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Background & Aim: Privacy is one of basic rights of the patients. Privacy becomes important for the adolescents when they hospitalize in an unfamiliar environment. This study aimed to compare the perceptions of inpatient adolescents with nurses on the observance of privacy and its importance.

Methods & Materials: In this cross-sectional study, 175 nurses and a convenience sample of 180 inpatient adolescents who had met the inclusion criteria were recruited to the study. Data was gathered using a questionnaire. Man-whitney u and kruskal-wallis statistical tests were used to analyze the data.

Results: The results showed that there was significant differences between nurses&apos and inpatient adolescents` perceptions on the observance of privacy and its importance (man-whitney u, P<0.001). The most important priority regarding the privacy from nurses&apos point of view was "covering the unnecessary parts of the body while caring" whilst it was "providing a pleasant decorated environment, telephone, toilet and bath in room, and hospitalization in a room with peers" from the adolescents&apos point of view. The most observed case about privacy from the nurses&apos point of view was "taking immediate action to help the teenagers if necessary" whilst, from the adolescents view, it was "calling them with their favorite names".

Conclusion: The mean perceptions of nurses were higher than the adolescences toward observance of privacy and its importance. The results can guide nurses to improve quality of care for this group.

 

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Background & Objective: Assessment of mental health is one of the most important aspects of assessing health status. Entering to the university is a challenging life event for young adults because students encounter with changes in social communication, expectations and roles. As a result, they are susceptible for experiencing stress and anxiety that could affect their functions. The aim of this study was to determine the mental health status and related stressors among Hamadan Medical Sciences University Students.

Methods & Materials: In this cross-sectional study, 180 medical sciences&apos students were selected using stratified sampling method. Data were collected using the Stressor questionnaire and the SCL90. Data were analyzed by SPSS.

Results: The study showed that 57.1 percent of the students were female. The ages ranged 18-22. Most of the students (94.8 percent) were single. Most of the students had no mental disorders (66.1%). Mild and moderate mental disorders were 29.4& and 4.4%, respectively. Mean of mental health score was 72.99 (±46.02). Mental health status was correlated with marital status, concerns about family, changes in religious activities, concerns about the future, working in the hospitals, problems with friends, sexual problems, and the number of experienced stressors (P<0.05).

Conclusion: Experiencing stressors threatens students&apos mental health status and provide a potential cause for mental disorders.

 

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Background & Aim: Pain is an unpleasant experience related to potential or actual tissue damage. Distraction is an effective technique to control pain. This study aimed to examine the effect of pressing a small soft ball during intravenous catheter insertion on pain related behavioral responses of children.

Methods & Materials: A randomized clinical trial study was conducted in surgical ward of the Qods hospital in Qazvin, Iran in 2010. Sixty children aged 4-6 were selected through a simple randomized sampling method. The children were allocated into two equal intervention and control groups. Data were collected using the FLACC scale. In the intervention group, children were asked to press a soft ball during IV catheter insertion. The researcher marked the FLACC during the procedure. In the control group, no distraction was made during the IV catheter placement. The data were analyzed using descriptive statistics, independent-sample t-test, Chi square at P<0.05.

Results: There was no significant difference between the two groups in terms of demographic variables including gender, birth order, race, age and type of disease. In the intervention group, none of the children experienced severe pain during IV catheter insertion and 63.3% of the children had moderate pain. In the control group, 50.0% of children had moderate pain and 23.3% of them experienced severe pain during IV catheter insertion. There was a significant difference in perceived pain between the children of two groups (P<0.001).

Conclusion: Distraction is an effective, non-expensive, and easy-to-access technique to control and reduce pain in children during IV catheter placement. This study showed that distraction through pressing a soft ball was effective in reducing the behavioral responses of pain in children who underwent IV catheter placement.

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Background & Aim: The challenges that patients face after intestinal ostomy surgery can lead to impaired adjustment and self-efficacy. There is evidence suggesting these variables have reciprocal effects on each other. Therefore, the present study aimed to determine the correlation between adjustment and self-efficacy in patients with intestinal ostomy.

