فهرست مطالب منیره انوشه

 Caring a patient with hemiplegia could affects different aspects of family caregivers’ health. This study aimed to determine the effect of a patient care education on stressors, anxiety and depression in family caregivers of patients with hemiplegia stroke.

This was a quasi-experimental study carried out in 2019. The samples were women caring for their patients with hemiplegia discharged from a teaching hospital in Koohdasht, Iran. The experimental group received 4 sessions of group discussion and 3 home visits in the designed educational program. Stress, anxiety and depression of caring women in both groups were measured using the DASS21 before and after the intervention. Data were analyzed using Fisherchr('39')s exact test, Chi-square, Wilcoxon, Mann-Whitney U test.

The results showed that stress, anxiety and depression of caregivers were significantly decreased in the experimental group one month after intervention as compared to the control group (P <0.05).

The findings showed that the training program for caregivers of hemiplegic stroke patients could reduce the stress, anxiety and depression.

Physical activity maintenance is an active process that requires active use of strategies and techniques for its maintenance. The present study was designed to understand these strategies from the viewpoints of adolescent girls, who are often significantly less physically active than their male counterparts. This study was a qualitative content analysis conducted through semi-structured interviews with 25 participants (16 adolescent girls, 7 mothers and two fathers). Data gathering was continued until data saturation. All the interviews were recorded, transcribed, and finally were analyzed by conventional content analysis using OneNote. The Strategy of "strive for perfection", with categories of reviewing experiences and thoughtful decision making and activity, was the dominant strategy used by adolescent girls to continue their sport activities. Adolescent girls in the recent study facilitated the continuation of their sports activities through using cognitive and behavioral strategies appropriate to their conditions. Therefore, it seems that paying attention to creating conditions for adolescents to have their own choices, decisions and strategies is useful in the continuation of sports activities.

Diabetes is a chronic illness which has serious physical and mental complication. Physical activity is one of the most important factors in preventing the mental complications of chronic illnesses. This study was performed to evaluate the effect of designed program of physical activity based on Pender health promotion model on type 2 diabetic middle-aged women’s mental health.
This was a quasi-experimental study carried out on 102 diabetic middle aged women referring to Diabetes Assembly of Varamin randomly put in two groups of case and control in 2016. The tools of study were demographic and Mental Health Middle-aged Woman (MHMW) questionnaire. Program of physical activity based on Pender health promotion model was accomplished for the women in the case group. At the beginning of study and two month after the intervention, mental health of both case and control group were evaluated. The data were analyzed using SPSS16, chi-square, t-test and Mann-Whitney tests.
After the intervention, the score of mental health in case group was 188/80 ±16/51 and in control group was 162/82 ±15/05; there was meaningful difference between them (P The results showed that the designed program of physical activity based on health promotion model has a positive effect on the increasing of diabetic middle-aged women’s mental health

Effective and appropriate interventions used by nursing mothers in exclusive breast feeding, in accordance with existing conditions, can have a great effect on the maintenance, continuity and promotion of breastfeeding. So, identifying these successful strategies is essential to make future breast feeding health plans for mothers and infants, and to ensure exclusive breastfeeding.
This was a qualitative study of conventional content analysis conducted in the year 2014. Participants included sixteen lactating mothers of kids up to one year old, and of successful experience in exclusive breastfeeding, who have refereed to health centers in Golestan and Mazandaran universities of medical sciences, Iran. Their experiences on the strategies used successfully in the first six months of exclusive breastfeeding were collected through unstructured and in-depth interviews. Sampling was purposive and was continued until reaching data saturation. The study data were analyzed using constant comparison analysis technique.
Eight main themes related to the nature and dimensions of mothers’ understanding of the strategies used to gain successful exclusive breastfeeding were extracted. These themes were as “comfortable and pleasant preparation before breastfeeding”, “information from reliable sources”, “lifestyle adjustment to breastfeeding”, “intelligent resiliency”, “resolutions for infant’s reluctance in breastfeeding”, “strengthening and ensuring the adequacy of milk and lactation”, “breast care during breastfeeding”, and “the use of religious instructions”.
It is recommended to consider the role and eminence of mothers, and their successful strategies and guidelines related to successful exclusive breastfeeding seriously in codification of health care policies.

