فهرست مطالب حمیدرضا صادقی گندمانی

 Colorectal cancer is a developing gastrointestinal disease that results in an ostomy operation. Meanwhile, stoma-related complications following ostomy surgery are associated with several physical and psychological diseases in patients. The present study aimed to determine the relationship between self-esteem and perceived social support in ostomy patients. 

 This was a correlational-descriptive study performed in 2017. The sample size was estimated at 390 individuals considering a 95% confidence interval, an 80% test power, and r=0.2. The participants were selected by continuous sampling, and those who were a member of the association and met the inclusion criteria (having a file in Iran ostomy association, no diagnosed physical-psychological diseases, not being in the progressive stage of the disease, having the ability to answer the questions of the questionnaire and at least six months of symptoms of the disease) were enrolled in the study. The researcher visited the association on different days of the week and distributed questionnaires among patients following explaining research objectives and how to complete the instrument and receiving written consent from the subjects. In this study, we applied three questionnaires on demographic characteristics (age, gender, marital status, occupational status, level of education, and duration of disease), self-esteem, and social support. The Rosenberg self-esteem questionnaire encompasses 10 items, which are scored based on a four-point Likert scale from zero (completely disagree) to 3 (completely agree). In this regard, the highest score is 30, and scores above 25, 15-25, and below 15 show high, moderate, and low self-esteem, respectively. The content validity of the mentioned tool was approved based on the opinions of its developers and different preliminary studies (26). In a research by Greenberger et al., the internal consistency of the scale was reported at 0.84. In addition, Pullman & Allik reported internal consistency of 0.91 for the mentioned scale. In the current research, the internal consistency of the instrument was approved at a Cronbach’s alpha of 0.90. Designed by Northouse, the perceived social support questionnaire contains 40 items in five sections the spouse, family members, friends, physician, and nurse. Each section includes eight items to assess patients’ social support perceived from their spouse, family members, friends, physician, and nurse. The items are scored based on a five-point Likert scale from 1 (completely disagree) to 5 (completely agree). The perceived social support score from each of the support sources is calculated separately from the total scores obtained for each resource and the overall perceived social support score from the total scores obtained in all sources. The range of changes in the overall perceived social support score of the five sources is from 40 to 200, and the range of changes in the perceived social support score of each resource separately is from 8 to 40. The perceived social support score is divided into three levels of low (40-92), moderate (93-146) and high (147-200), and the perceived social support score of each support source is classified into three levels of low (8-18), medium (19-29) and high (30-40). In Iran, the questionnaire was first applied by Heydari et al. (2005), who used the internal consistency method to confirm the reliability of the tool. In the end, the reliability of the tool was confirmed at a Cronbach’s alpha of 0.92. In the present research, the internal consistency of the questionnaire was approved at a Cronbach’s alpha of 0.80. After receiving approvals from the ethics committee of the university, the researcher received an introduction letter from the officials of Kashan University of Medical Sciences to enter the research setting. Afterwards, the researcher referred to the research center and gained permission from the manager and head of the center to start the research. First, the researcher selected participants based on the inclusion criteria received written consent from them, and ensured them of the confidentiality terms regarding their personal information. In the next stage, he read the questions for the subjects and wrote down their answers without any change. Data analysis was performed in SPSS version 16 using descriptive statistics (to regulate table), independent t-test (to analyze the data), as well as one-way ANOVA, Pearson’s correlation coefficient, and Tukey’s test. 

