فهرست مطالب seyedreza mazloom

One of the many complications and problems that the elderly experience due to the aging process is dependency in activities of daily living and also a decrease in the sense of hope. The purpose of this research was to determine the effect of leisure time physical activity program on activities of daily living and hope in the elderly.

This study is a randomized clinical trial type intervention on 60 elderly people randomly selected from two health centers in Mashhad who met the inclusion criteria and the health of the participants to participate in the intervention was approved by the medical group of the health center. It was done. For this purpose, first, before the intervention, questionnaires of demographic information, independence in performing daily activities of Barthel and Snyder hope scale were completed from the samples in person and through interviews.Then group leisure activities were performed in 8 sessions, once a week (8 weeks), and each session lasted at least 45 minutes. Two weeks after the completion of the intervention in the experimental group, questionnaires were completed by someone other than the researcher in both groups. The collected data was analyzed and reported using SPSS-V25 software and relevant statistical tests.

The mean and standard deviation of the age of the research units in the intervention group was 68.30 ± 3.31 and in the control group was 68.33 ± 2.85 years. The demographic and main variables of the study were compared and tested in the two intervention and control groups, and the two groups were homogeneous in terms of demographic variables, the amount of hope and the amount of activities of daily living.In the post-intervention stage, the mean and standard deviation of the hope score in the intervention group was 49.36±3.12 and in the control group was 46.96±5.32. The independent t-test showed that after the intervention, the hope score in theintervention group was significantly higher than the control group (P=0.03). The average score of activities of daily living in the post-intervention phase was 95.33 ± 4.40 in the intervention group and 92.36 ± 5.86 in the control group. The independent t-test showed that after the intervention, the score of activities of daily living in the intervention group was significantly higher than the control group (P=0.031).

The results of this study generally indicate that the physical activities of the elderly in their free time can play a significant role in the state of their activities of daily living and hope, therefore, it is recommended to the relevant planners and officials to provide The facilities increase the level of functional independence and hope among the elderly in the community.

The birth of a baby with congenital heart disease (CHD) is a source of stress, so the mother should be empowered to face difficult conditions. increasing resilience increases a person's ability to deal with stressful factors. This study was conducted with the aim of determining the effect of empowering mothers of infant with congenital heart disease on their resilience.

This research study was a semi-experimental clinical trial on 60 mothers with infant born with CHD in the NICU department of Imam Reza Hospital. Available sampling method and study tools were demographic questionnaire and Connor's resilience scale. The stages of empowering mothers were followed in 9 sessions of 30 minutes in the form of knowledge and skill training in the field of physical and emotional care. After collecting the data, statistical analysis was done with spss 20 software.

The results of the present study showed that the empowerment program of mothers of infant with CHD had a statistically significant effect on their resilience after the intervention and when the infant was one month old compared to the control group (p<0.001), but the average score Resilience within the group (in the intervention group) is not significant (p=0.61).

According to the results of the research, the empowerment of mothers with emphasis on emotional empowerment should be considered in nursing care programs for infants with CHD hospitalized in the neonatal intensive care unit.

Coma is one of the severe complications of traumatic brain injury. The study aimed to determine the effect of auditory sensory stimulation on the level of consciousness and cognitive function of patients with traumatic brain injury.

Methods & Materials:

 This study is a triple-blind randomized controlled clinical trial on 60 patients with traumatic brain injury selected using consecutive sampling. They were then randomly assigned to control and intervention groups. The patients in the intervention group received auditory sensory stimulation (twice a day for 15 minutes), while those in the control group only received the routine sounds of the ward (through headphones) for six days. The data were measured using the Glasgow Coma Scale and the Rancho Los Amigos Scale daily. SPSS software version 22 and descriptive and inferential statistics were used for data analysis.

According to the independent samples t-test, there was a significant increase in the level of consciousness on the third, fifth, and sixth days after the intervention among the patients in the intervention group compared to the control group (P=0.001). The findings of two-way repeated measures ANOVA revealed that auditory sensory stimulation could lead to a statistically significant improvement in the cognitive function of patients in the intervention group compared to the control group (P= 0.003).