Head lice are well known currently as a global health problem. The prevalence of the disease is higher in girls. and at school age. This study performed to evaluate effect of education about preventive behaviors of pediculosis among mothers on morbidity rate of their daughters to pediculosis capitis in primary schools.
This was a quasi-experimental study in two groups (case and control) carried out in 2016. The study samples were composed of 414 mothers and their daughters studying in elementary schools in Lowshan city (Guilan province, Iran). Simple random sampling method used. We provided the intervention group with group discussion in five sessions. There was no intervention in the mothers of the control group. The rate of student's infection was determined in two stages before and after the intervention and compared in two groups. The data were analyzed using SPSS windows version 16 by chi-square and t-test.
The results showed that among 414 daughters, 78 (18.8%) were infected with Pediculus Capitis, 38 (18.4%) were in the case group and 40 (19.2%) were in the control group. After intervention in the case group, the rate of infection of girls decreased from 18.4% to 8.2%, but did not change in the control group. Chi-square test showed a significant difference between mother's education in group discussion and morbidity rate of pediculosis capitis in their daughters after participation (P The findings showed that group discussion on preventive behaviors of pediculosis in mothers led to decrease in morbidity in daughters.

Puberty in adolescents is always accompanied with many psychological changes and they require education during this period of life. The need for education in adolescent females with vision loss is more sensitive.
This study aimed at investigating health education needs of puberty in blind adolescent females at specialized centers in Tehran in the academic year of 2012 to 2013.
The present research was a descriptive study. One hundred blind females between 9 to 19 years old were studied based on the use of simple sampling during the academic year of 2012 to 2013. The data collection tool was a self-made questionnaire including 30 questions, which was used by samples after the confirmation of validity and reliability. For data analysis, the SPSS software version 16 was used.
The rate of desirable awareness regarding physical and psychological health was 12% and 28%, respectively, and the most important source of obtaining information was the participants’ mothers with a frequency of 42%.
Discussion and Puberty education is a necessity in order to increase awareness of blind girls in relation to physical and psychological health. Since these adolescents’ mothers were the most important source of obtaining information, the researchers could achieve positive outcomes with education based on the adolescents needs.

Migraine is the main cause of disabilitating headaches.Sleep disorders are important stimulating factors of migraine. This study performed to determine the influence of sleep management program on headache indexes in migraine patients.
Subjects and

In this quasi-experimental study in 2013, 60 patients with migraine who referred to professional clinic of Razi hospital of Ghaemshahr, were examined in two experimental and control groups (with randomly allocation). Research tools included demographic data questionnaire, headache indexes questionnaire and the Pittsburgh sleep quality questionnaire. Four one-hour sessions of sleep management educational plan was performed for experimental group. Headache indexes and sleep quality measured before and one month after program performance and compared with control untrained? group. Statistical evaluation was done using paired-test and compared by independent t-test.

The means of headache frequency in experimental group significantly decreased and sleep quality improved after intervention (P0.05).

The presentfindings suggest that sleep management program is an effective way to reduce the frequency of migraine attacks. ►Please cite this paper as: Hadadi Barforush M, Anoosheh M, Memarian R. Effect of Sleep Management Program on Headache Indexes of Patients Suffering from Migraine Referred to Ghaemshahr Razi Hospital.

In order to reform in health system and downsizing and compensate employment in nursing¡ the 8th government outsourced the nursing services to private companies; but it wasn''t a successful policy in practice. Though study of obstacles could be useful for further activities of nurses.
Aim: Assessing the obstacles of outsourcing in nursing in teaching.
Method & Material: This study took place in 2013¡ which through it the cases was consisted whole nurses of two hospitals from total of three (n=71). Questioner was made of 40 items¡ (0/9) and validity assessed by faculty members and reliability computed by Alpha Cronbach (0. 90). The data was analyzed by SPSS and descriptive statistics and «Manwithney» test.
Nurse''s concern about job safety had the top score (%93). Lack of rules for improvision privatization (%90). prejudice between private session nurses and employees. Lack of planing (%37). Lack of supervision (%32) and execution (%31). Mentioned above¡ are the main factors for prevention of improvision in privatization.
with the obstacles ahead¡ to get matched with the main plicies of country¡ by providing logical concepts¡ must compensate the lack of compensation or it''s abscence for nurses¡ through the process of outsourcement; Specially job safety and ease of cooperation without discrimination of nurses

