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Down syndrome (DS) is a chromosomal condition that is characterized by multiple pathological phenotypes. Oxidative stress caused by DS in individuals leads to DS phenotypes, which include various morphological abnormalities and externalizing disorders. Oxidative stress is an imbalance between the production of free radicals and reactive metabolites and the antioxidant defenses. Considering the physical and behavioral problems of adolescents with DS, the family is the first source of support for these adolescents. So one of the methods that can help adolescents with DS is family-based intervention. This study aimed to investigate the effects of family-based interventions on oxidative stress and social skills of adolescents with DS. The design of the research was quasi-experimental and pre-test/post-test with a control group. The study sample was 24 adolescents with DS in Rasht City, Guilan Province, Iran, in 2023, who were selected by the convenience sampling method. To collect data, blood laboratory evaluation and strengths and difficulties questionnaire (teacher form) were used before and after the training. The experimental group received behavioral management group training for 10 sessions, and the control group did not receive any training. Data were analyzed using univariate and multivariate analysis of covariance. The results showed that family-based interventions improved oxidative stress and increased social skills of adolescents with DS (p < 0.001). According to these results, family-based interventions can have important implications for social adaptation and the prevention of physical problems in individuals with DS. [ABSTRACT FROM AUTHOR]

Background. By utilizing the nursing care process, healthcare professionals can implement nursing knowledge effectively and efficiently, ultimately leading to a significant improvement in the quality of care provided. Objective. This study aimed to assess writing nursing care plan competence among Ardabil nursing students in northwestern Iran. Methods. The study involved 248 nursing students from the second to eighth semesters in three nursing and midwifery schools located in the Ardabil province of northern Iran. The data were collected using a simple random sampling method and included a demographic questionnaire along with a survey questionnaire on nursing care plan writing skills. This was conducted between May and June 2023. Descriptive statistics, Pearson correlation, t-test, ANOVA, and multiple linear regression analyses were conducted for data analysis. Results. The mean score (SD) for writing a nursing care plan in a student survey was 3.35 (0.57) on a scale of 1 to 5. The survey's weighted mean score for each dimension is as follows: data gathering (D) = 3.40 (0.73), identification of client's problems (P) = 3.40 (0.73), sustainable goals (G) = 3.31 (0.77), appropriateness of intervention (I) = 3.30 (0.67), and recognizing outcomes (O) = 3.37 (0.69). This indicates that the students performed well overall. However, the lowest score was in the appropriateness of interventions dimension. Multiple linear regression analysis revealed that four variables, mean score of grade point average (GPA), age, academic term, and time spent studying (hours per day), were significant predictors of the student survey's scores on writing nursing care plans. These variables could predict 61% of the total variance. Implication for Nursing Management. Nursing school administrators can establish programs to improve education and practice in nursing care plan development based on this study. They can use these findings to enhance nursing education and practice for students, which will ultimately lead to better nursing care plans. Administrators should ensure that students have the necessary skills for writing efficient care plans and provide training courses to improve their writing and critical thinking skills. Policies can be implemented to encourage students to increase their study hours and maintain quality care programs. Conclusion. Nursing students are skilled in creating well-written nursing care plans that follow the nursing process. The quality of these plans improves with higher GPAs and longer study hours. To enhance nursing care plans, nursing education should focus on developing skills and allocating sufficient time for studying and practicing. Collaborating with faculty and administrators, as well as using reliable resources, can also help improve the quality of care plans. [ABSTRACT FROM AUTHOR]

BACKGROUND: Healthcare organizations are among high-risk organizations due to the nature of their work as well as structural, physical and technological complexities. Accordingly, it is important to use risk management and control programs in all departments of these organizations. OBJECTIVE: The present study was conducted for the first time to evaluate the risk management status of the operating room and laboratory departments of Hamadan hospitals in 2022. METHODS: In this descriptive-observational cross-sectional study, laboratory and operating room departments were selected as the research environment. To conduct this research, a valid and reliable questionnaire was used to collect data, and the data were analyzed using SPSS 22 statistical software. RESULTS: The findings of the present study showed that the overall mean score of risk management status for the laboratory and operating room departments was 2.66 ± 0.15 and 2.89 ± 0.13, respectively. Furthermore, there was no statistically significant difference in the mean scores of the research components based on work experience, education level, and gender. CONCLUSION: It is suggested that the laboratory and operating room departments should focus more on adopting policies and solutions to improve the position of risk management, training and budget allocation for risk management. [ABSTRACT FROM AUTHOR]

Childhood cancer can affect meaning of life as well as spirituality, causing significant changes in the family members' life, accordingly, the present study investigated the relationship between depression and spirituality among mothers of children with cancer. This study is a descriptive-analytical research of correlation type was conducted on 70 mothers of children with cancer in 2019 by available sample method. The measurement instruments utilized included "Beck depression inventory-II," and spiritual attitude assessment" questionnaires. Results of this study indicated an inverse correlation between depression and spirituality in mothers of children with cancer. It seems that promoting the spiritual attitude of mothers can help them cope with depression. [ABSTRACT FROM AUTHOR]

Introduction: Ethical issues are among the first concerns and important issues in the daily care of nurses, so that nurses always try to maintain and observe them in order to provide better and more basic care to patients. Moral intelligence (MI) can provide a framework for the proper functioning of nurses. The main purpose of this study was to determine the relationship between patient safety culture and the MI of nurses working in hospitals in Iran, Guilan province. Methods: In the present study which was descriptive and correlational research, the sample was 400 nurses from Iran. Data were collected by a standardized and modified questionnaire "Hospital Survey on Patient Safety Culture (HSOPSC)", and "Lennick & Kiel's Moral Intelligence Scale". The collected data were analyzed by Spearman correlation and Friedman test via SPSS software version 13. Results: The findings of the study showed that the relationship between the patient safety culture and MI, was significant, and the total MI score (P<0.0001 and r=0.30). Conclusion: There is a positive correlation between MI of nurses and patient safety culture. Therefore, planning to increase the MI of nurses can lead to improve patients' safety culture. [ABSTRACT FROM AUTHOR]

Background and Aim: Urinary tract infections (UTIs) pose a significant global health threat, primarily attributed to bacteria producing extended-spectrum beta-lactamases (ESBLs), with limited treatment options available. The specific genotypes of ESBL-producing strains remain largely unexplored in Guilan (northern Iran). Hence, the objective of this study was to determine the prevalence of ESBL-producing extra-intestinal pathogenic Escherichia coli (ExPEC) among hospitalized patients in this area. Materials and Methods: In this descriptive cross-sectional study, 269 isolates were examined phenotypically for ESBL production. All ESBLs producing isolates were screened for the presence of virulence and housekeeping genes by polymerase chain reaction (PCR) using specific primers. The antimicrobial susceptibility patterns were determined using the disk diffusion method according to the CLSI recommendation. Results: Out of the 269 E. coli isolates, 107 cases (39.8%) were identified as producers of ESBLs. Antibiotic susceptibility testing conducted on the ESBL-producing isolates revealed the highest levels of resistance to cefotaxime, ampicillin, amoxicillin-clavulanate, cephalothin, cefixime, and ceftriaxone (100.0%). Nalidixic acid exhibited a resistance rate of 91.6%, followed by ceftazidime at 84.1%. On the other hand, the isolates showed the highest susceptibility to imipenem (94.4%), followed by nitrofurantoin (87.9%) and gentamicin (63.9%). Conclusion: The frequency of ESBL-producing ExPEC isolated from UTIs is concerning in Guilan. The most suitable antibiotic with the lowest risk of resistance for the patient can be prescribed using the updated susceptibility and resistance patterns of the bacteria. [ABSTRACT FROM AUTHOR]

