asghar dalvandi

Schizophrenia is a severe mental disorder characteristics by abnormal thoughts, patterns, cognitive impairments, and either a diminished or exaggerated expression of emotions. This disorder follows a chronic clinical course, with many many individuals experiencing symptoms over extended periods. Patients with schizophrenia often lack insight into their condition, leading to frequent relapses and multiple hospitalizations. mental disordrs Mental disorders, in general, impose a significant burden on caregivers; however, schizophrenia presents unique challenges. Beyond the decline in individual and social functioning of patients and the direct impact of symptoms on caregivers’ quality of life, the early onset and debilitating nature of schizophrenia further exacerbate the strain on family caregivers. This policy brief outlines strategies aimed to reducing the caregiving burden for for families of individuals with schizophrenia.

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.

Patients With Stroke (PWS), like patients with other chronic health conditions, need long‑term care in home settings. Patient transfer from hospital to home is associated with challenges such as care quality impairment and ineffective patient need fulfillment. The aim of this study was to assess the principles of Home Care (HC) for PWS.

This integrative review was conducted in 2023 using the method recommended by Whittemore and Knafl. The Web of Science, Google Scholar, ScienceDirect, ProQuest, Scopus, Cumulative Index to Nursing and Allied Health Literature, PubMed, and specific databases for stroke care guidelines were searched to find relevant articles published between 2010 and 2023. The Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) statement was used for document screening and selection. The data were analyzed using the constant comparison method.

Primarily, 2608 documents were retrieved, and 22 of them were included in data analysis. The principles of HC for PWS were categorized into six main categories: principles of transition from hospital care to HC, principles of assessment for HC, principles of education for HC, principles of designing an HC plan, principles of HC measures, and principles of discharge from HC centers.

The present study provides a detailed overview of the principles of HC for PWS, which can be used to develop standard guidelines and improve the quality of HC for PWS.

 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 emancipation in the sense of empowerment, independence, and freedom came to the literature on disability with the emergence of a social model. Despite the importance of this concept, it is still unclear what effects the realization of the emancipation process has on the lives of people with disabilities and society.

This study aimed to explore the consequences of the emancipation process for people with physical disabilities.

The study was conducted using the grounded theory method in 2021. Participants included 23 people with physical disabilities, a welfare organization manager, a welfare organization employee, a rehabilitation nurse, a physician, and two family members. The research data reached theoretical saturation with 18 individual interviews and two focused groups with 11 people with physical disabilities. 5 people were in the first group, and six were in the second group.

Data were analyzed based on the approach of Corbin and Strauss (2008). Data analysis led to 833 codes, seven sub-themes, and three main themes. The main themes included excellence and growth, functional health, and realization of a disabled-friendly society, and subthemes included self-actualization, self-determination, improving personal performance, economic self-sufficiency, improving social relationships, cultural acceptance of disability, and realization of social participation.

The emancipation process leads to positive outcomes in the lives of individuals with physical disabilities. These consequences appear in individual areas, such as improving performance and self-sufficiency, social participation, and promoting community culture, which can be useful in planning and policy-making focusing on the realization of the emancipation process. A rehabilitation team can assist in achieving emancipation and its consequences.

Stroke is a significant and unpredictable event that affects physical and mental functions. A useful approach to returning to a normal life is to seek out health information. This study aimed to explore the experiences from health information seeking in the stroke survivors and their family caregivers.

This study was carried out using qualitative content analysis. Participants included five stroke survivors and fifteen family caregivers who were selected purposively from the Rofideh Rehabilitation Center and private physiotherapy centers in Tehran. Data were collected from semi-structured interviews. Data analysis was performed using Graneheim and Lundman’s method manually in Word software. Sampling was carried out in 2021.

Two main categories were extracted: 1) adapting and learning resulting from awareness including optimization of living environment and disease management, and 2) fear and inquietude on the information way including confused and insolvent in receiving information, and doubts about the accuracy of information.

