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Abstract Elderly individuals face an increased likelihood of developing chronic diseases such as diabetes. Self-care practices and medication adherence play crucial roles in preventing complications and adverse effects of this condition. Therefore, this study aimed to determine self-care behaviors, medication adherence status, and related factors among elderly patients with type 2 diabetes. This descriptive-analytical study was conducted on 374 elderly patients with type 2 diabetes who visited educational healthcare centers in Qazvin, Iran, during 2023 (March–September). Sampling was performed using the convenience method. Data collection instruments included a demographic characteristics checklist, the summary of diabetes self-care activities questionnaire, and the Morisky medication adherence scale. Data analysis was conducted using SPSS-22 software, employing the Kolmogorov–Smirnov test, mean, standard deviation, univariate and multivariate regression analyses. The significance level was set at p ≤ 0.05. The mean age of participants was 67.56 ± 5.93 years. In the self-care questionnaire, the highest score pertained to adherence to the diet recommended by the treating physician (3.16 ± 1.87). In contrast, the lowest scores were related to the frequency of checking inside shoes (0.17 ± 0.93) and foot examination (0.31 ± 1.07), respectively. Furthermore, results in self-care behaviors indicated that with increasing education levels, self-monitoring of blood glucose (SMBG) significantly decreased (P = 0.048). This variable was considerably higher in rural residents than in urban dwellers (P = 0.016). Additionally, the frequency of blood glucose measurements was significantly higher in urban residents than in rural inhabitants (p = 0.006). Based on the results, the mean score for medication adherence among patients was 5.53 ± 1.65. Based on our findings, the level of self-care in physical activity, SMBG, and foot care among the elderly is below average. Furthermore, medication adherence in these patients is poor. We expect that managers and policymakers take steps to reduce complications and improve these two variables by developing educational programs on self-care and emphasizing the importance of treatment adherence for these patients.

Abstract Background Clinical education is the basis of education in medical sciences. Clinical education, as the essence of education in nursing and midwifery, promotes social health, improves health care, and reduces mortality. Considering the position of nursing and midwifery, investigating the views of students in this field can be an effective step in improving clinical education. Therefore, the present study was conducted to investigate the status of clinical education and the factors affecting effective clinical education from the point of view of nursing and midwifery students. Methods A descriptive-analytical study was conducted among nursing and midwifery students at Qazvin University of Medical Sciences in 2022–2023. Using available sampling, 242 students were included in the study. Students were included in the study if they completed at least one unit of in-person internship. Refusing to continue the study for any reason and having a practical nurse certificate were the criteria for exclusion from the study. The data collection tools included a demographic information questionnaire, a questionnaire to assess the status of clinical education, and a questionnaire on factors affecting effective clinical education. The data were analysed with descriptive and inferential statistics and SPSS 20 software. Results The mean age of the participants in this study was 21.66 ± 2.25. A total of 180 (74.4%) of the participants were women, and the rest were men. The results showed that the general condition of clinical education is at an average level (103.16 ± 19.21). It was also found that the clinical education status of midwifery students was better than that of nursing students, and this difference was significant (p = 0.003). Among the fields of clinical education, the highest score belonging to the field of objectives and planning was reported on the average level (34.39 ± 6.66). Among the factors affecting effective clinical education, the highest score was given to the field of personal characteristics of the student (33.97 ± 5.99). The results showed that there is a significant relationship between the grades of the general state of clinical education with the academic semester (p = 0.001) and interest in the field of study (p

Abstract Background Young people are the main resources of any country and entering university is considered a sensitive period in their lives. Satisfaction with life is one of the indicators of successful adaptation to life. Lifestyle and spiritual intelligence can complement and give meaning to this variable. The present study was conducted to investigate the relationship between spiritual intelligence and lifestyle with life satisfaction in students of Medical Sciences. Methods This descriptive-analytical study was conducted among the students of Qazvin University of Medical Sciences in 2017. One hundred thirty-nine students were included in this study. Data collection tools were the King's spiritual intelligence scale, Miller-Smith lifestyle assessment inventory, satisfaction with life scale (Diener), and demographic information checklist. To analyze the data, descriptive and analytical tests such as independent T-test and one-way analysis of variance and SPSS version 22 software were used. The significance level of all tests was considered less than or equal to 0.05. Findings In the present study, 108 were women and the rest were men. 49.6% of students were under twenty years old. The results of this research showed that there is a significant negative relationship between lifestyle and life satisfaction (r = -.33) and a significant positive relationship between spiritual intelligence and life satisfaction (r = .27) (p

