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  Background & Aim: Medication usage is the bases of disease management in patients who undergo hemodialysis. Non-adherence to medication regimen increases the incidence of complications among the patients . The aim of this study was to investigate the effect of a cognitive-behavioral intervention on medication adherence in patients undergoing hemodialysis .

  Methods & Materials: In this clinical trial, 70 patients were selected from Imam Reza and Valiasr hospitals. Patients were assigned into two intervention (n=35) and control (n=35) groups. The intervention group received a cognitive-behavioral intervention including six steps: 1) Identifying the problem 2) Creating confidence and commitment 3) Increasing awareness of behavior 4) Developing and implementing the action plan 5) Evaluating the plan and 6) Maintaining the desired behavior. Adherence to medication regimen was assessed using a self-report questionnaire before and immediately after the intervention. Data were analyzed using the independent t-test . 

  Results: At baseline, there was no significant difference in adherence to medicine regimen between the intervention (20.77 ± 4.56) and control (22.34 ± 3.65) groups (P=0.1). After the intervention, significant difference was observed between the two groups in adherence to medication regimen (P<0.001) .

  Conclusion: Cognitive–behavioral intervention could improve medication adherence in patients undergoing hemodialysis. It is recommended for nurses to use this approach to improve medical care among the patients .

  

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  Background & Aim: Demographic transition and aging are global conditions result in increased risk of disability and chronic diseases such as diabetes. Considering stress as having mutual interaction with different aspects of health is vital in treatment of common disorders among older adults with diabetes. This study aimed to assess the relationship between the perceived stress with spiritual health among older adults with diabetes registered to the Association of Diabetes Prevention and Control in Babol .

  Methods & Materials: In this cross-sectional (descriptive- analytical) study, 194 older adults aged 60-75 years old were selected using convenience sampling from the Association of Diabetes Prevention and Control in Babol. Data were collected using the demographic form as well as the Perceived Stress Scale (PSS) and the Spiritual Well-being Questionnaire (SWB). The validity and reliability of the scales were confirmed previously. Data were analyzed using descriptive and inferential statistics including ANOVA, Chi-Squared tests, t-test and Pearson correlation coefficient in the SPSS-21 . 

  Results: The study findings showed that perceived stress was low in a substantial percentage of the elderly (74.2%) with the mean ± SD of 22.52±8.06. Also, the levels of spiritual health were medium to high among most participants (97.72 ± 11.51). Interestingly, there was a significant negative relationship between the perceived stress and spiritual health (r=-0.48, P<0.001) .

  Conclusion: This study elaborated the relationship between the perceived stress with spiritual health of elderly patients with diabetes. Considering the results, enhancing spiritual health as one of the health dimensions seems necessary .

  

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  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 .

  

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  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 .

  

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  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 .

  

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  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 .

  

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Background & Aim: Patient falling is one of the most important indicator of patient safety. Nurses have an important role in the prevention of patient falls and the improvement of patient safety standards. The current study aimed to determine the relationship between the incidence of patient falls and nurses’ professional commitment.

Methods & Materials: In this cross-sectional study,300 nurses employed in hospitals affiliated to Tehran University of Medical Sciences, were selected through a proportional stratified sampling method. Data were collected by a three-part questionnaire consisted of the demographic data, the Nurses’ Professional Commitment Scale and the reports on the number of patient falls in the past three months. Data were analyzed on SPSS software using statistical tests including Pearson's correlation coefficient, Kruskal-wallis and independent-t test.

Results: The mean score of patient falls in the past 3 months was 6±1.61(moderate) for each nurse and the mean score of nurses' professional commitment was 86±8.61 (committed).A significant and reverse relationship was observed between the incidence of patient falls and nurses’ professional commitment (R= -0.51; p<0.018).There is no relationship between nurses’ demographic characteristics and patient falls.

Conclusion: Despite the lower incidence of falls in the patient under the supervision of the committed nurses, its prevention entails taking into account all factors that influence this phenomenon besides improving professional commitment.

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Background & Aim: Lack of orgasm during intercourse and loss of libido in menopause is very common and can reduce women's quality of life. The aim of the present study was to determine the effect of Aphrodite on orgasm and sexual desire in postmenopausal women.

Methods & Materials: The study design was a randomized clinical trial with a control group. Participants were comprised of 80 postmenopausal women 50-60 years old. The instruments consisted of the demographic characteristics form and the Sabbatsbergsexual function scale that a part of itevaluates orgasm and sexual desire. Descriptive statistics, paired t-test and independent t-test were used to analyze data through SPSS software v.16.

Results: The mean score of orgasm before intervention in the Aphrodite group was 30.25±20.6 and in the placebo group was 29±21.9. One month after intervention, this score increased to 41.12±10.08 in the Aphrodite groupand was 29.12±29.66 in the placebo group, that the difference between the two groups was statistically significant (P=0.02). As well, for the sexual desire score, there was a significant difference between the two groups of Aphrodite and control after intervention (P=0.008).

