نشریه پرستاری ایران
پیاپی 142 (تیر 1402)

The ever-increasing speed of changes in today's world has led to the emergence of an era called uncertainty, and an environment full of opportunities and threats has made the current complex systems a precursor. One of the challenges of accurate and big planning for the future is the uncertainty inherent in the future and rapid changes in various fields in health. A powerful tool that predicts future competitive environments and develops long-term strategy even in environments with the greatest uncertainty is the scenario planning tool. Scenarios are descriptions of future situations and possible events in those situations so that a person can move from their current situation to a planned future. Scenario writing is not only a planning tool, but also an effective learning tool. Thinking about scenarios helps us to understand the logic of development, to recognize driving forces, trends and challenges. Drivers are a set of future-shaping forces that affect different futures globally or locally. Proponents perform the task of advancing and solving challenges simultaneously. For its development and sustainability, nursing education needs drivers so that it can maintain its existence in a turbulent age. Drivers are the main factors consisting of several processes that cause change in a studied area. Nursing education in the country, while having many challenges and crises, has diverse and somewhat unknown capacities. Drivers and trends that, if identified and applied, can overcome some of the existing challenges. Therefore, the current research tries to identify the key factors and the main drivers involved in nursing education and then by designing the desired and probable scenarios in the future, it provides a framework for policy making and flexible planning according to the conditions. Therefore, the current research was carried out with the aim of scenario planning the future of nursing education in Iran.

This research was conducted with an exploratory nature and with the aim of knowing the leading futures in the field of nursing education in Iran in the undergraduate course. In the first stage, in order to identify drivers and trends, qualitative interviews with nursing professors of Iran and Delphi universities were used. Sandelowski and Barroso's seven-step method was used for synthesis. In the second step, a semi-structured interview was used. The participants were selected in a goal-based way from nursing professors who had managerial experience in nursing education. Interviews were conducted by phone and in person. The Shannon entropy method was used to analyze the content of the codes. In the third step, the Delphi method was used to confirm and evaluate the drivers identified. 30 people, including nursing specialists (members of nursing board and teaching assistants and managers of nursing departments in all nursing schools of medical sciences universities of the country) participated in the research by means of targeted sampling. A report of the drivers and trends obtained from the previous stage along with a summary of the research method and research objectives was sent to the members. For evaluation, scoring was used in the form of 0 to 5. This process continued in three consecutive rounds of e-mail and face-to-face visits. Then, using a panel of experts, the influence and uncertainty of the identified trends were scored. In the next step, using influence/uncertainty diagrams, the key axes for writing the scenario were determined. Scenarios were designed by Scenario Wizard software version 11/4 and strategies were presented. The validity of the scenarios was examined from the four perspectives of feasibility, internal consistency, usefulness and differentiation. All four conditions were acceptable according to the experts.

In the meta-synthesis stage, after internet search, 723 articles were reviewed, among which nine articles were used for the final analysis. At the end of this stage, the researcher identified 127 codes, which according to the purpose of the research and also based on the semantic proximity and the only verbal difference between some codes, the codes were merged and brought under a common title. Finally, 24 codes were identified. In the next step, considering the concept of each of these codes, they were categorized into a similar concept. In order to evaluate the quality, the results were given to one of the experts to be evaluated by the Kappa index. Using SPSS version 16 software, at a significance level of 0.05, this coefficient was obtained as 0.83, which shows the appropriate reliability of the codes. In the interview phase, 17 nursing professors (2 professors, 6 associate professors, 6 assistant professors, and 3 instructors) with an average clinical experience of 16 ± 1.2 years and an average managerial experience of 6 ± 3.1 years were interviewed. A total of 23 interviews were conducted with an average of 25-30 minutes. 15 of the interviews were conducted over the phone and the rest of the interviews were conducted in person. In this step, 356 codes were obtained. The findings of the content analysis were categorized using Shannon's entropy, and the results were entered into the next step for agreement and confirmation. In the third step, the experts agreed on 6 drivers and 31 trends. With five key uncertainties, the scenario was designed in three optimistic, intermediate and pessimistic assumptions. According to the size of the matrix and its dimensions (15 x 15), four problem-oriented, ethical, maintaining the status quo and closed educational system scenarios were reported for nursing education in Iran.

