Hosna Ghorbani, Akram Ghahramanian, Arefeh Davoodi, Leila Valizadeh,
Volume 31, Issue 1 (4-2025)
Abstract
Background & Aim: Although chemotherapy is effective in treating leukemia, it is associated with multiple adverse effects. Mothers, as key members of the healthcare team, need adequate information regarding these side effects to provide optimal care. This study aimed to investigate the side effects of chemotherapy in pediatric and adolescent leukemia patients and examine their relationship with maternal treatment knowledge.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2023 and involved 110 mothers and their children aged 6-18 years hospitalized for leukemia at educational hospitals in Tabriz. A convenience sampling method was employed. Data collection instruments included the American Cancer Society's chemotherapy side effects checklist and an information questionnaire for parents of children with cancer, developed by Motlagh et al. The data were analyzed using SPSS version 24, applying chi-square tests, one-way ANOVA, paired t-tests, Pearson correlation coefficients, and repeated measures ANOVA.
Results: The mean age of mothers was 37 years, and that of the children was 11.61 years. The majority of diagnoses were Acute Lymphoblastic Leukemia (ALL). The severity of complications—such as fever, nausea, vomiting, mouth mucositis, diarrhea, anorexia, and bleeding—showed a significant increasing trend over the four-week observation period (P<0.001). Additionally, a significant difference was observed in mothers' treatment knowledge between the first and fourth weeks (P<0.001). There was a significant relationship between chemotherapy complications and mothers' treatment knowledge (P<0.05).
Conclusion: Mothers actively seek and obtain information regarding their children’s chemotherapy treatment, with their knowledge increasing as complication severity rises. Awareness of side effects and their management strategies enables parents to provide appropriate care and empowers caregivers to offer the best advice and support to patients and their families throughout the treatment course.
Amin Mahzoon, Khadijeh Yazdi, Shohreh Kolagari, Zahra Mehrbakhash, Fatemeh Shah Beiki,
Volume 31, Issue 1 (4-2025)
Abstract
Background & Aim: Nurses today experience high levels of fatigue that significantly impair their performance in delivering care, thereby affecting patient safety. This research aimed to determine the relationship between nurses’ compassion fatigue and alarm fatigue with patient safety in intensive care units (ICUs).
Methods & Materials: This cross-sectional, descriptive-analytical study was conducted in 2023 among 248 nurses working in the ICUs of hospitals in Golestan. A stratified sampling method with proportional allocation was employed. Data collection involved a demographic information checklist and three questionnaires assessing patient safety, alarm fatigue, and compassion fatigue. Data were analyzed using SPSS version 22, with a significance level set at P<0.05. Both univariate and multiple linear regression analyses were applied.
Results: The mean scores were as follows: compassion fatigue (86.13±25.20), alarm fatigue (22.67±7.38), and patient safety (62.23±13.67). A significant correlation was found between alarm fatigue and compassion fatigue (P<0.001). However, no significant relationship was observed between compassion fatigue (r=0.101, P=0.112) or alarm fatigue (r=0.090, P=0.158) with patient safety. Multiple linear regression analysis revealed significant associations between patient safety and work experience (P=0.031), income level (P=0.012), and employment type (P=0.039).
Conclusion: Despite moderate levels of compassion and alarm fatigue, patient safety remained within acceptable ranges, indicating that nurses continued to provide safe care even amidst occupational fatigue risks.
Hanieh Gholamnejad, Mahnaz Seyedoshohadaee, Parisa Bozorgzad, Shima Haghani, Raziyeh Omidvar, Fatemeh Kheirkhah,
Volume 31, Issue 1 (4-2025)
Abstract
Background & Aim: Medication adherence remains a significant challenge in the management of patients with cardiomyopathy, with many patients relying on external support systems to maintain compliance. The study aimed to assess the impact of family-centered educational interventions on medication adherence among patients with cardiomyopathy.
