نشریه پرستاری کودکان
سال ششم شماره 1 (پاییز 1398)

Independence in going to toilet, controlling urination and bowel movements, is one of the most important developmental stages for children and an important educational process for parents. The purpose of this study was to examine the experiences of mothers with the training of dry and urinary control in toddlers.
In this qualitative research (1397), 26 mothers with a child aged 3 to 5 years were enrolled using purposeful sampling with maximum variation. For collecting data, semi structured interviews and open-ended responses to mother's experiences of toilet training were used. The research environment was proportional to the qualitative research, the building of the health center. Interviews were recorded, handwritten and analyzed according to the method of "Content Quality Analysis".
The age range for mothers to start toilet training was two years and one month.
The decision to start toilet training has been on the advice of people around you or by finding out about the signs of being ready for children. The procedures used in the pediatric urinary training were "spoken and persuaded, repeated reminders, encouragement, punishment, and the use of various teaching aids." Fear of toilet, stinging with parents, fear of the appearance of urine and feces were among other things that the participants referred to.
This study made it possible to gain a better understanding of the experiences of mothers in toilet training. The dominant or prominent pattern in teaching children was not identified.   It seems that all mothers need education about toilet training for their children.

The nutritional dependency of infants on parents put them among the most vulnerable groups affected by food insecurity. The present study aimed to determine demographic characteristics related to food insecurity in Bushehrian households with infants aged 1-2 years.
In a descriptive and analytical cross-sectional study, 400 mothers with infants aged 1-2 years were randomly selected. The food security situation was measured with a 16-point questionnaire of localized Radimer cornell at three levels of the household, the individual and the child, with the internal consistency of food security as 0.89, 0.82 and 0.79, respectively.
The rate of food insecurity at household, individual, and child level was 51.5%, 22.3%, and 11.3%, respectively. Among the indicators affecting the food insecurity of Bushehrian households were the higher education of the mother (OR=8.09, CI=2.63-24.83), the higher education of the father (OR=8.93, CI=2.9-26.69), employment of the mother (OR=4.09, CI=2.33-7.19), multi-person household (OR=0.3, CI=0.13-0.7), the mother’s age (OR=1.04, CI=1-1.08), income between 10 to 20 million IRR (OR=4.18, CI=2.65-6.61), and income >20 million IRR (OR=17.44, CI=7.71-39.45). Binary logistic regression analysis of food security-related variables showed that only the father’s job and income have an independent effect on food security.
A 2-fold food insecurity at the individual level contrasted with infant’s food insecurity is an indicator of household’s self-sacrifice to prevent infant’s starvation. In the present study, household food security was evaluated quantitatively. Further research in the form of dietary recalls together with clinical trials is recommended to complement the current study.

Hospitalization causes children to be afraid,and this can be an important factor in delaying their recovery. Nurse's dress creates non-verbal communication and creates a low stressed environment . Children prefer colorful skirts to formal dresses  . Therefore, considering that nurses' appearance in treatment centers plays an important role in creating a sense of trust among patients, especially children, it is advisable for nurses to choose the color and design of their clothes in a way that attracts children's trust and attention. The purpose of this study was to influence of the illustrated clothing on fear of admission in children aged 6 to 3 years. In randomized control trial at Imam Reza hospital of Mashhad, 50 children aged between 3 and 6 years old who were admitted and was divided into two groups of intervention and control by simple random assignment. Data were collected using a questionnaire consisting of two sections. In the first part of the form, the individual characteristics were completed by interview and using the children's case file. In the second part, the Child Fear Scale was used to examine the fear. Findings showed that the level of fear was significantly higher in the control group than the intervention group and this difference was statistically significant (p<0.001). The study showed that the intervention with illustrated clothing reduces fear in children, therefore, it is recommended to use the illustrated clothing in the pediatric ward to reduce the child's fear.

