zahra molazem

Proper self-care practices play a crucial role in the well being and longevity of patientswith cardiovascular disease. To effectively engage in self-care, it is imperative for patients to receiveadequate education and training on the self-care process. This study was conducted to determine theeffect of family-oriented education (FOE) on the self-care behaviors of patients with acute myocardialinfarction (AMI). In this randomized clinical trial study, 70 patients hospitalized in two hospitals in Shirazduring November 2021-April 2022 participated after the first AMI. Patients were randomly assignedinto control (N=35) and intervention groups (N=35) based on random allocation. In the interventiongroup, an educational program was conducted for patients and active family members during threesessions of 45 to 60 minutes. The control group received routine care. Demographic information formand Self-Care Agency scale was completed by the patients before the educational intervention, onemonth, and two months after the educational intervention. Data analysis was done through SPSS 22using Chi-square test, independent t-test, Fisher’s exact, and Friedman test. P˂0.05 was considered asthe statistical significance level. There was no significant difference in self-care behaviors between the two groups before theintervention (P=0.71). The mean score of self-care behaviors in patients one month (P<0.001) and twomonths (P<0.001) after FOE in the intervention group showed a statistically significant difference withthe control group. Also, the mean score of self-care behaviors two months after the education in theintervention group was significantly higher than before and one month after the intervention (P<0.001). Given the positive effect of FOE on self-care behaviors of patients with AMI, it isrecommended that educational interventions related to the treatment plan of these patients with theparticipation of families should be conducted.Trial Registration Number: IRCT20211116053078N1

Poor reporting during patient handoff from emergency medical technicians to the emergency department can threaten patients’ safety. This study aimed to determine the effect of training on the quality of patient handoff from emergency medical technicians to the emergency department of the surgical emergency center.

This quasi-experimental study was conducted at Shahid Rajaee Surgical Emergency Center in Shiraz, Iran. The study sample included 80 emergency medical technicians with a mean age of 31.12±6.2 years, who were selected by simple random sampling and divided into two experimental and control groups by permuted block randomization. Data were collected by observing the handoff of three patients by each technician before and after the intervention with a rating scale developed by the researchers. The intervention consisted of a 4-hour training workshop about principles of patient reporting and handoff for emergency medical technicians. Data analysis was performed using descriptive statistics, chi-square, independent, and paired sample t-tests using SPSS version 20. The significance level was less than 0.05.

After the intervention, the mean score of patient handoff quality in the experimental group (29.94±2.73) compared to before the intervention (24.58±3.38, P<0.001) and compared to the control group (23.94±2.83, P<0.001) was significantly higher.

The findings showed that reporting training to emergency medical technicians can help to improve the quality of their patients’ handoff to emergency departments.

Nurses who are occupied in emergency departments play a critical role in health services provision and patient care. Considering the importance of providing appropriate and immediate care in emergency departments, nurses need to acquire sufficient skills and up-to-date knowledge.

This study aimed to identify the educational needs of nurses working in the emergency department and explore strategies to meet challenges against the elimination of these needs.

This qualitative study was conducted using a content analysis approach. This study selected the emergency departments of two large educational hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran. This study was conducted on 15 emergency department nurses selected via purposive sampling with maximum variation within January 2020 and March 2021.The data were collected by performing 15 in-depth, semi-structured interviews (11 face-to-face and 4 telephone interviews due to the coronavirus disease 2019 pandemic) and making field notes. Then, the recorded interviews were transcribed verbatim and analyzed using the qualitative content analysis approach proposed by Graneheim and Lundman. The consolidated criteria for reporting qualitative studies (COREQ) was used to report the findings of this study.

Three main themes, namely the need for comprehensive and continuous education, challenges of managing educational needs, and strategies to meet educational needs, were extracted following data analysis.

Clarifying the educational needs of nurses and exploring strategies to solve these challenges can be effective by providing continuous practical trainingandadopting effective teaching-learning strategies to promote nurses’ educationandimprove their performance in clinical skills. Accordingly, the provision of appropriate infrastructure for mobile health applications and utilization of mobile-based educational applications in emergency departments have to be taken into account by hospital managers and health policymakers. 

The complexities of the health care system have imposed complex ethical issues on nurses, resulting in moral distress in all categories of nurses with various specialties. Psychiatric nurses are also exposed to moral dilemmas because they care for vulnerable patients with delusions and suicidal ideation problems. Due to the different experiences of moral distress in different cultures, settings, and wards, we studied this phenomenon in Iranian psychiatric nurses.

