ابوالفضل ره گوی

The respiratory disease Covid-19 was first detected in Wuhan, China and spread as a pandemic. The mental vulnerability of nursing students to the stress caused by professional challenges, especially during the corona virus pandemic, was one of the problems that had to be addressed. The purpose of this study is to investigate depression, anxiety and stress in nursing students of Tehran Islamic Azad University of Medical Sciences during the corona virus pandemic in 2021.

This research is a cross-sectional descriptive study that was conducted in the secend half of 2021 in the nursing faculty of Tehran Islamic Azad University of Medical Sciences among 108 nursing students. The data collection tool includes two parts of the demographic characteristic's questionnaire as well as the DASS-21 depression, anxiety and stress scale, which was provided to the students as an online questionnaire. For data analysis, SPSS software version 16 was used for descriptive statistics and chi-square test, and a significance level of less than 0.05 was considered.

Based on DASS-21, the average stress intensity of the participants was 8.40 ± 0.5, the average depression intensity of the participants was 6.41 ± 0.51, and the average anxiety intensity of the participants was 5.48 ± 0.41. There was no significant relationship between the background variables of age, gender, marriage and hospital employment with the level of depression, anxiety and stress of the students participating in the research.

According to the obtained results, the stress subscale had the highest intensity and the anxiety subscale had the lowest intensity among the participants. It seems that nationwide vaccination against covid-19 disease and paying attention to training nursing students to face similar critical cases and increasing personal protective equipment during the pandemic can be effective in preventing nursing students from depression, stress and anxiety.

Urinary incontinence is one of the complications of spinal cord injury that affects various aspects of a person's life and has several negative consequences. This study investigated the effect of clean self-catheterization on anxiety and quality of life of spinal cord injury patients.

This study was a semi-experimental before-after intervention with the control group that studied 80 patients in Rafideh Rehabilitation Hospital in Tehran in 1399. The samples were selected as available and were assigned to two intervention groups (odd numbers) and control group (even numbers) using a regular method. Beck Anxiety Questionnaire and 23-item quality of life questionnaire of spinal cord injury patients were used to collect data, which were distributed to the people in printed versions in person. Data were analyzed using independent t-test, paired t-test, Mann-Whitney, Wilcoxon and covariance and SPSS software version 26 and Medcalc version 8. In order to conduct this research, the code of ethics IR.USWR.REC.1399.158 was obtained from the Research Vice-Chancellor of Tehran University of Rehabilitation Sciences and Social Health.

The findings showed that before the intervention, the two groups were homogeneous in terms of quality of life and anxiety, and the research intervention (intermittent clean survey) led to a significant increase in quality of life and a significant decrease in anxiety.

Intermittent self-probing by the patient can be used as a method to increase the quality of life of patients and reduce their anxiety.

Covid-19, as an emerging disease, has caused high cases of infections and deaths worldwide, which has led to fear and stress in various population groups around the world. The fear of getting sick during the covid pandemic in nurses is associated with frequent consequences on people's mental health. The purpose of this study was to determine the prevalence of the fear of contracting the disease (cronaphobia) and its related factors in the nurses of the Corona Center hospitals of Qazvin province during the covid-19 pandemic.

The present study is a cross-sectional, descriptive-analytical study. In this research, 356 nurses who met the criteria to enter the study and worked in Corona centers participated. The data collection tools in this study included two questionnaires of personal characteristics, demographics and a standard questionnaire of fear of contracting the coronavirus. After collecting information, the data was analyzed by considering the error of 0.05 and using SPSS software version 25.

According to the results, 59% of the nurses had a high level of fear of contracting the corona disease (cronaphobia). There was a significant difference between the number of corona vaccine injections and the presence of a previous history of mental illness between the two groups of low fear of contracting the corona disease (cronaphobia) and high fear of contracting the corona disease (cronaphobia) (p-value<0.05). So that the number of people who had a previous history of mental illness, almost three times more than people who did not have a previous history of mental illness, had a great fear of contracting corona disease (cronaphobia).

The findings of the present study indicated the high fear of nurses working in the covid ward, and several factors were related to the fear of contracting the corona disease. Identifying factors related to the fear of coronavirus can be important in planning and promoting mental health programs for nurses.

Nursing is a challenging profession. Workplace bullying is one of these challenges. Compared to other professions, prevalence of workplace bullying is higher in nursing. However, there is little information available about workplace bullying and work environment in nursing and psychiatric nursing in particular, in Iran. This study aimed to determine the relationship between workplace bullying and work environment of nurses working in Razi Educational and Therapeutic Psychiatric Center in Tehran in 2023.