Methods & Materials: This controlled clinical trial employed convenience sampling to select 80 patients attending the Heart Failure Clinic at Shahid Rajaee Hospital in Tehran in 2023. Participants were randomly assigned to two groups of 40 each. The intervention consisted of two 30-minute family-centered education sessions delivered to the intervention group, while the control group received standard informational care. Medication adherence was assessed using the Morisky Medication Adherence Scale two weeks post-intervention. Data were analyzed with SPSS version 22, using both descriptive and inferential statistics.
Results: The groups were comparable regarding demographic variables and disease characteristics (P>0.05). Prior to the intervention, the mean (±SD) medication adherence scores were 5.00±1.19 for the control group and 4.35±1.05 for the intervention group (P=0.12). Post-intervention, adherence scores improved significantly in the intervention group, with a mean (±SD) of 6.43±0.78 compared to 5.10±1.19 in the control group (P=0.001).
Conclusion: Family-centered educational programs can effectively enhance medication adherence in patients with cardiomyopathy. The results highlight the valuable role nurses play in leveraging the potential of family members to provide education and support to patients, ultimately contributing to improved quality of life.
Clinical trial registry: IRCT20230216057433N1
Kolsoum Abdolahi, Soghra Rabizadeh, Shima Haghani, Amir Mohammad Chekeni,
Volume 31, Issue 1 (4-2025)
Abstract
Background & Aim: Patients with hyperthyroidism need targeted interventions aimed at improving their quality of life and increasing awareness of potential drug side effects. This study aimed to investigate the effect of an intervention based on the continuous care model on drug side effects and quality of life in patients with hyperthyroidism.
Methods & Materials: This quasi-experimental study was conducted in 2021 on 75 hyperthyroid patients attending the endocrine clinics of Imam Khomeini Hospital and Shariati Hospital in Tehran. Participants were allocated into two groups of 38 patients each, using block randomization. The intervention group received care based on the continuous care model, while the control group received routine care. Data collection employed questionnaires assessing drug side effects and quality of life, administered before and after the intervention. Data were analyzed using SPSS version 25, employing both descriptive and inferential statistical methods.
Results: Analysis of covariance showed significant differences between the groups in both quality of life and drug side effects scores (P<0.001). Post-intervention, the mean quality of life scores across all dimensions were significantly higher in the intervention group compared to the control (P<0.001). Conversely, the mean scores for drug side effects and their respective dimensions were significantly lower in the intervention group following the intervention (P<0.001).
Conclusion: The findings suggest that implementing a continuous care model over a three-month period can positively influence the quality of life and decrease drug side effects among patients with hyperthyroidism.
Reza Abdollahi, Yousef Mohammadpour,
Volume 31, Issue 1 (4-2025)
Abstract
Background & Aim: Clinical competence may influence the level of compassion fatigue experienced by nursing staff. This study aimed to determine the relationship between clinical competence and compassion fatigue among emergency department nurses.
Methods & Materials: This descriptive-analytical study was conducted among nurses working in the emergency departments of teaching hospitals in Urmia in 2024. A total of 120 nurses were randomly selected for participation. Data collection was performed using three questionnaires: a socio-demographic characteristics questionnaire, Leo’s Clinical Competence Questionnaire, and Figley's Professional Quality of Life Scale. Data analysis was performed using the Chi-square test and Pearson correlation coefficient with SPSS version 23.
Results: The results showed a significant inverse relationship between clinical competence and compassion fatigue (r=-0.45; P<0.05). The mean score of clinical competence among participants was 201.13±0.54. The average scores for compassion fatigue, compassion satisfaction, and secondary traumatic stress were 27.73±8.54, 38.73±1.81, and 28.45±4.82, respectively.
Conclusion: The results suggest that higher levels of clinical competence are associated with lower levels of compassion fatigue among emergency nurses. To mitigate compassion fatigue, nursing administrators and policymakers should consider implementing targeted strategies, such as comprehensive training, ongoing in-service education, and staffing with experienced and specialized nurses, thereby fostering a supportive work environment that reduces compassion fatigue.
