نشریه پرستاری ایران
پیاپی 93-94 (اردیبهشت و تیر 1394)

Medication is one of the most important aspects of the nursing profession. This study was carried out with the aim of determining nurses’ perspective of types and causes of medication errors in selected hospitals of Zahedan University of Medical Sciences. It was a descriptive cross-sectional study that was conducted in 2013. The research population consisted of 127 nurses working in selected hospitals affiliated to Zahedan University of Medical Sciences who were recruited by census. Data was collected by a three-part questionnaire and analyzed by t-test and ANOVA using SPSS-PC (v. 16). The mean and standard deviation of the most frequent medication errors were respectively related to the rapid infusion of the medicines that nurses should have injected slowly (0.47±0.92), non- adherence to the necessary steps related to the medicines requiring special attention (0.46±0.82), and no dilution of medicines that must be diluted (0.37±0.72). Also the most common causes of medication errors were reported as fatigue related to heavy workload (99.2%), many ill patients (80.3%) and distorted and unreadable physician's orders (79.5%). Significant relationships were found between the occurrence of medication errors and type of employment and shift work (p<0.05). Regarding the types and causes of medication errors from nurses’ perspective, approaches to increase nursing staff, using electronic medical kardexes, and retraining courses on pharmacologic information would be helpful.

New graduate nurses bear high levels of stress which could lead to unpleasant personal and professional outcomes. This study aimed to determine the effectiveness of cognitive behavioral group intervention on the stress levels of new graduate nurses. It was a quasi-experimental pretest -posttest study with control group. A total of 80 new graduate nurses were first recruited by purposeful sampling and then were randomly assigned into two experimental and control groups (n=40). Eight, 90 minutes sessions of cognitive behavioral group intervention was performed for the experimental group two times a week. Control group received no intervention. The data was collected before and after the intervention by “Expanded Nursing Stress Scale” and analyzed by inferential statistics such as chi-square and independent T test using SPSS- PC (v. 20). The findings showed that the mean score of stress level has reduced significantly after the intervention (from 44/44 to 29/44) (p<0/001). No significant reduction was found in the stress levels of control group (p=0/276). There was also a significant difference between the mean score of stress levels of the two groups after intervention (p<0/001). According to the findings cognitive behavioral group intervention can reduce the stress levels of new graduate nurses. Therefore, using this intervention in the beginning of new graduate nurses’ work is suggested.

Promoting students’ critical thinking (CT) skills has been an essential goal of higher education, especially in nursing education. Unstable clinical situation requires nurses with proper ability of decision making which needs critical thinking. Accordingly this study was conducted to evaluate the critical thinking skills of nursing students of Isfahan University of Medical Sciences. It was a descriptive cross-sectional study. The sample consisted of 169 nursing students who were recruited by stratified proportion to size sampling. The Data was collected by “California Critical Thinking Skills Test B” and analyzed by spearman correlation, Pearson correlation, T test and ANOVA using SPSS-PC (v. 16). Critical thinking skills in nursing students in all three levels was less than 50 percent (%32/8) and There was no significant correlation between educational levels of students and the mean score of critical thinking skills and its subscales by ANOVA test (p>0/05). Despite the emphasis on the necessity of students’ critical thinking in higher education, the existent context does not have the required efficacy and needs some revision.

kangaroo care as a suitable and effective method of care for low birth weight and premature newborns and also their health promotion has been known in various countries around the world. Regarding the importance of nurses’ knowledge and performance about this kind of care, the study aimed to examine knowledge, performance and perceptions of nurses in NICUs and neonatal units of hospitals in Yazd city about kangaroo care and its barriers. It was a cross-sectional study. The sample consisted of 62 nurses working in NICUs and neonatal units of 6 hospitals of Yazd city. Data was collected by Kangaroo Care Questionnaire (KCQs) and analyzed by person correlation coefficient test using SPSS-PC (v. 16). According to the findings 69/5% of the sample reported that kangaroo care has been done in their work place and 82.8% reported that they have recommend kangaroo care to mothers. From the samples’ view, nurses’ refuse to participate in kangaroo care (30/9%) and this belief that "Incubator care is more effective than kangaroo care" (37/9%) were the most important barriers to kangaroo care. There was also a significant positive relationship between the constructs of knowledge and benefits with disadvantages and appropriateness (p< 0/01), and nurses’ age and working experience (p<0/05). Regarding the high percent of participation in kangaroo care, it seems that education and encouragement could be effective for the continuation of the method. In service education is also recommended to remove barriers.