This study used a cross-sectional descriptive analytical design that was conducted on 153 nurses working in Razi Educational and Therapeutic Psychiatric Center in Tehran in the fall of 2023. Participants were included in the study via simple random sampling method and based on inclusion and exclusion criteria. Demographic questionnaire, Negative Acts Questionnaire-Revised (NAQ-R) and Practice Environment Scale of Nursing Working Index (PES-NWI) were used to collect data. Data was analyzed by SPSS 25 software.

Prevalence of workplace bullying among nurses in the last 6 month was 24.2%. The mean score of Practice Environment Scale was 2.41±0.45. A higher work environment score [OR=0/129, 95% CI for OR (0/046, 0/359), p<0/001] was significantly associated with a lower risk of bullying. Having a good relationship with managers [OR=0/242, 95% CI for OR (0/081,0/724), p=0/011 ] and being interested in the work unit [OR=0/190, 95% CI for OR (0/063,0/549), p=0/003] were also associated with lower risk of bullying.

The work environment influences the presence of bullying. Therefore, nurse managers are advised to reduce workplace bullying by improving work environment. Improving nurses’ communication with managers and increasing their interest in the workplace can also be helpful in this regard.

Postmodernism is an intellectual, social, cultural, artistic, and moral evolutionist movement in the contemporary era. Nursing theorists consider postmodernism essential for formulating and presenting a care program because rethinking, critical thinking, and evidence-based training and practice are the main concepts of this philosophical thinking. The present study reviewed the available literature and evidence about postmodernism as an evidence-based approach to nursing.

In this study, a non-systematic narrative review method was used. Articles were searched using the keywords Postmodern, Postmodernism, Evidence-Based Practice, and Nursing. The search for Persian and English articles was done in the internal databases of SID and Magiran and external databases of PubMed, ProQuest, and Science Direct without time and methodological limitations. A total of 207 articles were found, and after reviewing the articles, 18 studies were evaluated and analyzed based on the inclusion and exclusion criteria for data extraction.

The results showed that the five features of postmodernism in evidence-based nursing science include "decentralization in care practice," "attention to patient values," "strengthening decision-making and clinical reasoning," "reflection and critical thinking in evidence," and "interaction and communication therapy."

Since the postmodernist theory shares many concepts with the evidence-based approach, this point of view can be used to increase the standards of education and care in nursing. Therefore, it is suggested that respected nurses consider using this approach. Also, professors, clinical nursing trainers, and nursing managers should pay more attention to applying this important approach.

In order to reduce the stress and anxiety caused by the spread of the Covid-19 disease, a beneficial and effective psychological variable such as resilience can play an adaptive role. Also, the therapeutic relationship is a meaningful and purposeful relationship between the nurse and the patient in order to solve the patient's problems and create adaptive responses.

The main purpose of this research was to determine the effect of communication therapy based on Peplau's theory on the level of anxiety and resilience of patients admitted to the corona ward of Khatam Al Anbia Hospital in Tehran in 2022.

In a semi-experimental study with a pre-test-post-test design with a control group, using Corona anxiety questionnaires and Connor and Davidson resilience, 60 eligible patients and random allocation in the intervention and control group (30 people), therapeutic communication stages based on Peplau's theory (acquaintance, identification, utilization of care planning and evaluation and conclusion) with prior coordination And it was done according to the treatment plan of corona patients. The data was analyzed through parametric and non-parametric statistical tests using SPSS version 22 software.

The average index of corona anxiety in the intervention group, respectively, decreased from 1.95±0.21 to 1.6±0.11 after the intervention. Also, the average resilience index in the intervention group increased from 1.93±0.46 to 2.33±0.28 after the intervention, and the results of the paired t-test showed that in the intervention group, compared to the control group, the corona anxiety, and resilience in the post-intervention stage had a statistically significant decrease, and the difference before and after the intervention group was more than the control group. Based on the results of the analysis of covariance, the difference between the two intervention and control groups in the post-intervention phase was statistically significant.

Considering the impact of the communication therapy model based on Peplau's theory on anxiety and resilience, conducting educational interventions for the use of communication therapy by patients with chronic diseases and caregivers, as well as applying the results of communication therapy based on Peplau's method to The use of upcoming crises and epidemics is recommended.

Job burnout and dyslexia can be risk factors among nurses. The purpose of this study was to investigate the relationship between job burnout with alexithymia in nurses who work in hospitals affiliated with the Kurdistan University of Medical Sciences.

This is a descriptive-correlation study. The samples included 311 nurses working in hospitals affiliated with the Kurdistan University of Medical Sciences, who were included in the study through the quota sampling method. The data collection tool consisted of a two-part questionnaire. The first part was related to demographic information and the second part was related to the 20-item Toronto Bagby et al.'s (1994) alexithymia evaluation questionnaire and the 22-item job burnout questionnaire by Meslach et al. (1993). Data were statistically analyzed using SPSS version 22 software and through Pearson's correlation analysis, independent t, one-way analysis of variance, one-way linear regression, and Sheffe's post hoc test.

