فهرست مطالب elnaz asghari

One of the most important and controversial roles of nurses is documentation, which is especially of great importance in the emergency department. Patients with a diagnosis of poisoning are one of the most common and challenging emergency department patients, which involve many ethical and legal issues. This research aimed to determine the related factors to the quality of nursing documentation of patients diagnosed with poisoning in the emergency department.

The present research is a cross-sectional study. Sampling among 1402 emergency cases (384 cases) in the first half of the year was done by simple random sampling. In order to collect data, the nursing documentation quality checklist was used with two dimensions’ report writing and medication administration.

The evaluation of the patients’ documents showed that the average and standard deviation of the age of the patients were 29.96 ± 9.93 years and most of the patients (60.2%) were women. The mean and standard deviation of the documentation quality were 8.75 ± 6.82 from the range of -48 to 48. The quality of nursing documentation had a statistically significant relationship with some characteristics of patients, including age, education, history of alcohol consumption, and history of admission to the emergency room.

Based on the findings of the study and considering the importance of nurse documentation as the most important document in judicial authorities, it is necessary to take basic steps to improve the documentation knowledge of nurses in the emergency department and specifically for patients diagnosed with poisoning. It is also necessary to pay more attention to elderly, illiterate patients and those with alcohol consumption.

Clinical reasoning is an essential competency for experienced and qualified nurses. Therefore, nurses must acquire clinical reasoning skills before entering the clinical field. Evidence shows that nursing education focusing on clinical reasoning can enhance nurses' ability to handle complex and unstable situations when dealing with patients. As per the curriculum approved by the Ministry of Health, one of the primary objectives of nursing courses is to enhance the clinical reasoning abilities of students. To achieve this goal, there are several educational methods that nursing students can utilize, such as being active in learning, critical thinking and problem solving, interdisciplinary communication, metacognition, simulation, constructive feedback, perception and mentoring. In general, nursing education requires long-term strategies that enhance the clinical reasoning competence of nursing students in order to train competent and self-assured nurses.

Stroke, as the primary and most critical cerebrovascular condition, is known as a leading cause of disability and mortality. Timely and appropriate care plays an important role in reducing death and associated complications. The purpose of this research is to assess the knowledge and adherence of emergency nurses to tissue plasminogen activator guidelines for patients with stroke.

Methods & Materials:

In this descriptive study, a random quota sampling method was employed to select participants. A total of 170 emergency department nurses in Tabriz hospitals in 2023 self-administered knowledge and adherence scales. Data were analyzed using SPSS version 26, employing t-test, one-way ANOVA and Pearson’s correlation coefficient.

The mean (SD) age of the nurses was 34.24±6.57 years, with a majority (101 nurses, 59.4%) having completed courses on the process and activation of Code-724. The mean scores for nurses' knowledge and adherence to tissue plasminogen activator guidelines were 52.67±10.37 (range score: 0-100) and 68.14±5.18 (range score: 15-75), respectively. A positive yet weak relationship was observed between nurses' knowledge and adherence to the guidelines (r=0.263, P=0.332). No significant association was found between nurses' socio-demographic characteristics and their knowledge and adherence scores (P>0.05).

The findings revealed suboptimal scores in nurses' knowledge and adherence to tissue plasminogen activator guidelines for stroke patients. Given the importance of adequate knowledge for adherence to guidelines, it is suggested to implement essential training and supervision measures for nurses.

Before being used in a variety of sectors, steel is often cleaned using acidic solutions. The steel corrosion rises as a result of this treatment, necessitating the inclusion of inhibitors in the cleaning bath. Due to this, it is constantly crucial to provide new, effective corrosion inhibitors. Rivaroxaban was investigated in the current study as a mild steel corrosion inhibitor in a 1.0 M HCl solution. At 25, 30, 40, and 50 ˚C temperatures and 1, 10, 20, 30, and 40 µM concentrations of inhibitor, corrosion experiments were conducted using potentiodynamic polarisation and electrochemical impedance spectroscopy (EIS). Steel sheets' surfaces were analyzed using SEM images in both the absence and presence of the inhibitor. At an ideal concentration of 40 µM, Rivaroxaban demonstrated inhibition efficiency greater than 92%, which was reduced with an increase in temperature and time of immersion in the acidic solution. Charge transfer resistance in the presence of Rivaroxaban after 144h decreased from 1470 to 231 Ω cm2.

