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To study and determine the educational needs of nurses after graduation in order to make them further capable, aims at promotion of their occupational standards and betterment of this profession. By means of this study we can identify their needs and make necessary planning to reduce the resultant shortcommings and problems. The present research is a descriptive and analytical study conducted to survey the educational needs of nurses regarding non-pharmacological methods of controlling chronic pans in patients at medical surgical wards of the hospitals of Tehran University Medical of Sciences. A total of 119 nurses working at one of these wards participated in this research. The tool for gathering the information was a three-part questionnaire. The first part deal with individual particulars, the second part was about questions regarding the feeling needs of nurses an the third part was about questions regarding the educational needs of nurses. The findings showed: As for the feeling needs, nurses needed training , as for the level of educational needs regarding the concept of pain (69.7%), characteristics of chronic pains (52.9%), guided imagery method (50.4%) of nurses were in need of a high level of training and regarding the progressive muscle relaxation (68.9%) of nurses were in need of a medium level of training. The results revealed the connection between some individual particulars with the level of educational need, to the extent the age, clinical work experience, work experience in medical and surgical ward and the type of ward affected the level of educational need, and by using the Pearson Coefficient a meaningful statistical difference appeared, in other words, as the years of service increases , the level of knowledge decrease and the educational needs rise up.

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Nurses must know about effect and indication ofl.V-Fluid Therapy. Priciples of WMuid therapy consist of:Appropriate solutions and the rate of administration of fluid, types of parenteral solutions and the factors that indicate whether a solution is appropriate or not, definition of smolarity andm smolality and how to use the standard formula. Knowing a pateint's body fluid concentration , or fluid status, is one way to determine how I.Vsolutions will infuse in specific situations. Cellularmembrance are permeable, water will shift into a compartment with a higher concentration or osmolality. The appropriate rate to infuse a solution depends on severalfactors, including the paitent's condition and type of solution. Other specific considerations ofpatients include: weight, urinary output, laboratory values, kidney Junction, length of illness, and assessment of skin turgor.

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Nurses play various roles and have various responsibilities in helping patients or other members of the society for example in training, providing support, caring, and in coordinating. The proper performance of these services is dependent on their undertaking of these various responsibilities. Nurses with increased knowledge as to their responsibilities and the proper fulfilling of these in the various fields can be influential in the success of treatment measures. This research is a descriptive study to assess the nursing staff’s perception of their roles and activities at hospitals affiliated to the Tehran University of Medical Sciences, conducted on a random sampling in the years of 2001 -2002. Some 104 male and female members of the nursing staff, randomly chosen, participated in this research. The data was collected by means of some questionnaires of 3 parts containing 8 questions related to demographic characteristics, 41 questions related to the quadric roles namely, teaching, supporting, protecting, coordinating, and 2 open questions regarding obstacles and their suggestions in preventing these obstacles. Analysis of data has been done by using SPSS descriptive and inferential statistics. The results with respect to the roles of nurses in different fields show that most of their roles were in teaching activities in relation to patients, in support relating to stressful and upset patients, in the field of protection during catheterizing and dressing and coordinating daily visits. Results relating to the level of performance of these responsibilities are as follows 31.7% in training activities, 35.6% supporting activities, 38.45% protection and 54.8% coordinating activities, respectively, stood at a favorable level. The greatest percentage of unfavorable performance was noted in the supporting role of the nurses. The results also showed that the level of readiness of the nurses to perform the above mentioned four roles was registered as average to good. In addition some factors such as frustration, lack of on the job training, insufficient number of personnel, lack of proper facilities, and insufficient income…, have a great impact on nurses and the removal of obstacles in the performance of their duties.