Patient safety is a major concern for health care organizations. The first step to improve culture of patient safety is its assessment. Accordingly this study was performed with the aim of assessing culture of patient safety from nurses’ perspective in the hospitals affiliated to Hormozgan University of Medical Sciences. It was a descriptive cross-sectional study. The sample consisted of 190 nurses working in educational hospitals of Hormozgan province who were recruited by stratified random sampling in 2012. Data was collected by Hospital Survey on Patient Safety Culture questionnaire (HOSPIC) and analyzed by independent T. test, one-way ANOVA and Post hoc test of LSD using SPSS- PC (v. 16). Among the different dimensions of patient safety culture, the lowest score was related to the number of employees and its related issues (40.25%) and the highest score was related to team work in the unit (85.60%). In the past 12 months, 63 nurses (35.7%) did not report any errors and 53 nurses (30.1%) reported only 1 or 2 error. Significant differences was seen between the score of different dimensions of patient safety culture and nurses’ work experience, the type of employment, hospitals, and the amount of working hours (p <0.05). Regarding the findings, it is suggested that managers and policy makers identify the factors involved in patient safety culture and improve the working environment, and promote supportive organizational climate in hospitals. Farther research is needed to detect the causes of nurse's failure to report medical errors.

Occupational hardiness as a set of personality traits is a source of resistance and protection against stressful life events. The aim of this study was assessment of psychometric properties of Occupational Hardiness Scale. A total of 210 nurses were recruited through stratified sampling method and responded to Occupational Hardiness Scale, Beck Depression Questionnaire, and Rosenberg Self-esteem Questionnaire. Data was analyzed by factor analysis, Cronbach's alpha coefficients and Pearson correlations using SPSS-PC (v. 22). Exploratory factor analysis, item-total correlation and reliability analyses were undertaken to assess the psychometric properties of the Occupational Hardiness Scale. Pearson correlation results indicated a significant relationship between hardiness and depression (r= -0.31 and p&le0.01) and self-esteem (r=0.28 and p&le0.01). Also hardiness scale reliability was assessed using Cronbach's alpha and it was 0.78 for the total scale, 0.81 for challenge, and 0.75 for commitment and 0.88 for control subscales. The Persian version of Occupational Hardiness Scale had acceptable psychometric properties in nurses’ population and it can be used as a valid instrument in psychological and health research.

In order to support the rights of the human subjects and to prevent their exposure to the probable risks arising from research, it is necessary to monitor the observance of all ethical principles and codes. This study was conducted to describe the state of ethical considerations’ reports in the nursing studies published by the nursing journals of Iran. All the articles published by five scientific nursing journals during 2014 were selected by census and their ethical considerations’ reports were assessed by a researcher made checklist. Data was analyzed by SPSS- PC and the frequency of the results was reported according to the type of the study and the published journals. Among 294 reviewed articles, 128 (43.5%) reported institutional review board permission, 203 (69%) reported obtaining informed consent; 119 (58.5%) reported obtaining written consent; 87 (29.6) reported confidentiality of information and 66 (22.4%) reported the awareness of the subjects of freedom to leave the study. The assessed journals were different by the reporting of these indexes and the percentage of institutional review board permission and obtaining informed consent was higher in two journals compared with other journals. The findings showed that adherence to ethical considerations have been overlooked in some cases; therefore, it is necessary that the research ethics committees monitor the ethical issues more precisely during implementation of nursing studies. Also holding research workshops and the workshops on reporting the ethical observations, more emphasis on ethical guidelines in nursing journals and reviewers’ attention to the ethical considerations of these journals are recommended.

Individual's perception of organizational justice is very important. The aim of this study was to identify the relationship between organizational justice and psychological empowerment of nurses working in hospitals affiliated to Shahid Beheshti University of Medical Sciences. It was a descriptive- correlational study. The sample consisted of 155 nurses working in hospitals affiliated to Shahid Beheshti University of Medical Sciences who were recruited by random stratified sampling during 2012. Data was collected by Niehooff and Moorman’s Organizational Justice questionnaire and Spreitzer’s Psychological Empowerment instrument and analyzed by descriptive statistics, Pearson correlation coefficient and multiple regression using SPSS-PC (v. 16). A significant positive correlation was found between organizational justice and nurses’ psychological empowerment (p= 0.005). Also the results of multiple regression showed that interactional justice can explain %53 of the variance of Psychological empowerment of nurses. Regarding the significant relationship between organizational justice and nurses’ psychological empowerment, managers’ attention to organizational justice of healthcare system to improve the nurses’ psychological empowerment is suggested.

