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Background & Aim: Falling is a serious problem in the elderly population, with many physical, psychological, social and economic consequences. The fear of falling has been considered an activity limiting condition, which can lead to a reduction in the quality of life of the elderly people. The study aimed to determine effect of fall care behaviors training on fear of falling among the elderly people referred to health centers.
Methods & Materials: This double-blind randomized clinical trial was carried out on 110 elderly people referred to health centers in Ardabil in 2017. Participants were selected by the multi-stage random sampling and divided into intervention and control groups by random allocation. The data collection tools were consisted of demographic questionnaire, Mini-Mental State Examination: MMSE, Abbreviated Mental Test Score: AMTS and Fall efficacy scale international: FES-I. Data were analyzed using statistical tests on the SPSS software version 22.
Results: The mean and standard deviation of fear of falling in the intervention and control groups before the intervention were 33.91±12.03 and 31.22±14.76, respectively (P=0.29). Three months after the intervention, the mean and standard deviation of fear of falling were 22.32±4.45 and 30.85±15.03 (P<0.001). Also, ANCOVA was used for controlling pre-test scores and level of education compared to the post-test scores in the two groups (P<0.001).
Conclusion: The results showed that education on fall care behaviors reduces the fear of falling in the elderly people. Therefore, this education is suggested to be considered in the self-care program for elderly people.
Clinical trial registry: IRCT20180205038618N1
 

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Background & Aim: Prostate cancer is one of the most common causes of death from cancers in men. The aim of this study was to determine the effect of an educational intervention based on protection motivation theory (PMT) on prostate cancer prevention behaviors in men 50 to 75 years old.
Methods & Materials: This study is a randomized controlled trial with control group conducted on 100 men referred to the retirement centers in Hamadan in 2017. Participants were selected by convenience sampling method and randomly divided into two experimental (n=50) and control groups (n=50). A self-administered questionnaire including demographic information and PMT constructs was completed by the participants. Educational intervention was administered over four sessions in the experimental group. The questionnaires were completed by the two groups two months after the intervention. Data were analyzed by the SPSS software version 16 using independent t-test, Chi-square and the analysis of covariance.
Results: Before the intervention, the two groups were homogeneous in terms of demographic characteristics and the PMT constructs (perceived rewards, perceived response cost, fear, perceived self-efficacy), and cancer screening behavior. The intervention could improve all the PMT constructs in the experimental group compared to the control group. Also, Prostate-Specific Antigen (PSA) screening behavior was 38(76) in the experimental group and 16(32) in the control group (P<0.001).
Conclusion: The results of the study showed that protection motivation theory can be used as a framework for designing educational programs to perform prostate cancer screening.
 

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Background & Aim: Iranian elderly population is increasing, and a high percentage of this population suffers from diabetes. Considering that the concept of active aging has not been developed in the context of chronic diseases that are common in aging (such as diabetes), the purpose of this study was to analyze the concept of active aging in diabetic elderly patients based on a hybrid model.
Methods & Materials: Three stages of hybrid model (theoretical, field work and final analysis) were used in this study. In the theoretical phase, 35 articles (published in 1990-2016) from scientific databases were analyzed. In the field work phase, 10 participants were interviewed and then a qualitative content analysis was performed. In the final phase, the findings of the two previous stages were merged and analyzed.
Results: The definition of active aging for the diabetic elderly is a comprehensive, dynamic, multidimensional and culturally dependent process that requires a sense of satisfaction, happiness, well-being, security, and physical and mental health, that is achieved through social participation, providence of appropriate health and employment services, awareness of diabetes, and financial, emotional, family, and governmental support that brings subjective and objective benefits to the international, national and individual levels (such as adaptation to illness, a sense of worth and self-esteem). In order to achieve this, paying attention to the whole life span from childhood to old age is needed.
Conclusion: The results of this study suggest that health, security, satisfaction, participation, access to health services, support and knowledge of diabetes play an important role in activating elderly people with diabetes in Iran.
 

