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 .

  Background & Aim: Family caregivers play major role in caring for the patients with dementia. Meanwhile, they are at risks of various diseases. Caring for a person with Alzheimer’s disease carries a significant physical, socioeconomic and psychological burden. This study described the impact of cognitive-behavioral management on burden and problems borne by family caregivers of patients with Alzheimer's disease .

  Methods & Materials: This non-randomized controlled clinical trial was conducted on 70 family caregivers of patients with Alzheimer’s disease. The participants were subjected to experimental and control groups. The Zarit Burden Interview was used to assess the burden experienced by family caregivers of the patients. Data were then analyzed using inferential and descriptive statistical parameters (mean and SD) and paired sample t-test on the difference between the scores of pre-test and post-test . 

  Results: The mean level of caregivers’ burden as measured by ZBI was 44.56± 6.77 and 42.57±5.98, in experimental and control groups before intervention respectively. Caregivers’ burden score was 39.54±5.88 and 44.86±5.87, in experimental and control groups after intervention respectively. Results showed a significant decrease in the training group’s score (P<0.001) .

  Conclusion: Given the obtained results indicating the effectiveness of cognitive- behavioral management in reduction of caregivers’ burden, the present study can be helpful in achieving an effective solution to decrease stress among family caregivers of patients who suffer from Alzheimer's disease .

Ethnography is a qualitative research method in which researchers study various values, beliefs and cultural meanings in a group of people or society. Critical ethnography puts more emphasis on social groups and individuals' power, prestige, authority and status (1). In ethnographic studies, researchers employing inductive logic focus on interactions between people to discover the meaning embedded in culture. Critical approach attracts researchers’ attention towards individuals who play a minor role in social interactions (2). Madison quoting Thomas contends that critical ethnography is a classic ethnography with a political aim. The ethnographer not only explains the meanings of interaction in a specific context, but also strives to know how these meanings are described against the broad structure of power (3). Thus, critical ethnography involves all the fields in which interactions are influenced by power relations. Critical ethnography plays an essential role in health research and nursing, in particular. Most of the nurses are female and power relations are one of many factors that affect the complex doctor-nurse and nurse-patient interactions (4).

  Background & Aim: Psychological and social factors such as attachment styles may influence chronic diseases through self-care behaviors. This study was conducted to determine the relationship between attachment styles and self-care behaviors in patients with heart failure .

  Methods & Materials: In this correlational study, 180 patients with heart failure hospitalized in CCUs and Post CCUs of educational hospitals in Zahedan in 2014 were selected through convenience sampling. Data collection tools included the Experiences in Close Relationships-Revised (ECR-R) questionnaire and Self-Care of Heart Failure Index (SCHFIV6.2). Data were analyzed in the SPSS-20 using the descriptive statistics, independent T-Test, Pearson's correlation and regression analysis . 

  Results: The mean and standard deviation of self-care behaviors score of the group with secure attachment style (62.89 ± 12.66) was significantly higher than the group with insecure attachment style (40.43 ± 16.11) (P<0.05). Also, the regression model showed that the score of anxiety, attachment avoidance and age were as predictors of the self care scores in patients .

  Conclusion: Regarding the relationship between attachment styles and self-care behaviors and the low level of self-care in patients with insecure attachment style, psychological interventions should be considered through long-term treatment of chronic heart failure .

  Background & Aim: Approximately 75% of patients with cancer experience acute nausea and vomiting (24 hours after chemotherapy). The aim of this study was to determine the effect of auricular acupressure in relieving acute nausea and vomiting among women with breast cancer receiving chemotherapy .

  Methods & Materials: This study was a posttest only randomized clinical trial conducted on 48 women with breast cancer receiving chemotherapy in Imam Khomeini and Hazrat Rasoul Akram hospital. Before chemotherapy and after obtaining informed consent, the patients were randomly allocated into intervention and control groups. Intervention group received routine medications for controlling nausea and vomiting as well as auricular acupressure. Meanwhile, the control group received only the routine medications. The data were gathered using demographic and Morrow Standard questionnaire and were compared using statistical tests in the SPSS-21 . 

