fariba taleghani

Encountering the coronavirus disease 2019 (COVID‑19) pandemic, nurses face many challenges due to various strategies and resources that can compromise the quality of care. This study aimed to identify nursing care challenges for patients with COVID‑19 from nurses’ viewpoint in Iran.

This descriptive qualitative study was conducted in one of the main admission centers in Isfahan to treat patients with COVID‑19. Data were collected through semi‑structured in‑depth interviews with 19 nurses from April 2020 to June 2020. The recorded interviews were transcribed and then analyzed through inductive content analysis.

The challenges of nursing care for patients infected with COVID‑19 from the nurses’ viewpoint were categorized into 11 subcategories and four main categories: work overload in disaster (lack of nurses with adequate clinical qualification and restrictions on the compliance of the infection control protocols), immersion in an ocean of psychological and social tensions (personal and family tensions, work environment tensions, perception of organizational injustice, and social stigma), quality of care in fragile condition (self‑preservation rather than patient care and contradictory patient care standards), and disaster preparedness, response, and management (passive resource management, information system challenges, and lack of guideline‑supported protocols).

The findings of this study suggest that policymakers should actively participate in supporting nurses in the form of reducing physical and mental stress in pandemics such as COVID‑19. Having the right perception of the challenges nurses face in such crises can contribute to providing patient safety, improving the quality of care, maintaining organizational resources, and properly managing the disaster.

The COVID‑19 pandemic has had considerable consequences in many areas of life, including the social area and childbearing plans. The present narrative review aimed to examine the childbearing decisions and its related factors during the COVID‑19 pandemic. This review was conducted by searching in scientific databases, including Web of Science, Science Direct, Google Scholar, Scopus, Cochrane, PubMed, ProQuest, Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology (IranDoc) and Iranian Journal Database (Magiran) in June 2022. The search resulted in 111 sources, of which 16 were in line with the research objective. Couples have mainly cancelled or delayed their previous plans related to childbearing decisions. There are two groups of direct and indirect factors related to childbearing decisions during the COVID‑19 pandemic: The former includes (1) well‑being‑related factors such as economic conditions, interpersonal relationships and gender roles in terms of task division; and (2) health‑related factors, including health emergencies and physical and psychological health. The latter includes factors such as social distancing and social media. Based on the results, governments should facilitate childbearing by adjusting existing policies, addressing economic insecurity and protecting the livelihoods of those affected by the crisis. Health policymakers and planners must also prioritize women’s access to reproductive health services in a safe environment while promoting equity in access. It is also necessary to promote the quality and quantity of indirect care and virtual counseling based on the needs of women in crisis.

Caring for a family member with cancer is a challenging issue for families. Family caregivers often need the help of supportive resources to solve problems in their care role. A deep understanding of the requirements of caregivers to seek help is an effective step toward their ability to use supportive resources. This study aimed to identify and describe the requirements for promoting help‑seeking behaviors in Iranian family caregivers of cancer patients.

This qualitative study was conducted through in‑depth semi‑structured interviews with 28 participants selected using purposeful sampling method from 2019 to 2021. An interview guide with general questions about seeking help was used to maintain coherence in data collection. The interviews continued until data saturation. All interviews were recorded, transcribed and analyzed through qualitative content analysis.

The requirements of promoting help‑seeking behaviors in family caregivers were grouped into four main categories: (1) improving social paths toward seeking help, (2) spiritual‑psychological‑cognitive empowerment toward seeking help, (3) strengthening the motivations behind seeking help, and (4) modifying the perception of cultural barriers to seeking help.

According to the results of this study, it is expected that by identifying the requirements of caregivers for seeking help and by health stakeholders designing comprehensive programs to address these needs, caregivers will be empowered to use supportive resources and provide a better care role.

Delay in parenthood and the related consequences for health, population, society, and economy are significant global challenges. This study was conducted to determine the factors affecting delay in childbearing.

This narrative review was conducted in February 2022 using databases: PubMed, Scopus, ProQuest, Web of Science, Science Direct, Cochrane, Scientific Information Database, Iranian Medical Articles Database, Iranian Research Institute for Information Science and Technology, Iranian Magazine Database, and Google Scholar search engine. The search terms used included “delayed childbearing,” “delayed parenthood,” “delayed fertility,” “delay of motherhood,” “parenthood postponement,” “deferred pregnancy,” “reproductive behavior,” and “fertility.”

