mousa alavi

Premature birth and hospitalization of infants in the Neonatal Intensive Care Unit (NICU) can contribute to Post‑Traumatic Stress Disorder (PTSD) in mothers who also experience high levels of hopelessness. It is essential that a proper strategy be used for managing these challenges. This study aims to determine the effect of Expressive Writing (EW) on PTSD and hopelessness in mothers with premature neonates who were hospitalized in NICU.

This clinical trial involved 65 mothers with premature neonates admitted to an NICU in Esfahan (Iran) in 2023. Samples were selected by the convenience sampling method and divided into control (n = 33) and intervention (n = 32) groups. The intervention group engaged in EW three times a week. All the participants completed the Perinatal Posttraumatic Stress Disorder Questionnaire and Beck’s Hopelessness Scale. Moreover, statistical analyses including independent t‑test, paired t‑test, Chi‑square test, and Fisher exact test were performed using SPSS 24.

Following the intervention, the mean scores of PTSD and hopelessness were significantly lower in the intervention group compared with the control group ((t = 13.86, df = 63, p ˂ 0.001) and (t = 8.32, df = 63, p ˂ 0.001), respectively).

Expressive writing proved effective in reducing PTSD and hopelessness in mothers with premature neonates. This low‑cost and effective intervention is recommended for enhancing maternal mental health and empowering mothers for optimal care of premature infants in NICUs and after discharge.

Emotion regulation strategies help family caregivers of chronic psychiatric patients to manage caring behaviors. However, evidence pointed out problems and therefore a need to execute respective programs to improve emotion regulation for caregivers. This study aimed to investigate the effectiveness of mental health literacy promotion programs on emotion regulation strategies of family caregivers of chronic psychiatric patients.

This is a clinical trial study, with two‑group pretest–post‑test design with a follow‑up period conducted in 2023. Sixty family caregivers of chronic psychiatric patients were randomly allocated to intervention control groups. Data collection was done using a demographic characteristics questionnaire and Gross and John’s Emotion Regulation Scale. The mental health literacy promotion program was implemented for the intervention group in six sessions weekly. Immediately and 1 month after the last meeting, the questionnaires were completed. The data were analyzed using Chi‑squared and Fisher’s exact tests, Mann–Whitney test, and analysis of covariance by SPSS‑22. The significance level was set to 0.05.

The results showed that the frequency distribution of demographic variables in the control and test groups had no statistically significant difference (p > 0.05). The intervention had significant effects on the mean score of emotion regulation strategies, and its subscales included re‑evaluation and suppression of family caregivers of chronic psychiatric patients in both the post‑test and follow‑up periods (p < 0.001).

According to improving the emotion regulation of family caregivers of chronic psychiatric patients through the mental health literacy promotion program, it is suggested to use this program to achieve the desired emotion regulation.

Empowering adolescents to manage and reduce unhealthy behaviors and promote adaptive behaviors is a promising approach to promoting healthy behaviors. This review was an attempt to evaluate adolescent empowerment programs aimed at preventing and managing risky behaviors.

This narrative review was conducted in 2023. The texts were reviewed in two sections: (1) a review of articles and books in databases and (2) a review of international websites. The keywords used to search for studies and programs included substance‑related disorders, risky behaviors, empowerment, program, adolescent, suicide, and risky sexual behaviors. These keywords were individually searched in international databases such as “PubMed, Scopus, and Web of Science.” In the second section, a search was conducted on the websites of international organizations such as the World Health Organization (WHO). The inclusion criteria included having the full text of the original articles, articles in English, articles related to the development and evaluation of the effectiveness of empowerment programs, and the age range of adolescents. The texts that only had abstracts and were in non‑English languages were excluded.

The programs designed to empower adolescents were in three areas: (1) community‑based and peer‑based programs, (2) family‑based programs, and (3) comprehensive programs. Most programs focused on peer group participation and skill interventions.

A powerful and effective empowering program for adolescents to prevent and control risky behaviors should be designed in the form of comprehensive programs in social, educational, economic, and health dimensions, and with the active engagement and participation of adolescents.

Heart failure patients experience a lot of emotional and psychological distress in the course of treatment and self-care, which affects all aspects of their lives. One of the basic challenges that affects most heart failure patients is the reduction of emotional self-efficacy. The present study was conducted with the aim of determining the effect of the emotion regulation program on the emotional self-efficacy of patients with chronic heart failure.

