مهناز خطیبان

Nursing model is used to improve the adaptation of patients. Patients' participation in support groups can play an important role in improving their adaptation by getting to know similar patients. The purpose of this study was to determine the effect of using support groups based on the nursing model on social adaptation of patients with implantable defibrillators.

Methods and Materials: 

In this randomized clinical trial, 60 patients referred to the heart clinics of Farshchian Hospitals in Hamedan and Kausar hospital in Shiraz were selected as convenience sampling. Patients were randomly assigned to intervention and control groups by blocking gender and ejection fraction. Patients in the intervention group participated in support groups based on Roy's nursing model, and then their condition was followed up twice a month through phone calls. Patients in the control group received only routine care. The social adaptation of the patients was assessed using Bell's adjustment inventory before and 3 months after the intervention. Data analysis was done by SPSS software using chi squared, t student and t paired tests.

The findings showed that mean age of the patients was 60.48 ± 4.38 years. The majority of patients (56.7%, n=34) were men, and 35% (n=21) had at least one shock per month. The most common cause of implantation of an implantable defibrillator in patients was heart failure (n=54, 80%). The patients in the two groups did not differ significantly from each other in terms of demographic characteristics. Patients in the test group had a significant difference in the social adaptation before and after the intervention. (p>0.001).

This study showed that patients' participation in support groups based on Roy's nursing model along with telephone follow-up of patients can be used as an effective strategy in improving the social adaptation of patients with implantable defibrillators.

Burn pain during therapeutic procedures causes anxiety in patients. Spiritual health and resilience are factors affecting anxiety. The present study aimed to determine the relationship between spiritual health with resilience and wound pain anxiety in burn patients.

In this cross-sectional study, 213 patients were selected by random sampling method. Demographic information, Polotzin and Ellison's spiritual health questionnaire, Connor-Davidson Resilience Scale, and Burns Specific Pain Anxiety Scale were used to collect data. T-tests and one-way analysis of variance were used to analyze the collected data. Data analysis was performed using SPSS software (version 21).

The findings showed that most patients were male (62.91%) with an average age of 38.21 ± 12.72. The average scores of spiritual health, wound pain anxiety, and resilience were 73.63 ± 21.20, 52.83 ± 16.18, and 58.24 ± 13.51, respectively. Although a significant relationship was found between spiritual health and resilience and between resilience and wound pain anxiety, no significant relationship was seen between spiritual health and wound pain anxiety.

Burn patients suffer a lot of pain during procedures such as dressings. Considering the relationship between spiritual health, burn pain anxiety and resilience, educational workshops are suggested to increase spiritual health, resilience and better tolerance during hospitalization.

Hyperglycemia can increase anxiety, depression, and stress in patients with type 1 diabetes, and as a result, poor control of the disease and a decrease in the patient's quality of life. The present study aimed to present the nursing process of an adolescent with hyperglycemia based on King's goal achievement model.

In the present case study, the research sample was a teenage client with frequent hyperglycemia who had visited the hospital several times and was hospitalized. For this purpose, sample selection was performed by available sampling from the research community (i.e., teenagers hospitalized in Hamedan Children's Department with hyperglycemia diagnosis). Data collection was performed through the client's file, interview, and observation of the client, family, doctor, and nurse. The nursing process, according to King's goal achievement model, started after the patient accepted the researcher's request on the last day of hospitalization. The stages of the nursing process(i.e., examination, diagnosis of nursing, determination of common goals and prioritization, transaction based on client's preferences, and evaluation of the degree of achievement of goals by the client by comparing before and after in the range of -2 to +2) were performed in the form of qualitative analysis.

The result pointed out that diabetic adolescents did not have a proper understanding of the factors affecting the stability of blood sugar levels in the normal range. Nonetheless, they found the necessary preparation to interact with the nurse by implementing the nursing process and understanding the conditions affecting hyperglycemia. The findings led to 4 nursing diagnoses and 12 care goals. In the evaluation, it was found that after the implementation of the nursing process, the adolescent client was able to experience the stability of the blood sugar level within the normal range.

