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Background & Aim: Pain can detrimentally affect physical functioning, psychological well-being and social interaction. Various attitudinal factors may be associated with inadequate pain control. Hence, studies should be undertaken to gain a better understanding of association between pain control attitudes and use of analgesics and cancer pain intensity. This study aimed to determine relationship between pain control attitudes and use of analgesics and pain intensity in cancer patients with pain.

Methods & Materials: A descriptive cross-sectional study was conducted with 200 cancer patients who underwent chemotherapy or radiotherapy and experienced pain in previous 24 hours. The pain control attitudes, use of analgesics, worrisome about using analgesics and physical and psychological impacts of pain were measured using questionnaires. The cancer pain intensity was measured using the visual analogue scale. Validity and reliability of the instruments were evaluated. Data were analyzed using independent t-test and ANOVA.

Results: About 58% of patients agreed that they would wait before asking for help. Beside, the findings indicated that willing to tolerate pain and perceived control over pain were associated with the time and frequency of taking analgesic and pain intensity in previous 24 hours and last week. Also concerns about addiction to pain-relieving medications were related to the analgesic type and pain intensity within last week (P=0.03), and fear of injection was related to analgesic use and pain intensity within last week (P<0.001).

Conclusion: Many cancer patients had attitudes which could interfere with pain relieving. Suggestions are made for developing patient education programs, accessing effective cancer pain controls and decision making for cancer pain relief.

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Background & Aim: Pregnancy can conflict with sexual function that can be affected by physical and psychological changes during pregnancy. The aim of this study was to compare sexual functions between nulliparous and multiparous pregnant women referred to health centers in Eastern district of Guilan.

Methods & Materials: This cross-sectional study was carried out in Guilan during 2009-2010. We used convenient sampling method to select 554 pregnant women. Data were gathered using a questionnaire including demographic characteristics, sexual function and fear of harm to fetus. The SPSS-16 was used to analyze the data by the Mann-Whitney U and Generalized linear models. The level of significance was set at 5%.

Results: There was no significant difference between nulliparous and multiparous pregnant women regarding sexual function in the first and second trimesters of pregnancy (P=0.353, P=0.251). There were significant differences between nulliparous and multiparous pregnant women regarding sexual desire (P=0.002), arousal (P=0.01), orgasm (P=0.01), pain (P=0.02) and sexual function total score (P=0.016). There was significant difference between nulliparous and multiparous pregnant women regarding sexual function (P=0.008).

Conclusion: Sexual counseling and rehabilitation programs should be compiled as part of the comprehensive care of prenatal care especially for multiparous pregnant women.

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  Background & Aim: Falling is common among elderly due to changes in sensory–motor function. Falling causes physical, emotional and financial problems and decreases the quality of life in elderly. Since the causes of falling are multifactorial, multi-dimensional approaches should be considered to prevent it. This study aimed to investigate the effect of a multidimensional fall prevention program on the incidence of falling and quality of life among old people living in nursing homes.

  Methods & Materials: This before-after quasi-experimental study was conducted on 60 old people living in nursing homes who met the inclusion criteria. Multidimensional fall prevention program was focused on: 1- exercise (stretching, balance, and strength) 2-training classes for caregivers and elderly and 3-environmental modification. Data were collected before and six months after the intervention using demographic and illness form, fall frequency form and the LEIPAD questionnaire. Collected data were analyzed using the paired t-test, one-way ANOVA, Mann-Whitney and Wilcoxon tests in the SPSS-16 . 

  Results: Before and six months after the intervention, the mean frequencies of falling were 2.00 (±0.70) and 0.20 (±0.55), respectively. The mean scores of quality of life before and six months after the intervention w ere 56.48 (±10.45) and 77.43 (±10.45), respectively. Results indicated that there were statistically significant difference between the study participants before and six months after the intervention regarding falling frequency (P<0.001) and quality of life score (P<0.001).

  Conclusion: The multi-dimensional fall prevention program decreased the fall frequency and increased quality of life of participants. Health care providers, particularly nurses can use the prevention program to diminish falling incidence among elderly and improve their quality of life.

  

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  Background & Aim: Nurses’ hands are important channels of micro-organisms transmission and hospital acquired infections. This study aimed to investigate knowledge, beliefs and practices of nurses regarding hand hygiene .

  Methods & Materials: This was a cross-sectional study conducted in 2012. All nurses (n=282) working in three hospitals of Lorestan University of Medical Sciences participated in the study. Data were gathered using a demographic form, social desirability questionnaire, and hand hygiene knowledge, belief and practice questionnaire. Data were analyzed through descriptive and statistical tests (Independent t-test, ANOVA, Pearson Coefficient) in the SPSS-PC (v.21.0). The level of significance was set at below 0.05 . 

