نازی دزواریی

The pediatric palliative care (PPC) includes active care of the child's body, soul, and mind, as well as family support. The purpose of this study was to develop a model for providing pediatric palliative care based on the point of views of the Irania nurses and the physicians in Iran. The objective of this descriptive analytic study was to develop a model for PPC and to confirm each of the factors presented in the model. Factor analysis was performed using Keizer-Meier (KMO) and Bartlett (BT) tests. A researcher-made questionnaire was used to measure the necessity of providing PPC services. This questionnaire contained 28 questions in three areas or factors (9 items about the children, 12 items related to the family issues, and 7 items related to national health), and the statistical analysis was done by using SPSS 21. The item "Attention to moral concepts in dealing with the family at the family level" had the highest mean score (4.4±0.28). The items "Trying to have a peaceful death in the end stages of life in the child's area" and "Benefiting from equal palliative services at the national level", respectively with average scores of 4.2±0.52 and 4.1±0.4 in the ranks, at the second and third of this necessity. The PPC model was developed based on the results of this questionnaire. According to the result of the questionnaire items used in this study, the palliative care necessity model was developed. It is also concluded that providing PPC in Iran is necessary.

Optimal collaboration between members of the patient management team; especially physicians and nurses; can effectively prevent stress by creating an appropriate moral atmosphere that leads to the improvement of the quality of care.This study aimed to determine the attitude of nurses and physicians toward physician-nurse collaboration working in the neonatal intensive care units of the teaching hospitals in Tehran, the capital of Iran.

In this descriptive and analytical study, carried out in the neonatal intensive care units of the teaching hospitals in Tehran in 2018-2019, 234 physicians and nurses, selected by the available sampling method, participated in the study. Data were analyzed by SPSS V21 software with T-test, Pearson, and Anova.

The mean attitude score of nurses was 24.15 with a frequency percentage (40.25%) compared to physicians' 25.70 with a frequency percentage (42.80%) (P<0.05). The highest average score in the questionnaire was related to teamwork and information sharing among physicians and nurses, 6.75 and 8.73 respectively. A significant relationship was found between nurses' attitudes toward work experience, working hours, and liability insurance (P<0.05).

The attitude of the nurses and physicians about physician-nurse collaboration in this study was revealed to be unsatisfactory. One of the important reasons for the negative score of the attitude of nurses and physicians towards collaboration may be the point that sufficient importance is not given to the role of nurses in patient management. It is therefore recommended to identify factors affecting the improvement of collaboration, as well as maintaining enough weight to the role of nurses in patient management by further studies.

Pediatric palliative care defined as any intervention that focuses on relieving suffering, slowing the progression of disease, and improving quality of life at any stage of disease is rather a new concept in Iran's health care system. This study aims at needs assessment of delivering pediatric palliative care from the viewpoint of pediatric nurses and physicians. 

211 pediatricians and pediatric nurses participated in this descriptive study. A self-administered pre-tested standardized questionnaire was used as the study material. Needs assessment of delivering pediatric palliative care was investigated through 28 Likert questions mainly on three domains including National, Family and Child (scores ranging from 28 to 140). To confirm the items on the questionnaire, confirmatory factor analysis was used. Mean scores of each domain was compared using Mann-Whitney test and Kruskal-Wallis. Correlations were studied through Pearson Correlation Test. Data was analyzed by SPSS version 21.

Overall score of necessity for delivering pediatric palliative care was 130.43. The item "Considering ethical issues while contacting the family" had the highest score (4.4±0.28) in the Family domain." In two other domains, National and Child, the items " Trying to have a peaceful death in the late stages of life " and " To benefit equally from palliative care" had the highest scores respectively (4.2±0.52 and 4.1±0.4).

The results of this study revealed the necessity of delivering pediatric palliative care in Iran. Additionally, considering ethical issues in palliative medicine and providing justice-oriented care were indicated as important subjects in this area. In the end, a pediatric palliative care model was designed based on the total score and the items of the questionnaire.

One of the most important needs of neonates after birth is emotional relationship with their mothers. Preterm birth is a stressful event for mothers. With preterm birth, the mother’s antenatal attachment to the neonate and preparation for the neonate’s birth is interrupted. Therefore, it has been assumed that preterm birth is a risk factor for insufficient development of the mother-neonate attachment. The aim of this study was to assess mother- newborn’s attachment and its related factors in mothers of preterm neonates hospitalized in neonatal intensive care units in Tehran.
It was a descriptive-analytic research. Through stratified sampling method, 463 mothers of preterm neonates’ were included in the study. Data was collected through demographic and maternal attachment questionnaire. The correlation between the attachment and demographic variables were assessed using SPSS v.19.
The mean of attachment score was 56.59%. There was significant relationship between neonate gender, desired pregnancy and desired neonate gender with attachment (p Findings suggest that desired pregnancy can affect the maternal attachment. Nurses should improve maternal psychological condition before delivery and providing some facilities to decrease stress of mothers of preterm neonates and involve them in caring of their neonate which may have positive effect on maternal attachment.