We conducted this study to investigate the causes of moral distress in Iranian psychiatric nurses.

This qualitative study was conducted based on a conventional content analysis on 12 psychiatric nurses selected by the purposive sampling method in 2020 in Shiraz, Iran, considering the maximum diversity. Data were collected through semi-structured interviews with participants for an average of 40 - 60 minutes per interview until data saturation.

We obtained causes of moral distress from 7 categories and 20 subcategories. The categories included “lack of professional competence”, “organizational culture”, “individual factors”, “environmental and organizational factors”, “management factors”, “weaknesses in professional and effective communication”, and “observation of moral dilemmas by nurses”.

This study demonstrated various causes of moral distress that managers should consider by providing a safe environment and appropriate facilities for psychiatric nurses.

Asthma is one of the most common chronic diseases that cause respiratory problems. Different training programs can effectively alleviate its symptoms and minimize the complications. This study aimed to determine the effect of a training program on asthma control.
This interventional study was performed on patients referred to clinics affiliated with Shiraz University of Medical Sciences. Cases were selected by convenience sampling and divided into two intervention and control groups, each consisting of 29 patients. Before the training program, data were collected using an asthma control questionnaire and a spirometry test, and they were analyzed using statistical tests and software.
The results showed that after the intervention, the mean of all spirometry test indices and asthma control scores of the questionnaire increased in the experimental group. Alterations in the mean scores of the clinical manifestations and spirometry indices (FEV1, FVC, FEV1/FVC, and FEF25%-75%) before and after the intervention in the experimental group were significant. After the intervention, all spirometry indices were increased in the experimental group compared to the control group (p<0.05).
The results showed the effectiveness of teach-back training in managing asthmatic patients. Therefore, this intervention can be used as an effective method to control asthma along with other methods such as exercise and medications.

Most hemophilia patients experience pain in their lives. Some complementary interventions might affect pain belief. This study aimed to determine the effect of Benson’s relaxation technique on pain intensity, pain belief and perception, and pain acceptance in hemophilia patients.
In this clinical trial study, 80 hemophilia patients were divided into an intervention (relaxation technique) and a control (routine care) group based on block randomization. This study was conducted in the hemophilia center of Shahid Dastgheib hospital affiliated to Shiraz University of Medical Sciences from October to December 2018. The intervention group listened to a voice containing relaxation technique twice a day for eight weeks. Numeric rating scale, pain belief and perception inventory, and chronic pain acceptance questionnaires were completed at the beginning and eight weeks after the intervention. Data were analyzed by SPSS 21 using independent t-test, Paired-t-test, Chi-square, Mann-Whitney U test, and ANCOVA. P-value <0.05 was considered as significant.
After the intervention, the mean scores of pain intensity, pain belief and perception inventory, and pain acceptance in the intervention group were 4.26±2.17, -13.35±1.50, and 67.24±9.49 and in the control groups were 5.85±2.61, -2±1.70, and 56.57±11.04, respectively. After the intervention, a difference was found between the groups regarding the mean score of pain intensity (P=0.007), pain belief and perception inventory (P<0.001) and its subscales (P<0.05) as well as total pain acceptance (P<0.001).
This study showed relaxation technique can be applied to reduce these patients’ pain intensity, improve their pain belief and perception, and enhance their pain acceptance.

Sudden cardiac death is the most common cause of mortality worldwide. Most cases occurat home and the individuals most likely witnessed are family members. Spouses play a significant role inthe recovery of such patients. We aimed to investigate the effect of Cardiopulmonary Resuscitation (CPR)and cardiac chest pain management trainings on the perceived control, depression, stress and anxiety in thespouses of the patients with Myocardial Infarction (MI). The present randomized controlled trial study was performed on 78 spouses of the patientsadmitted to Cardiac Care Unit of the hospitals affiliated to Shiraz University of Medical Sciences fromAugust 2013 to April 2014. The subjects were randomly assigned into intervention (n=40) and controlgroups (n=38). The intervention group took part in educational workshop on CPR and cardiac chest painmanagement and followed-up for six weeks. Data were collected using Depression Anxiety Stress (DASS)Scale and Rotter’s internal-external locus of Control Scale. Statistical methods of data analysis includeddescriptive statistics, Chi-squared test, paired sample t-test, independent sample t-test, one way analysis ofcovariance, and multivariate analysis of covariance. There were significant differences between intervention and control groups in perceived controland DASS subscales. After the intervention, perceived control scores reduced from 9.42±3.33 to 8.15±3.65(P=0.001); depression from 28.85±11.99 to 21.65±8.64 (P=0.001); anxiety from 26.6±9.46 to 20.70±6.29(P=0.02); and stress from 30.20±10.91 to 24.32±10.23 (P=0.01) in the intervention group. CPR and cardiac chest pain management trainings could effectively improve the perceivedcontrol, depression, anxiety, and stress in the spouses of the patients with MI.

