Iranian Journal Of Nursing and Midwifery Research
Volume:30 Issue: 2, Mar-Apr 2025

Accurate and complete intraoperative documentation is crucial for maintaining consistency in patient care, facilitating handoffs between surgical teams, and evaluating outcomes. This integrative review aimed to investigate the challenges of intraoperative documentation and its role in patient safety.

A search of English‑language databases including EMBASE, Proquest, Web of Science, PubMed, ScienceDirect, and Scopus was conducted from 2001 to 2022 using the keywords “intraoperative documentation”, “patient safety”, “documentation”, and “intraoperative”.

Nineteen articles were included from the initial 86 identified studies. Key findings were that protocols, safe surgical plans, accurate documentation, error/complication prevention measures, teamwork, safety culture, checklists, and instrument/sponge counts positively impact patient safety.

Operating rooms require precise patient information and documentation pre‑, intra‑ and post‑operatively. This review indicates intraoperative documentation can improve surgical team performance and patient safety by facilitating continuity of care, handoffs, and outcomes assessment.

Clinical nurses often encounter situations that challenge their professional integrity and values. In the face of these issues, many nurses have been subjected to moral outrage (MO) in response to moral violations by others, which can have different outcomes. This scoping review aimed to synthesize and summarize findings from existing articles regarding the consequences of moral outrage among nurses.

This paper presents a scoping review based on the Joanna Briggs Institute (JBI) methodology. PubMed, Springer, Scopus, and ScienceDirect databases were systematically searched using the keywords “moral outrage”, “nurses or nursing” and “consequences or outcomes or impacts or effects or influences of moral outrage” (viz., moral OR ethical AND outrage AND nurse*). The PRISMA checklist was used for the scoping review to evaluate articles thoroughly. The results were summarized using the inductive content analysis suggested by Elo and Kyngäs.

In total, 1014 articles were identified as potentially relevant to this study with 34 articles synthesized, including 24 qualitative studies, 5 quantitative studies, and 5 reviews focused on the consequences of moral offenses in nursing. Negative consequences such as mental exhaustion, job burnout, and interpersonal failures were observed, alongside positive consequences like nurses’ altruism, callousness, and professional solidarity.

These findings underscore the importance of addressing MO among nurses to prevent negative consequences such as burnout and moral degradation. Moreover, recognizing and fostering the altruistic and resilient aspects of nurses in response to moral outrage can lead to a more positive work environment and improved patient care.

COVID‑19 causes many respiratory problems. The most common clinical manifestation is acute respiratory failure. Respiratory rehabilitation is an important part of treatment, but little is known about it. This study was carried out to determine the effect of deep respiration and prone position on common respiratory symptoms in patients with COVID‑19.

In this clinical trial that was conducted in a hospital in Yasuj city, Iran, in 2021, 96 patients with COVID‑19 were selected using a non‑random convenience sampling method and were randomly assigned to three groups of deep respiration, prone position, and deep respiration and prone position. Data were collected using the Borg Rating of Perceived Exertion scale, the Visual Analog Scale, pulse oximetry, and a researcher‑made checklist of patients’ respiratory rates. The interventions were performed for 1 week (2–8 hours daily) based on patient tolerance. Data were collected before and immediately after the intervention.

There was no statistically significant difference (p > 0.05) among the three groups in terms of mean score of shortness of breath, intensity of symptoms, oxygen saturation of blood, and respiration rate before the interventions; however, significant differences were observed after the interventions (p < 0.05) in the three groups.

Deep respiration with prone position could improve respiratory symptoms in patients with COVID‑19 more than deep respiration or prone position alone. Respiratory exercise should be considered as a part of nursing cares and patients with respiratory symptoms should receive education in this regard.

Non‑pharmacological methods, either independently or in combination with pharmacological methods, are increasingly used for pain prevention and management. The aim of this study was to investigate the effect of Nature‑Based Sound Therapy (NBST) on Apgar score after Cesarean Section (CS) under Spinal Anesthesia (SA).

This randomized clinical trial was conducted from April to December, 2020. Participants were 92 candidates for elective CS under SA conveniently selected from Motahhari hospital, Jahrom, Iran. They were randomly assigned to a control group (n = 46) and an NBST group (n = 46). Participants in the NBST group listened to nature‑based sounds from twenty minutes before entering the operating room to the time of childbirth using an MP3 player and a headphone. Neonatal Apgar score was measured at minutes 1, 5, 10, 15, and 20 after birth.

There were no significant differences between the study groups respecting participants’ demographic characteristics (P > 0.05). The mean of 1‑minute Apgar score in the NBST group was significantly more than the control group (P = 0.003).

NBST is effective in significantly improving Apgar score after CS under SA and can be used to improve neonatal outcomes.

