---

To study and determine the educational needs of nurses after graduation in order to make them further capable, aims at promotion of their occupational standards and betterment of this profession. By means of this study we can identify their needs and make necessary planning to reduce the resultant shortcommings and problems. The present research is a descriptive and analytical study conducted to survey the educational needs of nurses regarding non-pharmacological methods of controlling chronic pans in patients at medical surgical wards of the hospitals of Tehran University Medical of Sciences. A total of 119 nurses working at one of these wards participated in this research. The tool for gathering the information was a three-part questionnaire. The first part deal with individual particulars, the second part was about questions regarding the feeling needs of nurses an the third part was about questions regarding the educational needs of nurses. The findings showed: As for the feeling needs, nurses needed training , as for the level of educational needs regarding the concept of pain (69.7%), characteristics of chronic pains (52.9%), guided imagery method (50.4%) of nurses were in need of a high level of training and regarding the progressive muscle relaxation (68.9%) of nurses were in need of a medium level of training. The results revealed the connection between some individual particulars with the level of educational need, to the extent the age, clinical work experience, work experience in medical and surgical ward and the type of ward affected the level of educational need, and by using the Pearson Coefficient a meaningful statistical difference appeared, in other words, as the years of service increases , the level of knowledge decrease and the educational needs rise up.

---

One of man's fundamental needs is communication. Nurses within their specialty sense this need in their relationship with their patients, even though in some cases with physical impediments e.g. the placing of bypass tubes, this relationship is endangered. This study is a quasi experimental research, whose main aim is to compare the effects of two types of communication methods on anxiety and satisfaction in patients after cardiac and bypass surgery having intubation, warded at chosen hospitals affiliated to the Tehran University of Medical Sciences. According to the specific criteria, 90 patients were randomly selected by divided into two groups (experimental and control). The researchers met all patients the day before the surgery explained the reason and use of the picture chart for the experimental group and the routine communication methods for the control group. Therefore on the day of surgery communication was established with both groups with their own particular method. Data collection was done through a questionnaire consisting of: 1) demographic specification and clinical history, 2) Spielburger's questionnaire for obvious anxiety and 3) visual analogue scale (10cm) for patient satisfaction evaluation which is undertaken the day after surgery and after extubation. The results of the χ² test and the Fisher's exact test showed significant statistical differences between the two groups concerning the level of the patient's anxiety and satisfaction. The use of the picture chart for the experimental group, decreased patient's anxiety resulting from speech disability and increased their satisfaction with their communication with nurses as compared to the control group. Considering the beneficial results from using picture charts in establishing communication with patients, nurses with the help of devices, must try to create better relationships with intubated patients in the post-surgery period and provide them with more desirable services.

---

Children are the biggest national investment that a society can make. With increased child population so too have their problems increased, amongst which are the increased incidence of street children, which as a result has endangered their health. This research is a descriptive and cross sectional study towards determining the effective factors on the self-concept of street children aged 6-12 years who were referred to the Khajouye Kermani culture house of Tehran in 1380. In this regard, 140 street children between the ages of 6-12 were chosen. The method was a 4-part questionnaire which included personal, family and societal information and questions related to the self- concept of the children. The data was collected by interviews with the children. In accordance with the average and the deviation criteria achieved, the level of self-concept was divided into four groups, extremely negative, negative, positive and extremely positive. The results showed that half of the subjects (50%) had very negative concepts of themselves and only 2.2% of them had a very positive self- concept levels. Therefore the street children had a very low self- concept level. Also as concerns the factors affecting self- concept was also a meaningful relationship between self- concept and some factors such as gender, education, level of income, duration of work, level of happiness within the family, counseling, reaction to the child's mistakes, having necessities for the home, adequate nutrition and clothing, having street friends before work (P<0.05). Therefore street children are at risk as regards their mental and physical development because they suffer from low self- concept levels and require special attention. Because of the vast responsibilities nurses can play an important role to improve of the health of these children.

---

Introduction: Stress is a complex and physiologic phenomenon that sometimes can be a source of problem. If an individual could not cope with stress, it would be a threat to physical and psychological health. Inclination to cope with stress is a positive way which helps one to improve his/her health.

