Modern Care Journal
Volume:15 Issue: 4, Oct 2018

Nursing documentation has significant roles in giving coherence to teamwork, making effective use of healthcare providers’ knowledge, improving care quality, maintaining care continuity, and identifying changes in patients’ conditions. However, studies show its poor quality. This study compared nurses’ and head nurses’ perspectives on the factors behind the quality of nursing documentation. This descriptive-correlational study was conducted in 2017 in Valiasr (PBUH) Hospital, Birjand, Iran. Accordingly, 140 eligible nurses and all 15 head-nurses in the hospital were recruited to the study through simple random sampling and census, respectively. They filled out a researcher-made 26-item questionnaire about factors behind the quality of nursing documentation. Because of the non-normal distribution of the study variables, the Mann-Whitney U, Kruskal-Wallis, and Friedman tests were used for data analysis. The level of significance was set at less than 0.05. Head nurses did not significantly differ from nurses respecting the mean scores of personal, managerial, and organizational factors behind the documentation quality (P > 0.05). The highest-scored factors were organizational factors. Organizational factors are the most important factors behind the quality of nursing documentation. Thus, adequate nurse staffing and avoidance from assigning non-nursing responsibilities to nurses are recommended to improve the quality of nursing documentation.

Health literacy and self-efficacy are two key factors behind a wide variety of health-related outcomes. This study aimed to examine the relationship of health literacy with hypertension self-efficacy and general self-efficacy. This cross-sectional descriptive-analytical study was conducted in 2016. Study sample consisted of 202 schoolteachers who were randomly selected from elementary and secondary schools in Qaenat county, Iran. Participants provided informed consent for participation and personally completed a demographic questionnaire, the short test of functional health literacy in adults,
Sherer’s general self-efficacy scale, and Mularcik’s hypertension self-efficacy scale. The SPSS program (V. 19.0) was employed for data analysis through running the independent-sample t, Chi-square, Tukey’s post hoc tests, Pearson correlation analysis, and one-way analysis of variance at a significance level of less than 0.05. The means of participants’ health literacy, hypertension self-efficacy, and general self-efficacy were 26.8  7.5, 47.9  11.5, and 38.18.9, respectively. Most participants had adequate health literacy (77.2%) and high hypertension self-efficacy (71.3%), while only 9.9% of them had high general self-efficacy. There was a significant negative relationship between general self-efficacy and educational level. Moreover, health literacyhada significant negative correlation with age (r=-0.17; P=0.013)andsignificant positive correlations with hypertension self-efficacy (r = 0.26; P = 0.001) and general self-efficacy (r = 0.15; P = 0.04). Health literacy has significant relationships with hypertension self-efficacy and general self-efficacy. Therefore, educational interventions can be used to improve health literacy, promote hypertension self-efficacy and general self-efficacy, and
facilitate hypertension management.

Nursing empathy, as an ethical behavior toward the maintenance of human dignity of patients, has always been a concern of hospital managers and healthcare policymakers on healthcare issues. The aim of this study was to investigate the relationship between the disposition towards critical thinking (CT) and empathy in nurses of educational hospitals in Birjand. The population of this correlational study included a total of 214 nurses who were working in the educational hospitals of Birjand and met the inclusion criteria. Participants were selected using the quota sampling method. Data collection tools included a demographic questionnaire and the California critical thinking disposition inventory (CCTDI) (Facione & Facione 1992) as well as and Jefferson’s scale of empathy (1987), which was completed by nurses. Data analysis was carried out using the Spearman correlation coefficient, multiple regression, Mann-Whitney U, and Kruskal-Wallis tests in SPSS ver.15 at a significant level of 0.05. The results showed a positive and significant relationship between the total CT disposition and empathy tools and their components (except for the systematicity and maturity displayed in standing in the patient’s shoes as well as truth-seeking with compassionate care components) (P< 0.05). Themeanempathy score in female nurses was significantly higher than in male nurses
(P = 0.01). However, the mean CT disposition score in male and female nurses was not significantly different. In addition, there was no significant difference between the mean CT and the empathy score in nurses based on their age (P > 0.05). Based on the results of this study, it is recommended that the planners in the field of nursing management training should develop the critical skills of nurses through workshops or in-service training to promote empathy among nurses.

