فهرست مطالب hamid haghani

Patients with heart failure experience poor sleep quality due to the nature of disease they suffer from. The aim of this study was to investigate the effect of music on the sleep quality of patients with heart failure.

The present study is a randomized clinical trial, which was performed on 76 patients with heart failure, hospitalized in the cardiac ward of an educational hospital. These patients had obtained a score of 5 or higher on Pittsburgh’s sleep quality index. The block randomization method was used to generate the allocation sequence. Thus, the number of subjects in each block was determined to be 4 people in 18 blocks. Intervention was collection of nature music played through headphones for 30 minutes over three nights, and at the end of the third night, the Pittsburgh’s index was completed again by both groups. Data were analyzed using descriptive and inferential statistics.

After the intervention, the mean scores of mental quality of sleep (p </em>= 0.007) and daily function disorders improved significantly in the intervention group (p </em>= 0.025). Significant differences were seen between the mean scores of mental quality of sleep (p </em>< 0.001), daily function disorders (p </em>= 0.002), delay in falling asleep (p </em>= 0.01), sleep disorders (p </em>< 0.001), and use of sleeping pills (p </em>< 0.001) before and after the intervention in the intervention group.

Playing relaxing music like nature sounds and spending time in nature after discharge can improve the sleep quality and sense of relaxation in patients with heart failure. The implementation of such affordable and amusing interventions can be proposed by nurses in heart failure patients.

The physiological changes with increasing age make older adults more prone to acquiring chronic diseases, and their treatment needs multiple drug regimens. However, the extensive use of medications is accompanied by an increased risk of adverse drug reactions (ADRs), partly due to polypharmacy (concomitant use of multiple drugs). Both polypharmacy band medication adherence are considered major public health concerns, which are growing worldwide.

This study was conducted to determine drug adherence in older adults with polypharmacy referred to selected educational medical centers of Iran University of Medical Sciences, Tehran City, Iran, in 2021.

The present study is a descriptive cross-sectional analytical study. The sample consisted of 243 older people. The participants were selected using a non-probability sampling method (continuous method with categorical proportional allocation). The inclusion criteria were older adults taking polypharmacy (five or more prescribed drugs). Data collection tools were a demographic personal and clinical characteristics form, a drug compliance questionnaire, and a 10-point visual analog scale (VAS) of self-perception of health. After the participants had completed the questionnaires, the raw data were analyzed using descriptive and inferential statistics methods, including analysis of variance, independent t-test, and the Pearson correlation coefficient. The significance level was considered P<0.05.

The mean age of the subjects was 69.38±6.6 years; their mean perception of health was 5.83±2.33, and the mean number of underlying diseases was 2.3±1.19. The study participants showed moderate drug adherence, which was insufficient. No significant relationship was found between demographic and clinical variables with drug adherence. The Pearson correlation test results showed a weak correlation between age and medication adherence (r= 0.029, P=0.001), as well as age and number of underlying diseases (r=0.031, P=0.001).

This study demonstrated moderate drug adherence in older adults with polypharmacy, which is not optimal. Healthcare professionals involved in patients’ medication use play a key role in providing essential education to older adults with polypharmacy to improve drug adherence.

Delirium is an unpleasant experience for patients and their family, which brings complications for them. Early diagnosis and reduction of risk factors affecting delirium requires the knowledge and awareness of doctors and nurses of special care departments about the nature of delirium symptoms, disease symptoms and factors affecting the occurrence of this syndrome. The present study was conducted with the aim of determining the factors related to delirium in patients and family caregivers of patients admitted to the Intensive Care Unit (ICU).

In this cross-sectional study carried out in 2023, 256 pairs of patients admitted to the ICU in hospitals affiliated to Tehran University of Medical Sciences and their family caregivers were selected using the proportional stratified sampling. To collect information, three questionnaires including demographic information, CAM-ICU questionnaire and sour seven questionnaire were used.

The patients participating in the research had an average age of 41.75 ± 17.07 and most of them were male (55%) with an average number of hospitalization days of 11.84 ± 8.82. Delirium was reported positively in 210 cases of patients (81.7%). Family caregivers had an average age of 42.25 ± 14 and were mostly women (66.9%). In addition, 171 (66.5%) of family caregivers had reported symptoms of delirium. The results of the statistical analysis showed that there is a statistically significant relationship between delirium in patients and delirium in family caregivers in the samples of the participants in this study (P<0.5).

Considering the high rate of delirium reported in patients and caregivers of patients hospitalized in the ICU, identification and screening of delirium is very important. By knowing the individual characteristics and factors related to the occurrence of delirium identified in this study and to the extent possible to correct some cases or support the caregivers, the ground can be prepared to improve the quality of care in the care system.

