فهرست مطالب میرحسین آقایی

Objectives :

Psychological support is one of the basic aspects of care for patients with cancer. It has been emphasized in literature and clinical practice for many years. This study aims to explore the experiences and perceptions of healthcare providers in Ardabil, Iran, about psychological support to patients with cancer.

Methods :

The research was conducted using conventional qualitative content analysis in cancer treatment centers in Ardabil, Iran, in 2021. Participants were 19 healthcare providers who were purposefully selected and interviewed to explore their experiences. After transcribing the recorded data, analysis was carried out based on Graneheim and Lundman’s content analysis method. 

Results :

Based on the content analysis results, four main themes, including “highlighting positive mental connection with oneself and others”, “positive awareness”, “positive change in the patient’s point of view,” and “strengthening the perceived value” were extracted. These categories reflected the healthcare providers’ efforts to “strengthen the positive mindsets” of patients and showed the formation of psychological support for patients with cancer.  

Conclusion:

 Strengthening of the positive mentality in patients with cancer is needed for their psychological support, and should be used as a strategic plan in the development of training programs for healthcare providers. It can be an indicator for evaluating psychological support to these patients and be a step towards providing quality care to them. The findings can be useful for designing a tool to measure the status of psychological support for patients with cancer in Iran or assess the care quality and performance of healthcare providers in giving psychological support to these patients.

One of the important missions of nursing education is the general health of students, which has faced many problems with the spread of Covid-19 in the educational system at all levels. The current study aimed to investigating the general health status of nursing students in virtual education during the corona pandemic.

During this cross-sectional study, 220 undergraduate nursing students of Ardabil University of Medical Sciences were included by stratified random sampling method in the winter of 1400. The data was collected using a questionnaire that had two parts of the student's demographic profile and the Goldberg General Health Standard Questionnaire (GHQ-28). To analyze the data, SPSS software version 26 and descriptive statistics tests, Pearson's correlation coefficient, ANOVA, and t-test were used to analyze the data. The tests were performed considering the confidence level of 95%.

The average overall score of general health was 20.1±11.7 and 77 (35%) of the students were suspected of having disorders in general health, and the average of physical subtests was 4.41±3.01, anxiety was 5.28 ± 3.88, social function was 6.90 ± 3.36 and depression was 3.55 ± 3.88. The statistical test showed a significant relationship between age and physical dimensions (P < 0.05). The statistically significant difference was found between the mean of physical sub-tests, anxiety, and total general health score with the type of gender (girl and boy) (P<0.05).

According to the findings, the general health of students in this period requires special attention to a significant extent, especially in the dimension of social performance. These critical conditions have had negative effects on the dimension of public health, especially girls, according to the present study, which requires special attention to the general health of female students in similar pandemics in the future.

Recently, Cardiovascular Disease (CVD) is one of the most common causes of mortality all around the world. Achieving the high Quality of Life (QOL) is considered to be important for these patients. Therefore, the objective of the present study is to investigate the quality of life among patients with CVD in Tabriz Province.

This study was conducted in Tabriz University of Medical Sciences in 2018. In this study, 180 patients were selected using convenience sampling method. World Health Organizations QOL-brief (WHOQOL-BREF) modified questionnaire was used for data collection. Questionnaire was consisted of 26 questions about different aspects of patients’ QOL. Descriptive statistics analysis including frequency, percentage and mean ± standard deviation was used to analyses the data. Independent samples T-test and One Way ANOVA was also used for data analysis by SPSS.16. P-value less than 5% was considered as statistically significant.

Most participants (about 80%) were in the age group of 50-69. Among the participants, about 30% of the participants were satisfied with their health status and only 12% expressed that they can afford their needs. Less than half of the participants stated that they are satisfied with their ability in running their daily affairs. Mean (SD) score of QOL among the participants was 81.37 (11.88), with a minimum and maximum of 52 and 105, respectively.  There was statistically significant relationship between age, place of residence, education and income with QOL (p<0.05).QOL

The results showed that QOL is low in patients with CVD in Iran. Therefore, further studies are needed on the above-mentioned factors in order to plan for improving the QOL in these patients.

