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Background & Aim: Evidence-based practice (EBP) education is essential in nursing education. Therefore, identifying factors influencing nurses' adoption of EBP is very important to perform optimum quality nursing interventions. The aim of present study was to determine the factors affecting the adoption of EBP based on Rogers' diffusion of innovations models in nurses.

Methods & Materials: This was a descriptive–analytical study. The research subjects were 130 nurses who worked in the hospitals affiliated to Tehran University of Medical Sciences in 2014. The research instruments were four questionnaires including demographic data; knowledge, attitude and the adoption of EBP; individual innovation and perceived attributes of EBP. Data were analyzed by descriptive and inferential statistics (Pearson correlation coefficient and path analysis) on SPSS v.19 and EQS.

Results: The study findings showed that age and the working experiences of nurses had significant inverse relationships with knowledge of EBP (r=-0.809, r=-0.805). There was a direct relationship between individual innovation and knowledge (r=0.776). In addition, knowledge not only had a significant direct relationship with the adoption of EBP but also had the greatest impact on the adoption of EBP compared to other variables of model (r=0.937). Perceived attributes of EBP had significant direct relationships with attitude and the adoption of EBP (r=0.898, r=0.888 respectively). Attitude toward EBP also had a direct and significant relationship with the adoption of EBP (r=0.869). The results of the path analysis indicated the model variables to have an optimal fit (P<0.001).

Conclusion: The results of this study identify the factors affecting the adoption of EBP. Determining these factors can be an effective step to more adopt it in clinical environments.

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Background & Aim: Violence against women is a serious social problem affecting public health. Given the relatively high prevalence of domestic violence and the need for screening, a simple tool for its correct diagnosis in a short time seems to be necessary. This study aimed to compare the diagnostic values of the HITS (Hurts, Insults, Threaten, and Screams) tool and CTS2 (Revised Conflict Tactics Scales) in domestic violence screening.

Methods & Materials: This cross-sectional study was conducted on 279 married women referred to health centers in Tabriz in 2014. Data were collected using the socio-demographic questionnaire, HITS and CTS2. Kappa index was used to assess agreement between instruments.

Results: Results showed that HITS tool had relatively good sensitivity (75.7%) and high specificity (93.5%). Positive predictive value and negative predictive value were 96.8% and 59.5% respectively. There was a moderate agreement between instruments (Kappa=0.6).

Conclusion: Given the simplicity of HITS and the possibility to complete it in a short time, this questionnaire can be recommended to identify people experiencing domestic violence at the broad level. In addition, the development of this tool is recommended in future studies.

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Background & Aim: Improving and modifying lifestyle is necessary for health maintenance and promotion. Modification of lifestyle can have an important role in the long-term health of women with Poly Cystic Ovarian Syndrome (PCOS). Therefore, this study aimed to determine the status of health promoting lifestyle and its socio-demographic predictors in women with PCOS.

Methods & Materials: This analytical descriptive cross-sectional study was conducted on 174 women with PCOS referred to gynecology and infertility clinics in Urmia-Iran, in 2015. The data were collected through the socio-demographic and Health Promoting Lifestyle Profile questionnaires. Descriptive statistics, independent t-test, one-way analysis of variance and multivariate linear regression were used to analyze the data through SPSS software version 21.

Results: The mean (standard deviation) of total score of the health promoting lifestyle was 2.2 (0.3) out of 4. The highest mean score was in nutrition subscale [2.9 (0.5)] and the lowest mean score was in the subscale of stress control [1.2 (0.5)]. Based on the multivariate linear regression model, the variables of BMI, spouse’s education level, the first supporter and menstrual bleeding amount were predictors of the health promoting lifestyle in women with PCOS.

Conclusion: Considering that the mean of total score of the health promoting lifestyle and some of its subscales were in the middle of the range of possible scores, it is necessary that besides other therapies, the improvement of health promoting lifestyle in women with PCOS, according to the influencing socio-demographic determinants, be on the agenda of health providers.