Because of the improvement of the level of consciousness and cognitive function resulting from auditory sensory stimulation, this method is recommended to improve consciousness and cognitive function in patients with traumatic brain injury.

Poor health literacy can increase the risk of chronic disease, especially in vulnerable groups such as pregnant women. Meanwhile, the self-care component can be affected by the level of health literacy. Despite the importance of this issue, accurate information on health literacy in Afghan pregnant mothers living in Iran, and its relationship with their self-care is not available. Therefore, the present study aimed to determine the relationship between health literacy and self-care in Afghan pregnant mothers with chronic diseases (diabetes, hypertension and heart diseases).  This descriptive correlational study was performed with the participation of 242 Afghan pregnant mothers referring to the health centers and maternity hospitals affiliated to Mashhad University of Medical Sciences in 2021. Mothers were selected by cluster and stratified methods. The study tools included the questionnaires of pregnant mothers' health literacy, gestational diabetes self-care behavior, hypertensive self-care, and heart disease self-care. Data were analyzed using SPSS 25 statistical software and descriptive statistics and Pearson correlation test.  The findings showed that there is no significant direct linear relationship between health literacy and self-care of Afghan pregnant women with diabetes (p= 0.001; r = 0.74), and hypertension self-care (p= 0.09; r =0.434), while health literacy has a significant inverse relationship with cardiovascular diseases self-care (p= 0.003; r = -0.37).  The findings of this study showed the significant relationship between Afghan pregnant mothers’ health literacy and their self-care ability, so it is necessary to pay attention to the increasing awareness of this growing population, which are mainly marginalized in metropolitan areas and are at risk of no awareness

After a coronary artery bypass graft (CABG), diabetic patients deal with various hemodynamic disorders. This study aimed to compare the effect of cardiac rehabilitation (CR) on the functional capacity of diabetic and nondiabetic patients following CABG.

This descriptive‑analytical study was performed on 40 diabetic and nondiabetic patients attending a similar CR program following CABG. The subjects were selected by convenience sampling and were divided into two diabetes and nondiabetes groups. All patients attended 24 exercise sessions held 3 days a week. The functional capacity of patients was measured and recorded with the metabolic equivalent of Task criterion before and after the CR program. In addition, data analysis was performed in SPSS version 19.

In this study, the mean age of the diabetic and nondiabetic patients was 54.45 ± 5.82 and 56.85 ± 5.36 years, respectively. There was no significant difference between the research groups regarding the systolic and diastolic blood pressure (P > 0.05). The mean functional capacity in the diabetes and nondiabetes groups was 4.5 ± 0.79 and 5.2 ± 1.7 before the rehabilitation, respectively. However, the results of Mann–Whitney U‑test were indicative of a lack of a significant difference in this respect (P > 0.05). After the CR program, the mean functional capacity in the diabetes and nondiabetes groups was 5.7 ± 1.31 and 6.3 ± 1.7, respectively, demonstrating an insignificant difference in this regard (P > 0.05).

According to the results of the study, there was no significant difference between the diabetic and nondiabetic patients, who underwent CABG, after a CR program. However, replication of the study is warranted.

Women experience many complications due to the physical and psychological changes of menopause. One of the most important of these complications is depression. Due to the side effects of chemical drugs, the use of herbal remedies has been considered by women today. This study was performed with aim to determine the effect of oral capsule of ocimum basilicum leaf extract on depression in menopausal women.

This triple-blind two-group randomized clinical trial study was performed on 60 menopausal women referred to Mashhad health centers in 2019-2020. Women eligible for the study received one 500 mg capsule of ocimum basilicum leaf extract or placebo for one month. Depression was assessed before and after the intervention with DASS21 tool. Data were analyzed by SPSS software (version 21) and independent t-test, Mann-Whitney, Wilcoxon. P < 0.05 was considered statistically significant.

Before the intervention, the mean score of depression in the ocimum basilicum group was 8.8± 6.3 and in the placebo group was 8.6 ±6.3, which was not statistically significant and the two groups were homogeneous (P = 0.904). After the intervention, the mean score of depression in the ocimum basilicum group (5.9± 5.3) was significantly lower than the placebo group (9.2 ± 6.2) (P = 0.049). The difference in the score of depression after the intervention compared to before the intervention decreased by 2.8 ± 4.5 in the ocimum basilicum group and increased by 0.6 ± 2.4 in the placebo group and this difference was statistically significant (P <0.001).

