طاهره یعقوبی

 Road traffic injuries pose a global public health challenge. This study aimed to determine the epidemiological trend and factors affecting traffic accidents in emergency medical services within the Mazandaran University of Medical Sciences jurisdiction between June 2021 and January 2024.

This analytical epidemiological study employed a cross-sectional, retrospective design, conducted within the pre-hospital emergency medical services of Mazandaran Medical Sciences University between June 2021 and January 2024. Descriptive and inferential statistical methods were used for data analysis. The Chi-square test and multiple logistic regression model were used to investigate factors associated with fatalities (such as age, gender, time of the incident, and patient status). All data were analyzed using SPSS version 27. Odds Ratios (OR) and P-values were reported. Statistical significance was set at P < 0.05.

This study collected and analyzed data from 83,973 emergency medical service calls in Mazandaran during the specified period. Of these calls, 62,316 victims were male (74.2%), and the rest were female. The mean age of the injured was 32.02 years. The highest number of calls concerned the young adult age group of 17-39 years (48.5%), and the lowest frequency was observed in individuals aged 85 years and older (0.2%). Traffic accident fatalities were associated with male gender, older age (≥85 years), incidents occurring at night (12:00 AM to 6:00 AM), and patient status (vehicle occupants).

The findings indicate that traffic accidents in this region remain a serious public health problem requiring special attention. Based on these findings, implementing targeted preventive interventions to reduce mortality in high-risk groups (young men, car and motorcycle drivers) and during high-risk times (nights, summer) is essential.

Active aging involves optimizing opportunities to enhance the quality of life in older age. Environmental differences and lifestyle variations between urban and rural areas can significantly affect active aging. This study aimed to compare the indicators of active aging among elderly individuals in urban and rural areas of Behshahr, while also identifying the factors associated with these indicators in 2023.

This cross-sectional, descriptive-analytical study employed a proportional quota sampling method to examine 350 elderly individuals from comprehensive health service centers in Behshahr. The tools used included a demographic-social factors form and a 40-item questionnaire on the Iranian Active Aging Index. Collected data were analyzed using SPSS version 20 and linear regression tests.

The mean age of the elderly participants was 70.96±13.8 years. Among the participants, 52% were men, and 61% were married. The average scores on the Active Aging Index were 111.47±30.48 for urban residents and 93.73±21.66 for rural residents, demonstrating that urban elderly individuals had significantly higher scores than their rural counterparts (P<0.001). Married elderly individuals in both groups scored significantly higher on the Active Aging Index compared to single individuals. Participants with higher education levels and income also achieved significantly greater scores. In contrast, an increase in age and the number of children was associated with a notable reduction in the Active Aging Index score (P<0.05).

Attention to geographical, cultural, and social differences is crucial when formulating policies for the elderly. Furthermore, there is an urgent need to develop infrastructure that improves access to health and social services for older adults in rural areas. These findings can guide policymakers in enhancing the quality of life for older adults, highlighting the importance of addressing the unique needs of diverse groups.

 Ensuring reproductive health is a tool for empowering families so that they can make responsible, informed and free decisions about when and how to have children. Therefore, this study was conducted with the aim of reviewing healthy pregnancy from the perspective of the Holy Quran.

 This study is based on conceptual review and was conducted by reviewing the sources published in English in PubMed, Cochrane Library, Scopus and Google scholar and in Persian in Magiran, SID, and Barkat databases. The search was performed using the keywords “healthy pregnancy”, “nutrition”, “mental health” and “the Holy Quran” from 2001-2024. Moreover, verses, hadiths and texts were collected using manual search in Holy Quran, Tafsir al-Mizan, Tafseer e Burhan, and Reihane Beheshti.

 Regarding health from a psychological aspect, reciting the Quran during pregnancy has an effective role in calming the pregnant mother. It can also have positive effects on the growth and development of the fetus. In the Holy Qur'an, Almighty God has mentioned the peace of hearts with the remembrance of God. From the physical aspect, eating foods such as fruit, dates, frankincense, pomegranate, etc. has positive effects on the pregnancy process of the mother.

 The results of the studies showed that the recitation of Quranic verses, especially Surah Asr, Muhammad and Yusuf, and the consumption of frankincense, dates, quinces, pears, chicory, pomegranates, and seviq during pregnancy have positive effects on the mother and the fetus. Therefore, it is recommended to increase the awareness of the staff of health and treatment centers and students of medical sciences to take the necessary training courses to convey the contents to women.