The nursing process, according to King's model, was able to stabilize the blood sugar level in the normal range in the patient under study. Therefore, it is possible to suggest the nursing process according to King's model in adolescents with type 1 diabetes in order to maintain the blood sugar level in the normal range.

Disease and complications can cause poor quality of life. Self-care provides desirable outcomes in providing, maintaining, and promoting the health of individuals. The Orem model is one of the models that participate in patient care and emphasizes self-care.

This systematic review was conducted by searching Persian articles with the keywords Orem, Self Care, Model/ Theory/ Framework Self Care and Quality of Life invalid Persian databases Google Scholar, SID, IranDoc, IranMedex, and Magiran, and search English articles with the keywords Orem, Self-care, Quality of life and Model/ Theory/ Framework Self-care invalid English databases Elsevier, Web of Sciences, PubMed, Cinahl, ProQuest, Google Scholar, Scopus, It was done in 2013 to 2018.

Initial search of 2206 articles found that after eliminating duplicates and including entry/ exit criteria, finally, 14 articles were aligned with the objectives of this study. Of the articles reviewed, 5 were published in English and 9 in Farsi. Regarding the research environment, 3 articles were conducted in Tehran, 3 in Isfahan, 2 in each of Shiraz, Hamedan, Orumieh, and 1 in Sabzevar and Ahvaz. All articles were original and interventional research studies. In 10 articles, using the Orem self-care model, quality of life increased significantly in all physical, emotional, and social dimensions, which was statistically significant, as in the other four articles, only in two dimensions of quality of life, including physical dimension. Moreover, a significant psychological increase has been observed.

Considering the positive effect of using the Orem self-care model to improve the quality of life of patients, it is recommended that health care providers improve the quality of life of patients by implementing Orem self-care Model.

Moral distress is a harmful factor in nursing and nursing care. Ethical courage helps nurses to perform nursing care. The present study aimed to determine the relationship between moral distress and moral courage of nurses working in selected hospitals of Hamadan University of Medical Sciences during the Covid-19 pandemic.

This cross-sectional study was conducted with the participation of 204 nurses working in selected educational hospitals by random sampling method. Data were collected by the self-report method using a demographic checklist, as well as Corelli Moral Distress and Sekerka Moral Courage questionnaires. The data were analyzed in SPSS software (version 21) using independent t-test, ANOVA, and regression analysis. A P≤0.050 was considered statistically significant.

The results demonstrated that the majority of nurses were male (55.40%) with a mean age of 41.96±9.53 years, working in the emergency department (43.20%), with 5-10 years of work experience (51.38%), and contract employment (57.45%). Moral distress was significantly correlated with gender, place of service, and work experience; moreover, moral courage and age were significantly associated (P≤0.050). Nevertheless, no significant relationship was detected between moral distress and the type of employment. Moral courage was not correlated with the type of employment, work experience, gender, and place of service (P≥0.050). There was a significant negative relationship between moral distress and moral courage (R=-0.863, P≤0.050). The results of the adjusted regression model illustrated that with each unit increase in the moral distress score, the moral courage score decreases by 0.33. This relationship was statistically significant (β=-.033, P<0.001). The mean scores of moral distress and moral courage were 57.61±3.32 and 36.92±2.46, respectively.

Since there is a significant negative relationship between moral distress and moral courage, it is recommended to hold moral motivation workshops to reduce moral distress and increase moral courage for nurses.

Leukemia and its treatment is a long process and requires adherence to self-care behaviors. Orem's self-care deficit nursing model provides a framework for the nursing process in this direction, therefore this study aims to apply The nursing process based on Orem's self-care deficit model was performed on a patient with acute myeloid leukemia.

In this case report, the nursing process of a client suffering from acute myeloid leukemia, referred to Beheshti Hospital in Hamadan city in 1401, based on the Orem's self-care deficit model, was presented. Data collection was done by using Orem evaluation form and by examination, interview, and observation methods. Based on the general self-care needs, development, and deviation from the patient's health, nursing diagnoses were determined, then planning and setting goals were done and the type of nursing system used was determined. Finally, nursing actions were performed based on promoting self-care, and the achievement of the patient's goals and progress was evaluated as a factor of self-care.

