nahid rajai

Medication adherence remains a significant challenge for individuals with chronic illnesses, particularly those suffering from cardiovascular diseases. Despite various nursing strategies, optimal solutions to this issue have yet to be achieved.

This study aimed to evaluate the impact of the liaison nurse’s role on improving medication adherence among cardiovascular patients presenting to the emergency department of a selected Aja hospital in Tehran.

This experimental study employed a post-test-only control group design in 2023. The participants were cardiovascular patients visiting the emergency department of the selected Aja hospital between November and February 2023. Thirty-six patients were purposively selected and randomly divided into experimental and control groups. The experimental group received routine care alongside training and support from a liaison nurse via telephone, while the control group only received routine care. Two weeks after the intervention, medication adherence was measured using the Morisky Medication Adherence Scale (MMAS). Data analysis was performed using SPSS version 19, with a significance level of less than 0.05.

Baseline demographic characteristics did not differ significantly between the two groups (P<0.05). However, two weeks after the intervention, the experimental group demonstrated significantly greater medication adherence )mean score: 6.38±0.91 (compared to the control group) mean score: 4.39±1.64; P>0.001).

The findings underscore the effectiveness of the liaison nurse’s role in enhancing medication adherence among cardiac patients in the emergency department. It is recommended that nursing administrators and healthcare policymakers consider integrating the liaison nurse model into routine hospital care to support patients and improve outcomes.

The repercussions of emotional fatigue in nurses significantly influence the quality of patient care.

This study sought to evaluate the impact of mindfulness interventions on alleviating emotional exhaustion among nurses in specialized care units in the post-COVID-19 period.

This research utilized a quantitative design within a randomized controlled clinical trial framework. The study population  comprised 47 nurses who met the inclusion criteria and were employed in the Covid-19 specialized departments of two military hospitals in Tehran , IRAN in 2023. Participants were assigned randomly using a simple random sampling method. The intervention group received mindfulness training, whereas no intervention was applied to the control group. Both demographic data and emotional fatigue assessments were collected from participants pre- and post-intervention. Subsequently, the data underwent statistical analysis.

The findings revealed no significant demographic differences between the two groups. Results from the independent t-test indicated that, prior to the intervention, the mean level of emotional exhaustion in the intervention group (20.79±4.21) did not significantly differ from that of the control group (20.87±6.45) (P=0.961). However, post-intervention, the mean emotional exhaustion score of the intervention group (16.63±2.18) was  significantly lower than that of the control group (21.35±5.95) (P=0.001), underscoring the beneficial effect of mindfulness interventions in alleviating emotional exhaustion among participants.

The findings revealed that mindful engagement of the conscious mind effectively enhances emotional resilience among nurses in specialized hospital wards in the post-COVID era. Consequently, it is recommended to implement mindfulness-based interventions to boost job satisfaction and  alleviate emotional exhaustion for nurses working in these critical care areas.

Suctioning has been to date documented as one of the most painful and anxiety-inducing experiences among mechanically ventilated patients admitted to intensive care units.

The present study was conducted with aim to investigate the impact of foot reflexology, as a non-pharmacological method, on suctioning-induced anxiety in ICU patients receiving mechanical ventilation.

This randomized controlled trial study was conducted on 36 mechanically ventilated patients in the ICU of a military hospital in Tehran, Iran, in 2021. The subjects were randomized into either the intervention group (foot reflexology) or the control group (routine care). After the completion of the suctioning procedure, the foot reflexology technique was applied for 20 minutes on reflex points of the heart and lungs (the anterior third of the sole of the foot) in the intervention group patients. Levels of anxiety were assessed using the Faces Anxiety Scale (FAS) before and after the intervention.

No statistically significant difference was found between the two groups in demographic characteristics and anxiety levels at the pre-intervention stage. However, anxiety was significantly reduced after foot reflexology treatment in the intervention group compared to the controls (p<0.001). Additionally, anxiety levels significantly decreased in the intervention group after the intervention compared to before the intervention (p<0.001), while increased in the control group (p=0.001).