Religiosity is a desirable alternative coping strategy for many people when facing negative life events including age-related infirmities and stressors. Religious coping mechanisms (RCMs) have been investigated meagerly with regard to religious minorities around the world and, to the best of current knowledge, no study has been conducted on Iranian Zorostrians to explore their religious coping mechanisms in dealing with age-related chronic diseases. This qualitative research, therefore, was aimed to canvas perceptions about RCMs that are utilized by Iranian Zoroastrian older adults to deal with chronic diseases in the city of Yazd, Iran. Semi-structured interviews were conducted with purposefully selected fourteen Zoroastrian older patients and four Zoroastrian priests in 2019. The main extracted themes included performing certain religious behaviors and having sincere religion-based beliefs as employed mechanisms for better coping with their chronic diseases. Prevalent dilemmas/barriers with mitigating impact on the coping capacities in dealing with a persistent illness was another predominant identified theme. Identification of RCMs that religious and ethnic minorities are using to better confront diverse life events, such as chronic diseases, could pave the path to expand new approaches in planing sustainable disease management and proactive quality of life improvement initiatives. [ABSTRACT FROM AUTHOR]

Introduction: Drug-drug interactions (DDIs) can reduce therapeutic efficacy and increase the duration and cost of hospitalization so that patients are sometimes exposed to significant complications and even death. Patients in the intensive care unit (ICU) are at higher risk of DDIs for a variety of reasons, including impaired absorption, decreased metabolism, and renal failure. The main objective of this study was to evaluate frequency, clinical ranking and risk factors of potential DDIs in the ICUs of 3 teaching hospitals in Ardabil. Methods : In this descriptive-analytical cross-sectional study, drug prescriptions 355 patients admitted to the ICUs were studied. Patient information including age, sex, diagnosis, number of prescribers, number of drugs, length of stay, and status of patients' discharge (recovery or death) were recorded and checked using the online software up to date and the book Drug Interaction Facts. Finally, the data were statistically analyzed using the SPSS software. Results : The number of patients studied was 355. The mean age of the patients were 51.88 ± 23.22 years, and on average, 8.45 drugs had been prescribed for each patient. The total number of DDIs was 1597 among which class X was 1.4%, class D was 26.2%, and class C was 67.7%. Four hundred ninety-seven unique pairs of DDIs were identified. Age, number of prescribed drugs and length of stay in ICU were associated with prevalence of DDIs. Age and number of drugs were also identified as the risk factors of patients' discharge caused by death. Conclusion : DDIs can complicate health state of patients in ICUs and may increase the length of hospital stay. Setting up computerized systems to alert drug interactions in hospital wards and pharmacotherapeutic intervention by clinical pharmacist can minimize DDIs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate neurocognitive functioning, quality of life, and global functional performance in Ultra-High Risk (UHR) individuals compared to Familial High-Risk (FHR) individuals for developing schizophrenia. Method: An observational cross-sectional study was conducted using a convenient sampling method at Roozbeh Hospital in Tehran, Iran, from June 2017 to January 2020. The study included 40 UHR individuals based on the Structured Interview for Psychosis Syndrome (SIPS) interview, as well as 34 FHR individuals due to genetic risk. Neurocognitive functioning, quality of life, and global functional performance were assessed by using the Cambridge Automated Neuropsychological Test Battery (CANTAB) and Controlled Oral Word Association Test (COWAT), Quality of Life Scale (QLS), and Global Assessment of Functioning (GAF). Results: UHR individuals for schizophrenia demonstrated significant lower scores in phonemic and semantic verbal fluency (t = 6.218, P < 0.001; t = 4.184, P < 0.001, respectively), more total errors for spatial working memory (t = -5.874, P < 0.001), and fewer problems solved in minimum moves in Stocking of Cambridge (SOC) (t = -2.706, P < 0.01) compared to FHR individuals. Intra-Extra Dimension (IED) did not differ significantly between the two groups. Moreover, the study indicated significant GAF decline (F = 79.257, P < 0.001) and lower total score on the QLS (t = -10.655, P < 0.001) in UHR compared to FHR individuals. Conclusion: It is possible to differentiate UHR individuals from FHR individuals through neurocognitive, quality of life, and global functioning assessment. [ABSTRACT FROM AUTHOR]

Background. Due to pathological differences with other chronic diseases, breast cancer causes psychological and emotional problems, such as negative feelings, anxiety and stress. Objectives. The present study aimed to measure the perceived level of stress and its socio-demographic predictors among women with breast cancer. Material and methods. This cross-sectional study was conducted on 166 women receiving treatment for breast cancer in Ghazi Tabatabaie, Al-Zahra, Vali-Asr and Shams hospitals of Tabriz-Iran in 2017. A convenience sampling method was employed to select the participants. The required data was gathered using Cohen’s Perceived Stress Scale (PSS) and then statistically analysed using the independent t-Test, one-way ANOVA, the Pearson correlation coefficient and multivariate linear regression analysis. Results. The mean (standard deviation) score of perceived stress was 32.9 (5.2) out of 56. The multivariate linear regression analysis showed that income, education of the mother and marital satisfaction were predictors of perceived stress. These variables predicted 21.5% of the observed variance in the total score of perceived stress. Conclusions. The results indicated that the mean score of perceived stress was higher than average in women receiving treatment for breast cancer. Therefore, it is necessary to develop and execute strategies to reduce stress in such patients, especially those with a family history of breast cancer. [ABSTRACT FROM AUTHOR]

This study analyzes recent scientific production in health literacy, assessing professional involvement and identifying areas for attention, gap addressing, and collaboration network establishment to enhance health outcomes. This comprehensive analysis examined scientific literature from 2018 to 2022 retrieved from Scopus database. The study focused on original articles in multiple languages and utilized tools like Biblioshiny and VOSviewer. It explored publication patterns, citation metrics, authorship trends, country contributions, keyword evolution, clusters of related terms, and professional involvement. This analysis yielded valuable insights into the research landscape of health literacy during the specified time frame, providing a deeper understanding of the field. The analysis encompassed 3,489 articles, revealing a significant increase in publications since 2019. Prolific authorship did not always correlate with citation impact in health literacy research. Nguyen H.C. emerged as the most cited author, particularly in COVID-19-related symptoms and health literacy. The analysis revealed significant contributions from influential countries such as the United States, Australia, Germany, Iran, and China. "Mental health" emerged as a prominent area of investigation based on keyword analysis. The study also found underrepresentation of nursing professionals but identified diverse health-related professionals and institutes as influential contributors. Health literacy publications, particularly related to COVID-19, have significantly increased, indicating a rising interest in addressing pandemic-related health literacy needs. The research landscape on health literacy is global, with the USA, Australia, Iran, China, Germany, Norway, and Denmark as leading contributors. Collaborations among institutions like the University of Houston, Uppsala University, and Mashhad University of Medical Sciences highlight the importance of international cooperation in advancing health literacy research. Research hotspots in health literacy include COVID-19, interventions, chronic disease management, healthcare access, and health disparities, guiding future research to improve health outcomes and tackle key challenges in the field. [ABSTRACT FROM AUTHOR]