Infertility is a stressful phenomenon and has psycho-social aspects. This study was carried out with the aim of comparing the quality of life and spiritual health and their different dimensions among fertile and infertile women in Ilam city.
It was a cross- sectional, comparative study. The sample consisted of 200 married 15-49 year old women who referred to obstetricians during the second half of 2014. Data was collected by SF36 and spiritual health questionnaire (SWB) and analyzed by descriptive and inferential statistics using SPSS-PC (v. 16).
The findings showed that there has been a significant difference between the mean scores of all assessed dimensions and the spiritual health and quality of life of fertile women was better than infertile women. There were also significant relationships between physical health and spiritual health (r=0.332), existential health and physical health (r=0.348), and existential health and quality of life (r=0.281) among fertile women.
Considering the low levels of spiritual health and quality of life among infertile women, it is recommended that obstetricians, gynecologists and midwives, pay special attention not only to therapeutic aspects but also to psychological and social issues related to infertile women.

Sleep is one of the physiological needs of patients; however, sleep disorders are prevalent among patients hospitalized in cardiac care units. This study aimed to compare the effect of Damask rose aromatherapy and blindfold on sleep quality of patients hospitalized in cardiac care units.
Material & In this randomized clinical trial, 60 patients who met the inclusion criteria were selected conveniently and randomly assigned into Damask rose aromatherapy and blindfold groups using blocked randomization. In addition to the routine care, interventions were implemented for three subsequent nights from 22:00 to 6:00 A.M. In both groups and the patients’ sleep quality was assessed using the Pittsburgh Sleep Quality Index, before and after the three nights. Data was analyzed using Chi-square, independent t, Mann-Whitney U and Wilcoxon signed-rank tests using SPSS-PC (v. 11.5).
The overall sleep quality significantly improved after the intervention in both Damask rose aromatherapy (P = 0.001) and blindfold groups (P = 0.001). Although improvement of sleep quality was higher in blindfold group (P = 0.005).
Both Damask rose aromatherapy and blindfold could improve the sleep quality of patients hospitalized in the cardiac care unit, though blindfold was more effective. Therefore, according to patient’s preference, one of these methods might be used to improve the sleep quality.

Anxiety and depression could lead to physical or psychological consequences and reduce the quality of life of patients. The present study was carried out to determine the relationship between anxiety and depression with quality of life in patients undergoing coronary artery bypass graft.
Material & It was a cross-sectional study. The sample consisted of 102 patients who had been undergone coronary artery bypass graft (CABG) in Azahra hospital of Shiraz city. The patients were recruited by convenience sampling method. Data was collected by standardized hospital anxiety and depression scale (HADS) and global Quality of Life questionnaire (WHOQOL-BREF) and analyzed by statistical tests of Pearson correlation, t-test and hierarchical multiple regression using SPSS-PC (v. 20).
There was a significantly negative relationship among depression and anxiety with quality of life (P Regarding the frequency of anxiety and depression among these patients and its negative impact on treatment outcome and quality of life of patients with coronary artery diseases, performing appropriate screening and therapeutic approaches for this group of patients is suggested.

Spirituality is a global phenomenon and everyone experience it. Nurses need to have a common understanding of spirituality before they begin to care for patients. However, there is yet ambiguity and disagreement on the definition and attributes of this concept. The present study was carried out to clarify the concept and reduce the semantic ambiguities in its definition to achieve a uniform, clear and understandable definition of spirituality in nursing.
Material & Walker and Avant's eight-step model was used as the method. After extensive review of all published articles from 2000 to 2015, 42 articles were included into the analysis. By following the steps of the model, definitions, properties, applications, antecedents, consequences and empirical referents of the concept of spirituality were derived.
According to the analysis, spirituality as a metaphysical or transcendental phenomenon, includes properties of personal, subjective, and inner experience and the power of coordinating other aspects of existence, search for meaning and purpose of life and significant relations (personal, interpersonal and transpersonal (God or a higher power). The consequences of the concept of spirituality include health or relief of suffering, coping, comfort, hope and finally, transcendence. The definition of spirituality will be influenced by the perspective of human-centered philosophy (and secular), or God-centered philosophy. A conceptual model was proposed based on the findings.
The concept of spirituality has different meanings depending on the cultural and philosophical background. In fact, it is a totally context dependent concept. Further research is suggested in this area, especially in the Islamic - Iranian context.