Methods & Materials: This descriptive correlational study was conducted on 76 patients with intestinal ostomy hospitalized in hospitals affiliated to Mashhad University of Medical Sciences using convenience sampling method in 2015. Research instruments were comprised of the demographic and disease information questionnaire, the Stoma Self-efficacy Scale, and the Ostomy Adjustment Inventory. The SPSS software v.19 using descriptive and inferential statistics was used to analyze the data.

Results: The results of Pearson correlation test showed a significant and positive linear correlation between the mean score of self-efficacy and the dimensions of adjustment: acceptance (P<0.001, r=0.518), anxious preoccupation (P<0.001, r=0.438), social engagement (p<0.001, r=0.488), and anger (P<0.001, r=0.384). Moreover, multiple regression analysis indicated that the dimensions of social engagement and acceptance have a significant and positive linear correlation with self-efficacy in patients with intestinal ostomy.

Conclusion: The results revealed that the dimensions of social engagement and acceptance of ostomy were the most important factors in relation to self-efficacy. Therefore, in order to care for patients with intestinal ostomy especially in the early months after surgery, it was recommended to help patients adjust themselves to the physical appearance of ostomy and maintain their social engagement, by designing and implementing appropriate educational and supportive interventions.

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Background & Aim: Pedestrians are the most vulnerable road users. In many cases, pedestrian-vehicle crashes are often the result of their risky road crossing behaviors. So, this qualitative study aimed to explore the reasons for risky road crossing behaviors among young people.

Methods & Materials: The current study was designed as a qualitative content analysis. Twelve males and females who had a car-accident were purposefully selected with maximum variation sampling. Data were collected and analyzed by semi-structured individual interviews.

Results: Conformity with the masses including “conformity with peers and conformity with the public space of society”, and anomie emerged as the most important social reasons for young pedestrian’s risky road crossing behaviors.

Conclusion: According to the results of this study, young pedestrian’s risky road crossing behaviors are affected by conformity with the masses and peers and as well as anomie so that risky behaviors have been commonplace and inevitable and a part of their lifestyle.

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Background & Aim: Randomized controlled trials often suffer from two major problems, i.e., noncompliance and missing outcomes. One potential solution to this problem is using the intention-to-treat (ITT) analysis approach. Therefore, the aim of this study was to review the concept of ITT and the most important issues related to it in practice since RCT researchers utilize it as a guide in order to improve the quality of RCT studies.

Methods & Materials: A review study was performed using available resources and comprehensive analysis. For this purpose, we searched the relevant articles in databases including Ovid/Medline, SCOPUS, Web of Science, Google scholar and Magiran. The key words that were used included randomized clinical trials, randomized controlled trials, intention-to-treat analysis, per-protocol analysis, ITT, as-treated.

Results: The advantages of ITT, the critique of ITT, the alternatives of ITT and their limitations, missing data and their management in clinical trial studies were discussed in this paper.

Conclusion: ITT approach, due to its adherence to the principles of randomization, protects clinical trials from confounding and bias and therefore leads to the generation of the highest quality scientific evidence in the clinical research field. ITT should be considered a strategy at all stages of research, including the design of study, implementation and data analysis, and it should not be considered only a statistical approach.

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Background & Aim: Spiritual care along with other nursing interventions balance body and soul. This study aimed to determine the effect of spiritual care on death anxiety in hemodialysis patients with end-stage of renal disease.
Methods & Materials: A clinical trial (IRCT2016308226961N1) was performed in Hamadan’s Shahid Beheshti and Besat hospitals in 2016. A total of 60 hemodialysis patients with end-stage of renal disease were randomly assigned into two groups of intervention (30 patients) and control (30 patients). In the intervention group, the spiritual care program consisted of protective care, supporting the patient’s rituals and using the support systems, was performed in hemodialysis ward at the patient’s bedside. The control group only received routine nursing care. The Templar’s death anxiety questionnaire was completed by both groups before and after the intervention. Data were analyzed by descriptive and inferential statistics using the SPSS software version 16.
Results: The average score for death anxiety before the intervention between the intervention group (8.10±2.26) and control group (8.53±2.47) had not significant difference (P=0.482), while the average score for death anxiety after the intervention had statistically significant difference (P=0.004) between the intervention group with median value of 8.0 (6.00-8.25) and control group with median value of 9.0 (7.00-10.25), and the patients’ death anxiety reduced in the intervention group.
Conclusion: Spiritual care program reduced death anxiety in hemodialysis patients with end-stage of renal disease. Nurses can use spiritual care program to reduce patients’ death anxiety.
 