Nursing education as part of the higher education system exapands  rapidly in the world in recent decades.Neglecting of the quality of educational contents and efficacy of graduated is an important cocerned. Due attention to few studies have been done on comparing the educational structure of the MSc nursing school of pediatric in Iran with other countries, this study aimed to compare the MSc nursing curriculum for pediatric in Iran and Toronto. This descriptive - comparative study was carried out in 2018. In order to comparing  the elements of the Iranian and Canadian MSc nursing curriculum for pediatric, necessary data  wsa collected through Internet search and the four-step model of George Beredy was used to  compare curriculum. Results show that curriculum in both faculties is full-time, in-person, and emphasis on student-centered principal. At the nursing faculty of Toronto, more emphasis is placed on students creativity and students participation in education,  also, evidence-based education and  research are among the core elements of their curriculum. Regarding the structure of the course and acceptance conditions, there are many differences, but in general there are similarities in goals, roles and abilities. The leadership role of graduated students and professional cross-border education are Toronto curriculum profile. The MSc curriculum of Pediatric nursing in Iran compared to the University of Toronto needs to be modified in light of the growing needs of this field and the expectations of graduates. Therefore, it is recommended to strengthening educational program, the curriculum of Pediatric nursing in Iran follows the world-wide educational standards according to its educational bases.

Nursing education has been developing rapidly in recent decades as part of the higher education system. It is worrying to pay attention to the quantity of training and neglect of the quality and efficiency of students led to this study the lack of comparing the structure of the nursing bachelor's degree in Iran with other countries. The aim is identify and compare the nursing bachelor program in Iran and Toronto, Canada.
This descriptive - comparative study was carried out in 2017. In order to compare the elements of Iran and Canada nursing undergraduate training programs, Internet search was performed by collecting the information and using the four-step model of implementation of the programs.
Both programs are full-time, in-person, with emphasis on student-centered principals. There are differences in structure but similarities in goals, roles and abilities. At Toronto, some courses are offered online, while evaluating practical lessons by pass / Fail. Stressing critical thinking is also emphasized in Toronto.
The turning point for the Toronto program is two years (three semesters), Of course, having passed the courses (humanities), students get a good understanding of the nature of humanity and altruism, with interest and motivation. In Iran, due to the growing needs of graduates and the expectations of graduates, there is a need for fundamental changes in the structure, content and educational technique. Therefore, it is advisable to review the Iranian curriculum in addition to the suggestions of the texts.

Today, the main concern of health education system is neglecting the quality of materials and the efficiency of students. Matching, comparing and analyzing different dimensions of programs with those of other countries would be helpful in solving this problem. This study was conducted with the aim of comparing the Ph.D. Nursing Program in Iran and Toronto. This descriptive study was carried out using a comparative approach and Beredy model. The relevant information was collected from two universities and classified according to the interpretation and adjacent stages. Then, the similarities and differences were analyzed. Both programs are full-time, in-person, and emphatically student centered. There are structural differences between the programs; but there are similarities during the educational period and the content of some courses, such as research education, research proposals and critique studies in Toronto, with the methodology of quantitative-qualitative research and critique of papers in Iran. Students' Proposal writing course faces similar challenges. Toronto does not focus on the article extracted from the thesis, but in Iran, it is considred necessary. Toronto's curriculum has been updated. In Iran, considering the increasing needs of graduates and the expectations of graduates, is necessary to make general changes. Therefore, it is recommended that in addition to the suggestions given in various texts to modify the program, the course in Iran should be reviewed in general terms and content.
Citation: Roshanzadeh M, Tajabadi A, Aghaei M. The educational system and curriculum of Ph.D nursing students in Iran and Toronto, Canada: a comparative study. Journal of Development Strategies in Medical Education 2018; 5(2): 40-62

Human Trafficking has weakened health, safety and security all nations that are affected and causes many people with physical and psychological problems. The nurses are first line the recognition, leadership and management of victims. Therefore, this review study aimed to investigate the role and function of nurses in dealing with victims of human trafficking. In this review article, published 17 articles were reviewed between years (2000-2018). Electronic search in two languages: Persian and English with keywords (human trafficking, human trafficking nursing, human health trafficking, Health provider role in human trafficking, nursing care and human trafficking, healthcare and human trafficking) were conducted on internal databases (SID, Magira, Iranmedex) and abroad (pubmed, proquest, Google Scholar, Scopus). In the face of victims of human trafficking, the medical staff is involved in three broad areas of support, identification and treatment and demonstrates its effective functioning. In addition to identifying the victims, they should be able to ask for proper and correct questions and to provide care and examination of any immediate need, including the treatment of physical lesions, sexually transmitted infections, pregnancy diagnosis, and suicidal thoughts. Solving this challenge requires an interdisciplinary team work (health system, judicial system, executive system, and legislatures). Its application in preventive services, identification, support and treatment of victims, which has a positive impact on the health of the community. It is suggested that the tripartite forces of the country look at this issue and work together to solve the problems of this phenomenon.

