Background & Aim: The ultimate goal of self-care behavior is patients' empowerment. There are limited studies on perspectives of patients with Parkinson's disease on self-care. This study aimed to explore for the process of self-care in patients with Parkinson’s disease during 2011 to 2013 .

  Methods & Materials: This exploratory qualitative study was carried out using grounded theory method. Data were collected via semi-structured in-depth interviews and field notes. We interviewed with 12 patients with Parkinson 's disease and four family caregivers . Participants were selected from two neurology clinics. Interviews were conducted at participants' homes or nursing homes. Data were analyzed using the Corbin and Strauss (2008) approach . 

  Results: Concepts of study were identified using a micro and general analysis. The 'fear of becoming crippled' was identified as a main concern. Strategies used in response to context included 'independency', 'spiritual care', 'informed self-care' and ‘seeking treatment’. 'Striving for taking independent self-care' was the most important process. Demographic, familial and social factors had important roles in self-care processes of patients with Parkinson's disease .

  Conclusion: The process of self-care in patients with Parkinson’s disease depends on the context and severity of the signs and symptoms. Health care providers especially nurses can support patients with Parkinson's disease in achieving maintain independence in self-care. In addition, attention to self-care behaviors with focus on person as self-care agent can considerably increase control and management of life .

  Background & Aim: Quality of work life seems to have impact on employees' job satisfaction, job involvement, job performance, turnover, and organizational transformation. This study aimed to assess the relationship between job satisfaction with the components of quality of work life among midwives in mashhad .

  Methods & Materials: This was a correlational study conducted among 230 midwives in mashhad in 2014. Data were collected using a demographic questionnaire, Walton's quality of work life, and the Minnesota job satisfaction questionnaire. Validity of the questionnaires was confirmed by 10 experts. The reliability was confirmed by alpha Cronbach. Data were analyzed using the descriptive statistics, Pearson, Spearman and ANOVA tests in the SPSS-19 . 

  Results: The overall quality of work life and job satisfaction had significant positive correlations (P<0.001 r_p=0.525 ). The job satisfaction had correlation with fair and adequate payment (r_p=0.277 P <0.001), safe working conditions (r_p=0.274 P <0.001), proper opportunity promotion ( r_p=0.306 P <0.001), o verall space of life ( r_p=0.327 P <0.001), job lawfulness ( r_p=0.233 P <0.001), social dependence in the work life ( r_p=0.207 P <0.001), s ocial cohesion in the organization (r_p=0.352 P <0.001), and proper opportunities to develop human capabilities (r_p=0.259 P <0.001) .

  Conclusion: Higher quality of work life is correlated with the higher job satisfaction. Managers can plan and implement appropriate strategies to promote components of quality of work life of midwives to provide efficient health services .

  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 .

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Background & Aim: Maternal request for caesarean section due to fear of normal vaginal delivery (NVD) is one of the main reasons for the high rate of caesarean section. This study aimed to compare the fear of NVD and type of delivery between two groups of pregnant women attended childbirth preparation classes (CPC) and women received routine prenatal care (RPC).

Methods & Materials: In this prospective cohort study, 202 Primigravid women attended healthcare centers for prenatal care services in the East of Guilan were selected using convenient sampling in 2013-2014. Fear of NVD was assessed using a childbirth attitude questionnaire at two stages (before attending CPC or receiving RPC, then at the third trimester of pregnancy). Both groups were followed up to the delivery time. Data were analyzed using inferential and descriptive statistics (Chi square, paired t-test, ANOVA, t-test) through SPSS v.16. P<0.05 was considered as significant.

Results: There was no significant difference (P=0.23) in the mean score of fear of NVD between two groups before attending CPC (35.59±8.78) and receiving RPC (37.08±9.08). The comparison of the mean score of fear of NVD between two groups at the third trimester of pregnancy showed a significant reduction (P<0.001) in the first group (32.30±8.31) than in the second group (37.29±9.55). A significant difference was also observed between two groups in the rate of NVD (P=0.002).