Consumption of basil leaf extract capsules led to decrease in depression score in menopausal women. Therefore, it can be used as medicinal plant to reduce depression in menopausal women.

Considering the importance of keeping the country population young and fertility control, particularly, in the elites and with regard to the influence of spiritual well-being on fertility behaviour and childbearing in the religious cultural context of Iran, the present study aimed to determine the relationship between spiritual well-being and fertility preferences in the selected higher education centers of Mashhad, Iran in 2019.

This correlational study was carried out on 296 married students of Mashhad University of Medical Sciences and Razavi University of Medical Sciences in Mashhad, Iran, who were selected using multistage sampling between 2018 and 2019. The data were collected using three questionnaires of individual-educational characteristics, spiritual health, and Miller's Fertility Preferences and Childbearing Questionnaire. The data were analyzed using descriptive statistics and Pearson’s correlation coefficient.

In terms of spiritual health, 222 (75.0%) students had a moderately score. Also, 143 (48.3%) subjects had a high level of willingness to have children. Regarding the number of children, 88 (29.7%) students tended to have two children, and 75 (25.9%) participants were inclined to have children within 1 to 2 years after marriage. There was a significant linear relationship between the spiritual health and fertility preferences of the students (r=0.29; p <0.001).

It is recommended to develop a codified and local curriculum for the education of spiritual health, and its impact on the fertility preferences of the students. However, further studies in this regard are suggested.

The postpartum period is a time of extreme vulnerability to various psychiatric disorders, such as anxiety, which exert profound negative impacts on the health of neonates, mothers, and families. Therefore, it is necessary to perform some interventions to prevent and mitigate postpartum anxiety. The current study investigated the effect of counseling based on Gamble's approach on postpartum anxiety in primiparous women.

This randomized clinical trial was carried out on 60 primiparous women referred to Mashhad health centers in 2018. Participants in the intervention group received midwife-led individual counseling based on Gamble's approach during three prenatal and one postpartum session, apart from routine prenatal care. The control group only received routine prenatal care. A questionnaire to measure demographic and obstetric data as well as Depression, Anxiety and Stress Scale-21 (DASS-21) were used to collect data. The obtained data were analyzed in SPSS software (version 16) using Mann-Whitney, chi-square and independent t-test.

There was no significant statistical difference between the two groups before intervention (p <0.05). The mean and standard deviations of women's anxiety in the intervention and control groups were obtained as 7.5±1.1 and 8.6±2.4, respectively. The results of the Mann-Whitney test demonstrated that the level of anxiety in the intervention group was significantly lower, compared to that in the control group (P=0.008).  

Counseling based on Gamble’s approach reduced postpartum anxiety in primiparous women. Therefore, it can be used during pregnancy and postpartum period as an effective, simple, and adverse-effect-free method to reduce anxiety during the postpartum period.

Menstrual health is a major part of adolescent health; nonetheless, the majority of girls do not have sufficient knowledge of menstrual changes. Therefore, current study aimed to assess effect of menstrual health education adopting the peer education method with the participation of mothers on adolescents' menstrual health behaviors.

This randomized clinical trial was conducted on 60 students with regular menstruation in two groups. Two high schools in Mashhad were selected by drawing lots as a random block. In intervention group, at first 10 students received the educational content and then were asked to train 4-7 of their classmates. Mothers of subjects received two 2-hour sessions with the same content. Control group received routine education by a health educator. Data were collected by a valid, reliable self-structured questionnaire of menstrual health behaviors, before intervention and also after the end of  the first and second menstrual cycles and were analyzed in SPSS software (version 16) using  Mann-Whitney, Friedman, and independent samples t-test .

Based on the results, mean score of menstrual health behaviors significantly increased in the two groups (p <0.001). However, mean score of menstrual health behaviors in intervention group was significantly higher, compared to the control group (after the end of the first and second menstrual cycles) (p <0.001).

peer education with participation of mothers was more effective in enhancement of adolescents' menstrual health behaviors, compared to the traditional routine method. It is recommended that health professionals apply participatory teaching methods for education of health issues, including menstrual health.