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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
 

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Background & Aim: Providing self-care education to patients and their family leads to improvement in the quality of life and increase in participation in self-care programs. The aim of this study was to compare the effect of education by peer and nurse on self-care in hemodialysis patients.
Methods & Materials: In this quasi-experimental study, 105 hemodialysis patients from three selected hospitals in three cities of Isfahan province (Zarinshahr, Falavarjan and Mobarakeh) were selected by the simple random sampling method from February 2016 to September 2016. Three centers were randomly assigned to three groups including education by peer, education by nurse and control. The individual face-to-face education was provided by the peer or the nurse to hemodialysis patients, and the control group only received routine education. Data gathering tool was the hemodialysis patients’ self-care questionnaire which was completed for three groups before and one month after education. The data were analyzed using the SPSS software version 18 through Chi-square test, paired t test, the analysis of variance and Tukey’s post-hoc test at the significance level of P<0.05.
Results: There were no significant differences between the three groups in age, duration of dialysis, gender, and level of education (P>0.05). The Tukey’s multiple comparisons tests showed that the effect of nurse intervention on self-care improvement was significantly more than peer intervention and the control group (P<0.001) and also the effect of peer intervention on self-care improvement was significantly more than the control group (P<0.001).
Conclusion: Education by a nurse is effective in the self-care behaviors of hemodialysis patients and will improve these behaviors. Also, using peer experiences has advantages for hemodialysis patients such as easy, low-cost and effective education, based on life experiences and lack of need for special equipment.
 

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Background & Aim: Osteoporosis is a silent and progressive disease that causes disability in people particularly women, with age and has irreversible consequences in their lives. This study aimed to determine the effect of an educational intervention program based on BASNEF model on prevention of osteoporosis among women referred to health centers in the south of Tehran.
Methods & Materials: This is a quasi-experimental study with two groups of intervention and control, performed on 162 women (81 in the intervention group and 81 in the control group) aged 30-49 years, referred to health centers in the south of Tehran in 2018. The data collection tool included demographic information, a researcher-made questionnaire based on BASNEF model constructs and another part of the questionnaire was Health Promotion Standards Questionnaire (HPLP II). Questionnaires were completed for both the intervention and control groups before and six months after the intervention. Data were analyzed by the SPSS software using chi-square, t-test, and paired t-test at a significance level of 0.05.
Results: The mean of women’s age in this study was 37.79±5.47 years old. There was no significant difference in demographic variables and BASNEF model constructs before the intervention (P>0.05). After the intervention, the mean score of BASNEF model constructs and the dimensions of health promoting behaviors significantly increased in the intervention group (P<0.001).
Conclusion: The study results revealed a positive effect of the BASNEF model-based educational program on health promoting behaviors regarding osteoporosis prevention among women. It is suggested to use this model as a successful model in educational interventions to prevent osteoporosis in women.
Clinical trial registry: IRCT20130213012460N15
 

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Background & Aim: Self-care education is one of the effective ways to improve the quality of life and health in patients with heart failure. The purpose of this study was to determine the effect of applying the specific situation theory on the quality of life in patients with heart failure.
Methods & Materials: In a clinical trial study, 80 patients with class 2 or 3 heart failure, referred to 12 Farvardin hospital in Kahnooj in 2018 were included. Data collection tool included a three-part questionnaire: demographic variables, Left Ventricular Dysfunction Scale to assess patients' quality of life, and Self-care Heart Failure Index. The questionnaires were completed at the first visit and three months after follow-up. Data was analyzed using independent and paired t-test, ANOVA, Pearson correlation through the SPSS software version 20.
Results: Before the intervention, there was no significant difference in the scores of quality of life and self-care between the two groups. After the intervention, the mean score of quality of life and self-care dimensions increased (P<0.001). Regarding self-care after the intervention, the highest score was related to self-care confidence with mean and standard deviation of 21.43 and 3.30 respectively, and the lowest score was related to self-care management with mean and standard deviation of 17.45 and 5.5 (P<0.001).
Conclusion: Paying attention to the dimensions of self-care based on a specific situation theory can lead to a better understanding of these patients’ problems and appropriate planning, and in turn improvement of the quality of life. Since in this study, most of the participants were illiterate, using visual teaching aids, adjusting the schedule according to the patient's conditions and readiness, and if necessary, family involvement can have positive results. It appears necessary to consider the underlying factors in the implementation of self-care programs, especially in people with lower levels of education and income.
Clinical trial registry: IRCT20141109019862N6
 

