zahra jannat alipour

Pain and its control is a significant health problem worldwide. The present study aimed to determine the effects of white noise (bird sound) on the severity of muscle vaccination pain in children under two years old.

This study was a case-control study conducted in 2021. The samples included seventy children under two years old referred to the health centers in Ramsar City, Iran. The samples were selected using the convenient sampling method and divided into experimental and control groups. The data were collected using the demographic characteristics questionnaire, facial expression, and pain assessment in pediatric patients (FLACC). They were then analyzed by SPSS16 using an independent t-test and analysis of covariance (P<0.05).

A significant difference was observed between the severity of muscle vaccination pain in children in the two groups (p=0.042); the pain intensity mean in the experimental group (6.45±2.01) was lower than the control group (8.94±1.28).

This method can be a harmless and inexpensive intervention to reduce pain intensity and behavioral pain responses in infants during painful procedures, especially vaccination.

Due to the importance of breastfeeding and the necessity of identifying the factors affecting the creation and promotion of this behavior, this study aims to determine the relationship between sleeping place, duration of weaning time, and breastfeeding in Children aged 2-3 years.

This study was descriptive and analytical-correlational research in 2021. The participants were 214 children aged 2-3 years old from the health centers of Ramsar city, Iran. The sampling method of the present study was convenient. The tool of the study was a researcher-made questionnaire on infant sleeping places and breastfeeding. The data were entered into SPSS 16 and analyzed using the univariate chi-square test, Pearson correlation coefficient, and analysis of variance(P = 0.05).

Exclusive feeding 69.2% (148 people) of children who were exclusively breastfed and in the usual place of sleep, 36.4% (78 people) of children slept in a shared bed with adults, and 57.5% (123 people) shared a room. However, in a separate bed, 1.6% (13 people) slept in a separate room. The average age of weaning in children sleeping in a shared room in the mother’s bed and next to the mother is 1.27 times and 1.30 times that of children sleeping in a separate room, respectively. The relationship between Infant’s sleeping place and the duration of exclusive breastfeeding (P = 0.005), age of weaning onset (P = 0.007), length of weaning (P = 0.018), and definite age of weaning (P = 0.014) was significant. 56.5% of infants (n = 121) were female, and 56.1% (n = 120) had the first birth rank. Breast milk exclusively fed 69.2% (n = 148) of infants.

The results showed that the place of sleep has a significant relationship with the exclusive feeding of milk and the age at which the child is weaned. The results of this study can be useful in planning interventions to promote exclusive breastfeeding and increase the duration of feeding infants with breast milk.

 Patients undergoing coronary artery bypass graft (CABG) surgery have moderate to poor treatment adherence. These patients should benefit from simple, feedback-centered educational methods that produce deep and sustainable learning to improve their treatment adherence.

 The present study was conducted to examine the effect of the G5 training program on treatment adherence in patients undergoing CABG.

 A quasi-experimental, pretest-posttest study was conducted on patients undergoing CABG visiting Rouhani Hospital, cardiology clinics, and cardiology physicians' offices in Babol, Iran. The participants were selected by convenience sampling, and those who met the study inclusion criteria were randomly assigned to an intervention (n = 37) or a control group (n = 37). Patients in the intervention group received a G5 training program (i.e., bags containing flashcards with questions and answers on lifestyle after surgery) and a 30-minute face-to-face, daily training session. The control group received 30 minutes of daily self-care instruction from a cardiac surgery nurse. A demographic and clinical data checklist and Modanloo's Adherence to Treatment Questionnaire (MATQ) were used to collect data before, one month, and two months after the intervention.

 Most participants in the intervention and control groups were male (64.9% and 56.8%, respectively). The mean baseline treatment adherence score was 119.59 ± 7.82 in the intervention group, which changed to 152.62 ± 8.44 and 151.43 ± 8.65 one and two months after the intervention, respectively (P < 0.001). The mean baseline treatment adherence score was 120.35 ± 8.76 in the control group, which did not change significantly during the study (117.67 ± 6.28 and 116.97 ± 6.67 one and two months after the intervention, respectively). Repeated-measures analysis showed that the intervention significantly increased the mean treatment adherence score in the intervention group over time (P = 0.001). Female patients, patients with academic education, and urban patients scored higher on the query about the treatment, commitment to treatment, and sticking to treatment subscales, respectively.