Adolescence is one of the most sensitive and most critical stages of human life. An entry in this period, most people are faced with numerous problems including low self-esteem stems. This study aimed to determine the role of attachment styles and personality characteristics in adolescents' self-esteem in Gonabad in 2017.
This study is analytical and cross-sectional and correlational study that on 202 adolescents studying in high school of Gonabad in 2017 was conducted. The samples were selected by random cluster sampling data through Rosenberg Self- Esteem, Collins and Reid attachment styles and NEO Personality questionnaires were collected. Then, with linear regression, Pearson correlation coefficient, t-test and ANOVA tests were analyzed. P-Value at the less level than 0/05 was considered significant.
Between secure and insecure attachment styles with self-esteem in a positive and significant relationship and between anxious attachment styles with self-esteem negative significant relationship there is. In addition to, between the scope of extraversion, agreeableness and conscientiousness with self-esteem there is a positive and significant relationship and between self-esteem with neuroticism scope there is negative and significant relationship.
Regarding the results, hence should be using psychologists, counselors and other effective professionals, to the education of parents and those involved in the educational system with a focus on "how to train children and students with secure attachment styles and personality characteristics positive predictor self-esteem" was taken to prevent the formation of some problems this time.

Infants with life-threatening conditions need to receive palliative care. Nurses should have appropriate attitudes due to their key role in end-of-life care to the patient.Therefore, this study is conducted with the aim of "determining attitude of nurses towards end-of-life care in neonatal intensive care units (NICUs) ".
In this descriptive cross-sectional study, 214 nurses working in Neonatal intensive care unit of medical education centers affiliated to Iran University of Medical Sciences, Shahid Beheshti and Tehran University were selected by available sampling method. The data collection tool was a Frommelt Attitudes toward Care of the Dying Scale (FATCOD). Content validity and reliability of the questionnaire were analyzed and the Intraclass Correlation Coefficient was determined 0.76.
The mean and standard deviation of nurses' attitude toward end-of-life care were 97.8 ± 9.59 out of a total score ranging from 30 to 150, which is more than the mean total score of the tool. Meanwhile, there was a statistically significant relationship between attitude and job position (P = 0.008).
Regarding the mean scores of attitudes obtained by nurses, there seems to be a readiness and willingness to provide end-of-life care education for nurses in neonatal intensive care units. This study suggests the importance of educational planning in order to promote the attitude of neonatal nurses toward end- of- life care and the educational curriculum in this regard

Children with cancer, along with medical treatments, need psychological treatments to overcome their illness and its consequences. The aim of this study was to determine the effects of cognitive-behavioral art-play therapy and cognitive-behavioral story therapy on pain perception and hope in children with cancer.
The current study was quasi-experimental research with pre-post-test and follow-up and control group. The research participants consisted of 36 children with cancer aged 8-12 years old in Amir Hospital, in Shiraz city, who were selected using purposeful sampling method and were randomly assigned to two therapeutic groups and a control group (each group with 12 people). Oucher Pain Scale (OPS-Beyer et al, 1992) and Children’s Hope Scale (CHS- Snyder et al, 1997) was used to measure the dependent variable in pretest, post-test and follow up. The first and second group along with medical treatments received a treatment course on cognitive-behavioral art-play therapy and cognitive-behavioral story therapy in 12 sessions and control group only continued regular medical treatments. The data were analyzed using rank-order repeated measures analysis of variance.
The results revealed that there was a significant difference between cognitive-behavioral art-play therapy and cognitive-behavioral story therapy with control group in pain perception (L=33.005, P <0.001) and hope of children (L=33.67, P <0.001) in post-test and follow-up stages. Also results revealed that there was no significant difference between cognitive-behavioral art-play therapy and cognitive-behavioral story therapy in pain perception, but there was a significant difference between cognitive-behavioral art-play therapy (stronger effect) and cognitive-behavioral story therapy in hope of children.
Cognitive-behavioral art-play therapy has been effective in increase hope and both of cognitive-behavioral art-play therapy and cognitive-behavioral story therapy has been effective in reducing the pain perception of children with cancer. Therefore, we can use these two therapies to improve the hope and decrease pain perception of these children in therapeutic centers.