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Background & Aim: Some women, throughout their life cycle, experience unintended pregnancy and had to decide on continuing or terminating it. Although the decision-making process always recurs, few studies have so far shed light on this complex, and context-based process. The aim of the present study was to explore Iranian women’s decision-making process to abort or continue an unintended pregnancy.
Methods & Materials: This was a qualitative study using grounded theory approach. Data were collected through unstructured, in-depth interviews with 29 participants in Tabriz from March 2016 to May 2017. The participants were selected through the purposeful sampling method and data collection were continued until reaching data saturation. Data analysis was carried out concurrently with the data collection, using the MAXQDA software version 10.
Results: Data analysis gave rise to four axial categories: “perceived threats”, “resistance mixed with indecision”, “values and supportive resources”, as well as “acceptance and confirmation of decision”. This means that the decision-making process among women with unintended pregnancy initially starts with a perceived threat as a main concern leading to their resistance towards accepting such a pregnancy, then exposure to threats arising from abortion can cause indecision and uncertainty in practicing abortion. In this respect, given the social support, women affected by religious values make efforts to choose the procedure with the least harm and threats and maximum acceptability and confirmability. “Confirmation of decision” is as well the outcome of the interactive process of decision-making.
Conclusion: What can differentiate the theory of decision-making on abortion or continuation of an unintended pregnancy from the general theories of decision-making is its sociocultural confirmability. Social acceptance of abortion and childbearing in line with moral evaluation of fetal development directs the confirmability process of decision-making about unintended pregnancy.
 

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Background & Aim: Each conceptual model in nursing seeks to explain the fundamental concepts of the discipline based on the culture and values of societies in order to be used more effectively, as a scientific and practical framework. The aim of this study was to design a conceptual model of care during infancy from Islam perspective.
Methods & Materials: The conceptual model used in this study was designed based on the model synthesis process developed by Walker and Avant (2011) in three steps in 2017: Concept development and specifying focal concept, statement synthesis and identifying connections between concepts, systematic organization of connections and building an integrated representation. Qur’an and its interpretation books and Shiite Hadith books were of the resources.
Results: As a result of developing the concept of “care during infancy in terms of Islam”, six concepts were synthesized. “Infant as a person with dignity and potential for excellence” was as the focal concept. Other concepts included “basic principles of nurturing”, “parents as the representatives of God in nurturing infants”, “mother as the symbol of creativity and divinity of God”, “healthy and competent child”, and “God as the merciful nurturer”. After defining connections between the concepts, the structure of conceptual model was presented.
Conclusion: Infant care is nurturing a human being who has dignity, rights and potential for excellence from the time of conception. From Islam perspective, God is the eternal nurturer who nurtures the infant with kindness and dignity, and mother is the manifestation of the creativity and divinity of God. The infant is entrusted to the parents by God, and parents are the agents of God who lay the groundwork for nurturing the infant. In order to have a healthy and competent child, observing the principles of nurturing is important. “Care during infancy from Islam perspective” model is a conceptual model that can be used for the development of applied theories, clinical practice, research, and education of nursing students and the community.
 

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Background & Aim: Traumatic brain injury management focuses on the prevention and treatment of secondary brain injuries. The aim of this study was to adapt a clinical guideline (CG) for nursing care of secondary brain injuries in adults.
Methods & Materials: This study was carried out through a multi-stage evolutionary study at Isfahan University of Medical Sciences in 2017. Based on the opinions of experts using AGREE tool, the quality of 8 out of 13 CGs for the treatment and care of head injuries was assessed as optimal. These were used in drafting the adaptive CG. In addition, 12 CGs, 13 articles and 5 books were used to complete the recommendations of the mentioned guideline. The CG draft was evaluated using the Delphi method and the panel of experts. Finally, it was presented as an adaptive CG.
Results: The adaptive CG for nursing care of secondary brain injuries was developed in 158 recommendations and five sections; nursing care to prevent and manage the increased intracranial pressure, nursing care to maintain and increase cerebral blood pressure, nursing care to prevent and control seizures, nursing care to prevent and control brain infections, and nursing care to prevent and control secondary extracranial injuries.
Conclusion: The nursing staff of emergency and neurological wards and intensive care units can apply the recommendations of this clinical guideline to address some of the care needs of the injured patients and improve their health conditions.
 