In the article published in volume 33, issue 225, 2023, the research center of Soghra Khani and the affiliation of Nahid Aghaei, were incorrect but have now been corrected

The transition from the family environment to the university and relative or complete independence are among the most important stressors for young people. This study reports on the feeling of homelessness and homesickness of a nursing student, from an educational perspective.

The case pertains to a 19-year-old male student in his first semester of nursing, with no history of mental disorders. He is the third son and the third child in a family of six members. He hails from a distant city and attends university there. Psychological and psychiatric findings indicate a sense of alienation in the student, manifested by his lack of response to psychological counseling and his suicidal ideation, for which he received pharmacological treatment and psychotherapy sessions. The student experienced social anxiety due to seeking psychological and psychiatric help and taking nerve and psychiatric medications. Academic decline in classroom grades and mid-term assessments was evident due to lack of focus on academic subjects. Following coordination with course instructors, theoretical courses were studied virtually, while practical courses were taken after the end-of-semester examinations and face-to-face training. Coordination was also made with the destination university for the student's transfer as a guest student.

The findings indicate that in order to prevent negative consequences of the sense of alienation in students, there is a need for teamwork and professional communication among professors, faculty officials, academic advisors, and psychologists within the college. Therefore, it is recommended to have counseling and psychotherapy centers available on a daily basis in dormitories and universities.

Aging is a physiological process, but during this period, with the passage of time and the influence of environmental factors and unhealthy lifestyles, the prevalence of diseases, especially chronic diseases, increases. One of these chronic diseases is diabetes. It has negative effects on their physical and mental health and as a result, reduces their quality of life. A relatively new issue that is raised today regarding the quality of life is hope. Because hope can ease the process of facing life's adversities and improve the quality of life. Hope therapy is based on the hope theory of Schneider and colleagues and is based on a positive psychology approach. This study aimed to determine the effect of group hope therapy on the quality of life of elderly women with diabetes.

The study was designed experimentally with a before and after design in two control and intervention groups. Eligible elderly women with diabetes were selected from the diabetes clinic of Imam Khomeini Medical Education Center in Sari and were randomly assigned to intervention (20 people) and control (20 people) groups. The group hopes therapy training was conducted in 8 sessions twice a week for 90 minutes. The quality-of-life questionnaire of Thomas diabetic patients (DQOL) of two groups was measured before, immediately, and one month after the intervention. Data analysis was done using the Mann-Whitney, Friedman, Wilcoxon test and SPSS software version 16 and P<0.05.

The level of high quality of life increased from 35% to 50% in the control group and from 45% to 100% in the intervention group. The comparison of the average quality of life in the pre-intervention phase in the two intervention and control groups did not show a statistically significant difference (P=0.472). Comparison of the average quality of life immediately after the intervention in the two intervention groups (59.55±2.84) and control (45.90±3.69) and one month after the intervention in the two intervention groups (60.00±2.714) and the control (45.75±3.75) showed a statistically significant difference (P=0.001). Based on the results of the present study, the average quality of life of the control group was lower than the intervention group at the end of the intervention and one month after the intervention.

The results of the research showed that group hope therapy is effective in improving the quality of life of elderly women with type 2 diabetes. Elderly women with diabetes learned that they can find the meaning of life even in the suffering and pain caused by the disease. The concept of hope in people causes their perspective to widen from the current difficult and suffering conditions. Increasing hope leads to happiness, peace, adaptation to the current situation, increased energy, meaningfulness, and success in life. As a result, group hope therapy can be implemented to increase the quality of life in the daily care programs of the elderly, especially women.

Happiness and happiness are among the basic and natural needs of human beings and I can consider it as one of the most important medical and community health. Since I spend most of my student time at university. There is a great need to create spiritual vitality in students. Therefore, this study is processed with the aim of influencing students' spiritual students.

A review study of an anecdote in 1399 was conducted. To get selected articles to enter the information center database, comprehensive humanities portal and Noor magazines database with a combination of keywords of spiritual publishing, students and external sites Google Scholar, Pubmed, Scopus with Spritual keys Neshat, student from Searched from the beginning of 1990 to the end of 2020.Login in this research includes articles that paid to spiritual students, there are main research articles in Persian or English. Finally, 6 articles have been included in the study. Of these 6 articles, 4 Persian articles and 2 English budget articles.

