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Background & Aim: Frustration is one of the important psychological consequences for the elderly in the nursing home. Spiritual care is a unique aspect of nursing care that can be a strong response to the dealing with frustration. The aim of this study was to determine the effect of spiritual care education on hope in the elderly residents of nursing homes.
Methods & Materials: The present study was a before-and-after semi-experimental study, conducted in 2018 on 35 elderly residents of nursing homes in Hamadan, assigned into two groups of intervention (35 people) and control (35 people). At the beginning of the study, both groups completed the Schneider hope scale. For the intervention group, the intervention based on spiritual care was performed in three sessions. The post-test was performed for both groups after one month. Spearman correlation and Kruskal-Wallis tests were used to analyze the data through the SPSS software version 16.
Results: There was no significant difference in overall hope score between the groups of intervention (22.94±9.80) and control (25.94±3.86) before the intervention (P=0.085); but after the intervention, there was a significant difference between the intervention (42.94±6.04) and control (23.80±4.09) groups (P<0.001).
Conclusion: Considering the positive effect of spiritual care on hope in the elderly in this research, planning for spiritual education is essential in this group of people.
 

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Background & Aim: Clinical competence is the ability to perform professional tasks and coordinate cognitive, communication and psycho-motion skills in patient care, and empathy is one of the factors influencing clinical competence. Given the role of clinical competence in the quality of midwifery care, this study aimed to determine the effect of empathy skill training on clinical competence in midwifery students.
Methods & Materials: This randomized clinical trial study was conducted on 73 midwifery students and 438 pregnant women in 2015. A clinical competence questionnaire was used to assess the clinical competence of the students, which was completed in two ways by self-assessment and researcher assessment (after reviewing the student's performance for 3 times). Data were analyzed by chi-square test, independent t-test and paired t-test using the SPSS software version 16.
Results: There was no significant difference between the two groups in the mean score of clinical competence in the ways of self-assessment and assessment by the researcher before the intervention (P>0.05). Results from the post-intervention showed that there was significant difference between the two groups. However, the clinical competence score by the researcher assessment in the intervention group was significantly higher than in the control group (P<0.05). Also, the difference in the mean scores of the self-assessment of clinical competence before and after the intervention between the two groups was not significant (P>0.05), but the difference in the mean scores of the researcher assessment of clinical competence before and after the intervention between the two groups was significant (P<0.05).
Conclusion: Empathy skill training is an effective way to increase the clinical competence of students.
Clinical trial registry: IRCT 2016051127855N1
 

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Background & Aim: Operating room personnel are always exposed to blood-borne infections because of Needlestick Injuries (NSIs). Thus, this study was conducted to determine the effectiveness of an educational intervention to promote NSIs preventive behaviors among the operating room personnel based on the health belief model (HBM).
Methods & Materials: This is an interventional study with a pre-test/post-test, control group design, conducted on 90 operating room personnel (45 personnel in each group) from four hospitals in Hamadan City in 2018. The participants completed a self-administered questionnaire including demographic and professional variables and HBM constructs. The intervention included four educational sessions held for the experimental group within one month. Both groups were followed up for three months after the intervention. Data were analyzed by the SPSS software version 18 using independent t-test, chi-square, Fisher exact test, and analysis of covariance (ANCOVA).
Results: The results showed that before the educational intervention, there was no statistically significant difference in the mean scores of HBM constructs between the experimental and control groups (P>0.05). However, after the educational intervention, both the experimental and control groups had a statistically significant difference between before and after changes in the mean scores of knowledge, perceived vulnerability, perceived benefits, perceived self-efficacy, and NSIs preventive behaviors (P<0.05).
Conclusion: According to the results, applying the educational intervention based on the HBM is an appropriate and effective approach in preventing NSIs among the operating room personnel.
 

