فهرست مطالب abbas ebadi

Spirituality is among prominent strategies to minimize negative emotions in different circumstances. Clarifying the concept of spiritual well-being in high-risk pregnancies enables healthcare providers to address and support their patients' spiritual needs. This study aimed to explore the perceptions and experiences of spiritual well-being among women with high-risk pregnancy.

This qualitative content analysis was conducted from December 2017 to March 2019 in public and private hospitals and health centers in Mashhad, Iran. The participants included 26 women with high-risk pregnancy, who selected using a purposive sampling. Data was collected through semi-structured and face-to-face individual interviews using the interview guide. The data analysis was carried out concurrently with the data collection, using the conventional content analysis based on the Graneheim and Lundman's method. 

Following data analysis, "Spiritual well-being in high-risk pregnancies” was characterized by two main categories including “Meaning-seeking and belief in purposeful pregnancy” and" Relying on spirituality in achieving health."

Searching for meaning and purposefulness in pregnancy and relying on spirituality to achieve health are among the components of spiritual well-being in high-risk pregnancy; hence, understanding women’s spiritual well-being could help tailoring strategies to reduce their tensions and discomforts caused by high-risk pregnancy. Thus, it is highly recommended that women with high-risk pregnancy receive spiritual care as part of their comprehensive care.

Diabetic foot ulcers are among leading causes of disability in diabetic patients, often resulting in amputation and disability. Proper foot care can prevent diabetic foot ulcers. One assessment tool is the Nottingham Assessment of Functional Footcare (NAFF). This study aimed to assess the psychometric properties of the Persian version of the Nottingham Assessment of Functional Footcare.

This cross-sectional study was conducted in the winter of 2023 on 517 patients with type 1 and type 2 diabetes who were referred to the diabetes clinics in Bam, Hamadan, and Asadabad cities, Iran. Patients were selected using convenience sampling. The instruments were examined to assess their psychometric properties, including face validity, content validity, construct validity, internal consistency, and stability.

The mean age and duration of diabetes in patients were 50.01±18.14 years and 10.70±9 years, respectively. Most samples were female (54%) and married (80.9%). More than one-third of the patients (36.4%) were taking hypoglycemic tablets. The exploratory factor analysis identified five factors: general foot self-care, foot examination, shoe examination, wound management, and use of appropriate shoes. Together, these factors accounted for 52.381% of the total variance. The internal consistency of all extracted factors was above 0.70, as measured by McDonald's Omega coefficient. The stability reliability of the questionnaire was 0.790 for the whole instrument with a two-week interval.

The Persian version of the Nottingham Assessment of Functional Foot-care tool is a valid and reliable tool for measuring the foot care of diabetic patients. It allows domestic researchers to use this tool along with other available tools to check and measure the concept of diabetic foot self-care based on their facilities and preferences.

The professionalization of nursing is one of the goals of academic education, which needs to be nurtured during education, so this research was conducted to study the views and experiences of nursing students and instructors regarding professional growth through role mode nursing instructors.

This was a qualitative study with directed content analysis based on the growing up and role modeling theory in nursing students’ education, which was conducted at two universities in Iran from April to September 2021. The participants included 16 undergraduate, master’s, and PhD students, and nursing instructors selected using purposeful sampling with maximum diversity. The data were collected through in‑depth interviews.

From the data analysis, 689 unrefined primary codes and 76 integrated codes were extracted. The three subcategories of the previous study included “effort to improve educational quality,” “clinical effectiveness,” and “promotion of professional status.” Generic categories were formed based on the grouping of codes. “Effort to improve educational quality” included the six generic categories of educational effectiveness, effective classroom management, comprehensive evaluation, adherence to educational rules, application of knowledge, and efforts to promote research. “Clinical effectiveness” included the generic category of effective clinical training. “Promotion of professional status” included the two generic categories of effective professional interactions and striving for professional independence.

It can be concluded that role model nursing instructors can increase the students’ abilities, and thus, facilitate their professional growth through a combination of strategies based on the generic categories mentioned.

The concept of resilience has emerged in recent years in association with disaster risk reduction. In assessing adolescents’ resilience, it is important to consider resilience as a multi-factorial construct and context-based issue. Currently, there is a short resilience questionnaire to assess this construct among Iranian adolescents. Given the importance of using a short and valid questionnaire to assess resilience, this study investigates psychometric properties and the underlying structure of the Iranian translation of the child and youth resilience measure 12 (CYRM-12).

After obtaining permission, the CYRM-12 was translated into Persian and then back-translated based on the Wild (2005) process. The final version was distributed among 653 high school adolescents in the age range of 14 to 18 years. The reliability scale was evaluated by using the Cronbach α and test re-test reliability among 35 adolescents. Subsequently, the intra-class correlation coefficients were assessed. Confirmatory factor analysis was evaluated as the validity.

