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Background & Aim: Postoperative pain is one of the clinical challenges for nurses who care for patients. The objective of this review was to evaluate the effect of preoperative education on postoperative pain after elective surgery.
Methods & Materials: A literature search was done on PubMed, CINAHL, Cochrane Library, Web of Science, Scopus and EMBASE to find the articles published in English on clinical trials from January 2012 to June 2018.
Results: Out of 153 studies retrieved, 13 studies (2482 people) were reviewed. Generally, most studies indicated the effectiveness of preoperative education on postoperative pain relief (7 studies, n=1678). In other studies, there was no significant difference between education and the degree of pain reduction in the patient. Also, the results of some studies (n=204) showed that education with empathy could reduce anxiety in half of the cases.
Conclusion: Preoperative education as a complex intervention can reduce postoperative pain. Interactive education with empathy reduces patient’s anxiety and the need for postoperative analgesics. Therefore, training skilled nurses and the providers of such education is suggested for managing pain in patients.
 

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Background & Aim: Menstrual health is an important aspect of adolescent health. Most girls do not have proper information about menstrual health, and incorrect information from unreliable sources makes problems for them. Aim of this study was to compare small group-based education with maternal participation and routine education on adolescent girls’ menstrual health behaviors.
Methods & Materials: This randomized clinical trial study was performed on 60 high school students with regular menstruation in the groups of intervention and control. Among high schools in Mashhad in 2018, two schools were assigned to one of two groups by lottery. Menstrual health education was provided to the intervention group in four sessions as the groups of 3-4 people. For mothers in this group, two 2-hour sessions with the same content were held and the students in control group received routine education. Data were collected by a questionnaire on menstrual health behaviors, before the intervention, after the end of the first and second menstrual cycle. Data were analyzed by Mann-Whitney, Chi square and independent samples t-test using the SPSS software version 16.
Results: before the intervention, there was a statistically significant difference in the menstrual health behaviors score (P=0.199). After the intervention, mean score of menstrual health behaviors (the end of the first and second menstrual cycles) significantly increased (P<0.001) for the two groups. Also, mean score of menstrual health behaviors for the intervention group was significantly higher than that of for the control group (P<0.001).
Conclusion: The small group-based education with the participation of mothers in comparison to routine education was more effective in promoting menstrual health behaviors in adolescent girls. This method is recommended to health planners for education of health issues, including menstrual health.
Clinical trial registry: IRCT20180904040952N2
 

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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: The inadequate level of pharmaceutical knowledge of nursing students carries the risk of medication errors, and this is one of the main concerns of clinical educators. Therefore, the aim of the study was to determine the effect of targeted and game-based pharmacology education on pharmacology scores of nursing students.
Methods & Materials: This quasi-experimental interventional study was conducted through the census method on third-semester nursing students of Abadan University of Medical Sciences in 2018-2019. The intervention included teaching clinical pharmacology in the form of game during an internship course (including 10 sessions). The first to third sessions included holding the pharmacology theoretical class, the fourth to ninth sessions included playing game, theoretical classes, and clinical practice, and the tenth session included a station review program and a competitive pharmaceutical data pool program. The pharmacology exam was given before and after the intervention. The data was analyzed by paired t-test using the SPSS software version 18.
Results: There were 77 students until the end of the study, of whom 42 were female and 35 were male. Their mean age was 21±2 years, the total average of students was 15.57±3.81 with a mean pharmacology score of 14.74±3.42. According to the test results, the pre-test mean score was 26.06±5.83 and the post-test mean score was 31.58±4.02, which indicated a significant difference between before and after the intervention (P<0.001).
Conclusion: This purposeful educational program increased the level of pharmacology scores of nursing students and can be used as a suitable method to improve students' knowledge and understanding of pharmacology.
 

