Iranian Journal Of Nursing and Midwifery Research
Volume:17 Issue: 2, Feb 2012

Migraine is defined as a chronic disabling condition which influences all physical, mental, and social dimensions of quality of life. Some 12-15% of the world population suffers from migraine. The disease is more common among women. The onset, frequency, duration, and severity of migraine attacks may be affected by other predisposing factors including nutrition. Therefore, determining these factors can greatly assist in identification and development of its prevention. Considering the importance of nutrition in maintaining and promoting health and preventing diseases, the present study was conducted to determine the relationship between headaches and nutritional habits (frequency and type of consumed foods) of women suffering from migraine. This analytical case-control study was conducted on 170 women (in two groups of 85) selected by convenient sampling for the case group and random sampling for the control group. Data collection tool was a 3-section questionnaire including personal information, headache features, and nutritional habits. The questionnaire was completed in an interview performed by the researcher. The data was then analyzed in SPSS using descriptive statistical tests (frequency distribution, mean, and standard deviation) and inferential tests (chi-square, independent t, Mann-Whitney, and Spearman's correlation tests). The results demonstrated a significant relationship between headache and some food items including proteins, carbohydrates, fat, fruits and vegetables. To be more precise, there were significant relationships between headaches and the frequency of consumption of red meat (p = 0.01), white meat (p = 0.002), cereals (p = 0.0005), vegetables (p = 0.009), fruits (p = 0.0005), salad dressing (p = 0.03), and eggs (p = 0.001). Moreover, a significant relationship existed between headache and type of consumed oil, meat, dairy products, fruits, and vegetables (p < 0.05). It is necessary to put more emphasis on the significance of correcting dietary patterns in order to prevent headache attacks and reduce the complications arising from drug consumption in migraine patients. Social and economical efficiency of the patients will thus be enhanced.

Sexual instinct which is the cause of numerous changes in an individual’s life could be influenced by different factors such as menopause and ageing. This study was designed to compare sexual dysfunction before and after menopause. This was a cross-sectional study. Participants were 174 menopausal women who referred to medical health centers of Isfahan, Iran. Data were collected through self constructed sexual dysfunctions questionnaire in relation to their sexual activities before and after menopause. The reliability and validity of this questionnaire was determined by content validity and Cronbach’s alpha coefficient. Findings showed that the relative frequency of sexual dysfunctions was 38% in the productive period and 72.4% in the menopause period. There was a significant association between sexual dysfunctions before and after the menopause period (p < 0.001). Sexual dysfunctions in these women in the productive and menopause period were 49.2% and 62.6% in desire disorder, 34.3% and 34.9% in dyspareunia, 26.8% and 75.3% in arousal disorder, 23.5% and 56.3% in orgasmic disorder and 16.4% and 15.6% in vaginismus, respectively. A considerable percentage of women experienced sexual dysfunctions in productive and menopause periods, and menopause could be a factor to maintain or intensify sexual dysfunctions.

Third stage of labor has been defined as the most dangerous stage. Due to the importance of the third stage, this study was performed in order to determine its length and related factors. This research is a cross sectional study which was carried out on 1000 deliveries in Shabihkhani Hospital (Kashan-Iran). Inclusion criteria consist of gestational age of higher than20 weeks, singleton pregnancy, and vaginal delivery without any instrument. The mean, median and standard deviation of the third stage of labor were 6.03, 5 and 5.15 minutes respectively. The finding also showed that there was a significant association between Para, Induction of labor, use of analgesic drugs during labor (pethidin), and umbilical drainage for third stage management (p < 0.05). There was no significant association between a history of Abortion, Gestational age and Third stage management (Oxytosine). The use of Induction, analgesic drugs during labor and umbilical drainage prolonged the third stage of labor, but multiparity decreased the duration of this stage. The diagnosis of these factors is recommended in order to predict and prevent the occurrence of the third stage dangers.

