فهرست مطالب kian norouzitabrizi

Following the emergence of population aging phenomenon in the world, “successful aging” as a quality concept has recently attracted the attention of many researchers and policy makers; yet it seems that there is no single and clear definition of it presented in the literature. This study aims to analyze the concept of successful aging.

The study was conducted with Walker and Avant’s 8-step approach. For this purpose, articles meeting the inclusion criteria were selected through searching the SID, Magiran, Noormags, ISI, Pubmed, Scopus and Proquest databases and using the keywords of aging, successful aging and related concepts during the years 2000-2022. Then they were analyzed using Graneheim and Lundman's content analysis method to extract the successful aging concept's applications, characteristics, antecedents and consequences.

The content analysis of 83 selected articles revealed the characteristics of successful aging in the following seven categories: 1) "manageable process", 2) "multi-dimensional and comprehensive", 3) "socio-cultural context-bounded", 4) "enjoyment of physical, psychological and social health", 5) "non-dependence on others", 6) "happiness", and 7) "continuity and active participation in different fields of life".

A comprehensive definition of successful aging was presented using the identified characteristics, antecedents and consequences, which can help to better understand this concept, recognize its various dimensions, and ultimately, plan for its realization.

 Nowadays, in the Post-COVID-19 period, paying attention to related psychological issues, such as loneliness and subsequent death anxiety among the elderly, is of particular importance. This study was conducted to determine the relationship of loneliness with death anxiety in the Post-COVID-19 era among the Older People in Ilam Province in 2023.

 In this cross-sectional descriptive-analytical study, 384 elderly men and women in Ilam province were included in the study after checking the inclusion criteria by cluster and simple random sampling methods. To collect data, demographic information questionnaires, the UCLA Loneliness Scale (Version 3), and Templer's Death Anxiety (DAS) were used. The obtained data were analyzed using descriptive statistics and Kolmogorov-Smirnov, Mann-Whitney, Kruskal-Wallis, and Spearman's correlation coefficient tests in SPSS version 22 software with a significance level of P< 0.05.

 The mean and standard deviation of loneliness and death anxiety scores were 51.88 ± 14.17 and 10.93 ± 4.55, respectively. A significant direct relationship was found between loneliness and death anxiety. Also, there was a significant direct correlation between age with loneliness (r = 0.29) and death anxiety (r = 0.88) and a significant inverse correlation between the number of children with death anxiety (r = -0.1). There was a statistically significant difference between loneliness and death anxiety with gender, insurance status, residence, and housemate segregation, and there was also a statistically significant difference between death anxiety with marital status, education level, underlying disease, and experiencing a stressful event.

 Considering the positive relationship between loneliness and death anxiety and the influencing factors in this study, health policymakers must plan to reduce loneliness and subsequent death anxiety in the elderly while paying attention to these factors.

Stress is an inevitable reality in life that can have a significant impact on one's physical and mental health and can suppress the immune system.The imperative need to examine the well-being of the elderly is that they are exposed to a lot of risks in the effects of events such as the end of employment and retirement, loss of spouses and friends, separation of children from their families, loneliness, rejection, and the pressures resulting from the industrialization of societies that leads to emotional detachment and psychological problems. Stress depends on the cultural and social aspects that vary from country to country. Nationality is one of the indicators of cultural difference. Culture includes ethnicity, race, religion, age, gender, family values, area in which a country is located and many other features that can affect psychopathology. This study aimed to determine the level of stress and related factors during the COVID-19 pandemic in the elderly and adults of the Zoroastrian community residing in Tehran.

This descriptive-analytical cross-sectional study was conducted on 123 elderly and 201 adult Zoroastrians residing in Tehran, using data collection through online questionnaires. The study gathered data through a two-part questionnaire comprising a demographic questionnaire and the Covid Stress Scale (CSS). The data were analyzed using the SPSS version 25 statistical software.

Findings indicate that the level of COVID-19 stress in the elderly, with a mean of 16.59 ± 47.16, is lower than in adults with a mean of 16.93 ± 56.93, showing a significant difference (t(322) = -4.908, p < 0.001). In both elderly and adults, stress is mild.