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Background & Aim: Epilepsy is the most common chronic neurological disease after headache. About half of the patients with epilepsy do not properly adhere to medication regimens, which leads to a lack of control over seizures, increased treatment costs, and even increased mortality rate in these patients. The aim of this study was to determine the effect of telephone education on medication adherence in patients with epilepsy.
Methods & Materials: In this quasi-experimental study, 60 patients referred to neurology clinic of Valiasr Hospital in Zanjan in 2019 were selected by the convenience sampling method, and were randomly divided into either control or experimental groups. The Morisky drug adherence Questionnaire was used for data collection. At the beginning of the study and after completing the questionnaires, a face-to-face training session was held for the study participants. Then, telephone education was performed for the experimental group for two months and no intervention for the control group. Two months after the intervention, all the patients completed the questionnaire again. Finally, the collected data were analyzed through the SPSS software version 25 using descriptive (mean and standard deviation) and inferential statistics (Chi-square, Fisher's exact test, independent t-test and paired t-test).
Results: Before the intervention, there was no statistically significant difference between the two groups in terms of individual characteristics and medication adherence scores (P<0.05); But two months after the intervention, a statistically significant difference was observed in the mean score of medication adherence between the two control and experimental groups so that the patients in the experimental group had higher scores of medication adherence (P<0.001).
Conclusion: The results of this study showed the usefulness of using the telephone education method in improving the medication adherence of patients with epilepsy. Therefore, it is recommended that this method be used in the training program for these patients. In addition, further studies are needed on the comparison of the effectiveness of telephone education with other methods of telemedicine such as cyberspace and online education.
 

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Background & Aim: Pre-hospital emergencies are one of the most stressful medical professions. Stressful jobs affect employees’ resilience and their ability to control anger. The aim of this study is to determine the effect of psycho-education on the level of anger and resilience among pre-hospital emergency staff.
Methods & Materials: In this quasi-experimental study, 120 people employed in urban and road centers in Zahedan were included through the convenience sampling method. To determine the intervention and control group, out of 24 available centers, 12 centers were randomly assigned to the intervention group and 12 centers to the control group. First, a demographic information form and the self-reported anger and resilience questionnaires were completed by both groups. Then, the intervention group participated in five sessions of psycho-education in groups of 8-12 people. The questionnaires were completed again by both groups two months after the intervention. Data was analyzed by the SPSS software version 16 using descriptive (mean and standard deviation) and inferential statistics (Chi-square test, independent t-test and paired t-test).
Results: The results of independent t-test showed no significant difference in the mean and standard deviation of resilience score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.492), but after the intervention the difference was significant (P=0.009). Also, the results of independent t-test showed no significant difference in the mean and standard deviation of anger control score among pre-hospital emergency staff between the intervention and control groups before the intervention (P=0.672), but after the intervention, mean and standard deviation of anger control score in the intervention group were significantly higher than those of in the control group (P<0.001).
Conclusion: The present study showed that psycho-education improved the resilience of emergency workers, and the employees were able to control their anger by enhancing resilience. It is suggested that in-service training programs for pre-hospital emergency staff include a psycho-education program to enhance resilience and control anger in those who face many stressful situations.
 

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Background & Aim: Health-related behaviors of patients with myocardial infarction (MI) are highly affected by their illness perceptions, and education is one of the ways to enhance illness perception. Accordingly, the aim of this study was to compare the effect of multimedia and telephone education on illness perception in patients with MI after discharge.
Methods & Materials: A randomized clinical trial was conducted on 32 patients with MI who were discharged in 2019-2020 in Gonabad and Mashhad. The samples were selected by the convenience sampling method and randomly assigned to the multimedia or telephone groups. The educational content was similar for both groups, and was provided as a conversation for the telephone group, and as video, audio, and image for the multimedia group. The Brief Illness Perception Questionnaire (Brief. IPQ) was completed by the patients on the first day and the sixth week after discharge. Data were analyzed through the SPSS software version 20 using Kolmogorov-Smirnov test, chi-square test, Fisher's exact test, independent t-test, Paired t-test and Levene's test, at a significance level of P<0.05.
Results: The results showed that the average score for the components of illness perception after the intervention compared to before the intervention in the both groups had a significant increase (P<0.05), but no significant difference was observed in the comparison between the two groups (P>0.05).
Conclusion: Both multimedia and telephone training methods improve illness perception in the patients. Therefore, the trainer is suggested to choose the type of training according to individual differences and facilities of the recipient, and health managers should apply appropriate policies for patients with MI to benefit from telenursing care after discharge.
Clinical trial registry: IRCT20190607043834N1

 