The results showed that alexithymia and job burnout were respectively 82.1(SD=2.05) and 119.4 (SD=6.95) and two of these variables were significantly correlated (r=0.57, p=0.001). Findings showed that alexithymia (33%) explains nurses' job burnout changes.

In general, it can be stated that the higher the level of emotional illiteracy in a person (i.e., the person is weak in describing and recognizing their feelings and emotions and having low objective thinking), the more they will develop burnout syndrome. Therefore, proper planning for the identification of nurses’ emotional status as well as burnout and its related factors and educational interventions about emotional management and prevention of job burnout is needed.

The high prevalence of covid-19 and the occurrence of stress and anxiety reduce the quality of life in patients with covid-19, so remote nursing is considered important to improve the quality of life in these patients. The present study was conducted to investigate the effect of remote nursing on the level of anxiety and quality of life of patients with covid-19 discharged from Imam Khomeini Amol Hospital in 2021.

This is a semi-experimental before-after study with a control group. The research population includes patients with covid-19 discharged from Imam Khomeini (RA) Amol Hospital. 64 patients with covid-19 were selected by the available method and randomly divided into two groups by quadruple block method. The data collection tools include demographic information, the Corona Disease Anxiety Scale questionnaire and the quality of life questionnaire. The intervention of the research was carried out in the form of providing a package of remote nursing services for one month during eight sessions, twice a week and each time for half an hour in the intervention group after discharge. After one month of training, the quality of life questionnaire and the Corona disease anxiety tool were completed again in the intervention group. After collecting the data, they were analysed by SPSS-25 statistical software and descriptive and analytical statistical tests.

The results of the paired t-test showed that the average anxiety score in the mental (p<0.001) and physical (p<0.001) areas in the intervention group decreased significantly after the intervention. Also, the average score of quality of life in physical health (p<0.001), mental health (p<0.001), social relations (p<0.001), environmental health (p<0.001) significantly increased in the intervention group after the intervention.

The results of this study showed that telenursing education can reduce the anxiety of corona patients and also increase the quality of life of these patients.

One of the side effects of electroconvulsive therapy is headache, which can be experienced immediately or shortly after the patient regains consciousness. Foot reflexology massage as a nursing intervention to reduce some symptoms and complications in different patients has been reported to be useful. This study was conducted with the aim of investigating the effect of foot reflexology massage on the headache rate of patients after electroconvulsive therapy.

This experimental before-after with control group design of 54 female patients undergoing electroconvulsive therapy at the Razi Psychiatric Training Center in Tehran. Based on the randomization of the available samples, the patients were assigned to three groups: foot reflexology massage, placebo and control. The visual pain measurement scale was completed after electroconvulsive therapy (before intervention) and 10 minutes after foot reflexology massage for the intervention and placebo groups and with the same time interval for the control group. The data were analyzed using descriptive and inferential statistics such as chi-square and one-variable covariance analysis.

There was no significant difference between the studied groups in terms of demographic characteristics and average headache scores before the intervention (p<0.05). But after the intervention, the mean headache score was significantly lower in the foot reflexology massage group (2.56±0.268) and the control group (3.48±0.266) than the placebo group (3.55±0.268) (p < 0.05), but there was no significant difference between the control groups and placebo group (p=0.84). In other words, the intervention (foot reflexology massage) caused a significant decrease in headache in the intervention group compared to the control and placebo group.

The use of foot reflexology massage is effective in reducing the intensity of headaches in women undergoing electroconvulsive therapy, therefore it is suggested that nurses in electroconvulsive therapy wards use this non-drug method to reduce headache symptoms.

Theory-practice gap is one of the basic and oldest problems of nursing, which has shown itself well in the bedside and training of nurses. The use of philosophical approaches such as pragmatism is a solution to help reduce this gap and recognize the existing challenges in order to solve this gap. Therefore, the present study was conducted with the aim of investigating the pragmatism approach on the nursing theory-practice gap.

The present study is a scoping review type and Persian and English articles extracted from internal databases SID, MAGIRAN and IRANDOC and external databases PubMed, EMBASE, ScienceDirect, Google Scholar, ProQuest, SCOPUS and CINHEAL in the period from 2012 to 2022 using keywords theory-clinic gap, theory-to-practice gap, theory-bedside gap, theory-practice challenges, practicality challenges of nursing theories, philosophy of nursing education, philosophical schools in education, critical thinking at the clinical, Evidence-based nursing, process nursing and clinical improvement, pragmatism and education, nursing and pragmatism separately, combined and its English equivalent using Boolean operators.