The findings indicate the effect of 5 factors (cognitive factor, personal factors, academic factors, environmental factors, family factors) in creating spiritual vitality in students.

In order to create spiritual vitality, there is a need for families to try to teach and strengthen their religious beliefs and children's role models. University officials should plan for educational and recreational activities, strengthen encouragement and cultural activities of the organization, and involve students in such activities to create spiritual students and the university atmosphere.

Background and

The physical location of colleges is vulnerable to natural disasters and accidents. Therefore, it is necessary to develop a preparedness and response plan. The present study aimed to assess the readiness of accident risk management and passive defense in the Faculty of Nursing and Midwifery at Mazandaran University of Medical Sciences.

This study applied an action research approach. The data collection procedure was performed by evaluating the readiness of the faculties of the University of Medical Sciences in managing the risk of accidents and passive defense. Data were analyzed using the descriptive statistics of frequency, percentage, mean, and standard deviation. Then the results were discussed in the risk management and passive defense committee of the faculty. After several consecutive brainstorming sessions, the solutions were proposed in order to fix the weaknesses.

In the initial evaluation, the level of preparation in the faculty was considered to be low (˂39%). The possibility of fire and the vulnerability of the building in terms of structural safety were determined to be the most risky factors in the college. After improving the risk management process, the faculty's level of preparedness was determined to be average (40-60%).

The current action research approach improved the safety of the college. No budget allocation for safety measures and the time-consuming communication process between different departments are the major obstacles to achieving optimal safety in educational spaces.

The elderly are generally important users of pre-hospital health care and emergency services. The aim of this study was to determine the level of satisfaction of the elderly with pre-hospital emergency services in Sari.

This descriptive-analytical study was conducted in Sari from May to February 2019. A total of 300 elderly people were selected on weekdays using convenience sampling method. A demographic-cognitive questionnaire and an emergency care satisfaction scale questionnaire were distributed in all 115 emergency centers. The collected data were statistically analyzed with SPSS 21 using Student's t-tests and analysis of variance.

Most people in the elderly age group were 60-75 years old (85.6%). The majority of the studied elderly were men (52%). Of the cases sent by the pre-hospital emergency service, 15% were related to traffic accidents and 85% were not accidents. The highest satisfaction was found in the areas of ambulance status (6.57), technician's professionalism (6.5), and technician's attitude (6.49). The lowest satisfaction was found in performance (6.2) and efficiency (6.44).

The satisfaction of the elderly with pre-hospital emergency services is almost optimal. Providing counseling services to improve communication of technicians in dealing with this age group is a more effective step to increase satisfaction of the elderly.

Proper provision of students' spiritual needs provides the basis for healthy and successful human development. Resilience is a variable that influences students' health and helps them adapt to people's problems. The present study aimed to determine the relationship between spiritual needs and resilience in nursing students of Mazandaran University of Medical Sciences.

The present study was conducted based on a descriptive correlational design, and the statistical population included all nursing students of Mazandaran University of Medical Sciences. A total of 175 students were included in the study by random sampling. The religious need scale and Connor and Davidson resilience scale were used for data collection. The data were analyzed in SPSS software (version 25) using descriptive and inferential statistics, independent t-tests, and analysis of variance.

The results of this research demonstrated that students' spiritual needs and resilience had a significant negative relationship (r=-0.5) (P=0.000). Moreover, regression analysis revealed that the need for spiritual safety, spiritual self-actualization, friendship with God, self-respect, and belonging to God, respectively, had the largest contribution to the prediction of resilience. Furthermore, 38.2% of students' resilience can be predicted from spiritual needs.

It is recommended to pay special attention to the spiritual needs of students in the nursing education system so that effective steps can be taken to increase the resilience of nursing students.

 Improper lifestyle is one of the influential factors in the occurrence of chronic diseases, including high blood pressure. Health literacy is an important factor for people to better understand their health management. The purpose of this study is to investigate the relationship between health literacy and lifestyle in the elderly with hypertension.