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Post-surgery pain is usually controlled by PRN drugs administered by nurses. According to the decision-making theories, this clinical decision-making depends on three factors: nurse-related factors child-related factors and hospital-related factors. This study deals with the first and second factors mentioned. This descriptive-analytic study aims at determining the perspective of nurses on factors which affect their decisions to administer the analgesic PRN to children after surgery in several chosen hospitals of Tehran. The study used a standardized questionnaire to collect data from 57 nurses in pediatric surgery wards. The questionnaire consisted of three parts: 1) nurses demographic data 2) 20 clinical scenario for nurses to make a decision for prescribing either analgesic medication, non-analgesic medication or no medication where necessary and 3) 12 factors which affect clinical decision-making in using analgesics.(in prioritizing among the above mentioned). The results show that factors such as age, nursing experience, pediatric nursing experience and motherhood were significantly related to choosing to use analgesics. Education and personal experience of extreme pain was also related to the type of analgesic chosen. Concerning the specifics of the children there was a significant difference between the choice to use analgesics and the type of analgesic used according to the various ages of the children. There was also a significant relationship between the type of surgery and the time of surgery and with the choice to use analgesics and the type of analgesics used, such that medication and analgesics were administered more frequently for complicated surgeries and in first 24 hours after surgery. Type of surgery, severity of pain, time of surgery and uneasy behaviors were selected respectively as the most effective in the administration of PRN analgesic drugs. Nurse and child related factors strongly influence nurses in making decisions to administer PRN analgesics postoperatively.

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Fear is an undesirable feeling which most of the time results in physiological changes and can affect on the cardiovascular function of the patient. This research is a cross-sectional descriptive study that describes the congruency opinions between 91 patients /nurses about the reasons for patients’ fear related to coronary angiography in two affiliated hospitals of Tehran University of Medical Sciences. The tools which were used included: questionnaire for study and recognition of patient and nurses demographic characteristics, a check list containing thirty probable reasons for patients’ fear which were filled out by patients and nurses, and a scale for analysis of the reasons for fear which were filled out by patients, descriptive statistics indicators, sign test, and t-test were applied in order to analyze the data, by SPSS software. The results showed that patients’ and nurses’ ideas about the reasons for fear before angiography are similar in two cases and only in one case after the operation. Among the thirty probable reasons which were mentioned for patients’ fear, seventeen cases caused less fear after angiography and two cases caused more fear after that. In the comparison between the intensity of fear caused by other reasons no insignificant result was observed. The comparison of intensity of fear showed that the intensity of patients’ fear after angiography is less than before (p= 0.005). According to these cases it may be concluded that because of the different reasons for patients’ fear concerning angiography, nurses need to pay more attention to patients’ fear. It is also suggested that an assessment tool be used in order to assess issues relating to patients, level of care and training related to coronary angiography.

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Links between violence, aggression, and mental illness are well documented. Despite this association, our current understanding of the factors for and optimal treatment of aggression remains limited. This lack of knowledge is alarming because nurses, particularly pediatric nurses who treat aggressive children, are frequent targets of patient aggression. Consequently, the aim of this article is to provide information regarding the concept of aggression in child patients, assessment of violent behavior, implementation of interventional treatment and a review of medical, psychological and social strategies which assist in the understanding of aggression and its clinical intervention. However, the etiology of aggression for the most part still remains a mystery.

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Introduction: Nurses as the main members of treatment-and-care team play an important role in improvement and promotion of health in society. Job stress is a recognized and integral part of modern nursing which has destructive effects on both nurses and patients.

Materials and Methods: The present descriptive and analytical study aims to determine the level of nurses&apos job stress in Tehran in 2004. It also tries to identify factors affecting job stress from nurses&apos point of view. A total of 111 nurses working in two educational and non-educational hospitals in Tehran were studied. The sampling was simple, i.e. the subjects volunteered to participate in the study. A questionnaire with 2 sections was developed. In the first section we asked about personal and professional characteristics and the second section was designed to evaluate job stress in following 5 categories: management, economy and welfare, mentality and social affairs, occupational health and ergonomics. There was also an open-ended question asking about nurses&apos attitude toward job stress. The questionnaire items were to be answered on a scale ranging from 0 to 4. We used descriptive statistics and Chi square statistical test to analyze the collected data.

Results: The results showed that 44.1% of samples had high levels of job stress while 54.1% suffered from medium and 1.8% from low levels of job stress. There was a significant relationship between hospital type and job stress job stress in the educational hospital was higher compared to the noneducational hospital. There was also an inverse relationship between years of experience and job stress.

Conclusion: Due to high percentage of the subjects with high to medium levels of job stress, employment of preventive and precautionary procedures regarding job stress is recommended.

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Introduction: Education of patients and helping them to be independent in process of self-care in both health and disease is one of the basic responsibilities of nurses.

