رسول اسلامی اکبر

Patients undergoing hemodialysis require a proactive program aimed at improving compliance with dietary and fluid restrictions. The current study was conducted with the aim of investigating the effect of implementing the continuous care model on the attitude related to adherence to diet and fluids in hemodialysis patients.

This semi-experimental research with intervention and control groups was conducted on 64 hemodialysis patients. The samples in this study were initially selected through convenience sampling and then randomly divided into two groups of the intervention group and the control group. Initially, demographic information and compliance-related attitude questionnaires were completed by the patients in both groups during the pre-test phase. Then, after providing an educational booklet, the follow-up care model was implemented in the intervention group. At the end of each month and until the end of the third month, the compliance-related attitude questionnaire was completed in both groups. Subsequently, the collected data were analyzed using statistical tests in SPSS software version 21.

The results of statistical analysis showed that there was no statistically significant difference in the mean score of compliance-related attitude toward dietary and fluid restrictions between the intervention and control groups before the intervention (p = 0.343); however, this score had significantly increased one month after the intervention (p = 0.005).

The results showed that by implementing the continuous care model one month after the intervention, patients exhibited greater adherence to diet and fluid restrictions; therefore, it is recommended that nurses use care models such as continuous care model in caring for patients.

Today, self-care education in thalassemia major patients can improve their care behaviors.The aim of this study was to compare the effect of self-care training through mobile and face-to-face methods on the care behaviors of patients with thalassemia major. 

This is a quasi-experimental study with the participation of 58 patients with thalassemia major referred to the Cooley's center of Ostad Motahari Hospital in Jahrom in 2020. Patients were randomly (by statistical software SAS) divided into three groups (two groups of 19 people and one group of 20 people) including education via mobile phone, face-to-face education and control group. The training was performed within two months. The data collection tool was a researcher-made self-care questionnaire, which was completed by patients before training, immediately and one month later. Data were analyzed using descriptive statistics and analytical in SPSS version 21. The level of significance in statistical analysis (p<0.05) was considered.

Before the intervention, there was no significant difference in the mean scores of patients' caring behavior between the intervention. and a control groups (p=0.638), however, after the intervention and one month later, a significant increase in the mean scores of care behaviors was observed in the face-to-face and mobile phone groups (p<0.05), however, there was no significant difference in the mean scores after the intervention and one month later between the face-to-face training group and the mobile phone group (p=0.613).

The results of this study indicated the positive and equal effect of two types of face-to-face and mobile phone training on the caring behaviors of patients with thalassemia major. Therefore, it is suggested to use any of the mentioned educational methods or a combination of the two mentioned methods in teaching thalassemia patients.

 Safe medication and prevention of medication errors are important tasks of the nursing profession; it seems that one of the causes of medication errors by nurses is incorrect habitual practices and actions without reflection.  The aim of the study was to Investigate the effect of reflection by nurses on their medication errors in Shahid Motahari Hospital in Jahrom.

This study was a quasi-experimental before and after single-group study, which was conducted on 30 nurses working in Motahhari Hospital in 2021 who were enrolled in the study by the census. The reflection training was conducted in three sessions in a presentation using the Gibbs cycle; In addition, nurses were trained for one month on the reflection process by using scientific and scenarios related to medication errors on WhatsApp. The 20-item medication error questionnaire with a specificity of 0.91 and reliability of r = 0.86 was completed by nurses before and 3 months after the intervention. The collected data were analyzed using the Wilcoxon test using SPSS20 software.

The results of the Wilcoxon test showed that the mean of total medication errors of nurses before the intervention was (22.20±26.44) and three months after the intervention was (12.57±17.33), and statistically, there was a significant decrease in the average medication errors of nurses (P = 0.001).

Performing reflection by nurses reduced their medication errors. Therefore, it is suggested to use this learning method in order to guide nurses to use critical and reflective thinking in playing a critical role in drug therapy in order to prevent medication errors and maintain patient safety.

Employing traditional teaching methods in universities may result in a lack of knowledge and practice of drug therapy in nursing students. This study aimed to determine the effect of case-based education on knowledge and practice of drug therapy in nursing students at Jahrom university of Medical Sciences.