Seyedeh Maryam Seyedi, Soheila Bakhtiari, Mahboubeh Valiani,
Volume 31, Issue 1 (4-2025)
Abstract
Background & Aim: Back pain is highly prevalent among operating room technologists, and conventional treatments—such as non-steroidal anti-inflammatory drugs—are often associated with adverse long-term side effects. This study aims to evaluate the effect of Tuinatherapy massage with chamomile oil extract on the severity of back pain in female operating room technologists.
Methods & Materials: This double-blind, randomized controlled clinical trial included 105 female operating room technologists selected via convenience sampling from several hospitals in Isfahan. Participants were randomly assigned to three groups of 35 individuals each: (1) Tuinatherapy massage with liquid oil supplemented with chamomile oil extract, (2) Tuinatherapy massage with liquid oil alone, and (3) a control group receiving no intervention. The Tuinatherapy massage sessions consisted of 10 sessions, each lasting 20 minutes and conducted every other day. Pain intensity was measured using the Visual Analog Scale (VAS) both before and after the intervention. Data analysis was performed using SPSS version 27, using one-way ANOVA and Tukey’s post hoc tests.
Results: Significant reductions in pain intensity were observed in groups one and two following the intervention compared to baseline (P<0.001). The control group showed no significant change. Prior to the intervention, there were no significant differences in pain scores among the three groups (P=0.230); however, post-intervention, pain intensity in group one was significantly lower than that in groups two and three (P<0.001).
Conclusion: Tuinatherapy massage effectively reduces back pain severity among female operating room technologists. Moreover, the inclusion of chamomile oil extract enhances this therapeutic effect. As an alternative to pharmacologic treatments, Tuinatherapy massage with chamomile oil may serve as a method for alleviating back pain in this population.
Clinical trial registry: IRCT20220725055548N1
Somayeh Mohammadi, Camellia Torabizadeh, Mostafa Roshanzadeh, Parvin Ghaemmaghami,
Volume 31, Issue 2 (7-2025)
Abstract
Background & Aim: Nurses’ attitudes towards death affect their caregiving practices. Spiritual intelligence, by promoting a deeper understanding of the meaning of life and death, may improve the nurses’ attitudes towards death. This study aimed to investigate the predictive role of spiritual intelligence on attitudes towards death and care for dying patients among intensive care unit (ICU) nurses.
Methods & Materials: This descriptive-analytical study was conducted in 2023 at Shiraz University of Medical Sciences, involving a sample of 200 ICU nurses. Data were collected using instruments, including demographic questionnaires, the Death Attitude Profile-Revised (DAPR), King’s Spiritual Intelligence Scale, and the End-of-Life Care Assessment Scale (EOLCAS). Data were analyzed using SPSS software version 16.
Results: Correlation analysis showed a statistically significant positive relationship between spiritual intelligence and both caring for dying patients (P<0.01, r=0.265) and attitudes towards death (P<0.001, r=0.360). Among the dimensions of spiritual intelligence, critical existential thinking emerged as a significant predictor of attitudes towards death (P<0.001, β=1.207) and evaluation of dying patient care (P<0.001, β=0.880).
Conclusion: The findings suggest that spiritual intelligence may play a vital role in shaping positive attitudes towards death and improving the quality of care for dying patients. It is recommended that nursing managers incorporate strategies to enhance spirituality in clinical practice to optimize end-of-life care.
Simin Kokabiasl, Ali Navidian, Nasrin Rezaee, Milad Amiri, Mahnaz Ghaljeh,
Volume 31, Issue 2 (7-2025)
Abstract
Background & Aim: Cognitive disorders and anxiety are known to adversely affect students' academic progress. Interventions that can be self-administered are particularly advantageous. This study aimed to evaluate the effect of mental imagery on anxiety levels and cognitive impairment among at Zahedan University of Medical Sciences.