Background & Aims :

Aging is associated with decreased physical and psychological functions. This study aims to investigate the ability to perform basic and instrumental activities of daily living (ADL) in elderly women with osteoporosis in Tehran, Iran.

Materials & Methods:

 This is a cross-sectional study conducted on 130 elderly women over 60 years of age referred to selected hospitals affiliated to Iran University of Medical Sciences in 2019-2020, who were selected by a consecutive sampling method. The data collection tools were a demographic form, the Barthel index for ADL, and the Lawton-Brody Instrumental ADL scale. The data was statistically analyzed in SPSS software, version 20.

Results :

The mean age of the women was 67.5±5.7 years. None of them had dependency for performing ADLs such as eating. The highest dependence was for urination (54.62%). Regarding instrumental ADLs, the highest inability was related to shopping (60.77%), and the lowest inability was related to managing one's own medication use (0.77%). The scores of basic and instrumental ADLs were significantly related to age and educational level (P<0.001).

Conclusion:

 More governmental, family and social support is needed for elderly women with osteoporosis (with older age and educational level) who have lower ability to perform their basic and instrumental ADLs.

Background & Aims :

Tracheostomy is often performed for people hospitalized in intensive care units (ICUs), but it can cause larynx damage and discomfort in the patient. Given that the final outcome and possible complications of tracheostomy are directly related to the quality of nursing care, this study aims to evaluate the effect of tracheostomy care training on the performance of nurses working in the ICUs of selected hospitals affiliated to Iran University of Medical Sciences.

Materials & Methods :

This quasi-experimental study was conducted on 64 nurses working in the ICUs of Rasul Akram and Firouzgar hospitals in 2021. The data collection tools were a demographic form and the tracheostomy patient care evaluation questionnaire of Atashzadeh et al. (2015). data analysis was performed in SPSS software, version 16 using descriptive and inferential statistics (paired t-test, and analysis of variance). P<0.05 was considered statistically significant.

Results:

 The mean age of nurses was 31.49±6.02 years. Most of them were female (70.3%) with a bachelor's degree (90.6%). Their mean overall work experience was 6.74±5.13 years, and their average work experience in the ICU was 4.92±4.66 years. Most of the nurses (43.8%) had permanent employment. Most of the nurses had rotating shift (89.1%), and had not completed the course of tracheostomy care (93.8%). The results of the paired t-test showed a statistically significant difference in the mean performance score of nurses before training (45.85±8.87) and after training (93.3±42.33) (P<0.001).

Conclusion:

 Considering that the performance of nurses in caring for patients with tracheostomy in the ICUs of selected hospitals is not satisfactory, educating nurses and providing sufficient facilities based on guidelines and opinions of experts are recommended to improve the quality of services to these patients by nurses in the hospitals.

The aim of this study was to evaluate the effects of thiamine (vitamin B1) on general health and infertilitytreatment outcomes in women with polycystic ovary syndrome (PCOS). The study is a triple-blinded, randomized, placebo-controlled clinical trial performed on 64 infertilewomen with PCOS referred to Sarem Hospital in Tehran, Iran. The primary outcomes of the study were general healthand infertility treatment outcomes. Eligible women were randomly assigned to the vitamin B1 group (n=32, vitamin B1tablet at a dose of 300 mg/day for 4 weeks) or the placebo group (n=32, placebo tablet daily for 4 weeks). A general healthquestionnaire was completed before and after the intervention by both groups and treatment success was evaluated at theend of the study. Data were analyzed using SPSS software ver.16 P<0.05 was considered statistically significant. The mean age of participants in the vitamin B1 (VB1) group was 30.4 ± 3.27 years and in the placebo (Pl)group was 29.1 ± 2.66 years with the mean duration of marriage 12.7 ± 3.01 and 13.2 ± 2.97 years respectively. Ourresults showed that there were significant differences between the two groups in overall score (P<0.001) and scoresfor all domains of the general health questionnaire including somatic symptoms (P<0.001), anxiety and insomnia(P<0.001), social dysfunction (P=0.028), and severe depression (P<0.001) after the intervention. Four weeks of consumptionof vitamin B1 also resulted in higher numbers of positive pregnancy tests (P=0.006), although the numberof fetuses was not significantly different between the two groups after the intervention. The results of the current study support a possible favourable effect of vitamin B1 on improving generalhealth, infertility treatment outcome, and retrieved follicle count without changing the number of fetuses in womenwith polycystic ovary syndrome (registration number: IRCT201510266917N3).

The present study aims to determine the fear of COVID-19 in the elderly newly diagnosed with cancer referred to selected hospitals affiliated to Alborz University of Medical Sciences.

