فهرست مطالب marziyeh asadizaker

As an epidemic, COVID‑19 has brought a new shock to the world’s healthcare system. The crisis caused by this disease and the prolonged involvement of communities and healthcare systems have intensified the duties and psychological burden of nurses. The current study aimed to explain the experience of ICU nurses during the COVID‑19 crisis.

The present study was conducted using conventional content analysis in 2021. Twenty nurses of the COVID‑19 ICU of Ahvaz hospitals were selected by purposive sampling. The main method of data collection was semistructured interview. The process of data analysis was done based on Granheim and Lundman’s approach using MAXQDA‑2020. For the scientific rigor of the findings, Guba and Lincoln’s four criteria were abided by. The COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist was used to ensure the study met the recommended standards of qualitative data reporting.

After data analysis, 22 subcategories, eight categories, and one theme (growth under pressure) were extracted. The eight main categories included (psychological crisis, physical exhaustion, family conflicts, complex care, professional development, expertise, life enrichment, and full support).

Despite the pressures that ICU nurses faced during the COVID‑19 pandemic, they were able to grow by benefiting from positive experiences. These findings can lead to the development and implementation of effective interventions to improve adaptation strategies of nurses, especially those working in the intensive care unit, during the COVID‑19 and other future crises.

Pressure ulcer is a common problem in ICUs and its prevention is one of nurses’ duties.

The present study was performed with aim to evaluate the effectiveness of preventive nursing care based on Braden’s scale on the incidence of pressure ulcer in ICU patients.

This clinical trial study was performed on 72 patients admitted to the ICUs of Golestan and Imam Khomeini hospitals of Ahvaz in 2020. The preventive care based on Braden scale was performed for 6 days in the intervention group. Routine care was provided for the control group. The rate and duration of pressure sores were measured based on Braden scale at the beginning of the study, every 48 for 3 times for the intervention group. The data was collected by demographic information questionnaire, Braden scale, and Pressure Ulcer Scale for Healing (PUSH).

The pressure ulcers occurred less in the intervention group (2.8%) than in the control group (8.3%), but this difference was significant (p=0.614). There was a significant difference between the two groups in terms of Braden's subscales during the intervention period (first, second and third 48 hours) (p<0.05). Preventive care increased the length of time required for the occurrence of pressure ulcers in the test group.

Implications for Practice:

 The results showed that the intervention based on the Braden scale reduces pressure ulcers, therefore it is recommended that nurses carry out care interventions based on the Braden scale to improve the quality of care and prevent pressure ulcers among ICU patients.

Metabolic and nutritional status influences the condition of patients under mechanical ventilation (MV) and determines if they can be disconnected from the ventilator.

This study was conducted to determine the effect of the planned Entera Meal solution on the duration of weaning patients and the length of intensive care unit (ICU) stay.

In this clinical trial with a pre-test/post-test design, 42 patients admitted to the ICUs of Golestan and Imam Khomeini hospitals of Ahvaz, Iran, who were under MV, were randomly assigned to the two groups of control and intervention. In the intervention group, the Entera Meal solution was used for energy supply. The administration of the solution was started from 50 mL every 3 hours and was scaled up to 30 mL to reach the calculated energy within 48 - 72 hours. For the control group, routine homemade hospital solutions were used. Data were collected by demographic and medical information questionnaires and a checklist for recording outcomes. The data were analyzed using SPSS software version 23.

The results showed that the length of ICU stay was significantly affected after the administration of the planned Entera Meal solution (P = 0.004). Although we observed that the duration of weaning patients from MV was shorter in the intervention group than in the control group, this difference was not statistically significant (5.23 ± 4.77 vs. 7.71 ± 6.14 days, P = 0.15).

The planned Entera Meal solution reduced the length of ICU hospitalization but did not have a statistically significant effect on the duration of patients weaning from the ventilator.

