مجله پژوهش پرستاری ایران
پیاپی 49 (مهر و آبان 1396)

In today's society, we face with a high rate of divorce and marital conflicts; therefore, developing a model that can help counselors and psychologists to reduce this rate seems necessary. The aim of this study was to develop a model of family functioning on the basis of the components of hope, intimacy and marital conflicts in couples referred to counseling centers in Kermanshah City.
This study was descriptive (non-test) and correlational with structural equation modeling. The study population consisted of all couples referred to the counseling centers in Kermanshah City; of which 500 patients (250 females, and 250 males) were randomly selected. Data were collected using four questionaires including family functioning (FAD), Snyder hope scale, an intimacy questionnaire and a questionnaire of marital conflicts. Then, the data were analyzed using inferential statistics (path analysis) by the LISREL software.
The studied model had a good fit. Marital conflicts predicted family functioning; marital conflicts with a mediating role of intimacy and hope predicted family functioning; marital conflicts predicted hope in couples; marital conflicts predicted the intimacy; intimacy predicted family functioning and hope predicted family functioning (in women and men).
The results of this study showed that the management and reduction of tensions and conflicts, and increasing couple's intimacy and hope can be effective in improving family functioning.

Amount and style of empathy with cancer patients by healthcare providers, including nurses, is an important subject which affects the patient and his family. This study was designed to determine the amount and type of empathy in nurses at oncology wards.
In this descriptive study with cross-sectional design, 181 nurses were recruited from oncology, hematology, and stem cell transplantation wards of seven educational hospitals affiliated to the three Universities of Medical Sciences in Tehran. First, the lists of all employed nurses in these wards were extracted, and then, after permission from the authorities of the wards and explaining the objectives of the study, the nurses who wished to participate in the study were recruited according to the inclusion criteria by the non-random sampling method. Data were collected using two questionnaires including the demographic/clinical information questionnaire and the interpersonal reactivity index from November to February 2017. Validity and reliability of the questionnaires were determined. Data analysis was performed using descriptive and analytical statistics by the SPSS software version 21.
The results showed that the majority of employed nurses in oncology wards were women (88.3%). The mean age of the employed nurses at oncology wards was 34.92 ± 6.79 years. The empathy score of the nurses was higher in “empathic concern” compared to the other subscales (20.5 ± 5.8). Approximately 89% of the nurses reported average and higher empathy in empathic concern. The subscale of perspective-taking was ranked lower than empathic concern by the nurses. The results of multiple linear regression analyses showed that five variables of age, marital status, work shift, type of employment and having children predicted 26% of changes in nurses’ scores for empathic concern in oncology wards.
Empathic concern as one of the components of affective empathy is higher than the cognitive component in oncology nurses. Therefore, in line with cognitive empathy, perspective- taking could be used as a powerful focus in the planning of educational interventions for the empowerment of oncology nurses.

Nurses are the largest group working in hospitals and play a vital role in the country's health care system and also as one of the most important group of health care workers have a very important effect on the health of the individual and society. So, the present study aimed to investigate the relationship between metacognitive beliefs and tendency to consume psychoactive drugs among nurses.
In this descriptive-correlational study, 350 nurses were selected from hospitals of Kermanshah city using the multistage cluster sampling in 2016. Data were collected using the short-form questionnaire of metacognitive beliefs by Wales and Krtraygt (2004) and Bahremand et al. (2014) psychoactive substance abuse questionnaire. Data analysis was performed using Pearson correlation and regression analysis with the SPSS 22 software.
Results showed that there was a significant relationship between the components of metacognitive beliefs and tendency to consume psychoactive drugs (P It can be concluded that the scale of metacognitive beliefs can predict the nurse's tendency to consume drugs; the components of metacognitive beliefs either separately or together can be related to trendency to abuse psychoactive substances.