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Background & Aim: Reduced quality of life and self-efficacy are among problems of mothers of children with chronic diseases. This study aimed to determine the effect of empowerment based on the Gibson model on self-efficacy and quality of life in the mothers of children with thalassemia.
Methods & Materials: In this quasi-experimental study, the study population were the mothers of children with thalassemia referred to rare disease clinics in Rafsanjan and Kerman in 2020. The sample size was 25. Mothers were selected by the convenience sampling method and divided into two groups. In the intervention group, mothers participated in five training sessions based on the Gibson model, and in the control group, mothers received routine care. Data collection tools included the Zhang’s self-efficacy questionnaire and the SF-36 which were completed before the intervention and six weeks after the intervention. Data were analyzed using chi-square test, independent and paired t-test via the SPSS software version 18.
Results: Before the intervention, the mean score of self-efficacy (P=0.31) and quality of life (P=0.47) were not statistically significant between the groups, but after the intervention, the mean score of self-efficacy in the intervention group (68.81±9.36) was significantly higher than that of in the control group (44.69±6.87) (P<0.001). But there was no significant difference in the mean score of quality of life between the intervention (60.64±10.08) and control (56.19±11.41) groups after the intervention (P=0.19).
Conclusion: According to the results, empowerment based on the Gibson model is an appropriate method for improving self-efficacy in the mothers of children with thalassemia. However, further studies are recommended about its effect on quality of life.

 

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Background & Aim: Considering the use of aromatherapy as a non-pharmacological method of pain control and a scarcity of studies in this area, the aim of the study was to compare the effect of breast milk odor and Rosa damascena aroma on pain and crying due to blood sampling in neonates.
Methods & Materials: In this cross over clinical trial study, 40 neonates hospitalized in the NICU of Ali Ibn Abitalib hospital in Rafsanjan were divided into two groups (breast milk odor and Rosa damascena aroma). In the first step, tree minutes before blood sampling until its completion, cotton soaked in 2 cc of breast milk was placed at a distance of three centimeters from the neonate’s nose. In the next step, cotton soaked with two drops of rose essential oil was used, similar to the method of breast milk. For the second sample, the order of interventions was changed. The pain was calculated with the NIPS instrument and crying with a stopwatch by a person who was blinded to the groups. The data were analyzed by STATA software version 14.
Results: The mean score of pain for two periods in two groups were 3.75±2.33 and 4.30±1.70 respectively, and there was no significant difference between the two groups (P=0.415). The mean score of crying for two periods in two groups were 16.98±16.21 and 15.03±9.99 respectively, and there was no significant difference between the two groups (P=0.650).
Conclusion: The breast milk odor and rose damascena aroma have a similar effect in reducing the pain of neonates. Thus, according to the conditions, each of these methods can be used.
Clinical trial registry: IRCT20150713023190N11

 