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Background & Aim: Pre-hospital emergency staff, as the first responder group at the scene of emergencies and disasters, should be able to cope with, and maintain their physical and mental health. The aim of this study was to investigate the relationship between resilience and self-efficacy of pre-hospital emergency staff with their professional quality of life.
Methods & Materials: The present study is a cross-sectional, descriptive study that was conducted in 2019. A total of 200 pre-hospital emergency operational staff from Alborz province participated in the study using proportional and convenience sampling. Data collection tools were a demographic form and three standardized questionnaires including the emergency medical services resilience scale, the Schwartz and Jerusalem self-efficacy scale, and the Stamm professional quality of life scale. Data were analyzed through the SPSS software version 20 using descriptive statistics (mean and standard deviation) and analytical statistics (Spearman correlation, one-way ANOVA and linear regression) at the significance level of P less than 0.05.
Results: The mean and standard deviation of self-efficacy (29.67±5.82), resilience (123.14±17.07), compassion satisfaction (39.81±8.09), burnout (12.06±4.76), and secondary traumatic stress (23.61±7.27). There was a significant correlation between self-efficacy and three components of professional quality of life (P<0.05). Self-efficacy was positively related to compassion satisfaction and negatively related to burnout and secondary traumatic stress. Self-efficacy and resilience were also predictors of compassion satisfaction and burnout (P<0.05). The effect of self-efficacy and resilience on compassion satisfaction was positive. The results of stepwise multiple linear regression analysis showed that five components of resilience including self-management, stress outcomes, communication challenges, maintaining peace of mind and job motivation had an effect on compassion satisfaction (P<0.05). The effect of all resilience components on compassion satisfaction was positive.
Conclusion: Alborz pre-hospital emergency operational staff were at an acceptable level in terms of resilience, self-efficacy and professional quality of life.
 

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Background & Aim: Nurses' organizational loyalty to health systems plays an important role in expanding organizational performance. Investigating the role of factors such as citizenship behaviors and adaptive performance can be helpful in this regard. The aim of the present study was to investigate the relationship between citizenship behavior and adaptive performance with organizational loyalty in nurses.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2019 on 200 nurses working in Valiasr hospital affiliated to Shahrekord University of Medical Sciences in Borujen, and were selected by the random sampling method. A demographic information form, the Lee & Allen’s citizenship behavior questionnaire, the Charbonnier-Voirin and Roussel’s adaptive performance scale, and the Kumar and Shekhar’s organizational loyalty questionnaire were used to collect the data. The data was analyzed by descriptive and inferential statistical tests using the SPSS software version 16.
Results: The Pearson's correlation coefficient indicated a significant positive correlation between citizenship behavior and adaptive performance with organizational loyalty (P<0.05). Regression tests showed that citizenship behavior (ADJ.R²=0.199) and adaptive performance (ADJ.R²=0.131) significantly predicted organizational loyalty. All dimensions of citizenship behavior and some dimensions of adaptive performance such as creativity, learning efforts and job stress management can predict organizational loyalty in nurses. The average scores for citizenship behavior (66.85±18.26), adaptive performance (68.76±16.98) and organizational loyalty (120.67±24.09) were reported to be moderate.
Conclusion: Managers and planners should pay attention to factors such as creativity, stress management, and continuing education along with improving healthy working relationships and nurses’ participation, which can play an important role in expanding organizational loyalty through the development of citizenship behavior and adaptive performance.
 

