فهرست مطالب malihe sadat moayed

 A complete adherence to treatment is essential for patients undergoing hemodialysis treatment. This health behavior is the product of various overlapping variables that may change over time.

 This study aimed to investigate treatment adherence based on general health and demographic characteristics among hemodialysis patients.

 This was a descriptive-correlation research conducted based on structural equation modeling. The population included all patients with chronic kidney disease in Tehran, Iran, of whom 200 patients undergoing hemodialysis admitted to 2 medical centers from September to March 2022 were selected by convenience sampling. The data were collected using the General Health Questionnaire (GHQ) and End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). The data were analyzed using correlation analysis and path analysis in SPSS v. 19 and SmartPLS v. 3.

 The results showed the direct and significant effect of general health (P = 0.001) and age (P = 0.017) on treatment adherence. However, sex, marital status, level of education, and duration of dialysis treatment had no significant effect on treatment adherence.

 Considering the power of general health and age in predicting treatment adherence, these two variables can be included in training, clinical, and psychological interventions.

Teamwork is an essential necessity for triage in war by healthcare science students and providers. The aim of this study was to evaluate the effects Online Micro Learning Interdisciplinary Education (OMIDE) about war victim triage on triage-related knowledge and practice of healthcare science students.

This quasi-experimental study was conducted in 2021 with a single-group pretest-posttest design. Participants were eighty male medical, nursing, and medical emergency students. They were purposively selected from a medical sciences university in Tehran, Iran, and randomly allocated to ten interdisciplinary WhatsApp groups. The intervention of the study was online micro learning video-based education about war victim triage provided through the ten WhatsApp groups. Participants’ knowledge and practice respecting war victim triage were assessed before, immediately after, and one month after the intervention using a war victim triage knowledge questionnaire and six scenarios about war victim triage practice, respectively. The SPSS software (v. 22.0) was used to analyze the data through the repeated measures analysis of variance.

The mean of participants’ age was 23.07±1.51 years. The mean scores of knowledges and practice respecting war victim triage significantly improved across the three measurement time points (P < 0.001).

Web-based OMIDE is effective in significantly improving healthcare science students’ knowledge and practice respecting war victim triage.

Most of the complications after heart surgery are related to immobility. Early mobilization helps prevent these problems from occurring. Despite the awareness of the importance of early mobilization, its implementation rate is still low due to the presence of many obstacles. Appreciative inquiry has been introduced as a key strategy for creating change. This study aimed to investigate the effect of the implementation of an appreciative inquiry strategy on the quality of early mobilization.

This clinical trial research was conducted in Tehran Jamaran Hospital on 98 patients undergoing open heart surgery in 1401. The sampling method was purpose-based based on the inclusion criteria. The quality of early mobilization of the patients was evaluated using a researcher-made checklist, which was validated. The intervention in the test group was carried out in the form of focused group discussions of four people regarding the strategy of appreciative inquiry for the implementation of Early mobilization of patients. The leaders of the open-heart intensive care unit, including the head of the department, his deputy, and the heads of the shifts participated in the discussions. The results were analyzed by statistical software SPSS version 22 using independent t, Mann-Whitney, and chi-square tests and analysis of variance.

The findings showed that the patients of the two test and control groups had no significant differences in terms of demographic characteristics, surgery characteristics, history of smoking and drug use, and underlying diseases. The results of checking the checklist scores using chi-square test showed that with the implementation of the Appreciative inquiry strategy among department leaders, the average score of the checklist for the quality of the implementation of the Early mobilization process went from 8/4 (±1/4) in the control group to 11/6 (±1/4) in the test group (P<0.001).

This study showed that the implementation of the appreciative inquiry strategy is effective in changing the approach of nurses regarding early mobilization and consequently creating a positive change for the implementation of this process. Considering the need to change the approach in different areas of nursing, including early mobilization, it is recommended This strategy can be used in nursing with the aim of creating positive changes.

The preparation of the healthcare staff is one of the influencing factors in providing the correct treatment, care, and proper control to deal with biological threats. Since the preparation of nurses is understood under the influence of variables of knowledge, attitude, performance, and sense of danger, so this study aims to determine the level of knowledge, attitude, performance, and sense of danger of military clinical nurses in facing biological threats with special emphasis on COVID-19 disease.

The present study is a cross-sectional descriptive-correlation study that was conducted in 2021 using stratified random sampling in 600 military clinical nurses in selected hospitals of East Azerbaijan. The validity and reliability of the nurses' preparation questionnaires were evaluated by calculating the content validity ratio (CVR=0.94) and content validity index (CVI=0.83). The information obtained from the questionnaires was entered into SPSS statistical software and the data analysis was performed at a significance level of 5%.