In this longitudinal study, 174 elderly people newly diagnosed with cancer referred to the selected hospitals participated, who were selected using a continus sampling method. To collect data, a demographic form, the Abbreviated Mental Test, and the 7-item fear of COVID-19 scale were used before diagnosis, one month after, and two months after. The data were analyzed in SPSS software, version 22.

Fear of COVID-19 level at the time of cancer diagnosis was moderate (mean score: 17.69±4.74). In the second stage (one month after the diagnosis), the mean score was 14.26±4.09. In the third stage (two months after diagnosis), the mean score was 11.81±4.13. Fear of COVID-19 at the time of cancer diagnosis was significantly different based on marital status (P=0.049), underlying diseases (P=0.014), and perception of health (P=0.004). 

Fear of COVID-19 can disrupt the process of treatment and chemotherapy in elderly patients with cancer. It is recommended to develop interventions to improve the mental health of the elderly with cancer during the pandemic.

Adolescence is a high-risk period. Teenagers experience risky behaviors in this period, including using abusive drugs and addiction. Meanwhile, sufficient awareness helps a person to interpret and analyze health-threatening factors. This study aimed to determine the relationship between health literacy and susceptibility to addiction in adolescents living in the western part of Tehran City, Iran. 

This descriptive-correlational study was performed on 265 senior high school students in the western part of Tehran in 2021. The subjects were recruited by cluster random sampling. The study data were collected online using the addiction susceptibility questionnaire and health literacy measure for adolescents. The obtained data were sorted by frequency distribution, Mean±SD and analyzed utilizing the Pearson correlation coefficient, independent t-test, and analysis of variance in SPSS software, version 16. The significance level was set at 0.05.

Most study subjects (56.4%) were female. Their Mean±SD score of health literacy was 65.31±21.15. Among the subscales of health literacy, “calculation”, with a Mean±SD score of 68.96±35.89, and “utilization”, with 61.29±25.05, had the highest and lowest mean scores, respectively. The Mean±SD score of addiction susceptibility was 25.3±30.05, and among its subscales, “showing off” with a mean score of 33.09±32.64 and “family dissatisfaction” with 19.75±35.47 had the highest and lowest mean scores, respectively. Health literacy and its dimensions had a negative correlation with addiction susceptibility (P<0.001).

According to the findings, it is recommended to use appropriate strategies to increase adolescent health literacy by health service providers, school officials, school health nurses, and teachers. The results of this study can be used as a source for further research on addiction and health literacy in adolescents.

Death in the place that the patient has selected and feels comfortable remaining in for the remainder of their life is one of the main objectives of palliative care for terminally ill cancer patients. Nevertheless, this problem is constantly disregarded. The goal of the present study was to look at variables that affected cancer patients' decisions about their place of death.   

A descriptive cross-sectional study was conducted from May to August 2018. Using a continuous sampling method, 631 patients who had passed away between 2011 and 2017 were selected among the patients with a history of cancer and hospitalization at the Firoozgar Hospital in Tehran. A self-made 3-section questionnaire with 21 questions was completed by phone calls made to the families who confirmed their patients’ deaths due to cancer. Data were managed by SPSS software Version 13, and descriptive statistics were used in data analysis.  

Based on the results, among 631 deceased patients, only 157 (24.9%) chose their place of death, and 474 (75.1%) had not spoken about it during their lifetime. Among the examined variables, age, sex, education, insurance status, duration of disease, activities of daily living, awareness of disease progression, and receiving home care had a significant association with this choice in people who died of cancer.   

Despite the importance of the choice of place of death by the patient in the final days of life, the possibility of having an option is not provided for most cancer patients. Patients who understand how their disease is progressing at this point are probably going to want to select where they pass away. Consequently, the healthcare system must be ready to grant cancer patients the option to choose their final resting place and ensure a comfortable and respectable passing. Future research can be built upon the results of this study.

Background : 

Medication errors can lead to serious negative consequences. Meanwhile, reading theory books or listening to lectures away from the real environment may disrupt learning. Simulation-based learning using a virtual environment imitates real-world activities and engages learners in physical and practical activities.   The aim of this study was to evaluate the effects of simulation-based education (SBE) on medication administration (MA) knowledge and performance among nursing students.

This quasi-experimental study was conducted in the 2018–2019 academic year using a   pretest-posttest design and a control group. The subjects included 66 nursing students of the sixth semester of the Faculty of Nursing and Midwifery of Iran university of Medical Sciences (IUMS), Tehran, Iran.. They were randomly allocated to the intervention   (n = 36) and control (n = 30) groups. Subjects in the intervention group were trained through SBE in two-hour weekly sessions for four consecutive weeks, and their conterparts in the control group received only routine traditional training.. The knowledge and performance were assessed using a researcher-made MA knowledge questionnaire and four MA performance checklists. Data were collected before, immediately after, and one month after the intervention and were analyzed using    repeated measures analysis of variance as well as  paired-samples t test, independent-samples t, Mann-Whitney U, Chi-square, and Fisher’s exact test in SPSS software (v. 16.0). Significance level was set at P≤ 0.05.  