 In this study, 350 questionnaires were completed. The mean age of ostomy patients was 37.7 ± 5.87 years. In addition, 52.3% of the subjects were married, 65.4% were female, and 38.6% had a diploma degree. Moreover, 40% of the subjects were dealing with the disease for more than seven years. The mean and standard deviation of patients’ perceived self-esteem and social support were 20.56 ± 5.17 (out of 30) and 131.17 ± 15.47 (out of 200), respectively. The majority of ostomy patients (68%) had moderate self-esteem. In addition, most of the participants (84.3%) had moderate perceived social support. The relationship between the mentioned variables was assessed using a Pearson’s correlation coefficient, the results of which were indicative of a significant and direct association between perceived social support and its dimensions with self-esteem (r=0.20, P=0.001). In addition, there was a significant relationship between the mean score of self-esteem and marital status (P=0.001). In fact, the mean score of self-esteem was significantly higher in married subjects, compared to single and divorced ones (P=0.001). Moreover, we found a significant correlation between self-esteem and level of education (P=0.008), in a way that the mean self-esteem score was significantly higher in the participants with an MSc degree, compared to other levels of education (P=0.008). Furthermore, we detected a significant relationship between perceived social support and level of education (P=0.005), in a way that the mean perceived social support score was higher in those with an MSc or BSc degree, compared to other levels of education (P=0.005). There was also a significant correlation between the mean score of perceived social support and duration of the disease (P=0.005) since the mentioned variable’s score was higher in those who had the disease for two-four years, compared to other participants (P=0.005). 

 Given the significant impact of perceived social support on self-esteem it is recommended that high-risk groups (in terms of social support perception and receiving) be recognized by nurses and their support needs be assessed constantly. In fact, great attention can be paid to this psychological dimension of patients by improving their psychological health and connecting them to the community, families and friends.

Colorectal cancer is a progressive gastrointestinal disease that leads to the insertion of an ostomy for patients. On the other hand, the manifestations and complications caused by the insertion of the ostomy cause many physical and mental problems for the patient. The aim of this study was to investigate the relationship between body-esteem and perceived social support in patients with ostomy in the Iranian Ostomy Association. This descriptive-correlational study was performed on 350 patients with ostomy referring to the Iranian Ostomy Association in Tehran. The Convenient method was used for sampling. The data collection tool was a Body-esteem Scale and Nortous social support questionnaire. Data were analyzed by SPSS software version 16 and independent t-test, ANOVA, Pearson correlation coefficient and Tukey test. The mean and standard deviation of Body-esteem and perceived social support of patients were 42.57 ± 10.24 and 131.17 ± 15.45. According to the findings of this study, the mean score of Body-esteem and social support in patients with ostomy was moderate. There is a direct and significant relationship between social support and Body-esteem (r = 0.13, P = 0.006). Since the perception of social support has considerable effect on Body-esteem, it is recommended that nurses, by identifying high-risk groups in terms of receiving and understanding social support, continuously examine the patient's support needs and improve their level of Mental health and also by connecting patients with the community, families and groups of friends pay attention to this psychological dimension.

Medication errors are one of the most common errors in care and these errors have a double importance among nurses. This descriptive-analytical study was carried out on 350 nurses working in Shahid Beheshti Hospital in Kashan, Iran by stratified sampling method. Data were collected using Pittsburgh sleep quality questionnaire, The Multidimensional Fatigue Inventory, and medication errors questionnaire. Data were analyzed by SPSS software version 16 and independent t-test, ANOVA, Pearson correlation coefficient and Tukey post hoc test. Based on the findings of this study, the incidence of nursing medication errors in the past 3 months was 12.39 ± 2.42 (total score 19) and the fatigue score of 78 ± 16.5 (total score 140) was moderate. There was a direct and significant correlation between the amount of fatigue with the occurrence of drug errors (r = 0.40, P < 0.001). According to the results of this study, it can be concluded that the occurrence of drug errors in nurses is common. Therefore, it is necessary to teach the principles of correct medication taking into account all safety points, identifying and eliminating the factors leading to fatigue of nurses in each department and providing conditions for nursing fatigue moderated.