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Background & Aim: Changes in hemodynamic parameters can indicate the health status of individuals, and treatment measures cause changes in hemodynamic parameters, and affect the treatment process of patients. Different ways of distraction can have different effects. The aim of this study was to determine the effect of music distraction and movie-watching on hemodynamic parameters of patients undergoing extracorporeal lithotripsy.
Methods & Materials: A quasi-experimental study with a three-group, before and after design was performed on 90 patients undergoing extracorporeal lithotripsy in the lithotripsy unit of Ayatollah Kashani hospital affiliated to Shahrekord University of Medical Sciences in 2018. Patients were selected using the convenience sampling method and randomly allocated into three groups. The intervention included visual and auditory distraction. Data was collected before and after the intervention using demographic characteristics questionnaire, calibrated mercury blood pressure monitor, and pulse oximeter. Descriptive statistical tests (mean and standard deviation, percentage, frequency) and inferential tests (paired t-test, Pearson correlation coefficient and analysis of variance) through the SPSS software version 16 were used to analyze the data.
Results: Analysis of variance showed that the mean scores of systolic and diastolic blood pressure, pulse rate and oxygen saturation in the auditory, visual and control groups were not significantly different before the intervention (P>0.05). Also, the mean scores of these variables in auditory, visual and control groups were not significantly different after the intervention (P>0.05). Paired t-test also showed the mean scores of pulse rate (P=0.133), systolic (P=0.159) and diastolic blood pressure (P=0.413), and oxygen saturation (P=0.083) did not have significant differences after the intervention compared to before the intervention between the groups.
Conclusion: According to the results, music and movie-watching did not have a significant effect on hemodynamic parameters of patients undergoing lithotripsy. Due to the lack of confirmatory studies, further research is needed on lithotripsy patients.
 

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Background & Aim: Due to the importance of breastfeeding in the health of premature infants, the present study was conducted with the aim of determining the effect of telephone counseling on the continuity and breastfeeding status of mothers with late preterm infants.
Methods & Materials: In this randomized controlled trial, 65 eligible mothers from Ahvaz in 2019-2020 were selected using the convenience sampling method and divided into two intervention and control groups using block randomization (with block sizes of 4). The routine care was provided for the control group. The intervention group received a daily telephone support counseling for 14 days after discharge. Data were collected using a questionnaire on the continuity of breastfeeding and breastfeeding status at the pre-counseling phase and then monthly up to four months after discharge. Data were analyzed using chi-square test, independent t-tests and Kaplan Meyer survival analysis at a significance level of 0.05 through the SPSS software version 16.
Results: According to Kaplan Meyer survival analysis, the rate of exclusive breastfeeding interruption in the control group was higher than that of in the intervention group (5 vs. 8) but it was not statistically significant. Improvement of breastfeeding status one month after discharge was significantly different between the two groups (P=0.048).
Conclusion: The results showed that telephone support counseling was effective in improving breastfeeding status up to the first month after discharge. Continuous telephone support counseling can be a good approach to improving breastfeeding and its continuity in the first month after discharge.
Clinical trial registry: IRCT20150731023423N13

 

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Background & Aim: Today, COVID-19 has become a serious threat to global health. Due to their certain conditions, hemodialysis patients are more at risk than others. Therefore, self-care in these patients is more necessary. We aimed to assess the self-care of hemodialysis patients against COVID-19 disease and the factors influencing self-care.
Methods & Materials: In this cross-sectional study, 219 patients referred to the dialysis ward of selected public hospitals in Lorestan province, were selected by the census method and examined. Patients' information was collected by a demographic questionnaire and a researcher-made questionnaire on self-care against COVID-19. Data were analyzed using the SPSS software version 22, with the significance level of 0.05.
Results: The mean score of self-care against COVID-19 in patients was 186.33, and most patients had a good level of self-care. There was a significant relationship between the self-care score and place of residence (P<0.001), and comorbidity (P=0.044). Among the multiple sources of information, there was a significant difference in the self-care score between cyberspace (P=0.047), and family and relatives (P<0.001). Also, comorbidity, urban residence, and academic education level significantly predicted self-care.
Conclusion: According to the results of this study, developing proper training programs is suggested considering the factors influencing self-care. Also, capacities such as cyberspace and patients' families should be used to make the training more effective.