Based on the recognition of the patient's self-care needs, ten nursing diagnoses were determined, and finally, the implementation of the nursing process based on the Orem model led to an increase in the quality of nursing services along with an increase in the patient's self-care performance regarding the problems caused by his illness, so that improving the patient's self-care ability in relation to pain control, reducing Risk of infection, control of bleeding and improvement of sleep, reduction of fear and dependence, an increase of motivation and self-confidence and sense of independence was observed in the patient.

Orem's self-care deficit model greatly helped to identify and comprehensively understand the patient's needs and facilitated the achievement of care goals by involving the patient in self-care.

Nursing profession and field, as a scientific field, needs a scientific basis of which nursing models were and still are. One of the prominent models in nursing is Orem's self-care model. Therefore, this study was conducted with the aim of applying the nursing process based on the Orem self-care model in patients with tibia fractures.

In this case study, the nursing process of a patient with tibia fracture admitted to Ba'ath Hospital in Hamedan city in 2019 was presented. In the stage of nursing research and recognition, data collection was done based on the "Orem self-care model survey form". Nursing diagnoses were compiled and care goals were determined and nursing measures were taken to achieve the goals. Data analysis was presented using a table.

The findings showed that cases of self-care deficiencies and patient self-care needs decreased after nursing measures based on the Orem self-care model. The findings led to 7 nursing diagnoses and 42 care goals.

Using Orem's self-care model as a framework for diagnosis, choosing the appropriate action and evaluating the results was very useful. It is suggested that nursing theories be applied in all departments and on different patients.

Burn is one of the most debilitating type of trauma. Preparing the patient to find the optimal way to deal with the disease as well as maintaining independence and happiness in life is an essential part of the treatment process for burn patients. The aim of this study was to apply the Callista Roy's adaptation model in the care of burn patients.

This study was a case study that was conducted with the participation of a burn patient hospitalized in the burn ward of Besat Hospital in Hamedan city in 2022. Data were collected using observation, interview and patient documentation and were analyzed in four dimensions, based on the steps of the nursing process in Roy's adaptation model.

The results of the study showed that the patient had compatible and incompatible behaviors in physiological dimensions, adaptation of self-perception, role playing, independence and dependence. However, after nursing care based on Roy's adaptation model, some of these incompatible behaviors decreased. Also, based on the information obtained from the Hospital Anxiety and Depression Scale (HADS), the application of the Roy's adaptation model reduced the patient's anxiety and depression in three stages. So that the overall score of the anxiety and depression questionnaire in the second and third time compared to the first time of completing the questionnaire decreased by 67% and 68%, respectively.

According to the results of the present study, the implementation of the nursing care program based on the Roy adaptation model can be effective on physical and psychological adaptation and reduction of incompatible behaviors in patients with burn injuries.

Self-evaluation and peer as formative evaluation have an effect in increase students' learning. To introduce a more effective method, this study was done to Purpose comparison of two formative evaluation methods on satisfaction and learning of clinical skills in nursing students.

In this interventional study to crossover design, all one semester of bachelor nursing students of hamadan nursing and midwifery school entered the study to perform two suction and dressing procedures. Standard checklists were used to evaluate each procedure. Using the checklists, Simultaneous with the instructor evaluation, all 49 students by lottery were don one procedure by self- evaluation and the next procedure to a peer evaluation. Two weeks later, each student was reassessed by the instructor during the procedure. The final score was considered as the learning criterion. Students' satisfaction with evaluation methods was assessed using a researcher-made questionnaire. Data were analyzed by SPSS-16 with a significance level of 0.05.

In the suction procedure, there was no difference between the final scores of the students in the two evaluation methods. In the dressing process, peer evaluation improves students' learning than the self-evaluation method (p<0.01). Peer evaluation led to higher satisfaction of students in the communication dimension and anxiety reduction (p <0.05).