  Results: T he results showed that using auricular acupressure led to a decrease in the number and the intensity of nausea at acute phases (P=0.001). Acupressure application did not lead to any complications in the patients .

  Conclusion: According to the results of this study, using auricular acupressure on Shenmen, Point zero, stomach, Brainstem, and cardia points can relieve nausea and vomiting at acute phase of chemotherapy. It is suggested that nurses use this pressure technique as a complementary treatment for relieving nausea and vomiting caused by chemotherapy.

  Background & Aim: The central venous pressure measurement is a common and important care provided by nurses in intensive units. The measurement should be according to the pre-defined standards. The purpose of this study was to evaluate the effect of using a checklist in measuring central venous pressure by nurses .

  Methods & Materials: This was a nonequivalent group design on 70 nurses working in ICUs. T he quality of measurement of central venous pressure by recruited nurses were measured via direct observation in the control (n=35) and experiment (n=35) groups. The intervention group nurses were recommended to use a performance checklist in each measurement of central venous pressure for one month. At the end of the intervention, the performances of both groups were evaluated through observation. Collected data were analyzed using the Chi-squared test, paired and independent test in the SPSS-17 . 

  Results: At b aseline, the mean scores in both groups were not statistically significant (P=0.7) The mean performance score of the control group at the beginning and one month later were 7.64±2.33 and 7.65±2.28, respectively (P=0.6). In the experiment group, the mean performance score was 7.85±2.29 before the intervention and 9.28±3.16 after the intervention (P=0.001). T he difference between the scores before and after the intervention were significant (P=0.001) in the intervention group .

  Conclusion: Using checklist by critical care nurses could enhance their performances in measurement of central venous pressure. This method can be used as an accessible, inexpensive, and simple method to improve quality of nursing practices .

  Background & Aim: Virtual education can be delivered via different routes. The purpose of this study was to investigate the effectiveness of interactive and non-interactive virtual educations about brain death and organ transplantation on knowledge and satisfaction of education among intensive care nurses .

  Methods & Materials: This quasi-experimental study was conducted on intensive care nurses of hospitals affiliated to Tehran University of Medical Sciences in 2014 . Participants were selected through a convenient sampling method and were assigned into two groups with 32 participants in each. The first group participated in an interactive electronic education while the second group received a non-interactive education about brain death and organ transplantation . Knowledge of both groups was measured before and after the education. The satisfaction of participants with the course was measured using a questionnaire. The scores were compared within and between groups using the paired and independent t-test, respectively . 

  Results: The knowledge of both groups increased significantly after the intervention (P<0.001) however, there was no significant difference between the mean scores of the two groups after the education (P<0.05). The s atisfaction with the course was significantly higher in the interactive education group (P=0.04) .

  Conclusion: B oth interactive and non-interactive electronic educations increased the knowledge of nurses. The nurses were more satisfied with the interactive education. Further studies are recommended .

  Background & Aim: Midwives are responsible for providing health services to mothers and infants in crises. The aim of this study was to identify educational needs of midwifery students regarding mother and infant mortality prevention in crisis situations .

  Methods & Materials: In this cross-sectional study, all 235 final-year BSc. and MSc. midwifery students were selected from four medical universities located in Tehran. Informed consent forms were completed and signed by the students. The students completed a researcher-made two-section questionnaire including demographic items and educational needs items regarding mother and child preventive services in crises. Data were analyzed in the SPSS . 

  Results: Mean score of the m aternal and neonatal prevention service dimensions were 70±21.5 ( out of 105 ) and 46.7 ± 9 (out of a 65), respectively. Most of the students (86.8% ) declared that their academic education did not prepare them for their roles in crises. Only 10.6% of the students had some courses on crisis and 11.5% of them had the experience of dealing with crisis. The students in the BSc. degree had more educational needs in both dimensions compared to the students in the MSc. degree (P<0.046). There were significant relationships between the age of students (P<0.001), their clinical experience (P<0.001), previous educational courses (P<0.001) and experience in crisis (P<0.05) with the educational needs. There was no significant relationship between the educational needs and the students’ universities ( P>0.05 ) .