 The present study was a descriptive-analytical study that was conducted on 210 elderly people with hypertension who referred to specialized clinics under Mazandaran University of Medical Sciences using a simple random method. The tools of data collection were health promoting lifestyle questionnaires (HPLP2) and health literacy of Iranian cattle (HELIA). Data analysis was done with SPSS version 23 software and Pearson correlation and regression tests.

The average age of the elderly was 67 years, of which 54.8% were men. The results of statistical analysis showed that 62% of the samples had a favorable lifestyle and 58% had sufficient health literacy. Men's lifestyle and health literacy had higher average scores than women (p<0.003). In the examination of the average scores of health literacy and lifestyle, a significant relationship was observed with the variables of employment status, education level, place of residence and the number of drugs consumed (p<0.05). A statistically significant correlation was seen between the variables of health literacy and lifestyle (p>0.001).

Increasing health literacy is an important step in improving lifestyle. It seems necessary to carry out educational-counseling interventions to improve the lifestyle of the elderly

due to the occurrence of covid-19 disease in the world and the lack of standard treatment for this disease, a lot of research was done to find the causes of the disease and the methods of treatment. and is not infected with covid 19.

This study is a case-control study and its statistical population was elderly people who referred to Bandargaz city hospital. 35 people in the case group and 107 people in the control group and a total of 142 patients were included in this study. Sampling was done to measure the level of vitamin D of these people with standard kits. The data of this study were analyzed using independent t-tests, analysis of variance, chi-square and linear regression.

The average level of serum vitamin D in people with a history of vitamin D consumption was equal to 40.49 ng/mL and in people with a history of not taking vitamin D, it was 15.6 ng/mL. The average serum level of vitamin D in the group infected with Covid-19 (24.48±18.22 ng/mL) compared to the non-infected group (25.95±23.54 ng/mL) showed no significant difference (<0.05). p).

The results of this study showed that there is no significant difference between the average serum level of vitamin D inferred in two groups with and without covid 19. It was also shown that the average serum level of vitamin D in the occupations of farmers and ranchers was lower than that of employees.

One of the most important aspects of human existence is spirituality. Coronavirus disease 2019 (COVID-19) has experienced a crisis in today's world. Evidence and information on the impact of this stressful crisis on spiritual and mental health is scarce and highly variable. The aim of this study was to investigate the role of spirituality on mental health during the COVID-19 pandemic.

In this narrative review study, the Persian studies were searched in Persian language databases such as Noormags, Alamnet, SID, Iran Medex and Magiran with the keywords: Spiritual Health, Spirituality, Coronavirus, COVID-19, Patient, during 2019-2021. The studies in English language were searched with the keywords: Spiritual Health, Spirituality, Coronavirus, COVID-19 and Patient, in PubMed and Scopus databases during 2019-2021. Besides, the search was done in Google Scholar database in Persian and English. Finally, 432 studies were found, of which 8 papers were included in the study by applying the inclusion and exclusion criteria and removing duplicate cases.

During the COVID-19 pandemic, spirituality had a positive effect on people's mental health. Spirituality leads to a reduction in fear of death, plays a mediating role in the negative effects of pervasive fear in terms of attitudes toward a positive future and the quality of relationships with family, and reduces depression and anxiety in those affected.

The results of the study indicate the need to pay attention to people's spirituality and mental health in relation to their personal and environmental health.

Moral intelligence is one of the dimensions of intelligence that can provide a framework for the proper functioning of human beings and is considered as a predictor of behavior. The purpose of this study is to investigate moral intelligence in nurses and the factors affecting it. This study was a narrative review. In the present study, to select studies, Persian language databases such as Magiran, SID, Barakat Knowledge Network System Scholar Google were searched with the keywords intelligence, nurse, ethics, professional. Criteria for the study included: a review of Persian articles in the period 2010-2020, which examined the moral intelligence of nurses. Exclusion criteria included non-Persian language articles, unrelated to the purpose of the research and lack of access to the full version of the article. Review articles were also excluded from the study. The search result was 150 articles using the keywords mentioned above. Finally, 11 articles appropriate to the research question were included in the study.
The findings showed that there is a significant relationship between moral intelligence and patient satisfaction with nursing care, resilience, anger, attitude towards patient education and quality of work life of nurses.
According to the findings of the study, spending time and money in order to increase moral intelligence in nurses is necessary. It is recommended for nurses to hold appropriate training programs on the subject of ethics in the form of in-service courses.