The preparedness of military clinical nurses in facing biological threats during the covid-19 pandemic had a significant correlation with the variables related to knowledge, attitude, performance, and sense of perceived risk (P<0.001). Univariate regression analysis showed that male nurses had a weaker level of knowledge and attitude and sense of perceived risk regarding the covid-19 disease. But female nurses had better performance than male nurses. In this study, history of suffering from this disease (P=0.683) and work shift (P=0.877) did not have a significant relationship with the performance of nurses in the face of covid-19 disease.

The level of knowledge and performance of clinical nurses is favorable and the level of their attitude and sense of perceived risk is average. It seems that in order to ensure the readiness of nursing staff against biological threats such as the covid-19 epidemic and to maintain it at the desired level, it is necessary to carry out interventions such as continuous training and in-service training.

Chronic Obstructive Pulmonary Disease patients are certainly the most challenging ones for weaning from mechanical ventilation. Mortality in these patients compared to others due to failure in the weaning process is more than seven times. The present study was performed on the population of ventilated chronic obstructive pulmonary disease purposes of determining cut-off points of New Integrative Weaning Index (NIWI) and conventional indexes and comparing differences between their predictive components.

The observational prospective, triple blinded study was conducted in 2012-2013 on 180 hospitalized COPD patients in critical care units of selected hospitals in Tehran in two groups including cut-off points determining group and determining different predicting weaning factors group. The process of weaning was based on the same and defined protocol. The ROC analysis was used to determine the cut-off points group and the predicting factors were used in the other group.

The highest area under the curves was devoted to Rapid Shallow Breathing Index (0.927) and NIWI (0.878). The highest sensitivity was related to NIWI with 100% and the highest specificity was related to RSBI index 90%, the positive predictive value to RSBI Index was 87.5%, the negative predictive value to NIWI with 100% and highest diagnostic accuracy related to RSBI was 98.67%. The cut-off point and the most desirable components predicting weaning were RSBI, NIWI, P0.1, and NIF indexes, respectively.

The NIWI index can be used as a complementary predictive indicator for weaning from mechanical ventilation in chronic obstructive pulmonary disease patients due to its good predictive components.

Among different variables affecting students' performance, academic motivation is one of the most vital factors. This study was carried out to investigate the relationship between self-esteem and academic motivation in postgraduate nursing students.

A total of 220 postgraduate nursing students were selected from 10 nursing schools in a cross-sectional study using multistage randomized sampling with replacement in 2014-2015. The Rosenberg Self-esteem Questionnaire and the Academic Motivation Scale of Vallerand were the data collection tools. A hierarchical regression model was used in seven blocks for evaluating the demographic, educational, familial, social, and spiritual well-being course characteristics.

According to the results, postgraduate students in nursing had low self-esteem (13.968) and moderate academic motivation (128.318). The correlation between self-esteem and academic motivation was 0.313 with a t-statistic of 4.874 at a significant positive level (p <0.001). The spiritual well-being course (P <0.0001) (as an educational variable) had a significant impact on academic motivation with an average increase in self-esteem.

Self-esteem should be considered as a criterion for screening applicants for master's degrees given the sensitivity of nursing postgraduate students' personal and occupational performance. Since the spiritual well-being course affects self-esteem, introducing cultural patterns and interventions in this field can be associated with increasing students ’self-esteem.

The COVID-19 epidemic is one of the major health problems worldwide due to its inconceivable spreading power and potential damage. Given the increasing prevalence of the disease, the identification of care needs and preferences of patients could play an important role in providing effective training and caring programs. This study was conducted to explain the preferences and needs of care based on the experiences of patients with COVID-19.

This qualitative study with a content analysis approach was performed in 2 months at a referral general hospital and quarantine centers of COVID-19 in Tehran, the capital of Iran, in 2020. The participants consisted of 15 COVID-19 patients selected through purposive sampling. The data analysis was performed using the conventional content analysis method according to the procedure proposed by Graneheim and Lundman.

The results were classified into 5 main categories: (1) access to desirable care and comfort services; (2) access to education and information from credible sources; (3) access to specialized care; (4) support social needs; and (5)  need for deep emotional interactions.

According to our results, identifying priorities and care needs from the perspective of patients with COVID-19 can help improve knowledge, reduce unrealistic patient concerns, and improve emotional interactions between patients and health care providers.

 Care and treatment adherence are important factors for given good liver transplantation outcomes.

 Design and validate an instrument to appraise adherence to care and treatment in liver transplantation recipients.