Seventeen articles were selected for final evaluation. The factors were studied at micro and macro levels. The factors in micro level fell into two classes: personal and interpersonal. Personal factors included extension of women’s education, participation in the labor market, personality traits, attitude and personal preferences, fertility knowledge, and physical and psychological preparation. The interpersonal factors included stable relations with spouse and other important people. The macro level included supportive policies, medical achievements, and sociocultural and economic factors.

Policy‑making and enforcement of interventions, such as improvement of the economic conditions, increased social trust, providing adequate social welfare protection, employment, and support of families using such strategies as creating family‑friendly laws, taking into consideration the conditions of the country will reduce the insecurity perceived by the spouses and contribute to a better childbearing plan. Also, improving self‑efficacy, increasing couples’ reproductive knowledge and modifying their attitude can be helpful to better decision‑making in childbearing.

 Compassion is the essence and the core of nursing care. Nurse’s affectionate and emotional work leads to many caring behaviours that are considered to be the basis of caring with kindness. The purpose of this study was to describe the components of compassion care in nurses working in the cardiac ward.

 This descriptive qualitative study was conducted in the medical and surgical cardiac wards of the selected hospital affiliation to Isfahan University of Medical Sciences in 2020- 2021. The participants were 36 nurses, 20 patients and 8 family members that selected using purposive sampling. Data collection was conducted through, in-depth semi-structured interviews; focus group discussions, and the field notes. Data analysis was carried out using the qualitative content analysis approach proposed by Graneheim and Lundman.

 The results of this study are presented in one main category, four sub categories including “using verbal and non-verbal language to express feelings”, “doing empathy activities”, “organizing patient-centered care”, and “adhering to the cultural context”, and twelve sub- sub categories.

 The patient-centered emotional discourse is the main issue in shaping the compassion care in nurses. Nursing managers can have a significant role in achieving care with affection by preparing appropriate work environment, paying attention to lack of nursing staff, ensuring the principles defined in compassion care, and supporting nursing staff. Teaching the concept of compassion, patient-centered care in the clinical setting are among the most important issues that should be considered.

Drug use is known as an important underlying factor in the occurrence of risky sexual behaviors. The present study was conducted to identify the factors associated with the involvement of women drug users in risky sexual behaviors.

This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), the Iranian Research Institute for Information Science and Technology (IranDoc), and the Iranian Medical Articles Database (IranMedex) and searching through the Google Scholar engine. All the articles published in English and Persian using the keywords including substance use, drug users, addiction, substance use disorders, substance‑related disorders, sexual risks, high‑risk sexual behavior, HIV risk behavior, unsafe sex, unprotected sex, and risky sex were searched from January 2000 to December 2020. After reviewing the articles, out of 110 articles, 21 articles were selected for final evaluation.

Factors related to the involvement of women drug users in risky sexual behaviors were divided into five categories: individual factors, factors related to drug use, inter‑personal relationships, gender discrimination, and socio‑economic factors.

The results can be used in the field of women’s social harms in finding strategies and designing the necessary interventions to prevent risky sexual behaviors in women drug users in different societies and cultural contexts. Also, the results can be used by all researchers who want to study the relationship between these factors and the involvement of women drug users in risky sexual behaviors.

Diabetes as a chronic disease requires a change in the paradigm of treatment and health care system based on acute illnesses to chronic conditions. Chronic Care Model has been designed to address this need. This study aimed to explore the lived experiences of the diabetes team and diabetic patients regarding the health care system after redesigning delivery system and supporting self-management based on the Chronic Care Model in Iran.

Research was conducted with a qualitative descriptive approach in one of the Isfahan city clinics in 2018. The participants were diabetes team (composed of diabetes physician, nurse, assistant nurse and dean of the clinic) and 17 type- 2 diabetic patients who were selected through purposive sampling. Data collection was performed through semi-structured interviews and then were analyzed using content analysis with an inductive approach.