Colorectal cancer and its treatment have short-term and long-term side effects for patients. One of the factors affecting these side effects is the nursing care method. This study was conducted to determine the effect of care based on the critical pathway on the duration of hospitalization, complications of the disease, and satisfaction with nursing care in patients with colorectal cancer. In a cluster-randomized controlled trial study, 70 patients with colorectal cancer were randomly selected from two hospitals of OMID (N=35) and GHAEM (N=35) in Mashhad, Iran. They were assigned to intervention and control groups. The data were collected using a characteristic of patients, and satisfaction questioner, a checklist of patient status and nursing performance, and analyzed by SPSS software version 18. There was a significant difference in the mean of satisfaction of patients from nursing care and length of hospital stay between pathway and routine care group (P<0.001). There were no significant differences between pathway and routine for the postoperative complications after 12 weeks of follow-up. Our study indicates that critical pathway care can increase the satisfaction of patients and decrease the duration of hospitalization. Future studies should investigate how to increase other clinical outcomes in the oncology wards.

Hemorrhoids is one of the most common problems during pregnancy. Lifestyle modification recommendations are associated with patients' noncompliance. The potential therapeutic properties of coconut oil on hemorrhoids have been suggested, but its scientific evidence has not been reported, therefore this study was performed with aim to determine the effect of coconut oil ointment on hemorrhoids symptoms in pregnant women.

This randomized clinical trial was performed on 60 pregnant women referred to comprehensive health services centers in Mashhad in 2018-2019. The subjects were randomly divided into intervention and control groups. In the intervention group, one applicator of coconut oil ointment was applied twice a day for two weeks; they also received lifestyle modification recommendations. The control group only received lifestyle modification recommendations based on national guidelines. The improvement of hemorrhoids symptoms was measured on the first, seventh and fourteenth days using Visual Analog Scale (pain, prolapse, itching and overall score of hemorrhoid symptom). Data were analyzed using SPSS software (version 16) and Mann-Whitney, Independent T and Friedman tests. P<0.05 was considered statistically significant.

The mean score of pain, prolapse, itching and overall score of hemorrhoid symptoms in coconut oil ointment group significantly decreased compared to the control group (p<0.05). In the intra-group evaluation, in the coconut oil ointment group, the pain score measured by day was significantly different (p<0.001) but in control group this difference was not significant (p=0.050).

Coconut oil ointment is effective in improving the hemorrhoids symptoms, therefore it is recommended for pregnant women with hemorrhoids grade 1 and 2.

Chronic pain is common in the elderly. Distraction is one of the important uses of cognitive-behavioral techniques and humor is one of the distraction techniques used in pain control. The aim of the present study was to determine the impact of humor therapy (HT) on quality and fear of pain in nursing homes.

We conducted a randomized clinical trial study on 55 elderly who had experienced chronic pain for at least 3 months and residing in nursing homes in Mashhad, Iran, 2016. The sampling was of convenience type as well as random allocation of nursing homes to two groups; the one receiving HT (n = 28) and a control group (n = 27) living in two similar nursing homes. The experimental group received 6 sessions of humor therapy over 6 weeks and the control group received the routine care. To this end, pain quality and fear of pain were assessed at the first, after the 3rd and 6th sessions in both groups respectively using the McGill Pain Questionnaire and Fear of Pain Questionnaire. The main data were also compared using the Mann-Whitney U test.

Total pain quality and fear of pain before the study was homogeneous in both groups (P > 0.05); but after 6th sessions in humor therapy the score of total pain quality decrease from 3.5 ± 1.1 to 2.4±0.7 (P < 0.001) and the score of fear of pain decrease from 36.0 ± 1.4 to 30.6 ± 0.8 (P < 0.05). These results were not significant in control group (P > 0.05).

HT as a low-cost method can be an effective way to reduce the quality and fear of pain in elderly pain.