Conclusion: Results confirm the importance of CPC in decreasing fear of NVD and increasing the rate of NVD in primigravid women attended these classes. Therefore, women’s attendance at CPC is recommended to be encouraged.

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

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

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

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

Background & Aim: Studies have shown that family caregivers’ attitude toward mental illness affects their caring to mental patients and may reduce the quality of caring to them. This study aimed to determine the effect of group psychoeducation on attitude toward mental illness in the family caregivers of patients with bipolar disorder.

Methods & Materials: In this randomized clinical trial study conducted in 2015, 74 family caregivers of the patients with bipolar disorder who had been hospitalized in the psychiatric wards of Razi hospital in Tabriz were selected by random sampling method. Then, they were randomly assigned into the experimental and control groups. The families of experimental group participated in 8 continuous 90-minute 2 times a week psychoeducational sessions. Family caregivers’ attitude toward mental illness was measured using the questionnaire of Opinion about Mental Illnesses (OMI) before and after intervention. Data analysis was conducted using descriptive statistics, Chi-square test, independent t-test, paired t-test and ANCOVA on SPSS software version 13.

Results: The results revealed that there was no significant difference in mean score of attitude toward mental illness between the experimental group and the control group before intervention (92.54±8.51 vs. 90.52±9.43, P>0.05). But the mean score of family caregivers' posttest in the experimental group significantly increased compared to the control group (105.43±14.72 vs. 90.52±7.50, P<0.05).

Conclusion: The study results demonstrate that psychoeducational program improves family caregivers’ attitude toward mental illness. Training methods such as group psychoeducation can be effective in promoting positive attitude in the families of patients with psychiatric disorder.

Background & Aim: Although mechanical ventilation is a life-saving intervention for many infants with respiratory distress syndrome, it carries potential complications. One of these complications is prolonged duration of mechanical ventilation. More than 15 days of mechanical ventilation is associated with increased risk of cerebral palsy and attention deficit hyperactivity disorder among extremely low birth weight infants. The current study aimed to determine the relationships between the length of mechanical ventilation and its related factors in neonates with respiratory distress syndrome.

Methods & Materials: In this analytical study, a convenience sample of 60 premature infants of 33 weeks’ gestation or less with respiratory distress syndrome was recruited from three hospitals (Mahdieh, Mofid, and Imam Hossein) affiliated to Shahid Beheshti University of Medical Sciences in 2014-2015. Then, factors related to the length of mechanical ventilation such as sex, type of birth, birth weight, gestational age, Apgar score at the first minute, Apgar score at the fifth minute were assessed. The data were analyzed using descriptive statistics, Pearson correlation, independent t-test, and multiple regression analysis on SPSS software v.20.

Results: The mean gestational age was 30.62±1.8 weeks and the mean weight of infants was 1510.33±390.940 grams. The mean length of mechanical ventilation was 3.58±2.97 days. There  were not any correlations between sex, type of birth and the length of mechanical ventilation (P>0.05). Gestational age and weight were significantly correlated to the length of mechanical ventilation (P<0.001). But in adjusted analysis using multiple regression, only gestational age remained a significant factor related to the length of mechanical ventilation (P<0.05).

Conclusion: The results of the current study revealed that among the studied factors, only gestational age was a factor affecting the length of mechanical ventilation.

Background & Aim: Extravasation is one of the complications of peripheral intravenous catheters. Doing standard nursing cares leads to more effective and safer treatment and care of extravasation and the reduction in the length of hospital stay for neonates. This study aimed to audit nursing cares related to the treatment of extravasation in neonatal intensive care units.

Methods & Materials: In this descriptive study (the audit), 200 nursing cares regarding neonatal extravasation were observed and assessed. Data gathering tool was a standard check list. The data collection method was the observation and recording of nursing cares related to neonatal extravasation in neonatal intensive care unit of selected hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2015. The data were analyzed using descriptive statistics on SPSS software v.21.