Tube feeding is used for the patients who are not able to feed orally but their digestive system can digest foods. This method is safe and economic for patients. It maintains the functions of digestive system and reduces the risk of infection and sepsis. However, incorrect administration of this type of feeding results in problems such as aspiration, pneumonia, infection, diarrhea, NG tube obstruction, etc. If tube feeding is performed based on its standard procedure, it can have a major role in reducing the complications, providing adaptability and desired lifestyle, reducing the duration of hospitalization as well as reducing the relevant costs. This research is a descriptive-analytic cross-sectional study on 37 nurses who worked in the general surgery and neurology wards and fed patients suffering from gastrostomy. A valid and reliable checklist was used for data collection. To analyze the data, the descriptive statistical method (frequency and mean) and inferential method (paired t test, Spearman Correlation Coefficient and variance Analysis with repetition of observations) were used. The findings showed that the mean score of measures in all the stages (before, during and after administration) was significantly lower than the standard (p<0.001). There was a significant reverse relation between the score of measures in all the three stages (before, during and after performance) and work record and work experience in the ward. Furthermore, the mean score of measures in all the three stages was significantly different between female and male subjects (p value = 0.031), in the manner that the mean score of women was higher than that of men. There was also a significant difference between the mean score of measures in all the three stages and the employment condition of samples, so that the mean score of provisionally employed personnel was higher than that of permanent employed personnel. Considering the findings of the research in which the mean score of measures before, during and after performing feeding through gastrostomy was lower than the standard (p<0.001), a gastroenterology advisor, a clinical nurse and a nutrition specialist should train the patients and their families as well as the personnel about preparation and storage of foods, method of administering food, protection of tube entrance and NG tube by considering the problems and complications arising from this type of feeding. Based on the findings of the present research, it is necessary to re-train the nurses and especially male nurses, nurses with more work experience and permanently employed nurses in terms of correct performance of clinical nursing skills including this type of feeding.

Chronic renal disease is a health problem in today’s world. In the end-stages of renal disease patients depend upon alternative therapies including dialysis for their survival. However, dialysis causes several stressors on physical, mental and social performance of patients. The present study aimed to review and compare the self-concept in patients undergoing hemodialysis and peritoneal dialysis.ETHODS: This was a case-control study including two groups of patients, undergoing hemodialysis and peritoneal dialysis, who referred to Al-Zahra and Ali Asghar Hospitals, which are affiliated to Isfahan University of Medical Sciences. These groups were compared to the control group. Data were collected through completing the form of demographic characteristics and a questionnaire, written by the researcher, pertaining to the self-concept which was collected by the samples. The data were analyzed by the Software SPSS version 18. ANOVA (analysis of variance) showed that statistically there was a significant difference between mean score of self-concept in the three physical (body-image), psychological, and social self aspects in the two groups of hemodialysis and peritoneal dialysis with the control group; however, Duncan’s post-hoc analysis showed no significant difference between mean score of self-concept in the three mentioned aspects in the two groups of hemodialysis and peritoneal dialysis. Furthermore, ANOVA (analysis of variance) showed that there was no significant difference between mean score of the spiritual aspect of the self-concept in the two groups of hemodialysis and peritoneal dialysis with the control group. Duncan’s post-hoc analysis also showed no significant difference in this aspect between the two groups of hemodialysis and peritoneal dialysis. Patients undergoing dialysis have many psychological disorders and the type of dialysis is not of much importance in this regard; therefore, adequate education and information for clients in order to use appropriate methods of adaptation as well as appropriate social relationship, continuing social support and developing health policies seem necessary in order to prevent mental disorders and providing required services and supports for patients.

The most common complication of hospitalization in intensive care units (ICU) is infections caused by health care. Although sepsis allocated a small percentage of infections, it has a high mortality rate. Intensive care nurses play a critical role in the prevention, early detection and beginning the therapeutic interventions in patients with sepsis. This study aimed to review the effect of a care program on knowledge, attitude and practice of ICU nurses in Shariati Hospital, Isfahan. This was a quasi-experimental study and the study population included 64 nurses with at least one year of experience in ICU that randomly divided into test and control groups. Nurses’ knowledge rate, attitude and practice reviewed through a researcher-made questionnaire before, immediately and three weeks after a one-day workshop. In the test group, there was a significant increase in knowledge rate, attitude and practice of nurses immediately and three weeks after the education than before; so that mean score of nurses’ knowledge before, immediately and 3 weeks after the intervention was 64.5, 84.9 and 85.2, respectively as well as attitude score (73, 79.7 and 83.3) and practice score (81.8, 90.5 and 91.3). Mean score of nurses’ knowledge in the control group before, immediately and 3 weeks later was 63.7, 63.9 and 63.5 respectively as well as attitude score (72.8, 73.3 and 73.2) and practice score (82.1, 82.9 and 82.7). The training sessions significantly improved knowledge rate, attitude and practice of ICU nurses in sepsis care. Therefore, compiling and organizing seminars and continuous basic educational workshops for sepsis care are recommended for health caregivers.

