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

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Background & Aim: The most common complication of peripheral intravenous catheter use is phlebitis. This study aimed to determine the effect of Arnebia Euchroma on the prevention of peripheral intravenous catheter-related phlebitis.
Methods & Materials: A double-blind randomized clinical trial done on 120 patients hospitalized in CCU and heart wards of Shariaty hospital in Tehran in 2017. The convenience samples were allocated into the two groups of control and intervention. After the insertion of an IV catheter (by sterile technique, in the site of upper limb without any signs of phlebitis), Arnebia Euchroma poultice for the intervention group and placebo poultice for the control group, was applied to the skin in the distal portion of IV catheter at 3×3 cm from the catheter insertion site. Then, this site was covered by sterile dressing. The patient was monitored every 12 hours by removing the dressing, and the poultice was applied again. Data were analyzed by descriptive and inferential statistics using the SPSS software.
Results: The two groups were homogeneous in terms of age and sex, but were different in the number of hospitalization days. While no phlebitis was observed in the baseline, there was a significant difference between the two groups (42.37% for intervention group vs 0% for control group) at the hour of 12. By adjusting the effect of hospitalization days, the difference was still significant (P<0.001).
Conclusion: Arnebia Euchroma poultice was effective in the prevention of phlebitis. Thus, this poultice can be used when inserting a peripheral intravenous catheter.
Clinical trial registry: IRCT2017012432147N1
 

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Economic evaluation is an invaluable and important tool in healthcare decision- and policy-making. The volume-based paradigm has been a prominent tool to evaluate healthcare economy for consecutive decades. In this approach, the main focus is on volume of treated patients alongside to reduce healthcare costs. Despite this view and during recent years, there was a dramatic rising in healthcare costs without attaining excellence in quality and health outcomes. This status is escalating to the point at which governmental budgets, service providers, and patients are unwilling or unable to afford its related costs (1). There is a similar situation in high-income countries that spend several times more money on health than middle-income and low-income countries (2).
The experts believed that one of the most important and underlying causes of this situation is ineffective healthcare service models that resulted in fragmentation, lack of coordination, reduced quality of care, and finally increased health costs (3). It is assumed that the health service delivery models can seriously affect health costs. Accordingly, health economics does not only refer to health costs but also it includes quality improvement, access to, and equity of health services (4).
For the first time in 2006, “value-based care” was developed to evaluate healthcare economy (5). This paradigm which is also considered a kind of healthcare delivery model, is based on patient outcomes payment as an alternative for the fee-for-service model of payment. Based on this approach, healthcare providers such as physicians and nurses will be rewarded when their services improve the health of patients, reduce the complications, and help to make a healthier life for patients (6); while the population transition to old age and an increase in noncommunicable diseases which require behavioural approches for modifying risk factors in addition to acute care only, are also fueling the mandate for change. Therefore, 30% of healthcare payments in the US by the end of 2016 and 50% of payments by the end of 2018 were tied to the value-based care approach. Based on that, new institutions such as Accountability Care Organizations (ACOs), Advanced Primary Care and Integrated Care models were launched (7). The focus of these institutions is on effective care pathways which, along with the reduction in health care costs, lead to prevention and primary care (7). The principals of new payment model are greater teamwork and integration, more effective coordination of health providers across settings, greater attention to population-based healthcare, and providing information system to improve care for patients (7).
A report in 2011 entitled “The future of nursing: leading change, advancing health” asserted that despite the financial concerns, nursing service can on the one hand address the increasing demand for safer and high-quality healthcare and on the other hand, create equitable and affordable access to health services for societies (8).
The report believed that nursing practice covers a broad continium from health promotion, to disease prevention, to coordination of care, to cure-when possible-and to palliative care-when cure is not possible. Therefore, nurses have a direct and indirect effect on patient care. They can provide assessments and care in hospitals, nursing homes, clinics, schools, ambulatory settings, and workplaces and accordingly they can contribute to the provision of accessible, equitable, and high quality care in healthcare system.
From value-based model perspective, quality, access, and value are key indicators that are specific and sensitive to health service effects on health economics (1). Evidence reveals that nursing services can suprisingly affect these three indicators. However, there are few studies showing that the development of nursing services results in lower costs, along with increased service quality. Of course the evidence in favor of such a conclusion is growing. The current evidence on these indicators are as follows:
Nursing and health service quality
Although causation is difficult to prove, an emerging body of literature has revealed that the quality of care depends, in a large degree, on nurses.  The association between nursing care and quality of hospital care such as patient outcomes, including lenghts of stay, mortality, pressure ulcer, deep vein thrombosis, and hospital-acquired infections has been published in several studies (9-11). Studies have shown the role of nurses in improving the quality and efficacy of hospital (12,13). However, the extent to which nursing care has an impact on health and life or death issues is still ambiguous (8) Also, the patient-centered nursing care has recently been disscussed as a cause of patient satisfaction which is an indicator of the delivered service quality in all over the world (14,15).
Nursing and access to health services
Evidence suggests that access to quality care can greatly be expanded by developing the use of nurses in primary, chronic, and transitional care from hospital to home. For example, If nurses are involved in special roles such as care coordinators or primary healthcare providers, that increase the level of access to services, the hospitalization and rehospitalization rates of patients will be reduced. A 52% reduction in emergency department (ED) visits with a cost per admission of at least $800 has been mentioned as a result of nursing postoperative visits and telephone follow-ups (16). In the coordination of transitional care from hospital, nursing visits during a three-month transition period in patients with heart failure showed the average savings of $4,845 per patient with a significant increase in survival and fewer readmissions (17). Also, performed activities such as self medication management and referral care coordination by nurses in community-based or ambulatory care settings can save $686 per patient in a 12-month period (18).
Nursing and value of health services
The value in healthcare is expressed as the physical health and sense of well-being achieved relative to the cost. There is little evidence at the macro level indicating that the development of nursing services results in cost savings to society while promoting outcomes and ensuring quality (19).  For example, managing nursing work hours is dramatically associated with 1.5 million fewer hospital days, nearly 60,000 fewer inpatient complications, and 0.5 percent reduction in costs (20). 
Overall, it seems that we need to conduct precise studies at macro-level to assess the net economic effects resulting from nursing care delivery models in order to seriously integrate them into health policy. Also, undrestanding the impact of nursing care on the health system requires the data to enable nurses have more effects on healthcare transformation.   
 