Results: The standard cares were performed by nurses in some cases, and in some standards, nurses showed poor performance. Among 25 common nursing cares of extravasation, 22 cares were far from standards. After third and fourth degree extravasation, none of required nursing cares were done properly.

Conclusion: Nursing cares of extravasation for neonates in NICU are far from standard cares. This could be attributed to the lack of nurses’ awareness of the importance of proper extravasation care and its consequences, failure in nurses’ education, lack of authorities’ supervision on cares, lack of facilities and equipments, and nursing shortage.

Background & Aim: Pressure ulcers are a common complication in patients hospitalized in intensive care units. This complication continues to be a major problem in all health care systems and reflects the quality of nursing care in hospitals. The aim of this study was to evaluate the correlation between nurses’ knowledge and quality of nursing care for prevention of pressure ulcers in intensive care units.

Methods & Materials: This was a descriptive correlational study on a purposive sample of 92 nurses employed in intensive care units of four hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2014. Data were collected through a questionnaire containing demographic and occupational information, the Pieper’s nursing knowledge questionnaire, and a checklist to assess the quality of nursing care for prevention of pressure ulcers. Descriptive and inferential statistics (independent t-test and Pearson’s correlation) were used to analyze data on SPSS software v. 21. The level of significance was considered at P≤0.05.

Results: The study results showed that the average score of nurses’ knowledge of pressure ulcers prevention was a total of 75.7±6.9. The quality of nursing care in more than half of cases (54.3%) was relatively favorable. There was no significant correlation between nurses’ knowledge and the quality of nursing care for pressure ulcers (P=0.86, r=0.01).

Conclusion: In addition to inadequate knowledge of pressure ulcers prevention, the nurses did not fully implement what they knew in clinical practices. Therefore, a more accurate evaluation is recommended in this regard.

Background & Aim: In recent years, health care workers' mobile phones have been considered important as a source of infection because they could have a significant role in nosocomial infections. The aim of this study is to determine the type of microbial contamination of health care workers' mobile phones in Sina hospital in Tabriz.

Methods & Materials: In this descriptive-analytical study, 140 samples were taken from health care workers' mobile phones by convenience sampling, in 2015. The samples were taken by a sterile swab and immediately transferred to the hospital laboratory. They were cultured after incubation for 48 hrs in two plates at 37° C. Finally, the grown microorganisms were identified by biochemical tests. The data were analyzed using descriptive statistics and Chi-square test on SPSS software version 13. A level of P<0.05 was considered significant.

Results: 84.28% of phones were positive for bacterial contamination. Coagulase-negative staphylococci (45%) had the most frequency and Bacillus species (19.28%) were in second rank. Acinetobacter found in only 1 case (0.71%) had the least frequency. More than one microorganism had grown on 5 contaminated phones (3.57%). The contamination rate was significantly higher in the intensive care units than in general wards (P<0.001).

Conclusion: According to the findings, health care workers' mobile phones is significantly contaminated. Therefore, it is necessary that the staff to be informed of the role of cell phone in the nosocomial infection, as the role of other hospital equipment. It is also important to be trained about periodic cleaning of mobile phones with suitable material such as 70% alcohol and frequent washing of hands after using the phone.

Background & Aim: Mechanical ventilation is one of the most common treatments in neonatal intensive care unit and is however associated with many complications. One of the ways to reduce complications is providing nursing care according to standards. This study was conducted with the aim of determining the conformity of nursing care related to weaning neonates from mechanical ventilation to the standards in neonatal intensive care units.

Methods & Materials: In this descriptive study (the audit), 105 nursing cares related to weaning neonates from mechanical ventilation in neonatal intensive care units at the selected hospitals affiliated to Shahid Beheshti University of Medical Sciences were selected and observed by the event sampling method in 2015. Data were gathered through a demographic questionnaire for nurses and hospitalized newborns, a checklist of nursing care related to weaning from mechanical ventilation. The data were analyzed using descriptive statistics and Chi-square test at the significance level less than 0.05.