Materials and Methods: This research is a quasi-experimental study with the aim of determining the effect of education of methods of coping with stress on rate of stress among women working at Tehran University of Medical Sciences. After primary study, 138 cases were chosen through census sampling. The collection tool was Chaudron stress scale. The statistical tests included t test and 2. Data were analyzed by SPSS software.         

Results: The result showed that there was no significant difference between level of stress before and after education in domains of job stress (p=0.22), life health stress (p=0.53), personal life stress (p=0.44) and personality stress (p=0.1). Also the statistical result of X2 did not show significant correlation between variables such as type of school, age, duration of work, marital status, number of children, educational level and housing condition with job stress.

Conclusion: The result showed that work environment is an important source of stress for working women. It could have undesirable effects on physical and emotional health of women. It seems that short term education can not decrease the stress of women therefore it is necessary to organize different long-term education programs, consultation and other strategies to reduce stress.

---

Background & Aim: Epilepsy as the most important chronic neurological disease affects on child and his/her family therefore it can lead to occur some stresses in family particularly in parents. This study has been done to determine ideas of parents with epileptic children about stressors and their coping with this agent in those who come to the optional therapeutic centers in Tehran.

Methods & Materials: This is a descriptive-analytical research which 400 parents with epileptic children were selected based on aim. The method of collecting data was by questionnaire for literate persons and by interview for illiterates whose research tool was questionnaire. The questionnaire was prepared in three parts (demographic information’s, stressors questions, and coping questions for parents with epileptic children. The data was collected in one stage and analyzed with SPSS software. To analyze the data, descriptive and inferential statistical methods (t-test, analyze variance) have been used.

Results: Statistical analysis showed that there is significant differences in stress between parents (p=0.001). The most percentage (86%) of fathers in comparison mothers (81.9%) have moderate level of stress and least percentage (5.4%) fathers and (4.4%) of mothers have low level of stress. The level of stress in parents showed significant correlation with personal variables. Most percentage (69%) of fathers and mothers (66.1%) have low-moderate level of coping and it has significant correlation with some personal variables. The analyze variance test showed that there was significant and converse relationship between stress and coping in parents with epileptic children and increasing stress lead to decrease coping. Conclusion: The results of this study have been shown that the stress in father of epileptic children is more that mothers however there is no significant differences in the level of coping.

---

Background & Objective: High levels of assertiveness and low levels of anxiety are important factors that result in suitable communication. They also increase intellectual abilities, abstract thought, power & autonomy, and personal well-being among nursing and midwifery students. The aim of this study was to determine the relationship between assertiveness and anxiety among midwifery and nursing students.

Methods & Materials: In this correlational, cross-sectional study, 173 nursing students (68 males & 105 females) were recruited using census and rational methods. Seventy seven midwifery students were also recruited using census method. Data were collected using a self-report tool including "personal information form", "Trait Spilberger Anxiety", and "Assertion Inventory" (AI) of Gambrill & Richey. Data were analyzed using descriptive and inferential statistical methods.

Results: Results showed that more than half of the nursing and midwifery students (59.5% and 59.7%, respectively) had moderate assertiveness. Also, 43.3% and 36.4% of them had moderate and high levels of anxiety. Pearson correlation test revealed that assertiveness and anxiety had negative correlations in nursing (r=-0.51, P<0.001) and midwifery (r=-0.449, P<0.001) students. Some demographic variables had significant correlations with assertiveness and anxiety among the students.

Conclusion: Regarding the relationship between assertiveness and anxiety and their effect on mental health, as well as educational and occupational functions of the students, more attention is needed to pay to theses issues. Also, it seems that appropriate interventions should be planned to increase assertiveness and to decrease anxiety among the students.

 

---

Background & Aim: Hospital infections are still one of the main causes of death. These infections may be transferred from one patient to another or through medical devices. The prevalence of hospital-acquired infection is 6%-12%. This rate increases to about 65% in some underdeveloped countries. The goal of this study was to compare the efficacy of Isopropyl alcohol and Ethanol in disinfection in pediatrics ward and neonatal intensive care unit.