Our community which now is walking into the graying of population era, could be exposed to various health care difficulties arising from the extended needs of elderly people. Existing evidence in developed countries has shown that a major cause of mortality is unhealthy life styles which may rise with aging. Due to the priority of prevention and risk factors control, designing a native promoting life style model for Iranian elderly seems an inevitable endevour. So, this research conducted with clarifying the concept, structure, and process nature of life style in Iranian elderly population by qualitative method. To achieving this aims a qualitative research method according to grounded theory was performed. We attempt to explore the concept, structure, and process nature and process of taking of life style in elderly population, by purposeful sampling at first and then continued by theoretical sampling sampling until data saturation. Unstructured interview was used for data collection. Participants of this study were elderly people (living with their families). 29 in depth individual interviews with 23 male and female participants were done. Collected data were transcript immediately and analysis using Strauss and Corbin approach 1998 was implemented. The following eight axial categories were emerged from the data analysis: aging restrictions, daily living behaviors, socio-familial structure, self-management, health deficits, insufficient efficacy, insufficient readiness and sprituality. Category of daily living behaviors was considered as phenomenon, self-management as action/reaction strategy, and health deficits as the consequence of these strategies. The category of spirituality, insufficient efficacy and insufficient readiness were the intervening conditions that affect the process nature of daily living behaviors promotion. Also self-management was found as the central category in this research. According to the consequences of the strategies adopted, it could be argued that older people are not healthy life style and their health has deficient. Based on the results of current grounded theory qualitative study, modification of unhealthy life style related behaviors seems essential.

Mental health is an important aspect of health and it is impossible to reach other parts of the health without it. According to this, present study aimed to explore women's experiences of mental health. Methods &

This study is a contract content analysis with a purposive sampling and maximum variation. 23 participants were selected gradually to saturate the information among middle-aged women living in Kashan. Data analysis was conducted simultaneously.

"The journey towards perfection" has emerged from the data as the theme of the study. This theme consisted of 5 main categories; "Feelings of adequacy", "Sense of sophistication"," Deepen relations", "Meaning-oriented", "Meeting the spiritual and financial prosperity" and multiple sub-categories.

The study presented the majority of women's health-promoting factors in middle age. Paying attention to these factors can promote the overall health status of the women of the country.

The success of establishing regular physical activity lies in the way these activities are built into a person's daily life. This study was designed to explore the causal conditions of adolescent girl's tendency toward physical activities.

A qualitative study was conducted by means of semi-structured interviews with 25 participants (16 adolescents, 7 mothers, and 2 fathers). The interviews were tape-recorded, transcribed verbatim, and analyzed using qualitative content analysis.

The theme of "the pursuit of excellence" with subthemes of "the need for physical health, psychological health, foresight, progress seeking, and desire for superiority and fitness" emerged as causal conditions of adolescent girl's tendency toward physical activities.

In the present study, adolescent girls seeking progress and excellence turned to physical activities. Through a better understanding of the casual conditions of adolescent girl's tendency toward physical activities, we can provide the appropriate context for the formation of exercising habit, and as a result, human health promotion.

familyelderly care with its entire shortcomings as the most important base of community care for the elderly is considered. the object of studywas toexplore the factors strengthening the family in care of the elderly constitutes. This was a qualitative study of the experiences of 11 family elderly caregivers through in-depth, semi-structure interviews conducted in 2011-2012.Data collection, recording, and transcribing were doneafter obtaining informed consents. Data analysis was performed according to thematic analysis by Brown and Clarke (2006). To ensure consistency and accuracy of data, credibility, transferability, dependability, and conformability criteria were assessed. In the present study, insight, management, support and underlying conditions as reinforcing agents in the care of elderly family members was extracted. Iranian families have the capacity in terms of knowledge and insight as well as the importance of social infrastructure in continuity and stability of family members care. Special attention to vulnerable families raised will further strengthen the structure. In this regard, in order to prevent the growth of threatening factors for the family in care of the elderly and providing a useful Iranian family model for other communities regardingthe quality of care for the elderly, Custodians of family health system attempts to preserve existing capacity planning and integratemechanisms of necessary calls.