The findings of this study were composed of the following two main categories: (1) educational function change, including the sub-categories of evidence-based nurse education and patients’ demand to ongoing participation in the training classes; and (2) treatment and care method upgrade, including the sub-categories of nurse’s role change in a team approach, continuity in cares and upgrading patients’ self-care behaviors.

Delivery system redesign and diabetes self-management support based on Chronic Care Model changed organizational structure and performance of the diabetes care system. It also reformed the structure of treatment providers from a vertical and hierarchical form to a team arrangement. Nurse’s educational function became evidence-based and patients’ self-care behaviors upgraded.

The nature of cancer is such that it causes several problems for patients and caregivers. As a vital source of support for patients with cancer, family caregivers must seek assistance and make use of available resources to overcome these issues and offer better care for the patient.

This study aimed at exploring the challenges of seeking help in Iranian family caregivers of patients with cancer from supportive sources.

This qualitative study was conducted from 2019 to 2021 on 15 family caregivers with a wide variety of caring experiences and 13 health professionals (i.e. nurse, physician, social worker, clergyman, and family counselor who were engaged with services for the patient and caregiver) via purposive sampling and semi-structured in-depth interviews in a central cancer care hospital in Isfahan. Graneheim and Lundman’s conventional qualitative content analysis approach was used to analyze the data. To assess data trustworthiness, Lincoln and Guba’s criteria were used. Data management was performed using MAXQDA (v. 10) software.

Four main categories were identified consisted of (1) being strained by social desirability; (2) stigmatizing attitudes toward help-seeking; (3) reactive self-forgetfulness; and (4) resistance to change.

The need to develop and implement interventions geared to enhance family caregivers’ preferred attitudes and personal skills in order to overcome socio-cultural obstacles to help-seeking behaviors was underlined in this research. Both health care professionals and the community should be prepared to make support services more accessible and usable for family caregivers.

Women undergoing breast cancer treatment, especially those of reproductive age, experience sexual health challenges. The aim of this study is to design an interventional program for promoting the sexual health of women undergoing breast cancer treatment.

This is a mixed qualitative‑quantitative exploratory study consisting of four phases. In the first phase, the needs and strategies for promoting sexual health of Iranian women with breast cancer in Isfahan city will be identified through a qualitative study. The patients will be selected using purposive sampling method and the data will be collected through semi‑structured interviews. In the second phase of the study, the relevant literature will be reviewed. In the third phase, the initial version of the program will be designed based on the results of qualitative study and review of literature, the appropriate strategies are prioritized by the members of the panel of experts, and then, the final interventional program is prepared. In the fourth phase, the designed interventional program will be conducted as a quasi‑experimental study in two groups of intervention and control and the effectiveness of the program on sexual quality of life, sexual satisfaction, and sexual function of women undergoing breast cancer treatment will be evaluated. The type of the intervention will be selected based on the results of the previous phases and the opinion of the expert panel.

The results of this study are expected to contribute to the design of an interventional program based on the needs of women undergoing breast cancer treatment and promote health and meet the sexual health needs of breast cancer patients.

Patient‑centered care (PCC) is a key component of high‑quality care. Given the different effects of cancer on patients, patient‑centeredness is very important in oncology nursing care. The aim of this study was to explore nurses’ perceptions of the patient‑centered in oncology nursing care.

This descriptive qualitative study was conducted in 2018–2020, Iran. Data collection methods included observation and semi‑structured interviews. Patient, family, and nurse behaviors were observed (total: 318 h). In addition, interviews were conducted with nurses and nursing managers (12 interviews). Data analysis was performed using Graneheim and Lundman’s approach.

Data analysis resulted in the emergence of four themes: “Organizational structure as a barrier to the PCC,” “Lack of institutionalization of PCC in nurses,” “Understanding and paying attention to the patient as PCC,” and “Situational PCC.” The final theme of this study is “PCC in the shadow of paternalism.”

The paternalism approach in the context of oncology nursing care has made the realization of PCC difficult. The first step to promote PCC is increasing nurses’ awareness of the impact of paternalism on patient‑centeredness. Providing patient‑centered oncology nursing care requires changing attitudes, values, and behaviors at individual, professional, and organizational levels.