Caregivers of cancer patients experience significant challenges that affect their physical, psychological, and social well‑being. This qualitative study aims to explore the specific challenges faced by caregivers of cancer patients during the COVID‑19 pandemic.

The present study is a conventional qualitative study based on the Graneheim method for content analysis. Data were collected through semi‑structured individual interviews with 11 family caregivers of cancer patients in Isfahan, Iran.

The challenges faced by family caregivers of cancer patients are classified into three main categories: 1) caregiver burnout which includes, “non‑cooperation of the patient with the caregiver,” “funding the costs of care and treatment,” “lack of support for the family caregiver by the family and society,” and “lack of knowledge and proper care skills.” 2) Health threats to the family caregiver which include, “imbalance of self‑care versus patient care,” “disruption of a healthy lifestyle,” and “occurrence of psychophysical symptoms caused by stress in caregivers.” 3) Work‑family‑care conflicts which include: “conflict between patient care and family” and “conflict between patient care and work.”

This study provides additional insights into the personal and societal challenges faced by family caregivers of cancer patients during the COVID‑19 pandemic. Based on our findings, health policymakers can take concrete steps to address these challenges and enhance the support for family caregivers, who play a crucial role in public health.

In Iran, Afghan women should be able to use the same maternal services provided to natives. Improvement of the utilization of maternal healthcare services (MHCS) requires knowledge of the specific needs of refugees. In this regard, the present study aimed to explore current use and barriers to healthcare service utilization among Afghan women refugees.

This sequential explanatory study with a mixed‑method design combined two sources of data, namely quantitative data based on data routinely collected from March 2022 to March 2023 in Zahedan city and qualitative data collected from interviews with Afghan women (n = 10) and local managers (n = 6). Purposeful sampling was used to select Afghan women refugees from birth centers. Inductive thematic analysis was used for qualitative data.

Only 7% of Afghan women attended antenatal care five times or more at 37–39 weeks of pregnancy. Moreover, 20.45% of Afghan women used traditional birth attendants in their recent birth (F1 = 3764.01, p < 0.001). Qualitative data showed that financial barriers (especially lack of insurance and low family income) were the most important barriers to poor access to antenatal and hospital services. In addition, obtaining poor or insufficient care was another barrier to the use of care.

The findings highlighted that Afghan women face different barriers to utilizing MHCS. These barriers should be addressed through collaboration between regional, national, and international agencies to provide community‑based interventions, address the health needs and expectations of the local community, and improve the utilization of MHCS.

Considering the importance of Knowledge Sharing (KS) among nurses, this research aimed to investigate the factors influencing the motivation of nurses for sharing knowledge online.

This research was a questionnaire survey. The statistical population included all 1403 nurses working in the hospitals of Hamadan, Iran, and the sample size was estimated to be 302 participants. The collection tool was a questionnaire adopted from the research by Nguyen et al., and its reliability and validity were measured and confirmed. Structural equation modeling was used to test the research hypotheses using PLS 3.

Of the studied nurses, 78.15% use the Internet “moderate” to “very much.” Self‑efficacy (β = 0.24, t = 5.03, p < 0.001), reputation (β = 0.54, t = 10.96, p < 0.001), and reciprocity (β = 0/09, t = 2.081, p = 0.04) had a direct and positive impact on the online KS behavior of nurses. In addition, the top management support and individual innovation capability did not have a moderating role in the effect of reciprocity, reputation, and self‑efficacy (p > 0.05) on the online KS of nurses.

This study helps to understand that reciprocity, reputation, and self‑efficacy are the factors influencing the increase of online KS among nurses, and it is necessary to support the creation of online space for facilitating reciprocal relationships and interpersonal interactions of nurses to increase their online KS.

With the increase in the proportion of working women, the workplace is fundamental in supporting breastfeeding. Jordan is among the lowest countries in exclusive breastfeeding for infants. This study aimed to assess the perceived workplace breastfeeding support among employed mothers in Jordanian universities.

Data collection took place between October 2021 and February 2022. A quantitative descriptive cross‑sectional design was used to collect the data from six universities. Convenience sampling was used to include 210 women who had children less than three years old. The Employee Perceptions of Breastfeeding Support Questionnaire was used, and the data were analyzed using descriptive statistics and correlational analysis.

Workplace breastfeeding support was perceived as moderate in accordance with the Employee Perceptions of Breastfeeding Support Questionnaire. The Mean (SD) of organizational support was 27.70 (5.60), manager support was 28.20 (5.80), co‑worker support was 15.0 (3.30), available time was 6.50 (2.30), and physical environment aspect of support was 17.20 (2.80). No significant differences in perceived workplace breastfeeding support concerning work sectors or exclusive breastfeeding were found. 