Conclusion: The use of Aphrodite can improve sexual desire and orgasm in menopausal women. So, it is essential that healthcare providers be familiar with this herbal supplement.

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Background & Aim: Male andropause begins with hormonal, physiological and chemical changes, and usually occurs in men between the ages of 40 to 55 years. These changes affect their quality of life. Hence, the current study investigated the quality of life of men with andropause and its related factors.

Methods & Materials: This preliminary cross-sectional study was conducted through the census method on 80 males aged 40 to 60 years, employed at the schools of Tehran University of Medical Sciences. Data were collected in 2014 using a demographic questionnaire, the Short-Form 36 (QOL) questionnaire, and the Persian version of the Aging Males' Symptoms (AMS) questionnaire. Data were analyzed by SPSS software v.22 through descriptive and inferential statistics (Independent t-test, one-way ANOVA, Pearson’s Correlation Coefficient and Stepwise multivariate Regression). The level of significance was set at 0.05.

Results: The mean age of the andropausal men was 47.6±4.79 years and the majority (38.8%) of the samples were in the 45-49 age group. The mean quality of life score was 61.75±13.52. Stepwise regression showed a significant relationship between age and the scores of overall quality of life, physical and psychological health dimensions. Moreover, significant associations were observed between the overall quality of life score and the andropause severity, and between physical health dimension and sleep hours per day.

Conclusion: This study indicates that andropause lowers the quality of life, and age, andropause severity and sleep hours affect the quality of life in the andropausal men.

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Background & Aim: Infant hospitalization in the intensive care unit is stressful for parents so that it affects their parental role. Nurses, due to their special situation, can play an important role in reducing parental stress. This study aimed to determine the effect of parental role training by a nurse on stress in the parents of hospitalized newborns in a neonatal intensive care unit.
Methods & Materials: A quasi-experimental study (IRCT201605131788N17) was conducted on 72 parents (36 couples in the intervention group, 36 couples in the control group) of hospitalized newborns in the neonatal intensive care unit of Ali-Asghar hospital in 2016. The intervention group received the parental role training based on their needs. Their stress level was compared with the control group using the Parental Stress Scale. Data were analyzed by descriptive statistics, chi-square test, paired t-test, independent t-test and Fisher's exact test using the SPSS software v.16.
Results: Before the education, there was no significant difference in the stress level between the two groups (P>0.05). After the education program, the stress level in the intervention group fell on the tenth day compared to the control group (P<0.001).
Conclusion: Training parents based on their educational needs reduces their stress. By reducing stress and improving the role of parents, it can be assured that the newborn is provided with the quality care at the time of admission.
 

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Background & Aim: The goal of asthma treatment and management is its control. Yoga is one of the complementary treatments which is used to control asthma. This study aimed to determine the effect of yoga breathing exercises on asthma control in 5-11 year-old children with asthma.
Methods & Materials: In this quasi-experimental study, 84 children with asthma, aged 5-11 years, referred to Asthma and Allergy Clinic of Aliasghar hospital, were included in the study in 2018. The participants were selected through continuous sampling and non-randomly allocated to an experiment- or a control group (42 in each group). The Childhood Asthma Control Test (C_ACT) was used to collect the data, before and after the intervention. The intervention included yoga breathing exercises. The researcher trained the children and their parents at the clinic and these exercises were performed by the children for two months, with parental supervision at home. Data were analyzed by the SPSS software version 21 using independent t-test, paired t-test, chi-square and Fishers exact test.
Results: The mean of age was 8.42(1.96) for the experiment group and 8.11(1.8) for the control group. In the experiment group, 76.2% were male, and 23.8% were female. In the control group, 73.8% were male and 26.2% were female. Before the intervention, the mean of asthma control score was 17.81±4.42 for the experiment group and 18.38±4.24 for the control group but this difference was not statistically significant (P=0.54). After the intervention, the mean of asthma control score for the experiment group and control group was 21.69±1.6 and 19.83±2.4, respectively. This difference was statistically significant (P˂0.001).
Conclusion: Yoga breathing exercises improved asthma in children. According to the results, yoga breathing exercises are suggested as scientific, simple and refreshing techniques in children with asthma.
Clinical trial registry: IRCT20180501039489N1
 

