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Background & Aim: Recent studies suggest that patients&apos perceptions might be more important than objective clinical assessments in determining quality of life (QOL) in patients with End Stage Renal Disease (ESRD). The aim of this study was to determine QOL in patients experiencing ESRD and its related factors.

Methods & Materials: In this descriptive-correlational study, we recruited 202 hemodialysis patients from Iran University of medical sciences&apos hemodialysis units using convenience sampling method. Data were collected using "Ferrans and Powers quality of life Index- dialysis version" instrument and analyzed using SPSS-14.

Results: Findings showed that the patients had a high perceived QOL. Lowest satisfaction mean scores were for the items "your health" (M=3.80, SD=1.74), "being able to take care of your financial needs" (M=3.31, SD=1.85), "achieving your personal goals" (M=4.02, SD=1.63), and "your family&aposs happiness" (M=4.96, SD=1.27). It was reported that "probably you will get a kidney transplant" (M=4.22, SD=2.15), "neighborhood" (M=4.32, SD=2.09, "personal appearance" (M=5.67, SD=0.91), and "your spouse"(M=5.84, SD=0.61) also had lowest mean score for importance from patients point of view. Financial status, educational levels, marital status and number of children were all associated with the QOL (P≤0.05). There were no relationship between age, sex, occupational status, with duration of dialysis treatment (P>0.05).

Conclusion: This study denoted financial status, educational levels, marital status and number of children is related to QOL of hemodialysis patients. So, these factors that affect quality of life may promote health and wellbeing and may increase survival in hemodialysis patients. The findings of this study can assist providers in planning and implementing educational and support programs for patients and their family.

 

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  The results of several studies show the relationship between the ratio of nurses/patients with quality of care and patient outcomes (1-3). This means that less the ratio, more expected adverse outcomes for patients. These findings have led some institutions to establish mandated nurse-patient ratios (4). Establishing standard ratios could potentially improve patients' outcomes such as patients' safety (5, 6), decrease length of stay (3) and readmission rates (7), and improve recruitment and retention of nurses in the system and reduce their burnouts (8).

  According to Mohammad Aqajani, Deputy of the Iran Ministry of Health and Medical Education (MOHME), the country is facing a serious nursing shortage as about 80 thousand nurses serve 80 thousand beds in public hospitals, i.e. one nurse per hospital bed. However, the national standards suggest at least two nurses per bed. Now each year there are nine thousand graduates of nursing baccalaureate program thus, even if no nurse is retired or leave the system and all graduates could be recruited to work in the nursing field, still at least nine years will be needed to provide adequate nurses. In fact, a significant number of nurses leave their job due to retirement, early retirement, turnover and migration so achieving the standard of nursing staffing in a ten-year timeframe seems impossible. ...

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

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Background & Aim: The physiologic childbirth program in Iran is an emerging program that needs to be evaluated like any other program to improve its quality and process. Evidence suggests that the implementation of the physiologic childbirth program faces some challenges. The present research aimed to explore the challenges of the physiologic childbirth program from the perspective of service providers.
Methods & Materials: This qualitative research was carried out through a content analysis method in two mother-friendly hospitals of Ahwaz and Mashhad in 2016-2017. Data were collected through semi-structured interviews with 17 physiologic childbirth service providers. The content analysis method of Elo and Kyngas was used for qualitative data analysis.
Results: Data analysis led to five main categories: low motivation of midwives in performing physiologic childbirth; barriers related to manpower; medical interventions in physiologic childbirth; challenges from the environment and facilities; and educational barriers.
Conclusion: Different challenges in interaction with each other create a complex environment in which the implementation of physiologic childbirth program becomes more difficult. Therefore, policymakers, authorities, doctors, midwives and mothers need to work in a coordinated way to resolve the mentioned challenge.
 

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According to a global report, 47 million people are currently living with dementia, and due to the aging population, its prevalence is expected to triple by 2050. In the future, Iran is expected to experience a significant increase in the elderly population. Currently, in Iran, the prevalence of dementia among individuals over 60 years old is 7.9%. Therefore, this group represents a significant population that warrants further research (1).
The best understanding and explanation of human experiences come from first-hand sources, specifically from people who have experienced those phenomena. Therefore, reliable research sources place great emphasis on including the voices of these individuals (2). Qualitative research out for its collaborative, inclusive, and flexible structure, enabling the exploration of complex issues, including mixed or ambiguous attitudes (2). It can reveal the profound experiences and core values of people with cognitive impairment that may not emerge in quantitative studies. Additionally, qualitative research excels in vividly portraying these experiences and values (3).
Throughout history, people with cognitive impairments have been marginalized from engagement in health and social research, resulting in their voices being inadequately represented in such studies. (2, 4). Instead, their perspectives have been channeled through their legal representatives or guardians, a practice that often entails constraints. These limitations include the inability to accurately predict the patient's decision-making process, the amount and manner of information provided, and the weight of decision-making responsibility placed on them (5).
Furthermore, excluding these individuals from the research process can dehumanize them and perpetuate negative stereotypes about people with cognitive disorders. This also contributes to power imbalances (2). Therefore, it is crucial to develop strategies that ensure the safe participation of these individuals in research endeavors. Through these efforts, we can improve our understanding of policy and measures aimed at promoting health and well-being (6).
 

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Diabetes is one of the most challenging chronic conditions, necessitating continuous and complex management efforts that impacts all aspects of an individual's life (1). Those living with diabetes often experience many social and psychological challenges alongside the disease, ultimately affecting the disease management (2). Addressing and managing these psychological challenges in individuals with diabetes are crucial for optimal disease management and the prevention of serious consequences (3). This issue necessitates the design and implementation of interventions to manage the psychological consequences of diabetes.
Storytelling has emerged as a therapeutic approach utilized in social projects, health promotion, disease prevention, coping with grief, and other concerns (4). Therapeutic storytelling aims to explore the psychological problems experienced by individuals through creative narratives, using problem-solving skills, and providing narrative-based alternatives (5).
Stories serve as a means of expressing viewpoints, revealing emotions, sharing experiences, and transferring information. By engaging in storytelling activities whether through oral or written narratives individuals can absorb valuable lessons, gaining insights into effective problem-solving strategies and emotional expression
Storytelling serve as a means of expressing opinions, revealing emotions, sharing experiences, and transferring information (6). By engaging in storytelling activities whether through oral or written narratives individuals (7)