  Conclusion: Educational curriculums should be revised regarding actions to be done on prevention of mother and infant mortality in crises .

  Background & Aim: Medication adherence affects the outcome of treatment in patients with epilepsy. Non adherence to the antiepileptic drugs in patients may result in exacerbation of seizure frequencies, higher health-care system costs and higher risk of morbidity and mortality . This study aimed to assess the medication adherence and its related factors in patients with epilepsy .

  Methods & Materials: In this cross-sectional study, we recruited 120 patients with epilepsy from the Iran Epilepsy Association using purposive sampling method. Data were gathered using a demographic checklist and the Morisky’s modified medication adherence questionnaire. Data were analyzed in the SPSS-16 . 

  Results: A total of 87.5%, 10.8% and 1.7% of the patients showed high, medium and low adherences, respectively. Being seizure-free for a period of time was the most cited reason of non-adherence (8.3%). There was a statistically significant relationship between the number of drugs and seizures with the medication adherence (P<0.05). The older people had more adherences to their medications. The patients, who had higher adherences, had experienced fewer seizures in the previous three months .

  Conclusion: The results showed high rates of medication adherences among the patients. Planning and implementing educational programs on medication regimens, emphasizing on necessity of continues use of antiepileptic drugs despite absence of seizures, can be useful in increasing the medication adherence .

  Background & Aim: Anxiety is associated with postpartum mood disorder and is increased with birth of high risk neonates. Foot reflexology is a nursing intervention that can be used to reduce anxiety. T he aim of this study was to evaluate the effect of foot reflexology on anxiety in mothers with high risk neonates after Cesarean section s .

  Methods & Materials: In this non-randomized clinical trial, 99 mothers having high risk neonates were recruited from the Women's General Hospital and Valieasr Hospital . The participants were allocated into three groups (n=33/group) using convenience sampling method . The group I received foot r eflexology for 40 minutes group II received leg massage and the control group received usual care after the Cesarean section. The Spielberger questionnaire was completed at baseline and three days after the interventions by the participants . Data were analyzed using the r epeated measure ANOVA and Chi-Squared in the SPSS-16 . 

  Results: At the baseline, there were no significant differences between the three groups in terms of demographic characteristics and the mean scores of anxiety . After the interventions, the mean score of anxiety was significantly lower in the reflexology and placebo groups than the control group (P<0.001). There was no significant difference between the reflexology and placebo groups in terms of the mean scores of anxiety (P>0.05). Comparing the mean score of anxiety between the reflexology (14.7±7.2) and placebo (9.4±8.5) groups indicated that the reflexology intervention was more effective in reducing anxiety .

  Conclusion: The use of foot reflexology was effective in reducing anxiety. Nurses should use this non-pharmacologic method to control the symptoms of anxiety among mothers .

Background & Aim: Because of the importance of empathy and positive impact on the relationship between patients and health care providers, as well as the lack of valid instrument to assess student's empathy in health domain, this study aimed to examine the factor structure and reliability of the Persian version of JSE-HPS in the students of the School of Nursing and Midwifery, Mashhad University of Medical Sciences in Iran.

Methods & Materials: In this cross-sectional study, 398 nursing and midwifery students of Mashhad University of Medical Sciences were selected using stratified random sampling. The data collection instrument was JSE-HP. The confirmatory factor analysis was used to investigate the factor structure of the instrument, and the Cronbach's alpha coefficient was applied to examine its reliability. The data analysis was done using LISREL version 8.8 and SPSS version 20.

Results: The results of the confirmatory factor analysis model showed given that fitness model parameters, including CFI, GFI, AGFI and NFI were approximately 1 and RMSEA index was less than 0.1, the fitness of three-factor model is appropriate. The Cronbach's alpha coefficient for the total instrument was 0.63.