Implications for Practice: 

The results of the present study showed that foot reflexology is effective in reducing suctioning-induced in ICU patients receiving mechanical ventilation. Therefore, it is recommended to use this non-pharmacological approach at the patient's bedside.

Clinical hand-off is a key factor in continuity of care and the most vital means of communication between nurses.

Considering the importance of improving the safety of patients this study aims to determine the effect of using the communication model ISBAR on the performance of nurses in the clinical hand-off patients with head or neck trauma in a selected hospital in Tehran.

This semi-experimental study was conducted with two control and intervention groups on 78 nurses working in a selected hospital in Tehran, , during the period of 2022-2023. Nurses were randomly assigned to either the test group (n=39) or the control group (n=39). Prior to the intervention, the researchers recorded the personal information and utilized a researcher-made checklist to assess the nurses’ performance based on the ISBAR model, which included the following five items: Identify, Situation, Background, Assessment, and Recommendation. This assessment was conducted through the researcher’s observational evaluation using the checklist. The test group underwent training on how to use the ISBAR communication model in patients with head or neck trauma, which comprised 5 face-to-face training sessions lasting 90 minutes each. The control group did not receive any intervention from the researchers. Subsequently, the researcher completed the checklist again for both groups.

The initial clinical performance record scores of the nurses in the test and control groups (6.53±5.19 vs 7.11±5.60, P=0.724) showed no statistically significant difference before the intervention. However, following the intervention, the test group demonstrated a significantly higher score (96.27±4.41) compared to the control group (43.12±14.06, P<0.001). Additionally, the overall clinical performance score in the test group increased significantly after the intervention (P<0.001). In contrast, the control group’s average clinical performance post-intervention was significantly higher than
before the intervention (P=0.001).

The implementation of the ISBAR communication model improved nurses’ performance in Clinical Hand-off for head or neck trauma patients. Therefore, integrating communication skills training with other programs to enhance patient safety can elevate nurses’ performance and the quality of care.

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

Lack of moral sensitivity and the existence of dysfunctional professional thoughts in emergency department nurses are important. Because wrong decisions cause irreparable damage to the patient.

The aim of this study was to evaluate the job performance of nurses in the emergency department of selected military hospitals in Tehran based on the variables of moral sensitivity and dysfunctional professional thoughts.

A descriptive-correlational study was conducted in 2020. The target population was nurses working in the emergency departments of selected military hospitals in Tehran. The sample size was 152 people. Sampling was done by stratified random sampling. Data collection tools included demographic and occupational characteristics form, Lutzen Ethical Sensitivity, Patterson Job Performance and Inefficient Professional Ethics Questionnaires. Data were analyzed using descriptive statistics (mean, standard deviation, frequency and frequency percentage) and tests such as a t-test with a significance level of P <0.05 by SPSS software.

The majority of study participants were women (60.5%). Most nurses had high moral sensitivity (51.3%). The mean job performance of nurses was 26.54±9.53. The mean total score of nurses' dysfunctional thoughts was 61.1±12.51. In addition, the mean total score of moral sensitivity in the present study was 70.84 ± 15.09. Between different hospitals, there was a significant difference in the total score scores of dysfunctional thoughts and sub-dimensions of confusion and inability to make decisions, impossible expectations, importance to others and perfectionism. There was no significant difference between moral sensitivity and dysfunctional professional thoughts among selected hospitals. Nurses had relatively high moral sensitivity (51.3%) and high job performance (73%). Regression results showed that moral sensitivity can predict about 32% of changes in job performance variables.

Due to the high level of moral sensitivity among nurses, their job performance was at a high level and they were not influenced by dysfunctional professional thoughts. This study also showed that moral sensitivity is able to predict changes in nurses' job performance significantly.

Spiritual self-care has played an important role in adapting nurses to stressful professional conditions, but has often been neglected by health systems.