Methods and Materials: This descriptive-analytic research was done to study perceptions of 317 nurses working in hospitals of Tehran University of Medical Sciences of factors affecting the process of patient education. Data was gathered by means of a questionnaire containing 30 questions about facilitating factors and 17 about inhibiting factors. We used Likert score to measure questions. Data analysis performed by SPSS software. Statistical test were Chi square, t test, variance analysis and correlation of variance.

Results: The highest percentage of nurses (52.1%) believed that enough attention is not being paid to facilitating factors such as considering patient education as priority in patient care, nurses being responsible for patient education, considering patient education as a criteria in nurses annual evaluation, importance of patient education for nurse administrators, having in-service education about patient teaching and having proper time, place and personnel for patient education. Majority of nurses (57.4%) believed factors such as shortage of nurses, lack of proper place, time and patient motivation for receiving education, nurses and nurse administrators’ inattention to patient education and negative attitude of doctors toward patient education by nurses are inhibiting factors in process of education. Statistical tests showed a meaningful relation between demographic variables such as sex, clinical background, shift work and position and facilitating factors. There was also a meaningful relation between variables like working in more than one shift, having clinical experience of patient education and being evaluated for patient education during study of nursing and inhibiting factors.      

Conclusion: This study shows low level of facilitating factors for patient education in hospitals of Tehran University of Medical Science. To improve patient education in these hospitals it is necessary to improve facilitating factors.

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Introduction: It is necessary to understand that psychological reactions after a natural disaster are as complex as disaster itself. Following a catastrophic earthquake like Bam’s, such reactions can be seen in nursing team members as well.

Materials and Methods: This study is a descriptive cross sectional analytic research, conducted with cooperation of Japanese Nursing Association to identify somatic and psychological problems of nursing team members of Bam. A total of 92 members of nursing team affiliated to healthcare centers of Bam were studied. Data collection tools were 2 questionnaires first for evaluating demographic characteristics and general health and second- questionnaire of Goldberg and Williams- for evaluation of four domains of psychosomatic problems, anxiety and insomnia, psychosocial functioning and severe depression. Each domain contained seven questions, each scored from 0 to 3 based on Likert score. Complete score of general health was 0-84. Scores were classified in four groups: 0-20 as optimal, 21-4 as approximately optimal, 41-6 as approximately suboptimal and 61 and higher as suboptimal.

Results: One year after the earthquake, evaluation of general health of nursing team members showed 30.3% of subjects had optimal psychosomatic status, 34.8% had moderate problems of anxiety and insomnia, 40.2% had approximately optimal psychosocial functioning and 44.2% of subjects were not severely depressed. Overall, 38.4% of nursing team members had approximately optimal general health.

Conclusion: This study showed that following a catastrophic earthquake, most of the victims suffer from several psychological and somatic reactions. In addition to on time rescue procedures, other important allaying factors are cultural and religious values and believing in God.

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Background & Aim: Cigarette smoking is the primary risk factor for COPD (chronic obstructive pulmonary diseases). Smoking cessation is the most effective strategy for prevention or treatment of COPD. Counseling is a efficacious method for smoking cessation. One of the nurses’ roles is counseling that they can use it in patients’ care. The aim of this study is evaluating the effects of counseling in smoking cessation on patient with COPD.

Methods & Materials: This study is an interventional clinical trial and the subjects consisted of 160 patients who had eligibility criteria for this study. Sampling was convenience sampling and subjects were allocated to two patients groups (Interventional and control). In interventional group smoking cessation counseling was used during 12 weeks. Counseling consisted of individual counseling Telephone counseling and self- help material. The data were collected by the questionnaire and Fagrostrom test before study and smoking rate were recorded before, 1 and 3 months after study. Research data were analyzed with spss statistic program and use of descriptive and inferential methods, such as 2, exact fisher test, mann-whitney and etc.      

Results: The rate of smoking cessation after 1 month in interventional group was 28.8% (n=23) versus in control group was 22.5% (n=18) (p<0.0001) and after 3 month in interventional group was 41.3% (n=33) versus in control group was 26.3% (n=21) (p=0.006). Mann-whitney test showed significant difference between smoking cessation in two groups after 1 and 3 month after study.