Methods & Materials: This quasi-experimental study involved a sample of 100 students selected through convenience sampling and subsequently randomly assigned to either an intervention or control group. Data collection was conducted using personal information forms, the Beck Anxiety Inventory, and the Broadbent Cognitive Dysfunction Questionnaire. The intervention group attended an initial in-person session designed to familiarize participants with the mental imagery technique, followed by eight sessions of imagery training delivered via audio files on WhatsApp. After a two-week interval, both groups completed the anxiety and cognitive dysfunction questionnaires again. No intervention was administered to the control group. Data analysis was performed using descriptive and inferential statistics with SPSS version 21.
Results: The results demonstrated a statistically significant reduction in both anxiety and cognitive impairment within the intervention group (P<0.05). In contrast, the control group showed no significant change (P>0.05). The analysis of covariance, controlling for baseline pre-test scores, revealed that post-intervention mean scores of cognitive impairment and anxiety differed significantly between the two groups (P<0.001).
Conclusion: Mental imagery training appears to effectively reduce anxiety and cognitive impairment among students. Therefore, educational authorities may consider incorporating this intervention to enhance students’ mental well-being and cognitive functioning, thereby potentially improving academic performance.
Arefeh Davoodi, Akram Ghahramanian, Hassan Rezazadeh, Faranak Jabbarzadeh Tabrizi,
Volume 31, Issue 2 (7-2025)
Abstract
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.
Malihe Izanloo, Abbas Shamsalinia, Sepide Mohammadi, Shahrbanoo Keyhanian,
Volume 31, Issue 2 (7-2025)
Abstract
Background & Aim: Emotional disclosure has been associated with improvements in psychological well-being, immune function, and physical health. This study aimed to evaluate the effect of written emotional disclosure on health behaviors and loneliness among family caregivers of cancer patients.
Methods & Materials: This is an experimental study with a pretest–posttest design and a control group. Seventy family caregivers of cancer patients who scored high on the UCLA Loneliness Scale (Version 3) and low on the health behaviors scale for family caregivers of cancer patients were selected by convenience sampling and randomly assigned to Intervention or Control groups. The Intervention group engaged in written emotional disclosure by documenting their deepest and most acute feelings for 15–20 minutes per session, over four consecutive days. The Control group received no intervention. Post-intervention assessments were conducted in both groups. Data were analyzed using SPSS version 26. Comparative analyses included chi-square tests, independent samples t-tests, and paired t-tests.
Results: At baseline, there were no significant differences between groups in health behaviors or their components (P>0.05). Post-intervention, the Intervention group demonstrated significantly higher health behaviors scores and component scores than the Control group (P<0.001). Furthermore, the mean loneliness score in the Intervention group decreased significantly after the intervention (P<0.001).
Conclusion: Written emotional disclosure has a positive and significant effect on loneliness and health behaviors among family caregivers of cancer patients. Given its ease of learning, potential for unsupervised practice, and minimal need for therapist involvement, this method may be a practical adjunct in caregiver support programs.
Mehrnoosh Elahinia, Zainab Alimoradi, Hosein Mozhdehipanah, Nasim Bahrami,
Volume 31, Issue 2 (7-2025)
Abstract
Background & Aim: Multiple sclerosis (MS) is a common autoimmune disorder of the central nervous system that can adversely affect patients’ sexual lives. This study aimed to compare the effects of counseling based on Leventhal’s self-regulation model and the BETTER model on sexual function and satisfaction in women with MS.
Methods & Materials: This randomized controlled trial with three parallel groups was conducted from April to September 2024 at the Neurology Clinic of Bu Ali Hospital in Qazvin, Iran. A convenience sample of 100 women with MS were randomly assigned to the study groups using a balanced block randomization method with a block size of six. Participants in the intervention groups received three weekly counseling sessions. The control group received educational materials on sexual health after study completion. Data were collected at baseline, and at one and three months post-intervention using the demographic questionnaire, the Female Sexual Satisfaction Scale, and the short form of the Female Sexual Function Index (FSFI). Data were analyzed with repeated-measures ANOVA using SPSS version 26.