Children are among the most susceptible groups of family violence and this is an important and worrying issue all over the world. Children with disabilities are more vulnerable to family violence. Children with autism are exposed to various types of violence due to their wide range of disabilities, as well as high tensions that are imposed on their families. Family violence against children with autism has not been studied in Iran, therefore, this study was conducted to explain the concept of family violence against children with autism from the perspectives of parents in Iran.

This is a qualitative research study. Data were gathered using individual and semi-structured interviews. Eighteen parents of autistic children were selected using purposeful sampling. Qualitative content analysis was used to analyze and interpret the data.

Four themes for family violence were defined with 9 sub-categories including physical violence, emotional violence, verbal violence and Sexual violence.

Based on the findings of the present study from the perspective of parents, autistic children need to be cared and educated in a safe environment where they are free from any kind of violence. Their privacy and individual identities are respected, and they are provided with the required treatment and education. These conditions would maintain the dignity of such children and consequently result in appropriate behavioral outcomes. Therefore, it is suggested that a culturally sound, and stable background be provided, which when supported by professional caregivers, will ensure that the rights of autistic children are protected and emphasized.

Parents of children with autism need to have unique competencies which are different from the competencies of parents with healthy children. Nurses and other health-care providers should know these competencies to be able to provide these parents with quality care and education. This study aimed to define the concept of parental competence from the perspectives of parents with autistic children. The main question of the study was, “What does parental competence mean?” This qualitative study was done in 2016 on 20 parents (12 mothers and eight fathers) of 20 autistic children. Parents were purposively recruited from the Autism Association of Shiraz University of Medical Sciences, Shiraz, Iran. Data collection was done through 16 semi-structured interviews and two focus group discussions. Interviews and focus group discussions were digitally recorded, transcribed verbatim, and analyzed using conventional content analysis. Data analysis led to the development of 13 subcategories, five main categories, and two main themes, namely, “restoration of family stability” and “excellence in child care.” The three main categories of the first theme were adaptation to the current situation, organization of family affairs, and improvement of satisfaction in the family. The second main theme also had two main categories, namely, self-confidence in child care and stability on the difficult path of child care. Parental competence among parents with autistic children is defined as “the ability to restore family stability and achieve excellence in child care.” Appropriate strategies are needed to evaluate and improve parental competence among parents with autistic children.

Diabetes patients are at risk of psychosocial problems. Some interventions might decrease these problems. This study aimed to evaluate the effect of coping skills training on depression, anxiety, stress, and self-efficacy of adolescents with type I diabetes.
This randomized controlled trial with pre- and post-test design was performed in the diabetes clinic in Shiraz from June to November 2015. This study was conducted on 100 adolescents with type 1 diabetes who were randomly divided into an intervention (receiving coping skills training in groups for eight sessions) and a control group (usual care). Depression, Anxiety, and Stress Scales (42-items, scores=0-42) and General Self-Efficacy questionnaire (17-items, scores=17-85) were used. The variables were measured at baseline and two months after starting the intervention. Data were analyzed using SPSS, version 16 through Chi-square test, independent t–test, and paired t-test. P After the intervention, the mean scores of depression, anxiety and stress in the intervention group were 5.41±4.58, 6.44±7.01, and 7.46±7.01, and in the control groups they were 19.73±11.80, 18.28±10.51, 21.10±10.94, respectively. Moreover, after the intervention, the mean scores of self-efficacy were 70.82±10.84, and 50.13±15.42 in the intervention and control groups, respectively. The results showed differences between the two groups regarding depression, anxiety, stress, and self-efficacy after starting the intervention (P As coping skills training reduced depression, anxiety, and stress and improved the patients’ self-efficacy, the use of this intervention could be a part of community-based nursing practice for adolescents with diabetes and more research for improving evidence-based practice in this regard are warranted.