Employees working in hospitals and health centers have always been in a state of threat to physical, mental and social health, which reduces performance and high costs. Spiritual intelligence is the ability to apply and express spiritual values ​​in a way that improves one's daily functioning and physical and mental health. Therefore, this review study was conducted to investigate spiritual intelligence and its related components in health care providers. This study was a systematic review.In the present study, Persian studies in Persian language databases such as Daneshgostar Barakat system, Iran Information Science and Technology Research Institute (IranDoc), SID, Magiran, with the keywords spiritual intelligence, nurse, health service providers searched from 2001 to the first half of 2021. To search for studies in English, the keywords Spiritual Intelligence, nurses were used in the Scopus, PubMed, Google scholar, Embase and Science Direct databases between 2020-2000. The Google Scholar database was also searched in Persian and English. Inclusion criteria included complete Persian and English articles. Exclusion criteria included not having access to the full article.  In this review study, out of 241 articles, 33 studies were used. Findings showed that spiritual intelligence has physical and psychological consequences such as general health, mental health, hardiness, self-discipline, quality of life, resilience, adaptive performance, psychological well-being, happiness, emotional reactions in health system employees and also consequences Organizational spiritual intelligence of health service providers includes job satisfaction, burnout, moral sensitivity, responsibility, clinical competence, ethical behavior, compliance with ethical codes, patient support, attitude to patient rights, improving the performance and quality of nursing care, self-efficacy. Given that spiritual intelligence has a positive effect on many personal and professional areas of health service providers, managers should plan to increase the spiritual intelligence of health system employees. Therefore, it is recommended to hold workshops and training courses. Improving the spiritual intelligence of health service providers and ultimately improving the performance of health workers, increasing patient satisfaction and improving the quality of health services.

Hypertension increases with age. Low levels of health literacy are more common in older people with chronic diseases and hypertension, and these people are probably more affected by the unpleasant effects of low health literacy than other people in society. The aim of this study was to investigate the health literacy of the elderly with hypertension and related factors.

This descriptive-analytical correlational study was conducted in 2019. The study sample was 210 elderly people with hypertension selected among patients referred to specialized clinics using the convenience sampling method. Data were collected using demographic medical information, Abbreviated Mental Test (AMT) and Health Literacy for Iranian Adults (HELIA) questionnaire. Data were analyzed via descriptive (frequency distribution tables, mean and standard deviation) and analytical (t-test, ANOVA and Pearson) statistics using SPSS 23 and a significance level of 0.05.

According to the results, most of the elderly (58.1%) had adequate health literacy. Moreover, there was a significant inverse relationship between health literacy and age in the elderly with hypertension (p<0.05). Furthermore, there was a significant relationship between health literacy and the variables of employment status, education level, place of residence and, number of medications consumed (p<0.05).

In this study, the health literacy of the elderly with hypertension was adequate and it was found that the health literacy decreased as the elderly aged.

COVID-19 pandemic caused high workload and led to high levels of burnout in medical staff including emergency medical personnel. Identifying and preventing occupational burnout can efficiently improve mental health in workplace and enhance the quality of services delivered. This research aimed to investigate the relationship between occupational burnout and moral intelligence in emergency medical staff.

This analytical cross-sectional study was conducted in 250 pre-hospital emergency staff in Mazandaran University of Medical Sciences, 2021. The participants were selected from emergency bases using stratified sampling. Data were collected using demographic characteristics checklist, Moral Intelligence Scale (Lennick & Kiel), and Maslach Burnout Inventory (MBI). Structural equation and maximum likelihood model were applied. Data analyses were carried out in SPSS 23 and Amos 24.

The mean scores for moral intelligence and burnout were 81.10±8.30 and 44.41±13.73, respectively. Every one point increase in moral intelligence score decreased burnout score by 1.55 (P=0.054). Significant relationships were seen between all dimensions of Moral Intelligence Scale and moral intelligence (P<0.001). Keeping promises (r=0.82, P<0.001) and the ability to let go of one’s own mistakes (r=0.79, P<0.001) were found to be highly correlated with moral intelligence. In MBI, only personal accomplishment showed a significant positive correlation coefficient with burnout (r=0.41, P=0.026).