The purpose of this study is to investigate spiritual self-care programs of nurses in Iran and other countries.

The present study is a narrative review and by searching the Persian and English databases, PubMed, SID, Iran doc, Magiran and a manual search in Google Scholar using the keywords nurse, health workers, spiritual self-care, self-care, spiritual health and health policy was done without time limit (until 2022). In total, out of 35309 articles obtained according to the inclusion criteria, 33 related articles were included in the study.

Despite the special place of spirituality in nursing, the implementation of spiritual self-care in nurses with individual barriers (lack of understanding of the concept of self-care and lack of evaluation, lack of motivation, ignorance of spiritual needs and misconception of spirituality) and organizational (selfish selfishness as a subset Nursing culture is associated with high workload with low salaries, lack of attention and planning of officials in this field. Health policymakers in countries such as the United States, Japan, Canada, the United Kingdom, Australia and Lebanon by implementing strategies such as developing national programs, forming associations and training programs and creating a requirement in self-care through ethical codes to raise the level of Nurses' spiritual self-care has helped. However, no program in this field is currently being implemented in Iran and no study has been found in this field.

It is suggested that health policymakers in Iran, by modeling the programs of leading countries in the field of spiritual self-care of nurses, help improve the spiritual self-care capacity of nurses.

Airway suctioning is one of the most important nursing interventions in patients under mechanical ventilation.Today, endotracheal suctioning is considered as the most painful experience of patients admitted to special wards.

The aim of this study was to investigate the effect of foot reflexology massage on pain caused by suction in patients under mechanical ventilation admitted to intensive care units.

This study was performed as a clinical trial on 36 patients (18 experimental patients and 18 control patients) under mechanical ventilation admitted to the intensive care unit. In this study, a simple randomization method was used to place patients in the experimental and intervention groups.To collect information from the demographic questionnaire and CPOT (Critical care pain observation) scale after suction and after the intervention to assess the level of pain in patients. Data were collected in SPSS software version 26 and to analyze the data. Mann-Whitney U and Wilcoxon tests were used.

The present study was performed on 36 patients under mechanical ventilation. In the study of demographic variables, there was a significant difference in terms of gender (P=1.000), underlying disease (P=0.603), level of consciousness (P=0.443), smoking (P= 1.000), cause of hospitalization (P=0.558), airway (P=1.000), drug intake (P=1.000) was not seen. In the experimental group, the amount of bad pain from the intervention had decreased (P<0.001) and was statistically significant, but in the control group, the amount of pain after 20 minutes not only did not decrease but also increased (P<0.001) and was statistically significant. It is meaningful.

Due to the effect of reflexology foot massage in reducing the pain caused by suction in patients under mechanical ventilation, the use of this method in intensive care units is recommended.

Diabetes is one of the most common chronic diseases that need a lot of care. Theories play an important role in improving the quality of care, and Orem’s self-care theory is pioneering in this field. Therefore, this study aimed to conduct an integrated review of the application of Orem’s theory in the care of diabetic patients.

The present study is an integrated review study of articles published from 2010 to 2022 that were collected from databases including SID, Magiran, Iranmedex, Irandoc, ProQuest, Google Scholar, and PubMed using the keywords, such as Orem, self-care, diabetes, Orem model and their Latin equivalents. The study procedure included five stages of text search, text selection, data evaluation, data extraction, and data classification in studies on the application of Orem’s self-care model on diabetes.

The initial search results included 243 articles. A total number of 14 articles were selected and included in the study after the careful examination of the titles, abstracts, and texts of the collected articles. The majority of studies have been conducted in Iran. All studies were interventional and five articles had a clinical trial design. Moreover, the studied variables included the main components of Orem’s theory, quality of life, laboratory factors such as blood sugar or glycosylated hemoglobin, adherence to treatment, self-efficacy, and peripheral neuropathy. All the studies were performed on the adult population and interventions were often conducted in the form of training sessions. In all the studies, interventions had a positive and significant effect on the variables under study.