Pain is one of the major problems for patients after cesarean section. The aim of this study was to assess the effect of amniotic membrane as cesarean wound dressing on pain after cesarean section.
This study was conducted on 90 pregnant women who underwent cesarean section in Amir-alMomenin hospital, Gerash, Iran. The participants were divided into 2 groups each of 45. The wound was dressed with amniotic membrane in one group and with simple gauze in the other group. Pain was measured and recorded in the 2 groups by visual analogue scale (VAS). The need for receiving analgesics 24 hours after the cesarean section was also assessed and compared between the 2 groups.
The results showed no signifcant difference between the 2 groups regarding the mean pain, 4 and 12 hours after the cesarean section (P=0.308 and P=0.628, respectively). However, a signifcant difference was observed between the 2 groups, in this regard, 24, 36, and 48 hours after the operation (P=0.026, P=0.026, and P=0.004, respectively). Moreover, the patients in the amniotic membrane group needed less analgesics compared to those in the control group 24 hours after cesarean section (P=0.041)
Use of amniotic membrane dressing can be effective in reducing pain after cesarean section and can eliminate the patients’ need for analgesics. Hence, it can be used as an effective complementary method along with usual analgesics for pain relief.

Along with an increase in the rate of cesarean sections, the complications and problems associated with this procedure have also increased in Iran. Factors such as complications associated with caesarean scars, the high cost of chemical treatments, and failure of medications in treatments have led to an increased use of traditional and biological therapies in the healing and preventing of cesarean wound infections.
To determine the effect of an amniotic membrane dressing on cesarean wound healing.
This study is a prospective, randomized double-blind clinical trial. Patients participating in the study were women who underwent cesarean sections at Amir-al-Momenin Hospital in Gerash, Iran. Patients were randomly divided into two groups (N = 45 for each group). In one group, the cesarean wound was dressed using an amniotic membrane; in the control group, the dressing was performed using a simple dressing. The wound healing was assessed by the Redness, Edema, Ecchymosis, Discharge, Approximation (REEDA) scale 24 hours and 8 days after the cesarean procedure.
The average REEDA score, reflecting wound healing was significantly different between the groups 24 hours after the cesarean section, which proved to be less in the amniotic membrane group (.00 ± .00 vs. 0.60 ± 1.30; P = .003). However, on the 8th day after the cesarean section, there was no significant difference between the groups (P = 0.078).
The findings of this study showed that the application of an amniotic membrane dressing can be helpful in early stage wound healing of cesarean.

Working in the complex and ever changing healthcare settings forces the nurses and nursing students to be equipped with lifelong learning skills. One of the lifelong learning skills is self-directed learning. This study aimed to explore the M.Sc. nursing students’ self-directed learning activities.
A qualitative design using conventional content analysis approach was used in this study. Semi-structured interviews were conducted with twelve Iranian M.Sc. nursing students who were selected using purposive sampling.
Data analysis indicated that the M.Sc. nursing students performed different activities in their self-directed learning. These activities were categorized into four main themes and ten subthemes. The main themes were “sensory perceptions”, “knowledge construction”, “problem-centered orientation”, and “interaction with others”.
According to the findings, the M.Sc. nursing students performed different intellectual and experiential self-directed activities for promoting their learning. Besides, the students’ perseverance and inquisitiveness played an important role in their self-directed learning in the challenging clinical environments.

Excessive iron accumulation in the visceral organs creates problems for patients with beta-thalassemia major. Despite chelation therapy, mortality rate from the complications of this disease is still quite high.
This study aimed to investigate the effectiveness of nutrition, exercise, and a praying program at reducing iron overload in patients with beta-thalassemia major.
Patients and This randomized clinical trial assessed the effect of the designed care program on iron overload. The study was conducted in 38 patients with beta-thalassemia major who ranged in age from 15 - 35 years and had been referred to the largest center for thalassemic patients in Shiraz. The patients were randomly assigned to an intervention (n = 18) and a control (n = 20) group. Blood samples were collected from the participants before and two months after the intervention. Then, the data were statistically analyzed using chi-square, Fisher’s exact test, Mann-Whitney U-test, Wilcoxon, independent samples t-test, and paired samples t-test.
The results showed that the mean level of serum ferritin significantly decreased in the intervention group two months after beginning the intervention. Also, the mean level of serum iron decreased in the intervention group, but the difference was not statistically significant.
The planned educational program could be used to reduce iron overload and ultimately improve the patients’ health status.