Considering students 'satisfaction of peer evaluation and its positive impact on students' learning of clinical skills, it is recommended to use this method in teaching students to the educational authorities.

Patients with stroke due to the complex and severe nature of the disease, need to implement a thorough and comprehensive nursing care program. The use of nursing models in the patient care process can provide a framework for nurse thinking in examining different patient conditions, better analyzing the situation and organizing thinking for the best decision for the patient. Therefore, this study was conducted with the aim of influencing the application of the nursing process based on Johnsonchr('39')s behavioral system model in patients with stroke.

In this report, the nursing process of a client with a stroke referred to the neurology clinic of Shahid Beheshti Hospital in Hamadan in 2021 was presented. Data were collected during the review phase based on the "Johnson Behavioral Model Review Form" by observation, interview, and physical examination. Nursing diagnoses were formulated as sustained and unstable behaviors and care goals were determined and discussed to increase the maintenance of sustained and decreasing behaviors or eliminate unstable behaviors. Nursing procedures were performed and evaluated to achieve the goals. Data analysis was presented using tables.

The results of the study showed that clients for unstable behaviors in the four sub-behavioral systems (dysfunction in the subsystems of aggression and protection, sexual and sexual). Unstable behaviors are reduced after the nursing procedures are designed.

The use of Johnsonchr('39')s behavioral model was very useful and helpful in modifying and correcting unstable behaviors. Therefore, it is suggested that this model be used as a framework for nursing care.

Cardiovascular disease is a major cause of death, creating huge health-related costs for health care systems. A client who understands the goals of treatment and care in line with their goals and priorities, will be more involved. King's goal attainment theory has addressed this issue. This study was performed to provide a nursing process in a client with acute coronary syndrome based on King's goal attainment Model.

In this case study, a myocardial infarction client with unsuccessful coronary angioplasty and the impossibility of open-heart surgery who was referred to the hospital twice within 10 days due to complications was evaluated. Data were collected through the client's file, observation and interview with the client, family, physician and nurse. The stages of the nursing process, namely, nursing diagnosis, common goals setting and prioritization, transaction based on client preferences, and evaluation of client achievement goals by comparing before and after in the range of 2- to 2+ were performed as a qualitative analysis.

Analyzes showed that although the client did not have a clear understanding of the importance of adherence to health and treatment behaviors, he was willing to interact with the nurse in a step-by step manner. Findings led to 7 nursing diagnoses and 42 caring goals. In the evaluation, the client was able to adhere the treatment well and modify the activities of daily living.

According to the nursing process based on King's goal achievement model, the Acute Coronary Syndrome client was able to act on his prioritized goals by trying to adjust daily activities. It is suggested that the nursing process be used based on King's goal achievement model in clients with acute coronary syndrome.

Emergency medical staff who are at the forefront of health care delivery face many occupational stresses that have psychological, physical, behavioral, and organizational consequences for them, including musculoskeletal disorders. The purpose of this study was to investigate the correlation between musculoskeletal injuries and stress load tolerance among medical emergency staffs in Hamedan province.

In this descriptive-correlational study, conducted in 2019, 76 (40%) of urban and 114 (60%) of employees of road bases were selected from among emergency medical staff of Hamadan, Iran. Data were collected using Nordic Musculoskeletal Injury Questionnaire and Occupational Stress Questionnaire. Data were analyzed by SPSS 23 using descriptive statistics, t-test and Spearman correlation coefficient.

The mean age of the participants was 34.05 (± 8.11) years and the work experience was 123.42 (±84.22) months. The majority (77%) were married, 57.3% had undergraduate degrees and 46.9% had formal employment. Employee stress burden was 503.3 (161.23%) out of 1050 points. Persons who had musculoskeletal disorder due to their job had reported more stress than others; hoever, this difference was not significant (P<0.05). People with musculoskeletal disorders in neck reported higher stress load (P<0.05) than others which was not significant. There was a significant relationship between type of employment, work experience, and type of exercise with musculoskeletal disorders (P<0.05).