A review of the selected articles showed that the gap between theory and practice based on the approach of pragmatism in nursing is divided into two main categories: a) individual factors including three subgroups: 1) motivation to study and continuous education, 2) strong communication skills, and 3) improving critical thinking, and b) Organizational factors include five main factors: 1) clinical-based training, 2) revision of the curriculum, 3) use of new training methods, 4) empowerment of nurses in different job positions, and 5) provision of new training facilities and equipment.

Paying attention to factors that increase the motivation and information of personnel along with strengthening critical thinking skills along with paying attention to organizational factors such as the use of new educational methods and empowering nurses in different branches can be a factor to reduce the gap in the theory of practice based on the pragmatism approach.

Hemodialysis patients on the one hand due to many physical problems, the presence of fistulas or shunts, dietary and drug restrictions and on the other hand due to stress, are not in a good mental state and complex physical problems related to treatment and disease and The long process of the disease before dialysis affects their mental state. Participatory care model is one of the new methods of self-care education. Participatory decision making is recognized as an ethical and spiritual standard in medical decision making, so that patient participation in care and disease management decisions is associated with high patient satisfaction and improvement of treatment outcomes in chronic diseases. Considering the effect of participatory care model on reducing mental and psychological problems of people with chronic diseases, the aim of this study was to investigate the effect of implementing participatory care model on psychological well-being of hemodialysis patients.

The present study was a quasi-experimental study with a pretest-posttest design with a control group. The sample consisted of 66 eligible hemodialysis patients of Imam Reza Hospital in Amol city in 1399 who were randomly assigned to two intervention groups (33 patients) and control (33 patients). Ryff Psychological Well-Being Questionnaire was used to collect data, which was completed by pre-test and post-test by research units. During 2 months, the participatory care model based on Mohammadi model (2002), the steps of Motivation, Reading, Involvement and Evaluation were performed in the intervention group and the control group received routine care. Data were analyzed by Wilcoxon statistical tests with symptomatic rank, independent t-test and SPSS Software 22.

Data analysis showed that, the two groups did not have a statistically significant difference in terms of demographic variables. Psychological well-being in the experimental group before the intervention, 3/37 ± 0/37, to 3/98 ± 0/78 after the intervention increased that t-test indicated a significant difference statistically rate of psychological well-being before and after the Group Intervened (p <0.001). Psychological well-being in the control group changed from 3/42 ± 0/49 before the intervention to 3/39 ± 0/38 after the intervention, but no statistically significant difference was observed in the control group in terms of psychological well-being.

The findings show that the participatory care model has increased the psychological well-being of hemodialysis patients. According to the results, it is recommended that nurses use this Model of care as a simple, low-cost method compared to other cognitive therapies in the care of hemodialysis patients.

The development of health services in recent years has made it necessary to train nurses especially at the master's level. In so doing, psychiatry nursing was set up in Iran for better nursing care to psychiatric patients and the curriculum was established in the year 2011. In this study, due to the lack of comprehensive evaluation of the adequacy of the new curriculum in this field as an important component, the opinions of educators in the field of psychiatric nursing was solocited.

This qualitative study was performed using Conventional content analysis in the academic year 2018. Participants were 9 psychiatric nursing lecturers with at least 2 semesters of teaching experience from universities across Iran randomly selected to take part in semi-structured oral interviews (30-60 minutes) and continued until data saturation, and open-source codes were extracted by repeated reading of the interviews.

After reviewing the gathered data, 90 primary open codes were extracted, which were divided into 4 categories and 5 sub-categories based on the relationship between the codes. Of these, 25% of the codes were related to the overall structure of the curriculum, 28.7% were related to the educational efficiency, 22.22% were related to the research efficiency and 24.07% of the codes were related to the clinical efficiency of the curriculum.

The results revealed the inefficiency of the curriculum in various aspects of education, research and clinical, which in turn suggests the reevaluation of the program to solve problems based on the views of educators.

Clinical competence is considered as the use of knowledge, skills, abilities, behaviors and characteristics to successfully perform important work tasks in the field of mental health nursing. Despite training that prepares nurses for diagnosis and intervention to promote mental health and reduce the risk of psychiatric illness, most nurses are currently limited in their willingness to provide psychiatric care.Therefore, the aim of this study was to Evaluation of psychiatric nursing clinical competencies in nurses working in Razi Psychiatric Hospital affiliated to the University of Social Welfare and Rehabilitation Sciences from the Viewpoints of themselves and their head-nurses in 2019.