In this study, improvements in moral intelligence score decreased the burnout score. Therefore, improving moral intelligence, as an acquired ability, in emergency medical personnel can reduce the levels of burnout experienced.

Women play a fundamental role in the family and should have a high degree of flexibility and resilience in life issues and difficulties, and considering that the spiritual dimension is very important in the lives of people, the aim of this study was to review the effect of spiritual therapy on women's resilience.

For this review study, published sources were reviewed in Persian in the Magiran, SID, and Barakat databases and in English in the PubMed, Cochrane Library, Scopus, Google Scholar, and Embase databases. The keywords of spirituality, spirituality therapy, resilience and women were searched for in the period 2000 to 2021. Finally, of 144 articles searched, 9 articles related to the target were examined. The studies were divided into two groups according to the type of intervention. These two groups included individual and group spiritual therapies.

Studies conducted with women in crisis included 4 studies: a study of women in the Covid 19 pandemic, divorced women, women with drug-addicted spouses, and individuals whose family member was admitted to the intensive care unit. Another 4 studies investigated spiritual therapy in women suffering from certain diseases such as breast cancer, systemic lupus erythematosus, and multiple sclerosis. The results of the studies have shown that spiritual therapy increases resilience and improves attitudes and interpretation of illness and life.

In fact, spiritual therapy brings about inner peace and strengthens planning to achieve goals. Spirituality helps people to evaluate negative life events differently. As a result, spirituality creates a stronger sense of control, which in this way contributes to psychological adjustment. It is suggested that health care professionals and providers use this intervention to prepare educational packages to strengthen women's resilience in times of crisis and certain diseases such as cancer, systemic lupus erythematosus, and multiple sclerosis.

Negative Affect is an action occurring when an individual is involved in a mutual interaction, triggered by verbal and non-verbal power in order to make the person to comply with the orders and ultimately, it accompanies with gaining benefits. Negative Affect in workplace in recent years has drawn lots of attention because it results in serious consequences for the individuals and the goals of the organization. For this reason, Negative Affect is viewed as one of the severe forms of organizational and interpersonal misbehaviors in organizational environments. Of such Negative Affect behaviors, we can mention some passive behaviors like: negligence, intentional inattention and active behaviors such as: overt and covert threat. Negative Affect at workplace lowers the staff’s efficiency and performance in the organization since this phenomenon is associated with job dissatisfaction, anxiety, depression, burnout and reduced job commitment. Of course, being exposed to bullying is viewed as a critical source of stress. On the one hand, one of the outcomes of bullying is psychosomatic complaint originating from psychological processes of human beings. Negative Affect is also characterized as a threating factor to the nurses’ health in hospital settings. The findings of a study revealed that by strengthening resilience and hope, it’s viable to control the consequences of encountering bullying on the psychosomatic health of the nurses. As the conducted studies suggest, various factors such as: lack of understanding among fellows and manager, personality traits, major changes in practice bring about bullying. The research by Johnson et al. (2019) suggested that Negative Affect outbreak is high among nurses and as Negative Affect increases, the quality of care provided by the nurses decreases and client’s safety declines and job burnout increases. Since one of the tasks in this profession is to maximally maintain people’s health, thus the nursing staff have to be equipped with maximum level of health. In particular, due to the nature of the ward, the nursing working in special wards are more exposed to the situations like the patients on the verge of death, emergencies and unpredictable conditions, noisy monitoring equipment and conducting clinical and drug administration processes with advanced and efficient devices. Despite the studies performed about hospital workplace related Negative Affect, nothing as exclusive has been discovered so far dealing with bullying association with special wards’ nurses’ mental health. This gap emphasizes the necessity for further studying. Consequently, the current study has been designed and performed pursuing the goal to outline the relationship between Negative Affect and special wards’ nurses’ mental health in the educational hospitals affiliated with MazandaranUniversity of Medical Sciences.