There were no significant differences between the groups before intervention (P > 0.05). The mean scores of MA knowledge and performance of the intervention group  increased significantly after the intervention (P < 0.05).The mean scores of the intervention group were significantly higher than the control group in both post-tests (P < 0.05). The mean score of MA knowledge in the intervention group was 12.36±3.04 at pretest, 18.6±1.13 at the first posttest, and 18.7±1.2 at the second posttest. the mean score of MA knowledge in the control group was 12.43±2.41 at pretest, 12.66±2.39 at the first posttest, and 12.66±2.63 at the second posttest The mean scores of MA performance (Total) in the intervention group was 18.99±9.7, at the first posttest and 18.08±11.05 at the second posttest. and The mean scores of MA performance (Total) in the control group was 10.35±10.39, at the first posttest and 11.35±10.66 at the second posttest.

SBE is effective in  improving nursing students’ MA knowledge and performance. SBE is suggested to reduce medication errors among nursing students.

Lack of social support may lead to destructive effects on pregnancy outcomes, especially for women with gestational diabetes.

This study aimed to examine the effect of spouse participation in gestational diabetes care on pregnant women’s perceived social support.

This quasi-experimental study was carried out in one of the health centers affiliated with Shahroud University of Medical Science, Shahroud, Iran, during 2018 - 19. A total of 80 pregnant women with gestational diabetes were non-randomly allocated to two groups of 40members. The control group received the standard care, whereas the experiment group received, in addition to the standard care, gestational diabetes care as well as face-to-face and online education with their spouses. Demographic and Diabetes Social Support Questionnaire-Family Version was filled by the two groups before and five weeks after the intervention. Data analyses were performed using descriptive statistics, independent t-test, paired t-test, and chi-squared test with SPSS (V16).

The total score of social support in the experiment group had a significant increase compared to that in the control group (3.42 ± 1.16, 3.06 ± 1.14, and P < 0.001). In addition, the three aspects of social support (i.e., taking blood sugar test, adhering to diet, and receiving social support) in the experiment group had a significant increase compared to those in the control group (P < 0.05).

Considering the positive effect of spouse participation on the perceived social support of pregnant women with gestational diabetes and on their healthy pregnancy, it was recommended that health policymakers should codify pregnancy cares, despite the cultural limitations, in order to facilitate maximum participation of spouses.

Health-related quality of life (HRQOL) is an important clinical outcome in patients with chronic Heart failure (CHF). The aim of this study was to evaluate HRQOL in patients with CHF and determine its relationship with demographic and clinical variables.

In this cross-sectional descriptivecorrelational study, 200 patients with CHF were selected from clients referring to teaching hospitals affiliated to Tehran University of Medical Sciences. They were interviewed to complete demographic and clinical questionnaires and the Kansas City Cardiomyopathy Questionnaire (KCCQ).  Some clinical variables were extracted from their medical records. KCCQ was used to measure their HRQOL. Descriptive statistics, independent t-test and ANOVA were used for data analysis.

Self–efficacy domain had the highest score (mean=61, SD=18.31) and physical symptoms had the lowest (mean=42.92, SD=13.45) in HRQOL. There was a significant relationship between HRQOL and 4 demographic variables: sex, educational level, economic condition, as well as occupational status and also between HRQOL and clinical variables including: duration of illness, number of hospitalizations, non-cardiac diseases, ejection fraction, diuretic consumption and body mass index there was a statistically significant relationship.

Patients with CHF had low HRQOL. Nurses and healthcare providers should plan care and programs to reduce frequency, severity and symptoms of heart failure and help improve HRQOL in these patients.

Women are the central pillar of social development and the main axis of family health. Success, survival, and promotion of society depend on the health of women in society. Since Health Promotion lifestyle and psychological well-being are important determinants of health, this study was conducted to determine the Health Promotion lifestyle and psychological well-being in women attending the health centers of Arak City in 2019.

Methods & Materials:

 In this cross-sectional study, among women who attended health centers in Arak City, 221 women who met the inclusion criteria were included in the study by continuous sampling and the form of demographic information, health promoting lifestyle profile-Ii (HPLP-II), and Ryff Psychological well-being Questionnaire was completed. Data were described using descriptive statistics of frequency, frequency percentage, mean, standard deviation, and data analysis by analysis of variance, independent t-test, and regression using SPSS software v. 19.