 

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Background & Aim: Pressure ulcers pose a serious and anticipated challenge within the health system. The present study aimed to determine the incidence of pressure ulcer and associated factors among children and newborns.
Methods & Materials: In this cohort study a sample size of 1025 children aged 0 to 14 years hospitalized in two medical training centers affiliated with Kermanshah University of Medical Sciences, were included. The sampling method employed was convenience sampling, conducted between March and July 2022. The data collection tools utilized in this study included a demographic information questionnaire, the Glasgow Coma Scale, National Pressure Ulcer Counseling Association classification, and Braden Q Scale. The data was analyzed using both univariate and multivariate logistic regression analyses.
Results: The incidence rate of pressure ulcers was found to be 4.97% (51 people). In terms of severity, the majority of pressure ulcers were categorized as first grade, accounting for 82.14% (46 people), with the hand area being the most frequently affected site of ulceration, representing 35.71% (20 people). The factors exhibited a significantly higher relative risk of pressure ulcers in children and infants included consciousness level of less than 14 (RR=6.07, 2.90-12.73: 95%CI), hospitalization duration of more than five days (RR=1.08, 1.05-1.12: 95%CI), presence of respiratory problems (RR=2.17, 1.19-3.94: 95%CI), immobility (RR=6.46, 3.44-12.13: 95% CI), utilization of NCPAP mask (RR=1.11, 1.05-1.18: 95% CI), and pulse oximeter (RR=6.07, 1.03-1.10: 95% CI). In the multivariate analysis, hospitalization duration of more than five days (RR=4.89, 2.29-10.40: 95% CI, P<0.001) and immobility (RR=2.49, 1.29-6.29: 95% CI, P=0.01) were found to be significantly associated with an increased risk of pressure ulcers.
Conclusion: The incidence rate of pressure ulcers observed in the present study was relatively low, measuring below 5%. Notably, prolonged hospitalization duration and immobility were identified as the most important risk factors contributing to the development of pressure ulcers among children and infants. Moreover, the utilization of specific medical devices, especially angiocaths and NCPAP masks, as well as the presence of respiratory diseases emerged as additional significant factors associated with the occurrence of pressure ulcers.

 

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Background & Aim: Intramuscular injections represent a painful procedure for premature infants. This study aimed to compare the effects of pressure massage at Hegu point versus Kunlun–Taixi pressure points on pulse rate, arterial oxygen saturation, and crying duration following intramuscular injection of vitamin K in premature infants.
Methods & Materials: A randomized, single-blind clinical trial was conducted on 100 premature infants admitted to the neonatal intensive care unit between 2020 and 2021. Participants were selected through convenience sampling and then randomly assigned into four groups of 25 individuals each: Hegu point massage, Kunlun–Taixi points simultaneous massage, placebo and control. Prior to the vitamin K injection, the intervention groups received targeted pressure point massage, the placebo group received nasal tip massages, and the control group received standard care. Pulse rate, arterial oxygen saturation, and crying duration were recorded before, during and after the intramuscular injection using a pulse oximeter and chronometer. Data were analyzed using two-way repeated measures analysis of variance in SPSS software version 24.
Results: Significant differences were observed in average pulse rate (P=0.013) and average arterial oxygen saturation (P=0.028). The group receiving simultaneous massage at Kunlun–Taixi points exhibited the lowest mean pulse rates during (149.24±7.78) and after (144.16±8.64) the injection, as well as the highest mean arterial oxygen saturation percentages during (88.36±9.37) and after (88.04±8.33) the injection.
Conclusion: Simultaneous massage of Kunlun–Taixi pressure points reduced changes in pulse rate and arterial oxygen saturation induced by intramuscular injection in premature infants. It is recommended to use this simple and low-priced method to reduce the physiological responses to injection-related pain in premature newborns.
Clinical trial registry: IRCT20210630051743N1

 