In this randomized clinical trial study; 70 patients with chronic heart failure were randomly selected into two test groups (35 people) and control (35 people). In the test group, the emotion regulation program was conducted in 6 sessions. The data collection tool was based on the demographic characteristics form and the emotional self-efficacy questionnaire of Beverly et al., which was completed by the patients in three stages before the intervention, immediately and one month after the intervention. The data were analyzed by SPSS software version 22 with descriptive and inferential statistical tests. The significance level in these tests was P < 0.05. 

The results showed that the average resilience score in the test group before, immediately and one month after the intervention was 24.29 ± 12.82, 90.37 ± 6.49 and 85.63 ± 7.77, respectively. From a statistical point of view, there was a significant difference (P < 0.001), while in the control group, the average resilience score during the mentioned time was 37.97 ± 25.10, 19.54 ± 14.80, and 20.82± 20.80, respectively. It was observed that 31.20% was not statistically significant; (P<0.05), in other words, the emotion regulation program has increased the emotional self-efficacy score in the test group compared to the control group.

The emotion regulation program is effective in improving emotional self-efficacy in patients with chronic heart failure; therefore, it is suggested that this intervention be provided for patients with chronic heart failure in a practical way by nurses working in the centers.

Clinical knowledge sharing (CKS) is one of the key points of knowledge management in the field of health and significantly increases the quality of care and patient safety. It also provides the achievement of an efficient system in hospitals and educational and treatment centers involved in clinical processes in order to make the best clinical decisions. The purpose of this research is to identify the factors that facilitate and inhibit CKS among medical specialists in the educational‑treatment hospitals in Iran.

This was an applied qualitative study with the conventional content analysis method conducted in 2022. The data collection tool was a semi‑structured interview. The participants were 13 medical specialists and sub‑specialists working in educational‑treatment hospitals of the country, who were selected by purposeful and snowball sampling. The method of data analysis was based on Graneheim and Lundman’s five‑step method, which was followed by codes, sub‑categories, main categories, and classifications.

After conducting the interviews and assessing their content, finally, 193 codes were extracted, which were identified in two general classification of facilitating and inhibiting factors with 92 and 101 concepts, respectively. Facilitating factors in the three main categories of “education in the context of culture, society and university”, “planning and implementation management”, and “behavioral‑motivational factors” and inhibiting factors in the four main categories of “infrastructural, policy‑making and cultural challenges”, “technological and scientific infrastructural challenges”, “personality‑behavioral challenges”, and “financial and non‑financial motivations” were classified.

The participants of the research pointed out the effective role of CKS in keeping them up‑to‑date in the use of diagnostic, therapeutic, and even drug prescribing methods. According to their belief, knowledge sharing (KS) in the clinical setting will reduce diagnostic errors and cause the primordial prevention of diseases as well as increase the knowledge and awareness of the society members.

Caring for a patient with a chronic mental disorder is a difficult and exhausting task that makes family caregivers face all kinds of psychosocial problems and ultimately reduces the quality of life of these people. This study aimed to investigate the effect of the virtual psychosocial empowerment program on the quality of life of family caregivers with chronic mental disorders.

This is a quasi-experimental study with a control group and a pre-test-post-test design that was performed on 70 family caregivers of patients with chronic mental disorders in Farabi and Noor educational- medical centers in Isfahan, Iran. The participants in this study were selected by convenience sampling method. Data were collected using a demographic information form and the WHO-QOL-BREF questionnaire, before, immediately, and one month after the intervention. The experimental group received the psychosocial empowerment program in 8 sessions and 4 weeks. At the end of the intervention, and one month later the WHO-QOL-BREF questionnaire was completed by the experimental and control groups and the data were analyzed using independent t-test and RM-ANOVA. Data were analyzed in SPSS20 software.

In this study, were 35 participants in the intervention group and 35 participants in the control group. Three intervention group members were excluded from the study, and finally data analysis was performed on 67 samples. There was a statistically significant difference between the average scores of different dimensions of quality of life three times before, immediately, and one month after the intervention in the test group (p<0.05). However, there was no statistically significant difference between the above cases three times before, immediately, and one month after the intervention in the control group (p<0.05).

Using the empowerment program for family caregivers of chronically mentally ill patients in virtual form can be effective on their quality of life and can be used as one of the supported methods for these families.