Conclusion: Results supported the use of smoking cessation counseling to stop smoking on patients with COPD.

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Background & Aim: Peripherally intravenous catheters (PIVs) are an important part of therapy for hospitalized children. Although such catheters provide necessary vascular access, their use puts patients at risk for local and systemic infectious complications with serious morbidity. Migration of skin organisms at the insertion site into the coetaneous catheter tract with colonization of the catheter tip is the most common rout of infection for peripherally inserted catheters in adults but in children this is controversial. The objective of this study is to find any relationship between colonization and catheter-related consequences.

Methods & Materials: In a descriptive cross-sectional study, 108 catheters of children and neonates hospitalized in NICU and infectious ward of Markaz Tebby Kodakan were cultured at a 2-month period. For all cases, a questionnaire of demographic characteristics and information about catheterization including location, dwell time, drugs and total parental nutrition was filled. The condition of catheterization for all cases was the same. Presence of only one colony was considered as positive colonization. Finally the data were analyzed by SPSS software.

Results: Excluding one case because of positive blood culture, from 107 catheters, 36 were colonized (33.6% of cases). Coagulate negative staphylococcus was the most common pathogen seen in 50% of total positive cases. Although there was a clinically significance between the dwell time of catheter and colonization but there was not any statistical significant association between colonization and any other variables including sex, age, hospitalization time, ward, location of catheter, dwell time, infusion of parental nutrition, and the administered drug.

Conclusion: This study is consistent with guidelines of CDC about avoiding unnecessarily routine replacement of catheters in neonates and children. As the risk of infection did not increase in association with dwell time of peripheral venous catheters, it seems it is better to leave catheters in place until there is a sign of local infection or infiltration.

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Background & Aim: Due to the fact that family centered care have a crucial role in pediatric nursing, it seems compatibility of nurses&apos and parents&apos perception about parents&apos needs can lead to deliver higher quality care. The aim of this study was to compare parents&apos and nurses&apos perceptions about needs of hospitalized children&aposs parents.

Methods & Materials: This is a cross-sectional survey. One hundred and fifty parents and 80 nurses were selected using convenient sampling method. Data was gathered using Kristjánsdóttir&aposs "parental needs of hospitalized children" questionnaire. Data were analyzed using descriptive and analytical (Chi-squared & Mann-Whitney U tests) methods.

Results: Research findings showed that there was significant difference between both parents&apos and nurses&apos perceptions about parents&apos needs (P=0.012). Both groups believed that parents&apos needs are met partially in hospitals. There was not meaningful difference between the parents&apos and nurses&apos perceptions concerning meeting parental needs (P=0.666). Based on their perceptions, understanding of parents&apos needs help them to meet their requirements in health care facilities. There was a significant difference between parents&apos and nurses&apos perceptions regarding parents&apos need (P=0.018).

Conclusion: Parents and nurses recognized all of the parents&apos needs to be important there were also deficits in meeting these needs. Therefore, parents&apos cooperation with health care team is necessary to facilitate the recovery of sick children as well as meeting parents&apos needs.

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Background & Aim: Today, quality of life measurement is important in health care systems especially for patients with chronic diseases. Heart failure has several complications that affect patients&apos lives. The aim of this study was to investigate the quality of life and its dimensions in patients with heart failure.

Methods & Materials: It is a cross-sectional study. Two hundred and fifty patients with heart failure referred to Tehran medical centers were selected using convenience random sampling method. Data were collected using "Ferrans and Powers quality of life Index". Data were analyzed using descriptive statistics, chi-square, and Pearson correlation coefficients.

Results: The study findings showed that 76/4% of the participants possessed undesirable and less desirable levels of quality of life. There was significant statistical relationship between quality of life with age, gender, education, marriage status, ejection fraction, length of heart disease, co-morbidity, and readmission.

Conclusion: Cardiac heart failure has negative effects on quality of life. So, it seems that if assessing the QOL of these patients becomes one of the nurses&apos duties, it will promote the major caring goals.

 

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Background & Aim: Privacy is one of basic rights of the patients. Privacy becomes important for the adolescents when they hospitalize in an unfamiliar environment. This study aimed to compare the perceptions of inpatient adolescents with nurses on the observance of privacy and its importance.