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Background & Aim: Osteoporosis is a common condition in the elderly, contributing to fracture incidence and associated pain. This study aims to analyze trends in osteoporosis-related fractures within the elderly population from 2017 to 2021.
Methods & Materials: A descriptive cross-sectional study was conducted in 2024 involving 448 elderly people over 60 who experienced pelvic, hip, distal hand, or spinal injuries during 2017-2021 in Kashan. Data were extracted from the National Trauma Registry of Iran, including demographic information, injury severity, and frequency of fractures. The data were analyzed using analysis of variance and chi-square tests, with a significance level set at P<0.05.
Results: Among the 448 participants, 244 were female (54.5%), with an average age exceeding 75 years among those diagnosed with osteoporosis. The most common fracture types included hip and pelvic fractures, affecting 331 individuals (73.9%), followed by distal hand fractures in 71 individuals (15.8%), and spinal fractures in 65 individuals (14.5%). The average injury severity score increased from 8.43±2.80 in 2017 to 8.96±2.77 in 2021. No significant changes were observed in the age distribution of the elderly population during this period; however, the proportion of males increased by approximately 6%.
Conclusion: The study results indicate a rising trend in hip fractures among the elderly in Kashan. To reduce fracture incidence, it is recommended to implement proactive screening for osteoporosis risk factors in this population.

 

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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: Aging is often accompanied by a decline in cognitive and motor performance. Various interventions have been proposed to improve cognitive function and balance, with recent approaches focusing on cognitive-motor training methods. The purpose of this study was to determine the effectiveness of body percussion rhythmic exercises on the balance and cognitive flexibility of the elderly.
Methods & Materials: This clinical trial utilized a pre-test-post-test design with a control group. The study population comprised healthy male seniors from a neighborhood hall, a center for the elderly in Kashmir, during 2022-2023. A total of 60 elderly men, aged 60 to 75 years, were purposefully selected and randomly assigned to either an intervention group or a control group, with each consisting of 30 participants. Data were collected using the Sharpened-Romberg test, the Timed Up and Go test, and the Wisconsin Card Sorting Test. The intervention group participated in 36 sessions of rhythmic body percussion exercises based on the BAPNE method, while the control group continued with their regular daily activities. Data were analyzed using multivariate covariance analysis (MANCOVA) in SPSS version 19.
Results: The results showed that rhythmic body percussion exercises significantly enhanced static balance (F=232.31, ƞ²=0.83, P=0.004), dynamic balance (F=359.68, ƞ²=0.86, P=0.002), cognitive flexibility (the number of categories achieved) (F=11.45, ƞ²=0.16, P=0.001) and preservatives errors (F=108.77, ƞ ²=0.65, P=0.001) in the elderly.
Conclusion: The findings of this study showed that rhythmic body percussion exercises improve both balance and cognitive flexibility in the elderly. Therefore, these cognitive-motor exercises are recommended for the elderly population.
Clinical trial registry: IRCT20220704055369N1
 

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Background & Aim: Nurses’ attitudes towards death affect their caregiving practices. Spiritual intelligence, by promoting a deeper understanding of the meaning of life and death, may improve the nurses’ attitudes towards death. This study aimed to investigate the predictive role of spiritual intelligence on attitudes towards death and care for dying patients among intensive care unit (ICU) nurses.
Methods & Materials: This descriptive-analytical study was conducted in 2023 at Shiraz University of Medical Sciences, involving a sample of 200 ICU nurses. Data were collected using instruments, including demographic questionnaires, the Death Attitude Profile-Revised (DAPR), King’s Spiritual Intelligence Scale, and the End-of-Life Care Assessment Scale (EOLCAS). Data were analyzed using SPSS software version 16.
Results: Correlation analysis showed a statistically significant positive relationship between spiritual intelligence and both caring for dying patients (P<0.01, r=0.265) and attitudes towards death (P<0.001, r=0.360). Among the dimensions of spiritual intelligence, critical existential thinking emerged as a significant predictor of attitudes towards death (P<0.001, β=1.207) and evaluation of dying patient care (P<0.001, β=0.880).
Conclusion: The findings suggest that spiritual intelligence may play a vital role in shaping positive attitudes towards death and improving the quality of care for dying patients. It is recommended that nursing managers incorporate strategies to enhance spirituality in clinical practice to optimize end-of-life care.