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Background & Aim: Pedestrians are the most vulnerable road users. In many cases, pedestrian-vehicle crashes are often the result of their risky road crossing behaviors. So, this qualitative study aimed to explore the reasons for risky road crossing behaviors among young people.

Methods & Materials: The current study was designed as a qualitative content analysis. Twelve males and females who had a car-accident were purposefully selected with maximum variation sampling. Data were collected and analyzed by semi-structured individual interviews.

Results: Conformity with the masses including “conformity with peers and conformity with the public space of society”, and anomie emerged as the most important social reasons for young pedestrian’s risky road crossing behaviors.

Conclusion: According to the results of this study, young pedestrian’s risky road crossing behaviors are affected by conformity with the masses and peers and as well as anomie so that risky behaviors have been commonplace and inevitable and a part of their lifestyle.

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The essence of nursing is protecting the public and nursing profession believes that receiving high quality and safe services, is the community’s right. During the past decades nursing has been considered as a significant profession with characteristics such as autonomy, professional commitment, expertise and responsiveness (1). The body of contemporary nursing is consisted of knowledge and skills, value system, academic education and professional socialization. Autonomy has been defined as nurse’s capacity for determining their action through independent choosing in all the fields of nursing practice and self-regulatory in nursing practice is necessary for achieving professional freedom of action (2).
Professional self-regulatory is the decision-making power for determining the inclusion criteria for the members to enter the profession and start their activity in that profession. It will determine who, with what specialties and how much knowledge and skills have the inclusion criteria for the profession (3). During the mid-19^th century, combination of knowledge and skills, emphasis on commitment to duty against seeking personal interests and also independence from external interferences in professional matters (autonomy) were mentioned as the most important features of self-regulated professions. From the early 20^th century, the motivations for professionalization got in line with professional self-regulatory (2). According to the Donabedian Model, a “social contract” exists between the society and the profession and under this contract the society will accept profession’s independence in exchange for their services and will give independence to that profession so that they could manage their own matters. In return for this privilege, the profession would act responsively to maintain the public interests (4).
Professional self-regulation would be granted to a profession as a privilege when the public would be able to receive the best possible services after that professions’ self-regulation (4). In fact, professional self-regulatory would guarantee the quality of services (2,5,6). During the past two decades, World Health Organization (WHO), to educate and employ competent and skilled nursing workforce, has recommended the governments to strengthen their professional self-regulatory frameworks. International Council of Nurses (ICN) in cooperation with the WHO has published a statement of their perspective of professional self-regulatory. This statement has mentioned that safe and high quality care, creating a monitoring system for licensing, professional policy making and applying the professional laws and rules could be reached by creating and improving the infrastructures of professional self-regulatory systems. ICN stated that professional self-regulatory is a method for applying discipline, stability and control over the profession and its performance (7, 8). National and international studies have shown that would improve educational and clinical standards which in turn would increase the power of the profession in managing its own matters.
Since professional self-regulatory would lead to the activity of qualified and competent individuals in a profession, it would increase people’s trust in professional services providers as capable and honest individuals and would provide the public interests (1). In professional self-regulatory, by firing professionally unqualified and uncommitted to the ethical codes individuals from the profession, the interests of the profession would be provided (4).
In the main, there are two ways a profession can be regulated: by the profession itself (professional self-regulatory) or directly by government. If the government would take the responsibility of managing the profession, the members of the profession would be forced to accept the laws and rules of the profession; while the approved laws by the self-regulated profession are flexible and would be accepted voluntarily (9).
Self-regulatory professions have two separate bodies for their activities: 1- the monitoring body and 2- the supporting body. The monitoring body maintains the interests of the profession through creating the inclusion criteria for the profession, licensing, certifying and disciplinary actions; while the supporting body would perform toward promoting the economic and professional benefits of the profession’s members. The goal of the supporting body is to develop the profession to assist the members and advance the profession; but the monitoring body will develop the profession to support the public interests. Most of the times, the public interests are not in conflict with the profession’s interest, but in case of such conflicts, professional self-regulatory should act toward achieving the public interest (10).
The condition of professional self-regulatory in Iranian nursing
Iranian nursing has had significant advancements during the recent years which development of academic education, formation of Iranian Nursing Organization (INO), establishment of Scientific Association of Iranian Nursing, establishment of research centers and publishing numerous research-scientific journals in different fields of nursing are some of them (11). However, the profession of nursing in Iran still has many shortcomings. Evaluating the laws of the Nursing Organization of the Islamic Republic of Iran, which is the greatest non-governmental nursing organization in Iran, although the goals of the organization are in line with the self-regulatory goals of the profession, but in most of the self-regulation requirements, no independent role has been defined for the organization, in a way that, in the definition of 6 duties out of 8 defined duties for the INO cooperation with or helping other organizations has been used and only in the third duty, “trying for improvement of the quality, skills and knowledge of nursing graduates” and the seventh duty, “determining standards for issuing, extending or cancelling membership cards”, the legislator has appointed an independent role for the organization. Maybe for this reason, and many other reasons that are not in the scope of this article, the INO has not considered professional self-regulation performances sufficiently. Other nursing associations in Iran, due to lack of regulatory mechanism and also the low number of members from the nursing profession, could not have an effective role in professional self-regulatory. In Iran, regulating the rules and managing the matters of nursing have always been a responsibility of the government (6,12). On the other hand, during the recent years, we have witnessed the establishment of the nursing deputy in the Ministry of Health and Medical Education (MOHME) which indicates the efforts for governmental management of this profession.
The authorities’ approach toward the nursing profession during the recent years for encountering various challenges is one of the examples of governmental management and lack of professional self-regulatory. For example, the nursing shortage could be mentioned which is a global problem. To resolve this problem, the MOHME has increased the capacity of training nursing students and the number of nursing schools. These measures have led to educating students at schools with no infrastructures and no competent educational board which is in conflict with the quality of services (public interests). In return, the next measure to compensate for the shortage in nursing workforce is educating practical nurses by the MOHME. Most of the experts have suggested this solution for the problem of shortage in nursing workforce, but it has been perceived as compulsory by the members of the profession and they disagree with it (13).
Considering that finding an appropriate self-regulatory mechanism for the profession requires the involvement of all the beneficiaries, especially the members of the profession, it is recommended that all of the active organizations in the field of nursing would start determining the characteristics and features of an appropriate self-regulatory organization for the nursing profession of Iran through conversations and then would make their best efforts for its establishment.
 