Family members of Chronic Mental Disorders (CMD), who are responsible for patient care, face many physical, psychological, and social problems which make them face the burden of care. This study aimed to investigate the effect of a psychosocial health promotion program on the care burden of family caregivers of patients with CMD.

This is a quasi‑experimental study that was conducted in two intervention and control groups in the form of pretest and posttest. This study was performed on 67 family caregivers of patients with CMD in Farabi and Noor centers in Isfahan, Iran. Participants in this study were randomly divided into two intervention and control groups. Data from the intervention and control groups were collected in two stages, before and after the intervention by demographic information form and Zarit burden questionnaire. The intervention group received a web‑based psychosocial health promotion program in eight sessions in 4 weeks. At the end of the intervention, the Zarit questionnaire was completed by the intervention and control groups.

The mean score of care burden between the intervention and control groups was not statistically significantly different before the implementation of the program (p </em>= 0.534). But after the intervention, the mean score of care burden was significantly different between the two groups (t</em>65 = 3.43, p </em>= 0.001).

This study provides evidence for the benefits of web‑based psychosocial health promotion program in reducing the perceived care burden of the caregiver of CMD.

Caring for a family member with cancer is a challenging issue for families. Family caregivers often need the help of supportive resources to solve problems in their care role. A deep understanding of the requirements of caregivers to seek help is an effective step toward their ability to use supportive resources. This study aimed to identify and describe the requirements for promoting help‑seeking behaviors in Iranian family caregivers of cancer patients.

This qualitative study was conducted through in‑depth semi‑structured interviews with 28 participants selected using purposeful sampling method from 2019 to 2021. An interview guide with general questions about seeking help was used to maintain coherence in data collection. The interviews continued until data saturation. All interviews were recorded, transcribed and analyzed through qualitative content analysis.

The requirements of promoting help‑seeking behaviors in family caregivers were grouped into four main categories: (1) improving social paths toward seeking help, (2) spiritual‑psychological‑cognitive empowerment toward seeking help, (3) strengthening the motivations behind seeking help, and (4) modifying the perception of cultural barriers to seeking help.

According to the results of this study, it is expected that by identifying the requirements of caregivers for seeking help and by health stakeholders designing comprehensive programs to address these needs, caregivers will be empowered to use supportive resources and provide a better care role.

Family caregivers of hemodialysis patients experience various physical, psychological, social, economic, and spiritual problems that reduce their quality of life. The present study aimed to determine the effect of a family‑centered education program on the quality of life of family caregivers of patients undergoing hemodialysis.

This was a randomized controlled trial that was performed on 70 caregivers of patients undergoing hemodialysis in the medical centers of Hazrate Ali Asghar and Hazrate Zahraye Marzieh in Isfahan. Caregivers were randomly divided into experimental and control groups, and the experimental group received an eight‑session family‑centered education program. Data were collected using the Quality of Life Scale (QOLS)‑short form immediately after and 1 month after the intervention. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 18 and analysis of variance and covariance.

The results showed that both experimental and control groups were homogeneous in terms of demographic information and there was no significant difference between them in this regard. Analysis of data on quality of life and its four domains showed that the mean scores of quality of life (P = 0.089) and its four domains including physical health (P = 0.367), mental health (P = 0.429), community relations (P = 0.132), and environmental health (P = 0.232) increased significantly immediately after and 1 month after the intervention (P < 0.001 in all cases).

Educational programs can improve the quality of life of family caregivers of hemodialysis patients. Therefore, it is recommended that programs be developed and evaluated in various studies in the future.

This systematic review protocol is developed with the objective to identify the strategies, facilitators, and barriers to interaction between researchers and policy makers to use research evidence in health policy making. It seems that review of interactive methods between researchers and policy makers can help to understand the role of researchers on evidence‑informed policy making. Moreover, identifying barriers and facilitators of these interactions can help universities and institutions associated to health policy making in planning to improve the interaction between researchers and policy makers to facilitate evidence‑informed policy making.

Adherence to treatment is highly important in the management of Cardiovascular Diseases (CVD). Barriers to effective and long‑term adherence to treatment by the patient make achieving care and treatment goals challenging. The aim of this study was to identify the adherence barriers to the treatment plan in patients with CVD.

