abbas ebadi

Effective pain assessment in neonatal care is crucial for ensuring the well‑being of newborns. However, barriers to its successful implementation persist. This study aims to identify the obstacles that hinder effective neonatal pain assessment by neonatal intensive care units (NICUs) nurses.

This qualitative study was conducted using the method of conventional content analysis. Purposive sampling was employed from February to September 2023, selecting 14 female nurses working in NICUs of hospitals in Tehran and Karaj as participants. Indepth, semistructured interviews were conducted to collect the data. The software “MAXQDA” version 2016 was utilized for managing qualitative data.

Four main themes and eleven subthemes were identified: “Overtasked,” “Discordant atmosphere,” “Soulless care,” and “Lack of awareness.” Each of these main themes is further elaborated through the subsequent subthemes.

This study found that the lack of knowledge and understanding of neonatal pain assessment tools, the busyness of nurses, lack of time, excessive documentation, and the inadequacy of staff relative to the number of newborns were the most significant obstacles to the assessment of newborn pain. Addressing these challenges is critical for optimal neonatal pain assessment and management, promoting the well‑being of newborns.

The rising prevalence of chronic and non-communicable diseases, presents significant challenges to health systems. This study aims to empower patients and their families by establishing patient education and follow-up units, thereby improving readmission rates, reducing unplanned referrals to emergency departments, and enhancing patient satisfaction, which are key nursing-sensitive indicators.

Methods & Materials: 

This perspective article presents a quality improvement project utilizing the Plan-Do-Study-Act cycle model. Initially, the problem of non-compliance among discharged patients and the resulting adverse consequences were identified. Consequently, a program for patient and family education and follow-up post-discharge was proposed. In the second step, patient education and follow-up units were implemented across three universities of medical sciences, and the results were analyzed in the third step. Upon confirming the achievement of the expected outcomes, the fourth step involved the national dissemination of implementation guidelines.

The established units in hospitals demonstrated significant improvements in NSIs. The percentage of readmission among follow-up patients decreased from 14.3% in the first half of 2023 to 6.6% in the first half of 2024. The indicator of unplanned referrals dropped from 8.93% to 6.1% over the same period. Additionally, patient satisfaction increased from 91% to 93%.

The experience of establishing patient education and follow-up units highlights that this strategy during the transition to home is an effective, affordable, and sustainable solution that can improve NSIs. This approach, facilitated by nurses, can play a crucial role in managing non-communicable and chronic diseases.

Emergency medical technicians (EMTs) should have good socioeconomic status and health status so that people in need can benefit from their services. The present study aims to measure the biopsychosocial health of EMTs in Tehran, Iran.

This is a descriptive cross-sectional study. The study population consists of the EMTs from six regions of Tehran, Iran. Of these, 563 EMTs were included in the study. Stueck et al.’s health cube battery (HCB) tool, which has six domains of individual resources, external resources, workload, stress consequences, biocentric performance, and socioeconomic status, was used to collect data online. The physiological reactions (blood pressure, pulse rate, and oxygen saturation) were assessed based on three levels of socioeconomic status (low, moderate, and high). The data analysis was performed in Excel and SPSS software, version 22.

The mean age of participants was 31.88±43.6 years, and their mean work experience ranged from 1 to 30 years (mean=14.7±73.5 years). The mean score for biocentric performance was higher than that of other domains. The mean levels of physiological reactions were within the normal range. Overall, 50% (n=281) had moderate socioeconomic status. There was no significant difference in terms of physiological conditions among the three socioeconomic groups.

The EMTs with better socioeconomic status have better performance and physiological status. There is a need for more attention to the socioeconomic status of EMTs in Tehran, which has a direct impact on their performance and an indirect effect on their physiological health.

 Person-centered care is of great importance in nursing due to its wide application and increasing importance. Therefore, it is considered as a quality indicator in the health system. This review study was conducted with the aim of investigating the person-centered care approach.