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Nurses are a major part of the health system workforce. Also, this group of healthcare workers has an important role in providing direct care to the patients. Therefore, nurses are considered an important pillar in any health system (1). However, during recent years, the shortage of nursing staff and high rate of job leaving have become a serious concern in many countries (2). To properly and timely deal with this challenge, it is necessary to have accurate information about all its relative factors such as number, age status, years of service, employment of nursing graduates, the number of active beds, their geographical distribution and the prediction of the number of nursing graduates in the next years.
While some studies have recently emphasized the issue that Iran, similar to many other countries, is facing nursing staff shortage (3), no clear picture is available of the current and future needs for nursing workforce due to the poor infrastructures of health information system in our country. Nejatian has stated that “there is still no accurate statistics on the shortage of nursing staff and the required nursing workforce” (4). However, some health ministry officials have suggested that there is a shortage of 200 thousand nursing staff (5).
Currently, if we accept that the country is facing the challenge of nursing shortage, it will be necessary to comprehensively consider all the factors related to supply and demand. One of the efforts made in recent years was to increase the capacity of nursing schools and establish new nursing schools for training a higher number of nurses. But some believe that a number of graduated nurses are not interested in working in the nursing field (6). For example, according to a governmental report, in 2013, about 1.6 million licensed nurses in the United States did not work in nursing (7). Therefore, further workforce training will not necessarily resolve the shortage of staff and it is necessary to consider other important factors influencing the recruitment and retention of nursing workforce. Among these factors, job satisfaction has a great role in the nurses’ intention to leave their profession (8) or decrease their working hours (9). Occupational burnout, social support (10) and the salaries and bonuses system (11) are other important factors that should be considered for resolving the problem of nursing shortage.
Considering the current situation, if the current shortage is caused by the lack of interest in working in nursing field or leaving nursing career, as Florence Nightingale proved that caring for the injured soldiers is less costly for the British army than letting them die and recruiting new soldiers (12), increasing the capacity for training nurses is not a cost-effective approach for resolving the problem of nursing shortage.
Despite what was mentioned above, the policy makers’ main strategy is still to increase the number of graduated nurses. In this regard, there are various experiences about developing and implementing nursing education programs in the world that could be an appropriate choice for resolving the problem of nursing staff shortage. One of these programs is “Accelerated Nursing Program” which has been developed for the graduates of non-nursing bachelor’s degree to be trained as a nurse. The first Accelerated Nursing Programs was developed in the early 1970s which gradually grew over the next years (13). These accelerated programs are based on the previous experiences of the students and provide an opportunity for individuals with a bachelor’s degree in other disciplines to enter the field of nursing (14). Accelerated nursing programs would provide the fastest way for issuing a nursing license to non-nursing graduates and last from 12 to 18 months (15). These programs are intense with courses offered full-time and there is no break between the courses; the students would pass the same hours of clinical internship as their counterparts in traditional nursing programs. Nursing staff value to the graduates of accelerated nursing programs because they would bring a great amount of skill and education to the workplace; they claim that these graduates are more mature and have stronger clinical skills and also are quick in learning the necessities of the job (14). Results of the study by Ouellet showed that accelerated programs would train qualified nurses who could be successfully prepared for clinical activities (16). Results of a retrospective study by Raines revealed that most graduates of accelerated nursing programs were working in nursing field and a great percentage of them were either studying or a higher degree graduates in nursing (15). Studies on the evaluation of accelerated nursing programs revealed positive results and outcomes in implementing these programs (17, 18).
Iran has high rates of unemployment among university graduates in many fields (19). Considering this important issue and our country’s priority in creating employment for them, it seems that applying the accelerated nursing programs rather than untested programs such as nurse training plan using the capacity of hospital, which has no clear structure, process and results, can be appropriate for the current situation in the country. Therefore, in order to find an answer to this challenge, it is recommended that nursing shortage area should be determined and these programs be launched in those areas. In such a framework, the required nursing staff can be provided in a shorter duration of time and with less cost.
 