  Results: The mean scores of nurses’ hand hygiene knowledge, beliefs and practices were 4.6±2.00, 3.8±0.40, and 4.33±0.50, respectively. Nurses washed their hands after contact with patients more often in compare with prior to contact with patient. There was a statistically positive and significant correlation between nurses’ practice in required situations and nurses’ beliefs regarding hand hygiene .

  Conclusion: According to the results, nurses’ knowledge regarding hand hygiene was low and hand hygiene practice in required situations was undesirable. Many nurses had negative and false beliefs regarding hand hygiene. Based on these results, it is necessary to plan programs to increase nurses’ knowledge, belief and practice regarding hand hygiene .

  

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Background & Aim: Maternal request for caesarean section due to fear of normal vaginal delivery (NVD) is one of the main reasons for the high rate of caesarean section. This study aimed to compare the fear of NVD and type of delivery between two groups of pregnant women attended childbirth preparation classes (CPC) and women received routine prenatal care (RPC).

Methods & Materials: In this prospective cohort study, 202 Primigravid women attended healthcare centers for prenatal care services in the East of Guilan were selected using convenient sampling in 2013-2014. Fear of NVD was assessed using a childbirth attitude questionnaire at two stages (before attending CPC or receiving RPC, then at the third trimester of pregnancy). Both groups were followed up to the delivery time. Data were analyzed using inferential and descriptive statistics (Chi square, paired t-test, ANOVA, t-test) through SPSS v.16. P<0.05 was considered as significant.

Results: There was no significant difference (P=0.23) in the mean score of fear of NVD between two groups before attending CPC (35.59±8.78) and receiving RPC (37.08±9.08). The comparison of the mean score of fear of NVD between two groups at the third trimester of pregnancy showed a significant reduction (P<0.001) in the first group (32.30±8.31) than in the second group (37.29±9.55). A significant difference was also observed between two groups in the rate of NVD (P=0.002).

Conclusion: Results confirm the importance of CPC in decreasing fear of NVD and increasing the rate of NVD in primigravid women attended these classes. Therefore, women’s attendance at CPC is recommended to be encouraged.

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Background & Aim: Urinary incontinence is a common disorder in women. Pelvic floor muscle exercise is one of the effective treatment methods. Self-efficacy is considered an effective and strong predictor of willingness to perform and continue these exercises. In Iran, there is no appropriate tool for assessing self-efficacy. So this study was performed to determine the psychometric properties of the Broome scale in women with urinary incontinence.
Methods & Materials: A psychometric study of the Broome scale was conducted on women with urinary incontinence who referred to health centers affiliated to Tehran University of medical sciences in 2015.In this study, following processes were implemented: translation, back translation, face validity, content validity using CVR and CVI, reliability using Cronbach’s α coefficient, and construct validity using explanatory factor analysis.
Results: The face validity was confirmed through the modification of ambiguous items based on the patients’ views. Content validity (CVR= 0.8 and CVI= 0.8 to 0.9) and reliability (Cronbach’s α= 0.96) were also confirmed. Explanatory factor analysis showed two factors with eigen value more than 1 including pelvic floor exercise self-efficacy in usual and special situations. These factors explained 82.08 percent of the total variance.
Conclusion: The reliability and validity of the Broome scale were confirmed for using by Iranian women with urinary incontinence, and this scale can be used to measure these women's self-efficacy in performing pelvic floor exercises.
 

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Background & Aim: The healthy nutrition education is one of the most important priorities in all life periods, especially in childhood. The teaching method is also considered one of the important factors for the effectiveness of education. Therefore, the aim of this study was to compare the effect of lecture and role-playing methods on awareness of healthy nutrition in school-age children.
Methods & Materials: This quasi-experimental study was conducted on 60 primary school students in Gonabad city in 2017. Participants were selected by multistage random sampling and allocated into two groups of role-playing and lecture. Students' awareness was measured by a self-structured questionnaire before, immediately and one month after education. Data were analyzed using the SPSS software version 16 by descriptive and inferential statistics. A P-value less than 0.05 was considered significant.
Results: The mean score of awareness for the role-playing group before, immediately and one month after the intervention respectively was 10.77±2.55, 14.1±55.15 and 14.50±1.10 and for the lecture group respectively was 11.07±1.85, 13.72±1.43 and 11.47±2.84 (the score range: 0-16). There was a significant difference in the mean score of awareness before, immediately and one month after the intervention between the two groups (P<0.001), and in the role-playing group, the increase in awareness score was more than in the lecture group.
Conclusion: Considering the greater effect of role-playing method than lecture on healthy nutrition education in school-age children, it is suggested that more attractive, dynamic and effective methods such as role-playing, in accordance with educational behavioral goals, be used in school nutrition education programs. In addition to enhancing educational efficiency, this will make the effects of education and learning more sustainable for students.
 