The study results suggest that in general, the elderly experience less stress compared to adults. Additionally, being female, married, having children, having a chronic illness, and exposure of relatives to COVID-19 or their death due to it contribute to increased COVID-19 stress.

One of the important dimensions of self-care in nurses is the spiritual dimension, but the concept of spiritual self-care is not well defined. Therefore, this study analyzed this concept to provide a clear definition.

This research was conducted to analyze the concept of nurses’ spiritual self-care using Walker's and Avant's eight-step approach. SID, Magiran, ISI, Pubmed, Scopus, and Iranmedex databases were searched using the keywords: nurse's self-care, spiritual self-care, and nurse spiritual self-care between 2000 and 2022. Then, eligible articles were selected and analyzed using the content analysis method of Graneheim and Landman.

The analysis of the data revealed that internal self-crystallization and behavior based on spiritual manifestation are among the characteristics of the nurses' spiritual self-care concept. It emerged from the antecedents of facing a lot of pressure and stress, understanding the spiritual nature of the nursing profession and a spiritual work environment, and led to consequences such as nursing spiritual self-polishing, resiliency, and effective nursing care.

The results of this study provide a comprehensive definition of spiritual self-care in nurses and show that spiritual self-care in nurses is a self-centered care process that leads to more nurses' attention to strengthening the inner spiritual dimensions. It also helps to provide effective care for patients in difficult and stressful professional situations.

The concept of emancipation in the sense of empowerment, independence, and freedom came to the literature on disability with the emergence of a social model. Despite the importance of this concept, it is still unclear what effects the realization of the emancipation process has on the lives of people with disabilities and society.

This study aimed to explore the consequences of the emancipation process for people with physical disabilities.

The study was conducted using the grounded theory method in 2021. Participants included 23 people with physical disabilities, a welfare organization manager, a welfare organization employee, a rehabilitation nurse, a physician, and two family members. The research data reached theoretical saturation with 18 individual interviews and two focused groups with 11 people with physical disabilities. 5 people were in the first group, and six were in the second group.

Data were analyzed based on the approach of Corbin and Strauss (2008). Data analysis led to 833 codes, seven sub-themes, and three main themes. The main themes included excellence and growth, functional health, and realization of a disabled-friendly society, and subthemes included self-actualization, self-determination, improving personal performance, economic self-sufficiency, improving social relationships, cultural acceptance of disability, and realization of social participation.

The emancipation process leads to positive outcomes in the lives of individuals with physical disabilities. These consequences appear in individual areas, such as improving performance and self-sufficiency, social participation, and promoting community culture, which can be useful in planning and policy-making focusing on the realization of the emancipation process. A rehabilitation team can assist in achieving emancipation and its consequences.

Clinical Reasoning (CR) is a main professional competency for nurses which have significant contribution to sound clinical performance in critical clinical conditions. Nonetheless, evidence shows that nurses do not have the necessary competencies and thinking skills for managing complex conditions in critical care units. This study aimed at exploring the barriers to the development of CR skills among coronary care nurses.

Using conventional content analysis, this qualitative study was conducted in 2020 in the Coronary Care Unit (CCU) of Heshmat Subspecialty Heart Center in Rasht, Iran. Participants were 15 nurses, head nurses, nursing supervisors, nursing managers, and nursing instructors. Data were collected using semi‑structured interviews and were analyzed using conventional content analysis.

The four main categories of the barriers to CR skill development among nurses were limited professional development, inefficient educational program, ineffective professional interactions, and limited professional self‑efficacy.

There are different personal, educational, professional, and interprofessional barriers to the development of CR skills among CCU nurses. Study findings can be used to develop effective strategies for supporting and developing nurses’ CR skills.</em>

 Substance abuse disorders are a major concern in today's world, which have both emotional and physical impacts on substance abusers. A significant part of these complications is caused by marking these patients with stigma and labeling them. The analysis of the concept of stigma regarding substance abuse disorders was carried out with the aim of reaching semantic integration, reducing ambiguities and increasing stability in the application of this concept.