Considering the positive results of interventions based on Orem’s self-care theory on the consequences of diabetic patients, it is recommended to remove the barriers to the application of the theory in the clinic. Furthermore, efforts should be made to translate knowledge and support upstream organizations in this regard. It is also suggested to pay attention to the acute complications of diabetes, study this disease in the pediatric population, and perform interventions with strong plans for researchers interested in this field.

Endotracheal extubation is associated with high complications such as sore throat, cough, and hoarseness.

This study was performed aimed to compare the effect of green tea and licorice gargle on sore throat, cough, and hoarseness after endotracheal extubation.

This randomized controlled clinical trial was performed in the operating rooms and surgical wards of two hospitals in Tehran during 2020-2021. A total of 102 candidates for elective surgery were allocated to licorice, green tea, and control groups by simple random allocation. The scores of sore throat, cough, and hoarseness were assessed one hour after endotracheal extubation. After the gag reflex returned, 30 cc of the prepared solutions was given to the patients to gargle for 30 seconds. The intervention was repeated two hours later. The scores were assessed in the three groups immediately after the first stage of the intervention (post test1), and two hours after the second stage of the intervention (Post-test 2). Data were analyzed by SPSS software (version 16) and One-way Analysis of Variance-ANOVA, Repeated Measure ANOVA and post hoc test. P<0.05 was considered statistically significant.

There was significant difference between the three groups regarding sore throat, cough, and hoarseness variables in the post-test 1 and post-test 2 stages (P<0.05). The intervention groups had significantly reduced scores in three main variables compared to the control group (P< 0.05), but the difference between the two intervention groups was not significant (P> 0.05). Implications for Practice: Gargle of licorice solutions or green tea is recommended as a non-pharmacological and low-cost intervention to reduce post-extubation complications.

Accreditation is one of the most important tools to improve the quality of education in nursing. This study has made a comparative comparison of the accreditation model of the Bachelor of Nursing training program in Iran, Canada and the United States.

A descriptive and comparative study was conducted in 2021. keywords like "accreditation", "undergraduate nursing", "educational program or curriculum", "Canada", "Iran", and "America" were searched in Persian and English via relevant sites and the Bereday model in 4 stages of description, interpretation, proximity, and comparison was used for comparative comparison.

Accreditation in the Iranian model is more focused on managerial, structural and administrative standards. In the American model, it focuses on global developments in the field of health, providing educational programs with intercultural and transnational perspectives, interprofessional cooperation, distance education, evaluating learning outcomes and using its results in the development of education. The Canadian model focuses on participatory management, inspirational leadership, development of nursing professional competencies tailored to community health needs, team care in various areas of prevention, treatment and rehabilitation, interprofessional training, independence and freedom of action in budgeting for faculty members.

Between the three study models, the Canadian and American models totaly specializes in nursing, and of course the Canadian model is more comprehensive, and since there are no specific accreditation standards for nursing in Iran, these two programs can be used as a suitable model to be taken.

Cough, hoarseness, and sore throat are complications of intubation. The aim of this study was to evaluate the effect of gargling with honey and lemon water on cough, sore throat, and hoarseness after extubation of endotracheal tube following surgery.

A clinical trial was carried out in 110 patients undergoing surgery in Neyshabur 22 Bahman Hospital, Iran 2020. They were selected using convenience sampling and randomly allocated to experimental or control group. In experimental group, 6 hours after surgery, 30 cc of honey lemon water was gargled, three times, every two hours and then swallowed. The control group received routine care. Postoperative sore throat, cough, and hoarseness were assessed before the intervention, and 12 and 24 hours after extubation of endotracheal tube. Data were analyzed by independent t-test and repeated measures analysis of variance.

Findings showed no significant difference between the two groups in cough and sore throat 12 hours after extubation, but the score for hoarseness was lower in experimental group (P= 0.05). Twenty-four hours after extubation, cough (P= 0.001), hoarseness (P= 0.006), and sore throat (P= 0.023) were significantly lower in experimental group. The passage of time was found to significantly affect all three variables (P<0.001).