One of the psychological stressors for the patients admitted to the coronary care units (CCUs) is being away from family members and lack of visiting time. Also, one of the special needs of families is to visit patients during their hospitalization period. In order to enforce visiting rules in CCUs, it is important to take the needs of all staff, patients, andvisitors into consideration, and a visiting policy should be adopted that ensures the most effective visiting system.

The present study aimed to design a visiting policy based on the challenges of the CCU ward using an interactive approach.

This qualitative research was conducted with a participatory action research (PAR) approach in 2016 at Ganjavian Hospital, Dezful, Iran. Content analysis was performed based on the method proposed by Graneheim and Lundman (2004). Forty stakeholder participants were included in focus groups consisting of 3 to 7 people using a purposeful sampling method.

In order to determine the current situation, after analyzing the extracted codes in the focus groups and according to the similarities and conceptual content, 36 subcategories, 11 categories, and 3 subthemes, including improper physical factors, problems related to human factors, and improper policy quality, were obtained. After determining the current status of the visiting policy and problems, the new policy was developed by the planning group consisting of a representative from each of the focus groups.

In the new visiting policy, efforts have been made to improve the quality of visiting by providing more opportunities for patient-companion and doctor-companion visiting, focusing on ensuring complete and timely information, assigning rooms for doctor-companion and patient-companion visiting, and paying attention to the required equipment. This program can be used by other planners while adjusting its items according to their conditions.

Transferring patients from intensive care units to general units can increase anxiety in patients and their families, which can lead to re-admission of patients in intensive units and increase hospitalization costs.

The present study was performed with aim to determine the effect of the transition nursing program from intensive care units to general units on the anxiety and satisfaction of patients and their families.

This randomized clinical trial study was conducted on 50 patients hospitalized in surgical ICUs and 50 of their relatives. The research units were randomly assigned to the intervention and control groups. Before transfer, patients and their families filled out the Spielberger and satisfaction questionnaire. Then, the transition nursing program was implemented and the patient was examined by the liaison nurse immediately, 8, 16 and 24 hours after transfer. Then, the questionnaires were filled out again. Data were analyzed by SPSS software (version 22). p<0.05 was considered statistically significant.

After the implementation of the nursing transfer program, the anxiety of patients (34.68±8.02) and their families (32.52±7.84) reduced in the intervention group compared with the control group (p<0.0001). Also, the satisfaction of the patients (47.64±5.65) and their families(45.56±6.10) significantly increased in the intervention group (p<0.000).

Implications for Practice: 

The transition nursing program reduces anxiety and increases the level of satisfaction in patients and their families. The findings of the present research can be suggested to the policymakers and nursing managers in order to plan to improve the role of nurses as liaison nurses.

The concept of adaptation has gained central importance in research on chronic diseases. However, this process is not clear in adult epileptic patients. This study aimed to explain the process of adaptation to disease in patients with epilepsy. This study was conducted using the grounded theory approach from December 2018 to January 2020 in Isfahan, Iran. Data were collected by semi-structured interviews with 18 patients with epilepsy. Participants were selected by purposeful or theoretical sampling method. Data collection was performed by the first author through conducting semi-structured interviews. Data analysis was performed by Strauss and Corbin’s (1998) method. Four main categories with ten sub-themes were obtained from the data analysis. The main themes include “Perceived disorder,” “Scrimmage with the disease,” “Moving towards adaptation,” and “Balancing life.” The Core category achieved was “Trying to balance life.” Based on the results, the process of adapting to epilepsy has four stages: “Perceived disorder,” “Scrimmage with the disease,” “Moving towards adaptation,” and “Balancing life.” The health providers’ awareness of these stages can provide a framework that can be used to help epilepsy patients achieve positive adaptation. Achievement of adaptation can help epileptic patients control the disease and improve their quality of life.

Pain and inflammation caused by needle insertion into the fistula is a common problem in hemodialysis patients. The aim of this study was to evaluate the effect of topical application of Rosemary essential oil on inflammation and pain severity caused by needle insertion into arteriovenous fistula in patients undergoing chronic hemodialysis.