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Background & Aim: Anxiety is one of the most common complications in cancer patients that can affect the physical and mental health of patients and disrupt the treatment process. For this reason, cancer patients undergoing chemotherapy need education about the disease and ways to cope with its complications and problems. The aim of this study was to compare the effects of video and written training methods on anxiety in patients with gastric and esophageal cancer undergoing outpatient chemotherapy.
Methods & Materials: This study is a randomized clinical trial that was conducted on 58 patients with gastric and esophageal cancer who underwent outpatient chemotherapy in Shariati and Imam Khomeini hospitals in Tehran. Participants were randomly assigned to either the video training group (n=28) or the written training group (n=30). Data was collected using the Spielberger State Anxiety Inventory (STAI), at the beginning of the study and then weekly for 12 weeks. The SPSS software version 20 was used to analyze the data.
Results: The results showed that the level of anxiety in both groups was significantly lower compared to before the intervention (P<0.05). There was no statistically significant difference in the anxiety mean score between the video group (56.07±9.85) and the written group (56.40±8.13) after the intervention (P=0.89).
Conclusion: In general, the results of this study showed that self-care education using video and written methods reduces the anxiety of cancer patients undergoing chemotherapy and both methods can be effective in reducing patients' anxiety.
Clinical trial registry: IRCT20181115041669N1
 

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Background & Aim: Caring for children with congenital heart disease is very challenging for their parents, and the mothers of these children have a low quality of life. The aim of this study was to evaluate the effect of discharge planning on quality of life among mothers of children with congenital heart disease undergoing surgery.
Methods & Materials: In this quasi-experimental study, 72 mothers of children with congenital heart disease referred to Shahid Rajaie Cardiovascular center in Tehran in 2019 were included in the study using the continuous sampling method and non-randomly allocated to experimental or control groups (36 in each group). Data collection tool included demographic questions and the SF-36 questionnaire, which was completed before and two months after the intervention. The intervention was performed in six thirty-minute training sessions at the time of admission, during hospitalization and discharge. The training follow-up continued for two months after discharge. Data was analyzed by the SPSS software version 20 using Chi-Square test, independent t-test and Fisher's exact test.
Results: The mean score of quality of life before the intervention was 58.93±19.35 in the experimental group and 64.93±16.78 in the control group, and there was no significant difference between groups (P=0.165). Two months after the intervention, the mean score of quality of life was 73.44±17.81 in the experimental group and 73.67±16.49 in the control group, and there was no statistically significant difference between groups (P=0.956).
Conclusion: The discharge planning did not improve the mothers’ quality of life. It is suggested that in addition to educating about proper care of the child, psychological support be provided for mothers while implementing discharge planning.
Clinical trial registry: IRCT20180501039489N3
 

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Background & Aim: Comfort is the ultimate goal in all the nursing processes. The aim of the study is to examine the comfort status of the hospitalized patients with mental disorders.
Methods & Materials: This study is a descriptive, cross-sectional study that was conducted on 275 patients hospitalized in the psychiatric wards of Lavasani hospital in Tehran in 2020. The study subjects were selected using the convenience sampling method. The patients completed a demographic form and the comfort questionnaire of psychiatric patients. Data were analyzed using descriptive and inferential statistics, independent t-test, analysis of variance, and the Scheffe test through the SPSS software version 24 at a significance level of 0.05.
Results: A total of 184 patients (66.9%) were male. The overall comfort score was 128.76, which was more than median based on the score from 38 to 190.
The highest scores in the dimensions of comfort, were respectively sociocultural domain (65.20±91.55), psychospiritual domain (64.19±31.50), physical domain (58.22±37.06), and environmental domain (49.19±22.39). The Scheffe test showed that the comfort score for the patients with sufficient income was significantly higher (P<0.001). Also, the patients who were employees had a higher comfort score compared to others (P=0.017).
Conclusion: The patients gained the least comfort score in the environmental domain, and the most comfort score in the sociocultural domain. Therefore, devising and implementing all nursing interventions are recommended with the aim of maintaining and improving comfort in the environment of psychiatric departments.

 

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Background & Aim: Attempting to improve the quality is an important issue in the nursing service and care system. The COVID-19 pandemic has created great challenges for healthcare systems, especially for the intensive care units, which can affect the quality of nursing care provided to these patients. The aim of this study was to determine the quality of nursing care in nurses working in the intensive care unit of COVID-19.
Methods & Materials: In this descriptive-cross-sectional conducted in 2021-22, 142 nurses from Valiasr, Amir Kabir, Amir al-Momenin and Khansari hospitals affiliated to Arak University of Medical Sciences were selected by the census method. The Martins’ nursing care quality questionnaire (including 25 items in 7 domains) was completed by the participants. The SPSS software version 16 and independent t-tests, analysis of variance and the Pearson's correlation coefficient were used for the data analysis.
Results: The result showed that the mean score of the nursing care quality was 83.83±7.74, which was considered favorable due to being higher than the median score of the tool (62.5). Among the individual characteristics of nurses, the nursing care quality had a statistically significant relationship with the type of employment (P=0.003), age, work experience and work experience in the intensive care unit (P<0.001).
Conclusion: Considering the significant relationship of the nursing care quality with the type of employment, age and work experience, it is recommended that health managers take an effective step in formulating the necessary policies to improve the quality of nursing care by taking into account the experience of skilled nurses in intensive care units.