Pay-for-performance (PFP) plan is regarded as one of the approaches to increase the efficiency of healthcare organizations.
In this respect, indifference to the challenges of implementing the given plan may result in its failure and irreparable damage to health systems. The present study aimed at identifying the challenges of implementing the PFP plan in the views of nurses working in hospitals of Mashhad University of Medical Sciences, Iran. This study was done in the form of qualitative research using a content analysis method conducted in a cross-sectional manner in early 2016. To this end, sampling was of a purposive type and it continued until the data saturation was fulfilled. The participants consisted of 12 men and 17 women with at least 10 years of service, who were selected out of nurses or head nurses
working in public hospitals in the city of Mashhad, Iran, as well as nursing experts of the headquarter office of the vice-chancellor for treatment affairs at Mashhad University of Medical Sciences. Data collection was carried out through semi-structured interviews.The content analysis method was employed for data analysis with regard to accuracy, precision, reliability, and consolidation of thedata (via triangulation). The results of the study led to the categorization of the data into fourmainthemesand25 subthemes. The fourmainthemes included structural challenges (10 subthemes), operational challenges (five subthemes), motivational challenges (six subthemes), and biases in decision-making (four subthemes). The theme of structural challenges, among the others, was mentioned as one of
the significant factors affecting the implementation of the PFP plan addressed by all study participants. It was concluded that the PFP plan is encountering many challenges in practice; thus, efforts to cope with them could be a big step toward meeting satisfaction in employees and patients. According to the study results, managers are recommended to consider the necessary measures prior to implementing this plan to avoid such challenges as much as possible.  

Physical disability is adamagethat limits the major activities of a person’s lifeandleads to anxiety, depression, mental health problems, and lowers happiness levels. In light of these consequences, it seems necessary to carry out some intervention to reduce depression and anxiety as well as promote the happiness of people with physical impairment. Therefore, this study sets out to investigate the effect of clay therapy on anxiety, depression, and happiness in physically impaired individuals under theWelfare Organization support in Qaen city. In this randomized controlled clinical trial, 50 individuals with a physical disability, under the Welfare Organization support in Qaen city, in the year 2016, who fulfilled the criteria for entering the study, were selected by convenience sampling and assigned to two groups, the experiment group (25 people) and the control group (25 people), through systematic random sampling.
The experiment group received a clay-working program for 12 sessions of 60 minutes each (two sessions per week). The data collection tool was a demographic questionnaire, a Depression, Anxiety, and Stress Scale (DASS-21), and the Oxford Happiness Inventory. Data were analyzed using SPSS 15 software, chi-square, independent t test, Mann-Whitney U test, Friedman test, and Wilcoxon test. The results of the present study show that the mean score of happiness after completing the sixth session was significantly higher in the experiment group than in the control group. The mean depression and anxiety scores after the intervention in the experiment group were significantly lower than that in the control group, while the mean score of happiness after the clay therapy
was significantly higher in the experiment group than that in the control group (P < 0.001). Based on the results, clay therapy has the potential to reduce anxiety and depression as well as increase the happiness of people with physical impairment underWelfare Organization support.

During acute severe muscular activities, the levels of inflammatory markers, including cortisol and C-reactive protein (CRP), significantly increase, which can be the underlying factor and the initiator of atherosclerosis and cardiovascular diseases.
Given the complications and high prices of sports supplements consumed to neutralize these undesirable effects following acute severe muscular activities. The purpose of this study was to evaluate the effect of consuming 500 mL of low-fat milk on cortisol and salivary CRP response after resistance training in young healthy women. In this study, two groups with the age range of 20 - 25 years and the body mass index (BMI) from 20 - 24.9 kg/m2 were recruited. Then, a group of 10 individuals performed two protocols at two intervals and were then compared together. The resistance training program included three sets with 10 reps and 75% intensity of a maximum rep in two one-hour sessions. On the first
day, salivary sampling was carried out in fasting conditions, immediately before and after training, and also at the 60th and 120th minutes following it. One week later, in the second phase, the above-mentioned steps were fulfilled using 250 mL of low-fat milk in two sessions during sports activities. Descriptive statistics were also used to determine the mean and the standard deviation; and repeated measures analysis of variance (ANOVA) was employed at the inferential level. This test was employed to examine the main and the combined effects within four different  times (immediately before and after training as well as one and two hours aftertraining) in the experimental group in two different situations. The significance level of the tests was also considered as P < 0.05. The results of the study did not reveal significant changes in the between-group comparisons of low-fat milk consumption in terms of cortisol and salivary CRP response after one-session resistance training program (P > 0.05). Based on the findings of this study, it was concluded that low-fat milk consumption was not able to adjust cortisol and CRP levels as inflammatory markers following one session of resistance training. Although milk consumption had reduced the CRP levels after training, this was not reported as a significant decrease. Definitely, measurement times in this test were of utmost
importance.