A qualitative content analysis study was conducted to explore the experience of patients, family caregivers, and healthcare professionals (n = 35) using qualitative content analysis. The study was carried out between 2019 and 2020 in Isfahan, Iran. Purposive sampling was performed. Data collection was conducted through in‑depth interviews and semi‑structured until data saturation. Graneheim and Landman content analysis was performed simultaneously with data collection.

After data analysis, 3 themes and 6 categories were identified and named. Themes (and categories) include “Patients unreadiness to change” (misunderstanding of conditions and consequences and deterrence cultural practices and beliefs); “gap in healthcare services” (lack of adequate support for patients and discordance between healthcare professionals); and “limited access to healthcare services” (limited physical access and financial burden).

The findings of the present study can provide a framework for healthcare professionals to employ preventive strategies, reduce disease complications, decrease unhealthy behaviours, and increase prolonged adherence to treatment recommendations in patients with CVD.  

The nature of cancer is such that it causes several problems for patients and caregivers. As a vital source of support for patients with cancer, family caregivers must seek assistance and make use of available resources to overcome these issues and offer better care for the patient.

This study aimed at exploring the challenges of seeking help in Iranian family caregivers of patients with cancer from supportive sources.

This qualitative study was conducted from 2019 to 2021 on 15 family caregivers with a wide variety of caring experiences and 13 health professionals (i.e. nurse, physician, social worker, clergyman, and family counselor who were engaged with services for the patient and caregiver) via purposive sampling and semi-structured in-depth interviews in a central cancer care hospital in Isfahan. Graneheim and Lundman’s conventional qualitative content analysis approach was used to analyze the data. To assess data trustworthiness, Lincoln and Guba’s criteria were used. Data management was performed using MAXQDA (v. 10) software.

Four main categories were identified consisted of (1) being strained by social desirability; (2) stigmatizing attitudes toward help-seeking; (3) reactive self-forgetfulness; and (4) resistance to change.

The need to develop and implement interventions geared to enhance family caregivers’ preferred attitudes and personal skills in order to overcome socio-cultural obstacles to help-seeking behaviors was underlined in this research. Both health care professionals and the community should be prepared to make support services more accessible and usable for family caregivers.

Today, the ability of the organizations to successfully knowledge management and sharing can help them in better performance. Effective knowledge sharing (KS) in the clinical context provides better clinical decisions and improves the quality of care services. This systematic review will be conducted to identify the factors related to the clinical KS (CKS). This systematic literature review will be conducted to search the published documents about the affecting factors on the (clinical) KS. To this end, PubMed, Scopus, Web of Science, ProQuest, Cochrane, Embase, SID, Magiran, IranDoc, and ISC will be thoroughly assessed with considered keywords and search strategy. No time limit will be considered and all relevant documents published will be evaluated until the start date of the search. To the best of our knowledge, no systematic review study has been conducted on the factors related to CKS and our research will try to comprehensively extract the effective factors in this topic. Identifying the factors affecting CKS will lead to transparency in the exchange and interpretation of clinical knowledge in clinical care delivery and making the best clinical decisions as well as improving the quality of clinical care. It will also provide a condition to facilitate the delivery of more effective clinical education for policymakers in the field of clinical education.

Concerns about the complications of diabetes and the responsibility of constantly managing a child’s blood glucose are stressful for parents, especially for mothers, and can reduce their resilience. This study aimed to investigate the effectiveness of a self‑compassion‑based training program on the resilience of mothers of children with type 1 diabetes.

This is a randomized clinical trial study. The statistical population of the study consisted of all mothers of children with type 1 diabetes who were being treated at the Isfahan Endocrine and Metabolism Research Centre, Iran. The study samples were recruited conveniently, 64 of whom were randomly divided into two groups (compassion training program = 32; control group = 32). The intervention group participated in eight training sessions. Data were analyzed using t‑test, and Analysis of Covariance (ANCOVA) tests for between‑group comparisons of dependent variables.

There was no significant difference between the mean scores of resilience before intervention (p > 0.05). Mean scores of resilience in the intervention group were significantly higher than the control group immediately (F1,60 = 9.726 p = 0.003) and 1 month after intervention (F1, 60 = 13.146, p = 0.001).

It may be worthwhile to suggest compassion‑based training program for mothers of children with type 1 diabetes to improve their resilience.