The Cronbach α coefficient for the CYRM-12 was 0.71 and the test re-test reliability was excellent (ICC=0.88, 95% confidence interval, 0.78–0.94). Confirmatory factor analysis showed that the root mean square error of approximation was significant (0.043) and all items were indicated with a high correlation with scales, including the comparative fit index (CFI), non-normed fit index (NNFI), normed fit index (NFI), incremental fit index (IFI), and relative fit index (RFI) that were more than 0.9 and only parsimony normed fixed index was 0.7 that would be acceptable as well. Moreover, the correlation between total anxiety and resilience is significant. This is the first study that used the Persian version of the CYRM-12 questionnaire in Iran. In disasters, time is important; therefore, this short version would be more appropriate to help measure children’s resilience more quickly. Moreover, the short version of the CYRM-12 questionnaire is suitable for measuring resilience.

This study determined good fitness, reliability, and test re-test reliability of the Persian CYRM-12 for Iranian adolescents.

 Effective assessment of pain in newborns leads to correct pain management and therefore the outcome of the treatment will be more favorable. However, despite significant advances in neonatal care, there are still barriers to pain assessment and interventions in hospitalized infants. 
The purpose of this study is to explore the barriers to pain assessment and measurement by nurses working in neonatal intensive care units.

In this qualitative study, a content analysis approach was used. Nurses working in neonatal intensive care units of Tehran and Karaj hospitals, who had more than 6 months of work experience and were willing to cooperate, were included in the study. In-depth and semi-structured interviews were conducted to collect data. Qualitative data analysis was done using MAXQDA software version 2016.

 Fourteen nurses working in neonatal intensive care units participated in this study. Interviews were conducted until data saturation. The results of the data analysis led to the emergence of four main categories "Increased Workload ", "Discordant Atmosphere", "Soulless care" and "lack of awareness" and eleven sub-categories.

This study will significantly contribute to future research by elucidating barriers to neonatal pain assessment. Based on the findings of this study, researchers can provide targeted interventions, comprehensive training programs, and clear guidelines to improve the quality of neonatal care.

The Intensive Care Unit (ICU) is a specialized hospital unit designed to provide care for critically ill patients. Nurses who work in these departments play an important role in ensuring patient safety and providing safe and quality nursing care. However, various factors can affect nurses' ability to provide safe nursing care in these settings. This study was conducted with the aim of investigating the factors affecting safe nursing care in the ICU department.

The present study was a qualitative study of conventional content analysis. The participants included nurses, doctors, and specialists in the field of patient safety, patients and accompanying patients. A total of 20 individuals were included in the study using purposive sampling method. Data collection was done using individual, in-depth and semi-structured interviews. Then, data analysis was done using the method proposed by Graneheim and Landman (2004) and the views of nurses and people related to patient safety in ICU were identified.

Two themes including holistic care and safety-oriented organization and four categories including systematic care, comprehensive care of all systems, human resource management and safe environment were extracted as effective factors in providing safe nursing care in ICU departments.

The results of this study reveal the importance of promoting safe nursing care in ICU departments through a holistic care approach as well as a safety-oriented organization. These findings support previous research that emphasizes the importance of systems thinking and safe nursing care in improving patient safety and overall quality of care. In this way, by implementing targeted interventions and strategies based on these factors, healthcare organizations can create a safer environment not only for patients but also for the staff of the ICU.

The basis of family-centered care is the participation of patients and their families in health decisions. Despite the advantages of family involvement in intensive care, this method is associated with many obstacles. Therefore, the present study aimed to explain the obstacles and suggested solutions for family participation in the ICU.

This qualitative study of contract content analysis was conducted in Tehran in 1402. The tools for collecting experiences were open questions and semi-structured interviews. Purposive sampling was used to identify the participants. The selection of samples was done by observing the principle of maximum diversity to achieve a diverse range of experiences. Sampling continued until information saturation, with no formation of classes and subclasses and new information. Qualitative data analysis was performed using the four stages of content analysis of Elo and Kyngäs (2008). Lincoln and Guba's four acceptability criteria were used to strengthen the results.

In this study, 15 participants, including four family members of patients, four nurses, and seven managers of the studied hospital with an average age of 49.53±12.09 years and an average years of service of 16.73±10.22 years participated. The results consisted of four classes: barriers related to the family, barriers related to the treatment team, barriers related to the physical structure of the department, and organizational barriers; 13 subclasses and 21 codes were formed.