The health information seeking created adaptability and relative stability in some stroke survivors and their family caregivers. However, in others, there was still a sense of anxiety and uncertainty. Thus, understanding health information seeking experiences helps health policymakers and administrators to provide information and training based on evidence and individual needs of the client and family.

Caregivers of stroke patients have many problems due to caring for patients. This study aimed to evaluate the psychometric properties of the Persian Version of the Bakas Caregiving Outcomes Scale (BCOS) in caregivers of stroke patients.

This methodological study was conducted in 2018 with 191 caregivers of stroke patients. In order to assess the scale validity and reliability, the face, content, internal consistency, stability of the scale, and construct validity (exploratory and confirmatory factor analysis) were done.

The scale face and content validity qualitatively were checked and confirmed by caregivers’ and experts’ opinions. In the reliability, Cronbach’s alpha was obtained to be 0.93. The test‑retest was conducted on 30 participants and showed good stability after 2 weeks. The Intraclass Correlation Coefficient (ICC) for the total scores was reported to be 0.94. The Kaiser‑Meyer‑Olkin p </em>value was 0.90, Bartlett’s sphericity test was significant (p </em>< 0.001), in the exploratory factor analysis, 2 factors with 14 items were extracted. The confirmatory factor analysis confirmed the appropriate model with 14 items (removal of item 13) with two factors at the expected level.

The Persian version of the 14 items of the BCOS indicates satisfactory reliability, and validity in the Iranian caregivers of stroke patients.

In the elderly, the rate of adherence to the medication regimen and the rate of remembering how to correctly prescribe medication is low due to old age and memory loss, which leads to poor therapeutic results. The aim of this study was to determine the relationship between anticoagulants knowledge and adherence to treatment in elderly cardiac patients with atrial fibrillation.

This cross-sectional study was performed on 110 elderly patients aged 60 to 89 years with atrial fibrillation admitted to the Cardiac and Intensive Care Unit of Tohid Hospital in Sanandaj, Iran in 2020. The volunteers were included by available sampling method. Morisky Medication Adherence Scale-8 (MMAS-8) and Anticoagulation Knowledge Tool (AKT) was used to assess the level of anticoagulant knowledge. The reliability of the AKT was confirmed by retesting by 15 patients after one month; the correlation coefficient was 99.4. For determination the reliability of AKT, the questionnaire was provided to cardiologists and nurses. The validity and reliability of the MMAS-8 have been proven in previous studies.

The mean level of anticoagulant knowledge in elderly patients was 17.82±9.36 which is in the intermediate range. The mean score of adherences to treatment in this study was 6±1.54 which is in the intermediate range, too. There is a direct and significant relationship between anticoagulant knowledge and adherence to treatment (P=0.02).

The mean score of patients' knowledge about anticoagulants was moderate. Adherence to medication regimen and anticoagulants knowledge were higher in elderly with higher education than others. Applying training programs for the elderly in a simple and understandable way in this field can be helpful.

Recovery of children does not appear on its own after cochlear implantation. Coherent, thoughtful, and comprehensive rehabilitation is needed to achieve complete success. The purpose of this study was to identify the types of rehabilitation interventions for children with cochlear implants that have been performed in Iran.

A scoping review study was conducted. An electronic search was carried out both in English and Persian. In English, the following keywords were used: cochlear implantation, child, cochlear implants, auditory rehabilitation, deaf, hearing loss, comprehensive, interventions, rehabilitation, and telerehabilitation and a combination of them in ProQuest, PubMed, Science Direct, and Scopus databases, Web of Sciences, Medline and Embase. Persian electronic search was conducted in the Scientific Information Database (SID) of Jihad Daneshgahi, Iran Journals Database (MagIran), and Islamic World Science Citation Database (ISC). Searches were done using articles published until September 25, 2020, and a total of 902 articles were found, of which 14 were directly related to the purpose of the study. Interventional studies were included in the study, and the quality of studies was measured using the Structured Effectiveness Quality Evaluation Scale.

The results showed that using music and rehabilitation equipment, different methods of speech therapy and auditory training, story-based instruction, creative play, family-centered instruction, and occupational therapy are interventions in cochlear implant rehabilitation. Speech therapy accounts for 54% of the rehabilitation share. The mean number of rehabilitation sessions was 26. These interventions were all somehow effective in children with cochlear implantation; the longer the training duration, the better the results.