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Background & Aim: Nursing prescription is an expanding category with many supporters and critics. The present research attempts to answer three questions: What are the fields of activity of nurse prescribers? What are the challenges of nursing prescription? and what are the positive outcomes of nursing prescription?
Methods & Materials: In the present systematic review, all relevant papers published until March 2017, were examined. Search was done in databases: SID, Iran Medex, Iran Doc, Magiran, Science Direct, Medline/PubMed, Web of Science, Scopus, ProQuest, Google Scholar, Cochrane Library and with keywords: nursing prescription, nurse prescribing, nurse prescriber, independent prescribing, supplementary prescribing and their equivalent terms in persian. Inclusion criteria were articles in English or persian, quasi experimental, questionnaire based study, qualitative study and relevant to the objectives of the study. Exclusion criteria were review articles, posters, presentation, and letter to the editor.
Results: A total of 72 articles that were included in the systematic review, showed extensive nurse prescribing activity in the fields of diabetes, mental health, rheumatology, dermatology, primary care, elderly care, epilepsy, pain, asthma, hypertension, constipation, emergency, hemodialysis, glaucoma and elderly. Challenges included: the critical look of the care team and lack of support, lack of attention to professional competence assessment, legal constraints, and lack of community awareness of the role of nurse purscribers. The positive outcomes of nursing prescription were classified in three areas related to the patient, the nurse and the organization.
Conclusion: Nurse prescribing activity is changing, and identifying its challenges and outcomes will help it progress.
 