 This study was conducted with the aim of clarifying and analyzing the concept of the stigma of substance abuse disorders and determining its dimensions and characteristics, using the concept analysis approach of Walker and Avant in 2022.

Ethical Considerations:

 In the current research, the ethical aspects of the review study, including the originality of the texts, honesty and trustworthiness, have been observed.

 After analyzing the studies, the characteristics of the multi-dimensional psycho-social process were obtained: Pervasiveness in different areas of life, rapid spread in the society, being based on the socio-cultural context, dependence on the type and the quantity of substance consumption and being chronic.

 In this conceptual study, a comprehensive definition of the stigma of substance abuse disorders, along with antecedents, characteristics and consequences, was achieved through the process of conceptual analysis. The investigation of the findings eventually led to model, borderline and contrary cases. The presented definition, which is also supported by the literature, claims that the stigma of substance abuse disorders is a chronic, multidimensional psycho-social process, which is pervasive in different areas of the affected individual's life, along with rapid spread in the society. Moreover, it is based on the socio-cultural context and depends on the type and the quantity of substance consumption. The unfair and criminalizing practices of healthcare and non-healthcare organizations, the social beliefs regarding the undesirable identity of the affected individual, people's ignorance, the relatives’ lack of personal experience in dealing with the substance abuser, the socioeconomic power gap between the stigmatizer and the affected individual and demographic characteristics trigger stigmatization. Stigmatization leads to comprehensive vulnerability of the stigmatized individual’s credibility and health in different aspects: personal, functional, family, social, cultural, economic and political. This definition as well as its antecedents, consequences and empirical references can be a basis for a more comprehensive perception and future applied studies.

 Violence against the elderly is a single, repetitive act or omission of appropriate action that occurs in an interpersonal relationship and causes harm or discomfort to an elderly person. The lack of a clear definition is one of the challenges of this concept. The present study has been conducted to explain the concept, provide ab operational definition and present some empirical references to violence against the elderly with a hybrid approach.

In this study, the hybrid concept analysis method was used, which includes three steps: theoretical, field research, and analytical. In the first step, the texts were reviewed using Walker and Avant’s approach. In the second step, unstructured interviews using purposive sampling were conducted. Finally, in the third step, the perceptual analysis method was used to integrate the results of the previous two steps.

The results of the final analysis expressed the definition of violence against the disabled elderly and its components, which are violence against the disabled elderly living in the family, including a range of behaviors or actions threatening human dignity and status with or without a purpose that is applied in the living environment or related situations by family members, caregivers or others in the form of exposing the elderly to emotional-mental violence, physical violence, economic violence, sexual violence, social violence, neglect, and abandonment. It is observed as apparent or hidden, intermittent or continuous, and mild to severe. Being neglected, interactive separation, predisposing factors related to the elderly person, and predisposing factors related to the violent perpetrator lead to its occurrence and are associated with destructive personal, family, and social harms.

 The findings of this study can provide a clearer picture of the experiences of this group of elderly people who have all been exposed to violence in some way. Knowledge of the elderly’s experiences and perceptions of the phenomenon of violence leads to an increase in nurses’ awareness of this phenomenon. It reveals essential concepts in nursing, especially in the elderly.

Trauma is one of the major non-communicable diseases of this century and one of the main problems threatening public health. Trauma injuries are the leading cause of disability and mortality in all countries. This study aimed to explore and understand the challenges of early rehabilitation care in multiple trauma patients from the experience of a multidisciplinary care team using a qualitative research method.  This study was conducted with the qualitative research approach using qualitative content analysis. Participants were seven nurses, two doctors, three physiotherapies, and two occupational therapists in inpatient wards and outpatient trauma were interviewed. Data were collected through semi-structured interviews with a purposive sampling continued until data saturation. Analysis of data collected concurrently with data for comparison was done. First, for depth descriptions of the participant statements, 800 codes were extracted and finally, for the analysis, and constant comparison, two main themes of the lack of holistic care and support structure were extracted. The results showed that comprehensive and rehabilitation-based care was essential to achieve important care goals in this group of patients. Understanding the challenges of early rehabilitation care in multiple trauma patients will help health policymakers that solve these problems and help improve the health of this group.