Maternal BMI and weight gain during pregnancy plays an important role in the outcome of pregnancy. This study aimed to determine the relationship between mother's BMI before the pregnancy with anthropometric indicators and jaundice in neonates of Gonabad city in 2017.
This cross-sectional study was performed on 327 women referring to community health centers of Gonabad city in 2017 by census method. Anthropometric indicators and maternal BMI were collected based on the information in urban health centers records. Data were analyzed by SPSS version 16 and descriptive statistics and linear regression. The significance level was less than 0.05.
The results showed that there was a significant relationship between mother’s primary BMI with weight and head circumference at birth However (P=0/009), there was no significant relationship between height at birth and the bilirubin level in neonates with jaundice and mother's primary BMI (P>0/05).
According to the relationship between mother's primary BMI with anthropometric indicators in neonates, it is necessary to provide nutritional education and counseling for mother in prenatal care while accurate evaluation mother's primary BMI. Therefore, the correction of health behaviors and weight adjustment plays an important role in the occurrence of healthy and unsafe childbirth and the prevention of complications.

Introduction; capitals and cities of many developing countries are the place where children live and work. Street life is accompanied by stress and dangers. One of the biggest dangers is sexual abuse. Antisocial behavior and physical aggression with fear and resentment, are the perpetual effects of child sexual abuse.
the present research is a semi-experimental and experimental research with a pre – test and post – test design with the experimental and control group. The statistical population of this study is sexual abused girls of 11-15 year old in Tehran`s child labor's group in 1397.and the sampling method, sampling available with random assignment. In this way 30 people were selected as samples and divided into two experimental and control groups. Measuring devices for variables aggression and social skills are questionnaire aggression Nielsen and questionnaire social Matson and independent variable is the ten sessions of gestalt group play therapy.
Finding showed that gestalt group play therapy with at least one of the dependent variables had a significant difference in the behavioral approach. (Aggression: P> 0/002    F=23/64) (Social skills: P>0/002 F= 20/695).
the results showed that considering the behavioral and psychological problems of   child sexual abuse in the child labor's group, one of the most effective therapeutic interventions would be gestalt group play therapy.

Childhood is the most important period of human prosperity and the most basic basis for health in the later periods of life, physically, mentally, socially and cognitively. In this regard, one of the most important factors affecting children's overall development is environmental factors. The present study aimed to compare motor competence, developmental dimensions and body mass index of children aged 4-6 in 3 environments; kindergartens, home and nursery in Tehran. This descriptive study was of causal-comparative type. The statistical population of the study was 4-6 years old girls in Tehran city in three different setting environments (home, kindergarten and nursery). Ninety children (30 in each environment) were selected by sampling method and based on inclusion criteria. Data were collected using a personal profile questionnaire, the short form of Bruininx-Oseretsky Expedition Test, anthropometric measurements and body mass index. There is a significant difference between motor skills of children at home, kindergarten and nursery. The kindergarten children have higher prevalence rates than home and nursery children. The effect of different environments on developmental factors was significant in height, percent of fat, shoulder width, pelvic width, and head circumference. Comparing the averages showed that kindergarten children had a higher height and fat percentage compared with children at home and nursery, while children at home had wider shoulder, pelvic and head circumference than kindergarten children. Differences in other developmental factors and body mass index were not significant but the values were higher in home and kindergarten children compared to children in nursery environment. The results showed that the type of environment in which the child was reared influences development of motor skill and some other developmental dimensions.

The death of an important person in every person's life is the hardest event that can experience. In the meantime, the bereaved children   of a vulnerable population are at risk of social and psychological harm.
The aim of this study was to investigate how children understand the concept of death and its components in cognitive-evolutionary periods based on Piaget's theory and Nagy' theory. This is a review study using a qualitative Content research method, the concepts of death in the Piaget and Nagy evolutionary theories are investigated and, with regard to open, axial, and selective coding, are partially conceptualized according to age and developmental stages and psychological features have been extracted. According to the studies, Nagy and Piaget's theories on the concept of death have had a great deal of commonality and complementarity.
Finally, from the implementation of these two theories, four axes or selected codes of the components of death are extracted: stability, generality, non-functionality and causation. The components of stability and causality are fully understood at the age of 7-11 and the rest of the components at the age of 11-16. The results of this research can be useful in improving the study of the evolution of the concept of death in children and the profound understanding of existing theories around this concept. Also, using the results can help raise the awareness of parents, educators, counselors and pediatricians in the treatment of subsequent symptoms of mourning.