In the current study, four different scenarios were designed. Ultimately, each of these scenarios is believable and each has the potential to be realized, but which one will happen depends on today's plans. Scenarios have no prescription for the future itself, but rather a short film of the possibilities that may occur. This research is an analysis of the reliable results of our current possible actions. Further researches can obtain indicators for these scenarios. The application of future planning methods such as scenario in Iran's national health system can be considered as a warning system for awareness of opportunities and threats before the crisis. In order to improve the future of nursing education in Iran, it is recommended to form an expert working group with technical skills of scenario planning for more coordination in the strategic planning of specialized and sub-specialized fields and to formulate a comprehensive plan for the correct implementation of future planning projects. The manager or decision maker of the health field can see the serious part of the consequences of different decisions in the form of future scenarios of experience and future failure points right now.

Admitting a child to a pediatric intensive care unit (PICU) brings various physical, psychological and social consequences for parents. Supporting parental self-efficacy is a step to ensure successful implementation of pediatric care. Therefore, it is necessary to provide appropriate interventions to reduce anxiety and stress and improve self-efficacy of parents. Although mobile-based education has been used for patients in many studies, its use for family caregivers of children admitted to PICU is limited. This study aims to assess the effect of a mobile-based educational program on the anxiety and self-efficacy of mothers with children admitted to PICUs in Iran.

In this quasi-experimental study, participants were 60 mothers of children admitted to the PICUs of hospitals in Shahrekord, Iran from April to August 2022. They were selected using a convenience sampling method and were divided into two intervention and control groups. The intervention group received a mobile-based educational program for four days, one session per day, each for  60 minutes. For the control group, routine education was given by the ward nurses. Data were collected by Spielberger’s state-trait anxiety inventory and Schwarzer & Jerusalem’s general self-efficacy scale. Data were analyzed using descriptive and inferential statistics.

The mean self-efficacy score in the intervention group increased significantly compared to the pre-intervention score (from 19.60±4.01 to 21.87±5.13; P<0.001), but no significant difference was observed in the control group (from 18.53±4.23 to 19.30±5.40; P=0.393). In the intervention group, the mean anxiety score decreased significantly compared to the pre-intervention score (from 47.33±5.52 to 43.63±5.27; P=0.001) but no significant difference was observed in the control group (from 48.30±6.88 to 46.43±9.02; P=0.131). There was no significant difference between the two groups in anxiety and self-efficacy scores before and after the intervention (P>0.05).

Nurses can reduce anxiety and increase the self-efficacy of mothers of children admitted to PICUs by using other measures along with virtual education, which requires more research in this field.

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

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

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

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

Patient care is the basis of the nursing profession, and the theoretical principles of nursing are based on understanding caring behaviors. Self-compassion can be a powerful source for these behaviors. This study aims to investigate the relationship between self-compassion and caring behaviors of Iranian nurses during the COVID-19 pandemic.

This cross-sectional study was conducted on 124 nurses working in selected hospitals affiliated to Iran University of Medical Sciences from March to May 2022. They were selected using a convenience sampling method. Data collection was done using a demographic/occupational form, Wolf’s caring behaviors inventory (CBI), and Neff’s self-compassion scale (SCS). After collecting the data, they were analyzed in SPSS software, vesion 22 using Spearman’s correlation test, Mann-Whitney U test, Kruskal-Wallis test, and linear regression analysis.

The mean total score of CBI was 82.06±7.76, which is a relatively high score. The highest score was related to the dimension of knowledge and skill. The mean total score of SCS was 79.47±12.73. The results of the Spearman correlation test showed that the relationship between self-compassion and caring behaviors was positive and significant (P<0.05). Also, the linear regression model showed a significant and direct linear relationship between the two variables.

Self-compassion of nurses has a significant relationship with their caring behaviors during the COVID-19 pandemic. With the increase of self-compassion, their caring behaviors improve. It is recommended to teach nurses self-compassion skills to improve their caring behaviors.

Breast cancer (BC) is one of the important challenges of the health system due to its impact on marital relationships. This study aims to compare sexual function and sexual distress of women with and without BC.
Materials & Methods In this case-control study, 75 women with BC and 75 healthy women from Zanjan, Iran participated. Data were collected using a demographic form, the female sexual distress scale-revised (FSDS-R), and the female sexual function index (FSFI). Data analysis was done in SPSS software, version 20 using the Mann-Whitney test and multivariate analysis of covariance.