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Background & Aim: Nurses play an important role in the health system and their turnover disrupts its performance. The aim of this study was to investigate intention to turnover and its relationship with healthy work environment among nursing staff.
Methods & Materials: This cross-sectional study was conducted on 295 nursing staff from Imam Khomeini hospital complex in Tehran in 2016. Nurses were selected by the stratified random sampling with a proportional allocation, and completed a demographic data form, the Healthy Work Environment questionnaire and the Anticipated Turnover Scale (ATS). Data were analyzed by descriptive statistics, independent t-test, one-way ANOVA, Pearson/Spearman correlation coefficient and multiple linear regression tests using the SPSS software version 20.
Results: The mean score for the intention to turnover was 36.21 (SD=4.38) ranged from 12 to 60. “Authentic leadership” and “skilled communication” domains obtained the highest (9.60±3) and lowest (8.97±2.74) scores respectively. There was poor correlation between the meaningful recognition domain and the anticipated turnover score (r=-0.135, P=0.024). In addition, the anticipated turnover score was significantly higher in male nurses than in female nurses (P=0.023).
Conclusion: Although there was no relationship between anticipated turnover and healthy work environment in this study, considering the importance of nurses’ recruitment and retention, there is a need to investigate the reasons for turnover, including characteristics of work environment, and take necessary measures.
 