The process of cochlear implant rehabilitation in children is multi-professional; auditory training and speech therapy possesses the highest share of rehabilitation. Therefore, it is recommended to develop speech therapy centers in Iran.

Optimizing care processes, especially in the emergency trauma departments, is considered an important issue in health care systems. Moreover, exploring strategies with the participation of stakeholders can significantly affect patient outcomes.

This study was conducted to identify, prioritize and optimize care strategies for trauma and emergency patients in Shiraz, in 2019.

Data using semi-structured interviews, Focus Group Discussions, and executive meetings with managers were collected, and the prioritization matrix was used to optimize strategies. Sampling was done purposefully until data saturation. The collected data were analyzed using qualitative inductive content analysis.

26 necessary corrective and preventive strategies were mentioned. After analyzing the data, various strategies such as rectifying managerial issues of the emergency system, specialized trauma nursing care, enhancing trauma emergency response preparedness, and adoption of a team approach were proposed.

The exploration of care strategies using employee participation provides to facilitate the development of care processes, especially in complex spaces such as trauma emergency wards. Therefore, the healthcare authorities such as nurse managers should pay special attention to these strategies. Moreover, nurses should provide more effective care in the trauma emergency departments based on the appropriate and applicable strategies.

One of the stroke complications is hemiplegia, which can cause subluxation of the shoulder joint and reduce the passive range of motion of the affected shoulder, resulting in limited movement. This study aimed to evaluate the effect of static magnet therapy on pain-free shoulder passive range of motion in patients with shoulder subluxation after stroke.

This clinical trial study was performed on 36 patients with stroke (18 in the intervention group and 18 in the control group) referred to Tabassum Stroke Rehabilitation Center in Tehran in 2016. Neodymium magnetic shoulder support with an intensity of 1500 gauss was used in the intervention group, and non-magnetic shoulder support was used for the control group. A goniometer measured Pain-free passive range of motion (abduction) of the (shoulder with subluxation) under the supervision of an occupational therapist. Data were analyzed using SPSS software version 18 using descriptive and inferential statistical tests. The significance level was considered 0.05.

After magnet therapy, the mean score of range of motion in the intervention group increased significantly (0.023). Post-test comparison between the intervention and control groups showed that the mean score of range of motion was higher in the intervention group, but this difference was not statistically significant.

Magnet therapy as a complementary, low-cost, and safe treatment with an increasing range of motion without shoulder pain can help improve individual activities and prevent complications. Further studies on the effectiveness of magnet therapy in improving the range of motion are recommended.

Caregiving for trauma patients has many challenges. Inadequate knowledge of these challenges can affect the patients and worsen their conditions.

We aimed to explore the caregivers’ experiences about these challenges and problems of caring for patients with trauma emergencies.

The study adopted a concurrent triangulation mixed-method and was conducted in Shahid Rajaee Hospital, southern Iran, in 2019. Semi-structured interviews, focus groups, observation and ward document assessments were conducted with focusing on the challenges experienced by the caregivers. A checklist was used to assess the performance of caregivers and measure the indices related to the care process. Statistical results and qualitative data on the main categories were compared and integrated for data analysis.

In total,307 codes were extracted by analyzing the content of the interviews and available evidence. The codes were summarized in 20 subcategories, and six main categories were extracted as follows: lack of professional capability, uncoordinated team response, deficits in managerial commitments, inadequate work motivation, complex nature of trauma emergency, and lack of clinical communication. The quantitative results indicated that caregivers’ performance was considerably far from the expected scores and also many indices indicated a waste of time in responding to the patient needs.

Various dimensions of trauma care challenges indicate that professional capability, team coordination and communication, managerial commitments and work motivation considering the complex nature of trauma emergency wards are crucial to enhance patients' access to optimum quality care. Caregivers’ performance and quality of indices also affect the care process. Future studies are required for compiling strategies and protocols for the quality of care for trauma patients.