Pain, as a crucial subsequence of joint hemorrhages in hemophilia patients, is chronic, debilitating, and distracting. This study aimed to describe and interpret pain experiences of hemophilia patients in their lives.
This qualitative study with hermeneutic phenomenological approach was conducted on fourteen hemophilia patients who had been referred to a hemophilia center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The study question was “what is the meaning of pain in hemophilia patients’ lives? The data were collected through semi-structured interviews and field notes through purposeful sampling. Then, thematic analysis with van Manen’s six-step methodological framework was used. MAX.QDA qualitative software package, 2010, was used to analyze the data.
The three main themes that emerged in this study were “alteration in physical health”, “engagement in psychological problems”, and “impairment in social relationships”. Alteration in physical health consisted of three subthemes, namely “impairment of physical function”, “change in body physics”, and “disturbance in sleep quality”. In addition, two subthemes including “nostalgia of pain in adults with hemophilia” and “psychological distress” emerged from engagement in psychological problems. Finally, “loss of social activity” and “change in relationships” were related to impairment in social relationships.
The present study highlighted alteration in physical health, engagement in psychological problems, and impairment in social relationship as a result of pain in hemophilia patients. Thus, healthcare providers and family members have to pay special attention to these problems. Besides, providing complementary therapy interventions is suggested for reducing these issues.

Research shows that parents have an immense influence over their children’s behavior during adolescence. Adolescents who grow up with parents who are addicted to drugs and alcohol are more likely to turn to self-destructive behaviors such as suicide attempts. Because addiction in Iran is a primarily masculine phenomenon and in traditional Iranian culture, the father is responsible for family affairs and is recognized as the family provider, paternal addiction affects adolescent children. However, the impact of this type of parental addiction on adolescent suicide attempts has received little attention..
This study was conducted to assess the impact of paternal addiction on adolescent suicide attempts..
Patients and This was a qualitative study that used a grounded theory approach. Thirteen participants, from two hospitals in Shiraz (southern Iran), were interviewed. We used purposeful sampling, followed by theoretical sampling. Data were collected from in-depth semi-structured interviews. Data analysis was done using Strauss and Corbin’s (1998) approach, followed by the constant comparative method..
The mean age of the adolescents was 15.75 ± 1.83, and all of them were single. Five main themes were extracted from the data: mental health problems, relationship problems, financial problems, family problems, and imitation of risky behaviors..
The findings suggest that in addition to the need to consider paternal addiction in health care plans, it is also necessary to pay attention to other family members, including the adolescents themselves. Health care providers, including nurses, can use the findings from this study for the purposes of prevention and education..

Since suicide attempt among adolescents is a major challenge and the reasons why this age group attempt suicide are complex, the aim of this study was to investigate the risk factors that contribute to suicide attempt among adolescents.
In this qualitative content analysis, 14 adolescents (12–19 years old) who were admitted in two hospitals in Shiraz, Iran, were interviewed. Participants who tried attempt suicide with medication were selected by purposive sampling and the data were gathered by semi‑structured interviews. Data analysis was guided by the conventional approach of qualitative content analysis.
Three major themes and 13 subthemes emerged from data analysis. The main themes were: (a) Individual factors and experiences (psycho‑emotional problems, puberty, religious beliefs, stress management strategies, marriage and love, field and level of education); (b) family factors (family structure, family relationship, family economic features, family health conditions); and (c) social factors (suicidal behavior in others, media influence, professional support).
This study identified three major themes related to suicide attempt among adolescents in the context. As a result, suicide prevention and care provision should formulate a comprehensive method, considering the interaction of medical besides individual, familiar, and social factors in their assessment and care provision.

Suicide attempts are more common among adolescents than other age groups. Although suicide is considered a worldwide problem, but the related factors, to suicidal behavior are different in various cultures.. The purpose of this study is to identify themes that explain suicide attempt process among adolescents in Iran..Patients and This is a qualitative study carried out based on grounded theory. Key informants were 16 adolescents referred to two hospitals in Shiraz after suicide attempts. Also, 4 family members, a nurse, a psychologist, and a psychiatrist participated in this study. Sampling started with purposive sampling method and continued with theoretical sampling. Data were collected using semi-structured in-depth interviews. Data analysis was carried out using Strauss and Corbin approach and constant comparative method until the point of data saturation.. Five main categories, including personal factors and life experiences; family factors, social and educational factors, psychological-emotional problems, and stress control strategies were extracted from the data. The central concept in the data was to escape the painful psychological condition, which was in connection with other concepts describing the process of suicide attempts in adolescents.. This study identified 5 categories of concepts as main themes that can be used to explain suicidal attempt process among Iranian adolescents..