The decision on whether or not to do episiotomy is ultimately made by midwives. Problem-solving is an essential skill in the workplace situations, which help overcoming unpredictable circumstances without relying on the others. The aim of this study was to investigate the effect of problem-solving skills training on the frequency of selective episiotomy among midwives. This randomized clinical trial was conducted on 60 midwives with a minimum of 6 months work experience at selected maternity hospitals in Mashhad, Iran in 2012. The participants were assigned into two intervention (N=30) and control (N=30) groups. The intervention included two 4-hour problem-solving skills training sessions. The midwives in the intervention group conducted two primiparous births before and two after the intervention. The control group just conducted four births. Both groups were asked to complete demographic, occupational as well as Baron problem-solving questionnaire before and after the study and their practice was assessed as selective or non-selective episiotomy based on a checklists.Data were analyzed in SPSS software (version 16) using the Chi-square, Wilcoxon and Mann-Whitney U tests.  There was no significant difference between mean scores of the problem-solving skills among midwives in intervention group before and after the intervention (23.2±2.2 vs 23.1±2, P=0.320). It was the same for control group (P=0.537). Also, no significant difference was observed between the two groups regarding selective episiotomy before (P=0.847) and after the intervention (P = 0.582); although, the rate of selective episiotomy in the intervention group was higher before than after intervention (33.3% vs 41.7%). Problem-solving skills training had no effects on the increased number of selective episiotomies. More research studies with larger sample size are recommend.

One of the most important factors for couples' happiness is having a good sexual function. One of the issues that affect couples' sexual function is their temperament. In this regard, the present study was conducted to determine the relationship of hot and cold temperaments with sexual function among women of reproductive age. This descriptive-correlational study was conducted on 200 non-pregnant women aged 20-40 years referring to the health centers of Mashhad, Iran, in 2017. The study population was selected using convenience sampling technique. The data were collected using the temperament questionnaire, 21-Item Depression, Anxiety, and Stress Scale, Female Sexual Function Index, and Female Sexual Distress Scale. Data analysis was performed in SPSS software (version 16) using independent t-test, Mann-Whitney U test, and Spearman’s rank-order correlation. Sexual function and all its subscales had a significant relationship with hot temperament. In this regard, the subjects with a higher score in sexual questionnaires had hot temperament (P<0.05). In addition, the total score of sexual function and subscales of libido, satisfaction, and pain during intercourse showed a significant relationship with cold temperament (P<0.05). The hot temperament subjects had a higher sexual function, compared to the cold temperament ones (P<0.001). Based on the findings, women with hot temperament had a better sexual function, compared to the cold temperament ones. Consequently, the healthcare providers should pay more attention to women with cold temperament in order to promote their sexual function.

Cesarean section (C-section) has often been one of the most common surgical procedures for women. It can be associated with several psychological and mental factors. Recently, spirituality related to adaptation with stressful situations has also been emphasized. Therefore, the purpose of this study was to investigate the relationship between spiritual health and pain intensity following a C-section. This cross-sectional study was conducted in Sayyad Shirazi Hospital, Gorgan city, Iran in 2013-2014. To this aim, 200 pregnant women, who wanted to undergo C-section were selected through convenience sampling method. The data were collected via demographic characteristics form, well-being Questionnaire at the beginning of the study, and Visual Analogue Scale at three stages of immediately, one hour, and 6-8 hours post-delivery. All the data were analyzed by statistical tests, including Pearson’s correlation and independent t-test using SPSS Version 16. This cross-sectional study was conducted in Sayyad Shirazi Hospital, Gorgan city, Iran in 2013-2014. To this aim, 200 pregnant women, who underwent C-section were selected through convenience sampling method. The data were collected via demographic questionnaire, Paloutzian and Ellison well-being Questionnaires (SWBQ,1982) at the beginning of the study, and Visual Analogue Scale at three stages of immediately, one hour, and 6-8 hours post-delivery. Data were analyzed by statistical tests, including Pearson’s correlation and independent t-test using SPSS Version 16. According to the results of this study, no relationship was found between the pain intensity after C-section and spiritual health at several stages of post-delivery phase.

