclusion: Through the intervention process, many valuable experiences were gained to be used in future interventions.

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  Background & Aim: Critical thinking is a necessary and important component of nursing profession. Since nurses are not limited to work under predetermined roles and need to meet various needs of patients, they should have critical thinking skills. This study aimed to determine the role of emotional intelligence and its components in critical thinking disposition .

  Methods & Materials: In this cross-sectional study, 118 female nurses working in educational hospitals of Qazvin were selected using quota sampling method. They completed the Trait Metal Mood Scale (TMMS) and the California Critical Thinking Disposition Inventory (CCTDI). Data were analyzed using descriptive statistics (frequency, mean, standards deviation and Pearson correlation coefficient) and inferential statistics (Multiple Regression) in the SPSS-16 . 

  Results: The results showed that there was a significant positive correlation between the total score of emotional intelligence with the total score of disposition toward critical thinking (r=0.385). There were also positive relationships between the total score of disposition toward critical thinking with the two subscales of emotional clarity (r=0.459) and emotional healing (r=0.220). There was no statistically significant relationship between the subscale of attention to emotion and total critical thinking score (r=0.117). The subscale of emotional clarity significantly predicted 21% of changes in critical thinking .

  Conclusion: Nurses who were more aware of their emotions and emotional transparency had higher critical thinking tendency. Empowering critical thinking can directly affect patients’ conditions. Given the major role of emotional intelligence in critical thinking, teaching nurses such skills could result in better performance and improving the quality of nursing care.

  

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Background & Aim: Pressure ulcers are a common complication in patients hospitalized in intensive care units. This complication continues to be a major problem in all health care systems and reflects the quality of nursing care in hospitals. The aim of this study was to evaluate the correlation between nurses’ knowledge and quality of nursing care for prevention of pressure ulcers in intensive care units.

Methods & Materials: This was a descriptive correlational study on a purposive sample of 92 nurses employed in intensive care units of four hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2014. Data were collected through a questionnaire containing demographic and occupational information, the Pieper’s nursing knowledge questionnaire, and a checklist to assess the quality of nursing care for prevention of pressure ulcers. Descriptive and inferential statistics (independent t-test and Pearson’s correlation) were used to analyze data on SPSS software v. 21. The level of significance was considered at P≤0.05.

Results: The study results showed that the average score of nurses’ knowledge of pressure ulcers prevention was a total of 75.7±6.9. The quality of nursing care in more than half of cases (54.3%) was relatively favorable. There was no significant correlation between nurses’ knowledge and the quality of nursing care for pressure ulcers (P=0.86, r=0.01).

Conclusion: In addition to inadequate knowledge of pressure ulcers prevention, the nurses did not fully implement what they knew in clinical practices. Therefore, a more accurate evaluation is recommended in this regard.

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Background & Aim: Diagnosis of cancer can cause emotional problems such as stress, anxiety, depression and incompatibility with the disease in the patient and his/her family, leading to adverse consequences in the improvement process and an increase in the complications of the disease. Considering the importance of this topic, the study was conducted to investigate the effect of Roy’s adaptation model-based care plan on the severity of depression, anxiety and stress in patients with colorectal cancer hospitalized in the treatment and educational centers of Urmia.
Methods & Materials: In this randomized clinical trial study, 36 patients with colorectal cancer (at the third or fourth stage of disease) hospitalized in the treatment and educational centers of Urmia were selected by a convenience sampling and were assigned to the intervention group or control group in 2016. Data collection tools were a form for assessing the Roy’s adaptation model and the depression, anxiety, and stress scale (DASS-21). The Roy’s adaptation model-based care plan was administered to the intervention group. Data analysis was performed using the SPSS software version 18 and t test and Chi-square test.
Results: The study results showed before the intervention, the mean scores of depression, anxiety and stress were 12.7±4.5, 13.9±4.8, 16.4±4.7 for the control group and were 15.7±4.5, 13.0±4.6, 12.6±4.2 for the intervention group, respectively. There was no statistically significant difference between the two groups (P<0.05). However, after the intervention, the mean scores of the studied variables increased in the control group (13.7±4.8, 13.93±4.9, 17.16±4.4) and decreased in the intervention group (10.46±3.1, 11.00±3.4, 13.8±5.2). There was a significant difference between the two groups (P<0.05).
Conclusion: Due to the severity of depression, anxiety, and stress among cancer patients, more cost-effective and non-pharmacological methods such as the Roy’s adaptation model, can be useful to control these complications and create a less stressful environment for these patients.
Clinical trial registry: IRCT20160220026662N5
 