One of the most important aims of rehabilitation in Spinal Cord Injuries (SCI) is regaining autonomy, which can affect individuals’ Quality of Life (QOL). This study was conducted to understand the experiences of individuals with SCI in terms of regaining autonomy during transition from hospital to community.

The present study was conducted using a qualitative research design. In this study, 15 semi‑structured, in‑depth interviews were conducted with individuals with SCI in Spinal Cord Injury (SCI) Association of Arak, Iran, from June 2018 to May 2019. The interviews were analyzed using the conventional content analysis method.

Data analysis emerged four core categories of “self‑management” (adaptation to a new life, self‑care, responsibility, and seeking information), “social support” (family and friends’ support, health care providers’ support, and peer support), “access to facilities and resources” (home modification, use of various rehabilitation techniques, and use of mobility equipment), and “spiritual and religious beliefs” (believing in divine destiny and performance of religious rites).

The present study showed that several factors influenced the regaining of autonomy in individuals with SCI. It is important to consider the impact of these factors during transition from hospital to community. Health service providers can use the findings of this research to help these individuals regain their autonomy.

The growth of the elderly population, on the one hand, and the increase in exposure to accidents and disasters, on the other hand, have highlighted the attention on the issues of the older adults in disasters. This study aimed to investigate the changes in the lives of the elderly after the earthquake.

The present qualitative study was conducted using the content analysis method. The study data were collected through in-depth and semi-structured interviews. In total, 26 participants were interviewed in this study, including 4 specialists (an accident and disaster specialist, an elderly specialist, a psychologist, a social worker), 18 older adults, and 4 caregivers of the older adults. The data collection and data analysis process were performed simultaneously, and the Granheim and Lundman approach was used in this regard.

In this study, two main categories were found about changes in the lives of the elderly after the earthquake: re-victimization and post-accident growth. Re-victimization category consisted of the subcategories of “increased dependency”, “declining physical and mental health”, “poverty and deprivation”, and “avoidance of work and family activities”, and post-accident growth included the subcategories of “individual growth”, “self-regulatory behaviors”, and “reinforcing the houses”.

Clarifying the nature and life changes of the elderly after the earthquake can enhance the knowledge of service providers. This information helps them make the necessary plans to prevent and reduce the problems that the elderly face after the earthquake.

Transition of patients with spinal cord injury (SCI) from hospital to home often involves a shift in caregiving responsibility from health‑care providers to family caregivers. Poor care transition may lead to poor care‑related outcomes.

The aim of this study was to explore experiences of care transition from hospital to home among the family caregivers of patients with SCI.

This qualitative study was conducted in 2018–2019. Participants were 17 family caregivers of patients with SCI who were purposively recruited from two specialty SCI care centers in Iran. In‑depth semi‑structured interviews were held for data collection. Interviews were audio‑recorded, transcribed, and analyzed using conventional content analysis.

The following four main categories were developed during data analysis: lack of knowledge (with two subcategories), excruciating care (with two subcategories), emotional burden of caregiving (with three subcategories), and need for support (with two subcategories). The nine subcategories of these main categories were lack of medical and care‑related information, seeking for information, heavy burden of daily caregiving, need for providing professional care at home, feelings of sadness and sorrow, feeling of insufficiency, restriction of life, limited support by family members and relatives, and limited financial support by the government.

Family caregivers of patients with SCI experience many challenges and problems during care transition from hospital to home, which can affect the quality of their care services for their patients. Therefore, they need ongoing support throughout the process of care.

Caregiving to patients with schizophrenia is burdensome for family caregivers and has profound effects on them.

This study aimed to explore the impacts of informal caregiving among the family caregivers of patients with schizophrenia.

This qualitative study was conducted on a purposive sample of 12 family caregivers of patients with schizophrenia and 3 health‑care providers. Semi‑structured interviews were held for data collection, and conventional content analysis was used for data analysis.

Four main subthemes were developed during data analysis, namely threatened health, helplessness, patient abandonment, and personal growth. Together with their eight subcategories, these subthemes were grouped into the main theme of the “Consequences of caregiving burden.”