Postpartum blues is the most common postpartum mood disorder, which can turn into a chronic depression.. Therefore, the prevention of this disorder is effective for the improvement of family mental health. The present study was conducted to investigate the effect of Melissa officinalis(Lemon balm) on the incidence of postpartum blues. The present triple-blinded placebo-controlled clinical trial was performed on 60 women with cesarean section(C- section)at teaching hospitals affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, in 2016-2017. The participants were randomly divided into case and placebo groups. The case group was administered lemon balm capsules (500 mg) from the first day after cesarean section three times a day for 10 days. Edinburgh postnatal depression scale was completed by all subjects at three stages, namely on the 3rd-5th,10th, and 14th days after C-section. The data were analyzed by SPSS software (version 16) using independent t-test, as well as Mann-Whitney U, Chi-square, Fisher's exact tests and Friedman test. P-value less than 0.05 was considered statistically significant. The Fisher's exact test showed that the incidence rates of postpartum blues on the 3rd-5th , 10th, and 14th days after C-section were 3.3% and 43.3% (P<0.00), 3.3% and 50% (P<0.00), and 0% and 33.3%  (P<0.00) in the case and placebo groups, respectively. The results of the two-way ANOVA test revealed that the depression score increased with maternal age due to the intervention (P=0.046). The present study showed that the use of lemon balm could reduce the incidence rate of postpartum blues, which is one of the most common postpartum psychiatric disorders, without the development of possible side effects. Therefore, it is recommended to use it especially in susceptible women after their delivery.

Estrogen and androgen deficiency in menopause leads to poor vulvovaginal blood flow, vaginal dryness, and dyspareunia which can reduce the quality of life among the women. In this regard, this study investigated the impact of date palm pollen capsules on vaginal lubrication and dyspareunia in postmenopausal women.
The present triple-blinded, placebo-controlled clinical trial was conducted on 60 menopausal women aged 40-65 years, who referred to the health centers affiliated to the Mashhad University of Medical Sciences, Mashhad, Iran, in 2015. The subjects were randomly assigned to two groups of intervention and placebo (n=30), receiving date palm pollen and placebo capsules (350 mg, daily), respectively, for 35 days. The data were collected at two stages (at the baseline and after treatment) using the Female Sexual Function Index, a part of which evaluated vaginal lubrication and dyspareunia. Data analysis was performed in SPSS (version 16) using the independent t-test, Mann-Whitney U test, and ANCOVA.
There was a significant difference between the two groups after the intervention in terms of vaginal lubrication (P As the findings indicated, the administration of date palm pollen could improve vaginal lubrication and reduce dyspareunia in the postmenopausal women.

Prematurity and the admission of preterm infants in neonatal intensive care units (NICUs) may pose emotional and practical challenges for parents and can cause acute stress disorder (ASD) in their mothers in case of mismanagement. Emotional support training to fathers may prevent mothers from these symptoms. Therefore, we aimed to investigate the effect of training emotional support to fathers on ASD symptoms in the mothers of preterm newborns admitted to NICUs.
This clinical trial was conducted on 61 parents, 31 of whom were assigned into the intervention group, with preterm infants admitted in NICUs of Omolbanin Women's Hospital, Imam Reza Hospital, and Ghaem Hospital in Mashhad, Iran, 2016. The parents in intervention group were trained the skills of emotional support in one 120-minute session. Then, they received the educational content in the form of a brochure. The participants in control group received routine care. Prior to the intervention and four weeks after the birth, the mothers in both groups completed the Stanford Acute Stress Reaction Questionnaire (SASRQ) and the emotional support scale (ESS). Data analysis was performed using independent and paired t-tests, as well as Mann-Whitney U, Chi-squared, and Fisher’s exact test and two-way analysis of variance in SPSS software, version 16.
The mean scores of SASRQ obtained by the intervention and control groups were 20.7±11.0 and 54.6±24.3, respectively in post-intervention phase. The results of the independent t-test showed a significant difference between the groups in terms of SASRQ scores (P Given the positive effect of training emotional support to fathers on ASD symptoms in mothers of preterm newborns admitted to NICUs, it is recommended to plan and implement such training courses for fathers during and after birth.