Using solutions such as holding training workshops on communication skills with patients and families, anger control methods, and allocating funds to create favorable changes in the physical space of the ICU and providing nurses can help effectively implement this approach

The ICU liberation campaign helping improve quality of intensive care and reduces post-intensive care syndromes through the release of ABCDEF bundle, which utilizes an interprofessional approach. Evidence has shown barriers to proper bundle implementation (such as complexity and multiplicity of bundle interventions, limited bundle understanding by staff, poor interprofessional collaboration, shortage of staff) may play an important role. A multistage study was conducted to localize the ABCDEF bundle.
 Firstly, the ABCDEF bundle was translated into Persian using the WHO protocol. The initial Persian translation was performed by both a nonmedical and medical individual. After combining and enhancing the translations, it was transformed into a checklist comprising 6 elements and 53 items, which were directed to experts to evaluate its face validity and qualitative content validity. After adjustment, the first expert panel validated the checklist, and a 5-point Likert rating system for assessment of importance, relevance, and feasibility were scored by them. Based on the results of descriptive analysis by SPSS, the experts' consensus led to elimination of one item and inclusion of other 52 items. Next, the second expert panel was held.
The final ABCDEF bundle was prepared with 52 items and, the plan, the proper time and implement responsible, for its management is proposed.
 Due to absence of the Iranian version of the ABCDEF bundle, our study provided a fluent and eloquent translation, to be both comprehensible and practical for the intensive care team members. The expert panel's opinion, adapted the bundle for implementation in the ICUs of Iran. We recommend that the localized ABCDEF bundle be implemented in specialized intensive fields (such as medical, surgical, trauma, etc). The contents of the bundle could not only be incorporated into ongoing training of staff, but also into the curriculum of undergraduates and medical residents.

The ever-increasing speed of changes in today's world has led to the emergence of an era called uncertainty, and an environment full of opportunities and threats has made the current complex systems a precursor. One of the challenges of accurate and big planning for the future is the uncertainty inherent in the future and rapid changes in various fields in health. A powerful tool that predicts future competitive environments and develops long-term strategy even in environments with the greatest uncertainty is the scenario planning tool. Scenarios are descriptions of future situations and possible events in those situations so that a person can move from their current situation to a planned future. Scenario writing is not only a planning tool, but also an effective learning tool. Thinking about scenarios helps us to understand the logic of development, to recognize driving forces, trends and challenges. Drivers are a set of future-shaping forces that affect different futures globally or locally. Proponents perform the task of advancing and solving challenges simultaneously. For its development and sustainability, nursing education needs drivers so that it can maintain its existence in a turbulent age. Drivers are the main factors consisting of several processes that cause change in a studied area. Nursing education in the country, while having many challenges and crises, has diverse and somewhat unknown capacities. Drivers and trends that, if identified and applied, can overcome some of the existing challenges. Therefore, the current research tries to identify the key factors and the main drivers involved in nursing education and then by designing the desired and probable scenarios in the future, it provides a framework for policy making and flexible planning according to the conditions. Therefore, the current research was carried out with the aim of scenario planning the future of nursing education in Iran.

This research was conducted with an exploratory nature and with the aim of knowing the leading futures in the field of nursing education in Iran in the undergraduate course. In the first stage, in order to identify drivers and trends, qualitative interviews with nursing professors of Iran and Delphi universities were used. Sandelowski and Barroso's seven-step method was used for synthesis. In the second step, a semi-structured interview was used. The participants were selected in a goal-based way from nursing professors who had managerial experience in nursing education. Interviews were conducted by phone and in person. The Shannon entropy method was used to analyze the content of the codes. In the third step, the Delphi method was used to confirm and evaluate the drivers identified. 30 people, including nursing specialists (members of nursing board and teaching assistants and managers of nursing departments in all nursing schools of medical sciences universities of the country) participated in the research by means of targeted sampling. A report of the drivers and trends obtained from the previous stage along with a summary of the research method and research objectives was sent to the members. For evaluation, scoring was used in the form of 0 to 5. This process continued in three consecutive rounds of e-mail and face-to-face visits. Then, using a panel of experts, the influence and uncertainty of the identified trends were scored. In the next step, using influence/uncertainty diagrams, the key axes for writing the scenario were determined. Scenarios were designed by Scenario Wizard software version 11/4 and strategies were presented. The validity of the scenarios was examined from the four perspectives of feasibility, internal consistency, usefulness and differentiation. All four conditions were acceptable according to the experts.