 A mixed-methods sequential exploratory study was conducted in two phases from 2017 to 2019, in the Liver Transplantation Clinic Tehran, Iran. In the qualitative phase, the concept of care and treatment adherence in liver transplantation recipients extracted by a conventional content analysis was performed on semi-structural interviews that were conducted on 18 liver transplantation recipients that were recruited through purposive sampling technique. Also, two physicians, one nurse coordinator of the liver transplantation team, and two family members were interviewed. The scale was developed based on operational definitions extracted from the qualitative phase. The validity was assessed by face, content, construct validity, and confirmatory factor analysis. The reliability was also evaluated by calculating test-retest intraclass correlation coefficient and Cronbach's alpha. The exploratory factor analysis was carried out with 286 filled the questionnaire.

 Four factors were extracted in factor analysis. These factors explained 45.622% of the variance. The final version of the scale consisted of 20 items. The Cronbach's alpha coefficient reported as 0.889 for the total scale and the intraclass correlation coefficient was reported as 0.912. The confirmatory factor analysis led to a fitting model. Chi-square indices were reported as CMIN/DF = 2.34, NFI = 0.94, CFI = 0.96, and RAMSEA = 0.067.

 With a four factors structure, validity and reliability of adherence to care and treatment scale are acceptable; therefore, it can be used for appraisal care and treatment adherence in liver transplant recipients.

Nurses need to have considerable knowledge of and great competence in carefully assessing and correctly diagnosing patients’ eye problems. There was little known about nurses’ eye care knowledge, attitude, and practice in Iran. This study aimed to evaluate intensive care nurses’ clinical competence in eye care.

Methods & Materials:

 In the cross-sectional descriptive study, ten hospitals selected by cluster sampling of 4 city located in Iran in 2015. Four hundred thirty two intensive care nurses were recruited by convenience sampling. The Eye Care Competence Inventory was employed for evaluating nurses’ eye care knowledge, attitude, and practice. The possible total score of each domain of the inventory ranged from 0 to 100. Data were analyzed by SPSS 18.

The means of participating nurses’ eye care knowledge, attitude, and practice were 43.3(SD=14.86), 84.56(SD=11.61), and 73.11(SD=17.17), respectively. Nurses who had eye care guidelines in their ward acquired significantly higher eye care knowledge, attitude, and practice scores than the nurses who did not have such guidelines in their ward (p<0.05).

The result showed that nurseschr knowledge in eye care of ICU patients was moderate and their attitude and practice were good. Accordingly, developing and implementing continuing education programs for promoting their eye care knowledge, attitude, and practice is strongly recommended.

Responses for medical emergencies can be different during most terrorist attacks in which civilians and military personnel might be killed or wounded. The present study aimed to reflect on injury patterns and the outcome of victims in terrorist attacks. A retrospective research design study was conducted on the data obtained from terrorist attacks in the city of Ahvaz, Iran, on September 22, 2018. In this deadly incident, 92 military and civilian victims had been transferred to hospitals within the first 24 hours. To this end, the data including age, gender, causes, site of injuries, outcomes, and the Injury Severity Score (ISS) values were analyzed.  Data were acquired from the Iranian Legal Medicine Organization, the Iranian Emergency Department, as well as health care facilities. The findings revealed that, out of 92 victims of Ahvaz terrorist attack, 85 cases (92.4%) were men. The mean age of these individuals was about 28.68±11.22 years and 41.3% of them were in need of urgent surgical interventions. There was no information regarding casualties in 22.3% of the cases. Moreover, 25% of the causalities had led to death. The mean of ISS was 8.19±13. Besides, there was a significant relationship between ISS values and patient outcomes (p <0.0001). A relationship was also observed between multiple injuries and mortality rates although it did not include main body parts. The results showed that the mortality rate of casualties in the Ahvaz terrorist attack was high. With respect to the findings, extensive actions are needed to maintain the readiness of the emergency medical care services and to manage such events.

Due to the increasing prevalence of diabetes in the world, the assessment of the patient needs is essential. Understanding the needs of patients will play a very important role in providing an effective training program for patients. This study aimed to explain the health‑care needs of patients with diabetes in Iran’s health‑care system.

The present study was conducted using a modified Delphi technique in three rounds in 2017–2018. In the first round, patients’ needs were extracted based on qualitative interviews and a review of the literature. Then, the second and third rounds were determined through surveys, achieving maximum consensus and grading the importance of the patients’ basic needs. Participants selected using purposeful sampling and included 58 diabetes patients, family, and providers of the health system who were referred to urban health centers, rural, and one of the clinics of Darreh Shahr, Ilam Province. For data analysis, qualitative content analysis was used in the first Delphi round and descriptive statistics were used in the second and third rounds.

