رویا منصورقناعی

Hypertension is one of the most common problems of the elderly in developing countries, including Iran. One of the main determinants of controlling hypertension is self-care behaviors and one of the factors affecting the level of awareness and thus its more effective control and prevention is health literacy. The aim of this study was to determine the correlation between health literacy and self-care behaviors in the elderly with hypertension admitted to cardiac intensive care units.

The present correlational study was performed in 2020 on 76 elderly patients with hypertension admitted to CCU and post CCU wards in East Guilan public hospitals. The instruments used in this study included a Health Literacy Questionnaire for Iranian Adults (HELIA) and a Self-Care Behavior Questionnaire for patients with hypertension.

The results showed that the majority of elderly people with hypertension had adequate health literacy (57.9%) and relatively desirable self-care behaviors (94.7%). Findings also revealed that there is a significant correlation between health literacy and self-care behaviors (r=0.528 and p<0.05).

Elderly health literacy affects the level of self-care of the elderly, and the higher the health literacy of the elderly, the higher the level of self-care of the elderly with hypertension. So, it can be acknowledged that the issue of health literacy in the elderly is of particular importance and empowering the elderly in the field of health literacy is an important factor in promoting self-care behaviors and ultimately the health of these people. Therefore, it is suggested that health officials and policy makers consider health literacy as one of the most important tools for improving self-care, and also pay special attention to the development, design and implementation of operational plans in this regard.

 Nurses in the clinical setting are confronted with multiple ethical decision-making that need ethical sensitivity to manage, so the present study was conducted to determine the nurses' moral sensitivity at hospitals of Guilan University of Medical Sciences.

 In this descriptive-cross-sectional study in 2017, 180 nurses were selected via multistage sampling from Hospital wards of Guilan University of Medical Sciences. Data were collected through a demographic and the Moral Sensitivity Questionnaire (MSQ). The data were analyzed by the SPSS software version 19 using descriptive and inferential statistics.

 The mean and standard deviation score for nurses’ moral sensitivity was (60.88±11.30). Moral sensitivity was low in 20 people (11.2%), moderate in 143 people (79.4%) and high in 17 people (9.4%). The highest scores were related to the domains of “professional knowledge” (Mean Rank=5.73) and the lowest scores were related to the domains of "honesty and benevolence" (Mean Rank=1.27). There was a significant relationship between Participate in ethics workshops and moral sensitivity (p=0.04).

Ethical Considerations: 

Written permission and ethical approval were obtained from Guilan University of Medical Sciences Ethics Code IR.GUMS.REC.1395. The goals of the study were explained to the participants and then a written informed consent was received from them. Participants were reassured that their participation in the research was voluntary and the information was confidential and results as a group analyze and report.

 In this study, nurses received a moderate score in moral sensitivity and a low score in honesty and compassion, which indicates the difficulty in communicating with empathy therefore, planning to provide emotional and social support and also reduce the workload of nurses seems necessary.

Elderly are vulnerable individuals in society, and are mostly exposed to mental disorders especially depression. Using non-medical factors to manage the depression, like perceived social support, can reduce the incidence of adverse reactions in such a vulnerable population. The current study aimed to determine the relationship between social support with depression among elderly in the eastern cities of Guilan.

This study was a cross-sectional, descriptive -correlational study conducted by the elderly living in the eastern cities of Guilan, in which 168 people were selected from two-stage, cluster random and available sampling.   Data was collected with using two standard tools include, Philips social support questionnaires (23 Items), and Geriatric depression scale (15 Items) Data were analyzed using SPSS, version 19, software, T-test, ANOVA and Pearson tests.

The mean of social support in elderly living in the eastern of Guilan was 73/25±9/18 (total score range of 23-92) and the mean of depression for them was 3/20±3/58 (total score range of 0-15). The analysis of the data indicated that there was a negative significant correlation between social support and depression (p<0/01, r=-0/47).

This study confirmed the role of social support in the development of depression in the elderly, so it is important to provide the conditions for promoting social support to reduce depression and thus improve the quality of life of the elderly.

One of the psychological characteristics decreased with age is self-concept. Self-concept is the mental image of every person. The self-concept of the elderly is also based on their experiences during life stages. The aim of this study was to determine the factors affecting the promotion of self-concept in the elderly and to discuss them.

This review study was conducted through searching IranMedex Google Scholar, SID, PubMed and Scopus databases. In this research, the full-text studies published in English and Persian all over the world from 2008 to 2018 and focused on self-concept and elderly (in English and Persian) were investigated. After qualitative evaluation of studies, they were assessed based on relevance. Then, the best findings were chosen.