Changes in physiological indicators are important symptoms in a respiratory distress syndrome (RDS). The aim of this study was to compare the physiological indicators of preterm neonates with RDS in prone and supine positions.
This longitudinal descriptive study was conducted in neonative intensive care unit (NICU) of Fatemieh Hospital in Hamedan city in 2016. Forty-five preterm neonates with RDS (gestational age of 32-35 weeks and birth age of 1-7 days) were randomly selected. Each neonate was placed 120 minutes in prone and then in supine positions. After 30 minutes in each position, arterial blood oxygen saturation (SpO2), heart rate (HR) and respiratory rate (RR) were measured three times with 30-minute intervals. Data were analyzed using repeated measurement ANOVA by the SPSS 20 software. The level of confidence was 0.95.
In both positions, the mean of SpO2 was significantly different between the three times of measurments (P In prone, SpO2 increased but RR was decreased after 60 minutes and HR did not change. In supine, only SpO2 was decreased after 60 minutes. So, placing preterm neonates with RDS less than 60 minutes in supine or prone could prevent changes in the physiological indicators.

Nurse's awareness of the rules and standards of their professional duties, the biggest obstacle to their mission in providing health services, care, treatment, and rehabilitation at the highest level is desirable. This study aimed at determining the level of nurse’s knowledge on the standards of care at intensive care units.
This descriptive cross sectional study on 94 nurses at the ICU (ICU, CCU and NICU) of government hospitals in Boroujerd, was done by sampling throught the census method. The used tools consisted of demographic, general, and specialized nursing duties at intensive care units, and the validity and reliability of the samples was measured by a self-report. Descriptive and inferential statistical analysis was performed by SPSS software version 21.
The results showed that mean scores of nurses in the 3 sections were not significantly different (P = 0.06), yet based on age and years of service, there was a statistically significant difference (P 0.05). There was a moderate positive linear correlation between knowledge score and years of service (0.42; P Nurses’ awareness of their mission, and management and official plans for promoting deficiencies in this regard could help promote health.

Located in a constant position during surgery, surgical patients are at risk of developing pressure sores, and attention to areas of the body that are more susceptible to pressure ulcers is important. This study aimed at determining the prevalence of pressure ulcers in different areas of the body after surgery.
This study was a systematic review and meta-analysis, conducted during year 2015, using the following key words, Pressure ulcer, Prevalence, surgical patient, and meta-analysis, in the following databases, PubMed, Google scholar, Scopus, Science direct, and Web of Science. The search was conducted in English language from January 2000 to October 2015 and studied the prevalence of pressure ulcers in different parts of the body after surgery. The Stata software was used for data analysis and criteria for pressure ulcer incidence of error in each study was calculated based on the binomial distribution formula. Finally, heterogeneity index (heterogeneity) by Cochran test (Q) was determined.
First, the findings of 105 articles were considered regarding the inclusion criteria, and 13 articles were included in the study. In this study, 7 main body areas with the highest prevalence of pressure ulcers were identified. The most common was sacral pressure ulcer (15.3 to 3.3; 9.3%), followed by buttocks (8.5 to 4.1; 6.3%) and heel (6.4 to 2.5; 4.4) ulcers.
According to the findings preoperative identification of patients at risk of pressure ulcer and the use of position changes and appropriate pressure-lowering action, particularly in the areas mentioned above, could reduce the risk of injury in these areas.

Students, especially nursing students, have many problems in terms of social and emotional adjustment. Therefore, the present research aimed at determining the effect of group therapy based on acceptance and commitment on social and emotional adjustment of nursing students.
This research was a semi-experimental with a pre-test and post-test with experimental and control groups. The research population included all nursing students of Islamic Azad University of Pishva branch, during academic years 2015 and 2016. From this group, 40 individuals were selected by available sampling method and randomly assigned to 2 equal groups. The experimental group was trained by the approach of group therapy based on acceptance and commitment during 8 sessions of 90 minutes. Both groups completed dimensions of social and emotional adjustment of Bell’s adjustment questionnaire. Data were analyzed using the SPSS-17 software and by multivariate analysis of covariance method.
The findings showed that there was a significant difference between experimental and control groups in the variables of social and emotional adjustment. In other words, group therapy based on acceptance and commitment significantly led to improvement in social and emotional adjustment of nursing students (P ≤ 0.05).
The results are due to the effect of group therapy based on acceptance and commitment method indicating increased social and emotional adjustment of nursing students. Therefore, it is suggest for counselors and therapists to use group therapy based on acceptance and commitment method to improve dimensions of adjustment-specific social and emotional adjustment.