Although clinical guidelines help in the prevention, diagnosis, and management of hypertension, individuals with hypertension often remain undiagnosed, or once diagnosed, may not receive adequate care and treatment.

In this study, we explored physicians’ perspectives of the factors influential in implementing the Iranian Recommendations on Prevention, Evaluation, and Management of Hypertension (IRPEM-HTN).

A qualitative descriptive study was conducted using the purposeful sampling method to enroll 30 physicians from October 2016 to May 2018. The physicians working in private offices or university-affiliated health centers/hospitals in the province of Isfahan, Iran, were included in this study one year after participating in the IRPEM-HTN program. The data were gathered through semi-structured interv iews. The transcribed data were thematically analyzed, and the rigor was ensured following the procedure outlined by Braun and Clark.

This themes identified were: 1) macro- and meso-contextual factors, emphasizing that a) policies at all levels affect guideline adherence, and b) environmental-contextual factors affect guideline adherence, 2) micro level factors, emphasizing that c) attributes of the guideline affect guideline adherence, and d) clinician- and patient-level factors affect guideline adherence. Micro-, meso- and macro-level factors influenced guideline implementation.

The attitudes, awareness, knowledge, and capacity of clinicians, as well as a broader socio-cultural context should be taken into account for guideline implementation.

Substance abuse can cause problems for family members, especially spouses, and impair the addictschr('39') quality of life; hence, it seems necessary to identify issues that can endanger their quality of life and health. Therefore, the present study aimed to determine the quality of life of women with addicted husbands, and its related factors.

We conducted the present cross-sectional study on 300 women with addicted husbands who were in the list of clients of private and public addiction treatment centers in Gorgan in 2018. The convenient sampling was used for recruited participants. We gathered data using the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the higher scores indicated a better quality of life. We also analyzed the data in SPSS 16 using descriptive statistics, Chi-square and Mann-Whitney tests at a 95% confidence interval.

The results indicated that women with addicted husbands had lower mean scores of physical health (33.3±19.1), mental health (28±3.19), environmental health (31.5±18.1), social relationship (30.2±21.4), and total scores of quality of life (31±18). There were significant correlation between scores of quality of life and its dimensions with womenchr('39')s job, family income, duration of substance abuse, and type of substance (P<0.001). Also, the quality of life was directly associated with womenchr('39')s jobs and family income, but inversely related to the husbandchr('39')s duration of substance abuse and type of substance.

Women with addicted husbands needed more support due to their low quality of life. These findings help the healthcare provider pay more attention to the problems of women with addicted husbands.

job burnout, depression, and anxiety, which can affect the healthcare systems and societies. This has been intensified by the outbreak of the Covid-19 pandemic. Many of the caregivers’ problems are due to insufficient psychosocial competence and lack of suitable training for basic skills such as self-awareness, rapport, empathy, compassion, reasoning, decision-making, etc. The main purpose of this study was to design a psychosocial service package for caregivers to help them throughout their lives.

 Data gathering was performed by conducting 2 focus groups, searching for studies to identify urgent and important healthcare needs, and finding the best way to address their necessities through a proactive and sustainable method.

 The online “healers' healing” platform is designed with 3 general objectives. The first objective was to present practical and effective materials to support caregivers in order to improve their psychosocial competence. The second objective was to monitor the member's progress and measure the effectiveness of the program. Moreover, to make the members more active in training and their own health promotion, this platform leads and supports self-help groups for caregivers as the third purpose of this project. Furthermore, healers can be active in content development and community education in order to experience a more productive interaction within the communities of caregivers.
 

Diabetes is one of the most common metabolic disorders in the world and because of high prevalence and incidence rate, it is a serious challenge posed to the health system in Iran. Despite extensive knowledge of the desirable care for these patients, evidence suggests that the quality of care provided to these patients is not desirable.

The aim is to develop a training program to enhance the preparation of health professionals for evidence utilization in providing comprehensive health cares to patients with diabetes.

This is an exploratory mixed‑method study using consecutive qualitative–quantitative methods that will be conducted in three phases using the approach proposed by Werner and DeSimone to design the program. In the first phase, a qualitative study will be conducted for context assessment and identification of the requirements to enhance evidence utilization taking into account the overall knowledge translation process using semi‑structured interviews with policymakers and health professionals. In the second phase, a training program will be designed based on the data extracted from the first phase, experts’ opinions, and review of the literature. In the third phase, the training program will be implemented, and its effectiveness on the readiness of multidisciplinary health professionals for evidence utilization will be evaluated.