Methods & Materials: In this trial, 116 specimens were collected from medical devices before and after disinfecting with Isopropyl alcohol and Ethanol. In order to assess the exact effect of these two disinfectants, some of the medical devices were exposed directly to microorganism colonies and then were disinfected using Isopropyl alcohol or Ethanol. Samples were cultured on Petri dishes.

Results: The results of cultured specimens before disinfection showed that some microorganisms such as Staphylococcus, Escherichia-Coli (E. coli), Pseudomonas, and Enterobacter were grown on medical devices. After disinfection, only two microorganisms grew (staphylococcus and Escherichia-Coli) on devices that were disinfected with Ethanol and there were no growth on the devices that were disinfected with Isopropyl alcohol.

Conclusion: The results of the study showed that the Isopropyl Alcohol is more effective in disinfecting than the Ethanol. Since the Ethanol needs more time and specific procedures to act, it should be better to use disinfectants like Isopropyl Alcohol that acts faster and simpler.

 

---

Background & Aim: Unhealthy snacks consumption has an important role in childhood obesity. The aim of this study was to evaluate the effect of an educational intervention for mothers on the consumption of healthy snacks in children aged 1-5 years using social cognitive theory.

Methods & Materials: This quasi-experimental study was (IRCT2013062912456N2) conducted on 126 mothers who had children 1-5 years old in 2013. The mothers were selected from Hamadan health centers and divided into two groups of intervention and control. The intervention consisted of four sessions, a booklet, a short video, and 6 written messages. The constructs of SCT and food consumption frequency were assessed at baseline, 10 days after the last session and 2-months after the intervention. The data were analyzed by Chi-square test, independent t-test, repeated measures and covariance analysis using SPSS software version 16.

Results: At baseline, the two groups were similar in the demographic characteristics, the constructs of SCT, and unhealthy snacks consumption frequency (P>0.05). Considering that the interaction effects of group and time in the repeated measurement analysis of variance were significant, the means of two groups were compared at each stage using independent t test and significant differences between the two groups were observed at two stages after the intervention.

Conclusion: This intervention had a positive effect on the consumption of healthy snacks. Therefore, SCT and the implemented procedure could be used to develop interventions to modify snack consumption patterns in children.

---

Background & Aim: Mother’s intense fear of and anxiety about labor pain lead to muscle contractions. Intense muscle contractions especially uterine contractions interfere with the normal process of labor. So, this study aimed to investigate the effect of salvia aroma on reducing the women’s anxiety level during labor.

Methods & Materials: The present study was a two-group randomized clinical trial (IRCT2016042727633N1) conducted in 2015 on 160 pregnant women laboring in Motazedi Hospital in Kermanshah. The subjects were randomly assigned into two groups. Prior to the intervention, the Spielberger’s State-Trait Anxiety Inventory (STAI) was completed by both groups and the anxiety scores were determined. In the intervention group, immediately after the onset of the active phase of labor, a gauze impregnated with three drops of the salvia essence was attached to the samples’ collars and repeated every half an hour. In the control group, a placebo was administered in a similar way. After the intervention, anxiety was measured at a cervical dilation of 5-7 cm. The chi-square test, Fisher test, Kolmogorov-Smirnov test, Wilcoxon and Mann-Whitney tests were employed to analyze the data.

Results: The mean score for anxiety was similar in the two groups prior to the intervention (P=0.15). However, after the intervention the mean score for anxiety was lower in the aromatherapy group (39.86±10.39) than in the control group (64.25±7.41) (P<0.001).

Conclusion: The findings suggested that the level of labor anxiety was reduced using aromatherapy with salvia essence. Accordingly, the use of salvia essence aroma is recommended for reducing anxiety labor.