This study is a descriptive cross-sectional research. The sample consisted of 173 nurses working in Razi Psychiatric Hospital affiliated to the University of Social Welfare and Rehabilitation Sciences. After obtaining written informed consent, they were enrolled in the study. The number of head-nurses was 25, who filled out the checklists for their subordinate nurses. The following tools were used to collect data: 1. Demographic Questionnaire, 2. Psychiatric nurses clinical competencies self-assessment questionnaire, and 3. Checklist of clinical competencies of psychiatric nurses. Data were analyzed using SPSS software version 22.                                                                                                                                                 

The total score for self-assessment of competencies was 148.62 and the total score for evaluation of nurses was 118.9. This means that the nurses rated their clinical competence at an excellent level and the head nurses rated their clinical competence at a good level. None of the independent variables had a significant relationship with the dependent variables (self-assessment of clinical competencies and evaluation of clinical competencies by the head nurse).

In general, it can be concluded that the clinical competence of psychiatric nurses was desirable from the perspective of themselves and their supervisors. Providing a model and performance plan for assessing clinical competency can help nursing managers and head nurses monitor their clinical staff in relation to their level of clinical skills. Because nurses need clinical competence in all aspects for optimal clinical performance. So that managers and supervisors should have full control over the clinical competence of their nursing staff and identify and encourage highly qualified staff and be aware of the areas in which nurses suffer from weakness and inadequacy and try to strengthen weaknesses.
Keywords: Psychiatric Nursing, Clinical Competence

 Assessment and management of pain in patients under artificial respiration and hospitalized in Intensive Care Units (ICUs) are difficult, and is less considered by physicians and nurses. This study aims to determine the effect of classical music on physiological characteristics, and observational and behavioral measures of pain in unconscious patients admitted to ICUs.

 This is a quasi-experimental study conducted in 2019 on 30 unconscious patients admitted to ICU of Shohadaye Haft-e-Tir Hospital in Tehran, Iran, who were selected using a convenience sampling method, and divided into two groups of intervention and control. After obtaining a written informed consent from patients to participate, they completed a demographic/physiological form, Critical Care Pain Observation Tool (COPT) and Behavioral Pain Scale (BPC). Collected data were analyzed in SPSS V. 22 software by using descriptive and inferential statistics.

 The Mean±SD age of patients in the intervention and control groups was 40.33±14.01 and 46±15.70 years, respectively. Comparison of physiological characteristics before and after the intervention showed no statistically significant difference in any groups except in Glasgow Coma Scale score (P<0.05). The mean pretest and posttest COPT scores in the intervention group were 3.73±0.94 and 1.96±1.32, respectively, and their mean pretest and posttest BPC scores were 5.94±1.39 and 4.22±1.08, respectively. Comparing the mean COPT and BPC scores before and after music therapy showed a statistically significant difference in the intervention group (P<0.05).

 It seems that classical music can reduce observational and behavioral measures of pain in unconscious patients hospitalized in ICUs. More studies are recommended for examining the effect of classical music on physiological characteristics of these patients.

  Anxiety is the most prevalent psychological reaction to childbirth in women, especially in primiparous ones who are not well prepared for assuming the maternal role. Given the importance of maintaining and improving health in women and reducing their psychological complications during pregnancy and childbirth as well as the costs of care and treatment, paying attention to accessible and cost-effective spiritual care-giving methods with fewer complications is crucial. The present study was conducted to investigate the effect of spiritual care on anxiety about childbirth in primiparous women.

The present quasi-experimental case-control study with a pretest posttest design was conducted on 40  primiparous women selected using random sampling and presenting in 2018 to the perinatal clinic of Kamali Hospital. The research was affiliated to Alborz University of Medical Sciences, Karaj, Iran. The data collection tools consisted of a demographic questionnaire and the Spiel Berger state-trait anxiety inventory, which was used to evaluate anxiety in both groups first before The performing spiritual care at 28 weeks of gestation and then at 32 and 34 weeks of gestation. The score of anxiety was 20-80 in this inventory. The intervention group received spiritual care through eight 45-minute sessions and participated in childbirth preparation classes. The data collected were analyzed in SPSS-20 using the independent t-test, the Chi-squared test and  Methods ANOVA.

The data obtained suggested statistically-significant differences in state and trait anxiety levels between before the intervention (28 weeks of gestation) and afterwards (32 weeks of gestation) in the intervention group compared to in the controls  (P<0.05). Statistically-significant differences were also observed in the levels of state and trait anxiety in the intervention group compared to in the control group at 34 weeks of pregnancy (P<0.05).

Spiritual care can be used to reduce anxiety about childbirth in primiparous women.

Nursing is one of the jobs that is associated with many problems and stressors in the workplace and family. The aim of this study was to determine the correlation between work-family conflict and happiness in the nursing staff of the selected Social Security hospital.

The present study was descriptive-correlational. The statistical population of this study was all employees of nurses working in a selected social security hospital.  210 nursing staff were selected by using non-random and quota sampling method. The study used demographic questionnaire, “Work-Family Conflict Scale” (WFCS) and the “Oxford Happiness Questionnaire” (OHQ), which had validity and reliability confirmed in previous studies. Data were analyzed using SPSS.24.