Considering the positive effects of gargling with honey and lemon water in reducing the complications of endotracheal tube and no side effects, it is recommended to be used after extubation.

The quality assurance of doctoral nursing education programs is one of the priorities of educational systems, with significant effects on the development and improvement of educational programs. Therefore, identifying the strengths and weaknesses of these programs through comparison can be useful.

This study aimed to compare the doctoral nursing education programs in Iran and Japan.

In this descriptive and comparative study, which was based on the model proposed by Beredy, the Iranian doctoral program in nursing education was compared with that of Japan in four stages of description, interpretation, juxtaposition, and comparison.

The doctoral nursing education program in Japan was older than its Iranian counterpart, based on historical records. The challenges of nursing education in Iran included the student admission system, inflexibility of the program, and emphasis on theoretical education. The strict rules regarding article publication in International Scientific Indexing (ISI) journals and the higher number of credits in the Iranian program, compared to its Japanese counterpart, were among the strengths of Iran’s program, increasing the level of students’ knowledge and preparation for research activities.

Comparison of the educational systems of Iran and Japan indicated the need for a more flexible and community-based curriculum in Iran.

Inappropriate leadership style can destroy a large portion of the organization's capital and the efforts of qualified employees. This study aimed to investigate the relationship between leadership styles with job stress, organizational deviant behaviors, and burnout in a military health, rescue, and treatment center.

In this descriptive-analytical study, 165 military personnel of a military health, rescue, and treatment center were recruited with census method in 2017. The instruments used were Bass leadership style questionnaire, Kahn et al. Stress questionnaire, Bennett's deviant behaviors questionnaire and Maslash burnout questionnaire.

There was a significant and inverse relationship between transformational leadership and job stress (r=-0/482, p<0/0001) and deviant organizational behaviors (r=-0/414, p<0/0001) and a significant direct relationship with burnout (r=-0/423, p<0/0001). Also, there was a significant and inverse relationship between exchange leadership with job stress (r=-0/238, p<0/0001) and deviant organizational behaviors (r=-0/262, p<0/0001) and a significant direct relationship with burnout (r=0/361, p<0/0001). There was a significant direct relationship between non-interventionist leadership with job stress (r=0/351, p<0/0001) and deviant organizational behaviors (r=-0/436, p<0/0001) and a significant inverse relationship between non-interventionist leadership and burnout (r=-0/482, p<0/0001).

Transformational, transactional and laissez-faire leadership styles are important predictors of job stress, organizational deviant behaviors, and burnout.

Emergency personnel are frequently exposed to high-risk physical and psychological factors that lead to increased occupational stress.

This study aimed to evaluate the effect of aromatherapy with rosa damascena essential oil on nurseschr('39') occupational stress in the emergency department.

This randomized controlled trial was conducted among sixty nurses in the trauma center of Besat Hospital, Tehran. The participants were selected by the convenience sampling method, and then randomly assigned to the aromatherapy with essential oil of Rosa damascena and control groups. Intervention in the experimental and control groups consisted of inhalation cotton swabs impregnated with two drops of essential oil of 40% Rosa damascena (Gole Mohammadi) and cotton soaked with two drops of distilled water as a placebo for 2 minutes, respectively. Nurseschr('39') stress level was assessed by the Nursing Stress Scale before and after the intervention. To analyze the data, independent t-test, paired t-test, and ANCOVA were performed in SPSS, version 22.

The mean age of the nurses was 29.07 ± 5.495 years, and the majority of them had a bachelorchr('39')s degree. The results of this study showed that stress scores in the experimental group were lower than those in the control group after the intervention (p<0.0001). The effect size was -1.5, which was large and desirable. Nurseschr('39') occupational stress scores in the experimental group diminished significantly after the intervention (p=0.012).