Methods & Materials: 

In this clinical trial, 60 hemodialysis patients from the hemodialysis ward of Golestan hospital and Imam Khomeini hospital in Ahvaz were randomly assigned to two groups using block randomization. The intervention group received rosemary essential oil, while the control group received distilled water applied to the needle insertion site 5 minutes before each hemodialysis session. Pain severity was assessed using the VAS scale and inflammation severity was determined using the Phlebitis checklist at baseline and during six sessions. Data were analyzed using t-test, chi-square test and repeated measures analysis of variance (ANOVA) on SPSS software version 22.

The results showed that the mean score for pain increased in the control group from 5.13±1.74  to 5.93±1.67, while it decreased in the intervention group from 5.83±1.53 to 3.77±1.43 (P=0.003). Additionally, the mean score for inflammation increased during the sessions in the control group, ranging from 1.27±1.20 to 2.07±1.08. However, in the intervention group, the mean score for inflammation decreased from 2.57±1.92 to 1.33±1.44. Nevertheless, this difference was found to be statistically insignificant (P=0.267).

The findings of the present study showed that the topical application of rosemary essential oil had a significant effect on reducing pain resulting from needling. However, its effect on reducing the severity of arteriovenous fistula inflammation in patients undergoing hemodialysis was not statistically significant. Based on these results, it is recommended to provide training to nursing staff and hemodialysis patients regarding the use of rosemary essential oil as a means to alleviate pain experienced during the procedure. Further research is required to investigate its potential for reducing the severity of fistula inflammation.

Fatigue and re-admissions are the important consequences of heart failure that cause limitations in patients’ daily activities, personal, and social affairs. Energy conservation techniques are among evidence-based and non-pharmacological approaches that can reduce fatigue in patients with chronic disease.      

The present study was performed with aim to determine the effects of tailored energy conservation training on fatigue and readmissions of patients with heart failure (HF).

This randomized clinical trial study was performed from May 2019 to March 2020 on 96 patients with HF admitted to CCU and cardiovascular clinics affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Patients who met the inclusion criteria were randomly assigned to the intervention and control groups. A three-part tool (demographic-clinical questionnaire and need assessment), the Fatigue Severity Scale (FSS) and a readmissions record checklist were used to collect data. After determining the training needs of each individual, the intervention group received five 45-minute face-to-face individual training sessions of energy conservation strategies reinforced by telephone support every two weeks and followed up for 12 weeks. The control group only received routine post-discharge training. Fatigue scores by FSS and the readmissions recorded were tested at baseline and three months after the end of the intervention.

At baseline, the two groups were comparable in the mean hospital admissions and fatigue scores. However, after the intervention, the mean frequency of hospital admissions and the mean fatigue score were significantly lower in the intervention group (1.36±1.26, P< 0.001; 2.86±1.01,P< 0.001) than in the control group (0.42±0.77, P< 0.001; 5.25±1.03, P< 0.001) respectively.

Implications for Practice: 

Nurses and physicians are recommended to teach energy conservation methods to patients with HF and chronic conditions who are prone to fatigue and its side effects.

Evaluation and accreditation of hospitals have essential roles in improving the quality, safety, and effectiveness of healthcare services. Nevertheless, this process may cause stress and anxiety among hospital staff. This study aims to determine and compare employees’ anxiety levels and perceived stress before and after the accreditation program in private hospitals in Ahvaz City, Iran.

This research was a quantitative, observational, and longitudinal study. A total of 456 employees of Ahvaz private hospitals were recruited by convenience sampling. The state-trait anxiety inventory (STAI) and the perceived stress scale-14 (PSS-14) were used to measure the level of anxiety and stress among hospital employees one month before and one month after implementing the hospital accreditation program. The data were analyzed in SPSS software, version 22 using descriptive and inferential statistics, such as the paired t-test, Pearson, and Spearman correlation coefficients. The significance level was set at P<0.05.