The findings showed that the improvement of self-concept in the elderly was related to some factors such as:  body image, fitness and appearance, improvement of quality of life (QoL), improvement of self-esteem and memory review, low and moderate intensity aerobic training, high education, being married and having different roles in different social environments.

As people with low self-concept experience a sense of inadequacy and worthlessness, it is imperative that caregivers adopt self-concept strategies appropriate to each elderly in order to improve the QoL in the elderly.

Hopelessness is one of the most important psychological problems in hemodialysis patients in severe stages of the disease. Hope plays an important role in confronting with the problems and their tensions, and is effective as a potentially powerful factor in improving and adapting patients. The aim of this study was to determine the relationship between hope and demographic characteristics in hemodialysis patients.

This cross-sectional descriptive study was conducted on 103 patients undergoing hemodialysis in the Rasht Razi Dialysis Center in 2017. Data were collected using Snyder’s Hope and Demographic Characteristics Inventory. The data were analyzed using descriptive (tables of frequency distribution, mean and standard deviation) and analytical statistics (ANOVA and T-test) on SPSS 16, considering the significant level of p<0.05.

A majority of patients (54.36%) had high hope. Moreover, the mean and standard deviation of hope value was higher in patients with academic education (41.67%±10.0), history of dialysis <1 year (40.11±9.5), sufficient income (45.62±11.3) and history of kidney transplant (40.0±7.9) as well as in patients who were self-employed (40.82±12.2) and married (36.86±8.8). A significant difference was found between the hope value and variables of education level, income status and hypertension (P<0.05).

According to the results, the patients' hope level is influenced by some demographic characteristics including gender, education level, occupational status, income and history of dialysis. The results of this study can be taken into consideration by the authorities to provide the necessary planning and measures to promote the hope and improve the health of hemodialysis patients.

In chronic diseases, the religious belief of the patient is at risk and the spiritual crisis arises in the person. The aim of this study was to determine the spiritual health and its relationship with demographic characteristics of hemodialysis patients in 2018. This cross-sectional study was conducted on 103 hemodialysis patients referred to the Razi Hemodialysis Center in Rasht and selected through a simplified random sampling. Data were collected using demographic characteristics and spiritual health questionnaires. The psychometrics of this questionnaire has been confirmed in the national studies. The data were analyzed through descriptive and analytical statistics (Mann-Whitney and Kruskal-Wallis) using SPSS 16, considering the significant level of P <0.05. The findings showed that the total mean score of spiritual health was 227.92 and its standard deviation was 19.01, indicating the high spiritual health among hemodialysis patients. The spiritual health was high among patients older than 60 years with college-level education, farmers, patients with a history of transplantation and a history of dialysis less than one year, income above 2.000.000 Tomans and without underlying disease. There was a significant difference between spiritual health with history of dialysis and income level (P <0.05). In this study, the spiritual health level of patients was influenced by some demographic characteristics. Knowledge of the results of the current study can be considered by the managers to provide context for improving the spiritual health of patients through planning and providing the necessary arrangements.

Nursing is a practical profession; therefore three basic factors of students, teachers and curriculum have a great effect on clinical education. There are no general consensuses among researchers on what characteristics constitute an effective clinical teacher. This study explores the views of third and fourth year nursing and midwifery students with regard to the characteristics of effective clinical teachers. This is a descriptive, cross – sectional study. We conducted the study on105 third and fourth year nursing and midwifery students at Guilan University of Medical Sciences from 2012-2013 using convenience sampling. We collected the data through a self made questionnaire that was developed based on characteristics of an effective clinical teacher from student's view points. The questionnaire had 47 statements in three sections such as professional competency, communication skill and personality domain. Data were analyzed using descriptive statistics, repeated measurement, Greenhouse, and Bonferroni test (P<0.05). Average age of students was 21.2±1.4 years. 89 (84.8%f) students were female and 68 (64.8%) of them were nursing students. The most important characteristic of effective clinical teachers in the domain of professional competency was clinical skills (5.58±0.69). In communication domain it was respect for students (5.71±0.63). High confidence was in the personality domain (5.68±0.61) as well. Repeated measurement showed significant difference among three characteristic domains of effective clinical teacher. Analysis of Bonferroni test showed a significant difference within the groups and between domains of professional competency and communication skill (P<0.05). According to student's views, all three characteristic domains of effective clinical teachers were necessary, and communication skills were introduced as the most important domain of effective clinical teachers. Consequently, teachers should improve their communication skills.