It is recommended to use complementary therapies such as aromatherapy with rose essential oil to reduce occupational stress in nurses. Further studies with larger sample sizes and in other occupational groups are recommended.

Body image is one of the important issues in humans’ mental health and trigger of behaviors.

The present study aimed to investigate the effect of some demographic variables on  mental image of the body of students of Zanjan University of medical sciences.

The present study isan analytical-cross sectional study done in the 2018 autumn at Zanjan University of medical sciences. Three faculties were selected through cluster sampling and 520 questionnaires were distributed randomly among respondents. Data were collected by Yonesi & Salagegheh body imagequestionnaire and tested using descriptive statistics and statistical tests of K2 and ANOVA. Significant p-value was considered 0.05. evel.

About one-third of the participants had an inappropriate body image. Further, the results showed that body image in female students was lower than that in male students. Those aged 25 years and earn more than 1.5 million tomans had better body image than the others.

The results generally showed that female students, under 25 years old and with low income, had an unfavorable mental image of themselves. Accordingly, universities must plan basic programs to improve the body image of students exposed to inappropriate mental image. On the other hand, improving this variable will improve the various aspects of the student’s life, including his educational dimension.

Nurses working in intensive cares unit are regularly "affected" by stressors in the workplace, professional self-concept is part of the care structure and affects the performance of the nurse and helps nurses in various roles to deal with Overcoming stressful working conditions to have better care of patients. Therefore, the present study was conducted to determine the relationship between professional self-concept and Occupational stress of nurses working in intensive care units in teaching hospitals in Tehran.

This study is a descriptive-correlational study. In 2020, it was performed on 126 nurses working in the intensive care unit in Tehran. Data collection tools included a demographic questionnaire, the Nurse Self-Concept Questionnaire (NSCQ) and the standardized Job Stress Scale.

Results showed that the total mean score of professional self-concept in pediatric nurses was 216.56±35.92 and the total mean score of occupational stress in nurses Working in Intensive Care Units was 39.09±4.79.The highest score were respectively related to dimensions of care (39.42±6.28) and communication (39.06±5.89) and the mean scores in other dimensions were also moderate. Moreover, there was a negative linear correlation between occupational stress and professional self-concept.

According to the results of the present study, Occupational stress decreases with increasing the professional self-concept of nurses in intensive care units. Therefore, it requires the attention of as many officials as possible in this regard.

During the removal of the angiographic sheath, due to the patient's vigilance and observation of the process, the patient experiences high levels of anxiety and stress.

To determine the effects of inhalation of lavender essential oil on stress and anxiety during sheath take out in patients after coronary angiography.

In a semi-experimental study, 70 patients were selected by random sampling method in 2012 - 2013 and randomly assigned to two experimental and control groups. After leaving the shield (4 hours after the completion of the angiography), the Spielberger anxiety questionnaire was completed by the patients in both groups. After 70 minutes, the patients in the experimental group smelled two drops of lavender essential oil and the control group smelled placebo for 20 minutes. At the end of 20 minutes, the anxiety and stress levels of the patients assessed again and compared with pretest.

After intervention, anxiety (P = 0.001) and stress (P <0.001) in the experimental group were significantly lower than the control group. Also, the anxiety and stress of the experimental group in the post-intervention phase was significantly lower than before the intervention (P <0.001). Fisher's exact test showed a significant difference between the two groups in terms of anxiety levels after intervention (P = 0.001); such that the majority of the experimental group showed a slight anxiety level (67.9%).

The use of lavender essential oil during sheath take out in patients after coronary angiography can reduce stress and anxiety.

One of the common problems of patients undergoing open heart surgery is physiological disorders due to anxiety that can affect the result of surgery. The aim of this study was to investigate the effect of Benson relaxation on the physiological sysmptoms of patients undergoing open heart surgery.