Background: Alarm fatigue is a condition in which a person experiences sensory overload or desensitization in exposure to frequent non‐actionable alarms. Nurses are the main users of alarms in health care and their behaviors for alarm management influence the occurrence of alarm fatigue. Objectives: This qualitative research aimed to explore strategies used by nurses in dealing with nurses' alarm fatigue in the intensive care unit (ICU). Design: Qualitative research was carried out. Eighteen nurses working in ICUs were selected purposefully and were invited to take part in individual semi‐structured interviews. Collected data were analyzed using content analysis for developing categories and subcategories. Setting: Twelve ICUs in ten hospitals in four urban areas of Iran. Results: The research's main category was "smart care" consisting of two categories of "technologic actions" and "non‐technologic actions." Also, six subcategories were developed: "identifying the cause and taking timely actions", "personalized alarm settings", "reducing the number of unnecessary alarms", "effective teamwork", "improving the physical environment and ward arrangement", and "self‐calmness". Conclusion: Smart care by nurses included a set of active and proactive interventions developed through thinking and reflection and the use of information, skills, and experiences in order to manage exposure to alarm fatigue. Strategies used by nurses to prevent alarm fatigue can reduce the physical and psychological burden caused by frequent exposure to alarms in the ICU and consequently can have direct impacts on the quality and safety of nursing care. Clinical Relevance: Nurses in the healthcare process often experience alarm fatigue that is influenced by the cultural‐contextual aspect of care and the care environment. Smart care in terms of technologic and non‐technologic actions helps with the prevention of alarm fatigue. [ABSTRACT FROM AUTHOR]

Nurses are living in unprecedented times and the first-line against the COVID-19 pandemic. Nurses see controversial issues and face different complications that lead to work-life conflicts and compromise patient safety. Finding volunteer nurses is a fantastic adventure in such a situation. This study attempted to analyze volunteer nurses' experiences and factors influencing care in the COVID-19 pandemic situation. A qualitative descriptive study was applied from Jun to May 2021 in four different hospitals in Iran. Data was collected by Semi-structured interviews (N:13) with an open-ended question until data saturation. Data were analyzed using qualitative content analysis. The study was approved by the ethics committee of Birjand University medical and science and was conducted in achievement of the moral standards in terms of voluntary participation, the confidentiality of data, anonymity, and verbal informed consent. Two main themes obtained were "A faith-based approach" and "Care, an opportunity for spiritual transcendence." Five categories are "Belief in a divine destiny," "Transformation of life meaning", "spiritual hedonism", "Wise self-sacrifice", and "Sacred Defense" and ten subcategories were extracted that indicated volunteer nurses' perspectives during the COVID-19 outbreak. Cultural and individual factors lead to making decisions in nurses. Themes indicate that spiritual perspectives, ethical issues, and religious points of view are factors that can influence willingness, commitment, and function of nurses. Spiritual transcendence is one of the most valuable humanistic situations that manifest for nurses than normal circumstances. It is pivotal for senior educational and clinical managers to identify, develop, and strengthen the capacity of nurses with such a vision to recruit them in high-responsibility departments, and know-how to transfer these perspectives to the next generation of nurses. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To familiarise yourself with factors that can affect employees' attitudes towards their role • To recognise the link between improved productivity in healthcare services and ensuring patients' health and well-being • To learn how organisational justice can be linked to improved productivity in emergency nurses Background: Human resource management and employees' performance are fundamental to the success of healthcare organisations. Therefore, it is important to consider the factors that may affect employees' performance. Aim: To determine the relationship between perceived organisational justice, positive organisational behaviour (POB) and the productivity of emergency nurses. Method: This was a descriptive-analytical study that involved distributing questionnaires to emergency nurses working in hospitals affiliated with Mazandaran University of Medical Sciences in Iran. The researchers used proportionate stratified sampling to calculate the sample size. Three questionnaires were used to collect data on organisational justice, POB and productivity. The data were analysed using the Pearson correlation coefficient and multiple regression tests. Results: The questionnaires were distributed to 284 emergency nurses and completed by 234 of them. The results demonstrated a significant relationship between the productivity of the emergency nurses and the variables of perceived organisational justice and POB. Conclusion: Higher levels of perceived organisational justice and POB in the ED setting are likely to lead to increased productivity among emergency nurses, and as a result the quality of patient care is likely to improve. Therefore, healthcare organisations should pay particular attention to the application of organisational justice, with the aim of promoting POB among nurses and increasing their productivity. [ABSTRACT FROM AUTHOR]

Treatment adherence is a fundamental aspect of heart failure (HF) management. This study aimed to explore the experiences of facilitators and inhibitors of treatment adherence in patients with HF. This descriptive qualitative study was conducted from May 2020 to June 2021. Participants including people with HF, their family caregivers and physicians, and nurses were selected purposefully, with the aim of obtaining sufficient information power. Semi-structured interviews were used to collect data. Data were analyzed using thematic analysis. Two main themes "the driving forces behind treatment adherence" and "the deterrent forces behind treatment adherence" emerged from the analysis. The first theme contained the following subthemes: "supportive family," "positive personality characteristics," and "having health literacy." The second theme consisted of "negligence," "psychological problems," "cultural, social, and economic problems," "physical limitations," and "lack of self-care management knowledge." Nurses can consider facilitators and inhibitors of treatment adherence in designing educational and care programs for patients with HF. [ABSTRACT FROM AUTHOR]

Background: The main objectives of this study were the translation, cultural adaptation, and assessment of the psychometric properties of the Persian version of Mini International Neuropsychiatric Interview (MINI). Methods: All processes of linguistic methodology were conducted according to the published guidelines. A total of 180 patients with psychiatric problems were interviewed using MINI and Structured Clinical Interview for DSM-5(R) - Clinician Version (SCID-5-CV) by different interviewers. Another 30 patients were selected for examining the test-retest reliability. The study sample was recruited from a psychiatric hospital and a general hospital in Tehran, Iran. Face validity, feasibility, time of the interview, test-retest reliability, and concurrent validity were evaluated. Results: Mean interview time was 19.76 ± 10.30 minutes, indicating satisfactory feasibility. The test-retest reliability was very good (phi = 2, Cramer's V = 0.89, P < 0.0001). The kappa values showed good or excellent agreement between MINI and SCID-5-CV for psychotic disorders (0.88), substance-related disorders (0.86), bipolar disorder (0.85), major depressive disorder (0.84), obsessive-compulsive disorder (0.74), and mental disorder due to other medical disorders (0.7). However, the kappa values were found to be lower for generalized anxiety disorder (0.44) and posttraumatic stress disorder (0.32) diagnoses. Conclusion: The Persian version of MINI is a feasible, reliable, and valid instrument for diagnosing some mental disorders. Further research is needed to evaluate the validity of this instrument in other categories of psychiatric diagnoses in the general population. [ABSTRACT FROM AUTHOR]

Background: Breast self-examination (BSE) is an important part of health care for all women in every stage of life. This study aimed to investigate the effect of theory of planned behavior (TPB) on doing BSE in a sample of Iranian women. Methods: A cross-sectional study was carried out to examine the factors affecting the BSE in 400 women. Then, a quasi-experimental study was conducted on 200 subjects (100 in experimental group and 100 in control group). The educational intervention for the experimental group consisted of 8 training sessions. A questionnaire including demographic characteristics, knowledge, and constructs of TPB was used to measure BSE performance before and 6 months after the intervention. Constructs of attitude, subjective norms, and perceived behavioral control predicted the intention to do the BSE. Results: The mean age of the subjects was 31.65 ± 7.59 years. The studied variables predicted 38.7% of behavioral intention (P <.001, odds ratio = 0.387). Six months after the intervention, the experimental group showed a significant increase in the knowledge, attitude, perceived behavioral control, subjective norms, intention, and BSE performance compared with the control group (P <.001). Conclusions: This study showed that educational intervention based on the TPB was effective in promoting breast cancer screening behavior such as BSE. Therefore, it is suggested that health educators and health care planners use educational texts based on these constructs of TPB to increase their influence on individuals via screening behavior for breast cancer. [ABSTRACT FROM AUTHOR]