Methods & Materials: In this cross-sectional study, 175 nurses and a convenience sample of 180 inpatient adolescents who had met the inclusion criteria were recruited to the study. Data was gathered using a questionnaire. Man-whitney u and kruskal-wallis statistical tests were used to analyze the data.

Results: The results showed that there was significant differences between nurses&apos and inpatient adolescents` perceptions on the observance of privacy and its importance (man-whitney u, P<0.001). The most important priority regarding the privacy from nurses&apos point of view was "covering the unnecessary parts of the body while caring" whilst it was "providing a pleasant decorated environment, telephone, toilet and bath in room, and hospitalization in a room with peers" from the adolescents&apos point of view. The most observed case about privacy from the nurses&apos point of view was "taking immediate action to help the teenagers if necessary" whilst, from the adolescents view, it was "calling them with their favorite names".

Conclusion: The mean perceptions of nurses were higher than the adolescences toward observance of privacy and its importance. The results can guide nurses to improve quality of care for this group.

 

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Background & Aim: Health systems are challenging with increased health demands and limited economic status whilst, nurses shortages is a worldwide issue. Job dissatisfaction among nurses is a main cause for work leaves. The aim of this study was to assess job satisfaction among Iranian nurses and its related factors.

Methods & Materials: In this cross-sectional study, 1058 nurses were selected randomly during 1384-5. A two-sectioned self-report questionnaire was used which included demographic data and job satisfaction scale. Data were analyzed in SPSS version 12.0.

Results: Findings showed that only about one third of nurses were satisfied (satisfied & very satisfied) with their jobs (34.30%). In this study, main factors of job satisfaction were job safety (44.5%) as well as working environment and facilities (44.26%). On the other hand, nurses were dissatisfied with their job because of the described job duties (74.75%), managers&apos way of communication (70%), and their social position (70.3%).

Conclusion: Increasing the salary and payment, job equity, modifying working time and shift plans, providing opportunities for the nurses to further their carriers, and continuing education are important issues in increasing job satisfaction.

 

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Background & Aim: The present research attempted to investigate the effect of time management training on work-life conflict among two hospitals&apos nurses.

Methods & Materials: In this randomized trial, we recruited all nurses of two public hospitals (n=106) in Hamadan and Tehran according to the inclusion criteria. We used balanced (permuted) block randomization for assigning the study sample into control (n=53) and intervention (n=47) groups. Six individuals did not participate in the study. Data were collected using two instruments: 1) work-family conflict scale and 2) time management behaviors scale. For content validity, ten experts in the field of the study commented on the items. The reliability coefficients (Cronbach&aposs alpha) for these scales were 0.86 and 0.75, respectively. All participants completed the questionnaires at baseline. The time management skills were taught in the intervention group for eight hours. One month later, all participants in two groups completed the questionnaires again.

Results: Considering the baseline characteristics, the groups were homogenous. Independent sample t-test indicated no significant differences between the two groups in all dimensions before the intervention (P>0.05). There was significant difference between two groups in the work-family conflict after the intervention (P<0.001). Also, the paired t-test showed significant difference in work-family conflict before and after the intervention in the intervention group (P<0.001).

Conclusion: According to our findings in the present research, time management training intervention had positive effect on work-family conflict among hospital nurses.

 

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Background & Objective: Research utilization is an important way to extent the knowledge in nursing practice. It empowers the nursing profession. Research utilization is a new paradigm in Iran&aposs nursing care. This study aimed to assess the extent of research utilization in nursing clinical practice in Tehran, Iran.

Methods & Materials: This is a cross-sectional study. The clinical nurses with at least one year of work experience were selected through a multistage stratified sampling method. They completed a five-sectioned self-report questionnaire. The scores were categorized into high, intermediate, and low. Data were analyzed using descriptive statistics and Chi-Square test in SPSS.

Results: Findings revealed that the research utilization in 66.9% of the nurses was low. There was significant relationships between the extent of research utilization and the level of education, professional condition, clinical setting, research activities, work shift, job satisfaction, and English language skills.

Conclusion: The majority of nurses&apos practice is not according to the research findings. We need to find appropriate strategies to enable us to utilize the research findings.