 

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Background & Aim: Emotional disclosure has been associated with improvements in psychological well-being, immune function, and physical health. This study aimed to evaluate the effect of written emotional disclosure on health behaviors and loneliness among family caregivers of cancer patients.
Methods & Materials: This is an experimental study with a pretest–posttest design and a control group. Seventy family caregivers of cancer patients who scored high on the UCLA Loneliness Scale (Version 3) and low on the health behaviors scale for family caregivers of cancer patients were selected by convenience sampling and randomly assigned to Intervention or Control groups. The Intervention group engaged in written emotional disclosure by documenting their deepest and most acute feelings for 15–20 minutes per session, over four consecutive days. The Control group received no intervention. Post-intervention assessments were conducted in both groups. Data were analyzed using SPSS version 26. Comparative analyses included chi-square tests, independent samples t-tests, and paired t-tests.
Results: At baseline, there were no significant differences between groups in health behaviors or their components (P>0.05). Post-intervention, the Intervention group demonstrated significantly higher health behaviors scores and component scores than the Control group (P<0.001). Furthermore, the mean loneliness score in the Intervention group decreased significantly after the intervention (P<0.001).
Conclusion: Written emotional disclosure has a positive and significant effect on loneliness and health behaviors among family caregivers of cancer patients. Given its ease of learning, potential for unsupervised practice, and minimal need for therapist involvement, this method may be a practical adjunct in caregiver support programs.

 

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Background & Aim: Nurses need up-to-date professional knowledge to deliver high-quality performance. Since knowledge within healthcare organizations requires effective management, identifying the level and relationship between knowledge management and nursing performance can play an important role in bridging the gap between knowledge and practice. Therefore, this study aimed to determine the relationship between knowledge management factors and nursing performance among nurses.
Methods & Materials: This descriptive-analytical study was conducted in 2023 at Shahrekord University of Medical Sciences. A total of 200 nurses working at Valiasr Hospital in Borujen were selected through simple random sampling. Data were collected using a demographic questionnaire, the Choi Knowledge Management Standard Questionnaire, and the Ko Nursing Performance Questionnaire. Data analysis was performed using SPSS version 16, employing independent t-tests, one-way ANOVA, and linear regression.
Results: The mean and standard deviation of knowledge management factors were 98.55±15.8, and the mean and standard deviation of nursing performance were 105.74±25.7. Pearson’s correlation coefficient indicated a significant positive relationship between knowledge management factors and nursing performance (r=0.72, P<0.001). The coefficient of determination (R²=0.518) showed that approximately 52% of the variance in nursing performance could be predicted by knowledge management factors (P<0.05).
Conclusion: Training in the knowledge management process and emphasizing dimensions such as promoting a culture of knowledge sharing, improving nursing management systems with a focus on process enhancement, and fostering creative management approaches can enhance knowledge management and thereby improve nursing performance.

 

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Background & Aim: The nursing process provides a structured and evidence-based framework for delivering comprehensive, individualized, and high-quality care. As a fundamental component of healthcare systems, patient safety culture plays a pivotal role in ensuring the safety and well-being of patients. Given the importance of these two constructs, this study aimed to examine the relationship between nursing process competency and nurses' perception of patient safety culture.
Methods & Materials: This descriptive-correlational study was conducted in 2023 on 266 clinical nurses working in educational-treatment centers in Ardabil, Iran, using a stratified random sampling method. Data were collected using the Nursing Process Competency Questionnaire (NPCQ) and the Hospital Survey on Patient Safety Culture (HSOPSC). Data analysis was performed using SPSS version 26 through descriptive statistics and inferential tests.
Results: Among the participants, 177 nurses (66.5%) were female and 164 (61.7%) were married. Most nurses reported a good level of nursing process competency (175, 65.8%) and a moderate level of perceived patient safety culture (264, 99.3%). Marital status and employment status were significantly associated with both nursing process competency and patient safety culture (P<0.05). Additionally, a significant positive correlation was observed between nursing process competency and patient safety culture (r=0.315, P<0.001).
Conclusion: The results highlight the essential role of nursing process competency in fostering positive perceptions of patient safety culture. They also emphasize the importance of considering personal and employment-related factors when designing interventions. Policymakers are encouraged to develop integrated strategies that simultaneously enhance nursing process competency and strengthen patient safety culture to promote safer and higher-quality patient care.