This study is a descriptive-analytical research done as cross-sectional in 2020. The statistical community is made up of all (ICUs, CCUs and dialysis wards) nurses from five educational hospitals of Mazandaran University of Medical Sciences. The nurses were selected through proportional and simple random methods, which overall resulted in 195 nurses. The data collection consisted of three questionnaires as the demographics, bullying and mental health. A) The demographics questionnaire including age, gender, hospital, marital status, job status and working history. B) Bullying (Negative Affect) questionnaire developed in 2001 and psychometrically assessed in Iran by Salimi et al. (2017). C) General Health Questionnaire (GHQ) was developed in 1972 and psychometrically assessed by Tehrani et al. (2011) in Iran and its reliability was reported as 0.93 using Alpha-Cronbach. The ethical considerations observed in the present research involved not requiring the name to be mentioned in the questionnaires, giving the samples information about the research objectives and the optional participation in the study. Having acquired the permit from Ethics Committee of Mazandaran University of Medical Sciences, the questionnaires were distributed in Google Form in the social networks of the nurses in the study hospitals and after completing and collecting the questionnaires, the obtained data were analyzed using SPSS -21 and descriptive statistics indices (frequency distribution tables, mean and standard deviation) and and correlation coefficient (predicting the random variable in terms of another variable) was analyzed.

The mean and the standard deviation of Negative Affect imposed on the CCU nurses got the max score as 62.53±14.90 and that of the ICU nurses got the min score as 55.68±15.77 and 72.6% of the participants were exposed to moderate rate of bullying. The mean and standard deviation of the mental health of the CCU nurses got the max score as 33.03 ±8.09 and that of the dialysis wards’ nurses got the min score as 29.11±2.61. Regarding the subscales of the General Health Questionnaire, the social area with a frequency of 93% was identified as the most prevalent disorder and depression with a frequency of 1.6% was detected as the least common disorder. According to the study findings, a significant positive correlation was discovered between Negative Affect and its dimensions and mental health and its dimensions (P≤0.00). Besides, in some cases, the correlation between the mental health dimensions and Negative Affect each other was achieved as poor: the correlation coefficient with social area was gained as 0.875 and with depression area as 0.225.

The positive correlation between Negative Affect and mental health indicates that as bullying score increases, the nurses' mental health decreases. Moreover, the findings revealed that the mental health of women and single individuals is more exposed to danger. Since one of the obligations in this profession is to maintain and promote people’s health, then the nursing staff have to be at the maximum level of health so that to be less affected by the consequences of this phenomenon when facing Negative Affect. Therefore, it’s imperative for the medical health system management to develop some programs to lower Negative Affect in nurses’ workplace environment. Regarding the significant relationship existing between Negative Affect and mental health, it can be inferred that by workplace bullying increases , the individuals’ mental health gets impaired .According to the study derived findings about the mental health of women and single individuals, it’s recommended to screen the organizational Negative Affect behavior in the professional health services of the organization, or to develop on-the-job training courses or some courses during their studies at university to increase their mental health and preparedness for Negative Affect behaviors among this group of people so that to be equipped with favorable mental health when encountered with Negative Affect behaviors. Moreover, to determine the proposed approaches’ effectiveness, it’s imperative to develop and conduct an intervention study.  Of the present study limitations, we can report lack of controlling the confounding factors of Covid-19 pandemic effect on nurses’ mental health which results in being cautious about generalizing and interpreting the study findings. Therefore, it’s required to perform extensive studies about Negative Affect and mental health of the nurses in other province located hospitals and also employ other tools such as qualitative approaches like interview in order to boost the accuracy of post-Covid-19 pandemic study findings.