Strategies such as expansion of roles, development of associations, documentation, determining proper measurement tools, specific and accurate definitions, interprofessional team formation, having the support of administrators, expansion of nursing services in the community, and interprofessional educations can play an effective and important role in the professional autonomy of nurses. According to Papathanassoglou et al., one of the important strategies of developing professional autonomy is expansion of the professional roles of nurses (1). In order to achieve positive professional identity and development of autonomy, nurses need to improve their public image and gain a stronger position in healthcare organizations, which can be obtained through increasing their presence in scientific and professional assemblies and specialized nursing organizations. In general, specialized nursing organizations must use strategies and establish rules to strengthen their professional identity and achieve autonomy in nurses.
Nursing standards act as a measure taken to form the professional and legal basis for nursing and obtain safe performance (2). The existence of standards makes nurses accountable and responsible for their actions and provides the necessary knowledge, attitude, skills, and judgment for clinical decision-makings. Nursing profession rules must be accurately employed by management groups as a factor for professional autonomy along with official relations. Having a determined function area by individuals and maintaining professional autonomy could be achieved by observing the professional regulations and establishing a job description. In this respect, one of the effective strategies is the use of hospital information system and quality of data report documentation, which can play an important role in achieving professional development. While the nursing process is carried out by nurses, it is necessary to improve the documentation system to further enhance the accreditation of interventions and increase its quality to achieve high-quality interprofessional communications.
According to Toulabi et al., nursing documentation system could be improved by providing a prepared nursing report form, placing the network on a portable electronic device or above the patients’ bedside, and having access to remote health, which consequently contribute to effective implementation of data recording system. Improvement of capabilities of the nursing electronic documentation system and interprofessional relations will lead to the provision of accurate and scientific care. In addition, enhancement of nursing documentation system leads to the recognition of duties and responsibilities by nurses and determining of the position of the field for other healthcare groups (3). Moreover, nursing information documentation systems increase the improvement of care and functional areas of nurses in fields of management and education, thereby improving the decision-making of nurses and their role as a member of the interprofessional team.
One of the important challenges in the field of professional autonomy is the vague definition and the use of inappropriate means for measurement. The existence of tools plays an important role in assessing and determining the strengths and weaknesses of roles and responsibilities of nurses. According to Skar, the lack of a clear definition of autonomy has led to multiple interpretations and the creation of a one-dimensional view on independent performance of nurses. Therefore, a definite definition of autonomy and a certain theory are required in the field of nursing (4).
Another important issue to be considered in this area is teamwork, which is a necessity of cooperation of nurses with other team members. According to Sollami et al., effective teamwork increases the quality of care and motivation and decreases work conflicts. One of the important influences of teamwork is increasing professional autonomy, which itself leads to improved skills, competency, responding ability, trust, respect, and decision-making ability in nurses (5). Independent decision-making requires the approval and support of managers since it improves the self-confidence, efficiency and progress of work, motivation and safety. Studies in this field have suggested that managers in clinical systems can help the autonomy of nurses by making proper decisions. According to Sarkoohijabalbarezi et al., inefficient management structures are the most important deficiencies in achieving progress in the nursing profession, creating negative attitudes (e.g., frustration and dissatisfaction) in nurses toward their profession and, thereby, causing the intention to leave the profession (6).
The support of managers and the approach used by these individuals to resolve conflicts among their staff can be effective in promoting relationships between members of a healthcare team. In fact, managers can contribute to the improvement of the interprofessional communications between employees with the appropriate support of the personnel. The development of nursing services at the community level is a great opportunity for nurses in the field of employment and presenting nursing society's capabilities in promoting community health and providing qualitative and suitable services to the public. In addition, expanding the primary services with the management of nurses in the community determines how a university nurse can provide people with low and affordable services. In this regard, Gagne and Choi have marked that service provision systems at the community level can play a significantly important role in the decision-making and planning, prevention, care, and referral to the physician in the healthcare team with the leadership of the nurses. Furthermore, promoting primary care by nurses will create an opportunity for introducing the nursing community to the people.
Management and planning of these services by nurses at an extensive level in the community increase the professional autonomy of these individuals (7). Freedom of action and authority in managing the conditions of community members and providing and improving care can be effective in the autonomy of nurses. On the other hand, while nurses can provide people with the most complex issues and problems and most critical services at home, cultural problems in society and obstacles to these activities must be resolved.
Finally, it seems that special attention must be paid to interprofessional education in order to achieve professional autonomy. In this respect, the priorities of nursing education must focus on creating educational programs that increase the strength of individuals. Therefore, it seems crucial to correct the curriculum of students to better recognize and respect themselves and develop their independent behaviors, and use educational strategies and proper interactive styles for empowering students and acquiring professional autonomy.