Background and Aim: Malaria is considered one of the most serious life-threatening diseases in Yazd, a central province of Iran, which hosts both domestic and foreign immigrants. This study aimed to investigate the trend of Malaria in Yazd during 2011-2020. Materials and Methods: In this descriptive retrospective study, all episodes of the disease (imported malaria) recorded at Yazd health center in Iran were carefully evaluated and reported. After preparing the peripheral blood smear and fixation with methanol, it was stained with Giemsa and examined with a light microscope by a skilled technician. Results and Conclusion: A total of 95 confirmed malaria patients were investigated from 2011 to 2020. Plasmodium falciparum was the predominant species with 81 cases (85.26%). The highest rate of infection was observed in 49 cases (51.63%) from Yazd city in the age group of 30-39 years with 29 cases (30.53%), and the working class with 69 cases (72.63%). Despite a decrease in Malaria cases through the implementation of the eradication program compared to the last two decades, its imported type is still showing up in the country, especially in the cosmopolitan city of Yazd, where domestic and foreign workers and tourists usually travel; thus it requires to be further monitored and controlled. [ABSTRACT FROM AUTHOR]

Given that physical activity can improve health, the present study was conducted to affect education based on the theory of planned behavior on the promotion of physical activity and awareness in the prevention of diabetes in students. This parallel quasi-experimental study with two equal groups of intervention and control was carried out in three stages by multistage sampling method. Students who were physically ill or had absence were excluded from the study. Only the intervention group received the required intervention and the evaluation was done before, immediately after and 3 months after the intervention in both groups. The educational program was implemented in various forms such as oral, pamphlets, brain storming, group discussions, role play for behavior modeling, and written media such as posters, and exercise demonstrations. Data collection was performed in primary schools of Mashhad. The questionnaire was contained; demographic information, diabetes awareness, physical activity based on the theory of planned behavior and physical activity (IPAQ). Data analysis was done by SPSS-16 software using Fisher's exact test, Chi-square, and marginal longitudinal models at the significance level of 0.05. The mean scores of knowledge (p < 0.001), subjective norm (p < 0.001), perceived behavior control (p = 0.015) and physical activity (p < 0.001) immediately after the intervention were higher in the intervention group compared to the control group and the differences were significant. Results of this study supported the effectiveness of education based on theory of planned behavior in the promotion of physical activity and knowledge of students regarding diabetes prevention. [ABSTRACT FROM AUTHOR]

Religious practices can raise the sense of merit and hope through overcoming the feeling of isolation. Studies conducted in this area have indicated that patients may desire to have their spiritual needs met. Nonetheless, sufficient attention has not been paid to these special needs. Therefore, this study aimed to identify the barriers to the provision of spiritual care for hospitalized patients. This is an action research study in which a total of 11 nurses and 76 hospitalized patients were recruited using purposive and convenience sampling, respectively. Data were collected using a combination of qualitative and quantitative methods. In the action cycles, the participants' concerns were examined, constructed, then evaluated, and re-constructed using reflective assessment. The qualitative and quantitative data were analyzed using the content analysis approach and the Mann–Whitney U, Chi-squared, and t-tests, respectively. At the first stage, the results of the content analysis showed the lack of professional knowledge and the existence of organizational barriers in the provision of spiritual care for patients. Reflection in the final stage led to the discovery of four concepts including (a) perceived advantages of change in performance, (b) being capable of providing spiritual care, (c) getting positive feedback, and (d) preparation for improving the provision of spiritual care. The results of the quantitative analysis indicated a significant increase in the mean score of patient satisfaction after the provision of spiritual care (p =.001). The results of this study led the authors to a deeper understanding of various dimensions of spiritual care among patients hospitalized in the cardiology ward and ultimately improved the patients and their families' level of satisfaction. [ABSTRACT FROM AUTHOR]

The aim of this study is to build a dynamic systems model (DSM) in order to construct scenarios for the future of university–industry collaboration (UIC) in Iran. A mixed research methodology was used and Fahey and Randall's (1998) six stages of scenario development were followed. To identify the key variables (forces that contribute to the promotion of UIC), the relevant innovation systems theories and literature related to UIC considering macro and micro environment was explored. A questionnaire was designed to identify the scenario driving forces of UIC in Iran and 90 respondents participated from both university and industry side. In order to construct a DSM based on Iranian context, generating and interpreting scenarios, 25 interviews were conducted with the major players of UIC including university professors, industrial experts and also experts from government institution associated with two Iranian cluster industries (Automotive and Biotechnology). These experts were selected based on a snowball sampling technique. Theme analysis was used to analyse the qualitative data and generate scenarios. A set of evolved states (exploratory and future-backwards scenarios) served to illustrate the plausible futures of UIC in Iran, and therefore to inform an improvement agenda for UIC activities. [ABSTRACT FROM AUTHOR]

Reflective thinking and teaching style are considered as two prominent and influential factors in the process of education. There have been several studies carried out to investigate different aspects of each of these two factors. However, no studies have been done to explore the possible relationship between these two crucial elements. Therefore, the present study set out to fill the gap and explore the relationship between reflective thinking and teaching style among EFL teachers in Iran. Ninety EFL teachers including 50 males and 40 females were chosen as the participants of this research. The questionnaires selected for the data collection phase were given to the teachers and they were asked to fill them out. The collected data were analyzed and it was found that there was a positive correlation between EFL teachers' reflective thinking and their teaching style. The results of this research study can be of use for EFL teachers and teacher educators. [ABSTRACT FROM AUTHOR]

Background and Objectives: Spirituality and psychological interventions are effective in promoting mental health and treating patients undergoing hemodialysis. The present study seeks to evaluate the effectiveness of treatment based on acceptance and commitment therapy (ACT) before dialysis, with and without mindfulness exercises during dialysis, on the spiritual health of these patients. Methods: The research design was quasi-experimental with a control group (two experimental groups and one control group) and a two-month follow-up. The study population included all patients on hemodialysis referring to hospitals affiliated to Imam Zaman Hospital in Mashhad City, Iran, from July to December 2020. A total of 60 patients were selected by a purposive sampling method based on the inclusion criteria. Then, they were randomly divided into three groups. The research instrument included a spiritual health questionnaire, and data analysis was performed by repeated-measures analysis of variance. Results: The results showed that both experimental groups of ACT before dialysis (P<0.001), with or without mindfulness plus exercises during dialysis (P=0.004), were effective on spiritual health in patients on hemodialysis. Conclusion: ACT alone as an effective intervention can be used in medical centers to increase the spiritual health of patients on hemodialysis. [ABSTRACT FROM AUTHOR]

Religion can lead to the creation of meaning. Therefore, religion gives meaning to the life and death of humans. Spirituality is far higher than religion and entails all concepts of human dimensions such as spiritual health, peace resulting from belief and spiritual adaptation as well as one's experiences in a unique and dynamic process (which is reflecting the belief in God and infinite power), connection (to someone, others, nature or God) and coalition. Regardless of considering the role of spirituality in the health section, what is worldly paid attention today, is the "spirituality" and "sublime values" in medical science education specially life skills and spiritual life skills education and the people of the society. This research sought to investigate the effect of religious and spiritual education on the mental health of girl students (2018–2019) of Technical and Vocational University in the architecture major of Tehran province. The methodology of the study was quasi-experimental having pretest and posttest and control group. The sample size included 152 individuals using Morgan table who were selected through multi-stage sampling. The statistical population was randomly divided into two experimental and control groups. Experimental group received educational–religious classes for 15 sessions. To analyze the data, Goldberg health questionnaire was utilized, and also descriptive as well as inferential statistics such as covariance analysis and LSD test were used in this regard. The results indicated that religious and spiritual effects were influential on the increase in mental health and social and physical performances as well as the decrease in students' depression. [ABSTRACT FROM AUTHOR]