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Background & Aim: Epilepsy is the most common chronic neurological disease after headache. About half of the patients with epilepsy do not properly adhere to medication regimens, which leads to a lack of control over seizures, increased treatment costs, and even increased mortality rate in these patients. The aim of this study was to determine the effect of telephone education on medication adherence in patients with epilepsy.
Methods & Materials: In this quasi-experimental study, 60 patients referred to neurology clinic of Valiasr Hospital in Zanjan in 2019 were selected by the convenience sampling method, and were randomly divided into either control or experimental groups. The Morisky drug adherence Questionnaire was used for data collection. At the beginning of the study and after completing the questionnaires, a face-to-face training session was held for the study participants. Then, telephone education was performed for the experimental group for two months and no intervention for the control group. Two months after the intervention, all the patients completed the questionnaire again. Finally, the collected data were analyzed through the SPSS software version 25 using descriptive (mean and standard deviation) and inferential statistics (Chi-square, Fisher's exact test, independent t-test and paired t-test).
Results: Before the intervention, there was no statistically significant difference between the two groups in terms of individual characteristics and medication adherence scores (P<0.05); But two months after the intervention, a statistically significant difference was observed in the mean score of medication adherence between the two control and experimental groups so that the patients in the experimental group had higher scores of medication adherence (P<0.001).
Conclusion: The results of this study showed the usefulness of using the telephone education method in improving the medication adherence of patients with epilepsy. Therefore, it is recommended that this method be used in the training program for these patients. In addition, further studies are needed on the comparison of the effectiveness of telephone education with other methods of telemedicine such as cyberspace and online education.
 

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Background & Aim: In recent years, women's experience of disrespect and misconduct during childbirth has been raised as a significant problem around the world. This study aimed to determine the prevalence of disrespectful maternity care and its associated factors.
Methods & Materials: This is a cross-sectional study conducted in 2019 on 357 mothers who gave birth at hospitals affiliated to TUMS. The data collection tool included socio-demographic characteristics form, and the disrespectful maternity care questionnaire, measuring various domains of abuse. The questionnaire was completed by interviewing mothers. Data was analyzed using descriptive tests, Chi-square test and multivariate logistic regression through the SPSS software version 24.
Results: All participants reported at least one form of disrespect, of which “not allowing for mobility, fluid and companion” was the most prevalent (99.7%) and “stigma and discrimination” was the least prevalent (4.5%). Statistical analysis showed a significant relationship between older age, ethnic minority, primiparity, higher socioeconomic status, delivery time (night, day) and a history of illness with more experience of different forms of disrespect.
Conclusion: This study confirmed a relatively high prevalence of disrespectful maternity care in hospitals based on international standards, which requires serious and prompt attention of top-level managers to take action to eliminate or limit this type of behavior.
 

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Background & Aim: Cultural competence is one of the main components of health care. Attention to cultural competence is essential to reduce healthcare inequalities and identify potential for improving healthcare delivery. The aim of this study was to investigate cultural competence and its related factors in health care providers working in comprehensive health centers affiliated with Tehran University of Medical Sciences (TUMS).
Methods & Materials: In this descriptive, cross-sectional study, 250 health care providers working in health centers affiliated with TUMS were selected using the convenience sampling method in 2020. The demographic characteristics form and the cultural competence scale for health workers (CCSN) were used to collect the data. Data were analyzed using descriptive and inferential statistical tests (t-test and ANOVA) through the SPSS software version 16 at a significance level of 0.05.
Results: The mean total score of cultural competence in health care providers was 162.66±28.41 (range: 33-231). According to the findings, the mean score of cultural competence for all dimensions was desirable. The mean score of cultural competence had a statistically significant relationship with intra-ethnic marriage (P>0.005) and work experience (P=0.012) while no statistically significant difference was observed with other demographic variables.
Conclusion: The study results showed that cultural competence in health care providers was at the desirable level. These results may be useful for managers and planners in the development and management of human resources and quality assurance of health services delivery.