Locomotive syndrome refers to reduced mobility due to impairment of locomotive organs. Because of the importance of screening locomotive syndrome among older people, this article is focused on psychometric characteristics of Geriatric Locomotive Function Scale (GLFS)-5 and comparing it with GLFS-25 in Iranian older adults

This research was conducted on 320 older Iranian people. Validity and reliability of the GLFS-5 were examined and confirmed using Content Validity Index (CVI), factor analysis, correlation coefficient with the European Quality of Life Scale-5 Dimension (EQ-5D) questionnaire, the Cronbach α value for internal consistency, and intraclass correlation and Receiver Operating Characteristic (ROC) technique to determine the cutoff score for the locomotive syndrome.

In phase 1 of the study, 250 Iranian older people ≥60 years were analyzed. The factor analysis showed that the GLFS-25 is a multi-dimensional scale (Activities of Daily Livings [ADLs] and Quality of Life [QoL], pain, social relationship, and psychological status), and GLFS-5 is a one-dimensional scale (the ability to perform daily activities). The Cronbach α values for GLFS-25 and GLFS-5 were 0.93 and 0.84, respectively. As for association between the GLFS-25 and GLFS-5 with EQ-5D and Visual Analogue Scale (VAS) (health self-perceived), the Pearson correlation coefficients were 0.85 and -0.72 for GLFS-25 (P=0.01) and 0.82 and -0.67 for GLFS-5 (P=0.01), respectively. The cutoff scores to identify locomotive syndrome for the GLFS-25 and GLFS-5 were 16 and 4, respectively. 

Considering the good validity and reliability properties of the GLFS-5 compared to GLFS-25 and the more convenient use of this short version of the GLFS, its application is highly recommended for community-based screening of locomotive syndrome in Iranian older people.

 Social participation among older adult is one of the key factors in active aging. Social participation is influenced by multiple contextual factors. The present study was conducted to explore the facilitators and barriers of social participation in community dwelling older adult.

 This is a qualitative study with a grounded theory approach. The study population consisted of community dwelling older adult that accepted participant in this study and able to communicate effetely. Data were collected through semi structured in-depth interviews. at first, we used purposeful sampling and then continued by theoretical sampling until data saturation achieved. in total fifteen interview were done in this study. each interview lasted forty-five to sixty minutes (each section 20 to 30 minutes). analysis was done using Strauss and Corbin approach (2015)

 Three main categories were emerged from data analysis: participating older adult, participatory family and community capacity in older adult social participation. Each of the main category has subcategories. Participating older adult had five sub categories. Participatory family two category and community capacity in older adult social participation had four categories.  in total eleven subcategories were emerged.

 Facilitating social participation in community dwelling older adult is associated by individual, family and society. It is necessary for older adult planners to planning in these areas. Providing facilitators for the development of social participation in the older adult social participation can facilitate move towards active aging.

One of the most important aims of rehabilitation in Spinal Cord Injuries (SCI) is regaining autonomy, which can affect individuals’ Quality of Life (QOL). This study was conducted to understand the experiences of individuals with SCI in terms of regaining autonomy during transition from hospital to community.

The present study was conducted using a qualitative research design. In this study, 15 semi‑structured, in‑depth interviews were conducted with individuals with SCI in Spinal Cord Injury (SCI) Association of Arak, Iran, from June 2018 to May 2019. The interviews were analyzed using the conventional content analysis method.

Data analysis emerged four core categories of “self‑management” (adaptation to a new life, self‑care, responsibility, and seeking information), “social support” (family and friends’ support, health care providers’ support, and peer support), “access to facilities and resources” (home modification, use of various rehabilitation techniques, and use of mobility equipment), and “spiritual and religious beliefs” (believing in divine destiny and performance of religious rites).

The present study showed that several factors influenced the regaining of autonomy in individuals with SCI. It is important to consider the impact of these factors during transition from hospital to community. Health service providers can use the findings of this research to help these individuals regain their autonomy.