Background and Objectives: Spiritual well-being is very important in adaptation and peace of mind, especially in certain periods of life. Middle age is associated with many biological, psychological, and social changes and problems such depression and hopelessness. This study aims to investigate the relationship between spiritual well-being, depression, and hope in middleaged women in Qom, Iran. Methods: This is a descriptive-analytical study with cross-sectional design that was conducted on 100 middle-aged women referred to community health centers in Qom city, who were selected by a convenience sampling method. Data were collected by three questionnaires including Paloutzian and Ellison's spiritual well-being scale (SWBS), Beck' depression inventory (BDI), adult hope scale (AHS), which were completed through interview. Data were analyzed in SPSS version 21 software using regression analysis. Results: The Mean±SD total scores of SWBS, BDI, and AHS were 73.43±1.25, 31.10±0.91, and 16.26±0.34, respectively. There was a significant relationship between spiritual well-being and depression and between spiritual health and hope (P=0.001). Moreover, spiritual well-being and hope had a significant relationship with depression (P=0.001). Conclusion: Middle-aged women with high spiritual well-being have less depression and more hope. It is recommended to pay more attention to spiritual well-being of these women to maintain their mental health and increase their hope. [ABSTRACT FROM AUTHOR]

Background: Among interventional studies, randomized controlled trials (RCTs) provide the highest level of evidence. However, RCTs can be susceptible to the risk of bias (RoB). Systematic reviews can be performed to appraise RoB in the included articles using evaluative tools. This study aimed to describe the main characteristics and focus on the RoB of RCTs conducted in Iran and included in Cochrane Reviews (CRs). Methods: We searched "Iran" by selecting the "Search All Text" and "Review" fields in the Cochrane Database of Systematic Reviews within Ovid. CRs that included the RCTs conducted in Iran were retrieved. A trial was selected only if it was included in CRs, described as a controlled clinical trial, involved human subjects and CR authors assessed its RoB. The trials were characterized by investigating the relevant articles and the table "Characteristics of included studies" in each CR. The RoB was investigated by collecting the review authors' judgments based on RoB assessment tables in the CRs. Results: Out of 1166 Iranian RCTs included by 571 CRs, low RoB was found in 44.9% for random sequence generation, 20.8% for allocation concealment, 32.3% for blinding of participants/personnel, 36.5% for blinding of outcome assessors, 56.3% for incomplete outcome data, 41.3% for selective outcome reporting and 53.8% for other sources of bias. Conclusion: The RoB in Iranian RCTs was found to be mostly high or unclear. While this is similar to the global situation, it is recommended that the methodological quality of conducting and reporting RCTs be addressed in Iran. [ABSTRACT FROM AUTHOR]

Introduction: The quality of nursing services is one of the main factors accelerating patients' recovery. The present study aimed to examine patients' perceptions of the quality of nursing services in the teaching hospitals of Iran. Methods: This cross-sectional research was a descriptive-analytical study conducted in 2021, in which 1067 patients were selected as the research sample. The Qualipak nursing quality questionnaire (QUALPAC) was used to collect the required data. Data were analyzed using t-test, ANOVA, and Pearson correlation coefficient using SPSS software version 23. Results: From the patients' perspective, the mean and standard deviation of the quality of nursing services was 191.47 ± 19.51. Among the quality dimensions, all services quality: psychosocial (91.34 ± 9.34), physical (65.72 ± 10.18), and communication (34.41 ± 6.21) were placed at the moderate level. A significant association was found between patients' age and nursing service quality. The perceived nursing service quality was subject to sex (P = 0.01, t = 1.921) and place of residence (P = 0.02, t = 1.873). Conclusion: According to the findings, the quality of nurses 'care was "moderate" from the patients' perspectives. Planning is recommended to reinforce and promote the quality of nursing services. [ABSTRACT FROM AUTHOR]

Healthcare providers agree that promoting spirituality among older adults while caring for them increases their quality of life. However, there is little knowledge about the spiritual needs of the elderly, especially in the Muslim community. This qualitative study attempted to explore the spiritual needs of Muslim older adults. Fifteen non-hospitalized Muslim older adults from Hamadan City, Iran, were interviewed. The semi-structured interviews were analyzed using conventional content analysis. After identifying semantic units from the text, related codes were extracted and placed in subcategories and categories based on their similarities. Once the data were analyzed, one theme was formed. The study's findings showed that the spiritual needs of older adults fell into three main categories: religious needs, the need for transcendence, and the need for connection. Religious needs included subcategories of religious practices and beliefs, and the need for transcendence included the search for meaning and purpose in life, and the need for peace and stability and balance. Also, the need for connection included the need to connect with nature and connect with others. Healthcare professionals and family caregivers should be trained in the specific competence of recognizing older people's unmet spiritual needs and fulfilling them. [ABSTRACT FROM AUTHOR]

Paying attention to and meeting the needs of people who are elderly helps to improve their health. Caring for the elderly includes addressing their spiritual needs which has been less investigated. This study aimed to examine the spiritual needs of the Muslim elderly living in nursing homes. A qualitative study was conducted using conventional content analysis. Seventeen elderly people (nine women and eight men) were selected from four nursing homes in Iran using purposive sampling. The subjects were asked to participate in semi-structured interviews. The interview transcripts were analyzed using content analysis. First, semantic units were identified and then related codes were extracted and classified into categories and subcategories based on their similarities. Finally, themes were extracted from the data. The elderly's spiritual needs were classified into three main themes: religious needs, existential needs, and communication needs. Religious needs were divided into religious beliefs, individual religious practices, and collective religious practices. Existential needs were categorized as meaning of life, purpose of life, and need for peace. Communication needs were conceptualized to include relationship with God and relationship with others. It is argued that caregivers of the elderly should recognize the elderly's spiritual needs, including religious, existential, and communication needs, and attempt to maintain and promote the elderly's spiritual health. [ABSTRACT FROM AUTHOR]

Background and Aim: Adolescents with hearing loss face many communication problems and challenges due to their hearing impairment. This study aimed to investigate the effect of psychodrama on communication skills of adolescents with hearing loss. Methods: This is a quasi-experimental study with a pretest/posttest design using a control group. The study population consists of all adolescents with hearing loss aged 12-15 years studying at Naghme School for the Deaf in Yazd, Iran. A total of 24 adolescents were selected using a purposive sampling technique and were randomly assigned into groups of control (n=12) and intervention (n=12). The intervention group received psychodrama at nine sessions of 90 minutes, while the control group received no treatment. The Queendom Communication Skills Test (QCST) was used to collect data. Data were analyzed using descriptive and inferential statistics. Results: Psychodrama can improve communication skills of adolescents with hearing loss, which is verbal communication. Conclusion: The mean and standard deviation of the pretest QCST score was 78.75±9.4 for the intervention group. After the treatment, the QCST scores was 105.08±6.28 for the intervention group. The results of ANCOVA showed an improvement in Queendom Communication Skills Test scores of adolescents after intervention (p<0.001). [ABSTRACT FROM AUTHOR]