The findings showed a significant difference between perceived stress and anxiety before and after implementing the accreditation program (P<0.05). There was a significant relationship between the employees’ perceived stress levels and their age, gender, and work experience. The subjects’ state-trait anxiety was also significantly associated with their sex, work experience, and organizational position (P<0.05).

Although the accreditation program usually improves the quality of healthcare, the employees experienced more stress and anxiety before the implementation of this program than after its completion, which can negatively affect the quality of care. Therefore, policymakers and managers should pay great attention to prevent stress and anxiety among healthcare providers while implementing the accreditation program.

Knee osteoarthritis is the most common arthritis and musculoskeletal disease. The low efficacy and significant side effects of synthetic drugs in the treatment of this disease have led many researchers to look for a drug that is effective but has fewer side effects. Recently, ginger is one of the most popular herbal remedies in the treatment of this disease. This study aimed to compare the effect of ginger by skin patch and oral capsule on pain intensity, joint dryness, and daily performance of patients with osteoarthritis of the knee.

This was a three-group clinical trial study that was performed on patients referred to Afshar orthopedic clinic in Dezful in 2015. Sampling was available. Subjects were randomly divided into three groups according to the table of random numbers: skin patch, ginger capsule, and control. All three groups received treatment prescribed by an orthopedic specialist. In addition, the ginger capsule group used 2 500 mg ginger capsules daily and the ginger skin patch group used one ginger skin patch daily in the middle of the waist for 9 weeks. The data collection tool was a demographic questionnaire and a translated version of the Arthritis Index of Western Ontario and McMaster Universities (WOMAC). One-way analysis of variance, paired t-test, and Tukey post hoc test aswas used to analyze the data. A significant level were considered 0.05.

The total number of participants in the study was 135.In the groups of ginger capsules, ginger skin patch, and control. the mean pain intensity before the intervention was 13.08, 14.52, and 13.55, respectively, and after the intervention, it decreased to 7.05, 8.62, and 11.37(P<0.00).

Ginger in both oral capsules and skin patches is effective in reducing the severity of pain and dysfunction in patients with osteoarthritis of the knee. It seems that only oral capsules reduce joint dryness and the ginger skin patch is ineffective.

One of the problems of the treatment system is the high mortality and length stay of patients in the intensive care unit (ICU), which has high costs. The aim of this study was to determine the effect of adjustment of positive end-expiratory pressure (PEEP) and fraction of inspired oxygen (FiO2) based on PaO2 on the care and treatment outcomes of ICU patients.

This was a randomized clinical trial study in which the statistical population consisted of all patients admitted to the ICU of Imam Khomeini hospital in Ahvaz, Iran, in the second half of 2020. 40 samples were selected based on available sampling method, and randomly divided into two groups of intervention and control. To collect the data, a demographic information questionnaire as well as Sequential Organ Failure Assessment (SOFA) scoring system were used. In the intervention group, adjustment of PEEP and FiO2 was performed based on PaO2 of patients in 7 days.

There was no difference between the two groups in terms of demographic variables. The mean scores of disease severity before intervention in the two groups were not statistically different; but after the intervention, disease severity score, duration of ventilator connection, and length of ICU stay were significantly lower in the intervention group.

The adjustment of PEEP and FiO2 based on PaO2 is effective in reducing the disease severity score, duration of ventilator connection, and ICU stay. It should be used as a nursing intervention in coordination with treatment team to reduce the consequences of hospitalization in ICU.

Given the wide cultural diversity of patients in the current world, nurses need to have great cultural competence. This study aimed to explore the concept of cultural competence in Iranian nurses.

This qualitative study was conducted in 2017–2018 using Graneheim and Lundman’s approach to qualitative content analysis. A purposeful sample of eighteen clinical nurses was recruited with maximum variation from hospitals of Isfahan and Ahvaz, Iran. Data were collected through eighteen semistructured interviews and simultaneously analyzed through directed content analysis.