Caregiving to patients with schizophrenia imposes heavy burden on family caregivers and has different consequences for them. The findings of this study can improve the knowledge and awareness of mental health and psychiatric nurses about schizophrenia and its consequences for family caregivers and can help them identify family caregivers who are at risk for negative consequences and design proper family‑based interventions to reduce the effects of these negative consequences.

Chronic diseases around the world are rapidly increasing. One of these chronic diseases is stroke. Given the multiplicity of problems in this disease, it needs to be managed and provided with appropriate education and support services to the patient and family to achieve self-management ability to maximize functions, feel good, reduce care burden, and improve quality of life. The purpose of this study was to investigate the effect of a self-management program based on the 5A Model on caregiver burden of family caregivers of stroke patients.

This quasi-experimental study was performed on 64 family caregivers of patients with stroke in Kashan Shahid Beheshti Hospital. Sampling was done by convenience sampling based on inclusion criteria. Data collection tools included demographic characteristics of the patient questionnaire and the primary caregiver and The Zarit Burden questionnaire. The data were analyzed using descriptive and inferential statistics and SPSS-19 software.

Findings showed that the mean age of patients was 69.28±15.57 and the mean age of caregivers was 44.10±10.80. Most of the patients’ main caregivers (62.5%) were their children. There was no statistically significant difference in the mean of caregiver burden between the intervention and control groups in the pre-test (P-value=0.109), while the caregiving burden was significantly decreased in the intervention group and increased in the control group in the post-test (P-value=0.001).

Implementation of a self-management program based on the 5A Model is helpful in reducing the caregiver burden for family caregivers of patients with stroke and can be used as one of the effective methods for empowering them.

After the psychiatric revolution and implementation of deinstitutionalization policies, caring for people with a mental health condition shifted from psychiatric hospitals to their families. In this way, family caregivers were forced to take full responsibility for taking care of the patients that lead to the occurrence of challenges for them. Only a few studies have investigated the caregiving challenges of family caregivers in patients with schizophrenia.

This study aimed to gain a better understanding of caregiving burden in family caregivers of patients with schizophrenia and its related factors.

This qualitative study was performed based on 12 family caregivers of schizophrenia patients visiting a psychiatric hospital in Tehran in 2018. Sampling was carried out based on the purposive sampling method and was continued until data saturation. All interviews were recorded, transcript, and imported into the MAXQDA software. Then, qualitative content analysis was conducted based on Graneheim and Lundman’s five‑step method.

One theme, two main categories, and five subcategories were identified from the continuous analysis and data comparison. The “Perceived objective burden” as theme included two main categories: “Heavy involvement of caregivers” and “Challenges of the healthcare system”.

The results of this study indicate that the family caregivers of the patients with schizophrenia encounter many problems related to multiple responsibilities in the caring process and challenges in the provision of mental health‑care services. This finding could improve psychiatric and mental health nurses’ knowledge and awareness about caregiving challenges in family caregiver of patients with schizophrenia and related factors.

Decreased self-efficacy and self-esteem are common complications after a stroke. Rehabilitation for patients after stroke is inevitable. The training of the use of mobility assistive devices helps to increase the level of activity and independence. This study aimed to determine the effect of movement assistive devices skills training on the self-efficacy and self-esteem of stroke patients.

This study was a controlled clinical trial that was performed on 62 patients with stroke in Kashani Hospital Shahrekord in 2018. Samples were selected by simple sampling, and based on the numbers generated by random allocation software; they were assigned to the control and experimental groups. Before Patients discharge, the intervention group was trained in the use of assistive mobility devices, and the control group received conventional training and treatment. At the next visit to the doctor (at least two weeks later), self-esteem and self-efficacy of patients were measured. Data were analyzed by SPSS software version 18 using descriptive and inferential statistics. The significance level was considered (0.05).