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Background & Aim: Sleep disturbances in type II diabetes patients due to insulin resistance is a risk factor for the exacerbation of the disease. Therefore, assessment of the factors affecting the improvement of sleep in diabetic patients is a necessity for health care providers. The aim of this study was to investigate the relationship between sleep quality and self-management in type 2 diabetes patients.
Methods & Materials: This is a descriptive, cross-sectional study. A total number of 170 patients with type 2 diabetes referred to the medical centers affiliated to Qazvin University of Medical Sciences were included using the convenience sampling method in 2018-2019. Data were collected by the Richards-Campbell Sleep Questionnaire (RCSQ) and the Diabetes Self-management Questionnaire (DSMQ). Data were analyzed by the SPSS software version 21 using the descriptive/analytical statistics.
Results: The results showed that the mean score of sleep quality was 49.89±25.90 (range: 0-100) and mean score of self-management was 31.82±6.80 (range: 0-48). The results from the Pearson correlation analysis showed a significant relationship between sleep quality and self-management (P<0.05). Also, the stepwise linear regression model showed that the use of health care systems and physical activity and other variables such as marital status and weight of patients had a significant effect on their sleep quality (P<0.05).
Conclusion: The results of the study showed that an increase in the patients’ self-care status, use of health care systems, increased daily physical activity and having an ideal weight can be predictors in improving patients' sleep quality. Therefore, providing infrastructure programs such as continuing education and providing appropriate care programs for diabetics to improve self-management activities, as well as increasing daily physical activity, increasing the use of health systems, and weight control can improve the sleep quality of this group of patients who account for a significant proportion of chronic diseases in communities.
 

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Background & Aim: With age, some physiological changes cause a negative effect on gait patterns. The aim of this study was to evaluate the effectiveness of a 6-week rotary exercises program on spatial and temporal gait parameters in elderly men.
Methods & Materials: This was a quasi-experimental study. A total of 38 employees and retirees over 60 years of age from Isfahan University of Technology in 2019, were selected by the convenience and purposeful sampling and were randomly divided into experimental and control groups (19 people). The gait parameters were assessed through marking the subjects’ trunk and lower extremities, along with simultaneously filming from three directions (anterior, posterior, and lateral) with a Canon 700D camera, and loading the videos into KINOVEA software. The exercise program were performed in three 60-minute sessions per week for six weeks. To analyze the data, descriptive statistics and the analysis of variance with repeated measures were used.
Results: The results showed a significant difference in the number of steps per minute (Cadence) (P<0.001), step speed (P=0.019), stride time (P<0.001), step time (P<0.001), time of stretching or deployment (P=0.002), oscillation time (P<0.001) and dual protection time (P=0.014), but other parameters such as stride length (P=0.102), step length (P=0.137) and step width (P=0.089) were not significantly different.
Conclusion: Implementation of the 6-week combined rotary exercises program in the elderly can improve the gait parameters, reduce the risk of falls and thus reduce the number of referrals to treatment centers in this age group.
 

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

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Background & Aim: Anxiety is one of the most important mental problems in patients who are candidate for coronary angiography, which can have negative physiological and psychological consequences and ultimately lead to the increased hospital stay, increased patient need for analgesics, increased costs and increased incidence of angiographic complications. Therefore, the aim of this study was to determine the effect of aromatherapy on anxiety in patients undergoing coronary angiography.
Methods & Materials: In this randomized clinical trial, 80 patients undergoing coronary angiography referred to the post-cath. ward of Shahid Mohammadi hospital in Bandar Abbas in 2018 were selected and allocated into two groups of intervention and control through the random numbers table. In the intervention group, the eye pads impregnated with 0.2 ml of peppermint oil were used, and in the control group, the pads impregnated with 0.2 ml of placebo were placed on their chest for 20 minutes. Patient’s anxiety levels were recorded before and after the intervention. A demographic characteristics questionnaire and the Spielberger standard questionnaire were used for the data collection. The   data were analyzed by the SPSS software version 24 using the descriptive and inferential statistical methods in accordance with the objectives of the study.
Results: The results of data analysis showed that aromatherapy reduced the anxiety of patients in the intervention group, which was significantly different from the control group (P=0.006). Paired t-test also showed that in the intervention group, the mean score of anxiety after the intervention was significantly lower than that of before the intervention (P<0.001), however this difference was not significant in the control group (P=0.90).
Conclusion: Based on the findings of the study, we can conclude that aromatherapy with the inhalation of peppermint aroma has been effective in reducing anxiety in patients undergoing coronary angiography. It is recommended that nurses use aromatherapy as a non-pharmacological approach to reduce the patients' anxiety.
Clinical trial registry: IRCT20190225042844N1
 