Results: There were no significant differences in demographic or clinical characteristics between the groups at baseline (P>0.05). The analysis showed significant effects of time and group, as well as a significant time-by-group interaction for sexual satisfaction and function (P<0.05). Both the BETTER-model and Leventhal-based interventions produced significant improvements in mean scores on sexual satisfaction and function compared to the control group (P<0.05). However, no statistically significant difference was found between the BETTER and Leventhal interventions in improving sexual satisfaction and function (P>0.05).
Conclusion: Counseling grounded in either the BETTER model or Leventhal’s self-regulation model appears to be effective for enhancing sexual satisfaction and function in women with MS.
Clinical trial registry: IRCT20221120056555N1
Fatemeh Nojavan, Fatemeh Tooiserkany, Zohre Khalajinia, Hamid Torabian, Mohammad Aghaali,
Volume 31, Issue 2 (7-2025)
Abstract
Background & Aim: Occupational fatigue reduces the quality-of-life of healthcare workers. Warm foot baths have been suggested as a simple, traditional intervention for prevention and management. The present study aimed to investigate the effect of warm foot baths on occupational fatigue and quality of life among intensive care unit (ICU) nurses.
Methods & Materials: A randomized controlled trial was conducted with 50 ICU nurses at Shahid Beheshti Hospital, Qom, in 2023. Participants were recruited by convenience sampling and randomly assigned to an intervention or a control group. The intervention consisted of immersing the legs below the knees in warm water for 15 minutes each night for two weeks. The control group received no intervention. The Swedish Occupational Fatigue Inventory (SOFI) and a quality-of-life questionnaire were completed at baseline and after the intervention. Data were analyzed using chi-square tests and t-tests in SPSS version 22.
Results: The total fatigue score (P=0.014) and the physical discomfort subscale (P=0.012) showed significantly greater reductions in the intervention group compared to the control group. No significant differences were observed in other fatigue subscales. Changes in quality of life and its subscales did not differ significantly between groups.
Conclusion: The findings indicate that warm foot baths effectively reduce occupational fatigue among ICU nurses. Therefore, the use of warm foot baths is recommended as an affordable, easy, and fast-acting solution to alleviate nurses' fatigue.
Clinical trial registry: IRCT20220109053677N1
Ali Alibakhoda, Mahnaz Ilkhani, Razieh Ghafouri, Malihe Nasiri,
Volume 31, Issue 2 (7-2025)
Abstract
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
Sorour Torfi, Nahid Hossein Abbasi,
Volume 31, Issue 3 (9-2025)
Abstract
Background & Aim: Intimacy and satisfaction in marriage, along with psychological well-being, are crucial for maintaining healthy marital and family relationships. The present study aims to examine the effectiveness of Gottman couple therapy on marital intimacy, life satisfaction, and psychological well-being among working couples.
Methods & Materials: This quasi-experimental study with a control group and a follow-up period was conducted on 40 working couples in Ahvaz in 2023. The sample was selected through convenience sampling and randomly assigned to intervention (20 couples) and control (20 couples) groups. Data were collected using demographic questionnaires, the Bagarozzi Marital Intimacy Scale (MINQ), the Diener et al. Life Satisfaction Scale (SWLS), and the Ryff Psychological Well-being Scale (RSPWB). After obtaining pre-test data, the Gottman couple therapy protocol was implemented over 14 sessions of 60 minutes each, held two to three times per week for the intervention group. Data were analyzed using descriptive statistics and analysis of covariance (ANCOVA) with SPSS version 25.
Results: The results showed a significant increase in mean scores for the intervention group compared to pre-intervention scores and to the control group in marital intimacy (from 128.45±13.04 to 178.90±30.55), life satisfaction (from 13.60±2.70 to 17.77±5.01), and psychological well-being (from 55.85±6.12 to 64.95±7.83) (P<0.01).
Conclusion: Gottman couple therapy is effective in enhancing marital intimacy, life satisfaction, and psychological well-being among working couples in Ahvaz. Therefore, this intervention can be applied to strengthen and enrich marital relationships.