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Background & Aim: Patients with heart failure experience some outcomes such as poor self-management, poor adherence to treatment and low quality of life. The aim of the current study was to evaluate the effect of self-management based discharge planning on treatment adherence in patients with heart failure.
Methods & Materials: In this quasi-experimental research, 80 patients with heart failure hospitalized in teaching hospitals in Zahedan in 2019-2020, were selected by convenience sampling and were randomly allocated into either intervention or control groups. The self-management-based discharge plan consisted of four educational sessions in hospital for the intervention group. In order to follow up, the first call was made 2-3 days after discharge. Then, the patients or their family caregivers were contacted weekly in the first month and twice a month in the second and third month. Data were collected by the treatment adherence questionnaire and were analyzed using independent sample t-test, Fisher exact test, Chi-square and repeated measures ANOVA by the SPSS software version 16.
Results: The two-way repeated measures analysis of variance showed a significant difference in the mean scores of treatment adherence over time (P<0.001) and in the intervention and control groups (P<0.001).
Conclusion: According to the findings, it is recommended that self-management-based discharge plan be employed in an integrated manner for patients with heart failure in medical wards.
 

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Background & Aim: Attempting to improve the quality is an important issue in the nursing service and care system. The COVID-19 pandemic has created great challenges for healthcare systems, especially for the intensive care units, which can affect the quality of nursing care provided to these patients. The aim of this study was to determine the quality of nursing care in nurses working in the intensive care unit of COVID-19.
Methods & Materials: In this descriptive-cross-sectional conducted in 2021-22, 142 nurses from Valiasr, Amir Kabir, Amir al-Momenin and Khansari hospitals affiliated to Arak University of Medical Sciences were selected by the census method. The Martins’ nursing care quality questionnaire (including 25 items in 7 domains) was completed by the participants. The SPSS software version 16 and independent t-tests, analysis of variance and the Pearson's correlation coefficient were used for the data analysis.
Results: The result showed that the mean score of the nursing care quality was 83.83±7.74, which was considered favorable due to being higher than the median score of the tool (62.5). Among the individual characteristics of nurses, the nursing care quality had a statistically significant relationship with the type of employment (P=0.003), age, work experience and work experience in the intensive care unit (P<0.001).
Conclusion: Considering the significant relationship of the nursing care quality with the type of employment, age and work experience, it is recommended that health managers take an effective step in formulating the necessary policies to improve the quality of nursing care by taking into account the experience of skilled nurses in intensive care units.

 

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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

 

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Background & Aim: Uncertainty is a multifaceted concept, inherently unavoidable, and can pose a significant obstacle to proper decision-making. In the nursing profession, which is marked by various challenges, nurses are expected to make precise and appropriate decisions. Confidence in decision-making is considered a vital element in the nursing profession. Given the ambiguities surrounding the concept of uncertainty, we aimed to conduct a concept analysis of uncertainty in nursing using the Walker and Avant’s approach.
Methods & Materials: This study is a concept analysis using the Walker and Avant’s approach to analyze the concept of uncertainty. Initially, a search was conducted on databases including Science Direct, SID, Medline, Iran Med, ProQuest, PubMed, and Scopus, using keywords such as uncertainty, nurse, and concept. A comprehensive review of articles published between 1990 and 2021 was then carried out, resulting in a total of 9 relevant articles.
Results: The literature review showed that uncertainty is an abstract and intricate concept that poses challenges in making informed decisions. In the context of nursing, uncertainty shares similarities with terms like confusion and doubt, while standing in contrast to concepts like self-confidence and assurance. The antecedents of uncertainty include the inability to make decisions and a lack of accountability. The consequence of uncertainty is the recognition of information needs, active pursuit of answers, and ultimately making informed and appropriate decisions.
Conclusion: The findings of this study indicate that nurses encounter uncertainty when they are unable to make independent decisions. As uncertainty in nursing decision-making directly affects patient care, managers and planners can take proactive measures to mitigate this issue. By promoting knowledge and awareness, fostering motivation, and encouraging continuous learning among nurses, the level of uncertainty can be reduced. This, in turn, will contribute to the improvement and enhancement of patients’ health outcomes.