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The pre-post test study with control group is one of the most widely used methods to evaluate clinical research and educational designs. The data analysis of this design is done in a variety of ways. However, considering that the interaction between the pre-test score and intervention score is considered a threat for external validity in these types of study designs, the ANCOVA test is recommended for its control. Also, due to the importance of accurately estimating the effect size of intervention, it is necessary to assess the differences in the accuracy of its estimate among conventional methods. In this regard, the ANCOVA test, a common linear model that combines the analysis of variance and regression, estimates the effect size better than other common analyzes. In this article, the data of a hypothetical study were analyzed using these two tests to clarify the different results between the independent t-test and the ANCOVA test. The result showed that the obtained effect size from ANCOVA was greater than that from the independent t-test. Therefore, it is suggested that the ANCOVA test be used to analyze the data and estimate the effect size in the pre-post test designs with control group.
 

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Background & Aim: Nursing care is an essential part of health care services. Missed nursing care is a new concept referring to any aspect of care, that is omitted or delayed. The present study aimed to assess missed nursing care and its related factors from the viewpoints of nurses working in the hospitals affiliated to Kerman University of Medical Sciences in 2017.
Methods & Materials: In this descriptive, cross-sectional study, 300 nurses participated. Two questionnaires on missed nursing care, and its related factors were used for data collection. Data were analyzed through the SPSS software version 20 using descriptive indices.
Results: The mean score of missed nursing care was 32.28±7.41, which was lower than the median (range) of the questionnaire. The highest mean score of missed nursing care and its related factor, respectively were “attending the interprofessional patient care conferences” and “the volume of activities related to patients’ admission and discharge”.
Conclusion: The level of missed nursing care was lower than the median in the present study, which can be lowered by proper management. In addition, by decreasing nurses’ workload, missed nursing care related factors can be reduced.
 

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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: Patient participation is an important component of the patient-centered care approach and part of patients’ rights, with positive outcomes for the health care system. The aim of this study was to explore the nurses' experiences of patient participation in nursing care and its related factors.
Methods & Materials: This qualitative study was carried out with the participation of 18 nurses working in educational hospitals of Tabriz in 2019. The purposeful sampling through semi-structured interviews and focus group sessions was used to collect the data. Data analysis was performed using conventional content analysis. To achieve the accuracy of the data, the Lincoln and Guba criteria were used.
Results: Analysis of the data resulted in four main categories "giving information, decision-making, collaboration and respect". The patient’s participation from the nurses’ perspectives was: an interactive process of decision-making and collaboration between the nurse and the patient with the exchange of information, respect, and permission from the patient. The results also included the prerequisites, domains, outcomes, barriers, and solutions for patient participation in nursing care.
Conclusion: Patient participation today is considered the legal right of the patient and also the gold standard of international health care systems. So nurses, health system policy makers, patients and academic centers can use these results to improve patient participation in the care.
 

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Background & Aim: Caring for children with chronic illness is associated with the care burden of families and affects their self-efficacy. In addition, family-centered care can have positive outcomes. The aim of this study was to determine the relationship of the perception of family-centered care, burden of care and self-efficacy in the mothers of children with chronic illness.
Methods & Materials: This descriptive-analytical study was conducted in 2019 on 220 mothers of children with chronic illness, admitted to pediatric hospitals in Tehran and were selected using the convenience sampling method. Data were collected using the Perception of Family-Centered Care-Parent, Perceived Maternal Parenting Self-Efficacy, and the Impact-on-Family Scale. Data were analyzed by SPSS software version18 using descriptive and inferential statistics such as Pearson correlation and regression tests at the significance level of 0.05.
Results: Results showed that perception of family-centered care is directly associated with self-efficacy and inversely associated with the burden of care (respectively P<0.001 and P=0.022), so that for each 1-unit increase in the score of perception of family-centered care, self-efficacy of mothers increased by 0.25 and the burden of care decreased by 0.23. No significant association was found between self-efficacy and the burden of care (P=0.962).
Conclusion: Given that family-centered care can lead to an increase in self-efficacy and a reduction in the burden of care, nurses can improve mothers’ self-efficacy and reduce their burden of care by improving family-centered care.
 