Nurses in surgical wards frequently need to make prompt decisions for critically-ill patients. Therefore, they need to be professionally empowered to make sound decisions and provide quality care. This study aimed to explore barriers to the promotion of nurses’ professional empowerment from the Perspectives of Nurses working in Surgical Ward of Kashan Shahid-Beheshti hospital. In this exploratory-descriptive qualitative study, 15 nurses working in the surgical ward, Kashan University of Medical Sciences Hospital, Iran were selected by purposeful sampling with maximum variability. Data were collected through fifteen in-depth semi-structured interviews from December to February 2018. The data were analyzed via conventional content analyses. Data analysis led to the identification of the main theme as "imposed and learned powerlessness." Participants in this study identified imposed and learned powerlessness as an important challenge in achieving professional empowerment. This main theme consists of the three main categories of low professional competence, lack of professional support, and shortage of resources. Surgical nurses in Iran are confronted with numerous challenges in achieving professional empowerment. Therefore, the professional empowerment of nurses in the surgical department should be enhanced by providing opportunities for achieving clinical knowledge and skills. Considering the role of nurses as an effective indicator on the quality of patient care and safety, the need for powerful professional organizations to professional support of nurses, nurses' recognition, and full description of the nursing realms and the clarification of job tasks is necessary.

Educational experts believe that effective teaching methods such as concept mapping are appropriate to help nursing students develop critical thinking skills. Hence, this study was carried out to review the effectiveness of concept mapping in developing critical thinking skills among nursing students in Iran and the world. A systematic review was conducted on thirteen research papers, review articles, and meta-analyzes published from 1998 to 2015 and assessed the effect of concept mapping method on nursing student's critical thinking. Farsi and English articles with full text available at Data bases such as Google Scholar, PubMed, Science Direct and Ovid were searched using keywords concept mapping, critical thinking skills, nursing student, and nursing education in the title or abstract of papers. Overall, eleven quasi-experimental studies and two experimental studies were reviewed. Most papers based on critical thinking questionnaires of California used to measure critical thinking. Most studies reported that concept mapping have been effective to promote critical thinking skills of nursing students. Our results showed that studies conducted on concept mapping are still in its infancy. Therefore, the positive impact of concept mapping method on nursing student's critical thinking skills is still an open question and requires further experimental and longitudinal studies with larger sample sizes and rigorous methodologies

Development of critical thinking and practical skills has remained a serious and considerable challenge throughout the nursing educational system in Iran. Conventional methods of teaching such as lectures as the dominant method used in higher education system is a passive style which ignores critical thinking. Therefore, the aim of this study was to compare the effect of instruction by Concept-Mapping and conventional Method on critical thinking skills of nursing students.
This quasi-experimental study was carried out on 70 nursing students of Tehran Nursing and Midwifery schoolwho were selected through convenient sampling method, then were divided randomly into the two equal Experimental and Control groups. Educational content was presented in the form of Concept-Mapping in the Experimental group and Lecture,Demonstration and Practicalexercises in the control group. Data collection included a demographic information and California Critical Thinking Skills (form B) questionnairewhich was completed at the beginning and at the end of the fourth week of Instructional period. Data were analyzed using SPSS software (V: 21), descriptive and analytical Statistics; at the significant level P Before the intervention, the mean of critical thinking skill score was 9.71±2.66 in concept mapping group and 9.64 ± 2.14 in conventional group and the difference was not significant (P=0.121), but after the intervention, a significant difference was found between the intervention and conventionalgroup (15.20±2.71 vs 10.25±2.06, P=0.003).
Using Concept mapping strategy in the education of nursing students may lead to developing critical thinking skills as one of the important missions of higher education. So it is recommended to usethis method in clinical nursing education.