These days, diabetes is deemed as one of the most important health–treatment and social- economic problems of the world. Since parents play a major role in treatment of diabetes, the most important part of managing diabetes is in the hands of the parents of children affected by diabetes. This special responsibility will increase the stress and family challenges and impacts parents’ emotional responses. The affective reactions or responses of the parents can also be conveyed to the child himself and reduce self-care, increase glucose levels, increase the possibility of complications and reduce the quality of life. Thus, it is highly important to recognize the affective reactions of parents during various stages of the disease for the purpose of intervention. Therefore, the researcher decided to conduct a study to determine affective reactions of parents after diagnosis of insulin-dependent diabetes in their children. This study is a prospective descriptive-analytic type. All parents of children diagnosed with insulin-dependent diabetes who came to Sedigheh-ye-Tahereh Endocrinology and Metabolism Research Center were selected, and the SCL90 questionnaire was given to them by the interviewer in five stages (immediately, one month, three months, six months, twelve months after diagnosis). Data were analyzed by using descriptive and analytic statistics and SPSS software. Convenient continuous sampling was used to select 45 people out of whom 10 dropped out during the study. The research findings demonstrate that the major problems of the study subjects at the beginning of diagnosis were depression, anxiety and physical problems, respectively, and three months, six months and twelve months later, they were depression, obsession and physical problems, respectively. Over time, the mean score of parents’ affective reactions declined which indicates the acceptance of the disease by parents over time. In view of the fact that both mother and father of children with diabetes suffer from affective problems and since fathers go to hospitals and diabetes centers less than mothers, some decisions should be made to mentally support both fathers and mothers.

Social adaptability is an important requirement of the social life of adolescents, which can be affected by their mother’s parenting style (PS). The purpose of this study is to compare the social adaptability in four parenting styles (authoritative, authoritarian, permissive and neglectful) through which mothers interact with their adolescent girls. This survey is a cross-sectional and analytical study on 737 adolescents that study in the all girls junior high schools in Isfahan. Data collection was done with a questionnaire. The questionnaires were completed by the adolescents. After data collection, the parenting styles were determined and the social adaptability of the four groups was compared. The mean social adaptability in adolescents who their mothers have the authoritative parenting style was 49.6 ± 6.1, in the permissive parenting style 50.1 ± 5.8, the authoritarian parenting style 44.2 ± 6.5 and in the neglectful parenting style was 42.2 ± 7.5. The social adaptability of the four groups was significantly different (p < 0.001). This study shows that the permissive parenting style and after that authoritative parenting style were followed by higher social adaptability in adolescent girls.

The negative attitudes and behaviors of Iranian nursing students impede learning and threaten their progression and retention in nursing programs. The need to understand students’ perception and experiences of nursing provide knowledge about effectiveness of nursing education program, as well as their professional identity. The purpose of this study was to discover experiences of nursing students of nursing. This was a descriptive, exploratory, qualitative study that twelve senior nursing students of Isfahan University of Medical Sciences (Faculty of Nursing and Midwifery) participated in. Data was collected via unstructured in-depth interview and thematic analysis method was used for analyzing the data. The findings from this study revealed that the nursing students in Iran experienced altered experiences during their education program as positive and negative. Two major themes were constructed from the thematic analysis of the transcripts: profession dimensions; and professional conflicts. Regarding the finding, positive experiences of students have leaded them to acceptance and satisfaction of nursing and negative experiences to rejection and hating of nursing and lack of adaptation with their professional roles. Therefore, it is recommended that revision and improvement in nursing education program is essential to facilitate positive experiences and remove negative experiences of nursing student’s educational environment.

Endometriosis is defined as the existence of endometrial-like tissue outside the uterus this disease. Diagnosis of endometriosis is a challenging theme, and inspite the broad search for innovative laboratory tests and advances in imaging technologies, there are still no easy, non invasive diagnostic tests available. Due to inflammatory process of endometriosis, still CRP level may be target of initial screening. The aim of this study was to investigate CRP levels as a marker of inflammatory process in serum and peritoneal fluid of patients with endometriosis. In a case control study 179 women endometriosis(N=90), and without endometriosis (N=89), evaluated. The venous blood samples were obtained from all patients before laprascopy, and the peritoneal fluid samples were collected from pelvis before any manipulation. Unpaired t- test was applied to compare the parameters between two groups. It was found that there is no significant difference between the CRP serum level in women with endometriosis and infertile women without endometriosis. There was significant difference in peritoneal level of CRP between case and control groups. The findings suggested, measurement of this marker in patients serum or plasma cannot be used to diagnose endometriosis. It is further recommended that a combination of different markers might be helpful in this regard, and other studies can investigate to find such useful markers.