Transition of patients with spinal cord injury (SCI) from hospital to home often involves a shift in caregiving responsibility from health‑care providers to family caregivers. Poor care transition may lead to poor care‑related outcomes.

The aim of this study was to explore experiences of care transition from hospital to home among the family caregivers of patients with SCI.

This qualitative study was conducted in 2018–2019. Participants were 17 family caregivers of patients with SCI who were purposively recruited from two specialty SCI care centers in Iran. In‑depth semi‑structured interviews were held for data collection. Interviews were audio‑recorded, transcribed, and analyzed using conventional content analysis.

The following four main categories were developed during data analysis: lack of knowledge (with two subcategories), excruciating care (with two subcategories), emotional burden of caregiving (with three subcategories), and need for support (with two subcategories). The nine subcategories of these main categories were lack of medical and care‑related information, seeking for information, heavy burden of daily caregiving, need for providing professional care at home, feelings of sadness and sorrow, feeling of insufficiency, restriction of life, limited support by family members and relatives, and limited financial support by the government.

Family caregivers of patients with SCI experience many challenges and problems during care transition from hospital to home, which can affect the quality of their care services for their patients. Therefore, they need ongoing support throughout the process of care.

 Locomotive Syndrome (LS) refers to reduced mobility due to the impairment of locomotive organs. LS results in movement limitation, loss of balance, pain sensation, muscle weakness, and ultimately increased demand for long-term nursing care. This study aimed to investigate LS in Iranian elderly and its risk factors.  This descriptive, cross-sectional study was conducted on randomly selected 320 community-dwelling elderly people in Qaem Shahr City, Iran, in 2018. The study was approved by the Ethics Committee of the University of Social Welfare. The study instruments were demographic form and geriatric locomotive function scale-25 Persian questionnaire. The obtained data were presented by descriptive statistics and logistic regression was used to investigate the correlation between the criterion and predictor variables. All analyses were done in SPSS-V23.  The Mean±SD age of the participants was 69.85±7.7 years. About 58% of the participants were in the LS group. Variables of age (OR=1.05, increase per 1 year), female gender (OR=2.7), positive history of chronic disease (OR=3.4), and positive history of chronic pain (OR=4.04) were the predictors of LS among elders.   Regarding the high prevalence of LS and its relationship with demographic factors (age and sex) as well as chronic disease and, chronic pain, screening methods to identify those at risk for LS and taking preventive measures are highly recommended.

In developed countries, daycare services have started to replace institutional care services since 3 decades ago, and played a major role in community-based care. The present study aimed to compare the daycare centers around the world and explore these centers in Iran.  The study was conducted using library research method on daycare centers in 2015. These centers were selected from the USA, the UK, China, Japan, Bahrain and Iran, using purposeful sampling method. Then, they were compared with each other. The data collection tool was a researcher-designed checklist assessing the provided services before reviewing daycare centers and completed after the review. The researcher evaluated the online registered centers which provided daycare services to the elderly. Most of the elderly daycare centers in the USA are privately owned, while in countries like Bahrain and the UK, they are governmental centers. On the other hand, centers in the UK have integrated care systems that use charity and voluntary supports from NGOs as their financial resources. Financially, elderly care centers in Bahrain are completely dependent on the government. In Iran, the hybrid model is more frequently used with the private-public source of financing. Governmental organizations such as the Welfare Organization support these centers. One of the most important problems of these centers in Iran is their transportation system. Because of the rapid aging process in Iran and transformation from a joint family to nuclear family, Iranian elderly are exposed to loneliness, isolation, and social exclusion. In this regard, community-based programs, such as daycare centers, by focusing on families and supporting them, seem appropriate programs to help prevent social isolation and exclusion of elderly people.

Today, trauma is considered as a major cause of temporary or permanent disabilities for millions of people. Any loss of ability has considerable effects on the quality of life. One of the most important causes of disability is limb trauma. However, the quality of life with limb trauma is relatively unexplored.

The objective of this study was to explore the quality of life following limb trauma.