The levels of perceived workplace breastfeeding support were moderate. Improvements are suggested in workplace policies, managers’ and co‑workers’ awareness and openness about supporting employed mothers, flexibility and time availability to facilitate breastfeeding/pumping, and appropriate locations for employed mothers to perform breastfeeding/pumping conveniently. Further research in diverse job settings is required to examine the relationship between workplace breastfeeding support and the duration of exclusive breastfeeding.

Obesity among girls can lead to physical, psychological, or social problems. Enhancing self‑esteem and reducing self‑stigma toward obesity can play a crucial role in girls’ health. This study aims to assess girls’ self‑esteem and its association with self‑stigma toward obesity.

A descriptive cross‑sectional design was used to meet the study’s objective. A convenience sampling method was used to gather the sample from 24 middle and high schools in five cities across Iraq from (January 2023 to March 2023). A total of 1326 girls participated in the study. Weight Self‑Stigma Questionnaire and Rosenberg Self‑Esteem Scale were used to assess self‑stigma and self‑esteem regarding obesity. Pearson’s rho (r) and one‑way ANOVA were used to analyze the data by SPSS version 26.

In total, 1200 girls scored on weight self‑stigma and self‑esteem, and the means (SD) were 29.28 (±7.06) and 30.47 (4.43), respectively. The results revealed that there was a significant negative correlation between weight self‑stigma and self‑esteem (r = ‑.404, p < 0.001).

Iraqi girls with higher obesity‑related stigma have lower self‑esteem. Hence, as obesity can affect girls’ body image, increasing girls’ self‑esteem can reduce their weight self‑stigma.

The prevalence of Internet Gaming Disorder (IGD) among elementary school children has raised concerns about its potential negative impact on academic performance, social interactions, and overall mental well‑being. In response, this research assessed the impact of the parenting Practice‑Based Care Module (PPCM) as an effective preventive strategy to empower parents and promote balanced gaming behavior in their children.

A quasi‑experimental study was conducted with 170 parents from Gresik Regency, Indonesia, in December 2022 using a non‑randomized control group pretest‑posttest design. The intervention group received psychoeducation and training on the PPCM, while the control group received training after data collection using a valid, reliable questionnaire.

The results are showed that the PPCM significantly improved parents’ ability to prevent IGD in their children. Eight parental factors significantly influenced endogenous variables, including parental responsiveness, mediation mechanism, parenting style, and parents’ ability to prevent IGD, with R2 values in the “good” range (0.50 to 0.75), explaining 60.60% of the variation. The model’s strong predictive relevance (Q2 values > 0) supported its effectiveness. Hypothesis testing revealed significant effects, such as parental responsiveness on the mediation mechanism (t‑statistic: 3.92) and mediation mechanism on parenting psychoeducation (t‑statistic: 2.60). Parenting style also positively impacted parents’ ability to prevent IGD (t‑statistic: 4.82). Notably, child factors had the most significant influence on parental responsiveness (path coefficient: 0.23).

This research underscores parents’ pivotal role in addressing IGD in elementary school children. The PPCM significantly enhances IGD prevention through key parental factors. Collaboration is essential for fostering a healthy digital environment.

The fertility rate has declined in many countries over the past decades. Fertility intention is the determinant of fertility behavior. Various factors may affect the fertility intention of couples with no or healthy children. However, some parents may also have children with intellectual disabilities that affect their childbearing. Therefore, the main objective of this study is to identify predictors of fertility intention in parents with educable intellectually disabled children.

The present study was a descriptive cross‑sectional study conducted on 193 parents with educable intellectually disabled children living in Isfahan. Sampling was implemented using clustering and the classification method from February to July 2019. Data were collected through a self‑report questionnaire and analyzed using SPSS 20, logistic regression, and independent t‑tests.

Approximately 83.9% of participants had negative fertility intentions. Predictors of fertility intention were perceived behavior control (95%CI: 1.14‑ 1.42; p = 0.001; OR = 1.28), attitude (95%CI: 1.06‑ 1.24; p = 0.001; OR = 1.14) and subjective norm (95%CI: 1.08‑ 1.33; p = 0.001; OR = 1.20), respectively. On the other hand, the perceived behavioral control was the strongest predictor. The son preference was higher in parents with positive fertility intentions (p < 0.05).

According to the results of the present study, it seemed that factors such as perceived behavior control, attitude, and subjective norms affected fertility intention in parents with intellectually disabled children. Therefore, it is suggested to gain knowledge about the roles of these predictors and counsel parents to choose contraceptive methods or encourage them in childbearing.

The failure to lose postpartum weight retention (PPWR) can impact obesity in later life, making programs aimed at reducing PPWR crucial. The study aimed to assess the effect of a self‑weight approach combined with dietary and physical activity interventions to reduce PPWR.