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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: Cardiovascular diseases, especially coronary artery disease, are one of the most common causes of death worldwide. Recently, coronary intervention through the skin has been used for treatment, which has significantly reduced mortality rates. Nursing care behavior is of special importance in reducing the complications of angioplasty. The purpose of this study was to determine the effect of primary nursing care on the patients’ perception of nursing care behavior after coronary angioplasty.
Methods & Materials: In this randomized controlled clinical trial, 60 patients admitted from February 2018 to April 2018, to the CCU of Razi hospital in Birjand were selected by the convenience sampling method and assigned into two groups of 30, using a simple random allocation method. For the patients in the control group, routine care was delivered case by case, and for the patients in the primary nursing care group, care was provided based on the nursing process. At the time of discharge, the Caring Behaviors Inventory (CBI) was completed for the patients via interviews. Data were analyzed using the independent t-test and the significance levels of 0.05.
Results: The results showed that the mean scores of perception of care behavior and dimensions "respect" and "assurance of humanistic presence" in the intervention group were significantly higher than those of in the control group (P<0.05). However, no significant differences were observed between the two groups in the dimensions "positive attitude and relationship", "knowledge and professional skill" and "attention to other experiences" (P>0.05).
Conclusion: Provision of primary nursing care leads to improving the patient’s perception of nursing care behavior, increasing sense of respect, and assurance of humanistic presence of the nurse. Therefore, it is recommended to use this caring method in the cardiac intensive care unit.
 

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

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Background & Aim: Decreased level of consciousness is one of the life-threatening complications associated with brain injuries. The aim of the study was to explore the effect of auditory and tactile stimulation by a family member on patients’ consciousness level.
Methods & Materials: This quasi-experimental study was conducted on 80 comatose patients with traumatic brain injury hospitalized in the intensive care units of Zahedan educational hospitals in 2019. Samples were selected by the convenience sampling methods and then randomly divided into experimental or control groups. Data collection tool included a demographic information questionnaire, and FOUR criteria for the level of awareness. For the experimental group, the intervention including auditory and tactile stimulation was performed by a family member for 10 minutes for seven consecutive days. The control group received routine interventions. To analyze the data, descriptive and inferential statistical tests (independent t-test, paired t-test, analysis of covariance, chi-square and repeated measures ANOVA) were used through the SPSS software version 21.
Results: The results indicated no significant differences in the level of consciousness between the two groups on the first and fourth days. Yet, independent t-test, analysis of covariance and repeated measures ANOVA showed that the intervention group had significantly a higher level of consciousness on the fifth, sixth and seventh days compared to the control group (P<0.001).
Conclusion: Findings showed that auditory and tactile stimulation by a family member is effective in increasing the level of consciousness in comatose patients with brain injury. So, this technique is recommended as an intervention in nursing care to increase the consciousness level in these patients.
 