This study was conducted in 2020 on 37 nursing interns of Jahrom university of Medical Sciences. The participants were selected through the census method. Online case-based training was conducted through the WhatsApp application in four 90-minute sessions over 4 days. Nursing students’ knowledge and practice of drug therapy were assessed before and after the intervention by a researcher-developed knowledge test related to drug therapy containing 26 multiple-choice questions and an  Objective Structured Clinical Examination containing 10 stations, respectively. The validity and reliability of both knowledge and practice tests were assessed before conducting the study. The collected data were analyzed using paired t-test and Wilcoxon tests in SPSS 21.

The means of drug therapy knowledge in nursing students before and after the intervention was 17.97 ± 2.69 and 22.11 ± 2.55 respectively, and the increase was statistically significant (p <0. 05). Also, the results showed that the means of drug therapy practice before and after the intervention were 61.88 ± 5.37 and 92.85 ± 2.56 respectively, and the increase was statistically significant (p <0. 05).

Case-based education improved knowledge and practice of drug therapy in nursing interns. Therefore, this method is suggested to improve the knowledge and practice of drug therapy.

The   experiences of  learners in the educational system is not limited to  explicit   curriculum and other factors in the form of hidden curriculum play a significant role to shaping students' learning. Due to the lack of comprehensive tools for its study in the medical sciences, the purpose of this study is to construct and validate the tools  in  hidden  curriculum  in medical education

This study is a qualitative study  as  a  hybrid approach. This study was conducted in two phases of design and validation of a questionnaire to study the hidden dimensions of the curriculum in medical education in 2020 at Jahrom University of Medical Sciences. In the design phase, a three-phase hybrid study was used (review of previous study / field research and final conclusion). In the second part,  validation indicators, validity, and reliability of were extracted. Face and content validity assessed by  8 expert professors and a student group with 20 people and its reliability with a group of 104 people. Construct validity by Exploratory Factor Analysis led to the confirmation of tool items.

 The results of the first part (hybrid study) led to the identification of 5  Dimensions. These areas included (teacher-student interactions, teachers' professional characteristics, the architecture of the educational environment and its rules, interactions and communication in the educational environment, and methods of evaluation and obtaining feedback). In the second stage, which was the validation phase, the validity (content, face, construct and reliability of the questionnaire were examined. All parts mentioned above were appropriate. These tools maybe use to assess hidden curriculum in medical education.

 According to the results, Due to the lack of specific tools in medical education, this tool can be used by medical education researchers.

This review study was conducted to review the effects, challenges and strategies for providing spiritual care in people with heart disease. Background. The management of people with heart disease is complex and the course of the disease is unpredictable. The needs of people with heart disease are varied. The available evidence confirms the high level of patients' spiritual needs and desire to receive spiritual care.

In this study, scientific databases and search engines such as Google Scholar, SID, Scopus, PubMed and Web of Science were used to find papers published between 2000 and 2020. The keywords included spiritual care, cardiac disease, cardiac patient, heart disease, coronary artery disease and their Persian equivalents. The selected articles for review were those in Persian or English language and about spiritual care and people with heart disease that their full text were available.

A total of 27 articles were reviewed. The spiritual needs of people with heart disease, the effect of spiritual interventions in reducing the symptoms of these patients and the problems of achieving this goal and the way to solve them were reviewed.

Spiritual care in patients with heart disease improves quality of life, spiritual well-being, reduces anxiety and depression; therefore, it is necessary to include spiritual care in the usual care of people with heart disease.

Clinical decision making is an essential part of nursing professional practice. The patient's changing and uncertain conditions, the clinical environment and the operating room require that anesthetist nurses be well-informed decision-makers so that they can respond to the needs of their clients. Considering the importance of this issue, the present study aimed to determine the factors related to the clinical decision making of anesthesiologists in the operating room.
In this descriptive cross-sectional study, all nurses working in Jahrom medical sciences hospitals (42 patients) were enrolled in the study. Data were collected through a researcher-made questionnaire that evaluated factors related to the clinical decision making of the anesthetist nurses in the operating room in four areas of individual, social, organizational and clinical factors. The research samples in a 5-point Likert spectrum were used to reflect their views on each statement in the questionnaire. Reliability of the questionnaire was 0.94 with Cronbach's alpha coefficient. Descriptive statistical methods such as mean, frequency and percentage were used to analyze the data in order to describe the variables studied.
Clinical dimension had the highest mean score among the factors influencing the clinical decision making of nurses in anesthesia (3.14 ± 0.51) and the lowest mean score was related to social dimension (2.99 ± 0.76).
By balancing the effective clinical factors, including the number of nurses in shifts, and providing and implementing guidelines for determining the scope of anesthesia nurse's empowerment, anesthesia can be empowered in deciding and improving the quality of care.