 Education using the G5 method effectively improved treatment adherence of patients undergoing CABG. Nurses are suggested to follow up with patients, check their treatment adherence, and implement simple and low-cost educational methods, such as the G5 method, to improve patients' adherence to treatment.

Toddlerhood is an important period of a child’s development to master the functioning of the bowel and bladder sphincters. In this regard, the present study aimed to determine the relationship between parental awareness, self-efficacy, and defecation control skills in Iranian toddlers.

The present study was descriptive cross-sectional research. The questionnaires on Demographic information of children and parents, parental awareness and self-efficacy, and defecation control skills were completed by 72 mothers of children aged 18-24 months old in the city of Ramsar. The data were analyzed using SPSS 18, descriptive tests of mean and standard deviation, analytical tests of analysis of variance, independent t-test, and Pearson’s correlation coefficient.

The results showed that the awareness and self-efficacy level was at a medium level of 17.70 ± 2.9230.54 ± 7.15, and their children’s defecation control skill was at a high level8.88 ± 2.91 respectively. Also, there was a positive significant relationship between parental awareness (r = 0.19, P = 0.02) and self-efficacy (r = 0.20, P = 0.01) with defecation control skills. There was a significant relationship between the mother’s occupation (P = 0.04), the father’s age (P = 0.04), and parental selfefficacy (P = 0.04). In addition, a significant relationship was found between the child’s age (P = 0.03) and the mother’s age (P = 0.01) with the child’s defecation control skill.

Promoting awareness and self-efficacy in training defecation control skills is a necessity for parents, and the policymakers should include the integrated care of children in the educational programs of the Ministry of Health so that it is included in the agenda of routine care of health centers in the country.

Colonoscopy is one of the endoscopic procedures in the lower gastrointestinal tract known to cause anxiety in patients. Treating anxiety is important because it can have adverse consequences in patients undergoing colonoscopy. The aim of the present study was to investigate the effect of nonpharmacologic interventions on the anxiety level of patients before colonoscopy.

For this review study, the databases CINAHL, Google Scholar, Web of Science, PubMed, Scopus, SID, and Magiran were searched. Articles were searched using the keywords anxiety, anxiety before colonoscopy, nonpharmacologic interventions and colonoscopy. After a qualitative assessment, the studies were reviewed for relevance, and the desired outcomes were extracted.

In these studies, methods such as patient education and information, aromatherapy, massage therapy, music listening, and pre-colonoscopy counseling were presented as effective methods of nonpharmacological treatment of pre-colonoscopy anxiety.

The results of this study have shown that the use of various nonpharmacological methods, especially massage, music listening, and aromatherapy, is very effective and efficient in treating patients’ pre-colonoscopy anxiety and has a significant effect on reducing their anxiety. Moreover, the use of these methods leads to a reduction in the use of sedatives and the side effects caused by their use.

Frailty is one of the most common syndromes that can affect the prognosis and outcomes of the disease in the elderly undergoing hemodialysis. Therefore, it is important to identify the factors associated with frailty in this group of elderly people. The aim of this study was to determine the degree of frailty and its related factors in the elderly undergoing hemodialysis.

This descriptive-analytical cross-sectional study was conducted on 198 older adults undergoing hemodialysis, selected using the convenience sampling method. Data were collected using questionnaire of demographic and clinical characteristics, Edmonton Frail Scale (EFS), and Fall Incidence Questionnaire. The data were analyzed using SPSS 26 through independent t-test, analysis of variance (ANOVA) and Pearson correlation coefficient.

The mean age of the elderly undergoing hemodialysis was 68.10.±7.40 years, as well as 55.4% of them were male. The mean and standard deviation of the frailty score of the older adults undergoing hemodialysis were 6.91±3.12, and most of them were susceptible to frailty. The results indicated that there was a positive and significant relationship between frailty with demographic and clinical characteristics and falling history in these people.

To improve the prognosis in the elderly undergoing hemodialysis, health care professionals should evaluate frailty using standard tools, especially considering factors such as age, gender, comorbidities, and other relevant factors and should help prevent and reduce the adverse consequences of frailty on the quality of life of this group of elderly people by designing individual care and support programs.