In this qualitative study a thematic analysis and purposive sample method was used to recruit 11 patients with a disability in the upper or lower limbs and a history of hospitalization caused by a traffic accident 6 months to 2 years earlier. Data were collected through semi-structured interviews continued until reaching saturation. The data analysis approach in this study was thematic analysis, which consists of a vigorous process of data familiarization, data coding, and theme development and revision. The trustworthiness of the results was ensured through constant comparisons, triangulation, member checks, and peer review.

Based on the participants’ experiences, three themes were conceptualized: existing with limitations, empowerment approaches in encountering disabilities, and seeking support.

The experience of living with limb disability was a limiting experience, and other person’s activities and relations could aid participants in achieving empowerment through strengthening and seeking compensatory mechanisms. More attention to the problems of patients, and more research is recommended.

Context: Considering the stressful conditions of life and social difficulties, an important question is why are some people can show positive adaptation and avoid mental health disorders, while others cannot? The present study aimed at reviewing the national studies on the correlation between resilience and mental health.
Evidence Acquisition: In this systematic review, all national articles published in international and national databases were searched without restrictions, using the following keywords: “Resilience OR Resiliency” AND “Mental health” OR “General Health” and their combinations. The Persian equivalents of these words were also used in Persian language sites. Finally, based on PRISMA guidelines, 15 studies were selected. The results of these studies were combined using the random effects model of meta-analysis.
In the present research, 16 correlation studies were examined without time limits, and with a sample size of 3157. Overall, a positive correlation was found between resilience and mental health in the national studies (r = 0.48). The results showed that the correlation between resilience and mental health was lower in the population of school and university students than among other populations (r = 0.39, compared to r = 0.54). The analysis based on geographical division indicated that the highest correlation between resilience and mental health existed in the fifth area (r = 0.83), and the lowest correlation was found in the fourth area (r = 0.35).
By providing cognitive, behavioral and emotional responses in stressful situations, resilience can maintain and improve mental health.

Rehabilitation is an interdisciplinary field of study and is dependent upon the culture of the place of study, and has a significant role in the patient’s well-being and their return to work and normal life. The sequence of a phenomenon rehabilitation care and socio-cultural context in which returning veterans with spinal cord injury, traumatic health and prepare the patient to return to normal life and this community have an important role to explore various aspects of rehabilitation. Several studies have investigated spinal cord injuries that take place at home with the aim of providing more effective services. Therefore, this study aimed to explore patients with spinal cord injuries, for whom traumatic home-based rehabilitation was performed.
A qualitative study was conducted during year 2014 in Tehran's hospitals. Participants included 12 victims of traffic accidents with injuries of the spine (spinal cord injury), two family caregivers, five nurses, four doctors, two physiotherapists, and two occupational therapists in inpatient wards and outpatient trauma centers that explained the process of care based rehabilitation at home for patients with spinal cord injury. Firstly, purposive sampling was performed and was continued by theoretical sampling on the basis of codes and classes. Data were collected through individual semi-structured interviews. Data were analyzed by the conventional content analysis approach.
Data analyzes led to the emergence of four main categories including home-based rehabilitation process of patients with traumatic spinal cord injury, consisting of four main sub-categories: facilitator of recovery, limitations, seek support and challenging return to society.
Support of spinal cord injury patients at home with a team of doctors, nurses, social workers, psychologists and clergy is necessary.

Traffic accidents are the main cause of death and disability in the world and Iran. The Injuries caused by traffic accidents may result in severe limitations and worst outcomes in various aspects of lives of traffic accident injured people and their families. Therefore, understanding their experiences is very important to design better programs with regard to their treatment and returning to the society. In this regard, we conducted this study with the aim of understanding and describing the experiences of encountering with physical trauma resulting from traffic accidents.
This study was conducted with qualitative research approach, using qualitative content analysis method. The study participants had a record of upper and or lower extremity injuries caused by traffic accidents of at least 3 months and at most 2 years after the accident. They were chosen by purposeful sampling method. Data were collected through semi-structured interviews and continued until data saturation. Data analysis was carried out using content analysis method.
The study findings based on the experiences of participants were conceptualized in three main categories; experiencing some limitations, disturbances in performing professional duties, and family problems caused by trauma.
The study findings showed that injured people due to traffic accidents experience numerous constraints in different areas of their lives. Accordingly, proper interventions can be designed based on understanding these needs and experiences from participants’ own words to alleviate these problems. Finally, the study results provide a new insight to the medical team to understand these patients and their real health problems in a more realistic way.