Introduction: Out-of-pocket (OOP) is among the payment methods in Iran's health system. The present study aimed to examine the OOP treatment costs for patients with COVID-19 in Iran. Methods: A descriptive-analytical, cross-sectional study was conducted in 2021. In this study, the cost records of 550 patients with COVID-19 hospitalized in a referral center of COVID-19 were selected using the stratified random sampling method. The required data were collected using a researcher-made questionnaire. Data were analyzed by t-test, ANOVA, and Pearson's correlation coefficient in SPSS software version 23 at p = 0.05. Results: The total direct costs were 1,037,992.15 US $. Moreover, the shares of patients (OOP), basic insurance, government subsidy, supplementary insurance, discounts, and out-of-government subsidy in the total direct costs were US $ 92,231.21, 746,932.99 US $, 155,127.08 US $, 39,690.25 US $ and 4010.61 US $, respectively. In addition, the results confirmed that there was a positive and significant relationship between the patients' OOP payments and the length of stay. It also found that the patients' OOP payments are subject to the type of insurance program and discharge method. Conclusion: According to the results, 8.89% of the total direct costs were directly paid out of the patients' pockets. The research findings confirm the urgent need to make decisions and implement effective interventions for COVID-19 disease by controlling risk factors and exploiting other countries' successful experiences and international organizations' recommendations to decrease the prevalence of the infected and consequently reduce the financial pressure of the disease on patients by approving the expansion of the insurance organizations' role. [ABSTRACT FROM AUTHOR]

Background: One of the leading health indicators during the COVID-19 crisis is health literacy and health-promoting behaviors. The present study aimed to investigate health literacy and health-promoting behaviors among women hospitalized during the COVID-19 pandemic in the southern part of Iran in 2020.Methods: This descriptive-analytical study encompassed 465 women hospitalized and treated in none teaching hospitals affiliated with the Shiraz University of Medical Sciences. Data collection tools were the Health Literacy for Iranian Adults (HELIA) and Health Promoting Lifestyle Profile II (HPLP-II). The collected data were analyzed using descriptive and inferential statistical methods.Results: The mean scores of the participants' "health literacy" and "health-promoting behaviors" were 64.41 ± 11.31 and 112.23 ± 16.09, respectively, indicating the poor level of health literacy and the average level of health-promoting behaviors. Moreover, there was a significant direct correlation between health literacy and health-promoting behaviors (P < 0.001, r = 0.471). Furthermore, all health literacy dimensions of comprehension (P < 0.001), accessibility (P < 0.001), reading skills (P < 0.001), evaluation (P = 0.002), and decision making and behavior (P = 0.003) were detected as the predictors of health-promoting behaviors. Further, statistically significant relationships were noticed between the mean score of health literacy with age (r =  - 0.327, P = 0.007), level of education (F = 3.119, P = 0.002), and place of residence (t = 2.416, P = 0.004) and between health-promoting behaviors with level of education (F = 3.341, P = 0.001) and marital status (F = 2.868, P = 0.02).Conclusion: According to the findings, health policymakers should adopt national measures for educational planning to promote health literacy and support health-promoting behaviors to encourage women to adopt a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Objective: Measuring hospital efficiency is one of the way how to use resources.The optimal hospital performance is the goals of healthcare policymakers. This study aimed to the current study was conducted to evaluate the efficiency the current study was conducted to evaluate the efficiency and assess the association between hospital size and hospital area population with technical efficiency in public hospitals. Methods: In this descriptive-analytical study, the statistical population consisted of 15 public hospitals in the west of Iran. First, the data envelopment analysis (DEA) method was used to evaluate technical efficiency. inputs included staff and beds, and outputs consisted of the number of surgeries, the number of patients, and the average length of stay. Then, according to the public ownership of all hospitals, their educational and therapeutic activities, as well as their size and population were considered as the environmental factor affecting efficiency. Thus, regression was applied to measure their effects on efficiency. Results: The average technical efficiency of the studied hospitals, the average management efficiency, and the average efficiency of the scale were 0.935, 0.961, and 0.987, respectively. Out of the total evaluated hospitals, six and nine hospitals had an efficiency of less than one and one, respectively. Moreover, the size of the hospital and the population as the environment variable were significant in the Tobit model. Our regression demonstrated that although the size of the hospital is positively associated with its technical efficiency, the hospital population negatively affects hospital efficiency. Conclusion: According to the size and area population of the hospitals, they decrease their inputs to maximize their efficacy by optimizing their surplus amounts. Tobit regression analysis concludes that hospital size and population covered by the hospital significant effect on hospitals' efficiency. [ABSTRACT FROM AUTHOR]

Background: Considering that exposure to sunlight in childhood and adolescence has an important role in skin cancer, so it seems that training protective behaviors in this period is more effective.Objectives: To survey the application of protection motivation theory (PMT) on skin cancer preventive behaviors among students in rural areas of Fasa city, Iran.Methods: This study was done in two stages: Phase I of this study, the descriptive-analytic and cross-sectional study was conducted in 2018 to investigate the predictive value of the protection motivation theory on skin cancer preventive behaviors. In the second stage, a quasi-experimental interventional study was conducted on 400 primary school students in 2019. The educational intervention was performed in the experimental group for 8 sessions. Data were collected using a demographic information questionnaire and protection motivation theory before and six months after the intervention.Results: The constructs of protection motivation theory predicted 58.6% of skin cancer preventive behaviors. The results indicated that there was no significant difference between the two groups in terms of knowledge, perceived sensitivity, perceived severity, reward, fear, protection motivation, response efficacy, self-efficacy, response costs, and the skin cancer preventive behaviors in before the intervention (p > 0.05). However, six months after the intervention, the experimental group showed a significant increase in each of the mentioned constructs and skin cancer protective behaviors (p < 0.05).Conclusion: This study showed the effectiveness of the intervention based on the PMT constructs in adoption of skin cancer preventive behaviors in 6 months' post intervention in primary school students. [ABSTRACT FROM AUTHOR]

Public reporting of hospitals' performance data is a growing trend. This transparency may improve patient choices, competition, and service quality. This study aims to provide recommendations to improve hospitals' transparency in Iran. A qualitative study designed with 18 semi-structured interviews. Recommendations were categorized into five main themes, including passing a comprehensive law on transparency to create political commitment, educating people and healthcare providers to create the culture, developing a simple and efficient structure to foster transparency, and monitoring and evaluating transparency. The most important issue is political commitment. If it exists, the rest of the obstacles can be solved. [ABSTRACT FROM AUTHOR]

Background. A growing body of research has examined the psychometric properties of popular mindfulness inventories for different population. The present study is aimed at exploring the psychometric properties and factor structure of the Relaxation/Meditation/Mindfulness (RMM) Tracker t Inventory in Iran. Method. This was a cross-sectional and methodological study that conducted in Kerman, southeast Iran. Fifty, 300, and 163 Iranian adult participants were participated in the pilot, exploratory, and confirmatory phase, respectively. Face, content, and structural validities, Cronbach's alpha, and Omega coefficient were used to validate the Persian scale. Results. The results showed that the "Persian version of RMM t" had acceptable content and face validities. The Principal Axis Factoring (PAF) with Promax Rotation showed that the P-RMM t has 3 scales of "Mindful Love, Thankfulness, and Transcendence," "Relaxation," and "Mindful Deepening" which further confirmed with confirmatory factor analysis. The internal consistency of all three scales was acceptable (Cronbach's alpha coefficients > 80). Conclusion. The Persian version of RMM Tracker t seems to be a valid and reliable questionnaire to assess the levels of mindfulness in the Iranian general population. [ABSTRACT FROM AUTHOR]