Mehrnaz Miri, Mahnaz Ghaljeh, Farnoosh Khojasteh, Benyamin Saadatifar,
Volume 31, Issue 3 (9-2025)
Abstract
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.
Faeghe Shiranni, Mostafa Roshanzadeh, Somayeh Mohammadi, Zahra Tahmasebi,
Volume 31, Issue 3 (9-2025)
Abstract
Background & Aim: Nurses need up-to-date professional knowledge to deliver high-quality performance. Since knowledge within healthcare organizations requires effective management, identifying the level and relationship between knowledge management and nursing performance can play an important role in bridging the gap between knowledge and practice. Therefore, this study aimed to determine the relationship between knowledge management factors and nursing performance among nurses.
Methods & Materials: This descriptive-analytical study was conducted in 2023 at Shahrekord University of Medical Sciences. A total of 200 nurses working at Valiasr Hospital in Borujen were selected through simple random sampling. Data were collected using a demographic questionnaire, the Choi Knowledge Management Standard Questionnaire, and the Ko Nursing Performance Questionnaire. Data analysis was performed using SPSS version 16, employing independent t-tests, one-way ANOVA, and linear regression.
Results: The mean and standard deviation of knowledge management factors were 98.55±15.8, and the mean and standard deviation of nursing performance were 105.74±25.7. Pearson’s correlation coefficient indicated a significant positive relationship between knowledge management factors and nursing performance (r=0.72, P<0.001). The coefficient of determination (R²=0.518) showed that approximately 52% of the variance in nursing performance could be predicted by knowledge management factors (P<0.05).
Conclusion: Training in the knowledge management process and emphasizing dimensions such as promoting a culture of knowledge sharing, improving nursing management systems with a focus on process enhancement, and fostering creative management approaches can enhance knowledge management and thereby improve nursing performance.
Mehdi Mahmoudzadeh, Sana Khalilzadeh Zia, Mohammad Ali Mohammadi, Behrouz Dadkhah,
Volume 31, Issue 3 (9-2025)
Abstract
Background & Aim: The nursing process provides a structured and evidence-based framework for delivering comprehensive, individualized, and high-quality care. As a fundamental component of healthcare systems, patient safety culture plays a pivotal role in ensuring the safety and well-being of patients. Given the importance of these two constructs, this study aimed to examine the relationship between nursing process competency and nurses' perception of patient safety culture.
Methods & Materials: This descriptive-correlational study was conducted in 2023 on 266 clinical nurses working in educational-treatment centers in Ardabil, Iran, using a stratified random sampling method. Data were collected using the Nursing Process Competency Questionnaire (NPCQ) and the Hospital Survey on Patient Safety Culture (HSOPSC). Data analysis was performed using SPSS version 26 through descriptive statistics and inferential tests.
Results: Among the participants, 177 nurses (66.5%) were female and 164 (61.7%) were married. Most nurses reported a good level of nursing process competency (175, 65.8%) and a moderate level of perceived patient safety culture (264, 99.3%). Marital status and employment status were significantly associated with both nursing process competency and patient safety culture (P<0.05). Additionally, a significant positive correlation was observed between nursing process competency and patient safety culture (r=0.315, P<0.001).
Conclusion: The results highlight the essential role of nursing process competency in fostering positive perceptions of patient safety culture. They also emphasize the importance of considering personal and employment-related factors when designing interventions. Policymakers are encouraged to develop integrated strategies that simultaneously enhance nursing process competency and strengthen patient safety culture to promote safer and higher-quality patient care.
Faezeh Naghiha, Narges Sadeghi, Azam Alavi,
Volume 31, Issue 3 (9-2025)
Abstract
Background & Aim: Diabetic ketoacidosis is a serious and potentially life-threatening complication of diabetes mellitus. Exploring non-pharmacological interventions that may support standard care in children with this condition is crucial for improving clinical outcomes. This study aimed to evaluate the effect of foot reflexology massage on the respiratory patterns of children hospitalized with diabetic ketoacidosis.