There was a significant relationship only between stress and musculoskeletal damage. By modifying and eliminating stressors in emergency personnel’s routines, by holding workshops on ergonomic principles as well as stress reduction principles, it is possible to reduce the physical disorders of emergency personnel.

Medicinal nonadherence prevents the achievement of therapeutic goals in cardiovascular patients. Training is essential to increase medicinal adherence. Therefore, the present study compared the effect of two teach-back and pictorial training methods on the medication adherence in heart failure patients.

This quasi-experimental study was performed on 210 heart failure patients in Hamadan Heart Hospital in 2019. Patients were selected by convenience sampling and randomly assigned to one of three groups of Teach-back, pictorial, and control training. Training sessions were held in three sessions on three consecutive days. Data were collected using demographic and medication adherence questionnaire (MMAS-8) before, immediately and 6 weeks after training. ANOVA, ANCOVA and Repeated measures ANOVA statistical tests were used.

There was no statistically significant difference between the three groups in medicinal adherence at baseline. Immediately after training, medication adherence was significantly higher in teach-back and pictorial groups than the control group (P<0.001), but there was no difference between teach back group and the pictorial group (P=0.123). Six weeks after training, medicinal adherence was significantly higher in teach-back group compared to the control and pictorial group (P<0.001). There was no significant difference between the two methods at different levels of education (P>0.05).

Teach-back training helps maintain medicinal adherence in heart failure patients. Therefore, it is recommended that nurses use this training method to improve medicinal adherence in these patients.

Patients transferred from ICU to general ward need a higher level of nursing attention and care than other patients admitted to the ward. The aim of this study was to investigate the effect of the role of the liaison nurse on physiological indicators and the level of consciousness of patients transferred from the intensive care unit.

The present article is the result of a two-group clinical trial that was performed on 90 patients admitted to the special and general wards of Besat Hospital in Hamadan, Iran. Available sampling and patients were randomly assigned to the two groups. The control group received routine care and in the intervention group was visited twice a day by the liaison nurse for up to three days. The instrument used was a checklist of physiological indices and the GCS scale. Mean, standard deviation, variance and frequency percentage were used to describe the data by SPSS 16.

There was no significant difference between the demographic and clinical characteristics of the two groups at the beginning of the study. After the intervention of the intensive care unit nurse, the two groups were not significantly different in terms of physiological parameters and level of consciousness (P> 0.05).

In nursing services, the interface is not effective on physiological indicators and level of consciousness in patients transferred from the intensive care unit to the general ward. Further studies in this area are recommended.

Patients with multiple sclerosis need a comprehensive nursing care program because of the chronic and complex nature of the disease. Nursing models can provide a framework and goals for the nursing process to provide more effective and comprehensive clinical care. The aim of this study was to investigate the effect of applying nursing process based on Johnson Behavioral Model on improving stable behaviors client with multiple sclerosis (MS).

In this case study, the nursing process was presented by a client with multiple sclerosis who met the MS criteria in Hamadan in 2019. In the Nursing assessment and Recognition phase, data were collected based on the "Johnson Behavioral Model scale" by observation, interview and physical examination. Data sources were the client herself, her family, physician, and medical record and MS staff. Nursing diagnoses were formulated as stable and unstable behaviors. And caring goals were set and shared with the client to increase stable behaviors and reduce or eliminate unstable behaviors. Nursing measures were performed and evaluated to achieve the goals. Data analysis was presented using the table.

The results of the study showed that the client had unstable behaviors in four behavioral subsystems (inefficiency in, Aggressive- protective, Elimination, restorative and sexual subsystems). Unstable behaviors decreased after planned nursing measures.

Johnson's behavioral model was useful in modifying and correcting the unstable behavior. So providing care based on nursing models, can increase the quality of care and client satisfaction.

Promoting education requires using of methods that enable students learn better and play an active role in learning. Achieving such a goal requires using of new teaching methods by teachers in designing teaching methods. The purpose of this study was to compare the effect of two training methods of "simulation patient" and "real patient" in transferring of spinal cord injury patients on knowledge, attitude and skill of occupational therapy students.