Introduction: A new coronavirus, called COVID-19, is an acute respiratory disease, which may arouse many psychological disorders since there is no specialized knowledge about it. The present study aimed to investigate the level of resilience and its relationship with hypochondriasis in nurses working in a COVID-19 reference hospital in south of Iran. Methods: This cross-sectional study was conducted in 2020, in which 312 nurses participated using the census method. Data collection tools were the Conker-Davidson standard resilience scale (CD-RISC) and the Evans Hypoglycaemia Awareness Questionnaire. Data were analyzed using t-test, ANOVA, Pearson correlation coefficient, and multiple linear regression using SPSS software version 23. Results: The mean scores of resilience and hypochondriasis were 72.38 ± 7.11 and 49.75 ± 8.13, respectively, indicating the moderate level of these two variables among nurses. Hypochondriasis in 18.91, 61.22, and 1.28% of the nurses was mild, moderate, and severe, respectively. There was a significant negative correlation between resilience and hypochondriasis (r = − 0.214 and P < 0.001). In this regard, control (P < 0.001), positive acceptance of change (P < 0.001), spiritual effects (P = 0.001), trust in individual instincts (P = 0.001), and perception of competence (P = 0.002) were detected as the predictors of nurses' hypochondriasis. Conclusion: The nurses had moderate levels of resilience and hypochondriasis. Promoting knowledge about COVID-19and increasing information on how to protect oneself and others against the disease along with supportive packages from their managers are thus recommended. [ABSTRACT FROM AUTHOR]

Problem: Adolescents with beta thalassemia major face various physical and psychosocial challenges. Resilience plays a protective role in coping with the stress resulting from this disease. Methods: This descriptive correlational study was carried out on 134 adolescents (age: 11-21 years old) with beta-thalassemia major who were referred at the Thalassemia Centre in southern Iran from October to December 2018 via convenience sampling method. The Jalowiec Coping scale and Connor-Davidson resilience scale were the instruments used in this study. Data analysis was done using Pearson correlation coefficient and linear regression. Findings: Resilience was shown to be correlated with the subscales of confrontive, optimistic, supportant, and evasive coping significantly and positively (p < .001), while in the subscale of emotive coping with resilience, this was not significant. In addition, 38% of variations in the scale of resilience were explained by the five coping subscales. Conclusions: The findings of this study, indicated the role of courageous coping in promoting resilience and defensive coping as a factor that leads to less resilience than optimal level. Hence, understanding the importance and the role of protective factors and risk factors can help healthcare providers in planning some effective interventions to increase resilience among adolescents with thalassemia. [ABSTRACT FROM AUTHOR]

Background: Inappropriate ways of health services purchasing for cancer patients can be challengeable and costly and seriously affect the access to health services and outcomes. This study aimed at Factors affecting health services strategic purchasing for breast cancer patients. Methods: As a mixed study, this research was conducted in Iran in 2020. In the qualitative phase, 21 specialists and professionals in the field of health services purchasing were purposefully selected and interviewed. After data saturation, interviews were analyzed with the framework analysis and a structured questionnaire was made based on these analyses. 400 breast cancer patients were selected by randomized sampling and completed the questionnaire. Data were analyzed with SPSS23 in p <.05. Results: The highest mean rate of the three main categories belonged to "insurance trusteeship" (4.71 ±.35), followed by "supply management" (4.48 ±.27) and "financial performance" (4.48 ±.37). There were significantly differences between the mean rates of the main categories and the cut-off point (p <.001). In addition, "insurance trusteeship" ranked first (2.58), followed by financial performance (1.77) and supply management (1.65). Conclusion: Of main components in health services strategic purchasing for breast cancer patients, insurance trusteeship, supply management, and financial performance ranked first to third, respectively. Therefore, healthcare policy-makers should consider the placement of insurance trusteeship and coordinate between purchasers and providers for making reform in the health system. [ABSTRACT FROM AUTHOR]

Background: Disasters may result in mass casualties and an imbalance between health care demands and supplies. This imbalance necessitates the prioritization of the victims based on the severity of their condition. Contributing factors and their effect on decision-making is a challenging issue in disaster triage. The present study seeks to address criteria for ethical decision-making in the prioritization of patients in disaster triage.Methods: This conventional content analysis study was conducted in 2017. Subjects were selected from among Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.Results: Efficient and effective triage and priority-oriented triage were the main categories. These categories summarized a number of medical and nonmedical factors that should be considered in the prioritization of the victims in disaster triage.Conclusion: A combination of measures should be considered to maximize the benefits of the prioritization of causalities in disasters. None of these measures alone would suffice to explain all aspects of ethical decision-making in disaster triage. Further investigations are needed to elaborate on these criteria in decision-making. [ABSTRACT FROM AUTHOR]

This article introduces a new self-report measure of perfectionism: the Spiritual/Religious Perfectionism Scale (SRPS). Following preliminary psychometric evidence for a 20-item SRPS (Besharat, 2017), the present investigation examined the structure of the SRPS using exploratory factor analysis in study 1 (368 students: 181 men, 187 women) and confirmatory factor analysis in study 2 (384 community adults: 189 men, 195 women) in Iran. After exploratory factor analysis, we retained 14 items. Confirmatory factor analysis supported the SRPS-14's unidimensionality and invariance across sex and sample type. The SRPS-14's internal consistency, test–retest reliability, and construct validity including criterion, convergent, incremental, and discriminant were examined. The results provided preliminary evidence for the reliability and validity of the SRPS-14 as a measure of spiritual/religious perfectionism. It should be noted that the English-language translation of the items presented in this paper has not yet been validated in an English-speaking sample, but should be validated in future research. [ABSTRACT FROM AUTHOR]

Background: Congenital malformations are one of the most important and common types of anomalies in infants, and they are considered as the leading causes of disability and mortality in children. These malformations impose enormous costs on families and organizations involved in the treatment, maintenance, and education of patients. Objectives: This study aimed to investigate the risk factors affecting the incidence of congenital anomalies in infants born in Iran. Methods: In this retrospective descriptive-analytical study, we registered various information of all newborns examined and their mothers, including gender, family relationship of parents, type of delivery, types of congenital malformations, anomalies of the hands and feet, and anomalies of the nervous and reproductive systems in the maternity wards of hospitals in Iran. Data were gathered using a checklist. The relationships between different factors were assessed by chi-square test, and the factors influencing congenital malformations were investigated by logistic regression using SPSS-26 software. The significance level of all tests was 0.05. Results: According to the results, 7.5% of newborns had congenital malformations. Eclampsia and diabetes mellitus increased the risk of congenital malformations by 15 and 11%, respectively. The risk of congenital malformations in rural areas was 12% higher than in urban areas. Factors such as consanguineous marriages, history of abortion, and gender also affected the risk of congenital malformations. Conclusions: Necessary measures and plans in the field of premarital counseling, regular pre-pregnancy and post-pregnancy tests and controls, especially in rural and deprived areas, are essential and effective in reducing the incidence of congenital malformations. [ABSTRACT FROM AUTHOR]

Aim: To explore the factors affecting the emergence of diplomacy in Iranian nurse managers. Background: Today, with the development of complex health systems, diplomacy in health care can take place at organizational, national and international levels. Introduction: Diplomacy's role is to convince others peacefully to achieve goals. Diplomacy in nursing can facilitate professional development and direct policy and decision‐making process towards the development of a healthcare system. Methods: The study used a qualitative descriptive approach. The sampling method was purposeful, and data were collected via in‐depth, unstructured and face‐to‐face interviews with 16 participants. The interviews were digitally recorded, transcribed verbatim and analysed through conventional content analysis based on Graneheim and Lundman's work. Results: In total, 212 codes were generated, which were grouped into three main categories, namely paradigmatic socio‐political changes (two subcategories), nurses' dissatisfaction with their status in healthcare system (two subcategories) and multidimensional development of the nursing profession (four subcategories). Discussion/Conclusions: Socio‐political changes, development of the nursing profession and nurses' dissatisfaction with the health system have led to the emergence of diplomacy roles in nurse managers, the recognition and development of which can improve the effectiveness of nurse managers in policymaking. Implications for Nursing & Health Policy: The recent COVID‐19 pandemic outbreak has demonstrated the urgent need to use diplomacy to solve health problems and adjust or develop policymaking at the national and international levels. Strengthening their role in diplomacy, nurse managers can play an important role as diplomats at various levels of policymaking and in health crisis management. [ABSTRACT FROM AUTHOR]