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Background & Aim: With advancements in treatment and an increase in the prevalence of diseases, the number of patients requiring mechanical ventilation in intensive care units (ICUs) continues to rise each year. The ABCDE bundle is a multi-component, evidence-based approach designed to improve patient outcomes in the ICU. This study aimed to determine the effect of the ABCDE bundle on the risk of pressure ulcers, deep vein thrombosis and delirium in patients undergoing mechanical ventilation.
Methods & Materials: This randomized, single-blind clinical trial was conducted between September 2021 and January 2022. The sample included 100 patients undergoing mechanical ventilation in the ICU department of Imam Reza Hospital in Mashhad, who were randomly assigned to either the intervention or control group using block randomization. The intervention group received the ABCDE bundle over a period of 7 days. The control group received routine care. The criteria for assessing complications included the risk of pressure ulcers and deep vein thrombosis (DVT), evaluated at the end of the intervention and on days 0, 1, 3, 5, and 7. The study utilized several assessment tools: the COMHON Index for pressure ulcers, the Wells Deep Vein Thrombosis Scale, and the Delirium Evaluation Tool in the Intensive Care Unit (CAM-ICU). Data analysis was performed using SPSS software version 20, employing chi-square, Mann-Whitney, and independent t-tests.
Results: A decrease in the average pressure ulcer risk score was observed in the intervention group on day seven (P<0.05). In this group, the incidence of delirium fell decreased from 64.4% to 13.3% (P<0.05), indicating a statistically significant reduction. Additionally, the risk score for deep vein thrombosis in the control group significantly increased on day seven compared to the intervention group (P<0.05).
Conclusion: The use of the ABCDE bundle significantly reduces the risk of pressure ulcers, deep vein thrombosis, and delirium in patients undergoing mechanical ventilation and represents an effective strategy that can be implemented by nurses and other trained healthcare professionals.
Clinical trial registry: IRCT20190625044000N1

 

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Background & Aim: Post-treatment follow-up care for breast cancer is crucial in reducing mortality rates, minimizing treatment costs, and enhancing patients' quality of life. This study aims to identify the psychosocial factors affecting post-treatment follow-up care in breast cancer patients.
Methods & Materials: This descriptive-analytical study involved 180 breast cancer patients from Babol and other cities of western Mazandaran province. Participants were selected using a simple random sampling method between 2021 and 2022. Data were collected through personal information questionnaires, the Zigmond Hospital Anxiety and Depression Scale, the Psychological Distress Thermometer, the Fear of Cancer Recurrence Scale, and a post-treatment breast cancer follow-up care checklist. Data analysis was conducted using SPSS version 18, employing descriptive and inferential statistical methods.
Results: The average age of the participants was 51.49 years (SD=12.01). The mean and standard deviation scores for depression, anxiety, and psychological distress were 6.16±2.71, 10.70±4.13, and 5.98±2.54, respectively. The results showed that individuals with higher levels of anxiety, depression, psychological distress, and fear of recurrence are less likely to engage in follow-up care (P<0.05).
Conclusion: The results suggest that health policymakers should address the psychological challenges faced by breast cancer patients. Specifically, providing insurance coverage for the screening and treatment of mental health problems may improve mental well-being, encourage self-care behaviors, and promote overall health.

 

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Background & Aim: The evidence shows that prehypertension is related to an increased risk of cardiovascular complications. This study aims to determine the effect of lavender inhalation aromatherapy on systolic and diastolic blood pressure (SBP & DBP) in people with prehypertension in Isfahan.
Methods & Materials: This two-group quasi-experimental study was conducted in 2023, involving 70 prehypertensive patients selected from comprehensive health service centers in Isfahan. Participants were selected through convenience sampling and were randomly assigned to either the experimental or control group. The intervention included inhalation aromatherapy using two drops of 100% pure lavender essential oil for 20 minutes in a single session. Blood pressure measurements were taken before, immediately after, and 10 and 20 minutes post-intervention under standardized conditions. The control group received routine health center training. Data analysis was performed using SPSS software version 26, employing descriptive and inferential statistics, including repeated measures analysis of variance (RMA) and analysis of covariance (ANCOVA), with a significance level set at 0.05.
Results: The results of the RMA indicated a significant interaction between time and group for both SBP (P<0.001) and DBP (P<0.001). Also, the intergroup effect for SBP was significant (P<0.001), demonstrating that the intervention group experienced a significantly greater reduction in average SBP compared to the control group. Intra-group analysis revealed a significant decrease in SBP before and after aromatherapy in the intervention group (P<0.001). In contrast, the control group did not show a significant change (P=0.068). Unlike SBP, the intergroup analysis for DBP did not yield significant results (P=0.141).
Conclusion: Considering the rising trend of high blood pressure and its widespread complications, along with the positive effects of aromatherapy as a cost-effective and accessible intervention, lavender inhalation aromatherapy is recommended as a complementary treatment strategy in conjunction with other methods.