Despite the progress in the diagnosis and treatment of diabetes, metabolic control in diabetic patients is still insufficient. Poor metabolic control may be due to failure in diabetes self-care by patients and inadequate intervention strategies by health care providers. Barriers to self-care training contribute to inefficient self-management by diabetic patients. In fact, an understanding of these barriers can promote self-care in patients. Therefore, the current study aimed to determine barriers to self-care training in diabetic patients from the viewpoints of nurses and patients. This descriptive, cross-sectional study was conducted in 5 hospitals affiliated to Iran University of Medical Sciences in Tehran, Iran. Overall, 48 diabetic patients and 42 nurses working at the departments of endocrinology and diabetes clinics were selected via convenience sampling. The subjects completed the researcher-made questionnaires, and the collected data were analyzed by SPSS version 15 and descriptive statistical tests. The results showed that environmental (mean=15.85) and management (mean=10.16) barriers were the most important factors from the viewpoints of nurses and patients, respectively. Also, the findings showed that insufficient access of nurses to updated scientific sources related to diabetes (e.g., books, journals, and articles) at the department of endocrinology, lack of a diabetes training center at the hospital, nursing shortage (for answering patients’ questions), nurses’ work overload, and insufficient time for providing information were the most important barriers from the patients’ perspective. As the results indicated, health care authorities and administrators at nursing faculties should update the available scientific sources, hold training courses for nurses, and specialize nurses in diabetes self-care in order to provide self-care training for diabetic patients and overcome barriers to diabetes self-care.

Urinary tract infection is the most common chronic childhood disease، especially in girls under 6 years old. This chronic disease reduces quality of life of mothers. This study aimed to determine the effect of Family Centered Empowerment Model on mothersۥ QOL (physical dimension) with daughter of urinary tract infection. This quasi experimental study was conducted in Motahari Hospital between 1991-1992 year، with 60 mothers whom were eligible for entry into the study in two control and intervention groups. Research instrument consisted of «Perceived Threat»، «Self-Efficacy»، «Mother Efficacy»، «Self-Control»، «Locus of Control»، «Cooper Smith Self-Esteem» and «SF36 Quality of Life Questionnaire». Content Validity Index، Content Validity Ratio and reliability with Cranach’s alpha coefficients calculation were measured for instruments. Data were collected for mothers in intervention group in three phase (before، after and during the model performing) and four stages in intervention time. The mother’s quality of life was assessed before، one and three months after empowering the mothers in intervention group. Data was analyzed by SPSS/18. There was not significant differences in the empowerment and quality of life scores before intervention (P<0. 05). There was a significant difference between the two groups (intervention and control) after family centered empowerment model accomplishment (P<0. 05). Family Centered Empowerment Model could increase quality of life scores of mothers. It is suggested that this model use clinically for families with children with other chronic illnesses.

One of the goals of professional nurses is to provide patient’s comfort. This is achieved through an understanding of the possible need for scientific, humanistic, ethical and communication care. Thus, how to identify comfort in hemodialysis patients is necessary, because it seems to be a constant presence in the ward. Therefore, this study aimed to "clarify the understanding and experience of patients undergoing hemodialysis nurse caring behaviors in comfort of hemodialysis patients".

This qualitative research was conducted with approaches and methods of content analysis. Purposive sampling began and continued until data saturation. Research environment of hemodialysis was at the Hamadan University of Medical Sciences. Collected data and conducted semi-structured interviews with 24 patients reached until saturation. Data were analyzed using qualitative content analysis in eight steps.

Main themes extracted from the data included “understanding the caring-humanistic needs”. The categories included "monitoring patients" and “having humanistic relationship”, "having a professional responsibility, “knowledge” and “having job experience” each of which has several sub-categories, respectively.

We understand and respect the need for nurses to patient care and how to handle them in order to provide appropriate supportive measures, the measures that have an important role in the convenience of these patients, during hemodialysis.

Mental health in middle ages، especially in women is vulnerable due to the frequent changes in this age period and consequences of the changes. Considering the importance of promoting mental health in this period، the present study aimed to explain the women''s experiences on their mental health promotion during the middle ages. In this conventional qualitative content analysis using a semi-structured interview، 23 participants were selected. Considering the maximum variation among the participants، sampling was made gradually until data saturation through purposive sampling from the middle-aged women living in Kashan. Data analysis and sampling were conducted simultaneously. Results showed that mental health promotion in the middle-ages can be contributed to two main themes including «continuity of mental health care to youth» and «mental reconstruction» with subcategories of achieving to physical ideals، happiness promotion، stress relief and spiritual growth. Findings of this study reveal that the middle-aged women use different strategies for achieving and promoting their mental health; some of these solutions have short-term efficacy. However، using the effective coping strategies and providing the facilities for the extensive use of these strategies by the mental health authorities can promote mental health of the middle-aged women.