Ethical Considerations: 

This study was approved by the Ethics Committee of Research Deputy of Iran University of Medical Sciences (Code: IR.IUMS.REC.1398.609).

 The mean health-promoting lifestyle in the study units was 135.96; the mean physical activity components were 16.31; The mean nutrition was 26.41, with the lowest and highest scores, respectively. The mean psychological well-being in the study units was 72.29. The mean components of purpose in life were 10.76, and the mean personal growth was 13.19, with the lowest and highest scores, respectively. Age, chronic diseases, employment, number of children, and alcohol consumption had a significant negative relationship with a health-promoting lifestyle, and a woman’s and her husband’s education had a significant positive relationship with a health-promoting lifestyle (P<0.05). Overall demographic variables predict as much as 13% of health-promoting lifestyles. Age, number of children, and chronic physical and psychological diseases had a significant negative relationship with psychological well-being and economic status. A woman’s and her husband’s education had a significant positive relationship with psychological well-being. Overall, demographic variables predict as much as 10% of psychological well-being. 

Considering that health-promoting lifestyle and psychological well-being are two critical determinants of health, studying these two indicators and the factors affecting them can help Intervention planning to promote women’s physical and mental health.

It is essential to pay attention to the psychological complications after a heart attack in line with other physiological complications. The proximity of these patients to death has caused death anxiety, which can weaken their morale. This study aims to determine death anxiety and demoralization in patients with acute myocardial infarction admitted to post-cardiac care units of the Iran University of Medical Sciences in 2021.

The present study is a descriptive cross-sectional study that was performed on 206 patients with myocardial infarction admitted to the educational-medical centers of Iran University of Medical Sciences in the first half of 2021. Data collection tools included the demographic profile form, Templer death anxiety questionnaire, and Kissane demoralization. Data were analyzed using SPSS software, version 20 and Pearson correlation coefficient, independent t test, and analysis of variance.

Most patients in the study were male, married, and self-employed with a mean age of 57.97±12.49 years. The mean score of death anxiety in patients with myocardial infarction was 6.26±1.62 (moderate). Most patients (43.7%) had moderate death anxiety. The mean score of demoralization syndrome was 11.88±5.34 (severe). Most patients (60.7%) had severe demoralization syndrome.

The death anxiety of patients after myocardial infarction was moderate and their demoralization syndrome was severe, therefore it is necessary to pay attention to them and recognize the factors affecting nurses working in intensive care units and recommend being included in the training of care for these patients.

The nurse’s ability to make an effective clinical decision affects the quality of care and differentiates professional nurses from non-professional ones. Many individual and organizational factors affect clinical decision-making of nurses. This study aims to examine the relationship between participation in clinical decision-making and organizational culture of nurses in intensive care units (ICUs) of selected hospitals in Tehran, Iran

This is a descriptive-correlational study. Participants were 317 nurses working in the ICUs of hospitals affiliated to Iran University of Medical Sciences, who were selected with proportional stratified sampling and sequential sampling methods. The data collection tools were the clinical decision-making questionnaire of Kyalo (2008) and the organizational culture assessment instrument of Cameron and Quinn (1990). The obtained data was analyzed in SPSS statistical software, version16. Descriptive indices (Mean±SD, frequency, percentage) were used to describe the data, and Pearson’s correlation test, independent t-test, and chi-square test were used to examine the relationships between the study variables.

Among nurses, 88.5% were female, 86.5% had a bachelor’s level, and 39.6% were working in the ICU general. Their mean age was 34.65 years, and their mean nursing experience and the work experience in the ICU was 10.38 and 7.25 years, respectively. The mean score of clinical decision-making was 70.16±11.65, which was higher than the cutoff point (>54), indicating that the participation of nurses in clinical decision-making was high. The dominant organizational culture in the current situation was the market culture. In the preferred situation, the organizational dominant culture was the clan culture. Organizational culture in the current situation had no significant relationship with clinical decision-making (P=0.13), but this relationship was significant in the preferred situation (P=0.014). Clinical decision-making in nurses with clan culture was significantly higher than in those with market culture (P=0.013).

The current organizational culture in the selected hospitals is different from their preferred organizational culture. Despite the significance of relationship between ICU nurses’ participation in clinical decision-making and organizational culture in the preferred situation, the relationship is weak. More studies are needed with a larger sample size. Considering that the clan culture is the preferred culture, planning is needed to establish the clan culture in the hospitals to increase the participation of ICU nurses in clinical decision-making.