 Although most countries have long used female staff for prehospital emergency medical services (EMS), this is quite a recent development for the Iranian health system. It is hence necessary to analyze the perspectives of its recipients about the feasibility of assigning female staff to prehospital EMS to improve this service and compare it with other countries. This study aimed to design and evaluate the psychometric properties of a scale for assessing the feasibility of using female staff in prehospital EMS.

This was a methodological study. The literature was reviewed to develop items for the scale. The scale's content validity index (CVI) was then evaluated based on expert opinions, and its face validity was examined by eliciting comments from the target group and experts. Following that, 456 EMS recipients from East Azerbaijan Province, Iran, completed the electronic version of the scale. Finally, the construct validity and reliability of this scale were determined using exploratory factor analysis (EFA) and internal consistency (Cronbach's alpha), respectively.  

 The findings confirmed the scale's high content validity and internal consistency, as well as its acceptable face validity. The EFA findings also revealed three factors, all of which were based on primary domains: the need for engagement (17 items), groundwork (14 items), and staffing (9 items).

 The study's findings suggested that the intended scale's design and psychometric properties were appropriate for Iranian culture. Therefore, it can be used to examine public opinion before, during, and after the inclusion of female personnel in prehospital EMS.

Career anchor identifies job-related values ​​and capabilities. Eight career anchors are: Functional- Technical, General Managerial, Autonomy & Independence, Security & Stability, Creativity & innovation, Serve & Dedication, Pure Challenge, and Lifestyle anchor. Each person has a special career anchor. Knowing the career anchors of employees is important both for the individuals themselves and for the managers of the organization. Adapting the career anchor to the nurse's work leads to improved work outcomes.

Methods & Materials:

This is a correlational study. Data collection tools included background characteristics, job satisfaction and job anchors questionnaire which consisted of eight anchors of Functional- Technical, General Managerial, Autonomy & Independence, Security & Stability, Creativity & innovation, Serve & Dedication, Pure Challenge, and Lifestyle. After obtaining the ethical approve, the link of electronic questionnaires was provided to all nurses working in the hospitals of East Azerbaijan University of Medical Sciences (about 4000 nurses). Inclusion criteria were having at least a bachelor's degree and employment as a clinical nurse and exclusion criteria were not completing more than 10% of the items by the respondents. Data were analyzed in SPSS 16 by descriptive, analytical and regression tests.

Findings:

 Data from 470 nurses were analyzed. The mean and standard deviation of the participants' age and work experience were 35.97±7.29 and 12.16±6.90, respectively. According to the results, the most dominant career anchors were the anchors of lifestyle, serve & dedication, and security and stability, respectively. The lowest scores were related to the Creativity & innovation anchor and the General Managerial anchor. The job satisfaction score was also in the middle range (12.99±14.46 from the range of 15 to 75). Job satisfaction scores were also moderate. After adjusting the confounders, the relationship between job satisfaction score and anchors of lifestyle, general management, functional- technical and autonomy & independence was significant.

 According to the findings, adjusting work shifts and stabilizing employment positions are recommended to increase job satisfaction and align the career anchor with the nursing job.

The nickel-phosphorus (Ni-P) and nickel-phosphorus-nanodiamond (Ni-P-ND) coatings were deposited on mild steel via electroless plating without ultrasound and under ultrasonic agitation with different frequencies of 25, 50, 75, 100, and 150 kHz. The as-prepared coatings were characterized using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and X-ray diffraction (XRD). The corrosion performance of the fabricated layers was evaluated in 3.5 wt% NaCl solution by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization. Results of the corrosion tests demonstrated that deposition under ultrasonic power provided coatings with higher stability in the corrosive environment. The corrosion rate decreased with increasing ultrasound frequency from 25 to 75 kHz but increased with further increase in frequency. This introduced 75 kHz as the optimum ultrasound frequency for electroless plating of Ni-P. It was also observed that the corrosion resistance of the proposed coating was improved through the incorporation of 40 ppm nanodiamond into the Ni-P matrix.

The novel coronavirus disease (COVID-19) has spread globally. Early and dynamic detection of prognostic factors is essential to improve the ability to treat COVID-19. The present study aimed to determine clinical characteristics and risk factors associated with the length of hospital stay and disease severity in hospitalized COVID-19 patients in Tabriz, Iran.