Hemodialysis patients need to refer to dialysis ward continuously. each dialysis takes time at least 3 hours. The need comfort environment. Nevertheless there are some of environmental factors cause discomforts during dialysis. The aim of this study was to explore the perception of end stage renal disease patients about environment al factors which cause discomfort in patients during hemodialysis.

this was a qualitative content analysis. twenty four patients were included in the study. We collected the data via semi structured interview in hemodialysis ward for 45-60 minutes. The sampling was started purposeful sampling and continues till data saturation. Data were analyzed in according eight stage of content analysis.

out of 24 contributors included in study، we concluded 350 primary codes، 19 subcategory، 6 category and 3 themes emerged for environmental factors barriers discomfort. These themed including: 1) suffer of work place condition in unit 2) dissatisfaction for lack of cultural and welfare facilities and suffering and bothering for dialysis equipment malfunction dialysis equipment.

it seems managers and planners of health filed should consider updating of hemodialysis equipment according needs and technology advances. They should improve work place conditions and cultural and welfare possibility in order to provide appropriates comfort for delivery service promotion.

The elderly care in families with social problems and hardships indicate the insight of family members in elderly care. This study aims to explain the concept of family insightful in care of the elderly. This is a qualitive study. Eleven family elderly care givers were selected and they taken semi-structured interviews through purposeful sampling، and thematic analysis in 90-91. 14 sub themes under four over arching themes namely deep thought، religious orientation، correct diagnosis، and effective operations were studied. Family capability with knowledge and religious belief can lead the person in right path. Therefore the family-based knowledge resulted from cognition and faith in God is the important factor in caring elderly. Family rehabilitation is suggested to trustee agencies.

The evolution of family structures changes family roles، and challenges in providing care for the elderly. Thus، the exploration of the factors limiting the care of elderly in families is the aim of this study. This was a qualitative study of the experiences of 11 family elderly caregivers through in-depth، semi-structure interviews conducted in 2011-2012. After obtaining informed consents، data collection، recording، and transcribing were done. Data analysis was performed according to thematic analysis by Brown and Clarke. To ensure consistency and accuracy of data، credibility، transferability، dependability، and conformability criteria were assessed. In this study poor health، behavioral problems، shortcomings in knowledge، Insufficient experience، economic problems، problems with the physical environment، being busy، insufficient supportive relatives and friends، and failure in formal support were limitation factors in elderly care for families. Individual problems of family members and the weakening factors of social and familial conditions in elderly care cause family health system infrastructures to be fair and use of existing potentials to be insufficient for family support in elderly care. The role of nurses in the exploration of new strategies with the aim of reducing the gap between family needs and existing potentials will be an effective step in strengthening family health infrastructures. In order to complete the results of this study، further studies should be undertaken for assessing existing potential and new strategies for family support in elderly care.

Family plays an important role in physical activity behaviors in children and adolescents although the procedure of this effect is not clear. This study was designed to explore the family role in forming female adolescents’ physical activity behavior. This study used a qualitative procedure and content analysis method. To collect data، semi–structured interviews were conducted with 25 participants (16 female adolescents، 7 mothers، and 2 fathers). All interviews were recorded، transcribed and finally analyzed by qualitative content analysis method. Three main themes emerged as the family role in forming female adolescents'' physical activity behavior: starter (talent identification، interest arousal)، strengthener (providing، companionship and encouraging)، and maintainer (try to eliminate barriers and try to acquire the agreement of the disagreed member in the family). This study provided a better understanding of how families influenced their girls'' physical activity behavior. Identifying the role of family can help health authorities and physical education coaches to design more effective family–based interventions and also to identify more areas for further research.

Philosophy of education is one of the epistemological domains of human science and one of the important courses in the curriculum of nursing doctoral degree. Quality of nursing education depends on the periodical assessment and improvement of this course. Therefore, the aim of this study was the pathological assessment of the principles and philosophy of education course in nursing doctoral degree. A qualitative design using a content analysis approach was used. Using a purposive sampling method, 11 doctoral degree students and 2 lecturers were interviewed. The interviews were transcribed verbatim and analyzed. Five categories were developed: educational planning, promoting motivational strategies, modification of the process of mutual evaluation, compliance of the content with philosophy and content compliance with student's needs. The main theme was the reform of the process of educational administration. Results of this study show the importance and necessity of review and revision of the principles and philosophy of education course. In order to improve the quality of this course, the course content should be designed based on the needs of nursing students to be applicable in education, research and practice.