 

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Background & Aim: The premenstrual syndrome (PMS) is a set of physical and psychological symptoms that occurs periodically and affects women’s social and individual functionings. This study aimed to investigate the effect of stress management group counseling on the symptoms of premenstrual syndrome.
Methods & Materials: This semi-experimental study (IRCT2016052127994N1) was conducted on 44 students with PMS (22 in the intervention group and 22 in the control group) from Zanjan University of Medical Sciences in 2016. Data were collected using a demographic characteristics form and premenstrual symptoms screening test (PSST). Descriptive and inferential statistics including independent t-test, Chi-square, ANCOVA and repeated measurement test were used for data analysis via the SPSS software version 21.
Results: Before treatment, the mean scores of mood-behavioral symptoms, physical symptoms and the impact of symptoms on life had not any significant differences between the two groups. At the first month after treatment, mood-behavioral symptoms (P<0.001) and the impact of symptoms on life (P=0.007) were different between the two groups. Two months after the intervention, the mean scores of mood-behavioral symptoms in the intervention group (53.2±4.84) were significantly different from those in the control group (70.2±4.81). There was a significant difference in the mean score of physical symptoms between the intervention group (36.7±5.87) and control group (64.9±7.84). Also, the mean score of the impact of symptoms on life had a significant difference between the intervention group (36±4.73) and control group (58.3±2.73) (P<0.001).
Conclusion: Stress management group counseling is effective in reducing the symptoms of premenstrual syndrome, and it can be used as a non-pharmacological method with no side effects.
 

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Health (hygienic) literacy is a cognitive skill and an important and effective issue in the healthcare system that was first proposed in 1974 in an educational panel about health education. Since then, this concept has been discussed by the researchers in various fields of literacy and health, and many definitions have been presented for it. Usually, health literacy is defined as a wide range of knowledge and skills in accessing, appraising, understanding and applying health information (1).
The importance of health literacy impact on the health outcomes of the patients has been well recognized and it has an important role in individual’s decision-making regarding their health needs (2). Health literacy as a social and cognitive skill has various aspects including accessing, appraising, understanding and applying. The ability to understand the educational content, as one of its aspects, has a significant importance in the patients (3-6). In recent years, health literacy has been recognized as an important skill that patients require for making an appropriate health decisions in difficult situations they encounter. Improving patients’ health literacy would cause outcomes such as increasing the patients’ potential to make informed decisions, decreasing health-threatening risks, increasing prevention of the diseases, improving patient safety, and improving quality of life and patient care (7-9).
To educate people, usually their general literacy would be considered, not their health literacy; while there is a significant difference between general literacy and health literacy. General literacy means having the ability to read and write and having basic skills. In contrast, health literacy is defined as a cognitive and social skill determining the individuals’ ability to access, understand, and apply information in order to promote health (10). Studies have shown that limited health literacy is associated with various complications in different aspects of health including lack of access to appropriate health services, less willingness to follow up treatments, less compliance with medication, increased number of visits to the emergency ward, increased duration of hospitalization, and increased mortality rate, and it has a significant effect on using healthcare services (3-6).
Furthermore, the negative economic effect of low health literacy on the patients and healthcare system could not be ignored. These issues would indicate the need for paying more attention to individuals’ health literacy.
According to a study conducted by Montazeri et al in Iran, it has been revealed that half of the Iranian population has a limited health literacy and this limitation is more common in the vulnerable groups such as the elderly, housewives, unemployed people and those with lower education levels; this would put them at more health risks (2). Also, results of various studies have shown that some health information is not appropriate for the audience and would not address their needs; whereas the effect of limited health literacy could be improved using appropriate health information. So, the challenging issue regarding these individuals is how to train them (regarding understanding health information); there are various strategies for resolving this issue such as limiting the information provided at each patient’s visit, avoiding technical terms, speaking slowly, finding educational content tailored to individuals’ ability to read, using pictures for explaining important concepts, encouraging people for asking more questions and assessing individuals’ understanding of the education provided using teach back and show me methods (11).
In this regard, in 2011, Centers for Disease Control and Prevention (CDC) designed the Health Literacy Index as a tool for providing appropriate educational content based on people’s health literacy. This comprehensive checklist comprises 63 items organized into 10 criteria; its criteria and items are shown in table 1. According to this checklist and based on its ten criteria, the educational process (content, procedure and evidence) would completely be evaluated to limit the effect of health literacy on the understanding of information provided to individuals (12).
 