Data analysis resulted in the formation of thirteen subcategories which were respectively grouped into the four categories of cultural cognition (cultural awareness, cultural knowledge, and cultural insight), cultural care intention (cultural encounter, cultural desire, and cultural eagerness), cultural flexibility (cultural attitude, cultural sensitivity, and resolving cultural conflicts), and cultural care skills (communication skills, cultural evaluation skills, behavioral skills, and skills to get feedback about cultural care).

Iran has many ethnic and religious groups which have a variety of subcultures, so Iranian nurses need to be sensitive about cultural diversity in health‑care settings and have the cultural competence to facilitate the delivery of quality culturally competent care to the patients of different cultures.

 Cancer-related fatigue (CRF) during chemotherapy and after it and decreased body energy are common problems in patients that do not resolve with sleep and rest.

 This study aimed to assess the effect of combination therapy of low-intensity exercise and slow stroke back massage (SSBM) on physical activity and fatigue intensity of patients undergoing chemotherapy.

 This clinical trial study was performed on 92 patients with cancer undergoing chemotherapy who were referred to the oncology wards of Baqhaiee-2 hospital Ahvaz-Iran (2018 - 2020). Patients were randomly divided into two groups. Intervention group patients who received three days a week for four weeks that each session 10 minutes for slow stroke back massage and 15 minutes’ low-intensity exercise. Control group patients who received usual care. Data were collected using a demographic questionnaire, Piper Fatigue Scale (PFS), and International Physical Activity Questionnaire (IPAQ) and then analyzed using SPSS software.

 The results showed the intensity of fatigue decreased in the experimental group, and there was a statistically significant difference between the two groups (P = 0.05). The trend of physical activity increased in the experimental group; however, there was no statistically significant difference between the two groups (P = 0.68).

 The combination of low-intensity exercise intervention and slow stroke back massage had a positive effect on fatigue severity but no statistically positive effect on physical activity.

Nursing training courses play a vital role in educating nursing students and they need to be of high quality to be able to train students to provide safe and quality care as qualified individuals. The aim of the current study is a comparison of the Iranian Nursing Ph.D. curriculum and the American Duke School of Nursing.

The current study is descriptive-comparative. In the study, the Iranian Nursing Ph.D. curriculum is compared with the Duke School of Nursing in the US. Data have been collected through searching on the websites of the Ministry of Health in Iran, the Duke School of Nursing, together with Persian and English databases. The adjustment between the two curricula is done using the Beredy method, which includes four steps of description, interpretation, proximity and comparison.

The Ph.D. curriculum in nursing in Iran is older than Duke School. Despite the centralized student admission method in Iran, Duke College operates independently in this regard. The presented courses in Duke Curriculum are more diverse and there is a lot of emphasis on statistics and research methods in the curriculum. The mission of Iranchr('39')s curriculum is defined at the national level, but Duke School has a cross-border perspective in expressing its mission.

Considering the existing challenges in the Iranian curriculum, it is necessary to seriously review the Iranian Nursing Ph.D. educational program to align with the needs of society, the health system, nursing and the needs of professors and students.

Cultural competence is an essential factor in providing effective services to care seekers. Providing cultural care is a necessity in nursing; thus, measuring cultural competence in nurses is of great importance. Accordingly, the current study aimed at introducing the scales for measuring cultural competence in nursing. 

The current narrative review study was conducted by searching the internet and library resources through credible databases. The keywords “cultural competence, cultural competency, cultural instruments, the measurement of cultural competency, nursing, nursing students, and cultural sensitivity” were used individually and in combination. The selected articles were in English, without any time limits, and only in the medical fields.

Among 16 articles related to cultural competence scales, 19 scales were discovered; 12 of which were in English and applicable in nursing. Nine tools were designed based on a conceptual framework/model, and only 6 of them received psychometric evaluations.

The comparison of the scales suggested that all of them were developed based on different conceptual frameworks; accordingly, various factors should be considered when using them. The compatibility of the scale with the culture and environmental conditions of the studied population, and the areas of cultural competence it investigates, are among such characteristics.