The compliance of professional ethics standards is inherent nature of nursing profession, so that ethical principles compliance in nursing practice leads to improve nursing service and its facilities improves satisfaction of care recipients. This study was aimed to determine facilitating factors of professional ethics compliance from the viewpoint of nurses.
This descriptive cross-sectional study was conducted with partnership of 120 working nurses in Jahrom University of Medical Sciences hospitals and was used census method. Data gathering tool was was a questionnaire made by researcher, including 36 questions to study facilitating factors of professional ethics in management, individual and patients dimensions. The content validity and reliability with α= 0.93 were confirmed. Data analysis was done by SPSS and using descriptive Statistical tests K- square and correlation coefficient.
From nurses viewpoint, the most important facilitating factors of ethics, in management dimension, were related to good interpersonal relationship of head nurses with nurses (59.2%), in individual dimension was connected to the critical thinking ability and right decision-making in ethical challenging situations (64.2%) and in patients dimension as well as related to proper behavior of patients with nursing staff (41.7%), So that the ability of critical thinking ability and right decision-making in ethical challenging situations (64.2%) were known as the most important facilitating factors.
Based on the study findings, the assistance and promotion of critical thinking and right decision making in ethical challenging situations to nursing staff through teaching and various workshops with a focus on ethical challenges and examples of simulation-based teaching position and also role play of the nurse managers seem necessary.

In recent years, physical examination skills are increasingly important in the health care professions, and effective and sustainable learning of these skills has been one of the main goals of medical education. This study aimed to determine student's satisfaction and learning by blended education of physical examination course. This action research study was accomplished on 15 second semester of medical emergencies students studied at the first semester of academic year in 2013-2014 at Jahrom University of Medical Sciences; all students participated in course of physical exam that educated through blended education. Afterwards, student's satisfaction about blended education was assessed with valid and reliable questionnaire (=0.9); and for evaluating student learning, the participant's scores were compared with the scores of students taught in the previous year, whom was educated with conventional training methods. Therefore, the result of the study showed that all students were satisfied with the implementation of blended education, and agreed and completely agreed with items such as using educational videos makes theoretical content and how to do skills more tangible, and with peer education increases their motivation to learn how to exam. Significant difference in student's scores with blended education and conventional teaching were commonly observable (df =40, t=-2.96, p=0.005); moreover, conventional education illustrated higher scores than that obtained by students in blended education. Combining various methods of education in addition to considering the facilitation role of peers in increasing student satisfaction will promote their motivation to learn provided training.

Lecture as a teacher-centered pattern is a common method in education. However, previous years showed a tendency of various disciplines of medical sciences toward a student-centered orientation. This study aimed to compare the effectiveness of teaching through lecture and conference presentation method on the learning level of anesthesiology students. This quasi-experimental study was performed on 44 anesthesiology students through census method in Jahrom University in 2013. This study compared teaching through peer learning with lecture method. At the end of the semester, satisfaction questionnaires were completed by the students. Also, at the end of the course, students were assessed using multiple-choice questions. Mean test scores in the classroom conference method and teacher lecture method were79.02 ± 11.43 and 78.57 ± 8.21, respectively. The difference was not statistically significant (p=0.76). Also the results showed that most of the students (68.36%) were satisfied with the class conference method. The two teaching methods used did not have a statistically significant difference and a tangible effect on the final exam results. However, conference method had the highest student’s satisfaction. In line with the finding of this study, learning method based on the student participation is recommended.