Abstract Background Pre-hospital emergency staffs as the frontline forces fighting against COVID -19 have been affected by this pandemic. Today, the occupational and mental health of these individuals is particularly important to the health care system. Death anxiety is one of the inevitable things in this job, and not paying attention to it can cause unwanted effects such as changing the level of job satisfaction of the personnel. The purpose of this study was to determine the role of predictive death anxiety in the job satisfaction of pre-hospital emergency personnel during the COVID-19 pandemic. Methods This cross-sectional descriptive study was conducted among pre-hospital emergency staffs in Qazvin Province, Iran in 2021–2022. Among the bases chosen by the census method, 198 samples were included in the study by the available method. Data collection tools included the Demographic Checklist, Templer's Death Anxiety scale, and the Minnesota Job Satisfaction Questionnaire. The data were analyzed with descriptive and inferential statistics and SPSS 20 software. Results The mean age of the samples was (33.14 ± 6.77). 167 persons were male and the others were female. The average job satisfaction and death anxiety of the personnel were 55.07 ± 11.50 and 8.18 ± 1.96, respectively. Pearson's correlation coefficient between the two variables was r = -0.126 And a null correlation coefficient hypothesis has been confirmed with p-value = 0.077. Conclusions The results showed a high level of death anxiety and average job satisfaction. Although these two variables do not have a significant relationship with each other, considering that they do not have the appropriate level, it needs more investigation and consideration.

Abstract Background Out-of-hospital cardiopulmonary arrest is a common and fatal problem. Rescuing patients with this problem by pre-hospital emergency medical services is associated with various barriers and facilitators. Identifying these barriers as well as the facilitators in a qualitative and an information-rich way will help to improve the quality of performing the maneuver and to increase the patients’ survival. Therefore, the current study was qualitatively conducted with the aim of identifying the factors affecting the cardiopulmonary resuscitation within the pre-hospital emergency medical services. Methods This qualitative study was conducted using a content analysis approach in Iran in 2021. The participants were 16 Iranian emergency medical technicians who were selected through a purposive sampling method. For data collection, in-depth and semi-structured interviews were conducted. For data analysis, the Elo and Kyngäs method was applied. Results The mean participants’ age was 33.06 ± 7.85 years, and their mean work experience was 10.62 ± 6.63 years. The collected information was categorized into one main category called “complex context of the cardiopulmonary resuscitation” and 5 general categories with 17 subcategories. These categories and subcategories include patient condition (patient’s underlying diseases, age, high weight, number of children, and place of living), dominant atmosphere in companions at home (companions’ feeling of agitation, companions doing harm, and companions helping), policy (educational policy, human resource policy, up-to-date equipment and technology, and do-not-resuscitate policy), performance of the out-of-organizational system (disorganization in the patient handover process, and cooperation of the support organizations), and conditions related to the treatment team (conscience, cultural dominance, and shift burden). Conclusions The results showed that the conditions related to the patient and his/her companions, as well as the organizational factors such as the policies and the out-of-organizational factors act as the barriers and the facilitators to the cardiopulmonary resuscitation within pre-hospital emergency medical services. Therefore, the barriers can be modified and the facilitators can be enhanced by taking various measures such as educating, human resource policy-making, upgrading the equipment, and considering appropriate management policies.

Background & Aim: Patient safety in general and medication errors in particular are the important indicators of hospital care quality. Risk management is an important and fundamental approach to preventing events caused by medication errors. The aim of this study was to determine the effect of risk management program on the rate of medication errors among intensive care unit nurses. Methods & Materials: The present study was a non-randomized pre-test, post-test study with a control group, conducted in 2020 in two hospitals in Tehran. The hospitals were randomly assigned to either an experimental group or a control group. According to the inclusion and exclusion criteria, 150 nurses (75 nurses in each group) were selected by the convenience sampling method. For the experimental group, a risk management program was implemented. Data collection tools included the nurses’ demographic questionnaire, the 14-item Wakefield medication error self-reporting questionnaire, and the nurses’ medication quality checklist. Data was collected before and after the intervention and analyzed by the SPSS software version 16 using descriptive and inferential statistics. Results: The results of independent t-test showed no statistically significant difference between two groups in demographic information and the rate of medication errors before the study (P>0.05). After the intervention, difference in the rate of medication errors was statistically significant between the two groups (P