 This article is a systematic review that targeted search without time limitation using the keywords person-centered care, nursing, intensive care unit and its English equivalent in the English language databases Web of Science, Scopus, PubMed and Persian SID, Iran Medex, Magiran and Google Scholar search engine. This search was conducted until March 2023.

 Out of 67 initial studies, 14 studies were included in the final analysis. In most of the studies, four factors of individuality, kindness, respect and comfort were reported as the main dimensions of person-centered care in Intensive Care Units (ICUs). Heavy workload and lack of cooperation between nurses were introduced as the main obstacles to the implementation of person-centered care and high work experience as an effective factor in improving the quality of person-centered care in the special care department. The provision of suitable clinical spaces for the family was also reported as one of the effective factors in improving the quality of person-centered care.

 Person-centered care, as a new approach, has been investigated in various studies. Paying attention to the patient as a whole person, emphasizing the individual's personality, participation in decision-making processes, respecting the wishes of the patient and his family can be effective factors in providing person-centered care in the special care department. Limited studies have been conducted in the field of person-centered care in the ICU, which is suggested to be further investigated in future studies.

Postpartum bonding disorder is a significant impairment in the mother-infant relationship during the postpartum period. The present study aimed to translate and validate the Postpartum Bonding Questionnaire (PBQ) in Iranian mothers.

A descriptive, cross-sectional survey design was employed in the current investigation. With the developer's permission, a back-translation procedure was used to translate the original questionnaire from English to Persian. Then, following qualitative face validity, a sample of primiparous mothers completed the questionnaire, and construct validity was assessed using exploratory factor analyses. Moreover, reliability was evaluated using internal consistency analysis (average inter-item correlation, Cronbach’s alpha, and McDonald’s omega) and construct reliability.

A total of 263 primiparous mothers completed the questionnaire. Exploratory factor analysis revealed the 13-item version of the PBQ with a three-factor (‘general factor,’ ‘rejection and anger,’ and ‘anxiety about care’) structure, which explained 49.19% of the overall variance observed, and this confirmed the construct validity of the tool. Cronbach's alpha coefficient for the subscales was equal to 0.744. In addition, the test-retest reliability (0.850-0.952) of the questionnaire with a two-week interval indicated an acceptable range of reliability.

The findings indicate that the Persian version of the 25-item PBQ is a reliable and valid tool for screening and identifying the postpartum bonding disorder among Iranian mothers.

Measuring changes in patient performance is crucial in studies assessing the effects of treatments in rehabilitation. Accurate measurement requires precise instruments. The COSMIN checklist is a valuable tool for selecting the best measurement options. This study aims to introduce the COSMIN checklist and its application in rehabilitation sciences. This review study examines the 2015 version of the COSMIN index guide, demonstrating its use in rehabilitation research.

The COSMIN checklist provides a standardized method for evaluating and selecting measurement tools in studies. It also assesses the quality of studies included in systematic reviews. The checklist includes tables that are completed with information from relevant studies, facilitating final decisions on the quality of a study or tool.

Given the importance of measurement in rehabilitation sciences and the standardization provided by the COSMIN checklist, it is a suitable tool for evaluating the quality of measurement tools used in rehabilitation studies.

The purpose of the present study was to design the Farsi Scale of Sexual-Reproductive Needs and Concerns of never-married women over 35 and to assess its psychometric properties.

This mixed method research had two phases. The first phase was qualitative (Conventional Content Analysis). We interviewed never-married Iranian women over 35; from their responses, we extracted specific statements which to be used as questionnaire items. To validate the questionnaire psychometrically, we tested its validity (face, content, and structure) and reliability (internal consistency and stability). For qualitative face validity, 15 never-married women and 5 experts commented on the style of sentences. For quantitative face validity, we used the impact score. For qualitative content validity, 15 experts commented on the items based on their appropriateness, and for quantitative content validity, we performed the Content Validity Ratio and Content Validity Index. Exploratory Factor Analysis was used to Construct Validity. To evaluate structural validity, a cross-sectional sample of 240 never-married women over the age of 35 completed the questionnaire. Cronbach’s Alpha was used for internal consistency. In addition, the test-retest method and Intraclass Correlation Coefficient were used to ensure stability.