Cardiovascular diseases have the highest death rates in human society. Coronary artery disease isamong the most important of these diseases. No treatment of cardiovascular disease has as much impact on the qualityof life of the patients as the heart surgery. The recovery from heart surgery is associated with symptoms of pain andpsychological distress. In the early recovery period, the patients will face moderate symptoms of anxiety and depression.In this regard, various measures of nursing, as complementary therapy practices have been performed to help thepatients for overcoming the physical and psychological needs. One of these methods, in recent years has been the use ofcomplementary and alternative therapies, particularly massage therapy, after heart surgery. Thus, the aim of this studywas to determine the effectiveness of massage therapy on the mood of patients after open-heart surgery in Isfahan ChamranHospital during 2010-11. In this study 72 patients, who underwent coronary artery bypass surgery, were selected. They were randomlyassigned to the two case and control groups. The patients of the case group (n = 36) received Swedish massage for 20minutes in 4 sessions in 4 consecutive days, 3 to 6 days after the open-heart surgery. The patients in the control groupreceived only the routine care. The mood questionnaire (POMS) which was used in this study has been completed theday before the start of the study and intervention and again after the last day of the intervention. SPSS software version12 and descriptive and inferential statistical methods were used for data analysis. The comparison of study results showed that massage decreased the overall rating of the patients’ mood afterthe surgery. The use of massage therapy as an effective nursing intervention can improve the patients’ mood afteropen-heart surgery. Due to the low cost and simplicity of this method, it can perhaps be used as a complement to drugtherapy and postoperative interventions used in these patients.

The tragedy of being with breast cancer can generate many challenges in women. Patients seek for someone to compare their emotional and physical reactions. This study was conducted to study the impact of implementation of peer support group on the quality of life of breast cancer patients. This clinical trial was conducted on patients who underwent modified radical mastectomy and/or lumpectomy in surgical wards of the studied cities. The participants were trained in order to attend the study after they volunteered and their capacity was evaluated. The volunteer group started contacting the patients after the surgery and continued it during treatments and several months after completion of the treatments. Patients were placed in two case and control groups by simple random sampling, and the quality of life patients in both groups was measured during the treatment and after completion of treatment using standard tools of National Medical Center & Beckman Research Institute. The mean score for the physical dimension of life quality in case and control groups in Tehran had a significant difference during two stages. There was no significant difference between the mean score of physical dimension of life quality in the two groups during two stages in city of Isfahan, however, the mean score of mental dimension of life quality showed a significant difference in two groups in Tehran during the two stages. This mean was significant during the second stage in Isfahan. There was a significant difference between the social dimension of quality of life in both groups in Isfahan (P=0.001). The mean score of the social dimension of quality of life showed a significant difference in both groups in Tehran during two stages (P=000). There was a significant difference in both groups regarding the mean score of spiritual dimension of life quality in Tehran (P=000). The results showed that those who participated in this study enjoyed a higher life quality compared to those who did not. The test results indicated the significance of differences in both the case and control groups in Tehran, but they were not similar to findings obtained in Isfahan. This may be due to incomplete matching of the peer group members, and incapability of the volunteers to maintain an effective and constructive communication with the patients.

Birth weight is considered as the most important index of neonate's growth as well as the most important determinant of infant's mortality. This study was conducted to investigate the growth pattern in normal, low and very low birth weight neonates for 18 months in the health care centers of Isfahan, Iran. In a cross-sectional and retrospective study, 214 neonates (90 with normal, 90 with low and 34 with very low birth weights) were enrolled in the health care centers of Isfahan and their growth in the 2nd, 4th, 6th, 9th, 12th, 15th and 18th months were investigated. The data collection tool was a 3-part questionnaire which was validated using content validity. A part of data was completed based on the health file of the family. The mean of weight, height and head circumference in the months 2, 4, 6, 9, 12 and 15 in the three groups with normal, low and very low birth weights were significantly different. In the ages of 6, 15, 12 and 18 months, there was the highest frequency of horizontal trend in the growth pattern of children in the three groups. In the growth rate of neonates with low birth weight,, there was the highest frequency of horizontal trend at the age of 12 months and there was the highest frequency of descending trend in the 15th months. The findings showed that according to National Center for Health Statistics (NCHS) percentiles, low and very low birth weight infants had lower growth in weight, length and head circumference compared to normal birth weight infants. Therefore, special attention should be given to healthcare and post-birth growth surveillance of these two groups to maintain and improve the health level of them.