The results of this study will provide a better understanding of how to identify and incorporate contextual factors and the real needs of health‑care professionals and develop a program tailored to improving their readiness to use evidence. It can subsequently lead to providing quality care to patients with diabetes

Postpartum period is associated with stress and pressure, and the woman must adjust herself to these changes. This study aimed to review the factors affecting women’s adjustment to postpartum changes in conducted studies.

This review was conducted by searching databases such as ISI Web of Science, Science Direct, Scopus, Cochrane, PubMed and Scientific Information Database (SID), Iranian Medical Articles Database (IranMedex), Iranian Research Institute for Information Science and Technology (IranDoc), and the Iranian Magazine Database (MagIran), as well as searching through Google Scholar (as a Web search engine) in December 2019. Publications from July 2004 to October 2019 were reviewed and limited to Persian and English. The keywords used included “Postpartum”, “Women’s needs”, “Adjustment” and “Coping”. After reviewing the articles, out of 60 original articles, 17 articles were selected for final evaluation.

Factors affecting adjustment to postpartum changes were divided into personal and social factors. Personal factors included previous experiences, coping styles and strategies, personality traits, self‑efficacy and awareness, and social factors included family and relatives, healthcare providers, cultural context, and laws and regulations.

Adjustment to postpartum changes depends on the personal and social factors that can interact with each other. Women’s awareness enables them to use positive coping strategies in this critical situation. Educating women’s spouse and family members can contribute to increase the women’s social support. Additionally, the law support guarantees the implementation of many interventions in promoting the mother’s health

Background:

 Substance abuse is regarded as a principle issue in the world which causes numerous devastating challenges for family members of the abuser. This study explores how family head addiction affects women’s and children’s lives.

This is a qualitative content analysis study that was conducted in 2018 in Gorgan city, Iran. Using a qualitative study design and purposive sampling, 36 participants (11 children including 5 boys and 6 girls who had substance-dependent fathers, 15 women whose husbands were involved in substance abuse, 10 service and healthcare providers) were subjected to a semi structured, in-depth individual interview. A conventional content analysis approach using the Granheim method was employed to analyze the data.

Results are divided into four main categories: 1) Psychological and physical disadvantages included three subcategories of family psychological breakdown, Family deprivation in terms of emotional, physical health concern, 2) Social isolators consisted of three subcategories of disadvantaged social status, family violating norms, and addiction as a family phenomenon, 3) Disrupted family included three subcategories of decline in sex, Rule of doubt in the family and marital conflicts, and 4) Economic constraint consisted of the family deprivation financially and addiction in contrast to welfare.

Conclusion:

 Given that children and women in these families have problems in various aspects, our results emphasize the importance of comprehensive interventions by therapists, healthcare providers, to maximize behavioral adaptation in children and women that live with family head substance abuser.

CONTEXT: One of the most important issues in patients with coronary artery disease is their mental health indices such as perceived stress and perception of disease.

The aim of this study was to evaluate the effectiveness of mindfulness‑based intervention on the perceived stress and disease perception of patients with acute coronary syndrome.

This is a clinical trial, two‑group, and three‑stage study on 76 patients with acute coronary syndrome who were randomly divided into intervention and control groups. Nine weekly sessions of mindfulness‑based training program were administered to the intervention group. The control group received routine services during this period. Data collection was done before, immediately, and 1 month after the intervention, using the Perceived Stress Scale and the Illness Perception Questionnaire. Data were analyzed using descriptive and inferential statistics.

There was no significant difference between the mean scores of perceived stress and illness perception before intervention. After the intervention and 1 month after it, the mean score of perceived stress in the intervention group was statistically significantly lower than the control group (P < 0.001), and the perception of disease in the intervention group was statistically significantly higher than that of the control group (P < 0.001).

It is worthwhile to suggest the mindfulness‑based training program to reduce the perceived stress and correct the perception of disease for patients with acute coronary syndrome.

Technology has made the quality of health care evolve, and widely deployed in healthcare service systems, but the entrance of technology to a defective system would intensify the same problems and the stress resulting from its application to users, which is called "Techno-stress".