 Job burnout can leads absenteeism, leaving the job or having the intention to leave, reduced quality of life, reduced performance, and reduced quality of patient care and commitment to the organization. Organizational climate has always been important in the nursing profession and in the hospital environment where the nurse’ performance is known as an important component in improving the quality of treatment. This study aims to determine the relationship of job burnout with organizational climate in nurses.

This descriptive correlational study with cross-sectional design was performed in 2020 in the internal surgical wards of four teaching hospitals affiliated to Iran University of Medical Sciences. The sampling was done by a cluster sampling method. The sample size was determined 200 at a 95% confidence level and considering a 80% test power. To collect data, a demographic form, the Maslach burnout inventory, and Halpin and Croft’s organizational climate description questionnaire were used. Data analysis was performed in SPSS v. 24 software using descriptive and inferential statistics.

 Emotional exhaustion domain of job burnout had a statistically significant correlation with all dimensions of organizational climate except for group spirit and disengagement; it had a negative significant correlation with the hindrance dimension and a positive significant correlation with other dimensions. With the increase of organizational climate, emotional exhaustion increases, resulting in more job burnout.

Health workers, especially nurses and managers, should take measures to reduce job burnout and improve organizational climate and patient satisfaction according to the existing conditions and resources. It is recommended that the educational supervisors of the hospitals develop and implement in-service training focusing on the components of job burnout and organizational climate.

Infertility and its treatment, as one of the most difficult experiences in life, affects the mental health and happiness of couples, especially women. This study compared the happiness of infertile women and the wives of infertile men.

This research was a comparative cross-sectional study. The study sample included 142 women (71 infertile women and 71 wives of infertile men) referring to the infertility clinic of Akbarabadi Hospital in Tehran, Iran, selected by consecutive sampling from February to August 2020. Demographic information and the Oxford happiness inventory (OHI) were used to collect the data. The data analysis was performed in SPSS software, version 16 using the Fisher exact-test, Chi-square, Kruskal-Wallis, and independent t-test. A P<0.05 was considered significant.

The study showed that infertile women are happier than the wives of infertile men (P=0.006). Also, the subscales of life satisfaction (P=0.016), efficacy (P=0.025), cheerfulness (P=0.001), and self-esteem (P=0.017) were higher in infertile women than in the other group. However, there was no significant difference between the two groups in the subscales of sociability and wellbeing.

According to the findings, spouses of infertile men may experience lower happiness levels than infertile women. In addition to paying more attention to the psychological condition of infertile men’s wives, more detailed studies with a larger sample size are needed to confirm the results. Also, qualitative studies are recommended to clarify all dimensions of happiness of infertile couples.

Parkinson’s disease is a progressive and chronic neurological disease with severe motor and non-motor disabilities that affect patients’ quality of life. Considering the importance of self-management education in chronic disease to improve quality of life, an upward trend of using mobile applications has recently been considered in clinical settings.

The objective of this study was to evaluate the effect of self-management education based on the mobile application on the quality of life of Parkinson’s disease.

This quasi-experimental study was conducted in the neurology clinics of selected educational centers of Iran University of medical sciences with 77 patients, with a convenience sampling method. After obtaining the code of ethics, the clinical trial code and obtaining written informed consent from eligible people, the Demographic checklist, clinical stage criteria, and quality of life questionnaire in Parkinson’s disease (PDQ-39) were sent by online links to eligible patients or caregivers before, one month after, and three months after the start of the intervention (12 weeks intervention). The content of the self-management education extracted from reliable medical, nursing, and rehabilitation references based on the mobile application "Parkin Seven," designed by a software consultant engineer, was provided to the clients at once by installing the mobile application in the research environment, with 15 - 20 minutes of in-person mobile application set up education. Data were analyzed by repeated measures analysis of variance in SPSS20 software.

The quality of life in the first stage was estimated at 48.26 ± 2.37, which was 34.27 ± 2.08 and 24.33 ± 1.76 for the second and third stages, respectively (P < 0.001).

Findings from this study indicate that self-management education based on a mobile application in patients with Parkinson’s disease effectively improves the quality of life. Therefore, utilizing this method by clinical professionals, especially rehabilitation nurses, is recommended to improve clinical efficiency.

The emerging diseases such as coronavirus disease 2019 (COVID-19) can cause a serious stress, fear, and anxiety in the elderly. This study aims to determine the perceived stress and fear of COVID-19 in the elderly referred to comprehensive health centers in Tehran, Iran.

In this descriptive cross-sectional study, 260 older people aged >60 years referred to two comprehensive health centers (130 from each center) in the west of Tehran participated, who were selected by cluster and stratified sampling methods. Data collection tools were a demographic form, the Perceived Stress Scale, and the Fear of COVID-19 Scale. Descriptive and inferential statistics were used to analyze the collected data in SPSS Software, version 20.