Ischemic Heart Disease (IHD) is one of the leading causes of death and disability among young and older women, respectively. Researches in this area mostly focused on manifestations, risk factors, and treatment of the patients with IHD. So, there is a lack of information on the aspects of affects and feelings of such patients. This study aimed to describe lived experience of women with IHD, to provide a suitable guide for nursing practice. This is a descriptive phenomenological study. Participants were eight women with IHD who were hospitalized in CCUs and ambulatory cardiac care centers of Isfahan University of Medical Sciences in Iran. They voluntarily responded to open-ended questions of semi-structured interviews. Data were analyzed using Colaizzi’s method to extract meanings and concepts. Findings were 14 subthemes leading to 5 main concepts of ‘Pain and Relief’ ‘Resistance’ ‘Introversion’ ‘Loss of Control’ and ‘Mutual Communication’ that emerged from participants` narratives. Ischemic heart event is an experience with multidimensional impact on various aspects of the patients’ lives. This study demonstrates this experience as having five fundamental elements. Women with IHD express their suffering from frequent cycles of pain that drives their feelings and thoughts toward themselves and provokes their sense of resistance. They also faced loss of control on various aspects of their lives and changes in their relationships with others, too. This image helps nurses to design their care plan based on a better understanding of these patients.

Teachers, parents and foundations should become objective-oriented for children with visual impairment so that learning and sensitization of necessary knowledge and skills for the behaviors of these children are assisted. Where there is impairment in the relations of children caregivers, their emotional security is disturbed and its effects will appear in their behaviors. Therefore, strong dependence on parents, teachers and other adults is the characteristics of most of the children with physical problems including blind children. Since use of the experiences of caregivers of these children increases their efficiency and life skills, this study was conducted aiming to understand the experiences of blind children caregivers in Isfahan. This study was a qualitative study with a phenomenological approach to investigate the experiences of blind children caregivers including mothers and teachers. Four mothers of blind children and four caregivers of blind children were purposefully selected and interviewed from 2007 to 2009. Data were collected through interviews which were recorded on cassette tapes. The obtained data were analyzed using Collizzi method. The experiences of the blind children caregivers were divided into two groups of challenge and role. The results of this study showed that upon diagnosing the child’s blindness, the parents suffer from mental stress. At first, they deny the problem, but then they begin to come along and accept the blind child. At this time, they analyze the effective factors in keeping and educating the child. At the same time, they act in response to the child influenced by several factors including the role of the society.

Nowadays, the concept of family planning has been detached from the population controlling and it is expressed as an essential element in women’s reproductive rights, empowering them and promoting their status in society. Family planning services have an important role in achieving women to their fertility decisions and using of contraception methods. This study was carried to explore the experience of women from the role of health centers in empowering them for family planning. This study was carried by the qualitative method. Among the volunteers, 37 married women who were eligible for contraception and also 8 staff and director of family planning services were selected by purposeful sampling in the city of Isfahan. Data were collected by recording discussions of focused group in 7 sessions and 5 individual interviews. Conventional content analysis was used for coding and classification of data. Analyzing of participants description about the role of health centers in empowering the family planning led to emerging of 4 main categories included Encouraging male`s participation in family planning, Providing comprehensive reproductive health services, Expanding free services for family planning, Appropriate technology for public awareness. Results showed that physical accessing to health centers and offering free services for family planning are not sufficient for empowering women to reach fully to their fertility desires. The health centers should offer comprehensive reproductive health services and provide family planning services with a new approach for helping women and men to make a consciously, freely and responsibly decision in order to have more control over their fertility.