 

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Background & Objective: Conflict occurs more frequently in health care organizations than the other settings due to complexity, frequent interaction between personnel, variations in specialties, roles, and hierarchy. Although conflict is not harmful and destructive in its nature and some degrees of conflict can help to improve health care services, high levels of conflict or its continuity may be harmful. Therefore, it is necessary to manage and control conflict. This study was carried out to assess the relationship between components of the conflict control model.

Methods & Materials: In this cross-sectional study, we developed a questionnaire that probed the relationships between components of conflict control model. A total of 290 nurses were recruited to the study using multi-stage sampling procedure from general educational hospitals in Tehran. Data were gathered using a questionnaire. Content validity of the questionnaire was examined by the expert panel. The internal consistency of the questionnaire was 0.81. Data were analyzed in the SPSS using descriptive statistics and spearman statistical test.

Results: The range of age was 22-53 (34.5±8.2). The majority of the respondents (88.6%) were female, 57.6% were married and 84.8% were staff nurses. From the majority of nurses&apos perspective, the meaning of conflict was discoordination, disagreement and disparity. However, some of the nurses meant it as violence, and difficult issues. About 41.4% of the respondents used negotiation, when they faced up to conflict. Other strategies were aggression, disagreement, avoidance, forgiveness, ignorance, and imposing own ideas to the others. From the respondents&apos point of view, factors that might cause or control the conflict were "mutual understanding and interaction" (32.4%), personality of nurses and their individual characteristics (26.6%), and conditions of the job (21.7%). Interaction was recognized to be the core strategy in conflict control model. Interaction had also significant associations with the five main variables in this study.

Conclusion: Lack of appropriate and efficient communication was an important factor in occurrence of conflict from the nurses&apos point of view. It is essential to improve nurses&apos and managers&apos communication channels by helping personnel to use effective communication skills. This measurement can be helpful for staff in understanding each other and reducing misconceptions. In addition, recognizing additional factors and variables that increases the occurrence of conflict can help to modify effective approaches.

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Background & Objective: Nurses&apos perspective on organizational climate can affect job satisfaction and quality of care. Organizational climate influences staffs&apos attitudes and behaviors in either positive directions, such as productivity, satisfaction, and motivation, or negative directions, such as absenteeism, staff turnover, and work accidents. The purpose of this study was to determine factors that influence the nurses&apos perspectives about organizational climate.

Methods & Materials: This descriptive study was carried out in four educational hospitals in Tehran during fall 2009. A total of 140 nurses were selected for the study using simple sampling method. Data were gathered using organizational climate questionnaire including 25 items about in-service education, work communication, group participation, leader supervision, job promotion, and work policies and standards. Data were analyzed in the SPSS v.13.

Results: The most important dimensions of organizational climate from the respondents&apos point of view were: leader supervision (31.4%), coworker communication and support (19.26%), and skills in practice (17%). The most important negative factors that influenced the nurses&apos perspectives were: lack of reward system (49.3%), high work pressure (47.1%), and lack of participation in important decision-makings (39.3%). The most important positive factors influenced nurses&apos perspectives were: adequate job information (63.6%), having good communication with coworkers and having supportive coworker (47.9%), and having good communications with the leaders (40.7%).

Conclusion: Using effective communication skills and making supportive systems in hospitals can help to create optimal organizational climate and may reduce rate of job dissatisfaction, absenteeism, and staff turnover.

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Background & Aim: Quality of health care services shows the degree of achievement of health outcomes. From ethical and legal perspectives, nurses should be responsible for quality of presented care. Retired nurses can help to elaborate real and valuable concepts related to effective factors on quality of nursing care due to their experiences. The aim of this study was to explore the perspectives of retired nurses on factors that affect quality of nursing care in Semnan.

Methods & Materials: In this qualitative content analysis method, 20 retired nurses were invited to the study using purposeful sampling. Data were collected mainly using semi-structured interviews. The analysis was carried out using content analysis.

Results: Findings of the study yielded to three significant themes including: 1) necessity of humanistic relationships 2) suitable selection and education (3) planning and organizing nursing cares related to quality of nursing cares.

Conclusion: Findings of this study explored perspectives of retired nurses on the effective factors on quality of nursing care. The three themes emerged in the study should be mentioned in planning programs.