Development of critical thinking and Procedural skills has remained a serious and considerable challenge throughout the nursing educational system in Iran. Conventional methods of teaching such as lecture, as the dominant method used in higher educational systems, is a passive style which ignores critical thinking. Therefore, the aim of this study was to compare the effects of instruction by concept-mapping and conventional methods in fundamentals of nursing on critical thinking skills in Tehran nursing students in 2014.
This quasi-experimental study was carried out on 70 nursing students, who were selected through convenient sampling method, then divided randomly into two equal experimental and control groups, in the Clinical Skills Center of Tehran Nursing and Midwifery School. Educational content was presented in the forms of concept-mapping for the experimental group and lecture in the control group. Data collection included a demographic information and California Critical Thinking Skills (form B) questionnaire; They were filled at the beginning and end of the fourth week of the Instructional period. Data were analyzed using SPSS software (v. 21), using descriptive and analytical statistics, at the significance level of 0.05.
Before the intervention, the mean of the total critical thinking skill score was 9.71 ± 2.66 in the concept mapping group and 9.64 ± 2.14 in the lecture group, and the difference was not significant (P = 0.121); but, after the intervention, the critical thinking skill score was 15.20 ± 2.71 in the intervention group and 10.25 ± 2.06 in the control group, which had a significant difference (P = 0.003).
Using concept mapping strategy in the education of nursing students may lead to developing critical thinking skills as one of the important missions of higher level education. Therefore, it is recommended to employ this method in clinical nursing education.

Fear of falling may restrict activities that can increase risk of falls. The aim of this study was to investigate the incidence of fall and fear of falling and their relationship. This descriptive cross sectional study was performed on 160 institutionalized old people (130 females, 30 males) with aged 65 and older that enrolled by all number of sampling. after receiving informed consent. Data were collected by demographic and illness form, fall frequency form and FSE questionnaire. Descriptive statistics for data classification and inferential statistics including one-way ANOVA, t-test and Pearson correlation were used for data analys. Validity and reliability of FSE questionnaire was confirmed after analyzing (Cronbach's alpha = 95%).It should be noted that the level of significance in this study is considered 0/05. Among 160 subjects, the majority of the elderly were women (81/2%) and with mean (SD) of age 67/63 ± 9/07 years. mean and SD of fall was 2.6 ± 0.85. 46/9% of the elderly have fallen three times in the past six months, while the majority of the elderly (76/2%), have moderate fear of falling. there was significant difference Between sex and using of drugs with the number of falls (p< 0.001). Between fear of falling and sex (p< 0.05) and residence time(p= 0.02) significant difference was seen. Pearson correlation showed a significant relationship between the number of falls and fear of falling With confidence of 99 percent. (p< 0.001). Due to the prevalence of falls and fear of falling in elderly and direct relationship with each other plan should be done for prevention and control them to improve the welfare of elderly life.

Promotion of creative skills is one of the goals of higher education for training nursing students and also the need for innovative nurses in intensive care wards is felt to provide exclusive complex care to very ill patients. Thus, this survey aimed to compare creative skills in the nursing students and nurses in 30 intensive care units of hospital covered by Tehran University of medical sciences in 2013.

In this cross-sectional study, all freshman (131) and senior (126) nursing students through census method and 150 nurses in the intensive care units of hospitals covered by Tehran University of Medical Sciences in 2013 were selected by random sampling. Abedi Creativity questionnaire was used for data gathering. Data were analyzed using SPSS software, with variance analysis and Toki tests; at the significant level P<0.05.

Mean score of creative skills scores for freshman students was 126.1±7.4, senior students 142.4±8.6 and for nurses 151/6±8/4 that was statistically significant. There is a meaningful difference between the freshman students with senior students (p<0.01), freshman students with nurses (p=0.02) and senior students with nurses (p=0.01) in terms of the mean scores of creative skills. So that nurses̛ creativity skills was more than of freshmen and senior students.

Research findings show that creative skill in critical care nurses is more than students and also in senior students is more than freshman students. Low levels of creative skill among nursing students compare to nurses indicates the necessity of the skill improvement by embedding them in students’ curriculum and using modern methods of teaching.