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Background & Aim: Self-efficacy disruption poses a significant challenge for patients with a stoma, affecting their ability to engage in community life and carry out daily activities. Utilizing remote training methods for patients presents an opportunity to maximize the use of these resources. This study aims to determine the effect of a telenursing-based training program on the self-efficacy of patients with a stoma.
Methods & Materials: This quasi-experimental study involved a convenient sample of 80 patients with a stoma in Zahedan in 2023, who were randomly assigned to two groups: intervention and control, each comprising 40 participants. The intervention group received the telenursing-based program application. Self-efficacy was assessed using the self-efficacy of stoma patients questionnaire before the intervention, as well as one and three months after the intervention. Data were analyzed using Chi-square test and a two-way repeated measures analysis of variance through SPSS software version 26.
Results: The intervention group exhibited a mean (SD) age of 42.84±12.98 years, while the control group had a mean (SD) age of 46.26±11.89 years (P=0.320). The self-efficacy total scores in the intervention group showed values of 69.75±8.05 before the intervention, 77.28±7.57 at one month, and 92.72±6.43 at three months post-intervention, suggesting a significant effect of the telenursing-based training on self-efficacy levels (P<0.001).
Conclusion: The results of the present study show the effect of the telenursing training program on improving self-efficacy levels in patients with stoma. Therefore, it is recommended to implement such programs to support this patient population.

 

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Background & Aim: The high prevalence of cesarean section in most developed countries, exceeding 50%, has led to detrimental effects on maternal and child health. Vaginal birth after cesarean (VBAC) is a beneficial way to reduce cesarean rates. This study aimed to determine the effect of theory of planned behavior-based training on the intention and behavior of VBAC in pregnant women with previous cesarean section.
Methods & Materials: In this randomized controlled trial study, a convenience sample of 70 pregnant women with a history of cesarean section, referred to comprehensive health centers in Ardabil in 2020, were randomly assigned to either the intervention or control group. The intervention group received four weekly education sessions based on the theory of planned behavior structures, while the control group received standard care. Data were collected using a researcher-developed questionnaire at three time points: before, immediately after, and four weeks after the intervention. Data analysis was conducted using SPSS software version 16, employing independent t-test, Fisher’s exact test, chi-square test, and repeated measures ANOVA at a 95% confidence level.
Results: Repeated measures ANOVA revealed significant differences in mean scores of attitude, subjective norm, perceived behavior control, intention, and awareness over time between the intervention and control groups (P<0.001). However, the educational intervention did not lead to a behavior change.
Conclusion: Based on the findings, it is imperative for health planners to focus on providing organizational support and fostering a positive attitude among obstetricians and midwives to prioritize the implementation of VBAC.
Clinical trial registry: IRCT20200519047509N1

 

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Background & Aim: Osteoporosis is a common problem in menopausal women, and adopting preventive behaviors is crucial in addressing this issue. The purpose of the study is to evaluate the effect of an educational intervention based on the health belief model (HBM) on promoting osteoporosis-preventive behaviors in menopausal women.
Methods & Materials: This quasi-experimental study with a control group was conducted on 64 menopausal women referred to Urmia urban health centers in 2023. Participants were selected using random sampling and then randomly allocated into two groups: control (32) and intervention (32). The data collection instruments included questionnaires comprising demographic information, knowledge assessments, Health Belief Model constructs, food frequency, and physical activity items. Following pre-test evaluations and needs assessment, a training program was designed and delivered to the intervention group. The collected data were analyzed using SPSS software version 26.
Results: The mean scores for knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived self-efficacy, and cues to action in the intervention group significantly increased compared to both the pre-intervention assessment and the control group. Conversely, there was a significant decrease in the mean score for perceived barriers (P<0.05). These changes resulted in a significant increase in the mean score for osteoporosis preventive behaviors within the intervention group (P<0.05).
Conclusion: Education based on the HBM has been effective in shaping the knowledge and health beliefs of menopausal women concerning osteoporosis and its preventive behaviors. Therefore, it is recommended that health educators incorporate the approaches and findings of this study when developing educational interventions related to osteoporosis.

 

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Background & Aim: Electrocardiography (ECG) is the most widely utilized diagnostic tool in medicine. However, nursing students often have problems with interpreting ECGs, highlighting the need for revised training methods. This study aimed to assess the effect of ECG drawing assignments on nursing students' learning and their perspectives on this teaching method in the context of a critical care nursing course.
Methods & Materials: This quasi-experimental study involved 52 fifth-semester BSc nursing students enrolled in the fall and spring terms at Qom University of Medical Sciences. For the fall group, traditional lectures and Q&A sessions were conducted during the first half of the semester, followed by an assignment requiring students to draw common ECGs in the second half. In contrast, for the spring group, students drew ECGs during the first half of the semester. Learning outcomes were assessed through a written test, while students’ perspectives on the drawing assignments were evaluated using a questionnaire. Data were analyzed using SPSS software version 22, employing Mann-Whitney and Wilcoxon tests to compare groups.
Results: The mean score from the perspective questionnaire regarding ECG drawing was 14.86±3.34 (maximum score of 18). In most cases, students had positive or relatively positive views towards this teaching method. A significant difference was observed between the course exam scores of students when they engaged in drawing ECGs compared to when they did not (P<0.001).
Conclusion: Drawing ECGs can be helpful in enhancing learning outcomes in the critical care nursing course and may increase students’ motivation to learn.