In the meta-synthesis stage, after internet search, 723 articles were reviewed, among which nine articles were used for the final analysis. At the end of this stage, the researcher identified 127 codes, which according to the purpose of the research and also based on the semantic proximity and the only verbal difference between some codes, the codes were merged and brought under a common title. Finally, 24 codes were identified. In the next step, considering the concept of each of these codes, they were categorized into a similar concept. In order to evaluate the quality, the results were given to one of the experts to be evaluated by the Kappa index. Using SPSS version 16 software, at a significance level of 0.05, this coefficient was obtained as 0.83, which shows the appropriate reliability of the codes. In the interview phase, 17 nursing professors (2 professors, 6 associate professors, 6 assistant professors, and 3 instructors) with an average clinical experience of 16 ± 1.2 years and an average managerial experience of 6 ± 3.1 years were interviewed. A total of 23 interviews were conducted with an average of 25-30 minutes. 15 of the interviews were conducted over the phone and the rest of the interviews were conducted in person. In this step, 356 codes were obtained. The findings of the content analysis were categorized using Shannon's entropy, and the results were entered into the next step for agreement and confirmation. In the third step, the experts agreed on 6 drivers and 31 trends. With five key uncertainties, the scenario was designed in three optimistic, intermediate and pessimistic assumptions. According to the size of the matrix and its dimensions (15 x 15), four problem-oriented, ethical, maintaining the status quo and closed educational system scenarios were reported for nursing education in Iran.

In the current study, four different scenarios were designed. Ultimately, each of these scenarios is believable and each has the potential to be realized, but which one will happen depends on today's plans. Scenarios have no prescription for the future itself, but rather a short film of the possibilities that may occur. This research is an analysis of the reliable results of our current possible actions. Further researches can obtain indicators for these scenarios. The application of future planning methods such as scenario in Iran's national health system can be considered as a warning system for awareness of opportunities and threats before the crisis. In order to improve the future of nursing education in Iran, it is recommended to form an expert working group with technical skills of scenario planning for more coordination in the strategic planning of specialized and sub-specialized fields and to formulate a comprehensive plan for the correct implementation of future planning projects. The manager or decision maker of the health field can see the serious part of the consequences of different decisions in the form of future scenarios of experience and future failure points right now.

In many healthcare centers, evidence-based practice (EBP) is a vital tool for providing better and safer healthcare services. 

This study investigates the psychometric properties of the Persian version of the EBP implementation questionnaire in nurses.

This is a methodological and cross-sectional descriptive analytical study. We selected 400 nurses (200 for exploratory factor analysis and 200 for confirmatory factor analysis) via convenience sampling. The study questionnaire was translated based on the World Health Organization (WHO)’s guidelines. Construct validities of the EBP were assessed through exploratory and confirmatory factor analyses. The repeatability was also evaluated by the test re-test method. The study was conducted based on the COSMIN (consensus-based standards for the selection of health status measurement instruments) checklist.

The exploratory factor analysis revealed four factors: Evidence evaluation, development of evidence use, evidence sharing, and access to evidence. These factors could explain 58.30% of the total variance of evidence-based care in the nurses. Confirmatory factor analysis confirmed the goodness of fit of the 4-factor model of EBP implementation. The reliability of the evidence evaluation, development of evidence uses, evidence sharing, and access to evidence factors was confirmed using the Cronbach α coefficient. In addition, this questionnaire had excellenttest re-test reliability and the intra-class correlation coefficient (ICC), whose values were reported to be 0.996 with a confidence interval (CI) of 0.991 to 0.998 and P=0.001. Also, its re-test reliability was equal to 0.85.

The Persian version of the EBP implementation scale has acceptable reliability and validity. In addition, the number of items in this questionnaire is low. Therefore, it can be used to measure the implementation of EBP in Iranian nurses and identify groups of nurses needing special interventions.

Professionalism in nursing is a fundamental concept for providing effective and high-quality nursing care. Due to the complexity and multiple sides of this concept, it lacks a clear and precise definition. This ambiguity has created different and even poor interpretations of meanings and characteristics, making its accurate measurement difficult.

This study aims to review the literature to provide the definition and attributes of “professionalism in nursing” and formulate a conceptual model for it.

In the present study, the integrated review method was used in five stages: Specifying the problem, searching the literature, evaluating and extracting data, analyzing data, and presenting the results. The studies published in English or Persian were searched in international databases, such as CINAHL, EBSCO, PubMed, ProQuest, The Cochrane Library, EMBASE, SAGE, Science Direct, and Google Scholar search engine, as well as national databases, including SID, MagIran, IranDoc, and the medical sciences theses search engine.

After reviewing and analyzing 54 studies (17 qualitative studies, 27 quantitative studies, 4 mixed-method studies, 4 review studies, and 2 guidelines), the definition, attributes, antecedents, and consequences of “professionalism in nursing” were stipulated. The attributes included academic specialized knowledge, continuous pursuit of competence, autonomy, professional commitment, professional interaction, accountability, adherence to ethical principles and values, and advocacy. The antecedents were personal/occupational, organizational, and social factors. The consequences were individual and social outcomes.

The results of integrative review of the literatures showed professionalism in nursing has evolved and encompassed new attributes and dimensions. Due to the comprehensiveness of the provided conceptual model, it can be used to design a tool to evaluate the professional qualities of nurses in their jobs.