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Background & Aim: Perimenopause is associated with severe changes in reproduction and hormones. The aim of this study was to determine the effect of group counseling on the severity of menopausal symptoms in the transition to menopause.
Methods & Materials: This clinical trial study was performed on ninety perimenopausal women in Javanrood city in 2019. Women were randomly assigned into the intervention or control groups using the block randomization method. Counseling was conducted for the intervention group in groups of 11 to 12 people in four 60-minute sessions for four consecutive weeks. After 8 weeks, the severity of menopausal symptoms was measured using the Menopause Symptoms Scale. Data were analyzed using the SPSS software version 21.
Results: There was no statistically significant difference between the two groups in terms of menopausal symptoms scores before the intervention (P=0.86). After the group counseling, the median (Q1, Q3) of menopausal symptoms, physical, mental and genitourinary symptoms in the intervention and control groups were 17.0 (15.0, 21.5) and 21.0 (17.0, 30.5) (P<0.001), 6.0 (5.0, 8.0) and 9.0 (6.5, 11.0) (P<0.001), 6.0 (5.0, 8.0) and 8.0 (5.0, 10.0) (P=0.004), and 5.0 (4.0, 6.0) and 6.0 (5.0, 8.5) (P<0.001), respectively. These values for the intervention group were significantly lower than those in the control group.
Conclusion: Providing group counseling for four sessions was effective in reducing the severity of menopausal symptoms in perimenopausal women. Therefore, it is suggested that this strategy be used to promote women's health in the premenopausal period.
Clinical trial registry: IRCT20120215009014N320
 

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Background & Aim: The caregivers of Alzheimer's patients frequently experience more psychological illness, depression, stress, and discomfort than their peers who do not care for Alzheimer's patients or care for physically ill patients. The aim of this study was to determine the effect of problem-oriented coping strategies training on perceived stress in the family caregivers of the elderly with Alzheimer.
Methods & Materials: The present study was a randomized field trial. The study population consisted of the family caregivers of the elderly with Alzheimer's disease living in Kerman in 2017. The samples were 72 people who were randomly assigned into the control or intervention groups. The caregivers in the intervention group received eight 45-minute sessions about the problem-focused coping strategies based on the specified content, once a week. Data were collected using a 14-item version of the Cohen’s Perceived Stress Scale before and two weeks after the intervention, and were analyzed using independent t-test, paired t-test and chi-square tests through the SPSS software version 18.
Results: Due to the significant difference in the perceived stress score between the intervention and control groups in the pre-intervention stage (P=0.030), and the lack of significant difference between the two groups after the intervention (P=0.06), in order to determine the effect of the intervention, the mean of changes between the two groups were compared and a significant difference was observed in the intervention group compared to the control group (P=0.02).
Conclusion: Considering the positive effect of the problem-focused coping strategy training on reducing perceived stress in the caregivers of the elderly with Alzheimer, designing and implementing interventions with an educational approach can promote the health of caregivers and in turn improve the quality of care for Alzheimer's patients.
Clinical trial registry: IRCT2016050327736N1
 

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Background & Aim: The important aspects of maternal postpartum adjustment are readiness in caring for the family, newly-added member and self as well as return to pre-pregnancy functional status. The aim of the study was to determine the predictors of postpartum maternal functioning.
Methods & Materials: This cross-sectional study was conducted on 422 newly delivered mothers attended the healthcare centers of Bonab in 2016 using the cluster random sampling method. Data were collected through a socio-demographic characteristics form, the Edinburgh postpartum depression scale, and the functional status questionnaire. The multivariate linear regression model on the SPSS software version 21 was used to determine the predictors of functional status.
Results: Mean (SD) of the functional status total score was 2.3 (0.24). The maximum and the minimum scores were in the subdomains “infant care” [3.64 (0.32)], and “social activities and society” [1.43 (0.41)], respectively. There was a significant inverse correlation between postpartum depression and total score of functional status, self-care and social activities and society subscales. According to the general linear model, postpartum depression, spouse’s age and job, economic status, mother’s education level and the number of pregnancy were the predictors of mothers’ functional status during postpartum period.
Conclusion: Postpartum depression and some socio-demographic characteristics are among the variables influencing maternal functional status. Therefore, the early diagnosis and treatment of postpartum depression and consideration of the mothers’ socio-demographic characteristics, can improve maternal functional status and result in better maternal postpartum adjustment.
 