 

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Background & Aim: Patients with heart failure often experience inadequate self-care and diminished quality of life, leading to significant constraints in their daily personal and social activities. This study aims to evaluate the effect of individually designed energy conservation training on enhancing self-care capabilities and improving the quality of life for patients with heart failure.
Methods & Materials: This randomized clinical trial was conducted from June 2022 to May 2023 and involved 60 heart failure patients in the CCU and cardiology ward, as well as cardiovascular clinic at Shahid Madani and Shohadai Ashayer Hospital in Khorramabad, Lorestan. Based on established inclusion criteria, participants were randomly assigned to either the intervention group (n=30) or the control group (n=30). The intervention group received individually designed training in four sessions, each lasting 30 minutes, spaced over three weeks (total duration of nine weeks). In contrast, the control group received standard nursing education upon discharge. Participants completed the European Heart Failure Self-Care Behavior Scale and the Minnesota Living with Heart Failure Questionnaire both prior to the intervention and at the tenth week post-intervention. Data were analyzed using SPSS software version 24, employing the Mann-Whitney U test, Wilcoxon test, independent t-test, and chi-square tests.
Results: After the intervention, the intervention group demonstrated a statistically significant decrease in mean scores for self-care and quality of life compared to the control group (P<0.001). These findings indicate an enhancement in self-care practices and an improvement in the quality of life.
Conclusion: Individually designed energy conservation training effectively improves self-care and quality of life in patients with heart failure. Therefore, using this complication-free, non-pharmacological approach can be beneficial for this patient population.
Clinical trial registry: IRCT20220612055150N1

 

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Background & Aim: Current clinical education programs in nursing often demonstrate moderate quality; despite a solid theoretical foundation, students frequently lack essential cognitive skills necessary for effective clinical decision-making. This study aimed to evaluate the impact of an integrated educational program using case study method and the nursing process on the clinical decision-making capabilities of nursing students.
Methods & Materials: This study employed a quantitative, quasi-experimental design with a pretest-posttest approach, conducted in 2019 among final-year undergraduate nursing students at the Faculty of Nursing and Midwifery in Tabriz. A census sampling method was utilized, resulting in a total sample size of 106 students. The intervention group received an integrated educational program incorporating case studies and the nursing process, whereas the control group received conventional training based on a standard logbook. Data collection occurred pre- and post-intervention using the Jenkins Clinical Decision-Making Scale. Data were analyzed using SPSS version 16 through independent t-tests, paired t-tests, and analysis of covariance (ANCOVA).
Results: Paired t-test comparisons within the control group revealed no significant change in overall clinical decision-making scores. Conversely, the intervention group exhibited a statistically significant improvement post-intervention. Between-group analyses indicated that both the total clinical decision-making scores and their four dimensions experienced significant increases after the intervention (P<0.001). ANCOVA, controlling for pretest scores and GPA (Grade Point Average) as covariates, confirmed that the differences in clinical decision-making between the two groups remained statistically significant (P=0.004), with an effect size of 0.08.
Conclusion: The integrated educational method significantly enhances clinical decision-making skills among nursing students. Therefore, nursing educators can enhance students' cognitive skills by using this method in clinical training.

 

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Background & Aim: Gastrointestinal ostomy surgery changes the normal digestive function of patients. Insufficient knowledge and skills regarding ostomy care can lead to physical, psychological, and social complications. The present study aimed to determine the effect of a pre-operative education program on ostomy self-efficacy in patients undergoing ostomy surgery.
Methods & Materials: This randomized clinical trial included patients scheduled for colostomy or ileostomy surgery at hospitals affiliated with Shahid Beheshti University of Medical Sciences during 2022-2023. Participants were randomly assigned to two groups: the intervention group (41 patients) and the control group (44 patients). The control group received only routine education before discharge, while the intervention group participated in the pre-operative education program. The modified ostomy self-efficacy questionnaire was administered to patients before the intervention and one month post-surgery. Data were analyzed using descriptive and inferential statistics in SPSS software version 20.
Results: One month after surgery, the ostomy self-efficacy scores were significantly higher in the intervention group compared to the control group (P<0.001). Furthermore, within the intervention group, the post-intervention ostomy self-efficacy scores were significantly greater than pre-intervention scores (P<0.001). Additionally, the length of hospitalization following surgery was significantly shorter in the intervention group than in the control group (P=0.007).
Conclusion: The results showed that pre-operative education enhances ostomy self-efficacy and reduces the length of hospitalization. Therefore, implementing pre-operative education on ostomy care for patients undergoing ostomy surgery is strongly recommended.
Clinical trial registry: IRCT20220731055588N1