The mean scores of work-family conflict and happiness were reported to be 39.89 and 118.62, respectively. 52.6% of nursing staff participating in the study have a high level of conflict between work and family. Happiness correlation with the family-job conflict variable was significant and inverse, but it was not significant with the job-family conflict variable. (P<0/05).

Due to the significant correlation between happiness and work-family conflict, it is recommended to focus more on hospital staff and create a suitable supportive environment to enhance happiness.

Psychological therapies can play an important role in the improvement of anxiety, depression and stress in patients with asthma. The purpose of this study was to investigate the effectiveness of cognitive-behavioral stress management group therapy in group therapy on anxiety, depression, stress and readmission in asthmatic patients.

In this quasi-experimental study, 38 patients with asthma were selected and randomly assigned to intervention and control groups. DASS-21 questionnaire was used for data collection which was completed at pre-test, post-test and follow-up. Cognitive-behavioral stress management therapy was administered to the intervention group on 10 sessions but no intervention conducted for the control group. Data were analyzed using ANCOVA, one-way ANOVA, t-test, and repeated measures.

The results showed that there was a significant difference between the mean score of depression in the intervention group before (6.42±7.9) and after the intervention (5.05±5.55) (p=0.00). There was also a significant difference between the mean score of depression between the intervention (5.05±5.55) and control groups (13.47±9.49) in first month (p=0.017). There was a significant difference between the mean scores of stress before (10.5±74.97) and after (9.05±5.22) the intervention in the intervention group (p = 0.00). The mean score of anxiety variable after the intervention was significant different between the intervention group (4.53±5.37) and control groups (10.95±7.90) (p=0.01). There was no significant difference in re-admission in the intervention and control groups before and after the intervention.

The results of the present study indicate the effectiveness of cognitive-behavioral stress management therapy in improving anxiety, depression and stress in patients with asthma. Given the high level of anxiety, depression and stress in patients with asthma and the effectiveness of cognitive-behavioral stress management training intervention and the need for serious attention to psychological therapies in this group of patients.

Students Academic tendency can affect different factors depending on time and place conditions. The purpose of this study was to determine Investigation factors affecting Academic tendency in Master student of Nursing in Students of Tehran University of Medical Sciences in 2017-2018 .

This study is a cross-sectional descriptive-analytic study consists Master students of nursing in Tehran University of Medical Sciences (470 number) in 2017-2018 Academic year. 190 students were included using Target-based sampling method and based on inclusion criteria. To collect data we used two questionnaires: demographic and Researcher-made questionnaire to determine the factors influencing the Academic tendency. Data analysis by using SPSS19 statistical software, and using Descriptive and inferential tests.
 

157 students (82.6%) were female and their mean age was 29.69 years. 65.3% (N=124) of them were single and 44 student were studying in medical-surgical nursing. The average work experience was 6.9 years and in consultation with 36.63% of them, they had consulted their professors before choosing a field. According to the students, the most important factor influencing the Academic tendency was individual factors (24%), followed by professional factors (21%), socio-environmental (20%), cultural (18%) and family and friends (17%).

According to the results of the research, it can be noted that individual and professional factors have the greatest impact on the Academic tendency and paying attention to these two, the student's interests and their application in their field of expertise, can both students and patients in care help. Also, consulting with professors due to expertise and experience can be helpful in student guidance. Therefore, it is suggested that faculties and nursing directors consider these issues in choosing their students and staff.

 Due to the prevalence and increasing trend of hypertension in urban communities, less research has been conducted in rural population. The aim of this study was to determine the prevalence of hypertension and its related factors in the elderly population living in the rural areas of the city of Germy.

 The statistical population of this cross-sectional study was the elderly living in rural areas of Germy. Data were collected through multi-stage random sampling and analyzed using SPSS and relevant statistical tests.

 The prevalence of hypertension in the elderly living in rural areas of Germy city was estimated 23.29%. Statistically, the prevalence of hypertension was significantly higher in men than women (p˂0.05). Hypertension was 2.1 times higher in those with undesirable family relationship than the rest (OR=2.13, p=0.008). Moreover, the favorable economic status significantly increased the chance of hypertension in the studied samples (OR=1.87, p=0.003).

 The results indicated high prevalence of hypertension in the elderly living in rural areas of Germy. The prevalence of hypertension was higher in men than women. Over 60 years of age, high BMI, favorable economic status, stress and poor family relationships were factors associated with hypertension in the elderly.