The Sexual-Reproductive Needs and Concerns Scale of Iranian Never-Married Women over 35 was developed with 15 items and three dimensions (Emotional burden; Sexual needs; Stigma). Cronbach's alpha for the instrument was 0.81 and the Intraclass Correlation Coefficient was 0.98.

The results of the study showed that the developed scale has acceptable validity and reliability, and thus can be used to assess the sexual-reproductive needs and concerns of never-married Iranian women of 35 and over.

Grief is a human, universal, personal and multidimensional experience. Although studies have been conducted to describe grief, there is no consensus among scholars about its theoretical or empirical definition in older adults. This study aims to analyze the concept of grief in old age.

This is a review study that was conducted in eight steps using Walker and Avant’s concept analysis method. To find studies related to grief in the elderly, a search in online databases including ScienceDirect, Scopus, PsychInfo, PubMed, Web of Science, and EMBASE using keywords: Grief, mourn, bereavement, old, geriatric, aging, age, later life, seniors, nonagenarian, octogenarian and centenarian. Also, articles were examined without considering the time limit published until January 30, 2023. The search strategy, screening, and data reporting were done based the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement.

Of 5963 articles, 34 were included. According to the findings, grief had five features, “a unique phenomenon”, “negative emotional experience”, “physiological irritation”, “experience of loneliness”, and “loss of previous meanings”. Three antecedents of grief included: Loss of loved ones, loss of pets, spouse divorce, and loss of health. Four consequences of grief included health consequences, social consequences, financial consequences, and resiliency.

The provided definition of grief in older adults can help the health team understand the concept better and carry out investigations, interventions, and evaluations to improve the health of the elderly.

Heart valve replacement (HVR) surgery represents a significant life event that can potentially impact the well-being (WB) of patients; however, there is a shortage of research on the understanding of WB in HVR patients. This study aims to elucidate the WB experiences of patients who have undergone HVR surgery. A qualitative directed content analysis approach was employed, focusing on patients who had undergone HVR surgery at hospitals affiliated with Mashhad University of Medical Sciences in Iran from March 2021 to June 2022. Data collection involved conducting 23 face-to-face, semi-structured, in-depth interviews with HVR patients until data saturation was reached. Data analysis was performed using the Elo and Kyngäs approach in MAXQDA software version 10. The analysis revealed 11 generic categories based on the Biopsychosocial-Spiritual (BPSS) model, encompassing the WB experiences of HVR patients. These categories included physical improvements, facilitated treatment compliance, personal and environmental mastery, optimism in life, resilience, healing therapeutic communication of medical staff, a positive supportive atmosphere, job and financial assurance, faith in a higher power, optimism regarding a purposeful future, and gratitude mixed with generosity. The findings of the current study revealed that the experience of WB in HVR patients was influenced by various conditions. By recognizing these conditions, healthcare providers can develop targeted interventions to improve the WB experience in these patients. Also, the findings provide a foundation for future research on WB in medical contexts.

There is uncertainty in identifying which aspects of functioning should be prioritized in the clinical brief assessment of children with cerebral palsy (CP). Brief ICF category sets specify the essential aspects of functioning that should be addressed in such assessments.

This study aimed to develop five brief ICF category sets based on the functional limitations of children with CP, as viewed by Iranian occupational therapists (OTs).

This cross-sectional, multi-method study was conducted from January to May 2022 in Iran. Nineteen OTs were recruited through purposive sampling for a Delphi process, and ten OTs through snowball sampling for an expert panel, all experienced in CP and ICF. The Delphi involved two rounds of electronic surveys, where participants identified categories that should be minimally addressed in brief assessments of children aged 6 - 12 with CP based on their functional limitations. The content validity of these sets was then quantitatively evaluated by the expert panel.