Dear Editor Patients in the hospitals are exposed to numerous accidents and disasters (1); One of the most important measures after the occurrence of accidents is the emergency evacuation of the affected area to temporary shelters and the provision of relief services (2). In the past, the need for emergency evacuation in most hospitals was considered a far-fetched phenomenon (3). The process of emergency evacuation of the hospital is extremely difficult and complex, and the transfer of patients in case of emergency evacuation and the continuation of medical services is an important challenge, especially in intensive care units such as hemodialysis (4). Hemodialysis is the most common treatment for end-stage chronic renal failure in Iran and the world. Hemodialysis increases the life expectancy of patients but at the same time imposes many limitations on these patients (5). In case of emergency evacuation of the hospital, hemodialysis patients who are receiving continuous medical services in the hospital will face more problems. A key factor in safe and rapid emergency evacuation of the hemodialysis ward is the readiness of the staff (6). The experience of one researcher showed that nurses face many challenges when there is a fire in the hemodialysis ward. The inability to extinguish the fire and spread to the inpatient wards led to the issuance of a complete emergency evacuation order. The main concern of the nurses of the hemodialysis ward was the sudden interruption of the hemodialysis process and the safe departure of patients connected to the device from the accident site. The difficulty of the transfer process is from the lessons learned from the hospital emergency evacuation. Timely, effective and safe evacuation of patients is a prerequisite for safe emergency evacuation in the hospital, but many dialysis service providers have received little or no training for emergency evacuation. Lack of expertise of hospital managers and firefighters to respond effectively to accidents in hemodialysis wards and on the other hand, lack of experience of personnel for rapid transfer of patients makes emergency evacuation conditions in hemodialysis wards more difficult. Because hemodialysis wards are located in advanced medical centers and receive a large number of patients daily, firefighting and emergency evacuation exercises are rarely performed. According to the clinical experiences of researchers, a very important point in the emergency evacuation of the hemodialysis ward is the continuation of the treatment of the patients connected to the hemodialysis machine. Any delay in the treatment plan of hemodialysis patients will cause health problems. Therefore, it is suggested that the following items be emphasized to reduce the challenges of hemodialysis patients in the emergency evacuation process of the hospital. 1. Paying attention to structural and non-structural resilience of hemodialysis wards against fire and earthquake accidents 2. Providing a suitable bed for easy movement of hemodialysis patients in the ward design 3. Access to mobile and removable hemodialysis units 4. Laying the groundwork for new hemodialysis approaches such as home hemodialysis, ambulance design with hemodialysis system 5. Training of staff of clinical wards, especially hemodialysis wards in the field of firefighting and emergency evacuation 6. Performing firefighting and emergency evacuation exercises in hospitals

The preceptorship model is a training and learning approach, evaluation of benefits of challenges of which can contribute to the improvement of education quality and training of efficient nurses. The present study aimed to review the challenges and benefits of the preceptorship model in nursing clinical education.

This study was conducted as a narrative review. To select articles, Farsi databases such as Magiran, Google Scholar, SID, and Barakat Knowledge Network System using keywords of “preceptorship”, “nursing education”, “challenge”, “preceptor”, and “nursing student” were searched. In addition, databases of Google Scholar, Scopus, Science Direct, PubMed and Web of Science were investigated applying keywords of preceptorship, nursing education, nursing student, challenge and preceptors. Inclusion criteria were Farsi and English articles published up to 2020 with no time limits, access to full texts of the articles and relevance to the research objective. In the end, 10 out of 160 extracted articles were considered appropriate and entered into the study.

In this study, the challenges of the preceptorship model were related to preceptors (high workload and insufficient time for education), preceptees (students’ lack of desire for direct care and lack of motivation) and the education atmosphere (insufficient support by school managers and poor correlation between theory and clinic). On the other hand, the benefits of the preceptorship model were related to students (reduced clinical errors and development of nursing skills) and education (ensuring compliance with the policies and procedures of the organization and targeted internships)

According to the results of the study, despite the numerous barriers to the implementation of the preceptorship model, it has many benefits. Therefore, our findings could help clinical instructors and nursing education authorities eliminate the challenges of the implementation of the model, which increases the quality of students’ clinical education.

Poor oral hygiene and falls are common problems that older people encounter. The aim of this study was to determine the relationship between oral health and the risk of falls in the elderly hemodialysis patients.

In this cross-sectional study, 400 elderly patients undergoing hemodialysis in hospitals affiliated with Mazandaran University of Medical Sciences were selected by cluster sampling in 2019. Data were collected using a demographic questionnaire, Geriatric Oral Health Assessment Index (GOHAI), and Morse Fall Scale (MFS) which were completed by one of the researchers. Data were analyzed in SPSS V21 applying Chi-square and Univariate and Multivariate logistic regression analysis.

The mean age of patients was 69.18 ± 6.42 years and 50.3% were women. The mean scores for oral health and risk of fall were 41.5 ± 5.3 and 72.15± 31.4, respectively (P<0.001). Univariate logistic regression model showed significant relationships between the risk of fall and the number of teeth (<10) and oral health score (<43.5) (P=0.031). In fact, these two groups were 1.44 times and 1.64 times more likely at risk of falls, respectively,  compared to those with number of teeth >10 and oral health score>43.5.

Elderly hemodialysis patients with poor oral health are more prone to falling. It is suggested that in planning and implementing preventive measures, attention to oral health and dental visits should be on the agenda.