 

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Background & Aim: Cancer is a disease that affects the quality of life of the patient, and palliative care is a solution that can improve it. However, home palliative care program has not developed in most countries of the world. The aim of this study is to improve a home palliative care program for cancer patients.
Methods & Materials: This research is an action research study that was conducted through quantitative and qualitative approaches in Tabriz over 2018-2020. Eighteen home care nurses were selected for interviews using purposive sampling in order to identify the care needs of cancer patients and the barriers to palliative care at home. In addition, a questionnaire to determine the attitude and knowledge was distributed among 60 home care nurses before and after the action stage. The qualitative data were analyzed using conventional content analysis method, and the SPSS software version 14 was used to analyze the quantitative data.
Results: The care needs of cancer patients were determined in five categories and barriers to palliative care in three categories. Cancer patients have physical, psychological, educational, financial and spiritual needs, and barriers to palliative care include poor instruction, families' desperation, and unprofessional caregivers. In the quantitative phase, nurses had average knowledge and negative attitude towards palliative care. Training through virtual space improved the knowledge and attitude of nurses, and the paired t-test showed that the mean score of nurses' knowledge after the action stage was significant.
Conclusion: according to the findings, to improve palliative care at home, the physical, psychological, educational, financial and spiritual needs of cancer patients should be considered. Removing barriers to palliative care including developing guidelines, supporting the families of cancer patients and training special nurses for palliative care at home can improve care in these patients.

 

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Background & Aim: In women experiencing intimate partner violence, resilience can serve as a protective factor against the worsening of psychological problems. Acceptance and Commitment Therapy has emerged as a potential means to enhance resilience in these individuals. The aim of this study is to determine the effect of Acceptance and Commitment Therapy on the resilience of women experiencing spousal abuse.
Methods & Materials: This is a quasi-experimental study. A total of 80 women experiencing spousal abuse were selected through quota sampling from the women referring to the health houses affiliated to the Mashhad ol-Kube health center in Arak, Iran between 2020 and 2021. The participants were then divided into intervention and control groups using the block randomization method. The intervention group received the Acceptance and Commitment Therapy in eight sessions, lasting 90 minutes each, once a week. The data collection tools included a questionnaire on personal and health characteristics, the Revised Conflict Tactics Scale, and the Connor‐Davidson Resilience Scale. The Resilience Scale was completed by both groups one week and five weeks after the intervention. The data were analyzed through the SPSS software version 23 using descriptive statistics, independent t-test, Chi-square test, Fisher’s exact test, and two-way repeated measures ANOVA. A significance level of P<0.05 was used to determine statistical significance.
Results: The mean and standard deviation of the resilience score for the intervention group increased from 59.21±13.29 before the intervention to 64.31±11.27 and 72.34±10.49 in the post-test and follow-up periods. For the control group, these figures were 52.47±17.2, 51.94±14.72, and 52.47±15.3, respectively. Based on the results of the two-way repeated measures ANOVA, there was a statistically significant difference in the mean score of resilience between the intervention and control groups at the three time points examined (P<0.001).
Conclusion: The implementation of Acceptance and Commitment Therapy can significantly improve the resilience of women experiencing spousal abuse. This intervention holds great potential for being incorporated into mental health improvement programs specifically designed for women who have experienced spousal abuse.

 

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Background & Aim: Knee osteoarthritis as a common chronic illness leading to disability, imposes numerous challenges on individuals in terms of daily living and self-care. Therefore, the implementation of tele-rehabilitation nursing interventions that foster patients' internal health locus of control and enhance the development of self-care behaviors may be useful. This study aimed to determine the effect of tele-nursing rehabilitation on the health locus of control in patients with knee osteoarthritis.
Methods & Materials: In this randomized clinical trial study, a total of 34 patients with knee osteoarthritis referred to the rehabilitation clinics affiliated with Shiraz University of Medical Sciences in 2022 were enrolled. The intervention group participated in an 8-session tele-rehabilitation nursing program, while the control group received standard routine care. The Multidimensional Health Locus of Control scale was administered to both groups on three separate occasions. The data were subjected to descriptive and inferential statistical analyses using SPSS software version 26.
Results: According to the results from a two-way repeated measures analysis of variance (ANOVA), a statistically significant difference was observed solely in the trend of changes in the mean score of internal belief between the two groups and over the study time period (P<0.001). Specifically, the scores of the intervention group exhibited a significant increase over time, surpassing those of the control group.
Conclusion: The implementation of tele-rehabilitation nursing care, which emphasizes patient responsibility for their internal health locus of control can improve self-care. Therefore, it is recommended that nurses employ this approach in managing additional chronic conditions.
Clinical trial registry: IRCT20220216054038N1

 