The mean age of patients was 36.49±6.53 years and the mean age of controls was 36±0.72 years. There was no statistically significant difference between the two groups in terms of some demographic variables such as age, educational level of women and their husbands, occupation of women and their husbands, place of residence, and number of children (P>0.05). The mean score of FSFI in all subscales in the patient group was lower than in the control group. This difference was statistically significant only in the dimension of desire (P=0.003). regarding the sexual distress variable, the mean FSDS-R score of healthy women was lower than that of women with breast cancer, but this difference was not statistically significant (P>0.05).

The difference between women with and without breast cancer is significant only in the desire domain of sexual function. There is no statistically significant difference between the two groups in sexual distress and in other domains of sexual function. The sexual problems of women with BC require consideration and support, and provding counseling in terms of sexual function.

safe nursing care is the use of knowledge and skills by nurses to provide quality patient care and it is considered one of the health goals in intensive care units. The feeling of being supported by the hospital play a key role in achieving this goal; it  can lead to job satisfaction, good job performance, and patient satisfaction. This study aims to determine the relationship between perceived organizational support and safe nursing care in nurses working in the intensive care units (ICUs) of public hospitals in Tabriz, Iran.

This is a descriptive-correlational study with a cross-sectional design that was conducted on 200 nurses working in the ICUs of hospitals affiliated to Tabriz University of Medical Sciences in 2021-2022, who were selected using a quota sampling method. Eisenberger et al.’s perceived organizational support scale and Rashvand et al.’s safe nursing care questionaire were used to collect data. Data analysis was done in SPSS v.16 software using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, analysis of variance, and Pearson correlation test). 

The mean score of perceived organizational support was 23.20±9.57, which was lower than the cutoff point. Safe nursing care was at a favorable level with a mean score of 322.89±34.1. The perceived organizational support had no statistically significant correlation with safe nursing care and its dimensions.
Conclusion Despite the unfavorable perceived organizational support of ICU nurses in Tabriz, their safe nursing care is favorable. There is no statistically significant relationship between their perceived organizational support and safe nursing care. This finding is probably due to the prevailing rules and professional beliefs in the work of nurses, which has caused the care provided to be safe despite the perception of low organizational support.

Healthcare providers are responsible for providing services to mothers and infants during disasters. The purpose of this study is to determine their educational needs for maternal and newborn care during disasters in Iran.
Materials & Methods This is a cross-sectional study that was conducted in 2017 on 208 healthcare providers (nurses, practical nurses, and midwives) from nine armed forces hospitals in Tehran, Iran who were selected by a census method. The data collection tool was a researcher-made questionnaire with acceptable face validity, content validity, and structure, with a Cronbach’s alpha of 0.94. The data were analyzed using descriptive and inferential statistics in SPSS software, version 16.

The mean score on the educational needs assessment scale was higher in the fields of sexual violence management (4.30±0.01) and information management (4.28±0.01), indicating the high need for education in these areas. The lowest scores were in the fields of postpartum care in newborns (2.19±0.96) and responsiveness (2.98±0.89). In total, the educational needs of healthcare providers were high (3.3±0.43).

The readiness of healthcare providers in Iran to provide maternal and newborn care during disasters is low and needs more attention. Therefore, it is recommended to compile and revise university educational programs and implement continuous education programs based on the results of this study in the proposed areas (especially sexual violence management and information management) in a regular, periodic, and continuous manner.

The numerous problems of children with congenital heart disease (CHD) and their care burden can reduce the quality of life of parents, especially mothers. Compliance with treatment after discharge from the hospital is crucial. It is necessary to provide home care educational programs for them. Given the advance of technology and the popularity of mobile phone use, this study aims to design an educational mobile application for home care after surgery to improve the quality of life and adherence to treatment in mothers of children with CHD in Iran.

This is a study protocol on 72 mothers of children with CHD referred to the Children’s Medical Center of a hospital (affiliated to Tehran University of Medical Sciences) for surgery. The data collection tools will be a demographic form, the 36-Item Short Form Health Survey (SF-36), and Fatemi et al.’s Adherence to Treatment Questionnaire. Data collection will be done before and one month after the intervention. The collected data will be analyzed using mean and standard deviation, independent t-test, paired t-test, chi-square test, Fisher’s exact test, and Mann-Whitney U test.
Results The results will be analyzed to assess the effectiveness of the mobile-based educational intervention in improving the quality of life and adherence to treatment of mothers of children with CHD.

This is the protocol of a study that examines the effect of a mobile-based post-surgery home care training application on the quality of life and adherence to treatment of mothers. The results of such studies can help identify the faster, easier and more effective methods of patient education.