Patient decision aid (PDA) is a tool, which helps the improvement of shared decisionmaking and is a part of the paradigm shift from physician-centered decisions to patientcentered shared decision making. In this study, we aimed to describe the process used to develop a PDA for facilitating shared decision-making about treatment in patients with inflammatory bowel disease (IBD) who need medication (corticosteroid, azathioprine, anti-TNF, and infliximab) or surgery.

The development process of PDA included: 1) The development of a prototype based on literature review and interview 2) ‘Alpha’ testing with patients and clinicians 3) ‘Beta’ testing in real conditions and 4) The production of a final version. This process took about 12 months (2019-2020). The participants were adult patients with IBD, gastroenterologists, and nurses.

The final PDA contains four important sections: 1) Introduction about IBD disease, the purpose of developing PDA, and emphasis on shared decision-making 2) Benefits and risks of main medicines 3) The success rate as well as the incidence of complications after surgery, and 4) The conclusion about patients’ satisfaction with PDA to choose the treatment options. Besides, PDA evaluation in the real world setting showed that 100% of physicians (n=4) and 86% of patients (n=12) were completely satisfied with the content of the PDA and considered it applicable and useful.

This PDA can help patients participate in the shared decision-making process and select the best medical and surgical treatment methods. The feedback received from clinicians and patients showed their satisfaction with using the PDA.

One of the most basic life events is fertility or reproduction, which, although known as a social phenomenon, is a complex and multidimensional concept with economic, cultural, political, and religious significance. The present study aims to explain the pattern of childbearing behaviors in couples.

This study is a focused ethnographic qualitative research. Participants of this study will be 20–35 years old couples who, using purposeful sampling method, will be selected from comprehensive health centers, ultrasound centers, laboratories, premarital counseling centers, offices of obstetricians and midwives, universities, shopping centers, cinemas, parks, restaurants, and entertainment centers in Isfahan, Iran. Sampling will continue considering the strategy of maximum variation in terms of age, occupation, education, and economic status until data saturation is reached. Data will be collected through semi‑structured and in‑depth individual interviews, focus group discussions, observation, field notes, daily notes, and document analysis. Simultaneous with data collection, the data will be analyzed using the thematic analysis method based on Braun and Clarke’s approach.

This present study is expected to lead to a deep understanding and identification of the attitudes, beliefs, and values of couples with regard to childbearing. Moreover, by understanding the pattern of childbearing behaviors of couples, useful information will be provided to the policymakers and planners for effective planning in the field of healthy childbearing. The findings can also be used in reproductive health counseling for newly married couples and community‑based interventions.

Nursing care happens with the artistic presence of the nurse in the care setting. Despite its importance in nursing, yet many ambiguities surround its definition and characteristics. The aim of this study was to analyze the concept of nursing care.

This concept analysis was conducted using Walker and Avant’s approach. An extensive literature search was done in the Medline, CINAHL, Embase and SID databases to find articles published in English between 1988 and 2019. The search keywords were “care”, “nursing care”, “concept”, “concept analysis”, and similar words. According to Walker and Avant’s approach, after selecting the concept and determining the aim of analysis, 3742 references were reviewed and 68 articles and 2 books were selected to determine and extract the defining attributes, antecedents, consequences, and empirical referents of the nursing care concept. 

The three main defining attributes of the concept were relationship, compassion, and professional action. The antecedents were nurse‑related, client‑related and environment‑related, and the consequences were for nurses, clients and community.

The defining attributes, antecedents, and consequences determined in the present study help better understand the concept of nursing care. This study highlights the importance of the communicative, caring, and advocacy roles of nurses and their compassionate professional action in the promotion of individual and community health.

Determining the needs and challenges of women, who care for patients with cancer and providing appropriate strategies to empower them in the design and implementation of appropriate change programs pave the way for the promotion of these women's health and empowerment.

This study aims at identifying the needs and challenges of women and developing a program to empower women, who care for patients with cancer.

The present study is based on a participatory action research approach and uses the Kemmis and McTaggart model. The participatory action research of this study will be in 4 phases of planning, action, observation, and reflection. In the planning phase, the needs and challenges of female caregivers are examined from the perspective of women and the health team and, then, women's empowerment strategies in providing home-based supportive and palliative care for patients with cancer are determined, using the results of the qualitative phase and review of the literature by using the decision matrix. In the action phase, the selected strategies are implemented with the help of process owners. In the observation phase, combining different methods, data will be collected to measure the results of change. Finally, in the reflection phase, the results of the implementation of the strategies are evaluated and this cycle continues until the intended results are achieved.