Methods & Materials: This clinical trial included two groups with pre- and post-intervention assessments. The study was conducted on children admitted with diabetic ketoacidosis to Imam Hossein Specialized Hospital in Isfahan in 2023. Participants were selected using convenience sampling and randomly assigned to either an experimental or a control group. The intervention consisted of foot reflexology massage administered every two hours, with each session lasting ten to fifteen minutes per leg, from admission until recovery from diabetic ketoacidosis. Data were analyzed using analysis of covariance and two-way repeated measures analysis of variance, with a significance level of 0.05, using SPSS software version 26.
Results: After controlling for blood glucose, blood PH, and bicarbonate levels, the mean recovery time from diabetic ketoacidosis was significantly shorter in the experimental group compared to the control group (P<0.001). Following the intervention, both groups exhibited a significant increase in blood PH and bicarbonate levels (P<0.001). Moreover, the experimental group demonstrated a significantly higher mean bicarbonate level compared to the control group after the intervention (P=0.009).
Conclusion: Foot reflexology massage was associated with a shorter duration of diabetic ketoacidosis in children, independent of blood glucose, PH, and bicarbonate levels. These findings suggest that incorporating foot reflexology massage as an adjunct to standard care may enhance patient recovery and improve clinical outcomes in pediatric diabetic ketoacidosis.
Clinical trial registry: IRCT20130812014333N202
Alireza Momeni, Abdolali Shariati, Shahram Molavynejad, Saeed Ghanbari,
Volume 31, Issue 3 (9-2025)
Abstract
Background & Aim: The most common problems in patients undergoing hemodialysis are sleep disturbances and fatigue, which affect their quality of life. Auricular acupressure, as a non-pharmacological method, can be effective in controlling these issues. The aim of this study was to evaluate the impact of auricular acupressure on sleep disturbances and the severity of fatigue in hemodialysis patients in Ahvaz.
Methods & Materials: In this clinical trial, 40 hemodialysis patients visiting the hemodialysis centers of Imam Khomeini and Golestan hospitals, affiliated with Jundishapur University of Medical Sciences in Ahvaz in 2021, were randomly assigned to two groups: the test group and the control group. The test group received auricular acupressure at true acupressure points, while the control group received acupressure at false points over a two-week period. Data collection tools included the Pittsburgh Sleep Quality Index and the Numeric Rating Scale to assess fatigue severity. Data analysis was performed using SPSS version 17 with descriptive and inferential statistical tests at a significance level of 0.05.
Results: In the intervention group, the mean sleep quality score before the intervention were 11.75±1.51, and 6.20±1.43 which decreased to 8.60±1.04 and 5.00±1.21 after the intervention, and this difference was statistically significant (P<0.0001).
Conclusion: The findings showed that auricular acupressure improves sleep quality and reduces sleep disturbances and fatigue severity in hemodialysis patients. Therefore, auricular acupressure can be used as an easy, safe, and inexpensive method alongside routine care for hemodialysis patients to reduce fatigue and sleep disturbances.
Clinical trial registry: IRCT20201021049102N1
Banafsheh Ghorbani, Pirhossein Kolivand, Majed Dehghani, Fatemeh Bahramnezhad,
Volume 31, Issue 3 (9-2025)
Abstract
The recent war between Iran and Israel exemplifies modern hybrid warfare, combining traditional and emerging threats, including cyberattacks, psychological and informational warfare, and biological operations. The healthcare system, as a critical target in such conflicts, is highly vulnerable both humanly and digitally, and any disruption to its infrastructure or digital systems can have severe human, social, and economic consequences. Experiences from countries like Ukraine, and South Korea demonstrate that enhancing cyber, human, and managerial resilience in healthcare—including establishing backup facilities, multi-skill training, advanced cybersecurity, and rapid response protocols—is crucial to ensure continuity of medical services and minimize damage. Therefore, developing national policies and programs to strengthen the resilience of healthcare systems against hybrid threats is essential, as preparedness today guarantees the continuity of health tomorrow.