Conclusion: The current study confirmed the three-factor structure of the Persian version of JSE-HPS (20 items), included perspective taking, compassionate care and standing in patient’s shoes. Thus, this instrument is appropriate to measure empathy for patient in the health service provider students.

Background & Aim: Adherence to the principles of appropriate nutrition and diet therapy is one of the most important aspects of diabetes management. The present study aimed to assess the effect of nutrition education based on "MyPlate" Food Guidance on the anthropometric indices and blood profiles in people with type 2 diabetes.

Methods & Materials: In this randomized clinical trial study conducted in 2014, 44 people with type 2 diabetes were randomly allocated either into the control group or the intervention group. Anthropometric measurements, blood profiles, energy intake and physical activity data were collected before and three months after the 2 hours face-to-face “MyPlate” nutrition education session for the intervention group or the usual educational sessions for the control group. Paired t-test, independent sample t-test, ANCOVA, and nonparametric tests were utilized to analyze the data.

Results: At the beginning of the study, the two groups were similar in terms of the anthropometric indices, glycosylated hemoglobin, blood sugar and physical activity. After intervention, except for physical activity which was higher in the nutrition education group based on "MyPlate" Food Guidance, the other above cases were lower than the control group (P<0.05), but no significant differences were seen in the changes of blood pressure (systolic and diastolic) and energy intake between two groups of education and control.

Conclusion: Nutrition education based on "MyPlate" Food Guidance for three months decreases the anthropometric indices and blood profiles in people with type 2 diabetes.

Background & Aim: Preterm infants are at increased risk for readmission after discharge from the neonatal intensive care unit. Some factors and characteristics of preterm infants have an effect on their readmissions. This study aimed to determine neonatal factors related to preterm infants’ readmissions to the neonatal intensive care unit.

Methods & Materials: This correlational study was conducted on a sample of preterm infants admitted to the neonatal intensive care unit at three teaching hospitals of Shahid Beheshti University of Medical Sciences in 2013. Samples were studied using a questionnaire on possible factors and characteristics related to readmission including sex, gestational age, birth weight, multiple birth and length of stay in the neonatal intensive care unit after discharge. The infants were also followed for readmission thirty days after discharge. The data were initially analyzed by univariate analysis and then by the logistic regression model.

Results: The results of univariate analysis revealed that the infants readmitted at the time of follow up were significantly more premature and had lower birth weight and a longer initial hospital stay in the neonatal intensive care units (P<0.001). In the logistic regression model, only gestational age and birth weight had a significant statistical association with infants’ readmission (R: 0.805, P=0.001 and odds ratio: 0.998, P=0.001 respectively).

Conclusion: Infants’ gestational age and birth weight were associated with hospital readmission within thirty days after discharge, so that the infants with lower gestational age and birth weight were more likely to be hospitalized again after discharge.

Background & Aim: In the view of the importance of evidence-based clinical practice in recent years, clinical disciplines such as nursing and midwifery have found a special need to systematic review and meta-analysis. However, systematic reviews and meta-analysises like any other studies may be poorly designed and implemented. Therefore, certain guidelines have been considered for reporting of such studies. The PRISMA statement is one of the most recent developments to improve the reporting quality of systematic reviews. The present study aimed to assess the reporting quality of systematic reviews and meta-analysises in the Iranian journals of Nursing and Midwifery, based on the PRISMA statement.

Methods & Materials: In this study, we conducted a comprehensive search on the Iranian journals of Nursing and Midwifery (Persian and English), indexed by the SID, Magiran, Irandoc, Iranmedex and Google Scholar databases during 2010 to 2015 years. The search was implemented using the key words such as systematic review and meta-analysis. Of the 44 articles found, after considering the inclusion criteria, 16 articles remained that were investigated using the PRISMA statement. Data were analyzed through the descriptive statistics and chi-square test using SPSS software version 16.