The mean score of perceived stress was 41.5±10.19, indicating high level of stress in the elderly. This variable had a statistically significant relationship with age, underlying disease, and self-perceived health (P<0.001). The results of the Scheffe post hoc test showed that perceived stress was significantly lower in married subjects, those with no underlying disease, and those with self-perceived health score of 5 or higher. Fear of COVID-19 with a mean score of 23.45±9.35, was also higher among the elderly.

The perceived stress and fear of COVID-19 are high among the elderly in Tehran, Therefore, a proper planning by the health system policymakers for this group is necessary during the pandemic.

Self-care of adolescents with congenital heart disease (CHD) is one of the challenges of the health care system. CHD is a common chronic disease that affects the quality of life (QoL) and self-efficacy of adolescents. This study compares the effectiveness of self-care education by face-to-face method and video clip (VC) on self-efficacy and QoL in late adolescents with CHD.

This research was a non-randomized clinical trial. A total of 111 late adolescents aged 18 to 21 years with CHD referred to Rajaie Cardiovascular, Medical, and Research Center in Tehran, Iran, were recruited by convenience sampling and non-randomly assigned to either control, face-to-face (F2F), or VC groups (37 subjects in each group). The F2F group participated in two educational sessions (each lasted 35-45 minutes) with an interval of one week, and the VC group received a 90-minute video to watch at home. The study data were collected before (T1) and two months after the intervention (T2), using the Generalized Self-Efficacy (GSE) scale and World Health Organization’s Quality of Life Questionnaire (WHOQOL-BREF) and analyzed in SPSS version 19 software using the Chi-square test, Fisher test, paired t test, Scheffé test, and ANOVA. The significance level was set at P<0.05.

Before the intervention, demographic variables, self-efficacy, and QoL were not significantly different in the three groups. The self-efficacy significantly increased in the F2F (P<0.004) and VC groups (P<0.031) at T2. Furthermore, QoL dimensions significantly improved in the F2F and VC groups (P<0.05), except for the environment dimension (P>0.05).

Self-care education through F2F and VC significantly affects the self-efficacy and QoL of late adolescents. Such educational programs can greatly reduce the possible complications of the disease by empowering this group.

The most common aging change is increased arteriosclerosis, which can prone the elderly to heart attacks. Physiological and psychological changes deteriorate the health-related quality of life (QoL) of the survivors of heart attacks. However, gender differences may affect the health-related QoL of the survivors. The present study aimed to compare the health-related QoL of elderly men and women after a heart attack in selected educational-therapeutic centers of Iran University of Medical Sciences in 2020.

This was a cross-sectional study with descriptive comparative design conducted on 196 elderly patients (98 men and 98 women in each group) who were referred to the heart clinics of selected educational-therapeutic centers of Iran University of Medical Sciences in Tehran, Iran in 2020. The subjects were selected through continuous sampling. Data were collected by abbreviated mental test (AMT) and MacNew Heart Disease health-related QoL (HRQoL) questionnaire and analyzed by Chi-square test, independent t-test, analysis of variance, Pearson correlation coefficient, and multiple linear regression using SPSS software, version 26. The significance level was set at P≤0.05.

The Mean±SD age of elderly women and men was 72.59±7.87 and 69.6±8.24 years, respectively. The Mean±SD health-related QoL of the elderly women was 3.89±0.58 and that of elderly men was 4.16±0.82. The results of the independent t-test showed that the scores of health-related QoL and its dimensions were significantly higher in men than in women (P<0.001). The results of the Pearson correlation coefficient revealed a negative and significant correlation between age and health-related QoL in elderly men (r=-0.253, P=0.012). The results of simultaneous multiple linear regression revealed that 26.8% of the changes in men’s health-related QoL were explained by their individual characteristics.

Considering the lower health-related QoL of women compared to men after a heart attack, more support for women after a heart attack seems necessary. Further research is also recommended to find out the causes of this difference.

Comfort is the ultimate goal in all the nursing processes. The aim of the study is to examine the comfort status of the hospitalized patients with mental disorders.

This study is a descriptive, cross-sectional study that was conducted on 275 patients hospitalized in the psychiatric wards of Lavasani hospital in Tehran in 2020. The study subjects were selected using the convenience sampling method. The patients completed a demographic form and the comfort questionnaire of psychiatric patients. Data were analyzed using descriptive and inferential statistics, independent t-test, analysis of variance, and the Scheffe test through the SPSS software version 24 at a significance level of 0.05.