Regarding health‑care needs of patients with diabetes, four main themes included: information and knowledge needs, need for reinforcement/reform of religious‑cultural beliefs, need for health self‑management, and ultimately supportive needs have emerged.

According to the results, before designing and developing effective educational programs, the need assessment to improve knowledge, correcting unrealistic attitudes and beliefs, as well as modifying their self‑care behaviors and performance in preventing diabetes is recommended.

During the last few decades, substantial research have been carried out identifying factors that contribute to the etiology and progression of Coronary Heart Disease (CHD). This systematic review and meta-analysis has been conducted to update and summarize the results of the published articles that examine the effect of perceived stress and its association with the incidence of CHD.

In order to carry out this study, five electronic databases including PubMed, Scopus, Web of Science, Science Direct, and ProQuest were used to search for potentially relevant articles. Articles published from 1948 to November 2018 were investigated in this research. All cross- sectional, prospective observational cohort, and case – control studies were selected which had measured self-reported perceived stress and had assessed the incidence of CHD. From among all the potentially identified relevant articles, 10 articles met the criteria (n=165819). The incidence of CHD was defined as a new diagnosis of, Ischemic Heart Diseases (IHD) for, or Cardiovascular Disease (CVD) and mortality secondary to CHD.

Meta-analysis yielded a risk ratio of 1.382% [CI 95% (1.056-1.808), and P=0.019] for CHD, and an aggregate IHD risk of 1.206% [CI 95% (1.112-1.308), and P<0.0001]. Pooled estimate were 1.455% [CI 95% (1.088-1.944), and P<0.011] for mortality, which showed that perceived stress had a significant increasing effect on mortality.

This systematic review and meta-analysis revealed that high levels of stress increases the risk of CHD, IHD and mortality. Lifestyle changes play an essential role in the clinical prevention of CVD.

Despite advancements in medical science, the treatment of AIDS remains a public health problem, and the number of cases has been rising steadily in recent years. Although there is no consensus, statistics collected by the Universities of Medical Sciences and Health Services indicate that, as of 2012, a total of 27 041 people with HIV/AIDS had been identified in Iran, 89.3% of whom were men and 10.7% were women. In 2009, 19 774 people had been recognized.1 Statistics show that the third wave of AIDS continues until women are its silent victims. Addicts and their wives have also been afflicted as have their children, and this completes the cycle of disaster. The percentage of women who have contracted HIV infection from sexual relations has risen to 60%.2 Data shows that transmission through the sharing of injecting needles is 56%.3 Growth in the number of patients involved, the increasing number of drug users, the sharing of needles, increased sexual contact, the rise in the age of marriage, and increases in the divorce rate have caused the rate of sexually transmitted infections to rise. Evidence offers that in addition to the development of patients, the risk of transmission is driven by unprotected sexual contact. Programs to control and prevent HIV/AIDS and educate the public, with a special emphasis on prevention, are top priority.4 Stopping unprotected sex is of specific importance. Results of another study indicated that only 5.2% of female sex workers use a condom, and 90% of them are addicts. Drug users are sexually active and have multiple partners; thus, unprotected sex is quite common. More than 35% of addicts are married and 40% are not; 27% had more than 5 sexual partners. The rate of men who have had sex with other men at least once was reported to be 7% in prison and 67% outside of prison.5 Prostitutes and injecting addicts are very worrying. Based on studies, it is clear that the need for educational measures to raise public awareness and expertise in the field of AIDS prevention are warranted. This is particularly true for women who are victims of these attacks; the World Health Organization and the Joint United Nations Program on AIDS (UNAIDS) emphasized the fact that sexually transmitted diseases, one of the problems in society today, necessitates integrated health care that provides peer education, empowerment, promotion of condom use, and effective treatment of sexually transmitted diseases in high-risk groups such as female sex workers.6 Studies conducted to evaluate the awareness of women sex workers have shown that these women have information about AIDS, but because of financial need and addiction they do not use the information they have. Due to cultural constraints and hidden relationships,4 a comprehensive plan to prevent and detect HIV/AIDS and to promote the use of health services among members of this group is essential. Due to the growing HIV epidemic in this group of people, there is a possibility that a subsequent increase in cases may follow.