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Background & Aim: The coping strategies employed by women in facing violence can influence the frequency and intensity of violence or related stress. Life skills training may serve as a way for improving these coping strategies. This study aims to determine the effect of life skills group counseling, using a cognitive-behavioral approach, on the coping strategies of abused women.
Methods & Materials: This quasi-experimental study involved 120 abused women who attended health centers affiliated to Arak University of Medical Sciences in 2022. Participants were assigned to an intervention group or a control group (60 people each). The intervention group participated in eight group counseling sessions focused on life skills training through a cognitive-behavioral approach. Data were collected using a demographic questionnaire, the Conflict Tactics Scale, and the Ways of Coping Questionnaire. Coping strategies were assessed at the end of the intervention and again 12 weeks later. Descriptive and inferential statistical analyses were conducted to analyze the data.
Results: The intervention led to a significant increase in mean scores for the subscales “distancing” (P<0.001), “planning” (P<0.001), “seeking social support” (P=0.002), and “problem-solving” (P<0.001) in the intervention group compared to the control group. Conversely, there was a significant reduction in the mean score for the “wishful thinking” subscale (P<0.001). The most substantial effect of the intervention was observed in the “planning” subscale, while the “seeking social support” subscale exhibited the least effect. Specifically, the mean±standard deviation scores for the “planning” subscale in the intervention group were 8.95±3.61 pre-test and 14.82±2.40 post-test. For the “seeking social support” subscale, the scores were 5.28±3.21 pre-test and 7.03±1.77 post-test.
Conclusion: Life skills group counseling, utilizing a cognitive-behavioral approach, significantly increased the adoption of coping strategies, such as distancing, planning, seeking social support, and problem-solving, while reducing reliance on wishful thinking among abused women. Therefore, this method can serve as a means to promote coping strategies for abused women.

 

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Background & Aim: Gastrointestinal ostomy surgery changes the normal digestive function of patients. Insufficient knowledge and skills regarding ostomy care can lead to physical, psychological, and social complications. The present study aimed to determine the effect of a pre-operative education program on ostomy self-efficacy in patients undergoing ostomy surgery.
Methods & Materials: This randomized clinical trial included patients scheduled for colostomy or ileostomy surgery at hospitals affiliated with Shahid Beheshti University of Medical Sciences during 2022-2023. Participants were randomly assigned to two groups: the intervention group (41 patients) and the control group (44 patients). The control group received only routine education before discharge, while the intervention group participated in the pre-operative education program. The modified ostomy self-efficacy questionnaire was administered to patients before the intervention and one month post-surgery. Data were analyzed using descriptive and inferential statistics in SPSS software version 20.
Results: One month after surgery, the ostomy self-efficacy scores were significantly higher in the intervention group compared to the control group (P<0.001). Furthermore, within the intervention group, the post-intervention ostomy self-efficacy scores were significantly greater than pre-intervention scores (P<0.001). Additionally, the length of hospitalization following surgery was significantly shorter in the intervention group than in the control group (P=0.007).
Conclusion: The results showed that pre-operative education enhances ostomy self-efficacy and reduces the length of hospitalization. Therefore, implementing pre-operative education on ostomy care for patients undergoing ostomy surgery is strongly recommended.
Clinical trial registry: IRCT20220731055588N1

 

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Background & Aim: Violence against women is associated with adverse outcomes. Resilience can be associated with reducing the amount of harm experienced by abused women. The solution-focused approach has been considered as an intervention to promote resilience. This study aimed to determine the effect of short-term solution-focused group counseling on the resilience of women experiencing spousal abuse.
Methods & Materials: In this randomized clinical trial, 60 women experiencing spousal abuse were selected through multistage sampling from health centers affiliated with Arak University of Medical Sciences in Arak, Iran in 2024 and were divided into intervention and control groups using the block randomization method (30 people in each group). For the intervention group, six group counseling sessions with a solution-focused approach were conducted. The control group received no intervention. Data were collected using the Personal and Health Characteristics Questionnaire, the Revised Conflict Tactics Scale, and the Connor-Davidson Resilience Scale before the intervention. The Resilience Scale was then completed again by both groups at the end of the intervention, four weeks, and 12 weeks after the end of the intervention. Data were analyzed using SPSS software version 25 with descriptive and inferential statistics. P<0.05 was considered statistically significant.
Results: The mean and standard deviation of the resilience score for the intervention group increased from 34.64±8.91 before the intervention to 63.03±6.30, 71.78±4.78, and 75.25±10.52 in the post-test and first and second follow-up periods. For the control group, these values were 33.66±8.65, 35.30±7.31, 38.83±6.39, and 40.50±5.99, respectively. Based on the results of two-way repeated measures ANOVA, there was a statistically significant difference in the mean resilience score between the two groups and across the four time points examined (P<0.001).
Conclusion: The implementation of short-term solution-focused group counseling can improve the resilience of women experiencing spousal abuse. Therefore, this intervention can be used in mental health promotion programs for women who have experienced spousal abuse.
Clinical trial registry: IRCT20240704062329N1