The most important barriers to patient education are nurses’ poor motivation and training, and poor quality of managerial supervision. Clinical supervision could be a powerful tool for overcoming these barriers. However, the associated patient, staff, and organization-related outcomes still require further research.
Aim: The present study aimed to evaluate the patient-, staff-, and organization-related outcomes of group clinical supervision with the goal of improving patient education.
This quasi-experimental study was conducted on 35 nurses and mothers of 94 children admitted to the surgery and nephrology wards of Dr. Sheikh Hospital, Mashhad, Iran, in 2016. A 3-month clinical supervision program consisting of support, education, feedback, and facilitation stages was implemented with the assistance of education facilitators. The data were collected using the questionnaire of patient’s satisfaction with nurses’ education, Herzberg’s job motivation questionnaire, and the checklists of nurses’ education performance and quality of education documentation. Data analysis was performed by Mann-Whitney U test, Fisher’s exact test, and independent-t test in SPSS, version 14.
The mean ages of the nurses, patients, and mothers were 30.3±6.7, 5.2±3.8, and 32.2±6.2, respectively. Mann-Whitney U test showed a significant improvement in patients’ satisfaction with nurses’ education performance (PImplications for Practice: Group clinical supervision could improve the quality of education documentation, nurses’ education performance, and patients’ satisfaction with provided education.

Parenthood is always a big challenge, especially primiparous who first encountered the baby, but the multiparouse encounter with new challenge, the study. "A comparative postpartum of stress and stressors of Appearance, care and behavior of neonate in the primiparity and multiparity in first and second month after delivery"was performed
This was conducted on 400 primiparous and multiparous no problem with medical and psychological term healthy child qualifies, referring to health centers of Mashhad days 28-8 after giving birth in 1390, based on sampling multistep cluster quit was available. The instruments used in this research unit questionnaire consisted of demographic characteristics, pregnancy and childbirth, baby, Stress Questionnaire of appearance, behavior and care of neonate. Data questionnaire reliability and validity have been verified in the first two months postpartum were collected. The data were analyzed using descriptive analytic statistics by SPSS.
The results showed that primiparous women appeared in all these aspects appearance, behavior and care of neonate causing more stress than multiparouse. The difference was significant were(p. According to encounter more stress primiparous women with children teaching them seem to be associated with beneficial results and Alsoconsidering that the the two groups will vary stressors should teach and inform the two groups look different

Aim. The aim of this study was to assess the causes of dysfunctional ventilatory weaning response after cardiac surgery
Background. One of the most important complications after cardiac surgery is the prolonged mechanical ventilation, because it is associated with the increase in mortality (30-40%). Extubation of endotracheal tube within the 6 hours post operation is considered as a gold standard improving heart function, increasing patients’ comfort, decreasing respiratory complication, and decreasing cost and hospitalization. The prolonged mechanical ventilation and dysfunctional ventilatory weaning response (DVWR) are the risk factors for cardiac surgery and controlling and preventing them is necessary.
Method. This was a descriptive cross-sectional study in which 80 patients admitted to Cardiac Surgery Department of Imam Reza Hospital in Mashhad were selected within a 4 months period by convenience sampling method. Patients with mechanical ventilation over 6 hours were recruited. Data were analyzed in SPSS software.
Findings. DVWR was significantly associated with smoking (p=0.03), and delayed recovery from anesthesia was the most common reason associating with DVWR (55.3%).
Conclusion. By controlling factors of the DVWR, we can reduce the duration of mechanical ventilation.

Patients often name post-operative pain as the most horrifying aspect of the surgery. The purpose of this study was to evaluate the effect of communication with patients on post-operative pain and agitation in the patients recovering from endoscopic sinus surgery.
This was a randomized clinical trial. Sixty patients scheduled for endoscopic sinus surgery were randomly allocated to control and intervention groups (30 patients in each group). A supportive and informative session was established for 20-30 minutes in two stages for the intervention group while the control group received routine information. After surgery, pain and agitation were assessed using the non-verbal pain scale, visual analog scale and Riker's sedation-agitation score.
The average pain scores in the recovery room by non-verbal pain scale and visual analog scale were (3.4±1.6) and (6.2±3.0) for the control group and (1.2±1.5) and (3.0±3.3) for the intervention group, respectively (P≤0.001). The average agitation score in the recovery room for the control group and the intervention group were (4.6±0.6) and (4.1±0.3), respectively (P=0.008).
The results demonstrate that simple communication techniques before the surgery can be effective in reducing post-operative pain and agitation in patients recovering from endoscopic sinus surgery.