Background: There is no validated measurement tool to assess vaginal symptoms (VS), sexual matter (SS), and quality of life (QOL) among Persian-speaking women. This study aimed at translating and assessing the validity and reliability of the Persian version of the International Consultation on Incontinence Questionnaire for Vaginal Symptoms (PICIQ-VS). Materials and Methods: In this cross-sectional study, after obtaining permission from the International Consultation on Incontinence Questionnaire (ICIQ) Advisory Board, the English version of ICIQ-VS was translated into Persian per a standard translate and back translate process, and the validity and reliability were studied. Two hundred women with and without pelvic organ prolapse were asked to complete the PICIQ-VS (mean age: 52.1, range: 22-84 years). A panel of 10 experts evaluated the content and face validity of the questionnaire. Cronbach's alpha examined the internal consistency reliability of the measure. To evaluate the test-retest reliability, we redistributed the questionnaire among 30 patients 2 weeks after their initial visit using intra-class correlation coefficient (ICC). Results: Content and face validity of the questionnaire was confirmed after some light modification (content validity ratio ranged from 0.69 to 1.00, and content validity index ranged from 0.79 to 1.00). PICIQ-VS showed an acceptable internal consistency and stability reliability (VS: α = 0.64, ICC = 0.84; SM: α = 0.69, ICC = 0.88; and total scale: α = 0.72, ICC = 0.91, respectively). Significant differences were observed between the asymptomatic and symptomatic groups for VS and the total score (P < 0.05). Conclusion: In the light of the results, interestingly, PICIQ-VS could be utilized as a valid and reliable tool to assess the VS among Persian-speaking women, both in research and clinical practice. [ABSTRACT FROM AUTHOR]

Problem: Mothers of children with autism spectrum disorders (ASD) experience higher levels of stress compared to mothers of typically developing children. This study identified mothers' perceptions of the stress caused by lifelong caregiving to a child with ASD. Methods: The current study was conducted in Iran using qualitative methods. In‐depth, semi‐structured interviews were conducted with twenty‐seven mothers. Content analysis was used to analyze and categorize the data. Findings: The main categories included (1) psychological concerns and suffering and (2) sociocultural challenges. The first category consisted of two subcategories, including disruption in mother–child relationships and fears and worries. Also, the second category included subcategories of cultural constraints and lack of social support. Conclusions: In this study, the mothers of autistic children experienced psychosocial pain. Identifying the stressors for these mothers could lead to appropriate planning to provide psychological, social, and cultural support for them in Iranian society. [ABSTRACT FROM AUTHOR]

Background/aims: Multiple sclerosis is a progressive neurological disease that can significantly impact the psychosocial aspects of primary caregivers of individuals with multiple sclerosis. This study explored the process of social isolation among primary caregivers of individuals with multiple sclerosis in Kerman, Iran. Methods: A grounded theory approach was employed to explore the various aspects of social isolation. Data were collected through unstructured and semi-structured interviews with 15 primary caregivers of individuals with multiple sclerosis, 13 individuals with multiple sclerosis and five health care providers who were selected based on purposeful and theoretical sampling. The data were analysed via constant comparative analysis. Results: The core variable identified from the interviews was social isolation. Other concepts that were connected with this were: insufficient knowledge and awareness, escaping stigma, occupational difficulties, marital challenges and management of restrictions. Conclusions: Social isolation can affect the wellbeing of primary caregivers of individuals with multiple sclerosis. Recognition and awareness of the process of social isolation and factors influencing it can be beneficial in designing theory-driven evaluation and intervention methods. It is recommended that rehabilitation specialists pay close attention to the common needs and interests of both individuals with multiple sclerosis and their primary caregivers. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the prevalence of feeding and eating disorders, and identified their correlates and comorbidities among children and adolescents. Method: We used the nationally representative sample of the Iranian Children and Adolescents' Psychiatric disorders (IRCAP) survey, with 30,532 participants randomly selected by a multistage cluster sampling method. We employed the kiddie schedule for affective disorders and schizophrenia‐present and lifetime version (K‐SADS‐PL) semi‐structured face‐to‐face interview to screen for any psychiatric disorders, including feeding and eating disorders, and associated factors. We used multivariate binary logistic regression to analyze the data. Results: Valid data from 27,111 participants were analyzed. The total prevalence of feeding and eating disorders among children and adolescents was 0.89 (0.81–1.10). In all types of feeding and eating disorders, the adjusted odds ratio was higher among girls (except binge‐eating disorder) and older adolescents but was lower among rural residents. The most common psychiatric comorbidities observed in children and adolescents with feeding and eating disorders were obsessive–compulsive disorder (20.2%), agoraphobia (20.2%), depressive disorder (16.4%), social phobia (10.1%), oppositional defiant disorder (10.1%), generalized anxiety disorder (9.4%), attention deficit hyperactivity disorder (7.5%), and conduct disorder (5.7%), which were significantly more common compared to their peers without feeding and eating disorders. Discussion: Older age, female gender and living in an urban area are predisposing factors in feeding and eating disorders (in binge‐eating disorder, the male gender is a positive correlate). We suggest that future works pay attention to the role of gender, comorbidities and predisposing factors. [ABSTRACT FROM AUTHOR]

Background: Nursing organizations play an important role in fulfilling the professional demands of nurses. The Iranian Nursing Organization (INO) is also using diplomatic activities in this direction. Aim: This study was conducted to explain the diplomatic activities of INO. Methods: A descriptive qualitative study was conducted using conventional content analysis. A purposive sampling approach was used. Data were collected via in‐depth, unstructured, face‐to‐face interviews with 21 nurses at various INOs in different cities from March to July 2020. The data collection process continued until data saturation. Interviews were analyzed using Graneheim and Lundman's (2004) guidelines. The MAXQDA software (v. 10) was used. Finding: The results showed that the diplomatic activities of INO comprise professional (three categories), social (two categories), and diplomacy in power network (two categories). Conclusion: INO carries out diplomatic activities at organizational, national and international levels and pursues its professional nursing goals through diplomacy. INO also uses social diplomacy and political diplomacy to influence decision‐makers in the community and network of power. [ABSTRACT FROM AUTHOR]

Background: Iron deficiency anemia disrupts the concentration of adolescent girls; reduces their academic achievement, productivity, and physical strength, and increases the risk of infection. This research aim was to evaluate the effectiveness of the PRECEDE model nutrition education on iron deficiency anemia among female students of Fasa City, Fars Province, Iran.Methods: This quasi-experimental study was done on 160 students (80 experimental and 80 control groups) who were selected using a random sampling method in Fasa City, Fars Province, Iran, in 2018-2019. The educational intervention included six sessions based PRECEDE model for 45 or 50 min. A scale of this study consisted of two parts; demographic information, and PRECEDE constructs were used to determine the nutritional behaviors status concluding preventing iron deficiency anemia and hemoglobin, hematocrit, and ferritin blood level in two (before and 4 months after intervention) times.Results: In the experimental group of the students the mean age was 13.85 + 1.72 years and in the controlled group was 13.60 + 1.81 years. Moreover, there was no significant difference in the PRECEDE constructs, and nutritional behaviors preventing iron deficiency anemia before the intervention in two groups of study. However, the experimental group showed a significant increase 4 months after the intervention. Also, there was no significant difference in the mean score of hemoglobin, hematocrit, and ferritin blood level between the two groups before the intervention. However, in ferritin level, a significant increase was shown in 4 months after the intervention in the experiential group.Conclusions: Based on results, the nutrition intervention education base on PRECEDE model has a positive effect to improve iron deficiency anemia preventive behaviors in female students. [ABSTRACT FROM AUTHOR]