---

Background & Aim: Infectious diseases represent a significant health concern within human communities. Considering the importance of pregnancy, the present study was conducted with the aim of exploring the health behaviors exhibited by pregnant women during the COVID-19 pandemic.
Methods & Materials: This qualitative study employed the conventional content analysis approach to examine a cohort of 16 pregnant women in 2021. The research was conducted within the health centers of Ilam, employing the purposeful sampling technique and unstructured interviews to collect the data. Simultaneous to the data collection, conventional content analysis was employed to analyze the data. MAXQDA version 10 software was utilized for data management purposes.
Results: The participants had a mean age of 30 years, while the average gestational age was 30.38 weeks. Through analysis, three main themes and eight categories were derived from the collected data. The main themes identified were as follows: 1- self-care practices for disease prevention, 2-  the adverse effects of the pandemic on pregnancy, and 3- changes in the healthcare system.
Conclusion: The results of the present study highlight the emergence of a novel form of self-care among pregnant women as a consequence of the COVID-19 pandemic. The adverse effects of the pandemic, such as quarantine measures, were associated with the development of negative ruminations within pregnant women. Following the quarantine restrictions, significant modifications were observed in the ways through which women sought health-related information and engaged in daily activities. Moreover, alterations were made to care policies. Paying attention to the comprehensive health needs of pregnant women, including both physical and mental health, is imperative within the context of pandemic-related health services.

 

---

Background & Aim: The main care need of patients with myocardial infarction (MI) is continuous care, presenting an important challenge in the field of nursing care. Therefore, This study aimed to evaluate the effect of nurse-led home-based cardiac rehabilitation on adherence to therapeutic regimens in patients with MI.
Methods & Materials: In this randomized clinical trial study, 80 eligible patients were selected through convenience sampling from selected hospitals affiliated with Tehran University of Medical Sciences in 2020-2021. Subsequently, they were randomly allocated to either the intervention or control groups. The control group received routine education upon hospital discharge, whereas the intervention group participated in a nurse-led cardiac rehabilitation program conducted both in-person at home and online, comprising four 90-minute sessions once a week, and were monitored for two months. Participants completed socio-demographic and treatment compliance questionnaires before and three months after the intervention. The collected data was analyzed using descriptive and inferential statistics with SPSS software version 20.
Results: Both groups were homogeneous in most demographic variables (P>0.05). The mean and standard deviation of treatment adherence scores before the intervention in the intervention and control groups were 70.82±7.91 and 67.94±11.20, respectively (P=0.015). After the intervention, these values changed to 75.10±6.13 and 68.77±10.12, respectively, with a statistically significant difference observed between the two groups (P<0.001).
Conclusion: The results revealed that nurse-led home-based cardiac rehabilitation was effective in enhancing treatment adherence. Therefore, it is suggested that cardiac rehabilitation care be consistently extended to the home setting.
Clinical trial registry: IRCT20201006048953N

 

---

Background & Aim: Medication non-adherence remains a significant problem in managing the global epidemic of hypertension. This study aimed to explore the factors affecting medication non-adherence from the perspectives of both patients with hypertension and healthcare providers in Mahan health centers, located in Kerman province.
Methods & Materials: This qualitative study utilized a conventional content analysis method within healthcare centers in Mahan city in 2022. A total of 29 participants were included in the study, selected through purposive sampling. Data were collected through in-depth semi-structured interviews, with all interviews being recorded, transcribed verbatim, and utilized as the primary data for analysis. The trustworthiness of data was evaluated in accordance with the criteria established by Guba and Lincoln criteria.
Results: Three categories of factors contributing to medication non-adherence among patients with hypertension were identified: ""nature of the disease and treatment," "individual and family factors," and "organizational factors." Factors related to the "nature of the disease and treatment" included the asymptomatic and chronic nature of hypertension as well as fatigue stemming from continuous drug use. "Individual and family factors" encompassed fear and internal doubts, a desire for non-pharmacological treatments, and inadequate family support. "Organizational factors" comprised high treatment costs and access to specialized services, insufficient support from treatment and care teams, and inadequate disease monitoring.
Conclusion: Various factors across a spectrum of influences contribute to medication non-adherence in patients with hypertension. It is crucial for healthcare providers to engage in consistent patient education regarding the nature of the condition and the importance of medication adherence to enhance compliance among patients.