The present study is a quasi-experimental study with two group plan: pre-test and post-test, which included 38 undergraduate occupational therapy students that selected by census method. Then participants through simple randomization divided in two groups (19 members). Content of education about transferring of spinal cord injury patients was presented in both groups via lecture and slide during two days. Then, for practical training, students were divided into two groups of training (simulation patient and real patient). Before and after practical -training, knowledge and attitude questionnaires and observational skills checklists were distributed and collected from two groups. Data were analyzed by Wilcoxon test and U Mann-Whitney test through SPSS.

There were no significant differences between the two groups in terms of age, gender, and marital status. After practical training, the results showed a significant difference between the two groups in changing the level of knowledge (P=0.019) skill in terms of general educational content (P=0.006), specific educational content (P=0.000) and relationship initiation (P=0.001).also, findings show significant difference between two groups in "real patient" method but no significant difference in "simulation patient" method.

According to the results, it can be concluded that clinical education can improve the level of knowledge and skill of occupational therapy students as compared to the role-playing method and as a new educational method in medical sciences, increase the quality of education.

The treatment process of hospitalized patients with obsessive-compulsive disorder is less studied. However, because of the complex nature of the disease, these patients require a comprehensive nursing care plan. Since nursing process based on Roy’s adaptation model is widely used to solve problems caused by chronic diseases, this study aimed to implement this model in a patient with obsessive-compulsive disorder.

This study was a case study performed on a patient with obsessive-compulsive disorder admitted in the psychiatric ward of Farshchian (Sina) Hospital in Hamadan, Iran, in 2019. Data were collected using observation, interview, and patient documentation, and they were analyzed in four dimensions based on the stages of the nursing process in Roy’s adaptation model.

Based on data from the assessment stage, manifestations of chronic maladaptive behaviors in the patient included unwanted, intrusive, repetitive thoughts and fears as the focual stimuli, family history of obsessive-compulsive disorder, parental divorce and weakness in coping mechanisms as the contexcual stimulus, beliefs of the patient's father, and psychiatric hospitalization as residual stimuli. Six types of maladaptive behaviors in four modes including inappropriate nutrition (physiological mode), reduced self-care, non-adherence to treatment, need to perform obsessive rituals, avoiding social interactions (self-concept mode), and father dependency (role function mode and interdependence mode) were identified.

Implementing a nursing process based on Roy’s adaptation model by deeply identifying maladaptive behaviors and then, promoting the use of regulate and cognitive coping mechanisms can help correct or modify maladaptive behaviors of patients with obsessive-compulsive disorder. However, achieving desirable outcomes after discharge requires long-term follow-up and support by psychiatric nurses.

Patients undergoing spinal column surgery, experience severe postoperative pain. One of the special methods of pain control is use of a patient-controlled analgesia (PCA) pump. Studies show that despite this pump, patients suffer from moderate to severe pain. Therefore, the teaching patients how to use the pump by nurses is essential. Therefore, the present study was conducted to determine the effect of patient education about patient-controlled analgesia pump preoperative on severity of pain, nausea and vomiting after spinal column surgery.

The present study was a randomized controlled trial during which 60 candidate patients of Spinal column surgery hospitalized in Shahid Fatemi hospital in Ardebil, were selected by accessible method and randomly assigned into two groups of 30 individuals, intervention and control group. Both groups received routine training in the use of the pump in the recovery department, but the intervention group received a 15-minute face-to-face intervention session using a sample of the PCA pump. Postoperative pain intensity, nausea, and vomiting in three times, 2, 4, 24 hours after surgery were assessed and compared. SPSS 16 was used to analyze the data.

The findings showed that there was a significant difference between the control and intervention groups regarding the severity of pain in times of 2, 4, and 24 hours postoperative (P<0.001). Pain severity in intervention group was decreased compared to control group. However, there was no significant difference in nausea and vomiting frequency between the two groups (P>0.05).

Training the use of patient-controlled analgesia pump before operation, without changing the severity of nausea and vomiting, reduces pain after spinal column surgery. Therefore, it is recommended that the way of using the pump, be taught before operation.