Ethical conflict is one of the problems of intensive care unit nurses that can occur for various reasons and have many consequences. Given the negative effects of ethical conflict and its impact on nurseschr('39') professional and ethical practices,it is important to identify factors associated with them that contribute to increasing the intensity and frequency of conflict. The purpose of this study was to determine the relationship between exposure to ethical conflicts with demographic characteristics and perceptions of the environment in nurses working in intensive care units.

This cross-sectional study was performed on251 nurses working in public hospitals affiliated to Ahvaz University of Medical Sciences. Samples were selected through census method and data were collected using demographic questionnaires, Nursing Questionnaire-Critical Care Version Ethical Conflict ،Perceptions of the clinical setting questionnaire. Statistical analysis was performed by SPSS 22 using ANOVA, independent t-test, Pearson correlation coefficient, and chi-square.

The findings indicated that there was a inverse correlation between ethical conflicts and age with (P<0.05)(r= -0 .129), intensive ward (P<0.05), experience (r= -0. 131) (P<0.05).Gender, shift،bioethics coueses had no significant relationship with ethical conflict (p> 0.05). the level of moral conflict in the private sector was moderate.

Nurses have a significant ethical conflict in the care.Nurses dont have a good perception of the environment and this exacerbates the conflict and has a negative impact on their career.The level and severity of ethical conflict in nurses is at a moderate level,recommended to investigate the frequency and severity of exposure to ethical conflict for intensive care unit nurses.

One of the common treatments for cancer is chemotherapy that is usually done by intravenous injection. Central catheters and portholes are used for the intravenous administration of chemotherapy drugs through peripheral vessels.

This study aimed to compare the caring outcomes of the two methods of drug injection through the peripheral vessels and ports in patients undergoing chemotherapy.

In this descriptive study, 68 cancer patients admitted to the Hematology and Oncology Wards of Shahid Baghaei Hospital 2 in Ahwaz during three months were evaluated in two groups of 34 patients receiving chemotherapy (one group via ports and one group via peripheral blood vessels). Data were collected by a questionnaire consisting of two parts: demographic information (sex, age, and type of disease) and information about the patient’s condition (drug injection method, serum, and catheter number), and an observational checklist including inflammation rate, drug extravasation, limitation of patientmovement,medical expenses, and patient satisfaction. Data were analyzed using SPSS version 24 software.

According to the results of the study, the two groups were compared in terms of inflammation (P = 0.0001, T = 4.908), drug extravasation (P = 0.0001, T = 3.872), movement limitation P = 0.000, T = 4.922) the cost of treatment (P = 0.0001, χ 2 = 56.973, P = 0.000, and patient satisfaction (P = 0.0001, T = -23.66).

Performing chemotherapy through the port has fewer side effects and brings more comfort to the patients.

Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major.

The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software.

Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients’ experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'.

According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.

Cultural competence is the ability to work effectively as an individual or an organization in the context of the cultural beliefs, behaviors and needs of customers and society. Due to the necessity of this feature in nurses, the present study aimed to investigate the level of cultural competence in employed nurses.

This descriptive study was performed on 230 nurses working in educational and private hospitals in Ahvaz and Isfahan, Iran, who were selected by random sampling with inclusion criteria. Data gathering tool was a researcher-made cultural competency questionnaire. Data were analyzed using SPSS 22 by describing and deduction examining like independent samples t-test, ANOVA, and Tukey test.

  Of the participants, 67.8% were women and 92.6% had undergraduate degrees. The average work experience was 10 years, and 69.1% of nurses reported experience of working with patients with different cultures. The mean score of nurseschr('39') cultural competence was in the average level (104.8±11.58). The results also showed that the mean score of cultural competence was the highest in cultural flexibility dimension (24.46 ± 3.46) and lowest in cultural desire dimension (10.73±3.90).

Due to the expansion of cultural diversity of patients in Iran, the average level of nurseschr('39') cultural competence in this study indicated the necessity of increasing the attention and planning of nursing managers to promote nurseschr('39') cultural competence.