Results: Conformity rate of nursing care related to weaning neonates from mechanical ventilation to standards, was 68.3 percent, and compliance with the standards of care was 71.4 percent before weaning, 65.7 percent during weaning and 66.4 percent after weaning.

Conclusion: Nursing cares related to weaning neonates from mechanical ventilation are far from standards, and for its improvement, applying clinical guideline for neonatal nursing care and clinical supervision by managers for optimizing its implementation are suggested.

Background & Aim: Nowadays in the NICU, family-centered care is the foundation of care, and communication is at the core of family-centered care. This study aimed to compare the perceptions of nurse-mother communication between neonatal intensive care nurses and mothers of hospitalized neonates.

Methods & Materials: This is a cross-sectional study. 70 mothers of hospitalized newborns and 70 nurses working in the NICU ward of university hospitals and social security hospitals in Yazd, were selected by convenience sampling in 2015. The study questionnaires included the mothers’ and nurses’ demographic characteristics questionnaire, “nurses’ perceptions of nurse-mother communication” questionnaire and “mothers’ perceptions of nurse-mother communication” questionnaire. The data were analyzed using descriptive statistical tests and independent t-test on SPSS software version 19.

Results: The mean age for nurses was 33.36±6.99 years and for mothers was 29.77±6.40 years. Mean score and standard deviation of perception of “nurse-mother communication” for nurses was 69±6.92 and for mothers was 57.66±11.99. Independent t-test showed statistically significant differences between mean scores (P<0.001).

Conclusion: Due to difference in nurses’ and mothers’ perceptions of nurse-mother communication, it seems necessary that interventions be designed and implemented to familiarize nurses with mothers’ expectations of quality and way of nurse-mother communication.

Background & Aim: Diabetes is a chronic disease that needs lifelong special self-care behaviors. Adolescents with type 1 diabetes need self-care education for the control of diabetes and the prevention of its complications. Therefore, this study aimed to determine the impact of self-care education on the control of diabetes complications, medications and HbA1C in adolescents with type 1 diabetes.

Methods & Materials: This study is a non-randomized clinical trial (IRCT2015051322258N1) carried out on seventy four adolescents aged 12-18 years old with type 1 diabetes referred to the Iran diabetes association. They were selected using convenience sampling method and allocated into two groups (intervention: 34 people, control: 40 people). An educational intervention was performed in five sessions for the intervention group. After education, the patients were trained and followed up using mobile services for three months. The instruments consisted of a demographic characteristics form and a section of the self-care behaviors scale evaluating medications and the control of complications. Data were analyzed by the SPSS software v.18.

Results: Before the education, no significant difference was observed in the mean scores of medications and control of complications and level of HbA1C between the two groups of intervention and control (P>0.05). After the education, there was a significant difference between two groups in the mean scores of medications and control of complications and level of HbA1C (P<0.05).

Conclusion: Self-care education and the follow up after educational sessions can lead to the reduction in diabetes complications and HbA1C level among adolescents with type 1 diabetes.

Background & Aim: Diabetes is a chronic disease that needs lifelong special self-care behaviors. Adolescents with type 1 diabetes need self-care education for the control of diabetes and the prevention of its complications. Therefore, this study aimed to determine the impact of self-care education on the control of diabetes complications, medications and HbA1C in adolescents with type 1 diabetes.

Methods & Materials: This study is a non-randomized clinical trial (IRCT2015051322258N1) carried out on seventy four adolescents aged 12-18 years old with type 1 diabetes referred to the Iran diabetes association. They were selected using convenience sampling method and allocated into two groups (intervention: 34 people, control: 40 people). An educational intervention was performed in five sessions for the intervention group. After education, the patients were trained and followed up using mobile services for three months. The instruments consisted of a demographic characteristics form and a section of the self-care behaviors scale evaluating medications and the control of complications. Data were analyzed by the SPSS software v.18.

Results: Before the education, no significant difference was observed in the mean scores of medications and control of complications and level of HbA1C between the two groups of intervention and control (P>0.05). After the education, there was a significant difference between two groups in the mean scores of medications and control of complications and level of HbA1C (P<0.05).

