---

In the many definitions that are accompanied with nursing, in addition to the scientific aspect, art has always been mentioned. Since Florence Nightingale introduced nursing as an art, several theorists have emphasized the aesthetic aspect of nursing in their literature. However, many experts believe that the word "art" has been accepted in nursing without deep thought and criticism.To judge the statement: "Nursing is an art", it seems that it is necessary to review the similarities and differences of "art" concept in nursing and other fields literature. Art has a complex and multidimensional meaning that is the backbone of many theories presented however, they each have their own strengths and weaknesses. Nursing has artistic properties but this characteristic is referred to as folk art and not to specific features of art. In comparing these theories with the concept of art used in nursing, it is essential to note that art in nursing refers to skills of nursing. In other words, nursing is not a kind of fine art.From the aesthetic perspective, nursing can be easily defined as a form of art however, we must put great importance in the inseparable words of "aesthetic" and "art of nursing". With such a connection, we are able to introduce and capture the true spirit of both art and nursing. In this article, we have reviewed the most important definitions and theories of art as a "specific term", and as "skill", where they have linked nursing to art. Moreover, we have discussed their similarities and differences.

---

Background & Aim: HIV/AIDS is a well-recognized global problem in the world, including Iran. It is necessary to comprehend and understand lived experience of HIV positive patients. The present study was designed and conducted to better understand the perspectives and experiences of HIV positive patients about the role of the spirituality and religious beliefs in their lives with HIV/AIDS.

Methods & Materials: This qualitative study was conducted using an interpretative phenomenological approach. In-depth, audio-taped and semi-structured interviews with 19 participants were conducted to collect data. Data were transcript. Observations were also recorded in comprehensive field notes. A hermeneutic approach was used to analyze the data, according to the method developed by Diekelmann.

Results: According to the findings, participants aged between 21 and 56 years of old at the time of contamination to the HIV. Almost half (47.4%) of the participants had CD4 counts under 200 cells/mm3. Analyzes of the data revealed three main themes: (a) Redefining religious values and communicating with God (b) Compensation and (c) Individual development. The themes included some sub-themes.

Conclusion: Experiencing difficult conditions in HIV positive individuals provide them with an opportunity to return to religious values, redefine themselves and give meaning to their lives, rather than fear or disappointment. Communicating with other HIV positive patients and religious experts are suggested as additional appropriate strategies.

---

  Background & Aim: Vascular events and strokes are third leading causes of death worldwide. There are also major causes of human morbidity. Various pharmacological and non-pharmacological treatments are proposed to patients with stroke. The purpose of this study was to determine effect of foot reflexology, as a non-pharmacological procedure, on systolic and diastolic blood pressures in patients with stroke.

  Methods & Materials: In this clinical trial, 68 patients with stroke were selected and divided randomly into two experiment (n=34) and control (n=34) groups. Each patient in the experiment group received foot reflexology for 30 minutes. Data were recorded in the demographic and blood pressure record form. Data were analyzed using t-tests and ANOVAs in the SPSS-20. 

  Results: There were no significant differences between the mean systolic and diastolic blood pressures of patients in experiment and control groups at baseline. The blood pressure was significantly reduced among the experiment group after receiving the foot reflexology (P<0.05). The mean systolic blood pressure was significantly reduced in the experiment group after 10 and 30 minutes of massage and the diastolic blood pressure was reduced significantly in all measured times (P<0.05).

  Conclusion: Results showed positive effects of foot reflexology on reducing blood pressure in patients with stroke. Foot reflexology should be recommended as a supplement treatment in patients with stroke.

  

---

  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: Increase in gastric residual volume and abdominal distention are important complications in patients with nasogastric tube feeding. This study aimed to determine the effect of local heat therapy on gastric residual volume and abdominal distention in patients with nasogastric tube feeding.
Methods & Materials: In this double-blind clinical trial, 64 patients with nasogastric tube feeding, were selected using the convenience sampling method according to the inclusion criteria and randomly assigned to either the experiment group or control group. For two groups, a hot pack was placed on the anterior abdominal region in two 23-minute sessions, about 1.5 hours after gavage. The temperature of the hot pack was 50°C for the experiment group and it was equal to the ambient temperature for the control group. The levels of patients’ abdominal distention and gastric residual volume were measured and compared half an hour before and 1.5 hours after gavage. Data collection tools were consisted of a demographic questionnaire and a data sheet for recording digestive function. Data were analyzed using the SPSS software version 16 through descriptive and inferential statistical tests. The p-value less than 0.05 was considered significant.
Results: According to the results, 46.9% of the patients were female and 53.1% were male. The age mean for the experiment and control groups were 12.5±72.5 and 15.3±7.8, respectively. There was no significant difference between the two groups in terms of demographic characteristics and disease-related information. Abdominal distention and gastric residual volume were similar in the two groups before the intervention, but significantly decreased in the experiment group after the intervention (P<0.05). However, there was no significant difference in the control group.
Conclusion: Local heat therapy reduces gastric residual volume and abdominal distention in patients with nasogastric tube feeding, and its application is suggested in further research.
Clinical trial registry: IRCT2015050822163N1
 