Stuttering is one of the speech disorders that appears in childhood. Many studies emphasize early interventions for its treatment. Circumstances such as a lack of therapists and the COVID-19 pandemic have limited the access to face-to-face therapy. Studies show some problems with this type of treatment. A detailed understanding of these problems in a cultural context can help increase the quality of providing telepractice. This study was conducted to discover the telepractice treatment of stuttering in preschool children.

This qualitative study was conducted in Iran from November 2020 to February 2022 using the grounded theory method. In this study, in-depth, free, and individual interviews were conducted with 9 therapists and 5 parents of children who stutter. The data were analyzed using the Corbin and Strauss method, version 2015.

After analyzing the data of this study, 6 main categories, 17 subcategories, and 63 primary categories were extracted. The main categories include “hesitation in choosing telepractice”, “characteristics of family and clients”, “technology and the knowledge to apply it”, “therapist skills for telepractice”, “payment system for telepractice fees”, and “efficiency of telepractice”.

In this study, “efficiency of telepractice” was chosen as the central concept that all participants were concerned about in some way. According to this model, “hesitation in choosing telepractice”, “characteristics of family and clients”, and “technology and the knowledge to apply it” as the context have effects on the processes that are taking place in relation to the telepractice in preschool children who stutter. These processes include “therapist skills for telepractice” and “ payment system for telepractice fees”. In the end, all these things increase the efficiency of telepractice.

Grammar is a key element of language knowledge and a factor in predicting language learning and success. Early diagnosis of grammatical errors in children before entering school is very important. So far, no tool has been designed to evaluate the Azerbaijani language grammar comprehension in Iran. The present study aims to design the Azerbaijani language grammar comprehension test for Iranian children aged 4-6 along and assess its validity.

This is a mixed-method (qualitative-quantitative) study. After searching in various databases and reviewing available articles, 42 grammatical structures of the Azerbaijani language were extracted, of which 8 were removed after preliminary examination by experts. Then, 204 items were formulated for the remaining 34 grammatical structures. To determine the content validity, the test was sent to 11 experts in the field of Azerbaijani language grammar to evaluate the items. According to their opinions, two more suitable items were selected from among four items for each grammatical structure and included in the initial version for the pilot study. The initial test version was conducted on 30 children aged 4-6 years with normal language development.

After calculating the content validity ratio (CVR), two grammatical structures were removed, and 32 structures with 128 items having CVR≥0.59 remained. After calculating the content validity index (CVI), the items with CVI≥0.79 were selected. The initial version had 32 grammatical structures and 64 items. None of the items were removed in the pilot phase, and only 10 items were modified. The CVR and CVI of the test were 0.91 and 0.87, respectively, indicating good content validity.

The Azerbaijani language grammar comprehension test has good content and face validity and can be used to evaluate the grammar comprehension of children with Azerbaijani language aged 4-6 years.

Context: 

Defined by several physiological and anatomical contributors, posture is essentially an accurate indicator of health status that is most frequently highlighted by affecting the configuration and operations of internal systems and organs. Quantifying body position has always been highlighted in clinical, academic, and industrial contexts, and various posture analysis approaches have been developed throughout the years.

This study aims to establish the reliability and validity of several novel observational approaches to postural load assessment and provide an overall view of related trends.

This review was designed and conducted following (PRISMA) guidelines and five databases were surveyed, namely PubMed, Science Direct, CINAHL, Ergonomic Abstracts, and EMBASE, utilizing both generic and specific search terms modified for each database. Articles introducing a novel approach to observational postural load analysis and concepts of reliability and validity of the introduced method were included. Cross-sectional, case-control, experimental, and controlled trial designs were considered. Studies were excluded if they were exclusively based on subjective approaches. The methodological quality of the studies was evaluated using the MacDermid checklist. Similarly, reliability, measurement error, content validity, and criterion validity were assessed using COSMIN (Consensus-based Standards for selecting health Measurement Instruments) boxes B, C, D, and H, respectively.

Twenty-five articles were selected for the final review. The studies mainly reported ICC for reliability and r and r2 for validity. The results on the MacDermid quality evaluation tool varied from 38 to 80%, with a mean of 61.60 ± 11.54%. Regarding the COSMIN checklists, the scores were 61.40 ± 10.39%, 59.16 ± 11.35%, 64 ± 16.07%, and 57.12 ± 15.19% for boxes B, C, D, and H, respectively. Some studies did not obtain high scores for specified inclusion and exclusion criteria and appropriate sample size, leading to a moderate quality rating in checklists.

Drawing comprehensive conclusions by directly comparing and contrasting observational techniques can be challenging due to their unique strengths, limitations, and inconsistencies. Such variations may arise from the methods’ characteristics, such as the fields, settings, populations, and the evaluated risk factors.