Introduction: Studies about Cardiopulmonary Resuscitation (CPR) in pre hospital setting in Iran is limited. Despite the importance of this issue, numerous challenges in this area are left unattended. Aim: To explore the challenges of the organisational structure and the human resources in pre hospital Emergency Medical Systems (EMSs) for CPR. Materials and Methods: This qualitative study was conducted using content analysis approach. Data was collected through semi-structured interviews in 2020, until saturation was achieved. The participants were 16 Iranian emergency medical staff who were selected through a purposive sampling method. Data were analysed based on the Graneheim UH and Lundman B approach. Results: Thirteen participants were males and the rest were females. The mean age of the participants was 33.06±7.85 years and their mean work experience was 10.62±6.63 years. By analysing the data, the information was placed in two main categories- “the challenges of human resources” which includes four sub categories (lack of experience and skills, intrapersonal challenges, non targeted performance and weakness in education as the existing challenges), and “the challenges of organisational structure” which includes three sub categories (improper structure and access, lack of organisational support and shortages of the facilities and the equipment as the existing challenges). Conclusion: Results from the present study revealed that pre hospital EMSs staff had to face various problems, challenges and limitations in CPR. Therefore, the ability of these staff to manage these challenges should be increased through the opportunity to acquire clinical knowledge and skills in order to improve patient-centered services.

Introduction: Cardiac arrest is one of the leading causes of death. Nurses are often the first members of the healthcare teams to deal with these patients. The management of how nurses performing resuscitation has drawn a lot of attention. Aim: The present study was conducted with an aim of determining nurses’ experiences of managing Cardiopulmonary Resuscitation (CPR). Materials and Methods: This qualitative study was conducted using the content analysis approach. Fourteen nurses with different positions and active roles in the CPR were selected purposefully. Data were collected through semi-structured interviews from July to December 2019. Data were analysed based on the Graneheim and Lundman’s approach. Guba and Lincoln’s trustworthiness criteria were used to obtain the trustworthiness of data. Results: Fourteen Nurses, with mean age of 32.14±4.34 years and mean work experience of 9.78±4.50 years were included in the study. Four main categories and fourteen subcategories were recognised in the questionnaire, including the role of human resources (fluctuation of coordination and cooperation, capability and motivation), management of procedures (cardiac massage, shock, airway, drug therapy, and vascular access), role of context and structure (equipment and physical space, contextual factors, and losing time) and the role of law and ethics (guideline, reporting and evaluation, and power of conscience). Conclusion: This study showed that nurses face various challenges and limitations at the beginning, during and after resuscitation in the management of CPR. Therefore, nurses’ ability to manage and execute this process should be enhanced.

Introduction: Musculoskeletal disorders can be associated with various physical and psychological disorders for the affected individuals. Objectives: In the present study, the prevalence of musculoskeletal disorders among nurses working in emergency departments was studied. Methods: The study was conducted in three teaching hospitals affiliated to Qazvin University of Medical Sciences (2018-2019). Musculoskeletal disorders were studied among 100 nurses working in the emergency department using Nordic questionnaire. Collected data were then analyzed using SPSS version 16. Results: A total number of 100 nurses participated in this study. Among them, 83 of them were female. The mean age of participants was 28.7±6.2 years. The most prevalent musculoskeletal disorders were in the lumbar region (67%) and then in the neck, knees and shoulders, respectively. The results also showed that rest, decreased activity, leaving the workplace, or inability to perform activity at work or home was occurred after musculoskeletal disorders (30%). No significant relationship between demographic variables and the prevalence of musculoskeletal disorders was observed (p>0.05). Conclusion: The present study showed that prevalence of musculoskeletal disorders among emergency nurses is high. Given the fact that a significant portion of hospital care services is provided by nurses, their physical health should always be considered by managers and policy makers and the necessary measures should be taken into account in this regard.

Introduction: One of the issues that have drawn many attentions in recent years is the matter of caregiver burden among caregivers of patients with chronic illnesses. Objectives: The present study was carried out with the aim of studying the caregiver burden among caregivers of older patients receiving hemodialysis and its relevant factors. Patients and Methods: In the present study 52 caregivers of elderly patients receiving hemodialysis for this study were recruited. Data collection was carried out using a researchermade demographic variables checklist and Novak and Guest Caregiver Burden Inventory (CBI). Results: The mean age of caregivers’ patients was 72.4 years. The mean total score of care burden was 57.9±20.1. Totally, 23.1%, 51.9% and 25% of the subjects had mild, moderate and severe level of burden respectively. Caregiver of ages, age of the elderlies and relationship status were effective factors on caregiver’s burden (P