Nurses are the biggest service providers group in the health system and cast a significant impact on the quality of health– therapeutic care and their complying with ethical norms will be an effective factor to improve their performance in providing patient care. So, this study was carried out with the aim of determining the factors associated with facilitating professional ethics compliance from the perspective of nurses. This study was a cross-sectional study and was conducted in a census way in 2011 involving 120 nurses working in hospitals affiliated with Jahrom University of Medical Sciences. The data collection tool was a researcher-made 17-question questionnaire which studied facilitating factors of professional ethics compliance in two levels, individual and patients. The validity and reliability of the questionnaire was approved. Data analysis was performed using 19 SPSS software and statistical tests and chi-square and correlation coefficient. From the perspective of nurses, the most important factor facilitating professional ethics in the individual dimension is related to the ability of critical thinking and the ability to make correct decisions in challenging moral situations (64/2%) and in the patient level it is associated with patients’ proper conduct in communication with nursing staff (41/7%). Furthermore, a significant discrepancy was found between sexuality and factors related to the patient dimension (p =0/01). Factors related to facilitate professional ethics compliance were identified and prioritized on the basis of nurses’ perspective. Therefore, based on the effectiveness of each of the studied factors that affect compliance with professional ethics, it is proposed that a consistent planning be performed in order to better adherence to professional ethics in the health care system.

Clinical environments in medical universities have an important role for the training and development of the society. Professors'' professional ethics because of the tremendous effect on students is very important. The purpose of this study was to Survey students’ viewpoint about status of professors’ professional ethics at the bedside. In this cross-sectional study، 142 third and fourth year students of nursing and para-medical faculty of Jahrom University of Medical Science by census method were included. Data gathered with valid and reliable researcher made questionnaire including demographic and professors’ professional ethics at the bedside questions based on A Likert scale. Data were analyzed using descriptive and inferential statistics. More than half of the students (55. 6%) were assessed competence of professors as a clinical instructor at an acceptable level. Students assessed professors ability in sympathy and compassion with the patient (77. 5%)، respect to colleagues (76. 1%) and reliability and responsibility for patient (74%)، acceptable. But their professors'' ability about compassion and sympathy with students (62. 7%)، criticism (66. 7%) and the ingenuity and innovation in the care of individual patients (44. 4%) were evaluated unacceptable. Since the professional ethics of professors in some topics of professional ethics is not desirable، it is recommended that in addition to hold continuous education programs in the field of professional ethics for clinical teachers، the root causes of non-compliance with some of the criteria are examined.

Since the application of ethical codes of professional commitment, nurses can provide safe care to the patient, the aim of this study was to evaluate patient's perception regarding compliance of codes of professional ethics, nurses’ professional commitment in Medical Sciences hospitals of Jahrom.
In this cross - sectional study, 210 patients of Hospitals in Jahrom University of Medical Sciences were attended who selected by quota sampling. The data gathering tool consisted of a researcher-made questionnaire including two sections of demographic information and 7 specify questions in domain of professional commitment with 5-point Likert scale. Data analysis was performed by descriptive and analytic statistics via SPSS.
The mean of compliance of codes of professional ethics by nurses in domain of professional commitment in patient's perspective was 24/57±7/86(total of 0 to 28). The most mean compliance was "respecting privacy while care" with a mean of 3/69± 2/99 and in this regard and the lowest mean compliance was" having honest" with a mean of 2/75±1/63(total of 0 to 4).There was no meaningful relationship between demographic characteristics of patients and the observance of nurses’ professional ethics codes.
With respect to results, it appears maintaining and improving the existing situation and identifies the causes of some deficiencies in the observance of codes of professional ethics should be considered by relevant authorities.

An important issue of nursing in the provision of care is to achieve the desirable quality of services in order to gain the satisfaction of patients. The aim of this study is to consider the views of patients regarding the observance of codes of professional ethics in the domain of clinical services by nurses working in hospitals affiliated to Jahrom University of Medical Sciences. In this descriptive-analytical study, 210 patients admitted in different hospitals of Jahrom University of Medical Sciences were selected using randomized quota sampling.The data gathering tool consisted of a valid, reliable (r=0/84) questionnaire including two sections of demographic information and 7 specific questions related to clinical services with 5-point Likert scale. Data analysis was performed by descriptive and analytic statistics via SPSS. The mean of observance of codes of professional ethics by nurses in the domain of clinical services through the perspective of patients was 20/68±5/33 (out of total 28). Findings of the research indicated no significant or meaningful relationship between the patients’ demographic data (age, sex, marital status, place of residence, education and occupation) and the characteristics of hospitalization (hospital and ward-inpatient, history of hospitalization and length of stay) in one hand, and the observance of codes of professional ethics for nurses on the other. With respect to the acceptable level of the observance of codes of professional ethic by nurses in the area of clinical services and according to the data collected from patients, it seems necessary that hospital authorities have to direct their efforts towards keeping and promoting the present situation.