Blood pressure is an important vital sign that reflects systemic and focal changes. Planning of treating most of the disease is based on the values obtained from this measurement. Regarding this, Knowledge about Blood pressure measurement procedure is important. The aim of this study was to determine the practical skill in measuring of blood pressure in undergraduate nursing students. This is an analytic-descriptive study of 350 first years to fourth year undergraduate nursing students who had studied in educational year 2012-2013 of Tehran University of Medical Sciences and samplized by census methods. Data collection was done through investigator-made questionnaire. The data was analyzed by using SPSS software (V: 21), using descriptive and analytical Statistics; at the significant level P<0.05. Findings showed the overall mean score of the students's knowledge in Blood pressure measurement was13/77±2/86. First year students's level of knowledge in Blood pressure measurement was higher than the other years, however the differences wasn's t statistically significant (P=0/93). These findings indicate that knowledge of participants was inadequate to perform blood pressure measurement in a standardized manner; therefore it is vital to have frequent, regular and up-to-date training for nurses in order to follow the new rules for measuring blood pressure.

Identifying the factors influencing nursing students’ academic success is of great importance. Due to controversies on the role of influencing factors, this study aimed to identify the predictors of academic success among nursing students of Kashan University of Medical Sciences.
In this cross-sectional study, 134 sophomore to senior nursing students studying at Kashan University of Medical Sciences were selected through systematic random sampling in 2014. The data was collected through a questionnaire including demographic and academic success information which was used after confirming its validity and reliability. Data were analyzed using Chi-square, Kruskal-Wallis, Mann-Whitney and Spearman correlation coefficient.
Non-native status and staying in dormitory had positive effects on academic success (p Considering the predicting role of demographic factors in the nursing students’ academic success; the authorities should plan to improve the students’ academic success.

Creativity is an essential part of nursing care. Thus developing creativity skills in nursing education is a priority. The aim of this study was to compare the effect of instruction by concept-mapping and update the fundamental of nursing by teaching creativity skills to nursing students. This quasi-experimental study was carried out on 70 nursing students, who were divided randomly into two equal experimental and control groups, in the Clinical Skills Lab of Tehran Nursing and Midwifery School. Educational content was presented in the form of concept-mapping in the experimental group and common method in the control group. Data collection included a demographic information and Abedi Creativity questionnaire; that filled at the beginning and at the end of four weeks course period. Data were analyzed using SPSS software (V. 21), using descriptive and analytical statistics at the significant level P<0.05. Before the intervention, mean total creativity’s score was 126.1±7.4 in the concept mapping group and 128.2±5.2 in the common group and the difference was not significant (P=0.07). However, after the intervention, a significant difference was found between the intervention and control group (157.8±7.3 vs. 138.1±5.1, P=0.01). After the intervention, the creativity skills in nursing students was improved in both group, but the Influence of education in concept-mapping group was greater than the common method. Further research with more time and for other lessons can be useful for evidence-based decision-making.

The advisor is a person who is responsible for students'' academic guidance and counseling with the advisor will help students to overcome educational problems. The aim of present study was to compare students’ viewpoints on academic advisors performance before and after the advisors project. In this descriptive cross-sectional study، viewpoints of 244 students of Shahrekord University of Medical Sciences on academic advisors performance before and after the advisors project using a researcher-made questionnaire were compared in 2011-12 and 2012-13 first semesters. Data were analyzed with SPSS 16 by paired-T and Chi square tests. There was a significant difference between students’ viewpoints on having advisor and refer to her، accepting her as a source of information، being aware of how to ask help from the advisor and question about continuing education and filing educational document before and after the project. Of the advisors performance، checking and signing the course selection form، guiding students on personal problems and review the student''s academic progress، were different significantly. Students’ viewpoints is better on having advisor and referring to her، accepting her as a source of information، being aware of how to ask help from the advisor and question about continuing education and filing educational document after the advisors project. Also، of the advisors performance، checking and signing the course selection form، guiding students on personal problems and review the student''s academic progress are improved after the project.