This retrospective cohort study included 260 early diagnosed cases with COVID-19 hospitalized at two COVID-19 specialized hospitals in Tabriz, Iran, from April 20 to June 20, 2020. Patients’ medical records were used to collect the data. Severe COVID-19 outcomes included need for intubation, admission to the intensive care unit, or death. The data were analyzed using descriptive and analytical statistics, including chi-squared test, Mann-Whitney U test, and logistic regression analysis in SPSS 16.

The need for O2 therapy (adjusted odds ratio [AOR] = 4.23; 95% CI: 1.15‒15.51; P = 0.03), the increased creatinine levels (AOR = 2.71; 95% CI: 1.25‒5.88; P = 0.01), and the white blood cell counts (AOR = 2.44; 95% CI: 1.12‒5.33; P = 0.02) were the main risk factors associated with prolonged hospital stay. Also, having kidney diseases (AOR = 7.33; 95% CI = 1.94‒27.70; P = 0.01), elevated the white blood cell counts (AOR = 4.52; 95% CI = 1.67‒12.26; P = 0.003), and lung diseases (AOR = 3.97; 95% CI: 1.18‒13.29; P = 0.03) were significant among the predictors of the disease severity.

According to the results, hypoxia and underlying diseases might lead to unwanted outcomes. The risk factors identified here confirm previous information and could be helpful to guide early clinical decision-making to reduce the mortality rates and improve the clinical outcomes of COVID-19.

In this paper, the precipitation of nickel-phosphorous (Ni-P) electroless coatings including Al2O3 nanoparticles (Ni-P-NA) using ultrasound waves on mild steel has been studied. Deposition process occurred in a lactic plating bath by the autocatalytic method using an ultrasound probe. The effect of radiation frequency on the properties of coatings was investigated, and the optimum frequency was determined. The obtained samples were evaluated for their corrosion resistance, surface morphology, and hardness by electrochemical impedance spectroscopy (EIS), potentiodynamic polarization, and scanning electron microscopy (SEM). The results showed that ultrasound waves caused an improvement in the corrosion resistance and uniformity of the coatings. Furthermore, five different wave frequencies applied during deposition disclosed the remarkable impact of frequency on the smoothness and corrosion resistance of the resultant coatings. On this basis, the Nyquist diagrams showed that the corrosion resistance of the prepared Ni-P-NA coating at an optimum frequency of 75 kHz was 2.59 kΩ·cm2. This value was about 2.5 times higher than the value obtained for the Ni-P-NA coating deposited without ultrasound power.

COVID-19 is a new infectious-disease first identified in December 2019 in China, and since it spread globally, it resulted in a Pandemic. Much research is needed to understand the disease, and especially its clinical characteristics. The aim of present study was to explore the clinical features, diagnosis, and treatment of COVID-19 in Tabriz, Iran.

This was a case series single center study that focused retrospectively on the clinical characteristics of 140 early consecutive cases with confirmed COVID-19, who were hospitalized at one of the referral hospitals for COVID-19 patients of Tabriz, from March 20 to May 3, 2020. We used patients’ records to obtain the data, which were analyzed by SPSS Version 16 using descriptive and analytic statistics (Student’s t-test, Mann-Whitney’s, and Chi-square test).

Findings showed that 34 out of 140 patients deceased. The highest percentage of patients were in the age range of 65 years and over. The most common symptom on admission was dry-cough (67.9%), followed by shortness of breath (55.7%), and fever (51.5%). During hospitalization, 27.1% showed an increase in white-blood-cell count. Only 20% were ventilated and others received oxygen by cannula, and/or mask. Recovered patients reported significant lower rates of pre-existing comorbid conditions than patients who died (p= .02). 

This single center study with a relatively small sample size showed that the most common symptom on admission among patients with COVID-19 was dry-cough, shortness of breath, and fever. The finding is mostly in accordance with the current evidence seen around the World.

Quality of life of infertile couples is affected by changes happening in their life. Knowledge about the quality of life, marital adjustment, and underlying factors of infertile couples is an important part of social health information. Such information can be used for developing health promotion programs by family counselors. The aim of this study was to predict the quality of life of infertile couples based on marital adjustment, factors related to infertility, and background characteristics.