Public-private partnership reduces the project fund. Besides, it focuses on utilizing private-sector capacities such as knowledge and specialized experience. The aim of this study was to match the public-private partnership models in medical education in five continents to choose a suitable model for the medical education system. Methods and Materials: This study has compared the public-private partnership models in higher education. The valid databases and websites of major universities across five continents have been searched by proper keywords of public-private partnership. The sampling of universities was done based on strategic choice, purposefulness, and access to information.

One of the good models of the partnership was to use private sector resources to train trainees in the real work environment that has benefited both public and private partners. The private sector partner had cheaper labor and the public sector partner saved money. There were furthermore, another appropriate model was consulting and knowledge transfer services for the private sector by the public sector.

It seems that using private-sector resources for clinical education as a public-private partnership in universities of medical sciences are suitable. On the other hand, the public sector lays education policy and regulation and monitors the quality and quantity of education. Correspondingly, the private sector will be responsible for providing learning space, transfer of knowledge and specialized experience.

Teaching the professional communication skills can be effective in developing the learners’ self-efficacy. In the patients' training with communication skills, the active and student-centered learning methods, such as role-playing, are emphasized. Therefore, this study was run to determine the effects of applying the role-playing method to communication education on the self-efficacy and communication skills of nursing students.   This controlled before-after quasi-experimental study was conducted in Hamadan University of Medical Sciences in 2015. Out of 15 student groups, four groups were randomly assigned to the role-playing (n=32) and four groups to the routine (n=32). Sherer's self-efficacy questionnaire was completed by students at the beginning and end of clinical education. Patient-nurse communication program training through role-playing method was implemented during the interval period. Data analysis was run using SPSS16 by statistical tests at 95% confidence level.   Students in the role-playing group were compared to the conventional group in terms of the individual characteristics (P >0.05). At the baseline, the control group had higher self-efficacy than those in the role-playing group (P<0.05). But after the intervention, analysis of covariance showed that the significant progress was only made in the role-playing students' self-efficacy compared to the control group when baseline score differences were controlled (P<0.001).   Using an active role-playing method can lead to self-efficacy of undergraduate nursing students in comparison with the traditional method.

Satisfaction of patients’ families is one of the criteria for assessing the quality of nurses’ performance. Considering the low satisfaction of stroke patient’s families in received information, the present study was done to determine effect of informational support on satisfaction of family caregivers of patients with hemiplegic stroke from received Information. In this semi-experimental study, 78 family caregivers of patients with hemiplegic stroke admitted to the neurology department of Farshchian (Sina) Hospital of Hamadan (2017), were selected by Convenience sampling, and were divided continuously into two groups: control (n=38) and intervention (n=40). The research intervention was conducted from third to eleventh day of hospitalization. Information was provided about the department, equipment, patient status, home care individually and as a group method. The control group received routine care. Satisfaction of family caregivers was measured before and after the intervention in both groups. The data collecting tool was a questionnaire of demographic characteristics of the caregiver and patient, a researcher-made questionnaire to assess the satisfaction analyzing the received information. Data were analyzed using SPSS16. Groups were similar in terms of demographic variables. There was a significant difference between before (79.15±21) and after (121.4±9.93) intervention at satisfaction scores in intervention group, and between the two groups (intervention and control) after intervention (P<0.001). Informational support is effective on increasing the satisfaction of family caregivers of patients with stroke. Therefore, informational support is recommended as an important nursing intervention.