Table 1. The criteria of the health literacy index

Criterion	Items	Evaluated subject
Plain language	8	Writing style (short and easily readable sentences) Terms (avoiding technical terms) numbers and data (ease in understanding the content)
Clear purpose	8	Precision, summaries and reviews Number of key points purpose of material (purposiveness) Using visual elements in the educational content
Supporting Graphic	6	Explanatory labels Graphic and images of the educational content in relation with the text to help the understanding of the abstract concepts
User involvement	7	Interactive strategies (the level of attention received by the audience and the extent of their active participation through the column of counseling, answer and question, games or competitions and storytelling narrations) Audience response
Skill-based learning	3	Focus on behavioral skills (modifying a health behavior and providing examples related to this modification)
Audience appropriateness	6	Match between audience and material (cultural and social appropriateness to the audience in terms of their experiences, values and beliefs) Audience identified
Instructions	6	User instructions Instructions for using the educational content regarding its technicality, applicability and comprehensiveness
Development details	3	Authors’ contact information Recent review of the studies
Evaluation methods	13	Process, formative and outcome evaluations
Strength of evidence	3	Evaluation findings

 
Andrade and colleagues studied the impact of using this index in providing educational materials for falling in the elderly. The results of this study showed that all the educational information is not suitable for audience and does not meet their needs. However, with the help of Health Literacy Index, it is possible to provide educational materials that are fit for the level of health literacy of elderly (7).
Due to the Low health literacy is very common particularly in the elders, it is crucial to provide educational materials that are consistent with the level of health literacy in target groups. Regarding the small number of studies have been conducted on the impacts of using health literacy index, It is imperative that the researchers in the related fields provide empirical evidence for its efficiency and effectiveness.
 
 
 

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Background & Aim: Family-centered care is a concept for describing the approach to caring for children and their families in health services and its main element is the involvement of parents in child care. This study aimed to compare the perception of family-centered care from the perspectives of nursing staff and mothers of hospitalized children in children’s wards.
Methods & Materials: This study was a cross-sectional study conducted on 82 mothers of hospitalized children and 60 nurses working in children’s wards of Afzalipour hospital in Kerman in 2017. In this study, a questionnaire on the family-centered care perception from the perspectives of nurses and mothers was used for data collection. Data were analyzed through SPSS software version 20 using t test, analysis of variance and Pearson correlation coefficient.
Results: Average scores for the perception of family-centered care from the perspective of nurses (3.17±0.79) and of the mothers (2.47±0.85) had significant differences between the two groups (P<0.001). In two groups, the highest average was related to the area of cooperation and the lowest average was related to the support area.
Conclusion: Findings showed nurses’ and mothers’ perceptions of family-centered care were positive but nurses have significantly more positive perception than mothers. This can be promising and nursing staff are required to be diligent about mothers’ participation in care so that the child receives better care.
 