Results: The compliance rate of studies on the basis of PRISMA statement was estimated to be about 63%. The most common deficiency in the reporting quality was related to methodology estimated to be about 57%. The most visible deficiencies in the reporting of systematic reviews and meta-analysises were related to bias in the primary studies and bias in combining the results of these studies and lack of reporting these biases.

Conclusion: In this study, the reporting quality of systematic reviews and meta-analysises in the Iranian journals of nursing and midwifery was in the moderate level. The most probable reason for this may be the lack of enough attention of researchers to the PRISMA statement or not using this statement in reviewing articles. Therefore, it is recommended that an appropriate share of the educational programs on research methodology be allocated to systematic reviews and familiarizing with valid criteria such as PRISMA statement.

Background & Aim: One of the assisted reproductive technologies is the use of donated oocyte. Although, the data about medical aspects of this process is available, knowledge of the psychological aspect related to this therapy is limited. Each individual's psychological aspects can be assessed by the self-concept and the self-discrepancy. Therefore, the present study aimed to assess the self-concept and self-discrepancy among women receiving and donating oocyte.

Methods & Materials: In this descriptive-analytical investigation, carried out in 2015, given the limited research population, 53 women referred to Royan infertility institute, were investigated in each of the donor and recipient groups using the available sampling method. The data were collected by three questionnaires including demographic questions, Rogers’s self-concept scale and self discrepancy scale (ideal-self discrepancy and ought-self discrepancy). The data were analyzed through the descriptive statistics, Chi-square and t-test using SPSS v.16.

Results: Results showed that the self-concept and self-discrepancy scores were poor in both the donor group and the recipient group. Scores of the recipient women (the questionnaire was reverse scored) were more than scores of the donor women. There was no significant difference between the two groups in the mean scores of self-concept (P=0.53). There was a significant difference between the two groups in the ought-self discrepancy score (P=0.02) but no significant difference was found between the two groups in the ideal-self discrepancy score (P=0.15).

Conclusion: According to the results, it should be noted that in the process of oocyte donation, only physical assessment is not enough but individuals’ psychological needs are necessary to be taken into account. So, the authorities should consider measures to assess the psychological aspects of women receiving and donating oocyte.

Background & Aim: Caring viewpoint is a requisite of high quality nursing care. It must be operational through the nursing education program. The present study was conducted to compare the viewpoints of undergraduate nursing students at the first, fifth, and eighth semesters about the importance of caring behaviors during their nursing education.

Methods & Materials: The present study is a descriptive-analytical study. In this study, three groups of 40 nursing students (semester one, five and eight) were selected by random sampling from Shahid Beheshti University of Medical Sciences in 2014. Caring Behavior Inventory completed through self-report by the students, was used for collecting data. Data were analyzed by the descriptive and inferential statistics (with the significance level<0.05) using SPSS software (version 20).

Results: The mean scores based on Caring Behaviors Inventory in three groups were: semester 1: 148.2, semester five: 123.6, semester eight: 122.05. ANOVA showed statistically significant differences between the mean scores for three groups of students (P<0.001). Also, the scores of students’ viewpoints were different in all instrument domains included respectful deference to the other (P<0.001), assurance of human presence (P<0.001), positive connectedness (P<0.001), professional skills and knowledge (P=0.004), attentiveness to the other’s experience (P<0.001). Considering the lack of homogeneity in the groups in terms of age and sex, analysis of covariance was used to eliminate their confounding effects on main variable, and despite controlling for the confounding role of age and sex, differences were significant (P<0.001).

Conclusion: The viewpoints of the higher-year students about the importance of caring behaviors not only had not promoted but also it had decreased compared to the lower-year students. Considering the fact that caring viewpoint is the requisite of high quality nursing care that must be operational through nursing education programs, and due to the fading of emotional aspect of care, more emphasis on clinical instructors and nurses and using mentors in clinical practice are needed to practically and concretely show nursing students the emotional aspect of caring.

Background & Aim: Given the importance of mothers’ health and considering that developmental delay in children affects their mothers’ mental health this study aimed to compare stress and perceived social support in mothers of 6-18 month old children with and without developmental delay.