Successful aging and life satisfaction accompanies with continued and high levels of hope in subsequent stages of life. This study examines the effect of reminiscence therapy on hope in elderly.
Material & It was a quasi-experimental study. A total of 24 elderly of Karaj city were randomly recruited among the elderly of Setayesh hospice and were voluntary assigned into experimental (n=12) and control (n=12) groups. Reminiscence therapy was performed during eight sessions for the experimental group. Hope was assessed in the two groups before and immediately after intervention by Snyder questionnaire. Data was analyzed by independent and pair T test using SPSS-PC (v. 21).
There was a significant difference between experimental and control groups after intervention (P According to the findings it can be said that reminiscence therapy increases elderly hope. Therefore using this simple, practical and inexpensive technique in hospices is recommended.

Despite widespread implementation of family-centered care (FCC) in children’s hospitals, there is insufficient information about the degree of and barriers to its implementation. This study aims to determine the perspectives of nurses and physicians about barriers to FCC in neonatal intensive care units (NICU) in hospitals affiliated to Tehran University of Medical Sciences.
Material & It was a descriptive cross-sectional study. The sample was all of the nurses and physicians working in the NICUs of the educational hospitals. Data was collected by a researcher-made valid questionnaire and analyzed by descriptive and inferential statistics using SPSS-PC (v.16).
“Units which are not equipped enough for family centered care implementation” (76.6%), “family problems (74%) and “Parents unwilling to stay in the units for a long time” (73.3%) were respectively the three most important barriers from nurses’ perspective. From physicians’ perspective, “Units which are not equipped enough for family-centered care implementation” (69%), “Parents unwilling to stay in the wards for a long time” (65%), and “absence of clear rules and guidelines for the level of involvement of parents in neonatal care” (64%) were respectively the three most important barriers to the implementation of family centered care.
Although nurses and physicians agreed upon two barriers but they were not so agree about other factors. To facilitate family centered care, it seems that consideration of the two groups’ perspective to provide an appropriate environment and needed changes in intensive care units is necessary.

Infertility as a biological phenomenon has personal and interpersonal psychological effects. Accordingly, expression of psychological consequences would be expectable after its diagnosis. The aim of current study is to determine the effectiveness of emotional regulation training on emotional well-being and marital satisfaction of infertile women.
Material & It was a quasi-experimental, pre-test and post-test study with control group. The statistical population was all infertile women attending to the obstetricians and gynecologists’ clinics in Parsabad city during 2014. A total of 40 infertile women were recruited by convenience sampling and then were assigned randomly to experimental and control groups. The three months period emotion regulation training was applied to the experimental group. Data was collected by marital satisfaction and emotional well-being questionnaires before and after intervention and analyzed by multivariate covariance analysis (MANCOVA) using SPSS-PC (v.16).
The results showed that emotional regulation training could significantly increase the emotional well-being and marital satisfaction among infertile women (P≥ 0.01).
According to the results emotion regulation training have positive effects on emotional well-being and marital satisfaction of infertile women. Accordingly especial training programs for these women are recommended.

computer games have inevitably devoted a significant portion of children and adolescent''s socialization. This study has been conducted with the aim of examining views of parents about the long-term effects of computer games on primary school girls.
Material & It was a descriptive cross-sectional study. The sample consisted of 150 mothers of school girls studying in first to sixth grade who were recruited by convenience sampling in 2013. Data was collected by a researcher-made questionnaire and analyzed by descriptive statistics and Chi-square test using SPSS-PC (v. 16).
The complications of long term use of computer game from mothers’ views was reported as reduction of social interaction and physical activity (%77.3)¡ burning eyes and Poor eyesight (%76.7)¡ dropout (%72.7)¡ aggression (%62)¡ obesity (%54)¡ and musculoskeletal problems (%36.7) respectively. In addition %59.3 of mothers reported that all family members use computer in their homes. The most important factor of long term use of computer from mothers’ view was no restriction to use computer games in their home (%68.7).
Regarding the findings¡ in order to protect and promote children’s health it is recommended that training courses will be initiated for children¡ parents and teachers in line with changing their viewpoints and supervision of the type and conditions of computer games¡ child nutrition and maintaining children’s ergonomic body condition while playing the games.