In this descriptive-analytic study, 131 women and 79 men referred to an infertility center in East Azerbaijan were recruited using a convenience method. Data were collected using the infertile women’s quality of life and Spiner’s marital adjustment questionnaires. Regression analysis was used for data analysis via the SPSS16.

The mean age of the female and male participants were 35.74 ± 6.11 years and 32.45 ± 5.72 years, respectively. Of variables with a p-value less than 0.1 that entered the regression analysis, marital adjustment, gender, and insurance accounted for 78% of the observed variance in the quality of life of the infertile couples.

It was revealed that the variables of this study had important impacts on the infertile couples’ quality of life. Therefore, holding consultation programs and conducting more studies are necessary for improving the couples’ quality of life and promoting sexual and marital adjustment in infertile couples. Removing underlying problems by interventional studies are suggested to modify couples’ quality of life.

Patient-centered care is considered a pivotal element of the mission of the healthcare system around the world. However implementing Patient-centered care is not always easy and nurses have admitted this fact reluctantly. The evidence suggests that the first step in implementing Patient-centered care is to change the professionals’ viewpoint, behavior, and understanding. This study examined nurses' perceptions of the components of Patient-centered care and its delivery.

This was qualitative descriptive research with a conventional content analysis approach. Face-to-face interviews were conducted with 21 nurses, working in teaching hospitals in Tabriz, Iran, and 5 field notes were collected. Data were analyzed using the Zhang and Wildemuth method of content analysis.

Three main themes and eleven sub-themes were extracted. Nurses identified “Effective Communication”, “Careful Care of Distinctive Needs”, and “Valuing the Patients and Their Rights” as the main elements of Patient-centered care.

Nurses implement some components of Patient-centered care. Yet Patient-centered care remains an ad hoc practice requiring more improvement. This study provided a deeper understanding of nurses' perceptions about the implementation of Patient-centered care and their weaknesses. The finding is consistent with current knowledge, shedding light on Patient-centered care-related practices performed by Iranian nurses and pointing to areas for improvement in implementing Patient-centered care.

Cesarean section (C-section) is one of the most common surgeries for women, which has numerous complications including anxiety and vital sign changes. Various non-drug methods exist for controlling these complications. Although nurse companionship is one of such methods, there is little information about the accompaniment of mothers by trained nurses during the C-section surgery. This study aimed to determine the effect of “nurse companionship” on the level of anxiety and vital sign changes of C-section candidates.

Using a random allocation method, this randomized control trial was performed on 128 C-section candidates in Al-Zahra teaching hospital of Tabriz in 2017. In addition to routine cares, intervention group mothers were accompanied and supported by a nurse 1 hour before to after the C-section surgery while mothers in the control group only received routine cares for the C-section. Data collection tools were demographic information form, visual analogue scale (VAS), digital blood pressure monitor, and chronometer. The anxiety level and vital sign changes were measured one hour before, during, and one hour after the C-section surgery. Finally, data were analyzed by SPSS 24 using the mixed repeated measures ANOVA.

The comparison of the results of the two groups showed that the accompaniment of the mothers had a significant effect on reducing anxiety during (P<0.001) and 1 hour after (P=0.011) C-section surgery while it had no significant effect on vital sign changes.

The results revealed the positive effect of nurse companionship on reducing mothers’ anxiety during and after the C-section surgery. Therefore, this method can be used as non-invasive nursing care during C-section surgeries and in operating rooms. However, cost-effectiveness assessment is recommended before the implementation of this method.

Considering that the main responsibility of the nurses is to give care to the patients, concept analysis of good care by providing a clear definition will promote nursing practice and quality of healthcare. This study aims to clarify the concept of good care through the use of Rodgers's evolutionary approach.

 This study used Rodgers's evolutionary approach. The keywords of good care, quality care, and similar words were used for searching from CINHAL, PubMed, Emerald, Elsevier and Scopus databases. Literature published in English between 2000- 2018 was included. Forty one articles were selected and content analysis was used to distinguish attributes, antecedents, and consequences of the good care.

According to the finding, care was considered as good that was accompanied by the up-to-date knowledge and by doing procedural cares skillfully and safely leaded to recovery, reducing health care costs, and patient satisfaction through an effective and efficient relationship with the patient.