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Background & Aim: Acute coronary syndrome is the most common cardiovascular disorder. Hope and optimism lead to adaptation to and moderation of the damaging effects of depressed mood on the outcome of this disorder. The aim of this study was to determine the effect of positive psychology-based audio messages on hope and optimism among patients with acute coronary syndrome.
Methods & Materials: In this randomized controlled clinical trial, 84 patients with acute coronary syndrome were assigned to either intervention or control groups in Shahrekord educational hospitals in 2017-2018. The intervention group received audio messages based on positive psychology and cardiovascular self-care, and control group only received self-care messages in two hospital admissions and six weeks after discharge. The Life Orientation Test-Revised and the Snyder's Hope Scale were completed before the intervention, at the discharge time, one week and six weeks after the intervention. Data were analyzed by c² and Fisher exact tests and analysis of variance using the SPSS software version 20.
Results: No significant difference is observed in the mean score of hope before the intervention and at the discharge time. However, the mean score of hope was significantly different between the two groups, one week and six weeks after the intervention (P<0.001). There was no significant difference in the mean score of optimism between the two groups before the intervention. Nevertheless, difference in the mean score of optimism was significant at the discharge time (P=0.027), one week and six weeks after the intervention (P<0.001).
Conclusion: Positive psychology-based messages improve hope and optimism in patients with acute coronary syndrome. Therefore, this intervention is recommended along with other treatments.
Clinical trial registry: IRCT2017092532764N4
 

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Background & Aim: Midwives experience high levels of stress due to the nature of their work. Some factors can play a significant role in the occupational stress experience. The aim of the study was to investigate the predictive role of emotional intelligence and individual-occupational factors on occupational stress among the midwives working in Rasht.
Methods & Materials: In this descriptive, correlational study, 250 midwives working in health centers and hospitals in Rasht, from May to September 2018 were included using stratified random sampling. Questionnaires on demographic characteristics, emotional intelligence and occupational stress were used to collect the data. Data were analyzed through the SPSS software version 23 using descriptive and inferential statistics including independent t-test, one-way ANOVA, Pearson correlation, multiple linear regression at the significant level of 0.05.
Results: The mean and standard deviation of emotional intelligence and occupational stress were 114.20±12.55, 119.66±15.48 respectively. Predictors of occupational stress (P<0.05) included workplace variables (private hospital: β=-0.19, P=0.012), overtime hours (β=-0.33, P<0.001), sleeping hours (β=0.13, P=0.011), social activity (β=0.11, P=0.029), age (β=0.25, P=0.045) and the overall score of emotional intelligence (β=0.55, P<0.001). These variables explained 54% of variance of occupational stress.
Conclusion: Overall, in the adjusted model of the workplace variables, overtime hours, sleeping hours, level of social activity, midwife’s age and the overall score of emotional intelligence were significant predictors of occupational stress. Accordingly, designing effective programs can improve the performance of midwives.
 

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Background & Aim: It is possible for food-related staff to be involved in transmitting covid-19 by their contact such as coughing or sneezing. Therefore, the knowledge of food-related staff about the transmission modes and prevention of covid-19 is very important. This study was conducted with the aim of investigating the awareness and performance of bakers working in Iranshahr city regarding the prevention of covid-19.
Methods & Materials: In this descriptive study, 47 bakeries in Iranshahr city were selected using stratified random sampling in 2020. Data were collected by a demographic characteristics form, a researcher-made questionnaire to measure the level of awareness (15 items), and the hygiene performance checklist (17 items). The data were analyzed by Friedman test using the SPSS software version 25 at the significance level of 0.05.
Results: Average age of the participants was 29.56±9.8. average work experience was 51.36±54, The highest percentage of education level was high school (36.2%), 64.9% were married), 89.4% were resident of Iranshahr city, and 46.8% were bread sellers. Average score of performance was 18.59±5.4 that was a little more than desirable amount (17). Average score of awareness was 25.48±2.9 that was much more than desirable amount (15).
Conclusion: Considering the importance of prevention and control of the epidemic and cutting the chain of transmission of the infection, appropriate educational interventions should be developed to improve the awareness and performance of each individual in the society, especially those who are involved in the preparation and distribution of the food products.
 