Being a nurse is more than just a series of business activities and skills. In fact, it is a part of the process of socialization, which is internalization and development of professional identity. Professional socialization is necessary for involving the students in professional practices. Thus, the purpose of this qualitative research was to increase the understanding of professional socialization in nursing and explore the related factors from the perspective of registered nurses and nursing students. In this qualitative design, data were collected on 43 nurses with a variety of experiences using semi-structured interviews and focus groups in the Shiraz University of Medical Sciences in 2012. Data were analyzed through inductive content analysis. The data analysis revealed two main categories: (1) sense of belonging with three sub-categories of theory-practice incongruence, educational experiences and tacit knowledge and (2) forming professional identity consisting of three sub-categories of relatedness, internal motivation and role model. This study demonstrates that in nursing, sense of belonging and professional identity contributes to professional socialization; it is suggested that these factors, which improve socialization in nurses, be taken into account by authorities.

Chronic renal failure disease is considered as one of the highest causes for mortality rate in Iran that affects on physical, psychological and social health aspects of patients. Various treatments like hemodialysis prolong the life of these patients, but they must tolerate many complications in many aspects. Due to the interactional and cultural nature, social support sounds to be vital and necessary to be investigated in patients.The aim of this study was to highlight perceived personal social support in hemodialysis wards as experienced by patients with chronic renal failure. A grounded theory approach was used in this qualitative research. Key informants were 22 patients who were treated by hemodialysis. Three nurses, 4 general practitioners, a specialist and two family members participated in the study, and they were interviewed from April to September 2012. Interviews were guided to unveil the perception of the drastic changes in their existence, needs for social support for the disease complications, and hemodialysis as a treatment process. Purposive sampling was done up to data saturation. Data analysis was done based on Strauss and Corbin method. Constant comparison analysis was done until data saturation. The research results appeared in 3 steps. In the first step, five main themes from 993 first codes were explored based on the meaning of general themes including “threats caused by disease and hemodialysis ", “searching for a social support", “attained social support”, “subjective values and beliefs”, and " acquired social support". The qualitative research completed our knowledge about patients’ needs and problems for social support. This issue reveals many problems for supporting the patients that are experienced by health team members, family members and social organizations. The findings reveals that individual experiences must be considered if social support should be done, and if health providers and policy makers consider these items in health facilities.

Burns are among the most prevalent mortality causes in developing countries, particularly Iran. In addition to large treatment expenses, burn victims suffer from long-term physical and psychological injuries.. This study intends to recognize the epidemiologic factors, causes and outcome of burns among hospitalized women in the Burn Wards of Ghotbeddin Hospital in Shiraz, Iran..Patients and This was a cross-sectional study carried out for a period of 2.5 years. The population consisted of all women hospitalized in the Burn Wards of Ghotbeddin Hospital from March 2009 until September 2011. Patients'' information was entered in a checklist using old records and documents after which the collected data were analyzed by SPSS software version 15.. A total of 619 women were hospitalized over a 2.5 year period due to burns. Their mean age was 25.78 ± 17 years with a range of 3 months to 103 years. Approximately half of the burns (45.4%) occurred at home, most of which (35.0%) occurred during the spring season. Kerosene was the most prevalent cause of burns (30.0%). Of these, 210 (33.92%) women were referred due to self-immolation; familial disputes were the main cause (46.6%) for these referrals. There were 232 (37.48%) cases whose deaths were attributed to burns and its complications during this period.. Annually, many women have been admitted and treated in burn hospitals, which result in tremendous financial expenses, physical deformities, psychological disabilities and mortality. Therefore, public education of burn prevention measures seems to be necessary..