 

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Background & Aim: Hypertension is a common, often asymptomatic chronic disease that can lead to severe complications if not properly controlled. Patient education plays a vital role in improving blood pressure management and preventing related complications. This study aimed to compare the effects of mobile health (mHealth) and face-to-face education on treatment adherence among patients with hypertension.
Methods & Materials: This quasi-experimental study was conducted on 110 patients with hypertension referred to teaching hospitals in Zahedan, Iran. Participants were selected using convenience sampling and randomly assigned to two groups. Data were collected using a demographic questionnaire and the Hypertension Treatment Adherence Questionnaire. In the mHealth group, patients received educational content via the Eitaa messaging application, and the adherence questionnaire was completed six weeks after the final message. In the face-to-face group, educational sessions were held once a week for three consecutive weeks, and the same questionnaire was administered six weeks after the last session. Data were analyzed using SPSS version 26 with independent and paired t-tests, chi-square test, Fisher’s exact test, and analysis of covariance (ANCOVA). A P-value<0.05 was considered statistically significant.
Results: Before the intervention, there were no significant differences between the two groups in total adherence scores and most of its subdimensions (except for dietary adherence). After the intervention, however, the difference between the two groups became statistically significant (P=0.001).
Conclusion: Both mHealth-based and face-to-face education effectively improved treatment adherence among patients with hypertension. However, mHealth-based education provides the additional advantage of flexible and continuous access to educational materials anytime and anywhere, making it a practical alternative for patient education.

 

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Background & Aim: In light of the holistic approach to health, it has become increasingly important to utilize spiritual capacities to meet patients' needs. Spiritual care education for nursing students is therefore essential. This study aimed to address the lack of educational content in this area within the Iranian medical education system by developing a spiritual care educational package for nursing students and evaluating its impact on students' spiritual care scores.
Methods & Materials: This study, conducted in 1401, followed the Rothwell model and involved 60 final-year nursing students from Tehran, Shahid Beheshti, and Iran Universities of Medical Sciences. Participants were selected through simple random sampling in proportion to the number of final-year nursing students at each university. The educational package was provided to students as a text file for self-study, discussion with clinical instructors, and application in internship settings. Students' spiritual care scores pre- and post-training were compared using descriptive and inferential statistics in SPSS version 26.
Results: The average spiritual care score of the participating students increased from 1.94 to 4.21, indicating a significant positive effect of the training package (P<0.05). However, variables such as age, gender, university of study, and interest in the field did not have a significant effect on the increase in score (P>0.05).
Conclusion: The results of the present study suggest that the training package was effective in improving students' spiritual care scores. Therefore, it is recommended that nurses and other health disciplines receive training in spiritual care through various m

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Background & Aim: The quality of communication between parents and adolescents can have profound effect on adolescents’ attitudes towards them and the formation of their emotional and social relationships. This study aimed to determine the effect of parent-child relationship training for parents on adolescents’ attitudes towards them.
Methods & Materials: This quasi-experimental study with a pre-test-post-test design and a control group was conducted on students aged 16 to 18 and their parents in 2023. In this study, 56 parents of students with poor parent-child relationships were placed in the intervention and control groups (28 people in each group) along with the relevant student. Parents in the intervention group received training on improving parent-child relationships, while the control group did not receive training. After 21 days, the quality of the parent-child relationship and adolescents’ attitudes towards parents were assessed. Data analysis was performed using SPSS version 27 software using independent t-test, paired t-test, Mann-Whitney, Fisher and Chi-square tests.
Results: The two groups were homogeneous in terms of demographic characteristics (P>0.05). The results showed that after the intervention, the quality of the parent-child relationship and adolescents' attitudes towards parents in the intervention group significantly improved compared to before the intervention and compared to the control group (P<0.001).
Conclusion: Training  in parent-child communication skills has a positive effect on improving parental relationships and adolescents' attitudes. These findings emphasize the importance of including parenting training in family education programs.