---

Background & Aim: Diabetic neuropathy is found in 50% of people with diabetes and refers to a group of diseases that affect all nerves such as peripheral, autonomic and spinal nerves. This study aimed to investigate the effect of topical heat therapy on clinical symptoms of peripheral neuropathy in patients with type 2 diabetes.
Methods & Materials: The present study was a randomized controlled clinical trial conducted on 52 patients with type 2 diabetes with peripheral neuropathy referred to the clinic of Allameh Behlool Gonabadi Hospital in 2018. The participants were randomly divided into two groups of intervention and placebo. The intervention group received heat therapy using a hot pack at 40 ° C twice a day for 20 minutes for a week. The control group received all routine care similar to the intervention group. A demographic information form and NSS questionnaire were used to collect the data through interview. Data were analyzed using the SPSS software version 23 at a significance level of less than 0.05.
Results: The mean scores of neuropathy symptoms before and after the intervention were 5.46±1.90 and 4.12±1.55 respectively for the intervention group, and 4.88±1.53 and 5.08±1.52 for the control group that no significant difference was observed between the both groups before the intervention (P=0.23), but there was a statistically significant difference after the intervention (P=0.03). Also, the comparison of the mean scores of two groups after the intervention showed a significant difference (P<0.001).
Conclusion: The findings showed that topical heat therapy can improve the clinical symptoms of peripheral neuropathy. Since this technique is easy to learn and inexpensive, it can be used to reduce treatment costs and drug side effects, as well as to improve patient self-care.
Clinical trial registry: IRCT20181015041354N1

 

---

Background & Aim: Patients undergoing hemodialysis commonly experience discomfort due to the insertion of needles into their arteriovenous fistula. The aim of the study was to compare the effect of EMLA ointment and lidocaine spray, along with the use of rhythmic breathing on the intensity of pain caused by the insertion of needles in the arteriovenous fistula among hemodialysis patients.
Methods & Materials: This study was a randomized clinical trial conducted on a total of 80 patients who were referred to Imam Khomeini and Golestan hospitals in Ahvaz in 2022. The numerical pain measurement scale was used as the data collection tool. The participants were selected using the convenience sampling method and then randomly allocated into two groups. In the EMLA ointment group (n=39), a total of 2 grams of EMLA ointment was applied to the target area 60 minutes before the hemodialysis procedure. In the lidocaine spray group with rhythmic breathing (n=41), 2 puffs of lidocaine spray were administered along with rhythmic breathing 5 minutes prior to needle insertion. The pain intensity was then measured and recorded. The collected data was analyzed using descriptive and inferential statistics in SPSS version 20, with a significance level set at 0.05.
Results: The group receiving EMLA ointment and the group receiving lidocaine spray, with rhythmic breathing had mean pain scores of 1.95±1.09 and 2.12±1.10, respectively. Although the mean pain score in the EMLA ointment group was lower than that in the lidocaine spray group with rhythmic breathing, the difference was not statistically significant (P=0.479).
Conclusion: The findings of this study indicate that both EMLA ointment and lidocaine spray, along with the use of rhythmic breathing, have comparable efficacy in reducing pain among hemodialysis patients. Therefore, considering the patient's condition, the utilization of either of these methods is recommended.
Clinical trial registry: IRCT20220512054826N1

 

---

Background & Aim: Clinical competence may influence the level of compassion fatigue experienced by nursing staff. This study aimed to determine the relationship between clinical competence and compassion fatigue among emergency department nurses.
Methods & Materials: This descriptive-analytical study was conducted among nurses working in the emergency departments of teaching hospitals in Urmia in 2024. A total of 120 nurses were randomly selected for participation. Data collection was performed using three questionnaires: a socio-demographic characteristics questionnaire, Leo’s Clinical Competence Questionnaire, and Figley's Professional Quality of Life Scale. Data analysis was performed using the Chi-square test and Pearson correlation coefficient with SPSS version 23.
Results: The results showed a significant inverse relationship between clinical competence and compassion fatigue (r=-0.45; P<0.05). The mean score of clinical competence among participants was 201.13±0.54. The average scores for compassion fatigue, compassion satisfaction, and secondary traumatic stress were 27.73±8.54, 38.73±1.81, and 28.45±4.82, respectively.
Conclusion: The results suggest that higher levels of clinical competence are associated with lower levels of compassion fatigue among emergency nurses. To mitigate compassion fatigue, nursing administrators and policymakers should consider implementing targeted strategies, such as comprehensive training, ongoing in-service education, and staffing with experienced and specialized nurses, thereby fostering a supportive work environment that reduces compassion fatigue.