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Background & Aim: Proper recording of the nursing report indicates the nurse’s optimal clinical performance and compliance with the standards. Nanda Nursing Diagnosis is one of the most important and widely used international standard terms for recording nursing care. The aim of this study was to determine the degree of compliance and frequency of nursing diagnoses registered in the pediatric oncology department with the statements of nursing diagnoses of the Nanda classification system.
Methods & Materials: In this descriptive study, the nursing reports recorded in the files of children hospitalized in the pediatric oncology wards of two hospitals affiliated to Shahid Beheshti University of Medical Sciences in the first quarter of 2016, were reviewed. Sampling was done by the census method for 3 consecutive months. Overall, 86 files and 3701 nursing reports were reviewed. Nurses' documentation was analyzed through the manifest content analysis. The obtained expressions were adapted to the nursing diagnoses of the Nanda classification system and the degree of adaptation and frequency of nursing diagnoses were determined.
Results: The overall compliance between the diagnoses extracted from the nursing reports and the Nanda nursing diagnoses was 14.7%. The most frequent nursing diagnoses were diagnoses related to safety/protection classification with a frequency of 47.95%, followed by diagnoses related to nutrition classification with a frequency of 24.42% and finally a frequency of 12.8% for nursing diagnoses related to comfort classification.
Conclusion: The findings of the present study indicated the low levels of compliance with the Nanda nursing diagnoses and nursing process in the nursing reports. Therefore, practical training is suggested to increase nurses' knowledge and motivation to apply Nanda nursing diagnoses.
 

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Background & Aim: Each conceptual model in nursing seeks to explain the fundamental concepts of the discipline based on the culture and values of societies in order to be used more effectively, as a scientific and practical framework. The aim of this study was to design a conceptual model of care during infancy from Islam perspective.
Methods & Materials: The conceptual model used in this study was designed based on the model synthesis process developed by Walker and Avant (2011) in three steps in 2017: Concept development and specifying focal concept, statement synthesis and identifying connections between concepts, systematic organization of connections and building an integrated representation. Qur’an and its interpretation books and Shiite Hadith books were of the resources.
Results: As a result of developing the concept of “care during infancy in terms of Islam”, six concepts were synthesized. “Infant as a person with dignity and potential for excellence” was as the focal concept. Other concepts included “basic principles of nurturing”, “parents as the representatives of God in nurturing infants”, “mother as the symbol of creativity and divinity of God”, “healthy and competent child”, and “God as the merciful nurturer”. After defining connections between the concepts, the structure of conceptual model was presented.
Conclusion: Infant care is nurturing a human being who has dignity, rights and potential for excellence from the time of conception. From Islam perspective, God is the eternal nurturer who nurtures the infant with kindness and dignity, and mother is the manifestation of the creativity and divinity of God. The infant is entrusted to the parents by God, and parents are the agents of God who lay the groundwork for nurturing the infant. In order to have a healthy and competent child, observing the principles of nurturing is important. “Care during infancy from Islam perspective” model is a conceptual model that can be used for the development of applied theories, clinical practice, research, and education of nursing students and the community.
 

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Background & Aim: Cardiovascular diseases, especially coronary artery disease, are one of the most common causes of death worldwide. Recently, coronary intervention through the skin has been used for treatment, which has significantly reduced mortality rates. Nursing care behavior is of special importance in reducing the complications of angioplasty. The purpose of this study was to determine the effect of primary nursing care on the patients’ perception of nursing care behavior after coronary angioplasty.
Methods & Materials: In this randomized controlled clinical trial, 60 patients admitted from February 2018 to April 2018, to the CCU of Razi hospital in Birjand were selected by the convenience sampling method and assigned into two groups of 30, using a simple random allocation method. For the patients in the control group, routine care was delivered case by case, and for the patients in the primary nursing care group, care was provided based on the nursing process. At the time of discharge, the Caring Behaviors Inventory (CBI) was completed for the patients via interviews. Data were analyzed using the independent t-test and the significance levels of 0.05.
Results: The results showed that the mean scores of perception of care behavior and dimensions "respect" and "assurance of humanistic presence" in the intervention group were significantly higher than those of in the control group (P<0.05). However, no significant differences were observed between the two groups in the dimensions "positive attitude and relationship", "knowledge and professional skill" and "attention to other experiences" (P>0.05).
Conclusion: Provision of primary nursing care leads to improving the patient’s perception of nursing care behavior, increasing sense of respect, and assurance of humanistic presence of the nurse. Therefore, it is recommended to use this caring method in the cardiac intensive care unit.
 