Methods & Materials: This cross-sectional, analytical study was performed on 610 mothers and their 6-18 month-old infants in health centers affiliated to Shahid Beheshti University of Medical Sciences. The participants were selected through the multi-stage random sampling. To collect data, the following questionnaires were used: obstetric and demographic characteristics, socio-economic status, infants’ characteristics, the Cohen perceived stress scale, perceived social support, and Ages and Stages questionnaire to determine the children’s development status. The data were analyzed by SPSS v.19 software and using descriptive statistics, Pearson correlation, chi-square, independent t-test and Man-Whitney statistical tests.

Results: The mean age of infants were 10.68±4.5 months. Independent t-test revealed a significant difference between mothers’ perceived stress (P=0.004) and social support (P=0.01) in the two groups. In addition, a relationship was observed between the mother’s social support and stress (P<0.04).

Conclusion: The results showed that mothers of children with developmental delays have more stress and lower perceived social support than mothers of normal children. Therefore, it is recommended to perform developmental screening for further examination and the reduction of mothers’ stress, as well as to provide appropriate social support.

Background & Aim: Teamwork (between obstetricians and midwives) is one of the main pillars of success in the provision of appropriate services in the maternity wards. Therefore, this study aimed to identify the factors influencing teamwork in a maternity ward in a public hospital in Tehran, Iran.

Methods & Materials: In this qualitative study, nine midwives and four obstetricians were selected through purposive sampling. Data were collected through semi-structured interviews from an affiliated hospital of Tehran University of Medical Sciences in 2013-2014. Data were analyzed using conventional content analysis.

Results: Two themes including the teamwork barriers (four categories) and facilitators (three categories) were extracted from the data analysis. The main categories of teamwork barriers were the underlying issues (inter-professional conflicts, legal issues, and salary and financial issues), individual problems (physical problems, negative personality characteristics and domestic problems), lack of skills (lack of abilities and motivation, educational weakness and lack of experience) and the external management system (inappropriate policy making and planning, hierarchical structure, lack of team evaluation and lack of justice). The main categories of teamwork facilitators were the internal management of team (good leader or manager, appropriate workplace climate, values clarification of the team members’ practices, and proper implementation of regulations), cooperation, collaboration and empathy (help and cooperation and empathy and support), and essential personal qualities for teamwork (good communication and good personality characteristics).

Conclusion: In this study, the teamwork barriers and facilitators in the maternity wards were comprehensively identified at different levels. According to the results, interventions can be designed and implemented to enhance teamwork.

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.

Background & Aim: Poor oral care for the ventilated patients in intensive care units (ICU) can result in the accumulation of pathogens and respiratory infections. In this regard, in addition to the chemical methods, a mechanical method has been recommended to be added. However, concerning its effect on pneumonia, different findings have been reported. Therefore, this study was conducted to compare the effects of chlorhexidine solution with or without toothbrushing on the development of ventilator-associated pneumonia among patients in ICUs.

Methods & Materials: This was a single-blind, randomized controlled clinical trial conducted in two selected hospitals of Ahvaz city in 2014. A convenience sample of 68 ventilated patients was randomly allocated to the toothbrush group (34 patients) or the gauze swab group (34 patients) using R software. Both groups received 0.2% Chlorhexidine solution. The intervention was performed in both groups for 3 minutes twice a day for five days. At the end of the fifth day, the development of pneumonia was assessed using the Clinical Pulmonary Infection Score (CPIS). Data were analyzed by Chi-square and t-independent test through SPSS v.16.

Results: The two groups were similar for age, sex, cause of admission, level of consciousness, medication and tobacco use. The majority of patients (58.8%) were diagnosed with pneumonia (Group A: 55.9% and Group B: 61.8%). The Chi-square test showed no significant difference between the two groups for the development of pneumonia (P>0.05).

Conclusion: The use of Chlorhexidine solution with toothbrushing compared to using Chlorhexidine with swab could not reduce the development of pneumonia. However, due to its importance, further research is needed in this regard.