The quiz is one of the most commonly formative evaluations to attaining the educational goals. This study aimed to compare the academic members’ and students’ perspectives about the formative evaluation by quiz and provide feedback to improve learning at Hamadan University of Medical Sciences.
In this survey, 27 teachers and 180 students were included by convenience sampling. In order to achieve specific goals, a self-report questionnaire was developed according to the literature. The questionnaire contained three parts: a- demographic characteristic (7 items) for both students and teachers, b- 25 items to determine the participants views about the quiz characteristics as how to organize (9 items), holding time (4 questions), feedback (6 questions), better strategies to organize (4 questions), and c- 18 questions on a Likert scale to determine their attitude. Content and face validity of the instrument were approved by the faculty members and its Cronbach's alpha coefficient was 0.85. Data collected were analyzed by 16-Spss software.
This study showed that the view of teachers and students were similar in the most items, however, in some cases, significant differences were obtained. The mean scores of the attitudes indicated the positive attitudes of teachers and students, the Mann-Whitney test (with P=0.59) did not show significant differences between two groups.
In attention to the research findings on the quiz characteristics and particularly the participants’ positive attitudes to quiz, it can be said that the quiz should be considered as a simple and economic formative evaluation in medical education.

The recent research has shown the efficacy of physical activity on various aspects of quality of life. According to this, this study was aimed to investigate the effects of participation on recreational physical activity in women with Schizophrenia.
Research design was Semi-experimental. The statistical society consisted of all women referred to Razi psychiatric hospital in 2015. Among them 24 were selected by purposive sampling and were divided into two groups (12experimental and 12 control). Experimental group received 12 sessions of recreational physical activity, 3 times a week. Research instruments was Quality of Life Questionnaire which has four sub-scales public health, environmental health, mental health and physical health and were performed on pre-test and post-test. To analyze the data uni-variate and multivariate analysis of covariance was used by spss23.
According to the findings F (1,17) = 12/03 there was a significant difference between the two groups in the total score of quality of life. Also, F = 34/39 in physical health, F = 27/24 in mental health subscale, F = 35/39 in terms of social health and F = 50/53 environmental health was significant in 0/05 level.
The results showed that Participation in recreational sports activities, improving quality of life in people with chronic mental disorders. In Addition, participate in Physical - recreational leads to increased physical, mental, social and environmental health of these patients.

Effective communication is one of the basic elements in nursing. Nursing theories are among the sources of guidance in this area. Peplau’s theory is one of the nursing theories which emphasize the importance of the nurse - patient relationship. The objective of this study was to investigate the application of the Peplau’s theory in clinical nursing practice.
The present study was a systematic review in which the keywords " Peplau, Interpersonal Theory, Peplau Nursing Theory" were searched in English in Web of Science, PubMed, and Scopus and in Persian in SID, Magi Ran and Iran Doc between January 2007 and August 2017. The initial comprehensive search resulted in 592 articles in all databases and after considering the inclusion criteria nine articles were finally chosen.
The results showed the positive effect of the application of Peplau’s theory of interpersonal relations in reducing the stress of hemodialysis patients, increasing the satisfaction of patients in the cardiac care unit, reducing the anxiety of patients undergoing coronary artery bypass graft surgery, gaining the trust of patients with sexual and emotional abuse, promoting the health of pregnant women, reducing the harms of children with a parent in jail and increase patients’ cooperation in care.
considering of positive outcomes of the use of Peplau Nursing Theory in practice, it is suggested to consider the promotion of nurses’ awareness of this theory and its training and application in nursing.

Maturity and adolescence is an important phase of human growth. Maturity leads to physiological, social and psychological changes in adolescents. These changes effect on different dimensions of person’s life, including child-parental relations and the control of adolescents’ emotions. The aim of this research was to determine the impact of awareness group training of maturity health to mothers on child-parental conflicts and control of adolescents’ emotions in the first high school course female students.
The present study was a quasi-experimental with a pre-test post-test and control group design. Thirty mothers with child-parental conflict selected by clustered sampling and then randomly assigned to the control or experiment group. The group training of maturity health was done during 12 90-minute sessions. The research tools as, 1- demographic questionnaire, 2-conflict to parents’ questionnaire (CT), 3- affective control scale were completed by mothers and daughters before and after the intervention. Data were analyzed by ANCOVA by the SPSS version 16.
The results of ANCOVA showed a significant difference between two groups in child-parent conflict questionnaire and this sub-scales (P The findings of research revealed that having useful knowledge and awareness about maturity can be helpful for mothers and prevent from child-parental conflict and leads to control adolescent's affective.