Empowerment of the women, who care for patients with cancer requires awareness, motivation, and active participation of women and the health team. As many cultural and social factors affect the health and participation of these women, participatory research can involve them in promoting their health.

Knowledge of the history and developments of a discipline paves the way for comprehension of what has happened before as well as understanding the contemporary phenomena and creating insight for the future; this way, it creates knowledge and leads to the creation and reconstruction of a discipline. Accordingly, understanding evolution from historical facet in nursing seems indispensable. Despite the fact that more than 50 years have passed since the establishment of schools and nursing education in Isfahan not much information is available and a very few studies have been done in this regard; in so doing, this study endeavors to examine the evolution of nursing education in Isfahan.

The is a qualitative research with historical survey that 12 in-depth interviews were conducted and 80 journals, booklets and old books, 350 historical and old photographs were examined. The codes obtained from the interviews as well as the items obtained from the texts were put together to develop the structure of the narrative, which shows the evolution of education in the nursing in Isfahan.

The obtained narratives were as follows: Higher School of Nursing from the years 1968 to 1976 and 1976 to 1982, educational complex of Isfahan belonging to the Ministry of Health and Welfare and the evolution of the Isfahan faculty of Nursing and Midwifery during and after the Islamic revolution.

Since nursing care and nursing education has grown rapidly in other countries, it seems that nursing education, especially in Isfahan as one of the metropolitan cities in Iran has many prospects in the future and can move towards promotion of professionalism and specialization.

Increasing the level of emotional intelligence (EI) is seen as a strategy for improving both relational quality and efficiency at work. As of today, there was no validated Persian brief instrument for evaluating EI. To fill this gap, this article was aimed to investigate the validity and reliability of the Persian version of the Brief Emotional Intelligence Scale (BEIS‑10).

A methodological cross‑sectional study was conducted among 201 Persian‑speaking individuals. These individuals were selected from different parts of Iran using the convenience sampling method. Translation of the BEIS‑10 was conducted by employed forward–backward method. Internal consistency was evaluated by Cronbach’s α, and for test–retest reliability, the intraclass correlation coefficient (ICC) was employed. The construct validity was investigated by confirmatory factor analysis (CFA).

The Persian version of BEIS‑10 indicates a good test–retest reliability (ICC = 0.612, 95% confidence interval: 0.384 and 0.769) as well as internal consistency (Cronbach’s alpha = 0.748, ranging from 0.359 to 0.868 for different domains). The construct validity was evaluated by CFA and five factors from ten items were confirmed and all goodness‑of‑fit‑indices were in acceptable levels.

The article concludes that the Persian version of BEIS‑10 in five factors from ten items was a reliable and valid instrument for measuring EI in the general population. As well, the article was suggesting that the Persian version of BEIS‑10 may stand as a suitable alternative to time‑consuming tools for EI measurement since this scale appears to be time‑saving and applicable to Iranian society.

Respectful relationship among nurses is an important influencing factor of positive work environment and nursing outcomes. Disrespectful interpersonal behaviors set the scene for an unpleasant and unhealthy workplace in nursing. This can be harmful to persons and their organization and affect health care outcomes. This study was designed in order to search for contextual barriers to respectful behaviors in the context of nursing.

This study was a focused ethnography that was carried out in medical‑surgical wards of Shahid Chamran Hospital in Isfahan in 2018‑2019. The data collection method consisted of 140 h of participant observation and semi‑structured interviews with 34 informants. The nformants comprised 29 nurses, 2 assistant nurses, a physician, and 2 patients who were selected by purposive sampling. The first author of the study made direct observations as an outsider. The data were analyzed by Spradley’s method.

Three main categories and eight subcategories were obtained from data analysis that are as follows: 1) Personal self: challenges of perceived respect (negative self‑concept, unpleasant feelings, and ineffective communication), 2) Organizational‑based perceived disrespect (poor organizational climate, inadequate job condition, restrictive organizational structure), 3) Social self: challenges of showed respect (implicit social norms, cultural gap).