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Background & Aim: Diagnosis of cancer can cause emotional problems such as stress, anxiety, depression and incompatibility with the disease in the patient and his/her family, leading to adverse consequences in the improvement process and an increase in the complications of the disease. Considering the importance of this topic, the study was conducted to investigate the effect of Roy’s adaptation model-based care plan on the severity of depression, anxiety and stress in patients with colorectal cancer hospitalized in the treatment and educational centers of Urmia.
Methods & Materials: In this randomized clinical trial study, 36 patients with colorectal cancer (at the third or fourth stage of disease) hospitalized in the treatment and educational centers of Urmia were selected by a convenience sampling and were assigned to the intervention group or control group in 2016. Data collection tools were a form for assessing the Roy’s adaptation model and the depression, anxiety, and stress scale (DASS-21). The Roy’s adaptation model-based care plan was administered to the intervention group. Data analysis was performed using the SPSS software version 18 and t test and Chi-square test.
Results: The study results showed before the intervention, the mean scores of depression, anxiety and stress were 12.7±4.5, 13.9±4.8, 16.4±4.7 for the control group and were 15.7±4.5, 13.0±4.6, 12.6±4.2 for the intervention group, respectively. There was no statistically significant difference between the two groups (P<0.05). However, after the intervention, the mean scores of the studied variables increased in the control group (13.7±4.8, 13.93±4.9, 17.16±4.4) and decreased in the intervention group (10.46±3.1, 11.00±3.4, 13.8±5.2). There was a significant difference between the two groups (P<0.05).
Conclusion: Due to the severity of depression, anxiety, and stress among cancer patients, more cost-effective and non-pharmacological methods such as the Roy’s adaptation model, can be useful to control these complications and create a less stressful environment for these patients.
Clinical trial registry: IRCT20160220026662N5
 

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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: 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: 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
 

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Background & Aim: Cultural competence is one of the main components of health care. Attention to cultural competence is essential to reduce healthcare inequalities and identify potential for improving healthcare delivery. The aim of this study was to investigate cultural competence and its related factors in health care providers working in comprehensive health centers affiliated with Tehran University of Medical Sciences (TUMS).
Methods & Materials: In this descriptive, cross-sectional study, 250 health care providers working in health centers affiliated with TUMS were selected using the convenience sampling method in 2020. The demographic characteristics form and the cultural competence scale for health workers (CCSN) were used to collect the data. Data were analyzed using descriptive and inferential statistical tests (t-test and ANOVA) through the SPSS software version 16 at a significance level of 0.05.
Results: The mean total score of cultural competence in health care providers was 162.66±28.41 (range: 33-231). According to the findings, the mean score of cultural competence for all dimensions was desirable. The mean score of cultural competence had a statistically significant relationship with intra-ethnic marriage (P>0.005) and work experience (P=0.012) while no statistically significant difference was observed with other demographic variables.
Conclusion: The study results showed that cultural competence in health care providers was at the desirable level. These results may be useful for managers and planners in the development and management of human resources and quality assurance of health services delivery.

 

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Background & Aim: Adolescence is characterized by social, emotional, and physical development, during which aggression emerges as a significant psychological risk factor. This study was designed to compare the effects of puberty counseling for mothers and adolescents on the aggression levels of female adolescents.
Methods & Materials: This field trial was conducted with 92 participants divided into three groups: two intervention groups (mothers and adolescents) and one control group. The study was carried out in schools in Qazvin in 2023, with data collected before and after the intervention. Sampling was conducted using a multi-stage random sampling method, and participants were randomly allocated into three groups across six blocks. Each intervention group attended six one-hour face-to-face sessions, while the control group received no intervention. Data were collected using the Novaco Aggression Questionnaire and analyzed with multivariate covariance analysis in SPSS software version 25.
Results: The mean aggression scores before the intervention were 50.10±21.68 for the girls’ group, 57.10±93.32 for the mothers’ group, and 54.56±10.61 for the control group (P=0.018). After the intervention, the scores were 37.68±10.16 for the girls’ group, 43.14±76.66 for the mothers’ group, and 49.60±16.11 for the control group, showing a statistically significant difference (P=0.014). Additionally, the intervention had a significant overall effect on reducing the total aggression score (P=0.020), with an effect size estimated at 0.09 based on Partial Eta Squared.
Conclusion: The results of this study suggest that puberty education for mothers, as well as for adolescents, can effectively reduce aggression levels in female adolescents.