Pregnancy is associated with extensive mental and physical changes in pregnant women. Stress, anxiety and depression are factors affecting pregnant women’s performance that lead to lack of attention to their own self-care. Orem's self-care theory is one of the most widely used theories in the field of self-care. This study was performed with aim to investigate the relationship of self-care behaviors in pregnancy based on Orem’s theory with stress, anxiety and depression in women at risk of preterm delivery.
This descriptive correlational study was done on 176 pregnant women in 24-26 week of pregnancy at risk for preterm delivery referring to health centers affiliated to Mashhad University of Medical Sciences in 2015. The research tools included Holbrook risk-scoring for preterm labor questionnaire, demographic and obstetric questionnaire, Hart prenatal care actions scale and DASS21 (stress, anxiety and depression questionnaire). According to Holbrook risk-scoring for preterm labor questionnaire, the subjects who met inclusion criteria were selected. Self-care behaviors were assessed according to Hart prenatal care actions scale, and stress, anxiety and depression were evaluated according to DASS21 questionnaire. Data were analyzed using SPSS software (version16) and using Pearson and Spearman correlation tests. P There was inverse linear significant relationship between prenatal self-care and stress (P =0.004) and depression (P =0.032). But no significant relationship was seen between prenatal self-care and anxiety (P =0.374).
The increasing stress and depression in women at risk of preterm delivery reduce self-care behaviors in these patients. Therefore, management and identifying of pregnant women at risk for stress and depression and planning for reducing their stress and depression will lead to increased self-care behaviors in women at risk for preterm delivery.

One of the most widely used theories in the field of self-care is the Orem's theory. According to this theory, patients can recover more quickly and holistically if they carry out their own self cares to the best of their ability. This study was performed with aim to investigate the application of Orem's theory for promotion of self-care behaviors of pregnant women at risk for preterm delivery.
This clinical trial was done on 176 pregnant women at 24-26 gestational week at risk for preterm delivery who referred to health centers of Mashhad University of Medical Sciences in 2015-2016. The research tools included Holbrook risk-scoring for preterm labor questionnaire, demographic and obstetric questionnaire and Hart prenatal care actions scale. According to Holbrook risk-scoring for preterm labor questionnaire, the women who had inclusion criteria were selected. According to Hart prenatal care actions scale, the educational needs of intervention group and self-care behaviors were evaluated. Data were analyzed by SPSS software (Version16), and repeated measures ANOVA, Chi-square, Fisher exact and Mann–Whitney U tests. P The mean score of prenatal self-care was not significantly different in intervention and control group before educational intervention (P=0.899). But one week (P The educational intervention based on Orem’s theory is recommended to increase the prenatal self-care behaviors of pregnant women at risk for preterm delivery, identifying and training the prenatal self-care based on Orem’s theory for women at risk for preterm birth in health care centers.

Revising the medical education programs to meet the needs of society has become both a necessity and an important priority due to the considerable increase of population, changing patterns of diseases, and new health priorities. While this necessity has been highlighted in Iran’s Fifth Development Plan as well as its National 2025 Vision Plan, the determinants of social accountability have not been explained yet. This study aimed to develop determinants of social accountability in the Iranian Nursing and Midwifery Schools.
This classic Delphi study included thirty experts in Nursing and Midwifery Education, Research and Services selected based on purposive sampling and three rounds of Delphi technique and conducted in Nursing and Midwifery School of Mashhad University of Medical Sciences. The primary data were collected using an initial structured questionnaire prepared through extensive review of literature. SPSS 11.5 software was used to analyze the data. The interquartile deviation and percentage of agreement were also used to study the consensus of opinion by experts.
Finding obtained from the rounds of Delphi resulted in selecting 69 determinants out of the initial pool of 128 primary determinants of social accountability. The items were selected based on experts’ consensus and categorized under three mainactivities of Nursing and Midwifery School, namely education, research, and service.
Social accountability determinants were explained by 69 items for Schools of Nursing and Midwifery in Iran. The proposed determinants can be used by managers and authorities of Nursing and Midwifery School, policy makers, and evaluating institutions associated with them to ensure realizing social accountability goals.