One of the important and effective strategies to promote the comprehensive health of the elderly is the establishment of elderly-friendly hospitals. The purpose of this study was to investigate the characteristics and components of elderly-friendly hospitals and its role and importance in promoting the health of the elderly.

This review study was conducted through searching Irandoc, SID, PubMed, Magiran, Google Scholar, Scopus and SienceDirect without time limitation and focused on Elderly, Hospital, Elderly-Friendly Hospital and Senior Friendly Hospital (in English and Persian). In the initial search, 45 articles were found. After reviewing the inclusion and exclusion criteria, finally 28 articles were included in the study based on their relevance to the subject.

The design of the physical environment of the hospitals was not completely based on principles and components of the elderly-friendly Hospitals and elderly client's conditions and needs. In most hospitals, care and services provided to the elderly were not based on elderly -friendly principles, and medical staff did not receive the necessary training in the field of geriatric care, and there were no specialists in geriatrics in most of these centers.

In order to achieve elderly-friendly health care in hospitals, it seems necessary to apply strategies and make changes in various aspects of management, support, supervision and optimization policies, staff training and physical environment.

Decreased physical functioning and increased risk of fall are among the most common age-related problems among elderly people. This study aimed at assessing the effects of tai chi exercise on gait speed (GS) and fall rate among a group of elderly women in Iran.

This randomized controlled trial was conducted in 2018. Participants were sixty elderly women purposefully selected from comprehensive healthcare centers in Lahijan, Iran, and randomly assigned to an intervention and a control group. Study intervention was Yang-style tai chi exercise implemented in two group sessions per week for twelve consecutive weeks. GS was assessed before and after the intervention using the short physical performance battery and fall rate was assessed using a researcher-made self-report fall assessment checklist. The SPSS program for Windows (v. 18.0) was employed for data analysis at a significance level of less than 0.05.

Between-group differences respecting the pretest and the posttest GS were not statistically significant (P > 0.05). Moreover, posttest fall rate in the intervention group was less than the control group.

Tai chi exercise is effective in increasing GS and reducing fall rate among elderly women and is recommended for elderly people.

Family caregivers carry a heavy care burden when caring for the elderly with a chronic illness. Due to the fact that the care burden is affected by various factors; therefore, the aim of this study was to review the factors related to the care burden in family caregivers of the elderly with chronic diseases.

This review study was conducted through searching, Irandoc, SID, PubMed, Magiran, Google Scholar, Scopus and SienceDirect without time limitation with the keywords caregivers, family, elderly, care burden and chronic illness (in English and Persian). In the initial search, 65 articles were found so that after reviewing the inclusion and exclusion criteria, finally 36 articles were included in the study based on their relevance to the subject.

The care burden in family caregivers of the elderly with chronic diseases was influenced by factors related to caregivers (age, sex, marital status, health status, resilience and ...), factors related to patient (degree of patient dependence on caregiver, comorbidity of several chronic underlying diseases, cognitive disorders, age and...) and factors related to care (duration of care, assistance in daily living activities and…).

Considering that reducing the care burden of caregivers improves the quality of care for the elderly; hence, it is suggested that the findings of this study should be used in the development and implementation of support, educational and counseling programs to reduce the care burden.

The number of the elderly with chronic renal failure has increased across the world. Although hemodialysis is the most common and appropriate therapy for the elderly, it involves certain challenges. The aim of this study was to investigate the stressors and fatigue in elderly patients undergoing hemodialysis.

This descriptive cross-sectional study was performed on 60 elderly patients undergoing hemodialysis in two dialysis centers of Babol Shahid Beheshti and Behshahr Imam Khomeini Hospitals in 2018. Sampling was done using available method. Data were collected via demographic questionnaire, brief fatigue inventory and hemodialysis stress scale. Questionnaires were completed by the researcher and finally, data were analyzed by SPSS 19 using descriptive and analytical statistics.

