مجله پرستاری گروه های آسیب پذیر
سال دوم شماره 3 (پیاپی 4، پاییز 1394)

Thalassemia major (TM) is among the most common genetic diseases in Iran and around the world. Like any other chronic disease, TM exerts negative physical and psychological effects. Depression is one of the most important psychological effects of TM which affects a large percentage of the patients.
To determine the association between depression and social support in patients with TM.
This cross-sectional study recruited 180 patients with TM from thalassemia centers in Bushehr, Iran during 2014. The patients were selected using census sampling. The Beck Depression Inventory and the Social Support Appraisals Scale were administered for data collection. Data were analyzed using descriptive statistics, independent t, chi square, and Tukey’s post hoc tests, analysis of variance (ANOVA), and Pearson's correlation analysis. All analyses were performed in SPSS 19.0 at a significance level of 0.05.
The patients’ mean depression score was 11.57 ± 9.87. According to the obtained Pearson’s correlation coefficients, depression had significant inverse relationships with the total scores of social support and the scores of family support and support from other significant individuals. However, the relationship between friend support and depression was not statistically significant.
The present study highlighted the role of social support in reducing the rates of depression among patients with TM. Therefore, individuals with TM need to receive not only routine medical care, but also support from strong social networks.

A precise and specialized questionnaire to evaluate living with chronic pain among the older adults is essential to the holistic assessment and effective management of chronic pain among this population.
To develop and analyze the psychometric properties of a questionnaire to assess living with non-cancerous chronic pain among older individuals.
This study was a part of a sequential mixed exploratory research. The development and psychometric analysis of a questionnaire to assess living with non-cancerous chronic pain among the older individuals was conducted in three stages. In the first stage, the grounded theory approach was applied to explore the mentioned concept based on the viewpoints of 30 older individuals with chronic pain, three relatives, and 29 healthcare providers. The participants were selected through purposive and theoretical sampling methods. In the second stage, the items of the questionnaire were developed based on the results of the qualitative stage (first stage) and the review of the relevant literature. In the last stage (psychometric analysis), the methodological approach was applied to evaluate the face, content, and construct validity, internal consistency reliability, and stability of the questionnaire.
Based on the participants’ viewpoints in the qualitative part of the study, an older individual’s living with chronic pain involved a series of different methods adopted by the individual to actively adapt with pain. The initial questionnaire was developed during the second stage. In the third phase of the study, the face and content validity of the questionnaire were measured by qualitative and quantitative approaches, respectively (CVR= 0/91, the mean content validity index = 0.93). Moreover, exploratory factor analysis to assess construct validity resulted in two factors. The first factor (individual lifestyle) included eight items and the second factor (social lifestyle) contained seven items. Finally, after test-retest, the internal consistency (α = 0.89) and stability (ICC = 0.94) of the questionnaire were confirmed.
Considering the acceptable validity and reliability of the developed questionnaire, it can be administered to assess living with chronic pain in older individuals. The obtained results can then be used by healthcare providers and researchers for effective pain management among the mentioned population.

Liver transplant is a unique and rare experience through which an individual gets a second chance to live. Awareness of liver transplant recipients’ experiences can improve our understanding of their needs and the quality of their care.
To assess the psychological experiences of liver transplant recipients.
In this qualitative phenomenological study, liver transplant recipients were purposefully selected from Afzalipour Hospital, Kerman, Iran. Data were collected through unstructured in-depth interviews with eight patients. The Colaizzi’s method was used for data analysis.
Four main themes emerged from data analysis. These themes were impatience, depression, fear, and tendency toward pious deeds.
The psychological problems identified in the studied liver transplant recipients emphasize the necessity of attention to these patients’ not only somatic symptoms, but also psychological needs. Therefore, these patients have to receive psychological counselling both before and after the surgery.

Chronic renal failure (RF) is a major health issue with an increasing prevalence throughout the world. Since many CRF risk factors are controllable, their early detection can delay the incidence of end-stage renal disease (ESRD) and facilitate the management of the condition.
To investigate the causes of CRF in patients undergoing dialysis in Shohada Hospital, Bushehr, Iran.
This cross-sectional study was performed on 93 patients undergoing continuous hemodialysis at the Hemodialysis Center of Shohada Hospital. The history of kidney stones, urinary tract infections, diabetes mellitus, hypertension, and edema was extracted from patient files. Data were analyzed using SPSS 19.0.
The main causes of CRF in the studied population were hypertension (34.2%), diabetes (26.9%), an unknown agent (12.9%), diabetes plus hypertension (10.8%), infection (4.3%), and other factors such as lupus, kidney stones, congenital diseases, anemia, and Alport syndrome (10.9%).
The most common causes of CRF in male patients were diabetes (28.6%) and hypertension (26.5%). While the same two conditions were the main causes of CRF in women, hypertension had a higher frequency than diabetes (36.4% vs. 27.2%). Since the identified factors are treatable, relevant strategies need to be adopted to prevent CRF or delay its onset.

Since many deformities, oral diseases, and oral hygiene habits are formed in two-five-year-old children, mothers have a critical role in promoting their children's oral health.
To evaluate the knowledge, attitude, and practice of mothers toward dental and oral care of two-five-year-old children.
This descriptive-analytic study was conducted in 2013-14. Mothers who visited dental clinics in Isfahan (Iran) were selected through stratified multistage sampling. Three questionnaires were administered to assess mother's knowledge, attitude, and performance regarding their children’s oral health. Five other items were also included to evaluate the participants’ personal and family characteristics. The collected were analyzed using descriptive statistics, Spearman’s correlation analysis, and analysis of variance (ANOVA) in SPSS 17.0. P values less than 0.05 were considered significant.
Low (0-5), moderate (6-10), and high levels of knowledge about oral health were found in (8.6%), (47.4%), and (44%) mothers, respectively. While none of the mothers had negative attitudes (0-23), neutral (23-69) and positive (69-88) attitudes were present in (40.1%) and (59.9%) participants, respectively. There was a significantly relationship between knowledge and employment status (P Mothers’ knowledge and performance toward their children’s oral health was undesirable. Therefore, health education programs are required to promote the knowledge of mothers in this regard.

Clinical decision support systems are increasingly administered as a modern method to improve the quality of clinical therapeutic services delivered to patients.
To answer the following questions: 1. What are the widespread applications of clinical decision support systems in the field of nursing? 2. What are the most important barriers to clinical decision support systems in nursing? 3. What are the best strategies to reduce, remove, or overcome the barriers to clinical decision support systems in nursing?
In this systematic review study, English-language databases, including Science Direct, PubMed, Cochrane, and CINAHL, as well as a Persian-language database (the Scientific Information Database) were searched in three steps. Articles published during 2008 to the beginning of 2015 were searched for “clinical decision support system” (both in English and Persian) as the keyword. The keyword was selected from the Medical Subject Headings (MeSH) terms. The articles were selected based on three inclusion criteria, i.e. publication data after 2008, being in either Persian or English, publication in domestic or international scientific and research journals and accessibility of full texts or abstracts.
From the 1034 searched articles in the first phase, 337 articles were selected for the second phase. However, only 11 articles which were deeply related to the field of nursing were finally investigated. Using the given answers to the study questions, socio-technical factors were declared as the major theme. It was concluded that the expansion of clinical decision support systems in nursing required focus on three factors including communication between clinical information systems, clinical decision support systems, clients, and system errors, nurse's perspectives, and organizational changes.
Clinical decision support systems in nursing are still in their early stages of development. Since the progress of these systems in nursing has been significantly slower than that in other fields of medicine, innovative strategies are necessary to increase their application.