Patients in both intervention and control groups were matched in terms of demographic variables. Self-efficacy and self-esteem before and after training were not significantly different in the control group (self-efficacy P = 0.221, self-esteem P = 0.102). P ≥ 0.05 But in the intervention group, the difference was significant and improved P ≤ 0.05. Self-efficacy and self-esteem in the intervention group compared to the control group in the covariance test (self-efficacy F = 50.704 self-esteem F = 59.69) Therefore, self-efficacy and self-esteem in the intervention group compared with the control group had a significant difference (sig = 0.000).

The teaching of motor aid to stroke patients improves self-esteem and self-efficacy in controlling the complications of the disease. Therefore, it is recommended to use these tools to increase self-esteem and self-efficacy.

Adherence to rehabilitation regimens is a major issue in the treatment of stroke. Despite the agreement on the importance of adherence, there is still no clear definition of this concept in rehabilitation. The aim of this study was the concept analysis of the concept of adherence to rehabilitation regimens in stroke patients.

This qualitative concept analysis was performed using Walker and Avant’s method. English and Persian articles were searched using keywords such as “adherence”, “compliance”, “rehabilitation”, “stroke”, and other related keywords among articles published from 1997 to 2018 in PubMed, Scopus, Web of Science, Google Scholar, Iranmedex, Magiran, and Scientific Information Database (SID). Related textbooks were also searched and all articles containing definitions, attributes, antecedents, and consequences of the concept were included in the study.

The attributes of the concept included complex, multidimensional, and dynamic behavior in the treatment process, personal experience, and adaptive behavior in patients, changeable, situational, voluntary, and collaborative behavior, and active communication between the patient and the healthcare provider. Common antecedents of the concept of adherence to the rehabilitation regimen were classified into patient‑related and environmental‑related categories and the consequences were classified into the three categories of patient‑related, healthcare professional‑related, and healthcare system‑related.

This concept analysis can be useful in eliminating any ambiguity of the concept of adherence to rehabilitation regimens. It helps clarify the vague concepts used in nursing rehabilitation instead of adherence. The results of this study can be helpful for researchers for further studies in this context.

Providing patient safety is considered as one of the most important goals of the health sector, and health organizations have placed it as one of the main focus on improving the quality of services provided to patients. This study aimed to determine if the effect of inter-professional communication skills training on patient safety culture among Emergency department staff in Bahman hospital of Tehran in 2018.

This study is a Semi-experimental study that in that Pretest-posttest plan with a control group was used. All of the Emergency Department staff of Bahman hospital in the second six months of 2018 was our statistical research community. 50 personnel were selected Based on inclusion criteria and purposive sampling method and randomly divided into two groups of experimental and control by using a table of random numbers. The intervention group received three sessions of one and a half hours by lecture and question and answer methodology, along with providing a booklet on inter-professional communication with the SBAR model. Samples filled the standard patient safety culture questionnaire before and after the intervention. SPSS statistical software SPSS19 data using chi-square, Fisher's exact test, and independent t-test and paired T was performed.

Results showed no difference between two groups of intervention and control about demographic characteristics (P > 0.05). The mean patient safety culture Score was 102.96 ± 9.27 in the intervention group, and 105.52 ± 6.35 in the control group before the intervention, which respectively reached to 115.44 ± 9.19 and 107.12 ± 6.78 after implementation of the intervention and this difference was significant in intervention group (P < 0.001).

According to the results, we can say that interprofessional communication skills training is effective in improving patient safety culture among Emergency department staff. So it can be an applied method of this study as a pure, non-invasive, low-cost, and effective in improving r patient safety culture in Emergency department staff.

Understanding the consequences of perceived self-care ability in stroke patients living at home is of great importance, as it is associated with continuity of care, health promotion, and improved quality of life.

The current study aimed at determining the consequences of perceived self-care ability in stroke patients living at home in Iran.

In this qualitative study, conventional content analysis was performed. Both unstructured and semi-structured interviews were conducted with 10 patients, who had experienced chronic strokes. One interview was conducted at home, while nine others were conducted at the rehabilitation centers of Tehran, Iran. Sampling continued until reaching data saturation. All interviews were recorded, transcribed, and entered in MAXQDA. Content analysis was performed based on Graneheim and Lundman’s five-step approach.