Based on the results, the mean age of participants was 73.43±7.87. The mean score of fatigue in the elderly under hemodialysis was 7.51±1.37 and the mean score of stressors was 81.85 ± 9.31, indicating that there is severe fatigue and stress in the elderly. Among physiological stressors, the frequent and severe arteriovenous perforations as well as fatigue, and among psychosocial stressors, the fluid restriction, physical activity restriction, fear of loneliness and diet restriction were the most frequent stressors in the elderly undergoing hemodialysis. There was a significant relationship between duration of hemodialysis with stressors and fatigue (p<0/05).

The findings can help nurses develop age-appropriate strategies to prevent or reduce stressors and thereby promote optimal well-being of the elderly undergoing hemodialysis, who may spend the rest of their lives on hemodialysis.
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Nowadays, the expansion of urbanization and technology has caused a decrease in physical activity among society’s members. The exercise is one of the main ways to achieve the health. The aim of this study was to evaluate the perspective of women on the barriers to participation in exercise in Tonekabon City. In this descriptive-analytical study, the sample was 350 women aged 40-70 years in Tonekabon. Random samples were taken from three parks in Tonekabon. The data were collected using a researcher-made questionnaire including five areas of managerial, in-person, peripheral, psychological and time-limited factors based on Likert scale. The validity of the questionnaire was confirmed by physical education instructors and its reliability was confirmed using Cronbach's alpha coefficient of 0.91 (p<0.05). Totally, 40/1% of samples were 45-49.9 years old and%50 of them had the experience of group exercise at least once. There was a significant relationship between the barriers to participation in exercise and variables including educational level (p=0.00), income level (p= 0.004), having sportsperson in the family (p=0.001) and having sportsfriends (p=0.001), respectively. In this study, the barriers to participation in exercise from the perspective of women were factors such as low level of education, absence of a sportsperson in the family and sportsfriends, as well as lack of places suitable for women's exercise. By organizing effective factors in the participation of women in sport, the society's policymakers can take steps to maintain the health of this group. Providing educational programs through mass media on the beneficial effects of sports activities can make widespread changes in the perspective of women.

Fatigue is one of the most common complications in hemodialysis patients, which affects their physical, psychological, emotional and cognitive status. The aim of this study was to investigate the effect of tele-nursing on fatigue in the elderly undergoing hemodialysis. This quasi-experimental study was performed on 60 elderly patients undergoing hemodialysis. Samples were firstly selected by available sampling method according to sample characteristics and were then randomly divided into two groups of test and control. The data were collected by Fatigue Questionnaire in two stages before and after the intervention. Data were analyzed by SPSS software version 24 using descriptive and analytical statistical tests. The mean age of participants was 73.43 ± 7.87 years. According to the findings, 76.7% of the control group and 70% of the test group had severe fatigue before intervention. This amount reached 43.3% in the control group and zero in the test group after the intervention. The mean of the fatigue score before the intervention in the test and control group was 7.39 ± 0.96 and 7.64 ± 1.79, respectively. After the intervention was carried this score changed to 3.15 ± 1.26 and 6.25 ±1.25. Based on t-test, there was a significant difference between the mean of fatigue scores in the elderly patients undergoing hemodialysis before and after the intervention in the test and control groups (p<0/05). Tele- nursing has been effective in reducing the amount and severity of fatigue in the elderly undergoing hemodialysis. Therefore, it is recommended that nurses use this method as a non-drug intervention to reduce fatigue in the elderly undergoing hemodialysis.

Time management is one of the most important skills in learning activities. So that in some of the studies time management has been mentioned as one of the most effective factors affecting academic achievement. The aim of this study was to investigate the relationship between time management skills and academic achievement in nursing and public health students.
This is a cross-sectional descriptive-analytic study. This study was performed on 243 of nursing and public health students during the academic year 2016- 2017. Samples were selected by convenience sampling.Tesser time management questionnaire was used to measure students’ time management skills. Data were analyzed with SPSS 24, using descriptive statistics, Pearson correlation coefficient, independent t-test and ANOVA. In all statistical tests, p FINDINGS: Results showed a significant correlation between time management skills and academic achievement in students (p=0.0001). According to the study, there was a statistically significant relationship between time management skills with gender, age, education level, housing, the enthusiasm for education (p0.05).
In this study, time management skills has affected the student's academic achievement but student's time management skills was almost desirable. Therefore, it is recommended to upgrade student's time management workshops to be held.