Road traffic accident (RTA) victims also suffer from different types of injuries and disabilities, which can affect their quality of life. They usually face with various physical, mental, and social problems. Most traffic accident victims had difficulty to return to normal life.
This study aimed to understand the experiences of return to normal life in RTA victims.
Patients and This qualitative study with content analysis approach was conducted on 18 Iranian patients with disability in the upper or lower limbs caused by traffic accidents, who had passed a time between 3 months till 2 years. A purposeful sampling method was applied until reaching data saturation. Data were collected using semi-structured interviews. Afterwards, the gathered data were analyzed through conventional content analysis.
By analyzing 498 primary codes, four main categories, including supportive needs, adaptation to the new situation, seeking information, and transition from functional limitation, were extracted from traffic accident victims’ experiences of reintegration to normal life.
The results of this study may help policy-makers to take steps toward health promotion and recovery of RTA victims. Considering the results of this study, it is a need for further research to investigate RTAs victims’ needs for reintegration to home and community. Access to training and supportive facilities like strong therapeutic, nursing and social support, and the possibility to participate in self-care activities is essential for reintegration to community in RTA victims.

Fatigue is the most annoying side effect of cancer treatment in children who experience it from the time of diagnosis till conclusion of therapy. About 75% to 90% of children undergoing chemotherapy suffer from this complication. To relieve this problem, massage therapy is recommended which is the most widely applied adjuvant therapy. The purpose of this study was to determine the effect of Swedish massage on fatigue relieve in children aged 7-12 years suffering from acute lymphoblastic leukemia (ALL) who are undergoing chemotherapy at the Children’s Medical Center of Tehran, Iran.
In this clinical trial, 50 children with ALL undergoing chemotherapy were assigned into 2 groups of intervention and control. First, the severity of fatigue in both groups was measured employing a child fatigue scale questionnaire. Then, in the intervention group, the Swedish massage with the effleurage technique was applied by the child’s mother daily for 4 weeks. The fatigue in both groups was measured at the end of each week. The obtained data were analyzed, using descriptive and inferential statistics (repeated measures analysis).
Indicated a significant difference in total score of quality of life and the mean score of fatigue between two groups after intervention (P Considering the results of this study, applying the Swedish massage by the mother as a supplemental and non-invasive intervention can be effective in reducing fatigue in children suffering from ALL who are undergoing chemotherapy.

Road traffic injuries (RTIs) are a major public health problem and the most important cause of disability, morbidity and mortality worldwide. Early rehabilitation can play a significant role in minimizing complications, morbidity and mortality.

The aim of this study was to describe perceptions of barriers precluding provision of early rehabilitation care for RTI victims.

A qualitative content analysis was carried out on 15 nurses with at least one year experience caring for RTI victims. The nurses were selected from various wards (emergency, orthopedic, neurosurgery, and clinic) of Sina and Imam Khomeini Hospitals via targeted sampling. Data were collected through semi-structured interviews and targeted sampling until data saturation. Data were analyzed and assessed.

After continuous analysis and comparison of data, major causes precluding nurses from early rehabilitation of RTI patients were retrieved. These barriers included: (a) lack of insight, (b) lack of comprehensive care (c) excessive costs; facilitating factors included (d) training for cooperation and (e) support for coping.

The findings of this study show that the need for early rehabilitation in the hospital phase of care for RTI victims is needed. Knowledge about the barriers precluding nurses from early rehabiltiation of RTI patients and facilitators that can help health care workers and policy makers eliminate the barriers precluding early rehabilitation can help health care workers, especially nurses enable patients get over their disability and gain social and family support.