Individual and social attitudes, interactive communication, and organizational factors are the contextual determinants of a respectful workplace in nursing. Consequently, improving self‑concept and effective communication skills as well as adjust organizational conditions and value conceptualization in society may effect a respectful workplace in nursing.

Although the work environment of oncology nurses is highly complex and challenging, their occupational health needs are scarcely studied. This study aimed to explore the occupational health needs of oncology nurses.

This qualitative descriptive study was conducted in 2018–2019. The participants consisted of 52 oncology nurses and 11 other key informants. They were chosen from eight cancer treatment centers in different cities of Iran. Data were collected through semi‑structured individual interviews and analyzed using conventional content analysis.

The occupational health needs of oncology nurses were grouped into three main categories included needs for self‑care, development of professional competency, and a safe and healthy work environment.

The work environment of oncology nurses needs to be optimized in terms of physical, psychological, organizational, and sociocultural conditions. Furthermore, the necessary measures should be taken to encourage oncology nurses to implement self‑care, thus creating the preparedness to face the challenges of the workplace by developing their professional competencies.

Chronic and cancer diseases are expected to rise with the growing population of the elderly in the world. Home palliative care might be a possible solution for improving these patients’ quality of life; therefore, the present study sets out to investigate home care nurses’ attitude towards and knowledge of home palliative care.

This is a descriptive cross‑sectional study (2018‑19), in which 168 home care nurses and nursing assistants in East Azerbaijan Province (Iran) were included (2018). The questionnaire used was specifically designed by Shimizu et al. in 2016 for determining the nurses’ attitude towards and knowledge of home care. Data analysis was carried out using descriptive and inferential statistics (T‑test and ANOVA).

In this study, 95 (56.60%) and 113 (67.90%) of the participants were found to have negative attitudes and limited knowledge, respectively. The other participants seemed to have neutral attitudes towards and average knowledge of home palliative care. The Mean (SD) attitude score on terminal home care was estimated 2.33 (0.83), and the knowledge score on dying care was calculated 41.76%, which were the lowest in comparison with the scores of other dimensions.

The home care nurses’ attitude towards and knowledge of home palliative care were found to be negative and limited, respectively, which underscores the need to endeavor to improve the attitude towards home care and the knowledge of dying care.

Stroke is a major cause of disability around the world. Different studies have shown the inadequate knowledge and skills of nurses to educate and manage stroke patients. Therefore, stroke patients are facing many challenges in their lifetime. In this study, we investigated the effects of nursing empowerment on stroke patients’ satisfaction.

This cross‑sectional study is the fifth stage (evaluation phase) of action research study that was conducted on 29 stroke patients from Alzahra hospital, Isfahan, Iran, during 2013‑2014. Workshops, pamphlets, and booklets were used for nursing empowerment. The stroke patients have been trained by empowered nurses. The data gathering tool that was the researcher‑made survey questionnaire included the characteristics of patients, participants’ satisfaction with self‑care training and nurses’performances. T‑test was used for the analysis of the obtained data.

Twenty‑seven (93.10%) cases mentioned that “they would try to follow all the received trainings”. Twenty‑three (73.10%) cases were satisfied with self‑care training. Majority of patients, 25 (85%) participants were satisfied with the training performances by the empowered nurses and 24 (82.80%) cases were highly satisfied with the nurses’ training method.

Most patients were satisfied with the self‑care training held by the nurses. Based on the obtained data by questionnaires, the nurses’ performance and their training methods were directly associated with a high satisfaction level in stroke patients. Therefore, improving the skills and knowledge of nurses could be a potential approach for increasing the satisfaction levels among stroke patients.

CONTEXT:

An increasingly common complaint of staff nurses in hospitals is not receiving respect. One of the strategies to create a healthy and positive work environment is to strengthen the respectful behaviors among nurses.

This study aims to explore the barriers of respect in nursing workplace.
SETTINGS AND DESIGN: This qualitative content analysis was carried out at the School of Nursing and Midwifery of Golestan University of Medical Sciences.
SUBJECTS AND

The semi-structured interview method was employed in this qualitative study on 14 nursing staff in 2018. We transcribed the interviews verbatim and analyzed them using the conventional content analysis approach.