Promotion of nursing clinical education requires an effective measure with high quality. In this regard, clinical faculty plans are needed to solve the challenge between the theory and the clinical course. A review of this area suggests the uncertain effects of this plan in addressing the challenges posed by clinical nursing education. On one hand, the presence of nursing professors as a faculty member in the role of formal clinical environments will cause the clinical environment to deal with less problems and, on the other hand, there are many uncertainties regarding the clinical responsibilities of these individuals. Therefore, this article intended to present some of the problems of existing clinical education, examining the advantages, and disadvantages of the subjects of clinical faculty in the form of a perspective.

Nurses are involved in providing end of life care for end stage individuals. Thus knowledge and attitude of them can be used as a key factor in planning and implementing programs for such care. The purpose of this study was to determine the knowledge and attitude of nurses Toward Caring for End of Life Patients.
In this cross-sectional study the stratified non-random sampling method was used to select the 240 participant nurses from the teaching hospitals of Tabriz, Iran. Data collection tools were the knowledge test and the Frommelt Attitude Toward Caring For Dying Patients questionnaire. Data analysis was done by descriptive statistics, independent samples T-test, ANOVA, and Pearson correlation.
Mean score of nurse's knowledge of end-of-life care was 14.26 (SD=4.37) out of 29. Fifty-five percent of the nurses stated that they have not received sufficient training on providing end of life care. With a score of 100.32 (11.79) of a maximum score of 150, Participant's attitudes toward patient care were positive. The attitude level was higher in staff with an experience of care in home care centers (P Considering the low level of nurse's knowledge about providing end-of-life care, educational programs should be developed to improve the knowledge of nurses. Regarding the positive attitude of the nurses toward such care, training programs can contribute to developing professional end of life care in Iran.

Electronic databases are the most important sources of information and use of these resources in each university to be considered as key indicators of development. The aim of this study was to investigate the knowledge of Ardabil medical students in using of electronic information resources. in this descriptive cross sectional study 250 students in fields of medicine، Para medicine، health and nursing selected by classified randomly sampling method and their knowledge about information resources evaluated by a questionnaire which its validity and reliability was checked by scientific methods. Collected data analyzed by descriptive statistics (frequency، percentage، means) and analytic statistic Chi-square test through SPSS. 65% of samples have no familiarity with digital library. The mean total rate of student’s familiarity with information resources was about 46. 5%. Latin and Persian databases that were used most by students were EBSCO (36. 4%) and SID (26. 4%) respectively. There is no significant difference among students with different filed of study in using information resources. Results showed that the knowledge of students in using electronic information resources was in lower rate. Therefore، designing a program for encouraging students to use more and better of these resources is necessary.

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The aim of this study was to assess the infrastructures and barriers of effective accreditation in East Azerbaijan hospitals.

In this triangulation (qualitative-quantitative) study, all the managers of 43 hospitals in East Azerbaijan were selected. The authors developed an 8-item questionnaire for quantitative section of the study which its validity was improved by experts’ comments and its reliability was assessed by half-structure methods (9. =α). In addition, two open-ended questions were used in qualitative section of the study. Quantitative data were analyzed using descriptive statistics, t-test, and ANOVA test using SPSS version 20 statistical software packages. Qualitative content analysis was used to analyze the responses to the two open-ended questions.

Seventy-six percent of the managers agreed to implementation of accreditation in hospitals and believed that accreditation could improve the health services and increase the patient and staff satisfaction. Fifty percent of the participants had lack of required knowledge about the accreditation and they declared that the hospitals managed by them were not prepared to implement accreditation with respect to resources, manager’s commitment, staff skills and knowledge. In Tabriz hospitals, resources and infrastructures were mentioned to exist in a significantly higher proportion than other cities (P < 0.01). Important barriers were explored to include the lack of the following: manpower, participation of clinicians, resources, appropriate documentation and information systems.

Considering the barriers and lack of infrastructures in the hospitals of East Azerbaijan to achieve an effective accreditation, it is essential to eliminate the existing barriers and provide appropriate infrastructures.