Psychosocial factors have a significant role in prognosis of patients with heart failure. The aim of this study was to determine the relationship between psychosocial factors and self-care behaviors among elderly with HF.
In this study, 184 elderly with HF were selected using the convenience sampling method from 4 teaching hospitals of Mazandaran University of Medical Sciences. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Social support was assessed using Multidimensional Scale of Perceived Social Support (MSPSS). To assess self-care behaviors, the European Heart failure Self Care Behaviors (EHFSCB) questionnaire was used. Statistical analysis was performed using the t test, Analysis of Variance (ANOVA), Fisher’s exact test, gamma test, and logistic regression of the SPSS version 16.0 software.
The mean self-care score was 31.86 ± 8.09 (minimum 13 and maximum 54) with 95% CI 30.68 to 33.04. Living status (P = 0.001), income (P = 0.003), and prior experiences (P Regarding the results of this study, recognition of psychosocial factors of self-care behaviors among elderly with HF seems necessary.

Falls in the elderly cause all kinds of damage that may lead to dependence, lower self-efficacy, depression, daily activity limitation, hospitalization or admission to nursing homes and the cost to individuals and society. This study aimed to investigate the effect of fall preventive programs, falling frequency and quality of life in the elderly living in nursing homes in Khorramabad and Ilam cities.
This semi-experimental study was conducted on 50 elderly people living in two nursing homes in Khorramabad and Ilam cities. Duration of interventions was two months and then four months follow-up after the interventions. The intervention included exercise programs (stretching, balance, strength and Pilates), training for older people, and staff and environment reforms. Data collection tools included demographic data form, form of frequency of falling in the last 6 months, fear of falling questionnaire (FES), and SF-36 quality of life in the form of 36 questions. Data were analyzed using independent and paired t-test, Wilcoxon, Mann-Whitney, Kruskal-Wallis and Spearman correlation coefficient by the SPSS 18 software.
The mean age of the participants was 69.63 ± 8.71 years. Results showed that the mean and standard deviation of fear of falling before and after the intervention were 65.86 ± 11.03 and 48.74 ± 9.84, respectively (P = 0.0001). The mean and standard deviation of the number of falls before and after the intervention were 2.56 ± 1.09 and 1.5 ± 0.707, respectively (P = 0.0001). Also, the mean and standard deviation of the quality of life before and after the intervention were 36.26 ± 13.65 and 56.21 ± 11.67, respectively (P = 0.0001).
The results showed that implementing fall-preventive programs in the elderly can reduce the frequency of falls, and fear of falling and improve the quality of life of the elderly living in nursing homes. Therefore, this issue needs more attention and care on a massive scale, including training and paying attention to the elderlie's living places and removing environmental risks.

Knowledge is a valuable and strategic resource and is also the most important variable for the growth of all-around health-oriented organizations and enterprises. Today, organizations are not limited to capital and human resources. As a result, organizations have stepped up knowledge management to improve and maintain their competitive power. This competition is also based on health-oriented organizations and related to community health systems. In organizations and health systems, there is a gap between knowledge management and their performance, which should be removed by a model of that distance. The aim of this study was to design a model that can determine the levels of knowledge management in the communication system, and the role and interactive functions of these layers in achieving the organization's goals, including sharing and applying knowledge.
This is an applied research, but the research method is descriptive / survey type and, the method of data collection is quantitative type that a group sampling method was used for collecting data. The sample size of the target population was estimated to be 70 person. In this research, with the extensive review of theoretical foundations, the primary factors influencing the model were set and after the initial questionnaire of the research and obtaining opinions of the experts and modifying the factors of the conceptual model of the research were designed, in which two factors and several components were identified and explained. After clarifying the factors, components and indicators of the knowledge management system in large organizations, using the coefficient of significance and load factors using Smart PLS software, confirmed the research hypotheses, and then the final model of knowledge management system was designed.
The first part included a review of the meaningful coefficients Z (values of t-values) for each of the hypotheses. The output of the model showed that the 14 coefficients of the paths between the components determined in the conceptual model of the research were significant. The output of the standardized coefficient of the path between the components and factors showed that the policy component determined 92% of the changes in the level of organizational factors directly.
The proposed model in the knowledge management system of large organizations, such as health-based organizations, is a simple yet feasible model that has been used as a bridge in knowledge management and organizational factors.