Data analysis led to the emergence of 377 primary codes, 13 categories, and 4 themes. The four themes were as follows: (a) feeling of ignored; (b) socio-cultural conditions in society; (c) lack of Support by Managers; (d) poor organizational climate.

Nursing managers can promote a healthy work environment in the nursing workplace through recognizing these challenges and applying mitigation strategies and take benefits of their consequences such as self-efficacy, self-confidence, and organizational commitment.

Youths are considered as a susceptible group in terms of engagement in pre-marital sexual relationships. Therefore, this study was conducted to explain factors protecting youths in engagement in pre-marital sexual relationships.

This qualitative study was performed on 30 youths as well as 17 other participants (other than the youths) living in Isfahan in 2013. Data were collected through semi-structured interviews. Data were analyzed using qualitative conventional content analysis.

After data analysis, two themes including "having a strong and secure personality" and "obeying the religious beliefs and principles" were obtained.

According to the results, having a healthy personality and obeying religious beliefs play an outstanding role in protecting youths in engagement in pre-marital sexual relationships? The results of this study can pave the way toward interventions for internalizing religious values as well as developing healthy personality in youth, which help their sexual health promotion.

Patients with stroke are dependent on their family to relieve their physical and emotional needs after discharge from the hospital. The family plays an important role in caring for them, which is a stressful task for the caregivers.

This study aimed at investigating the experiences of caregivers of patients with stroke.

This is a qualitative study (descriptive phenomenology), in which the participants included seven caregivers of stroke patients. Data were collected through semi-structured interviews. Data analysis was performed based on Colaizzi.

The results in the study were summarized in three main categories: anxiety (tension and stress, concern about economic future), care consequences (fatigue, reduced family interactions), and neglected needs (psychological needs, educational needs).

According to the purpose of the study and its implications, it is concluded that nurses and physicians should pay more attention to the needs and concerns of patients and their caregivers and try to resolve them with regard to the consequences of the disease.

The present study was conducted to investigate the effect of implementing domestic truth-telling protocol on stress, anxiety, and depression in cancer patients.

In this study, a semi-experimental design was used to examine the effect of truth-telling protocol implementation on psychological factors (i.e., stress, anxiety, and depression) in cancer patients. A total of 60 cancer patients participated in this study, 30 of them in the intervention group (who informed their disease with truth-telling protocol) and 30 others in the control group (who informed their disease with usual way and without protocol). Patients’ psychological factors were compared in intervention and control groups, three and eight weeks after the cancer disclosure by depression, anxiety, and stress scale-21.

In this study, except higher stress level of patients in intervention compared to the control group, no statistically significant difference was seen in other variables three weeks after cancer disclosure (P=0.046, Z= -1.99). Eight weeks after the intervention, all variables were significantly lower in the intervention group (P=0.000, Z=-5.864; P= 0.000, Z=-0.651; P=0.000, Z=-5.351).

Exercising truth-telling practice through implementing a localized culture-based protocol, especially after passing the initial acute phase of hearing the bad news, can lead to improved psychological factors in cancer patients.

Compassion is the heart of nursing care. Barriers to compassion in nursing may be influenced by the prevailing culture and religion of a society. Determining the barriers to providing compassion‑based care would help nurses to plan better and more appropriate interventions. This study aimed to explore the challenges and barriers to compassionate care in nurses. This ethnographic study was performed in 2014–2016. The study participants consisted of 40 nurses, 16 patients, and 8 family members in medical and surgical wards. Data collection was performed through observations and interviews. Data analysis was performed based on Strauss and Corbin’s constant comparative method.  Data analysis defined three themes as the challenges and barriers to compassionate care; challenges and barriers related to the contextual environment of hospitals, sociocultural challenges and barriers, and challenges; and barriers related to staff. This study described the challenges and barriers to compassionate care. Therefore, to eliminate these barriers and challenges, corrective action should be taken by managers. Attention to teaching the concept of compassion and patient‑centered care and increasing the number of nurses and positive attitude toward the nursing profession in clinical environment can be effective in providing compassionate care.