Skillful practice, well-informed knowledge and effective communication are the most important inputs for nurses to provide good care for the patients and the lack of these, especially in the case of using unprofessional workforce in nursing, is a serious threat to patient care.

Patient safety has become one of the main concerns of healthcare provider organizations, given that it is one of the basic principles of health care; because the error in the care process can sometimes lead to injury or even death. The present study aimed to investigate the patient safety culture from the viewpoint of nurses working in Sina Tabriz Educational Center in 2017. The present descriptive-correlation study with simple random sampling was conducted to assess the nurses' view using a standard and validated questionnaire and HSOPSC (hospital survey on patient safety culture) in 12 dimensions. The average percentage of positive responses to dimensions of the safety culture was 56.85%. The mean score of "Teamwork within the ward" with the highest score were 82.22% and the average "Transfer and shift in hospital" in the hospital with the lowest score was 28.15%. There was a significant reverse relationship between safety culture and work experience in the hospital (P<0.01, r=-.480)‏. Reporting errors with a non-reciprocal response approach and encouraging self-reporting errors in order to correct processes need for culture is more than ever. Considering the positive impact of hospital management on the development of the dimensions of the safety culture and the removal of barriers to patient safety, it is necessary that the problems associated with each dimension of safety culture are identified and low safety culture dimensions are promoted.

Career success as an important concept, is associated with many professional and work outcomes such as error and absenteeism. Despite the importance of success in career, this concept is not clearly recognized in nursing. This study aimed to determine the predictive factors of nurses' career success. This cross-sectional study was conducted on 530 nurses working in educational hospitals of Tabriz in 2017. Random cluster sampling was performed and the data was collected using demographic and nurses' career success scale. Data was analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient and linear regression test in SPSS-21. The mean and standard deviation of nurses' success score was 139.14 ± 12.82 (range= 39-195). According to the results of the regression, kind of the ward and documented incentive predicted 13.5% of the variance of career success. According to the results, variables that indicate horizontal improvement and capacity enhancement can play a role in nursing career success. Also, since this study is one of the first studies in the field of nurses' career success, the results of this study can be used as a guide for nursing managers and nursing instructors in order to improve the position and success of nursing profession.

Discharge against Medical Advice (DAMA) is a global problem with unpleasant consequences, mandating to conduct studies for its Predictors and outcome. This study aimed to investigate the reasons of DAMA from a general referral hospital.

A cross-sectional descriptive study was conducted in Sina Hospital. A researcher-made questionnaire was used after determining its validity and reliability. All patients who wanted to DAMA, completed the questionnaire. The data was analyzed by SPSS 19, using descriptive and inferential statistics.

DAMA was more seen within men, married, native, and under diploma patients with age range of 19 to 39 years. Prolongation of hospital stay (13.2%), other hospital staff’s suggestion (6.8%) and dissatisfaction with the facilities (12.3%) were among the main reasons for discharging. The reasons of DAMA had only significant relationship with hospital wards.

Improvement of training, providing innovate facilities for young people, providing more advanced facilities and equipment, and continuing the necessary treatment as outpatient are important factors that must be prepared in order to decrease the rate of DAMA.

Being the first-line treatment of patients, emergency units have an especial importance. The mortality of patients in the emergency department is a problem that has been exacerbated in recent years. Further studies on the causes of death are required in the emergency for correct judgment. This study is conducted in order to better understand the causes of death, in patients referred to emergency unit of Tabriz Imam Reza hospital in 2014 – 2015.
This cross-sectional study was carried out on the profiles of all patients admitted to the emergency department of Tabriz Imam Reza hospital. Demographic data and causes of death were extracted.
Of the 604 patients who died in the emergency department, 60.6% were men, 54.6% married and 31.5% had over 75 years. The most common causes of death were internal illnesses (22.2%) and trauma (19%). In total, 39.1% patients were died before in the emergency department and 32.1% of patients were referred from anther hospitals.
It seems that internal illnesses and trauma are the most common causes of death in the emergency department. The high rate of mortality shows the importance of early aids and proper referral system.