The present study aimed to develop an instrument for assessing nursing students’ satisfaction with First Clinical Practical Education (SFCPE), and then to test the validity and reliability of the instrument.

In this methodological research, the views of a panel of 15 clinical professors, in terms of the clinical nursing principles and skills training, were used to develop the instrument. The content validity of the instrument was evaluated quantitatively and qualitatively based on the panel’s views. The data was collected from the questionnaire completed by 380 second‑ and third‑semester nursing students in 15 medical universities of Iran. The Exploratory Factor Analysis (EFA) was later performed to determine the construct validity of the instrument. The reliability of the instrument and stability analysis were evaluated using the internal consistency test by calculating Cronbach’s alpha and by the test‑retest method, respectively.

Throughout the development phase, 16 items were added to the SFCPE instrument, and a 42‑item instrument was later developed. During the qualitative and quantitative content validity reviews, the number of added items decreased to 38 items. Finally, a 37‑item instrument consisting of seven factors was developed. The Cronbach’s alpha coefficients of 0.95 and 0.75–0.9 were obtained for the whole instrument and the factors, respectively. Pearson’s correlation coefficient was within the normal range (0.71–1).

The developed SFCPE is a valid and reliable instrument that can be used for assessing the satisfaction of nursing students in terms of clinical nursing principles and skills.

Nowadays, home-based cardiac rehabilitation (HBCR) program is one of the major methods that can improve the quality of life of patients following coronary artery bypass graft surgery. The present study aimed to investigate the effect of a HBCR on the quality of life of patients following CABG.
Methods & Materials: In this clinical trial, 104 inpatients at Golestan and Imam Khomeini hospitals in Ahvaz in 2017, based on permuted-block randomization were assigned to an intervention or a control group. The intervention group received four training sessions for four days at the hospital and then six sessions of home-based cardiac rehabilitation (at 2-week intervals for three months). The Mac-New quality of life questionnaire was completed by the intervention and control groups before the surgery and three months after CABG surgery. Data were analyzed using the SPSS software version 22.

The postoperative mean scores for quality of life subscales and for overall quality of life in the intervention group were greater compared to the control group (P<0.001). The obtained effect sizes were 1.17 for the emotional, 1.42 for the physical, and 1.91 for the social subscales and 1.67 for the overall quality of life. The Eta-squared value (0.408) indicated that the effect of the home-based cardiac rehabilitation program on the quality of life was significant (P<0.0001).

The study findings suggest that the home-based cardiac rehabilitation program has positive effects on the various subscales of quality of life. HBCR is recommended as a cost-effective care model for all patients attending heart surgery centers.
Clinical trial registry: IRCT20171114037468N1

Coronary artery disease (CAD) is the most common chronic disease with marked effects on different health aspects, which can affect the quality of life (QOL) of patients. Today, open heart surgery is one of the most common treatments for patients with CAD. This study was conducted to determine the QOL of patients before coronary artery bypass graft (CABG). This descriptive-analytical study was conducted in 2017 - 2018 on 104 candidates for CABG in the Golestan and Imam Khomeini hospitals, affiliated to Jundishapur University of Medical Sciences in Ahvaz. The subjects were selected using the convenience sampling technique. Data collection instruments included a demographic questionnaire and the MacNew quality of life questionnaire. Data was collected on the day before surgery and evaluated with mean, percentage, and frequency in SPSS 22. Findings showed that the overall QOL score was 87.3 ± 0.76. The score mean in the emotional dimension, physical dimension, and social dimension were respectively; 4.01 ± 0.72, 3.25 ± 0.78, and 3.45 ± 0.80. Regarding the effect of CAD on QOL of patients, healthcare providers should plan to improve their QOL.

Cardiovascular Diseases (CVDs) have been considered to be the leading cause of morbidity and mortality throughout the world. Various factors such as occupational and environmental risk factors affect CVDs. Nowadays, shift work is considered to be an occupational stressor. Previous studies have shown conflicting results regarding to the relationship between shift work and cardiovascular diseases. The aim of this study was to determine the relationship between shift work and the risk of cardiovascular diseases based on the Framingham Risk Score among nurses working in hospitals associated with Abadan Faculty of Medical Science during 2019.