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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: Health promotion nursing activities for the elderly with COPD is different in various health care structures, and research in this area can help to identify the existing knowledge gap. The aim of this study was to determine health promotion nursing activities for the elderly with COPD.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2020. A total of 180 nurses working in teaching hospitals affiliated to Mazandaran University of Medical Sciences were selected using the convenience sampling method. Data collection tools included a demographic questionnaire and a researcher-made questionnaire on health promotion nursing activities for the elderly with COPD. The data was analyzed through the SPSS software version 18 using t-test, ANOVA and multivariate regression.
Results: The mean age of nurses was 34.58±8.05 years, 84.4% were female and 70.6% were married. The mean score of health promotion nursing activities was 197.10±37.90. Among the dimensions related to health promotion activities, “drugs/smoking cessation” (34.4%) and “self-empowerment” (32.8%) had the lowest frequency. There was a significant relationship between health promotion nursing activities with the work place (P=0.034), age (P<0.001), gender (P=0.022) and marital status (P=0.014).
Conclusion: The health promotion nursing activities for the elderly with COPD was above moderate levels. In-service training programs and internal conferences are needed especially in the area of ​​counseling behaviors and smoking cessation in order to improve the professional competency of nurses.
 

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Background & Aim: Nurses constitute the majority of the workforce in the healthcare system. The use of digital technologies, including mHealth applications, is essential and effective in improving the quality level of healthcare services provided by nursing staff. Therefore, the primary purpose of this study is to investigate the use of mHealth applications for professional purposes by nurses during the COVID-19 pandemic.
Methods & Materials: This is an applied study conducted using the descriptive, cross-sectional method in 2021. The study population was nurses in four public hospitals in Isfahan. The sampling method was a one-stage cluster sampling. The data collection tool was a questionnaire whose validity and reliability was assessed. Data analysis was performed using descriptive and inferential statistics on the SPSS software version 26.
Results: The data of 93 questionnaires were analyzed. About 63 percent of nurses answered (with a reason) that they did not use these applications. This study showed that the use of mHealth applications is not common among the nurses. They need the training to use the applications. There were concerns regarding the mHealth applications' quality. The nurses believed that using a mHealth application would help them perform their nursing duties during the COVID-19 pandemic.
Conclusion: Based on the study results, planning for the development of mHealth applications tailored to the nurses' needs and training nurses to use the applications in clinical settings are recommended. There is also a need to provide and develop specialized evaluation tools and working groups to review and report on the quality of mHealth applications.

 

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Background & Aim: Although pain control in patients with burns has improved over recent years, the ineffectiveness of some treatments to reduce pain in this group of patients remains a challenging issue for health care professionals. This systematic review was conducted to investigate nursing interventions in the field of pain relief in burn patients.
Methods & Materials: In this systematic review and meta-analysis, relevant information was searched from databases PubMed, Science Direct, Scopus, Irandoc, SID, and Cochrane library with keywords nursing interventions, pain, burns and their equivalent Persian keywords in the period 2010-2020. To increase the validity and reliability of the study, three people evaluated the quality of the articles separately and Jedad criterion was used to evaluate the articles.
Results: After assessing 181 articles on the databases, 19 articles were systeatically reviewed. Nursing interventions to reduce pain in burn patients included using breathing techniques, new dressings, muscle relaxation, music therapy, transcutaneous electrical nerve stimulation (TENS), electrical brain stimulation, play therapy, aromatherapy, use of Zekr Allah, massage, guided imagery, distraction techniques, and eye movement desensitization. In eight meta-analyses, total mean differences of pain relief score were estimated 1.28 (0.95% CI: 0.78-1.78).
Conclusion: Most nursing interventions reduced pain in burn patients. Easier-to-use pain relief techniques such as muscle relaxation, guided imagery, and spiritual care are emphasized.