Overcrowding in emergency departments (ED) is a global concern, emphasizing the need for effective resource allocation. Triage plays a crucial role in prioritizing patients based on medical needs. This study aimed to evaluate the accuracy of National Early Warning Score (NEWS) in predicting the ED patients’ outcomes.

A cross-sectional study was conducted in two tertiary hospitals in Tehran, Iran, from June to July 2023. Adult patients presenting to ED were included. Data for calculating the NEWs and emergency severity index (ESI), as well as outcomes were recorded by trained nurses, and then the accuracy of each score in predicting the outcomeswas evaluated.

A total of 2,085 patients were analyzed. The majority were male (57%) with a mean age of 54.4 years. The primary outcome, cardiopulmonary resuscitation (CPR) within 24 hours of admission, occurred in 1.9% of patients, while the need for intensive care unit (ICU) care and/or mechanical ventilation happened in 3.4%, and CPR or need for ICU care and/or mechanical ventilation was observed in 4.3% of studied cases. Each one-point increase in NEWS was associated with a 52% higher likelihood of CPR (95% confidence interval (CI): 1.41 to 1.65, p<0.001). Receiver operating characteristic curve analyses for the NEWS yielded the optimum cut-off value to be 6 for all three outcomes, with an overall area under the curve (AUC) of 0.856 (95% CI: 0.840 to 0.871), 0.834 (95% CI: 0.817 to 0.850), and 0.854 (95%CI: 0.838 to 0.869) for the primary, secondary, and tertiary outcomes, respectively.

NEWS 6 was associated with a higher incidence of adverse outcomes, including ICU admission and need for CPR. The good predictive validity of NEWS highlights its value in identifying patients at higher risk of adverse outcomes.

Marine medicine is one of the medical science fields that deals with the health and safety of people related to the sea but marine medicine syllabus for education to students is not specified yet. The present study aimed to specify the syllabus of marine medicine education.

 This qualitative study was conducted through inductive content analysis approach between 2021-2022 in Tehran, Iran. A total of 12 person that were expert and have experience with marine medicine were selected by purposive sampling method. A semi-structured interview was conducted, then carefully transcribed and analyzed using Graneheim & Lundman qualitative content analysis approach.

Six category and twenty-five subcategories emerged after data analysis. Categories include introduction to the sea and marine medicine, health at sea, common diseases and injuries in the sea, diving and hyperbaric medicine, emergency care at sea and psychology at the sea.  

 Marine medicine is an extent and specialized medical field and medical science students in their general course just needs to educated by its main topics.

As to the significance of clinical competency, the competency concept should be up-to-date periodically until clinical competency is evaluated based on it. This study aimed to develop and evaluate psychometric properties of a new tool to measure the postgraduate psychiatric nursing students’ competencies. The current study was conducted with a sequential exploratory mixed-method, in Iran, in 2019 -2022. The qualitative part was conventional content analysis, and the quantitative part was a methodology study. The questionnaire was developed by the item generation via individual semi-structured interviews with 21 participants sampled purposefully, and a literature systematic review. In the quantitative phase, psychometric analysis was performed based onconsensus-based standards for the selection of health status measurement instruments (COSMIN) criteria, and using face, content, and construct (i.e., convergent, known group, and exploratory factor analysis done on 199 postgraduate psychiatric nursing students by available sampling) validity. t-test analysis was used to compare the clinical competenceratings of two groups of experienced and inexperienced postgraduate psychiatric nursing students. Additionally, dependability was examined for internal consistency, stability over a one-month period, and measurement error. The sampling technique used for content validity was deliberate. Then, the responsiveness (through minimally detectablechanges), and interpretability (through minimal important changes) were calculated. The questionnaire consisted of 43 items. Construct validity assessment via exploratory factor analysis (EFA) showed that 67.53% of the cumulative variance was explained by two factors: “Education and nursing care” (23 items) and “Evidence based psychiatric nursing interventions” (20 items). The convergent validity with one golden standard instrument was 0.49. The difference of the clinical competency scores of the two groups of experienced and novice was significant (P<0.001). The internal consistency of the entire instrument, and the first and second factors analyzed using alpha Cronbach (α) were respectively 0.947, 0.897, and 0.891. Stability was confirmed by the ICC agreement 0.956 for interrater (CI 0.907-0.980). Standard error of measurement was 3.14. The competency score of students based on their demographic information was not significant (P>0.05). The 43-item postgraduate psychiatric nursing students’ clinical competency questionnaire is a valid and reliable newly developed instrument. Further studies are recommended to be conducted to assess competency with the largest sample size to promote instrument.

The nursing education course faces challenges that can be solved with simple and low-cost measures if properly identified. Otherwise, the challenges will turn into a crisis and their solution will be difficult and costly. However, there is no tool available to examine the challenges of nursing education in Iran.