Conclusion: Self-care education and the follow up after educational sessions can lead to the reduction in diabetes complications and HbA1C level among adolescents with type 1 diabetes.

Background & Aim: Although compassionate care is recognized as a core component of nursing care, there is not still a precise definition about this complex and challenging concept. This study aimed to analyze the concept of compassionate care in nursing using a hybrid model.

Methods & Materials: A three-phase hybrid model (theoretical, field work, and final analysis) was used in this study. In the theoretical phase, the concept of compassionate care was searched in main databases from 2000 to 2016. In the field work phase, in-depth, face to face interviews were done with 11 nurses. The content analysis method was used to analyze the data. Final analysis was done in the last phase.

Results: The results of the final analysis showed that compassionate care is a process in which nurses interactively communicate with patients, try to explore patients’ concerns by putting themselves in their positions and understanding their situations, and do their utmost to eliminate these concerns.

Conclusion: According to this concept analysis, the constructive interaction between nurse and patient is one of the most important features of compassionate care that has not been mentioned in previous definitions. Also in this study, the nurses emphasized that they did their best to resolve the patients’ concerns. Therefore, the current study could be the basis for future studies in the area of compassionate care.

Background & Aim: Besides medical treatment, self-care education is necessary for patients with heart failure. The aim of this study is to compare the effect of telenursing and education without follow-up in the caregivers of heart failure patients on the self-care behavior and clinical status of heart failure patients.

Methods & Materials: This clinical trial (IRCT2016080829184N2) was performed on 66 heart failure patients referred to the clinic of Taleghani hospital in Abadan in 2015-2016. The patients were randomly divided into three groups: control, intervention-1 and intervention-2 groups. Control group did not receive any intervention. Patients and caregivers in the intervention-1 group received verbal education, and caregivers in the intervention-2 group received continuous phone follow-up plus verbal education. Self-care behavior, fatigue severity and exercise tolerance were assessed in the patients by the self-care behavior questionnaire, fatigue severity scale and six minutes walking test at baseline and the end of 3 months. Descriptive statistics, chi-square, paired t-test, ANOVA, ANCOVA and Scheffe post hoc test were used to analyze the data using the SPSS software v.18.

Results: At baseline, three groups were consistent in terms of demographic variables and three variables. At the post-test, there was a significant difference between the intervention-2 group with the control group and intervention-1 group in self-care behavior (P<0.001) and the patients’ fatigue score mean (P<0.004). But, no significant difference was observed between three groups in the patients’ exercise tolerance score mean.

Conclusion: Telenursing for the caregivers of heart failure patients can lead to the improvement of self-care behavior and decrease in fatigue among the patients.

Background & Aim: Culturally sensitive care is an essential component of professional development process and one of the predictive factors of nurses’ cultural competency. This care is the most important approach to improve the quality of nursing care in culturally diverse groups. The current study aimed to explore the consequences of culturally sensitive care in pediatric nursing.

Methods & Materials: This study is a qualitative study using conventional content analysis. 25 nurses and 9 parents were purposefully selected with maximum variation sampling from the pediatric wards of three referral teaching hospitals in Tabriz and Tehran in 2015-2016. Data were collected through in-depth interviews and field notes and simultaneously analyzed using MAXQDA software version 10.

Results: The consequences of culturally sensitive care in pediatric nursing emerged in two categories: justice-based care (with three subcategories: the lack of cultural bias, culture-based communication and effective participation) and cultural satisfaction (with two subcategories: reduced cultural stress and safe care). Culturally sensitive care prevents misunderstandings and improves nurse-child/parents communication and leads to parents’ honesty to share information and express cultural needs. The expression of cultural needs decreases stress levels in parents and children and results in safe care by reducing intractable traditional treatment.

Conclusion: According to the findings of this study, it is suggested that effective culturally sensitive interventions in pediatric wards should be included in in-service courses and nursing curriculum.