This study is a descriptive-analytic study which has been conducted on 120 nurses divided to 60 shift workers and 60 day workers working in hospitals associated with Abadan Faculty of Medical Science. The participants were selected through stratified random sampling technique. Data were collected using two-section tools including demographic data (smoking and medical and occupational history) and the Framingham Risk Score which were collected through check lists and interviews. Blood pressure (BP) was measured using a digital measuring device. The participants' blood pressure was measured by standard method and two month follow-up. Measurements were taken at the beginning and end of the shift. Blood Total Chol and HDL were measured in a 5cc intravenous blood sample after 10-12 hours fasting time and were measured by standard laboratory technique. In all the tests, a confidence level of 95% and a significance level less than 0.05 was considered. Data were analyzed by descriptive and inferential statistics using SPSS version 22.

According to the results of this study it can be concluded that the mean age shift workers and day workers were 32.20±2.97 and 37.43±2.90 respectively. Also, job experience in shift workers and day workers were 8.40±4.42 and 14.10±3.12 years respectively. There was a statistically significant difference between prevalence of CVD risk and shift work based on Framingham Risk Score (p=0.04).

The results of this study revealed that shift work is a risk factor for CVD disturbances. These findings may be of use for nurses and other relevant authorities for screening and even preventing CVD

Knee osteoarthritis is the most common type of arthritis and musculoskeletal disease. Due to low efficacy and significant side effects of synthetic drugs in the treatment of this disease, many researchers are looking for drugs that besides effectiveness have fewer side effects, and recently ginger has become one of the most popular herbal remedies in the treatment of this disease in controversial researches.
The aim of this study was to determine the effect of ginger on pain and satisfaction of patients with knee osteoarthritis.
This study was a clinical trial. A total of 90 patients with knee osteoarthritis were randomly divided to ginger and control groups. In addition, treatment was prescribed by orthopedic specialists; the ginger group received two tablets of 500 mg/day for 12 weeks. The control group only received the treatment prescribed by the orthopedic specialist. Pain was measured using a linear visual assessment scale (VAS) and satisfaction using a researcher-made questionnaire at the beginning and end of the twelfth week.
There was no significant difference between pain scores of the two groups before the intervention, yet after the intervention, pain scores declined in both groups, but it was greater in the ginger group (P = 0.001). In terms of satisfaction with treatment, a statistically significant difference was shown between the two groups (P = 0.012), so that it was higher in the group receiving ginger. On the other hand, the incidence of side effects was not statistically significant between the two groups.
The results of this study showed that ginger is effective in relieving pain in patients with knee osteoarthritis and it can be used as a safe method to improve pain in patients with knee osteoarthritis.

Pressure ulcer is one of the main concerns of nurses in medical centers around the world, which, if untreated, causes irreparable problems for patients. In recent years, nitric oxide (NO) has been proposed as an effective method for wound healing. This study was conducted to determine the effect of nitric oxide on pressure ulcer healing.
In this clinical trial, 58 patients with pressure ulcer at hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences were homogenized and later divided randomly into two groups of treatment (nitric oxide cream; n = 29) and control (placebo cream; n = 29). In this research, the data collection tool was the Pressure Ulcer Scale for Healing (PUSH). At the outset of the study (before using the cream), the patients’ ulcers were examined weekly in terms of size, amount of exudates, and tissue type using the PUSH tool for 3 weeks. By integrating these three factors, wound healing was determined. Data were analyzed using SPSS.
Although no significant difference was found in terms of the mean of score size, the amount of exudates, and the tissue type between the two groups, the mean of total score (healing) between the two groups was statistically significant (P = 0.04).
Nitric oxide cream seems to accelerate wound healing. Therefore, considering its easy availability and cost-effectiveness, it can be used for treating pressure ulcers in the future.