This research is a combined study that was conducted in two stages. In the first stage, the terms of the questionnaire were compiled using the qualitative interview of the study, as well as the review of authentic texts related to the topic of the research. In the next step, during a methodological study, the psychometric characteristics of the questionnaire were determined using face validity, content (CVR & CVI) and exploratory factor analysis, as well as reliability with internal consistency and stability methods.

The pool of items including 30 expressions was extracted. After determining face validity, qualitative and quantitative content validity, the number of questionnaire statements was reduced to 28 items. The result of the exploratory factor analysis of this questionnaire, three factors including "defective educational cycle", "educational structure challenge" and "overall neglect as a member of the education family", these three factors explained a total of 72.01% of the variance of the entire test. Cronbach's alpha coefficient was 0.865 and the stability through retest with intraclass correlation test was 0.8.

Considering the desired validity and reliability of the 27-item questionnaire of nursing education challenges, its use by researchers is recommended.

Protein-energy malnutrition is an important problem for hemodialysis patients due to decreased quality of life, increased hospitalization, and mortality. The present study aimed to investigate the effect of nutritional supplement programs on the malnutrition and biochemical indicators of patients undergoing hemodialysis. In this Randomized Controlled Trial study, 66 patients undergoing hemodialysis were allocated to three groups according to the random allocation methods. Groups A and B received nutritional supplements IsoWhey protein powder (one cup or 24 grams’ powder) and BCAA Muscle Guard Tablet (6 tablets per day: 2 tablets every 8 hours), respectively, along with a schedule of nutrition counseling, nephrology visits, and telephone follow-up for two months. The control group (group C) received a routine diet without supplementation. Biochemical indicators (Hemoglobin, BUN before and after dialysis, creatinine, cholesterol, triglyceride, TIBC, total protein, albumin, ferritin) were measured for all three groups before, one and two months after the intervention, and nutritional status based on SGA was assessed before and after the intervention. Before the intervention, three groups were homogeneous in demographic variables, biochemical indicators, and nutritional status (P>0.05). But, after the intervention, there was a statistically significant difference between groups in means of TIBC, total protein, and albumin (P<0.05). Also, nutritional status significantly differed in groups after intervention (P=0.02). The two intervention groups achieved a better nutritional status after two months of taking the dietary supplement (P=0.008). But in the control group, there was no significant difference in nutritional status before and after the study (P<0.05). According to the results of this study, it could be suggested that the use of nutritional supplements under the supervision of a nutritionist, along with patient education and consistent nutritional assessment, is suggested to improve the nutritional status of patients undergoing hemodialysis.

Smoking is one of the modifiable risk factors for cardiovascular disease (CVD) that is related to different types of chronic disorders. Many patients with CVD consider smoking cessation a difficult task due to various reasons. The goal of the present study was to translate the Challenges to Stopping Smoking Scale (CSS) into Persian and examine its psychometric properties.
In this cross-sectional methodological study, a total of 341 patients with CVD [141 for exploratory factor analysis (EFA) and 200 for confirmatory factor analysis (CFA)] participated, and were selected using a convenience sampling method. Participants completed the Persian version of the CSS. Face, content, and construct validities were examined. Internal consistency was assessed using the McDonald’s Omega and Cronbach’s alpha coefficients, and stability was examined using the test-retest method.
In the EFA, two factors of Internal Challenges and External Challenges were extracted that together explained 42.619% of the total variance. Cronbach’s alpha coefficients of 0.740 and 0.799 and Intraclass correlation coefficients of 0.862 and 0.869 were found for Internal and External Challenges, respectively. According to the results of CFA, the three-factor model had a good fit to the data. (RMSEA: 0.059; CFI: 0.94; GFI: 0.97; NFI: 0.90; PNFI: 0.77).
The Persian version of the CSS has good validity and reliability, and can be used as a valid and reliable instrument in future studies.

Type 1 diabetes mellitus (T1DM) can profoundly influence different dimension of health such as sexual and reproductive health (SRH). The aim of this study is to develop and evaluate the psychometric properties of the Sexual and Reproductive Health Questionnaire for Women with Type 1 Diabetes Mellitus (SRHQ-WT1DM).

This protocol for a sequential exploratory mixed-methods study has two phases. Conducting a literature review, the first phase of the study will develop the items of SRHQ-WT1DM. Data analysis in this phase will be performed using directed content analysis and according to the framework proposed by the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) for SRH in women. The second phase will evaluate the psychometric properties of SRHQWT1DM through a methodological study. Face and content validity will be evaluated both qualitatively and quantitatively, and construct validity will be done by exploratory factor analysis and convergent validity. The questionnaire’s reliability and stability will be examined using internal consistency (by Cronbach’s alpha calculation) and test-retest method (by Intra class correlation coefficient calculation), respectively. Descriptive statistics, Pearson correlation coefficient, and independent t-test will also be used. Women with T1DM who are of childbearing age and have unknown mental disorders will be selected as participants in the study from the Iranian Diabetes Society.