A total of 184 patients (66.9%) were male. The overall comfort score was 128.76, which was more than median based on the score from 38 to 190.
The highest scores in the dimensions of comfort, were respectively sociocultural domain (65.20±91.55), psychospiritual domain (64.19±31.50), physical domain (58.22±37.06), and environmental domain (49.19±22.39). The Scheffe test showed that the comfort score for the patients with sufficient income was significantly higher (P<0.001). Also, the patients who were employees had a higher comfort score compared to others (P=0.017).

The patients gained the least comfort score in the environmental domain, and the most comfort score in the sociocultural domain. Therefore, devising and implementing all nursing interventions are recommended with the aim of maintaining and improving comfort in the environment of psychiatric departments.

 Due to the complexities of self-care in the elderly with chronic kidney failure, with information based on scientific evidence and appropriate health planning, the elderly with self-care and self-management of the disease from others will lead to a healthier life and a better quality of life. Therefore, this study aimed to determine self-care in the elderly with chronic renal failure referred to selected educational and medical centers of Iran University of Medical Sciences in 1399.Procedure: This study was a cross-sectional (descriptive) study. The study population was the elderly with chronic renal failure referred to selected educational and medical centers of Iran University of Medical Sciences. Two hundred ninety-two people initially stratified sampling with proportional allocation, and Then the continuous method was used in the centers. Data were collected using the short cognitive test form (AMT), demographic form, and Chronic Kidney Disease Self-Care Scale (CKDSC). Data analysis was performed using SPSS software version 20 in two sections, descriptive statistics, and inferential statistics, and the significance level of the test was considered p≥0.05.

 The results showed that the mean age of the elderly participating in this study was 69.3 ± 7.7 years. The mean of self-care in the elderly was 66.20 ± 6.06, and the highest score was for better self-care. It should be noted that the questionnaire did not have a poor, average, or good rating. 61.3% of the elderly received more than average self-care and 38.7 less than average. According to the maximum score of 72 in the present study, the elderly had good self-care. Among the demographic characteristics, the level of self-care had a significant relationship with the variables of employment status (0.001 ≥p), Duration of illness (p = 0.01), and gender (0.002). Among the demographic characteristics, the level of self-care had a significant relationship with the variables of employment status (0.001 ≥p), Duration of illness (p = 0.01), and gender (0.002), and the variables of employment status were one of the most effective roles for self-care 

 According to the results, it can be acknowledged that employment status, Duration of education disease, and the number of conditions are the underlying variables affecting self-care in the elderly were studied. Therefore, it is necessary to consider demographic variables in educational and counseling planning that can be intervened to increase the self-care of the elderly with chronic renal failure. It contributed to their health and quality of life.

Burn injury is an example of damage to a person's health that causes many problems in the patient, including pain and anxiety. The purpose of this study was to determine the correlation between pain and anxiety in burn patients.

In this cross-sectional study, 86 patients with burn injury admitted to Shahid Motahhari hospital, were selected using available sampling. Anxiety and Background pain severity were measured using spielberger state anxiety inventory and visual analog scale In two occasions, with an interval of one week. Data were analyzed by descriptive statistics using Spss version 20.

According to the study, there was no significant statistical correlation between background pain severity and level of anxiety in the first visit (p=0.609, r=0.056), but in the second visit, a significant relationship was observed between these two variables (p=0.002, r=0.334). 

According to the results of this study, anxiety and background pain are the main factors affecting burn patients and there is a significant relationship between these two. So, assessment and treatment of background pain and anxiety are essential elements of management in burn patients.

Chronic pain is one of the most common and serious problems in old age that if not controlled, leads to reduced daily activities. The aim of this study was to determine the effect of acupressure on pain and daily activities in elderly women. 

This was a quasi-experimental study with a pre-test and post-test design, which was conducted on 80 elderly women who were referred to the health centers of Qazvin, Iran. The subjects were randomly assigned to the experimental (n=40) and control (n=40) groups. The data were collected by visual analogue scale (VAS) and barthel index (BI). The experimental group received ten sessions of acupressure for three consecutive weeks on the related acupoints (LIV3, UB62, SP9, GB34, UB17, GB30, UB (UB25-UB11), GB20, GB21). Each acupoint was massaged for one minute in a circular motion until the elderly could bear it. The control group received sham acupressure. Post-test was performed one week after the end of ten intervention sessions. The data were analyzed by Chi-square test and independent t-test using SPSS software v. 20. The significance level was set at P<0.05.

Before the intervention, there was no statistically significant difference in the level of pain intensity (P=0.352) and daily activities (P=0.420) between the groups. After the intervention, the pain intensity of the subjects in the intervention group decreased (P<0.001) and their daily activities improved compared to the control group (P<0.001). 

According to the findings, acupressure is an affordable, low-cost, easy, and non-invasive complementary therapy, which is recommended to reduce pain intensity and promote activities of daily living in older women.