Aged people population around the world is increasing، therefore، as service learning method can be effective and suitable for putting students services into practice in the society. The aim of this study is to reinforce knowledge and skill of study، establish communication، and teaching the elderlies by an emphasis on precaution and assessment of the service learning in nursing students. This is a descriptive evaluative study. This program was performed by system learning design pattern of ADDIE. In this regard، 14 volunteer students were selected to perform the process through the convenience sampling. They were assigned to a 16-hour internship course under supervision of an instructor in Lahijan elderly sanitarium. Reflective notes، focus group discussion، and observing the performance، photos، and films were also applied in this work. Themes including “good experience”، “learning the importance of mental healthcare giving in the elderlies”، “life lesson”، “being familiarized with elderlies”، “improvement of altruistic and usefulness sense”، “importance of public participation”، and “systematic learning of the communication with elderlies” were extracted from focus group interviews and reflective notes. In this regard، observing the students’ performance indicated the overall score of 17 out of 20. As-service learning method exposes students to different experience occasions such as working with health social institutes and dealing with specific populations، e. g.، elderlies، in the society and leads to deep understanding of the cultural and value differences and issues around the elderlies.

health care providers are among those groups with greatest risk of blood born infections as Hepatitis C. This affects their practice toward patients with this type of infection. We conducted this survey to study health care provider's knowledge and attitude toward patients with hepatitis C in Razi Hospital in Rasht to increase our knowledge about this issue as well as to improveprofessional health level and health care service toward these patients. 239 health care professionals of Razi hospital in Rasht (the central of Guilan province) entered an analytical cross-sectional study. Inclusion criteria were working in Razi hospital as doctors,nurses and operation room technicians. Questionnaires consisted of questions on demographic characteristics, knowledge and attitude toward hepatitis C documented by a pilot study and validated by Cronbach's alpha (alpha= 0.7) which were distributed among participants. Data were collected and analyzed by SPSS16 software.P<0.05 was considered significant. The mean knowledge score was 17.43 ± 2.65 (from the total of 22), 51.9% of participants achieved upper scores while 48.1% got scores than this limit lower. There was a significant relationship between knowledge score and age, sex, occupation and Level of education of study group. Also there was a significant relationship between attitude level and age, sex, working and educational Background of population under study. Physicians were significantly more knowledgeable and showed more positive attitudes than the other occupational groups. There was a positive correlation between knowledge scores and attitude scores that means better knowledge correlates with better attitude. Present data show that discriminatory attitude is common among health care providers toward hepatitis C patients. Increasing health care provider's knowledge toward this disease is necessary to provide optimal health services for hepatitis C patients.

Education is a mutual process leads to learning and influence the individual behaviors ultimately. The patient education main goals include helping person to improve the quality of life، to achieve the optimal psychosomatic development، and to boost the self-confidence. Among the health-care providers، the nurses spent much time with patients and their family، and so they potentially are the most eligible professionals to identify and respond the patients’ educational needs. This research aims to evaluate the staff nurses’ opinion regarding the importance of patient education and determination of its main facilitators and barriers.

This was a cross-sectional study conducting on nurses who are working in a hospital in East of Guilan province، Iran. The data gathering instrument was a questionnaire divided into 4 sections as follows: (1) questions regarding demographic characteristics (2) sixteen items to find out the subjects’ opinion about the importance of patient education (3) ten items to assess the facilitators to patient education and; (4) ten items to determine the barriers to patient education. To establish the validity of questionnaire the technique of content-related validity according to the opinions of the experts was used. The reliability was confirmed using test-retest technique. Descriptive statistics was applied to interpret the data.

Almost all subjects had a positive attitude regarding the importance of patient education. They introduced “the patient’s interest and cooperation in planning and executing the education” as the most important facilitator (Mean=4. 56; SD=0. 52) and “selecting and educating of special personnel for providing patient education” as the least important facilitator (Mean=3. 23; SD=0. 7) in patient education. They also pointed out “lack of appropriate knowledge and skills regarding recognition of patient educational needs in respect of type of disease” as the most important factor (Mean=4. 53; SD=0. 61) and “unmatched educator and patients in terms of sex” as the least important factor (Mean=3. 19; SD=1. 37) act as barriers to patient education.

Considering the patients interest and cooperation as the most important role along side an optimal nurse – patient relationship، using of audio – visual methods provide more cooperation and facilitate knowing patient eduction requitement.