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Background & Aim: Dialysis headache is one of the most common complications of hemodialysis and is often a challenge for nephrologists, neurologists and headache specialists. Therefore, this study was conducted to investigate the effect of inhalation aromatherapy using lavender on the severity of headache in hemodialysis patients.
Methods & Materials: In this randomized clinical trial, 82 patients from hemodialysis wards of Golestan Hospital in Ahvaz and Shahidzadeh Hospital in Behbahan in 2019 were selected and randomly assigned to either intervention or control groups using the stratified permuted block randomization. For the intervention group, cotton soaked in three drops of lavender essential oil 20% was attached to the collar of the patient and he/she was asked to inhale it for 30 minutes. For the control group, distilled water was used. The intervention was repeated for four weeks (three days per week). The severity of dialysis headache was measured using the Numeric Rating Scale.
Results: In the intervention group, both the severity and the frequency of dialysis headache decreased during 12 sessions of aromatherapy, compared to the control group (placebo), and the decrease was statistically significant (P˂0.001).
Conclusion: Due to the fact that complementary medicine has increasingly become a part of nursing care, aromatherapy with lavender can be used as a complementary measure reducing the severity and frequency of dialysis headaches.
Clinical trial registry: IRCT20190718044263N1
 

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Background & Aim: Designing healthcare spaces and physical facilities requires the identification of the patient's family needs, and it is considered an important component of nursing theories. The aim of this study was to explain the needs of family caregivers of patients undergoing gynecological surgery for physical facilities and equipment in hospital.
Methods & Materials: This study is based on the results of the qualitative part of a large hybrid study on the development and implementation of a need-based service delivery program for the caregivers of patients undergoing gynecological surgery in 2017. The selection of participants was purposefully done with maximum variation. The study data were collected using 31 (16 caregivers, 6 nurses, 4 doctors, 3 patients and 2 service workers) in-depth interviews and observations and analyzed by the conventional qualitative content analysis using the Zhang and Wildemuth approach.
Results: Data analysis led to the development of the theme "need for physical facilities", which fell into two categories "need for proper physical structure in the hospital" with the following subcategories: "need for care facilities behind the operating room door", "need to provide welfare facilities in the hospital for caregivers", "need for welfare facilities in the surgical ward", "necessity of allocating rooms to the similar patients", and category "need for appropriate hospital facilities and equipment" with subcategories "caregiver’s need for facilities and amenities", and "caregiver’s need for facilities and amenities for the comfort of the patient".
Conclusion: The results show the importance of having a physical structure tailored to the needs of family caregivers as well as the availability of appropriate facilities and equipment in hospital. One of the limitations of the study was preventing men from visiting patients in the women’s hospital. It is recommended that the needs of male companions and the necessity of their presence according to the cultural context be studied. Also, a new architectural design is suggested to create a suitable therapeutic environment and positive effect on patients’ improvement and increase patient and family satisfaction.
 

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Background & Aim: Considering the importance of communication skills in nursing, we aimed to study the impact of online support and e-content on communication skills of nurses with patients.
Methods & Materials: In this quasi-experimental study with pre- and post-design, 100 nurses employed in the orthopedic wards of Chamran hospital affiliated to Shiraz University of Medical Sciences in 2018 were selected randomly and assigned into two groups of 50. Both groups received the electronic content of communication skills. In the intervention group, in addition to receiving educational content, online support was provided through social media for four weeks with the presence of a psychologist, so that by asking real questions and problems or simulated scenarios, appropriate behavior in that situation was discussed. Before and eight weeks after the intervention, communication skills in the both groups were assessed by the Burton Jay's Communication Skills questionnaire, and data was compared using independent t-test and analysis of covariance.
Results: The results showed that there was no significant difference between the two groups in the communication skills score before the intervention, but eight weeks after receiving the e-content, the participants' scores increased in the both groups. This increase was greater in the online support group (P<0.001). In fact, online support caused a difference (0.637) in the communication skills score between the two groups.
Conclusion: The results of this study showed the provision of e-content along with online support has led to the improvement of communication skills. It is recommended that in addition to education through e-content, social media be used in the empowerment programs of the treatment team including communication skills improvement, due to their advantages such as ease of use, availability and relatively low cost.
Clinical trial registry: IRCT20090127001599N27