Applying theories in clinical practices is an important factor in development of nursing science and reduction of the gap between theory and practice. The aim of this study is to assess outcomes of applying Neuman system theory in intensive care units.
A review study was conducted in 2016 through searching on Cochrane Library, Science Direct, Ovid, Google scholar, PubMed, Wiley, ProQuest, and Blackwell databases. The search was performed by using ICU, critical care, defense line, client system, nursing, and neuman system model as key words. Finally, 7 articles in English were assessed in this study, comprised of 5 quantitative studies, 1 qualitative study, and 1 case report study.
Outcomes of applying the theory were assessed in three categories including: 1. Caregivers (nurses), 2. Care receivers (patients and their families) and, 3. Intensive care unit environment. Regarding nurses, the results indicated an improvement in supporting of nurses, creating a social network in the workplace, and preventing post-traumatic disorder by using three prevention levels. Regarding patients and their families, identifying environmental stressors and controlling them resulted in high quality care and by using evidence-based care, it led to the prevention of delirium. Family was found to have an important role in terms of the created environment and acceleration in patients’ improvement; regarding factors related to the unit, creating a relaxing environment by playing music resulted in stress reduction.
Correct evaluation of the elements of treatment process leads to identify different kinds of stressors in nurses, patients, clients’ families, and intensive care unit environment as well as providing appropriate strategies which can cause stress reduction and subsequently satisfactory treatment outcomes. Achieved knowledge and awareness may lead to new studies for combining theory with clinical practice. This new knowledge can provide dynamic and scientific care.

Injuries caused by sharp objects, which involve biological hazards are considered as one of the most important factors that lead to stress among the nursing staff. Contact with sharp objects is a major concern among healthcare workers, especially nurses.
This study was done to determine the amount of stress caused by exposure to sharp medical instruments among nurses.
This was a cross-sectional research on 527 nurses, working at different medical centers across Iran, with a cluster-sampling method. The relevant data was collected with a valid and reliable questionnaire. The Cronbach’s alpha coefficient of internal consistency of this instrument was 0.92 and interclass correlation coefficient was 0.94
The results showed that ward satisfaction, having master of science, age, and number of contacts were significantly able to predict variance in stress scores. The adjusted line regression model explained 36% of the overall variance in stress score (R2 = 0.60)
The results of this study showed that exposure to sharp objects may cause high stress in the nursing staff. Considering higher levels of stress in the area of contact care, the provisions on how to deal with patients and safe care can help reduce stress.

Nursing education and training of doctoral students are vital, because they are expected to be a factor for the Advancement of Science in Nursing, professional advisors and also training future researchers. The aim of this study is comparesion of nursing education system in Iran with the Johns Hopkins University
This descriptive-comparative study was carried out in 2016. In order to compare components of nursing PhD program curriculum in Iran and JOHN HOPKINS University, data were collected by searching the internet with using of databases Persian and English and compared using Bereday’s four-stage model: description, interpretation, juxta position and comparison.
If we want to compare Nursing education at Johns Hopkins School and Iran, from beginning of the modern nursing education, also the establishment of all nursing steps from licence to PhD, Johns Hopkins School was done earlier than Iran. Entrance to PhD, without passing the test and student's criteria admission, is imposed independently by the university in America. Educational plans are more various, and students have the ability to choose the course units. Some of the units are optional and they are selected by the appropriateness of student's need, thesis title and supervisor's recommendation. Iran's Nursing Doctoral philosophy is fit with the culture and beliefs of the Muslim community.
In Johns Hopkins a significant relationship exists between the mission and goals of the curriculum. Community's problems and needs are covered with locating the lessons. Educational planners should be more careful in communicating the goals and structure of teaching.

Health care services can cause injuries to medical staff. One of these injuries is exposure to needle-sticks. This can result in the transmission of blood-borne diseases, such as HIV and hepatitis B; the staff undergo continuous stress. Thus, it is necessary to use some method to reduce this stress.

The purpose of this study was to examine the effect of education based on the stabilization model on stress induced exposure to needle sticks among nurses working in emergency and trauma wards.

This Quast- Experiental Study was performed on 35 nurses working in emergency and trauma wards of our hospital in October-December 2013. Data were collected using a two-part questionnaire; Reliability and validity of the questionnaire were confirmed (α = 0. 92 and ICC = 0.94).Data were analyzed using SPSS version 20. The one-sample Kolmogorov-Smirnov test, independent t-test and paired sample t-test were also used.

The mean and standard deviation of stress experienced by nurses before and after the intervention were 64.94 ± 15.67 and 43.91 ± 10.73, respectively. Findings indicated that education decrease needle stick stress in nurses significantly (P < 0.001).

According to the results of this study, the stress level induced due to needle-stick exposure and its complications is high and interventions for reduction are essential.