The ethical climate of hospitals and job satisfaction are two main factors behind nurse's productivity. Yet, there is limited information about ethical climate and nurse's job satisfaction in the operating room (OR).
This study aimed to investigate the relationship of ethical climate with nurse's job satisfaction in the OR.
This cross-sectional study was done on 197 OR nurses. The Olson Hospital Ethical Climate Survey and the Minnesota Job Satisfaction Questionnaire were used for data collection. Data were analyzed by doing Spearman's rank correlation.
About half of the participants had a moderate job satisfaction and negative perceptions about the ethical climate of the OR. Ethical climate was significantly correlated with nurse's job satisfaction (r = 0.93, P There are some defects in the ethical climate of the ORs. Health policymakers need to devise strategies to improve both ethical climate and nurse's job satisfaction in the ORs.

Incivility is a prevalent and on rise, but yet vague problem in healthcare settings..
This study aimed to explore the perception of nurses about workplace incivility via description of actual experiences..
This is a qualitative study with a content analysis approach. Participants were 34 nurses selected through purposive sampling. The data was collected using semi-structured interviews and field notes in training hospitals in Iran. The rigor of the study was established by principles of credibility, transferability, dependability, and confirmability..
Data analysis resulted in 975 codes. The classification of the codes resulted in 3 themes. Missed ring in system, working in the shadow of fear, and being scapegoats are the main features to describe the meaning of workplace incivility from the nurses’ perspective..
The finding provided basic information to understand the meaning of incivility. Based on the finding, invisibility, unsafe environment, and the carelessness of the other personnel may be perceived as incivility..

Many articles have studied workplace incivility and its influence on outcomes, but very few have been conducted to assess how to prevent this issue. In this study, we aimed to determine how to prevent workplace incivility from the nurses’ perspective.
This was a qualitative study which was based on a conventional content analysis approach. Thirty four nurses (25 to 52 years old) from seven training hospitals in Tabriz, Iran were selected through purposive sampling. Thirty six semi‑structured interviews and eight field notes were analyzed.
The data analysis revealed 417 codes, ten categories, three subthemes and one theme, that is, A Need for a Comprehensive Attempt. Attempt of organization, nurses, and public as subthemes are needed to prevent workplace incivility.
The findings of the study indicated that a comprehensive and systematic attempt was needed to prevent incivility. Nurses should try to improve their skills; officials should try to show the real image and position of nurses and hospitals to the community.

Breast cancer is the most common cancer among women. Many of the women with breast cancer suffer from sleep disorders. This study aimed to investigate the quality of sleep and its related issues in women with breast cancer referred to the Hematology and Oncology Research Center affiliated with Tabriz University of Medical Sciences, Tabriz, Iran.
In this cross-sectional study, 103 women with breast cancer were chosen using the census method. Data were collected using the Pittsburgh Sleep Quality Index. Descriptive and analytic statistics and linear re-gression test were used for data analysis.
The mean age of the sample was 42.59 years [standard deviation (SD): 11.72 years] and the average length of diagnosis was 19.90 months (SD: 12.67 months). The mean score of sleep quality was 11.50 (SD: 3.71) in a range from 0 to 21. Except the history of mastectomy, age, smoking status, the remaining demographic data could predict 39.5% of the variance of sleep quality.
The results of this study are a wakeup call for officials. To prevent the negative impact of poor quality of sleep, there is a need to design holistic and appropriate interventions. The findings provide valuable information with scheduling for these interventions.

Medication nonadherence is highly prevalent in patients with bipolar disorders and often results in worsening disease prognosis. The purpose of this study was to investigate the effect of group psychoeducation on medication adherence in female patients with bipolar mood disorder type I.
This randomized controlled trial was conducted on 76 patients with bipolar mood disorder admitted in female psychiatric wards of Razi teaching hospital, Tabriz, Iran. The participants were selected by convenience sampling method and were randomly assigned to experimental and control groups. Patients in experimental group received 10 continuous 90 minutes sessions of psychoeducation, two times a week. Medication adherence was measured using the medicine check list and medication adherence rating scale (MARS) before and after intervention. Data analysis was performed with SPSS ver.13.
There was no significant difference between two groups regarding medication adherence before the intervention. After the study intervention, the mean scores of medication adherence check list and medication adherence rating scale in the experimental group were significantly higher than the control group.
Since group psychoeducation was effective in improving patient's medication adherence, it could be recommended for psychiatric nurses to apply this intervention in the clinical setting.