Kidney transplant needs long term treatment, care and a follow up. Patients with kidney transplant need support in fields of knowledge, skills and motivations. Several researches showed existing challenges regarding education of these patients. A qualitative study was conducted to define patient's experiences from their received education about the process of kidney transplant. This was a qualitative study with a content analysis approach. Sampling was purposive up to data saturation. The participants aged 18-60 years, had experienced transplantation. The data were collected by semi-structural individual in-depth interviews with 18 participants. The interviews were analyzed by Graneheim and Lundman content analysis method. Three general themes of "educational experiences at the beginning of transplantation", “educational experiences in post transplantation care", and "patient's struggle to enhance their awareness in order to preserve their transplanted kidney" were emerged. The findings showed that patient's did not receive adequate knowledge about kidney transplant process. This issue reveals an unstructured and uncoordinated education given to kidney transplant patients by health team members during kidney transplant process. With regard to high motivation of the patients, designing such educational program based on self-management in the process of kidney transplant for these recipients is essential. Nurses in their educational role can enable the patients through educating them about problem solving methods and selection of the best solution to preserve their transplanted kidney and consider renal transplant recipient self-management as their first priority toward these patients.

Considering the relationship of low and high levels of‎ hemoglobin and hematocrit with some pregnancy complications, we decided to study their relationship with pregnancy outcome. This study also aimed to investigate the changes in hemoglobin and hematocrit values during the second and first half of pregnancy and its relationship with pregnancy outcome. In a prospective cohort study, 520‏‎ Iranian pregnant women, aged 15 to 45‎‏‏ years that were supported by health centers in Isfahan, Iran, were recruited using quota sampling method. Exclusion criteria comprised of 36‏ conditions that were related to the maternal and infant outcomes. Hemoglobin and hematocrit were measured in eligible mothers during the 6th-‏11‏th weeks and 26‎‏‏th-30‎‏‏th weeks of pregnancy. They were monitored until delivery and the data regarding their pregnancy outcome were collected. Low levels of hemoglobin during the first‎ half of pregnancy was associated with preeclampsia (p = ‎‏0.024). Moreover, ‎low levels of hemoglobin during the second half of pregnancy was associated with the risk of preterm premature rupture of membranes ‎(p =‎‏‎ 0.01). In addition, mothers with lower blood dilution, as a physiological process during pregnancy, were more prone to preeclampsia (p = 0.04‎‏‏‎).‎ Hemoglobin levels in the first and second half of pregnancy can predict preeclampsia and premature preterm rupture of membranes. Increased hematocrit levels in the second half of‎ pregnancy or lack of reduction of hematocrit levels in the second half compared to the first half can estimate preeclampsia.‎

Nurses and other members of health care team provide mental patients with health services through interprofessional collaboration which is a main strategy to improve health services. Nevertheless, many difficulties are evidently influencing interprofessional collaboration in Iranian context. This paper presented the results of a study aimed to explore the context. A qualitative study was conducted using in-depth interviews to collect data from 20 health professionals and 4 clients or their family members who were selected purposefully from the health centers affiliated with Isfahan University of Medical Sciences. Themes were identified using latent qualitative content analysis. Trustworthiness of the study was supported considering auditability, neutrality, consistency and transferability. The study lasted from 2010 to 2011. Some important challenges were identified as protecting professional territory, medical oriented approach and teamwork deficits. They were all under a main theme emphasizing professional's divergent views. It could shed insight into underlying causes of collaboration gaps among nurses and other health professionals. The three introduced themes implied difficulties mainly related to "divergences" among health professionals. Moreover, the difficulties revealed the need for training chiefly to improve their convergent shared views and approaches. Therefore, it is worthwhile to suggest interprofessional education for nurses and other professionals with special attention to improving interpersonal skills as well as mental health need-based services.

Each group or profession has its own discourse. Discourses create identity, support institutions, and reproduce power relationships. Professional identity of Iranian nurses, which has recently had the opportunity to represent itself in social arena, needs investigation. This study aims to making clear internal aspect of this identity. This study was conducted by discourse analysis, using data of 23 semi-structured individual interviews, and 4 focus group interviews with nurses and senior nursing students of Tehran and Isfahan University of Medical Sciences to evaluate their professional identity. In professional self concept, variables elements like spirituality value and low financial benefits, conflicting features of holiness and humility, identity emerging, identity escape, low professional self confidence, and justice seeking, lost professional authority, and pride. Nursing professional identity has formed based on cultural social structure, values and beliefs governing health system. This identity is a spectrum of a growing and emerging identity to a developed but forgotten identity. Although nursing discourse is subordinate in health system discourse, signs of moving toward professional maturity have emerged.