Two main categories and three subcategories were extracted in this study. The two main categories included “promotion of adaptive strategies” (self-efficacy and adaptation to disability) and “maintaining a healthy lifestyle” (individual autonomy).

Based on the findings, the more patients are aware of their abilities and restrictions, the more they will be able to cope with the consequences of their disease during the transition from the acute to chronic phase; these patients can also adopt more suitable coping strategies

Cerebral palsy is a chronic condition that can have a negative impact on the family unit. Families of children with cerebral palsy have numerous difficulties with the family's Apgar Criteria, including "adaptation, participation, growth, affection, and ability to solve problems in life" that necessitate proper interventions. The aim of this study was to determine the effect of self-management training program on Apgar scores of families of children with cerebral palsy.
In this quasi-experimental study, conducted in 2015-2016, 47 parents of children with cerebral palsy ranging from 4 to 12 years of age were selected through Census. In the post intervention phase, due to the decline of the study samples, 23 families were included in the intervention group and 16 families in the control group. After assessment of reliability and validity, data were analyzed using the parent and child cognitive demographic questionnaire and the "smilkstein family Apgar" questionnaire by both parents in a two-step pre-test and post-test self-management program. Data were analyzed using the SPSS version 22 software.
The mean Apgar score in the intervention group increase from 6.46 to 7.82 and in the control group from 6.83 to 6.31. The results showed that there was no significant difference in family Apgar scores in the intervention and control groups before the intervention (p = 0.381); nonetheless, in the post-intervention phase there was a significant difference between the two groups in terms of family Apgar scores. “Self-management program based on the 5 A's model” affected families' Apgar score and improved it from the average inefficient to the efficient level (P=0.022).
Apgar scores of families of children with cerebral palsy are moderate and education through “self-management program based on the 5 A's model” improved it. In this regard, it is vital that the supporting authorities, in addition to addressing the condition of children, pay more attention to their families.

Nurses are required to use stress management methods due to their high exposure to daily stress. The purpose of this study was to determine the effect of resilience skills training on nursing stress of nursing staff in hospitals of Golestan Province. The present study is quasi-experimental. Participants included nurses working in hospitals in Golestan province who were randomly selected and randomly assigned to participate in the study. The samples were 40 in each of the experimental and control groups. The experimental group underwent a 4-session workshop on resilience skills. Data were collected using a two-part instrument consisting of demographic questions and “Nursing Stress Scale” (NSS). The Scale was completed by participants in the three stages before, immediately and one month after the intervention. The reliability of this scale before the intervention was performed by Cronbach's method. Collected data was analyzed using SPSS. 21. In the test group, the difference between the mean score of total nursing stress before and after the training was 101.05, 93.50, respectively. After intervention, training of resilience skills between two groups of test and control was also significant in nursing stress variable. In other words, intervention significantly decreased nursing stress in nursing staff (n = 141.104, P < 0.001). Training of resilience skills reduced nursing stress in nursing staff. Training this skill for nurses is recommended.

Spiritual health is an important dimension of health in humans. It coordinates individuals’ forces, and ultimately, their overall health. There are Many challenges to this concept in older people. The current study aimed to analyze the concept of spiritual health in the elderly.  We used Walker and Avant’s approach. We searched for the studies using the following keywords: “elderly people, elderly person, spirituality, spiritual health, spiritual wellbeing, elderly, older adult, and geriatric”. We reviewed the literature in accordance with the study inclusion criteria, consisting of Persian and English Language studies published from 1996 to 2016; a total of 32 articles related to the concept were analyses.  Spiritual health is a dynamic and multidimensional concept in older people's view. Some of the spiritual health attitudes in the elderly were the love of supreme power and mental balance. With respect to the afterlife, antecedents were having abilities, faith, trust, and commitment to morals and their consequences, nearness to God, peace, a higher quality of life, and providing social support to others. The conceptual definition of spiritual health can help healthcare providers better understand this concept and conduct the interventions and evaluations of health promotion efforts to help the elderly.