The purpose of this paper is to introduce and recognize academic practices and skills and strategies to manage anger from the perspective of religious training to doctors and nurses. This study was done in the form of reviewing the literature, namely the use of professional nursing and medical articles and Islamic sources including both Shiite and Sunni and the application of Islamic sciences software such as: (Erfan 2 – JamiAhadith 3.5 – JamiTafasir 2). According to religious sources and aphorisms quoted by imams and religious scholars for anger control and prevention of extremism in it, at least two major recommendations have been expressed: One is "patience" means tolerance and other "appease the wrath" which is in fact the same as anger control. Numerous other approaches were mentioned in religious texts, and some of them have theoretical and cognitive aspects. Some also have practical and behavioral aspects, each of these are mechanisms to subdue the rebellious soul. This paper presents six theoretical approaches and seven practical strategies from the perspective of Islamic ethics. Islam has not merely expressed a general content about anger management. Instead, it provides practical solutions. Firstly, because of the priority of these teachings over modern psychology and Secondly, due to the trust of doctors and nurses Muslim community in religious teachings, studying this issue in the perspective of religious teachings increases the possibility of their accentuation and application by them.

Althougheducation with method of students'' classroom conference in teaching and learning process can be beautiful، provocative، dynamic and effective; howeverusing thismethod of teachingto be flowed with challengesfor students andteachers. Thepresent studyinvestigatedthe importance of each of these challengesinthequality of preparing and presentation ofclassroom conference from perspective of a group of studentsinvolvedinthis teaching - learning process. This study method was descriptive- cross sectionaland study samples included all35 Continuous and discontinuous AnesthesiologyUndergraduateDegree students who respectively were enrolled at fifth semester and second semester; these students spent jointly pathophysiology courseinone class by methods of professors lectures and conference presentations by themselves during the semester. Informationcollected throughself-reporting and data gathering toolto investigatechallenges of Students Conference was questionnaire that its validityandreliability (α=0/85) confirmed and with that، studentsidentified the importance ofeach of thechallenges of classroom conference posed inthequestionnaireon a five Likert scale (from verylow tovery high). The obtaineddata were analyzed with SPSS version 16with usingdescriptive and inferentialstatistical tests (t-test، PearsonandSpearman row) The resultsshowed in challenges related to students،with high impotency in questionnaire scale، most frequency respectively belonging to challenges of «lack of sufficientunderstandingcontent prepared for conference presentation» (%57/2) and «lack of enough attention of studentsto thematerialpresented by theclassmates» (%57/1); results also showed in challengesrelated to teachers، in perspective of students respectively challenges with most frequency simultaneously with high impotency were «unclear criteria for evaluation of conference» (%57/2) andlack ofconsultation sessions withteachersbeforeconferences presentation «(%40). Basedthe results of this research، Attention of teachers tofactors such asthe topicof the conference،cognitive andaffectivepreparednessof students،providing a suitable context for discussion and questioningand answering and actively engagement of students while presentation of theclassroom conference and finallyidentifying and introducingclearevaluation criteriatostudentsinvolved in this teachingand learning method، justmight be some of thewayscan provide the conferencemore effectiveandefficient.

Nursing education planners believe the most important part of nursing education is clinical education. This study aimed to determine the importance of obstacles in obtaining clinical training goals from the prospective of nursing educators, nursing students and nursing managers of Jahrom University of Medical Sciences. This cross-sectional study was performed by a self-report questionnaire. Sampling was performed by census and the samples consisted of all nursing students who had passed at least one course of clinical education (n: 101), all nursing educators (n: 9) and all nursing managers who had management experience for at least for 6 months (n=31). Data analysis was performed by SPSS 12.0 and statistical methods. The most important obstacle to obtain educational goals was the presence of many students in wards (52.5%) according to the students’ views. In educators’ view the most important obstacles were students’ disinterest in nursing, nursing managers’ lack of positive attitude toward education, and the lack of course plan in clinical education (66.7%). Finally, educators’ disinterest in nursing profession was rated as the most important obstacle by the nursing managers. Attending to factors such as the large body of students, educators’ and students’ disinterest toward nursing profession, and the lack of course plan in clinical education, and nursing managers’ lack of positive attitude toward education which are regarded as the most serious obstacles in reaching the educational goals of practitioners’ clinical education can contribute to the quality of future clinical education.