 Renal failure is the irreversible degeneration of renal function, which is typically treated by hemodialysis. Hemodialysis causes mental stresses, fatigue, and depression in affected patients. The purpose of this study was to determine the effect of laughter therapy on fatigue and depression in hemodialysis patients.

 This clinical trial study was carried out based on total count sampling on 70 hemodialysis patients in the cities of Sowmehsara and Fouman in 2017. The Demographic Questionnaire, Multidimensional Fatigue Questionnaire, and Beck Depression Inventory-II (BDI-II) were completed by both groups before the intervention. Afterward, 8 laughter therapy sessions each lasting 30-45 minutes were held for four weeks for the participants in the intervention group. At the end of the last session, the questionnaires were again completed by the participants in both groups. During the intervention, the control group received only usual treatments. The collected data were analyzed using independent samples t-test, Loon test, non-parametric Mann-Whitney U test, and Wilcoxon rank-sum test.

 The mean scores of depression and fatigue in the two groups were not significant before the intervention (p>0.5). However, after the intervention, depression and fatigue scores showed significant differences between the two groups (p=0.001). The depression score in the treatment group decreased from 24.73±11.56 to 10.88±5.00 and the fatigue score decreased from 74.95±16.07 to 52.53±14.70.

 According to the findings, laughter therapy reduced depression and fatigue in patients undergoing hemodialysis. Therefore, senior nursing managers are recommended to take required actions to apply laughter therapy to improve the quality of life of hemodialysis patients.

Many people with mental health problems do not seek professional help but their use of other sources of help is unclear. This study conducted to determine the referral pathways in mental patients in Gilan, Iran. In this cross sectional study, 308 mental patient's psychiatric patients who referred to the emergency department of Shafa educational – remedial Hospital located in Rasht, Iran (Only psychiatric hospital in Gilan province), were enrolled during the period January to March 2017. In the current study, as data collecting tools, a researcher-made questionnaire was employed. The questionnaire was completed during an interview. The questions were about socio-demographic characteristics of patients, psychiatric diagnosis, and the onset of the disease, age of onset of psychiatric patients, referral source, the first treatment method employed by the mentally ill, reasons for referring to non-medical staff. Collected data were analyzed using frequency tables as well Fisher's exact and Chi-square analyses.  All statistical analyses were conducted using the software package SPSS 20.0(SPSS Inc., Chicago, Illinois). The mean age of the respondents 38.4 years (SD±12/9 years; Min: 5, Max: 75 years). Seventy-five (24/4%) respondents were female. The main reported information sources on the help sought were family 264 (85/7%) and Jurisdictions 31 (10/1%). First therapeutic approach employed by respondents were avow (33/8%), followed by traditional and faith healer (39/2%) and only 26/9% of them was medical team. The main reasons for the treatment options employed were recommendations from friends and relatives (46.3%), belief in a physical cause for the psychiatric disorder (14.2%), and fear of stigma (14%).  Manner of the psychiatric disorder onset (gradually or sudden onset), age of patient, age at onset of psychiatric disorder, place of residence and income were significantly associated with the first employed approach (all P value were less than 0.05). But, others including gender, marital status, educational level, nationality and occupation status had not a significant effect on the first employed approach (all P value were more than 0/05). According to our results, a large number of psychiatric patients prefer to visit non-medical practitioners (e.g. traditional and faith healers) at first, especially in rural areas residence, lower- income and older age at onset as well those who experienced gradual onset of disease. Non-medical practitioners had more likely to be approached first because of locally availability, belief that mental illness are caused by supernatural powers and other prevalent cultural belief and the stigma attached to mental illness.

Attention-deficit/hyperactivity disorder is the most common behavioral disorder in children that results in social, educational, and familial ability problems. Psychodrama is one of the effective psychotherapy methods in curing some of psychological disorders. Therefore, the aim of this research is to study the effect of psychodrama on social skills of school children suffering from attention-deficit/hyperactivity disorder. This research is a semi-experimental research including a pretest-posttest instrument with a control group. The statistical population includes all school children suffering from attention-deficit/hyperactivity disorder were referred to Tehran NezamMafi Rehabilitation Clinic in 2016; in 90 children who had the quality of participating in the research 40 children were selected to be available and were placed accidentally and simply into two equal 20-population experiment and control groups. The Social Skill Rating System (SSRS) by Gresham & Elliot (1990) was used to investigate the children’s social skills. After the pretest, the experiment group participated in 12 sessions of psychodrama lasting 40-60 minutes and the control group received routine interventions. After conducting the experiment, the social skills of the two experiment and control group were investigated and the data was analyzed through descriptive statistical calculations and differential T-test by SPSS v.22 software. The comparison of the scores between two experimental and control groups of the children with attention-deficit/hyperactivity disorder showed that the average of the scores in experimental group was 35.72 with standard deviation 19.4 )P = 0.001) that was more than the average of the control group 29.63 with standard deviation of 30.2 (P = 0.069), and it showed that the experiment group in comparison with the control group had a meaningful increase in social skills and their subdivisions (P < 01.0, t = 71.5). The findings demonstrates that psychodrama increases social skills of children with attention-deficit/hyperactivity disorder, so it can be used as a therapeutically method in teaching social skills to these children.