 

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

 

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Background & Aim: Uncertainty is a multifaceted concept, inherently unavoidable, and can pose a significant obstacle to proper decision-making. In the nursing profession, which is marked by various challenges, nurses are expected to make precise and appropriate decisions. Confidence in decision-making is considered a vital element in the nursing profession. Given the ambiguities surrounding the concept of uncertainty, we aimed to conduct a concept analysis of uncertainty in nursing using the Walker and Avant’s approach.
Methods & Materials: This study is a concept analysis using the Walker and Avant’s approach to analyze the concept of uncertainty. Initially, a search was conducted on databases including Science Direct, SID, Medline, Iran Med, ProQuest, PubMed, and Scopus, using keywords such as uncertainty, nurse, and concept. A comprehensive review of articles published between 1990 and 2021 was then carried out, resulting in a total of 9 relevant articles.
Results: The literature review showed that uncertainty is an abstract and intricate concept that poses challenges in making informed decisions. In the context of nursing, uncertainty shares similarities with terms like confusion and doubt, while standing in contrast to concepts like self-confidence and assurance. The antecedents of uncertainty include the inability to make decisions and a lack of accountability. The consequence of uncertainty is the recognition of information needs, active pursuit of answers, and ultimately making informed and appropriate decisions.
Conclusion: The findings of this study indicate that nurses encounter uncertainty when they are unable to make independent decisions. As uncertainty in nursing decision-making directly affects patient care, managers and planners can take proactive measures to mitigate this issue. By promoting knowledge and awareness, fostering motivation, and encouraging continuous learning among nurses, the level of uncertainty can be reduced. This, in turn, will contribute to the improvement and enhancement of patients’ health outcomes.

 

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Background & Aim: Presenteeism and productivity are two crucial aspects within the realm of human resources. Presenteeism poses a significant challenge as it refers to employees being present at the workplace despite being unwell. In the context of nursing services, the productivity objective encompasses attaining a level of nursing care that is both suitable and cost-effective. Due to the importance of presenteeism and productivity, this study was conducted to determine the relationship between physical presenteeism and productivity of nurses in intensive care units of hospitals affiliated with Tehran University of Medical Sciences.
Methods & Materials: The present study is a descriptive-analytical study that was conducted in 2020-2021. The sample included 305 nurses working in intensive care units within hospitals affiliated with Tehran University of Medical Sciences. The participants were selected using a stratified simple random sampling technique. The data collection was conducted using a demographic questionnaire, the Stanford presenteeism Scale 6-item questionnaire and the Productivity Assessment Questionnaire. Data were analyzed through SPSS software version 16 using descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation coefficient, Spearman correlation coefficient, t-tests, ANOVA and regression analysis).
Results: The levels of presenteeism and productivity among nurses were found to be average based on the mean scores of 19.15±4.7 and 47.4±10.19, respectively. Furthermore, there was a significant inverse correlation between productivity and presenteeism (r=-0.345). Regarding the demographic variables, only age, working experience in intensive care units, hospital and current department showed a significant inverse relationship with nurses' productivity (P<0.001). The inclusion of these demographic variables and the two main research variables in the regression analysis produced a significant impact on this relationship.
Conclusion: The results of this study showed that nurses' presenteeism diminishes their productivity, which imposes considerable indirect costs on the organization. Given the high prevalence of presenteeism among nurses and its detrimental consequences, it is recommended to undertake various measures aimed at mitigating this issue. These measures can encompass adjusting organizational and managerial policies, revising administrative rules and regulations to permit sick leave during illnesses, and creating conditions conducive to employees taking time off when unwell.