Beginning of academic life is one of position that accompany with factors like being in a new social situation, educational duties and changing place of sleep that all causes deterioration in sleep habits and adverse outcome of that; upon this base, present study done with purpose of investigating prevalence of sleep disorders, causes and related outcomes of them in students settled in Jahrome medical university dormitories in 1387. Study was done with cross sectional method and data gathered with self reporting questionnaire that its validity and reliability acquired before. Sampling done with census method and contained all students that settled in dormitories of Jahrom Medical university of sciences(n=418).Information gathered was analyzed with software of SPSS version 14 and using descriptive and x2. Result showed 88/9 % of female student and 84/5 % of male student that settled in Jahrom Medical university dormitories suffered from sleep disorders. the most causes of sleep disorders in deferent majors of students was existing poor physical condition in dormitories and the highest frequency in outcomes of sleep disorders was felling of tired and havent well and happy sense during day (48/8). With considering finding of this study, using strategies that aim causes of sleep disorders and so decrease adverse outcome of sleep disorders that have straight effect to academic advantage and learning of student,is very important and need to consider with responsible persons.

Nursing authorities believe that the ability to think critically by nurses plays an important role in providing individual care, solving problems, making complex decisions, Therefore, critical thinking ability needs to be developed and evaluated during educational experience and be promoted after employment as a professional nurse. The aim of this study was to determine and compare critical thinking abilities among the first and last term baccalaureate nursing students and clinical nurses of Jahrom University of Medical Sciences. This is a cross-sectional study and the data were collected through self reporting using Watson and Glaser standard questionnaire (form A) matched with social and cultural circumstances of Iran country. Its validity and reliability was determined in a pilot study. The subjects of this study included 53 first term and last term baccalaureate nursing students and 41 baccalaureate clinical nurses. The sampling method inused was nonrandom while nurse contributors were selected through random sampling. The findings showed that the mean score of critical thinking of the first term nursing students was 45/1 SD± 8/1, the last term nursing students was 44/3 ± 6/05 and clinical nurses was 44/3 ± 7/7, indicating the weakness in critical thinking abilities in t he study groups. Also, there were no significant differences between nursing students and clinical nurses in the mean scores of the five sub -scores and total scores of WG critical thinking appraisal. Regarding the weakness and also lack of differences in critical thinking ability of the first term and last term nursing students and clinical nurses, there is a need to revise the present traditional educational strategies. The, use of more active learning methods, and application of caring methods leading to active participation of nurses in clinical decisions are suggested.

Authorities of nursing believe that the ability to think critically by nurses play an important role in providing individual care, solving problems and making complex decisions. Therefore, critical thinking ability is to be established during scientific experiences in nursing students and to be promoted in employed nurses. Determining and comparing critical thinking abilitys in first and last term baccalaureate nursing students and clinical nurses, a descriptive - comparative study was carried out in which 172 contributors, selected with stratified random sampling method filled up self reporting questionnaires.Findings revealed that 98.3% of clinical nurses, 94% of last term students and 93% of first term students were weak in critical thinking abilities, besides, there were significantly differences between nursing students and clinical nurses in average scores of inference (p<0.0001), interpretation (p=0.026), evaluation of arguments (p<00.01), and also, total scores of critical thinking abilities. In other words, differentiated aspects of critical thinking ability had higher levels in student nurses. Furthermore, we did not find significant differences between students and clinical nurses from the point of diagnosis of assumption and deduction abilities. To Conclude, regarding findings, although last term students had been involved in a 4 years nursing education curriculum, they were the same with the first term students from the point of their critical thinking abilities, and also, inspite of 2 years of clinical nursing experiences in nurses, their critical thinking abilities were significantly lower than students. So, revising present educational strategies and applying active learning method, both in theory and practice seems to be critical, and regarding clinical nurses, participating in problem solving and decision making situations is of great importance, and for both groups individual patient care with the basis of nursing process will promoted knowledge, attitude, skills and motivation, which all will promote critical thinking abilities consequently.