Since cultural care is not included in nurses’ retraining and continuing education، clinical nurses should deal with the cultural needs of patients according to their own personal experiences. While measures to implement cultural interventions are unknown، the recognition of cultural factors influencing cultural care education is necessary to increase nurses'' ability to provide efficient care. The purpose of this study was to explore the context of the cultural care education in Iran.

Using a qualitative study، 23 clinical nurses with the experience of working in practice، were selected using purposive sampling. Semi-structured were held for data gathering. A content analysis approach was used to analyze the collected data.

During the data analysis the following themes were developed: “inadequate academic training”، and “inadequate retraining”.

It was believed that in course planning، how to provide care to patients with different cultures، was a hidden part of the bachelor’s degree nursing program. Nurses learnt how to communicate with others based on their own experiences and mostly in the workplace.

It is vital that the managers identify and use some appropriate methods to increase job satisfaction. Performance appraisal is one of the essential task for managers to achieve organizational goals، improving the quality of services and one of the factor for job satisfaction.

The aim of the study was to assess the correlation between quality of performance appraisal and job satisfaction of nurses in hospitals of Arak University of Medical Sciences.

This study was a descriptive – correlation that all nurses (133) in teaching hospitals of Arak in 1390 were selected. Data were collected by two questionnaires; performance appraisal had 44 and job satisfaction had 20 questions. Their reliabilities were 0. 85 and 0. 72 respectively by Cronbach Alpha. Data analysis was done by Spearman correlation coefficient and used software SPSS 13.

Results showed that nurses believed that head nurses have moderate competence for the implementation of performance appraisal (80. 5%). Also، qualities of process and outcome performance appraisal were average level; respectively، by 50. 4 % and 60. 9% of nurses. The majority (72. 2%) of nurses expressed moderate level of job satisfaction. There was a significant relationship between a feeling of job satisfaction and nurses’ perceptions of head nurses’ competence، process and outcome qualities (P<0/05).

Regarding the results، it is necessary all nurse managers try for self- empowerment and promote the quality of the performance appraisal process.

Inadequate attention to health education and lifestyle modification are major barriers to prevention، control and treatment of high blood pressure. This study investigated the effects of group discussion with high school youth on lifestyle of their parents who have hypertension. 61 high school boys and their parents were divided into two groups. 8 sessions of group discussion for a month، regarding the need for lifestyle modification in hypertensive patients، was designed for students in the intervention group. Lifestyle changes investigated via measuring of body mass index and scales of drug consumption، frequency of blood pressure measurements، walking and feeding patterns questionnaire in month before and two months after intervention. At the end of study، mean of BMI in intervention group 0/408±0/401 and control group 0/096±0/273 decreased. Independent T-test showed statistically significant difference between groups (P>0. 01). 74/2% of the parent of intervention group and 33/3% of control group at the end of study took their medication regularly. Chi-square showed significant difference between groups (P>0. 01). At the end of study، these statistical tests also showed significantly difference between the experimental group and control group، regarding consumption salt، oil، sugar، white meat، vegetables and dairy products. Group discussion with high school students is effective on BMI، diet، regular walking and taking anti-hypertensive drugs by the parents.

Objective (s): To determine how nurses manage intercultural communication with their patients. The type of this qualitative study was content analysis. 21 nurses were participated in this study. Sampling was purposeful. They have a diversity of age, sex, clinical experiences and different positions. Data were collected via unstructured interview. Content analysis and constant comparative analysis method was used for data analysis. The strategies of prolonged engagement, peer debriefing, member checking and journal writing were used to establish the trustworthiness of the study. Data analysis showed that various strategies were used for inter cultural communication such as: member of family, secretaries of ward, nonverbal communication, using the previous vocabulary, and also translators. Different strategies such as relatives, bilingual and bicultural nurse, orderly, secretary of the ward, nonverbal language, use of previous words and translators are used. According to the results, it can be concluded that nurses when patients are facing cultural diversity, based on their professional and moral obligation, use a combination of strategies to provide complete and effective care.