Angioplasty is one of the most common methods for treating coronary artery diseases. However, a large number of those undergoing this treatment face psychological problems that negatively affect the quality of their life and recovery. We aimed to determine the effects of discharge planning on stress, anxiety, and depression in patients undergone percutaneous transluminal coronary angioplasty (PTCA). In this randomized controlled trial, 80 candidates for PTCA during January to April 2013 were randomly assigned to equal experimental and control groups. The patients in the experimental group participated in two training sessions before and after the procedure and an informative booklet was used for their training. These patients were followed by phone during the two weeks after discharge. The depression anxiety stress scale (DASS-21) was completed by all subjects upon admission, at discharge, and one month after discharge. Data were analyzed using SPSS software, version 18. t test was used as appropriated. The experimental group showed a statistically significant decrease in their stress, anxiety and depression a month after receiving the planned discharge (P<0.001). Although scores of stress (P=0.696), anxiety (P=0.110), depression (P=0.073) of the experimental group did not differ significantly on the day of discharge, the decrease was considerable compared with that of the control group. Using a planned discharge program in patients undergoing PTCA lowered their stress, anxiety, and depression.

Various treatments such as hemodialysis prolong the life of chronic renal failure disease patients who must tolerate many physical, emotional, social and economic difficulties. Therefore, social support is considered as a vital area of investigation for such patients.. In this qualitative research, a grounded theory approach was used and written as a content analysis form to study hemodialysis patients and family experience of perceived social support..Patients and Three nurses, 4 general practitioners, a specialist and two family members who participated were interviewed from April to September 2012 in Urmia, Iran. Interviews were guided to divulge the perception of changes in their lives, needs for social support for disease complications, and the type of treatment process. Purposive sampling continued up to data saturation. Data analysis was performed based on Strauss and Corbin Method. Constant comparison analysis was performed until data saturation.. The research results are shown in 3 steps. In the first step, 113 categories and four main themes from 993 first codes were explored. Social support was explored based on the implications of five general themes including “Perceived Threats Caused by Disease Complications”, “Searching for Social Support”, “Accessible Social Support”, “Beliefs and Values”, and “Perceived Social Support”.. The core variable of our research is acceptance of the reality of the conditions caused by the disease. The research finalized our knowledge about patient problems regarding social support and revealed many problems of supporting patients by Health Team Members, family members and organizations. The findings suggest that individual aspects of patient experiences must be considered if social support is to be given and Healthcare Providers have to facilitate positive health services..

Family caregivers usually report the reduction of their life quality due to one of the family member’s spinal cord injury. Thus, the present study aimed to investigate the effectiveness of psycho-educational interventions on the life quality of the family caregivers of the patients with spinal cord injury. The present randomized controlled trial was conducted on 72 family caregivers who had the primary responsibility of taking care of the patients with spinal cord injury. The participants were randomly divided into intervention (n=36) and control groups (n=36). The intervention group was involved in 90-minute educational sessions held once a week for four weeks. Both groups completed SF-36 questionnaire before and 2 and 6 weeks after the intervention. Then, the data were analyzed through independent t-test, Chi-square, and repeated measures ANOVA. All the caregivers had low quality of life and the lowest mean score was related to mental health in both groups. After the intervention, various dimensions of life quality had improved in the intervention group’s caregivers compared to the control group (P<0.05). The study results revealed the positive effect of psycho-educational interventions on the life quality of the caregivers of the patients with spinal cord injury. According to the results, the authorities have to pay special attention to the problems of this group and educational interventions have to be continuously followed.

Family caregivers are often responsible for providing significant support to relatives who require care at home. However, evidence suggests that family caregivers have limited information, resources or support to prepare them for such a role. Furthermore, family caregiving can be associated with negative physical and psychosocial outcomes. This study examines the short-term impact of psychoeducational interventions on genera health of family caregivers of patients with spinal cord injury. In this randomized controlled trial 62 caregivers, who had a primary role, participated in this study; these candidates were randomly categorized into intervention (n=33) and control (n=29) groups. Caregivers of the intervention group took part in the training sections, which were held once a week for four successive weeks (each session lasting 90 minutes), while control group received no training. Both groups completed the general health questionnaire (GHQ-28) before the intervention and 2 and 6 weeks after the intervention. A Chi-square test, independent t-tests, fisher exact test and Repeated Measures Analysis of Variance were used with the SPSS program for data analysis. The results have revealed that all the participants had mental health disorders, in both groups. After the intervention a significant difference was found between the two study groups regarding the mean score of mental health 2 and 6 weeks after the intervention (p= 0.001). Similar results were also obtained regarding the domains of mental health (p<0.05). The results revealed the effectiveness of psycho-educational interventions in improving general health among caregivers of patients with spinal cord injury. Designing continual programs along with consultation is essential and beneficial in promoting general health of family caregivers of spinal cord injury patients.