Development and psychometric evaluation of a specific tool for SRH assessment in women will help identify and fulfill their SRH-related needs and improve dimensions of their SRH.

This study aims to evaluate the prevalence, severity, and nature of adverse events (AEs) and provide suggestions on how to prevent AEs recurrence in an inpatient rehabilitation hospital in Iran.

This retrospective descriptive-analytical study was conducted in 2021 at Rofaydeh Rehabilitation Hospital in Tehran City, Iran. AEs associated with rehabilitation services and nursing care, which were reported in the hospital’s voluntary reporting system from 2018 to 2021 were evaluated. A standard checklist codified by the Ministry of Health of Iran was used to collect the data from the medical error documentation. The data were analyzed by the SPSS software, version 21, using descriptive statistics, the chi-square, and the Fisher exact tests.

A total of 5642 patients had been hospitalized in the study setting and 517 AEs had been documented during the 4 years of the study. The most common AEs in descending order were as follows: falls 288(55.7%), pressure ulcers 57(11.02%), medication errors 50(9.67%), clinical process 49(9.47%), clinical administration (issues with admission process 10(1.93%) and wrong patient identification 5(0.96%). Among 58(11.21%) cases of hospital-acquired infections, 45(77.58%) cases were urinary tract infections. There was a significant relationship between age and fall (P=0.026), pressure ulcer (P=0.006), and hospital-acquired infection (P=0.001), and between gender and fall (P=0.01), pressure ulcer (P=003), and hospital-acquired infection (P=0.01). The severity of identified AEs was categorized into mild 431(83.36%), moderate 61(11.79%), and severe 25(4.83%). The most common causes of AEs were limited supervision of patients by healthcare providers.

This study showed that patient fall, pressure ulcer, and hospital-acquired infection were the most prevalent AEs in the rehabilitation hospital. Future efforts to improve patient safety in these settings should focus on reducing such AEs along with removing barriers to voluntary incident reporting.

Considering the threats in the operating room during the COVID‑19 pandemic, the optimal care and safety of the operating room nurses should be maintained when performing surgery on an acute respiratory patient. It seems necessary to design a tool to measure the caring behaviors of operating room nurses. Therefore, the present study was conducted with the aim to design a valid and reliable tool for measuring the caring behavior of operating room nurses during the COVID‑19 pandemic.

In this sequential, exploratory, mixed‑method study, the designing and psychometric evaluation of the caring behaviors of operating room nurses questionnaire during the COVID‑19 pandemic were performed in qualitative and quantitative phases from August 2021 to July 2022 in Aja University of Medical Sciences, Iran. In the qualitative phase, the concept of caring behaviors of operating room nurses was explored through interviews and a literature review based on online searches. In the quantitative phase, validity (face, content, and construct), and reliability of the questionnaire were evaluated.

The findings supported 21 items in the 5 factors of caring behaviors related to attitude toward patients, knowledge of surgical care, virus prevention principles, self‑care knowledge, and self‑care performance, which explained 35.92 of the total variance. Scale‑Content Validity Index/Average and Cronbach’s alpha were calculated to be 0.93 and 0.89, respectively.

Given its desirable reliability and validity, simple scoring, and ease of use by operating room nurses, the Caring Behaviors of Operating Room Nurses Questionnaire is applicable and its use is recommended.

With the advancement of information and communication technology, the use of telepractice has expanded to provide speech, language, and swallowing services. In different countries, studies have been conducted in the field of telepractice of speech, language, and swallowing disorders, including stuttering, and these studies have confirmed the effectiveness of this method of providing treatment and have mentioned some problems. To present this method of treatment more effectively, the challenges of this treatment should be examined. The present study has been conducted to investigate the facilitators and barriers to the telepractice of stuttering in preschool children.

In this qualitative study, individual unstructured interviews have conducted using qualitative content analysis with 11 participants, including therapists with experience in stuttering telepractice in preschool children, therapists who were opposed to this treatment (n=7 people) as well as parents who have had successful telepractice and parents who have had unsuccessful telepractice (n=4).

Telepractice facilitators included cost reduction, therapist-client communication between sessions, greater parental cooperation and responsibility in telepractice, reduced stress and increased child-therapist collaboration in the natural environment, more time freedom, and time flexibility for the family and therapist. Barriers to telepractice in this group included lower trust in the therapist in telepractice, limited communication cues, spending more energy by the therapist, difficulty in educating parents, and lack of comprehensive protocols in telepractice.

When these cases are recognized, it is possible to provide higher-quality treatment to people who need these services by reducing barriers and strengthening facilitators. To achieve this goal, it is necessary to conduct studies to develop comprehensive and detailed protocols for providing this method of treatment, taking into account the existing facilitators and obstacles.