This is a clinical trial performed on 90 candidates for open heart surgery referred to the hospitals affiliated to AJA University of Medical Sciences in Tehran in 2014. The subjects were randomly divided into two experimental and control groups. In both groups, the physiological symptoms (respiratory rate, pulse rate, systolic and diastolic blood pressure) of the patients were measured one day before surgery. Benson relaxation was performed on patients in the experimental group in the morning of the surgery day and the physiological symptoms of both groups were evaluated after intervention. Data analysis was performed in SPSS V. 21 software using Chi-square test, paired t-test and independent t-test at a significance level of P<0.05.

There was no significant difference in physiological symptoms of both groups before intervention. After intervention, a significant difference between the groups was reported in terms of all physiological variables (P=0.001). Paired t-test results also showed a significant difference between the two groups before and after the intervention in terms of all physiological variables except diastolic blood pressure.

Benson relaxation significantly improved the physiological status of patients undergoing open heart surgery. It is recommended that nurses use this method to improve the physiological status of these patients.

Patients with angina pectoris need the training to control their disease. This training is mainly provided by nurses; therefore, they must be equipped with up-to-date and sufficient knowledge and skills to be capable of caring for patients.

This study aimed at exploring the effect of lecture-based training and clinical training on the knowledge and skill of emergency nurses in caring for patients with angina.

This randomized clinical trial was carried out between 2018 and 2019 on all nurses working at the emergency ward of three hospitals in Mashhad, Iran. Based on their working hospital, the subjects were randomized into three groups of lecture-based education, clinical training, and control. Using researcher-made questionnaires, nurses’ knowledge and skill in caring for patients with angina were assessed and compared before, immediately, and one month after the intervention. Data were analyzed by SPSS V. 22 using Kruskal-Wallis, one-way ANOVA, chi-square, and Friedman tests.

Friedman’s test showed a significant difference in nurses’ knowledge and skill scores of the two experimental groups at three stages of the study (P = 0.001), such that these scores were lower before the intervention than immediately and one month after the intervention. Moreover, Kruskal-Wallis test revealed a significant difference between the three groups in terms of knowledge and skill immediately after the intervention (P = 0.001) and one month after the intervention (P = 0.001), with the clinical training group scoring highest among the study groups in both of these stages.

The results established that while both lecture-based education and clinical training could enrich nurses’ knowledge and skill in caring for patients with angina, clinical training depicts a greater efficacy and durability. Hence, it is suggested that health policy-makers adopt clinical approaches in their attempt to enhance nurses’ skills and performance. Furthermore, studies with higher sample sizes are needed to evaluate the effectiveness and sustainability of these two educational methods in nursing.

Depression and anxiety are among the most common mental disorders before and after surgery. Aromatherapy is a treatment that has grown substantially in recent years in comparison with other complementary and alternative medicines (CAM) to relieve anxiety..
This study investigated the effect of inhaling lavender essence on the physiological and psychological status of patients who are candidates for coronary artery bypass graft (CABG) surgery..
This randomized clinical trial was performed on 60 patients who were undergoing CABG surgery at the hospitals of Artesh Jomhory Eslami (AJA) University of Medical Sciences in Iran. Patients who met specific inclusion criteria were selected and randomly allocated into two groups: a control group that inhaled room air and an experimental group that inhaled from a piece of cotton impregnated with two drops of lavender essence. This intervention was done on the morning of surgery. To evaluate these measures, a Depression Anxiety Stress Scale (DASS) questionnaire was filled out by the patient before and after the intervention. The data collected were analyzed using descriptive and analytic statistics..
After the intervention, the study results showed statistically significant differences between the two study groups in heart rate (mean = 78.83, P = 0.02) and anxiety level (mean = 6.63, P = 0.02). However, the differences between the two groups were not significant regarding stress level (mean = 8.63, P = 0.55) and other physiological variables..
Inhalation aromatherapy is an effective method for reducing the heart rate and the level of anxiety in patients before CABG surgery. Given that the physiological and psychological health of patients are important responsibilities for nurses, aromatherapy can be considered a safe and effective relaxation method before invasive interventions. Learning this method is recommended for students and nurses..