This study aimed to assess the relationship between Technology Management and Techno-stress level among nurses. Data were analyzed using mean, standard deviation, Pearson and linear regression in SPSS 16.

This survey was conducted to evaluate the frequency, intensity and levels of “Techno-stress and its dimensions” and “Technology Management by Two validated questionnaires.

The mean score of Techno-stress in the studied samples (195 registered nurses) was 51.55 ± 15.607 (highest mean score in the field of feeling pressure and the lowest mean score in the technology involving). In addition, there was a significant correlation Technology Management and the Techno-stress score (r= -0.242, p<0.001). In addition, the highest correlation between the score of the Technology Management and the feeling stress (r= 0.422, p<0.001) Implication.

Nurses experience an overall relative Techno-stress and this related to nursing how managers do about technology. Nursing managers of medical centers need to plan to eliminate the stress caused by the use of technology and better management in order to eliminate and prevent the Techno-stress.

Supporting family caregivers of clients with mental illness, in addition to feeling relaxed and safe, will have a qualitative and quantitative impact on the type of care provided to their patients. The purpose of this study was to investigate the safety and security of family caregivers of clients with mental illness.

In this qualitative study, 20 family caregivers of clients with mental illness and 29 service providers and policy-makers were selected through purposive sampling method and underwent semi-structured in-depth interviews. Data were analyzed inductively using conventional qualitative content analysis.

675 codes were obtained and classified in 7 sub-categories and the sub-categories were grouped in 3 main categories. The main categories included “Sense of physical security”, “sense of legal security”, and “sense of social security”.

The results indicated the challenging areas and important constituents of understanding the safety and security of family caregivers of clients with mental illness that require attention and consideration in social support development policies to support these family caregivers.

Factors affecting labor pain include physiological, psychological, and social factors, among which psychological factors refer to attitudes and beliefs about labor pain. Hence, the present study was conducted to determine the relationship between attitude toward labor pain and length of the first, second, and third stages in primigravida women.

This cross‑sectional study was performed on 230 pregnant women who were referred to hospitals affiliated to Isfahan University of Medical Sciences in a two‑stage sampling in 2018. In the beginning, the participants completed the questionnaire of demographic/fertility characteristics and attitude to labor pain (25Q), and at the next stage, the researcher completed the form of labor information including length of the labor stages. Data were analyzed by SPSS software version 22 and Pearson correlation coefficient, Student’s t‑test, one‑way ANOVA, and general linear regression.

The mean (standard deviation) of the attitude to labor pain was 53.96 (1.9), and the length of the first stage was 10.01 (0.3) (h), the second stage was 1.6 (0.4) (h), and the third stage was 15.9 (1.7) (min). One hundred and eighty‑three (79.6%) had negative attitude and 47 (20.4%) had positive attitude toward labor pain. There was a significant positive correlation between attitude toward labor pain and length of the first (P = 0.001, r = 0.37) and second stages of labor (P = 0.001, r = 0.24). There was no significant between length of third stage of labor and attitude toward labor pain (P = 714).

The results showed that the majority of primiparous women had a higher (negative) attitude toward labor pain, which was associated with longe the first and second stages of labor.

Balint Work is getting introduced and Balint Group Trials are being held in Iran in recent years. This is the first study of a Balint group trial participated by Iranian General Practitioners (GPs). This was a qualitative study to explore the themes which feature the GPs' described experience of their participation. A phenomenological approach was applied to examine the GPs' experience of participation in a seven-session Balint-group-trial. The participants were eight Iranian GPs working in the primary health-care network of Natanz-Iran. A focus group and in-depth semi-structured interviews were applied and the transcribed.  Verbatim were analyzed through a phenomenological explorative and descriptive process by a three-membered research team. Three ground themes and four main-themes emerged as the main features through which the participant-GPs had explained their experience. The main themes were1) Improving the Skills and Wisdom of Doctor-Patient-Relationship, 2) Exceptional Training Method/Learning Experience, 3) Emotional healing for doctors, 4) Job Morality Inspirations. Iranian physicians described their participation in a Balint group trial as a missing, needed and valuable experience of different sort of a peer-discussion-group, an insight-inducing and skill-improving one and an emotionally-supportive one. Minor particularities and major similarities were found between the participation experience as portrayed by Iranian physicians and by physicians of other countries. The study also adds a demonstration of the trans-cultural nature of the Balint group experience.