Increasing the prevalence of Dementia is one of the consequences of aging, Due to the nature of Dementia and high level of dependency, taking care of these patients’ leads to mental disorders in family caregivers. On the other hand, the existence of these disorders makes the family functioning disturbed. Hence, evaluating family functioning can be a suitable tool to predict family mental health. The evaluation of Anxiety in caregivers of elderly patients with dementia and their relationship with the family function was the aim of this study. This methodological study was a correlation one. 150 family caregivers of the elderly suffering from Dementia referring to Iran’s Alzheimer's Association in Tehran by sampling in 1394-95 and according to Inclusion criteria were selected. caregivers' anxiety and their family function was measured through the Zung Anxiety Inventory and family functioning McMaster Data were analyzed using Pearson correlation coefficient, variance analysis, Scheffe post hoc test and multiple stepwise regression analysis using SPSS 19 software. 19. 4% ٫and 1. 3% of studied family caregivers of elderly suffering from Dementia had mild anxiety, and severe anxiety respectively. Family function in these patients was found in all dimensions except for the problem solving; also, there was a negative and significant relationship between all family subscales and carers' anxiety (P <0. 001). The results of multiple stepwise linear regression analysis to predict anxiety on the dimensions of family function and underlying variables indicated that behavioral, economic status and health status were able to predict the variance of carers' anxiety. According to the prevalence of Anxiety syndrome in caregivers of patients with dementia and the relation between families functioning with Anxiety, evaluating dimensions of family functioning as one of the important indicators of Family Therapy and Education can improve these caregivers’ health.

Pregnancy and childbirth are stages of life that cause a lot of anxiety, especially in people, who experience them for the first time, and they are accompanied with changes in physical, psychological, economic, social, and sexual systems, which create problems for the mother and the baby in different ways. To deal with such anxieties, several coping models are needed and one of them is the presence of a support person. The present study aimed at investigating the effect of support person presence on the the anxiety of primiparous pregnant females.
In the present study, 70 primiparous pregnant females were selected using the convenience sampling method. They were randomly assigned to control and intervention groups by the coin flipping method. In the intervention group, an intervention of the support person presence was used and in the control group, no intervention was used and only the usual hospital measures were taken. The research tool was the Spielberger State-Trait Anxiety Inventory (STAI). Independent t-test and covariance analysis were used to analyze the data.
The results showed that the means of state anxiety variable decreased from 51.74 to 34.54 (by about 57%) through the intervention and the mean of trait anxiety variable decreased from 49.17 to 39.69 (by about 50%) through the intervention. After the intervention, the weighted mean of anxiety variable decreased from 100.91 to 71.23 (by about 60%). The intervention resulted in a significant reduction in state and trait anxiety scores (P Given the above results, it can be concluded that support person presence was effective in reducing the anxiety of primiparous females and decreased their state and trait anxiety. Therefore, it is suggested to consider some facilities for pregnant females to be accompanied by a support person in hospitals and maternity hospitals.

A preterm neonate puts the mother in complicated conditions, and affects the natural process of neonatal care as well as parental role, particularly the mother’s role. Self-efficacy is a factor that significantly influences the proper function and responsibility of mother, and also is a determining factor in the evolution of mother’s performance and has a close relationship with the growth and development of infant. On the other hand, quality of life (QoL) is related with self-efficacy. The current study aimed at determining the relationship between self-efficacy and QoL in mothers with preterm neonates in Kamali Hospital, Karaj, Iran, in 2015.
The current cross sectional, descriptive-analytical study was conducted using the convenience sampling method on 115 mothers with preterm neonates. Data were collected using a demographic questionnaire, perceived maternal parenting self-efficacy (PMP S-E), and the Persian version of quality of life questionnaire. Then, the relationship of QoL with self-efficacy and some relevant factors was assessed.
In the current study, by increasing the self-efficacy, the QoL also increased. In other words, by one point increase in self-efficacy, the QoL increased 0.5 point. Level of income and maternal education were considered as the factors significantly influencing the increase of self-efficacy and QoL. In this regard, it seems that the employment of the mother and unwanted pregnancy were the indices that affected the reduction of self-efficacy and QoL scores.
According to the positive and direct relationship between self-efficacy and QoL that plays a significant role in different aspects of individuals’ social life, targeted therapeutic programs to promote self-efficacy and QoL in mothers with preterm infants should be planed.