Angiography is an invasive diagnostic procedure in cardiovascular diseases. In some cases, before angiography, patients experience anxiety and increase in vital signs in response to sympathetic system activation. The aim of this study was to determine the effect of P6 acupressure point on physiological indexes in coronary angiography candidates.
In a randomized clinical trial, after taking written informed consent, 60 candidates for coronary angiography were randomly divided into two groups of intervention (pressure on the P6 point of both hands for 10 minutes) and control (pressure on the tip of thumb of both hands for 10 minutes). Vital signs were measured before and half an hour after the intervention. Independent t-test and Fisher exact test were used to analyze data.
The two groups did not have significant differences in demographic information and physiological variables before the intervention (p> 0.05). But after intervention a significant difference was seen between the two groups in terms of respiratory rate and systolic blood pressure.
P6 acupressure point can reduce some physiological parameters of patients before angiography. Acupressure as a part of nursing care can be offered for these patients. Further studies in this area is recommended.

Increasing students’ academic stress especially during taking final exams may result in sleep disorders, fatigue, poor academic performance and low functional efficiency. The aim of this study was to determine the relationship between sleep quality with fatigue severity and academic performance of nursing students.Methods & Materials: In a cross-sectional study, the sleep quality and fatigue of nursing students (n=138) of AJA University of Medical Sciences in Tehran, Iran were assessed using Pittsburgh Sleep Quality Index and Fatigue Severity Scale within last week of exams of second semester in 2013. Subjects filled demographic questionnaires and the response rate was 86.8%. The data were analyzed using SPSS software with descriptive and analytic statistics including Chi square, Pearson and Spearman’s rho correlation coefficients. Sleep quality in 64.4% of students was poor. About 77% of students suffered from fatigue in moderate to severe levels. The mean of total scores of lessens was 16.16. Chi-square test and Pearson correlation coefficient did not indicate significant relationship between sleep quality and age, gender, education semester and educational level, material status, habitancy location, caffeine consuming, smoking, experience of suffering from chronic and psychological diseases, working and also experience of major stress (p>0.05). Spearman’s rho correlation coefficient indicated significant relationship between sleep quality and fatigue severity (p≤0.0000), whereas Pearson correlation coefficient did not show significant relationship between sleep quality and academic performance and also between fatigue severity and academic performance (p>0.05). Prevalence of poor sleep quality and fatigue during final exams in nursing students is high. Considering importance of sleep quality and quantity and its effect on academic performances, creating suitable conditions for improving sleep quality is suggested.

Mother-infant separation is one of the main causes of sleep-wake states dis- orders in neonatal intensive care unit (NICU). The current study was conducted to investigate the effect of in-arms-holding by mothers on sleep-wake states disorders of preterm neonates.Methods & Materials: In a pilot study, through a semi-experimental pretest-posttest method, 35 pre- term neonates with gestational age between 32 and 37 weeks and their mothers were selected from NICU of Valiasr Hospital, Tehran, Iran. Data collection process was carried out using the behavioral states scale of Newborn Individualized Developmental Care and Assessment Program. Sleep-wake states data were collected in three phases: 20 min before intervention, 70 min of intervention (mother holding), and 20 min after intervention. The collected data were analyzed using repeated measures analysis of variance (RM ANOVA) and Bonferroni test in the SPSS for Windows 17.0. About 57% of neonates were male. The results of RM ANOVA showed that there were significant differences between three phases of study in terms of deep sleep (P < 0.001, F = 20.400), light sleep (P < 0.001, F = 167.230), drowsiness (P < 0.001, F = 26.770), quietly awake (P < 0.001, F = 27.380) and crying (P = 0.001, F = 4.370), but there was no significant difference for actively awake. Holding the preterm neonates by their mothers seems to improve their sleep-wake states. Medical and nursing staff in NICUs and nurseries may be recommended to use this kind of care to prevent sleep and wake disorders of neonates.