Most confirmed categories in the gross and fine motor brief sets pertained to body structure and function, while those in the eating-and-drinking and communication-function brief sets related to cognition and motor reflexes. Categories in the visual function brief set mostly pertained to activity, participation, and environmental factors. Content validity ratio (CVR) and item-content validity indexes (I-CVI) ranged from 0.80 to 1 across all categories/brief sets, with scale-content validity index/Average (S-CVI/Ave) ranging from 0.95 to 0.98.

These functional-based ICF brief sets are the first developed for children with CP in this age group and provide occupational therapists with tools to address crucial aspects of functioning, tailored to specific functional limitations. However, cultural biases and the generalizability of these brief sets remain limitations.

The COVID-19 pandemic has resulted in widespread physical and psychological challenges, including persistent psychological distress (PD). Research suggests that while some COVID survivors maintain satisfactory psychological functioning, others may experience long-term, severe PD. Addressing these challenges, along with associated sociodemographic determinants, requires a comprehensive, community-based approach.

This study aims to determine the prevalence of PD, including depression, anxiety, and stress, among Iranian COVID survivors by analyzing various regional, temporal, and sociodemographic determinants.

The study, conducted between July 2021 and February 2022, aimed to determine persistent PD among Iranian COVID survivors. Ethical approval and other necessary permits were obtained. The final sample size consisted of 300 participants selected from an initial pool of 11,337 medical records. Participants received questionnaires electronically, including the “Socio-Demographic Clinical Questionnaire (SDCQ)” and the “Depression, Anxiety, and Stress Scale 21 (DASS21).” The study used SPSS 26 for statistical analysis, calculating means, standard deviations, and frequencies. Relationships between determinants were examined using ANOVA and chi-square tests. Bayesian regression analysis was employed to explore correlations and predictive power between COVID-19, PD, and the various determinants.

The prevalence of depression, anxiety, and stress, considered collectively as PD among participants, was 49%, 53%, and 61%, respectively, with mean severity scores of 10.68 ± 2.16 for depression, 9.18 ± 1.84 for anxiety, and 15.93 ± 2.79 for stress. More severe manifestations of PD were observed in participants from Hospital III (P > 0.05, r ≈ 0.17) and during the temporal period of 12 - 24 weeks post-infection (P < 0.05, r ≈ -0.12). Additionally, significant correlations between PD and determinants such as sex, Intensive Care Unit (ICU) admissions, and intubation were noted (P < 0.05). Bayesian analysis further highlighted cross-correlations between PD and other determinants among Iranian COVID survivors (P < 0.05, BF < 0.1).

In conclusion, the study found that Iranian COVID survivors experienced mild levels of depression, anxiety, and stress, with prevalence rates ranging from 49% to 61%. The highest severity of PD was observed in participants from Hospital III and during the period of 12 - 24 weeks post-infection. Additionally, a network of cross-correlations was identified between PD and various other determinants among Iranian COVID survivors.

Adaptation to complications of hysterectomy is one of the topics of concern for women and health care providers. There is no instrument for evaluating adaptation to hysterectomy. This study aimed to design the Hysterectomy Adaptation Scale (HAS) and assess its psychometric properties.

This methodological study was conducted from 2018 to 2020 in Mashhad, Iran. To develop the item pool, qualitative data from directed content analysis and data from the review of adaptation and coping instruments were used. The face, content, construct validity, internal consistency, and stability were used to evaluate the psychometric properties of HAS.

The final version of the HAS consisted of 24 items with a reported content validity index of 0.9. Six factors were extracted from the principal component analysis, which explained 60.3 of the observed variance. Model fit indices in confirmatory factor analysis showed that the model was well fitted. The values of the alpha coefficient and intra‑class coefficient were 0.86 and 0.95, respectively.

The HAS is a valid and reliable scale for evaluating the adaptation level of hysterectomized Iranian women. HAS can distinguish between hysterectomized women who have adapted to hysterectomy and those who have not. It can be used to assess the adaptation of hysterectomized women in research and clinical practice.

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.

 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 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.

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.