This quasi‑experimental study employed a three‑group, pretest–posttest design. The study recruited 178 postpartum mothers who attended a 6‑week postpartum check‑up at a university hospital in Chiang Mai, Thailand, from 2018 to 2020. Data was collected using a self‑administered questionnaire. The intervention groups received dietary counseling combined with self‑weighting (D) and diet and physical activity counseling combined with self‑weighting (DP), while the control group received standard care. Analysis of covariance was used for data analysis, with pre‑pregnancy weight as the covariance.

PPWR was 3.39 kg for the D group, 3.20 kg for the DP group, and 4.14 kg for the control group (F (2,174) =1.91, p > 0.05). At 6 months postpartum, on comparing self‑weighting and non‑self‑weighting groups, it was found that PPWR was 2.88 and 3.99 kg for the self‑weighting and non‑self‑weighting groups, respectively (t176= ‑2.28, p = 0.024).

The study results indicated that dietary or combined dietary and physical activity counseling for postpartum mothers is necessary. For optimal success, postpartum mothers should be encouraged to undertake daily or weekly self‑weighing to reduce PPWR.

The advancement of information technology opens up new possibilities for integrating mobile health into healthcare services. The Breast Milk Mother applications offer an alternative to provide information on breastfeeding. This study aims to analyze the effectiveness of the Breast Milk Mother mobile applications in increasing knowledge, attitudes, breastfeeding timing, and breast milk adequacy for infants.

This quasiexperimental study with a pre‑post control design was conducted in 2022 in Candirejo, Magetan, East Java, Indonesia. The sample consisted of 100 pregnant women in their third trimester until their infants were 7 days old, divided into two groups: intervention (50) and control (50). Purposive sampling was used, with the intervention group receiving the Breast Milk Mother applications, while the control group received breastfeeding counseling. Data on knowledge and attitude were collected using questionnaires and analyzed using the Mann–Whitney U test and Wilcoxon test, with significance set at p < 0.05.

There was no significant difference in knowledge and attitudes between the intervention and control groups before treatment (Z = ‑0.40, p > 0.05 and Z = ‑0.66, p > 0.05). After treatment, significant differences were found (Z = ‑7.81, p < 0.001 and Z = ‑5.76, p < 0.001). In both groups, significant improvements in knowledge and attitudes were observed post treatment (Z = ‑6.10, p < 0.001 for the intervention group and Z = ‑5.66, p < 0.001 for the control group).

The Breast Milk Mother mobile applications effectively improve knowledge, attitudes, breastfeeding timing, and breast milk adequacy for infants. The Breast Milk Mother mobile applications support exclusive breastfeeding and enhance midwifery services.

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

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

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

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

The breastfeeding pattern of mothers in different societies has its roots in different social and cultural issues. Recognizing the significance of this issue and the absence of similar research in the western region of Iran, this study explored the relationship between perceived stress and breastfeeding patterns among primiparous mothers.

This cross‑sectional study was conducted on 269 mothers from January to May 2023 in the city of Hamadan, Iran. The demographic and midwifery information questionnaire and the perceived stress scale (PSS) were used. Data analysis was performed using Stata software, with the significance level set at 0.05.

In the present study, only 24.16% of breastfeeding mothers breastfed exclusively. The findings showed that with each unit increase in the perceived stress score, the chance of not exclusively breastfeeding increased by 54%. Moreover, with each year of increase in the mother’s age, the chance of not exclusively breastfeeding decreased by 15%.

The results showed a negative association between stress and exclusive breastfeeding. Therefore, it is recommended that mental health promotion be incorporated into policy‑making and planning for maternal and neonate healthcare to ensure the continuation of exclusive breastfeeding.

Nursing students required to be prepared to face ethical problems in their future workplace. Solving moral dilemmas requires the implementation of moral decisions, which necessitates significant moral courage. Moral sensitivity and moral reasoning can play a key role in the emergence of morally courageous behavior. The aim of this study was to investigate the relationship between moral sensitivity and moral reasoning with moral courage in nursing students.

This was a cross‑sectional study. The participants consisted of 296 nursing students of Isfahan University of Medical Sciences, Iran, in 2021, which selected through the census method. Data were collected using the Persian versions of the Moral Sensitivity and Sekerka’s Moral Courage questionnaires and Nursing Dilemma Test. Data were analyzed by SPSS software (v. 25.0) using descriptive and analytical statistical methods (t‑test, ANOVA, Pearson correlation, and regression analysis).

A total of 296 nursing students participated in this study. The results showed no significant correlation between moral sensitivity and moral courage (r = 0.04, p = 0.41); however, a significant positive correlation was observed between moral reasoning and moral courage (r = 0.19, p < 0.05). The results of multiple regression analysis showed that moral reasoning was the only predictor of moral courage in nursing students (p < 0.05).

Moral reasoning ability played a more significant role in developing moral courage than moral sensitivity. Tracking the sensitivity, reasoning, and moral courage status during education can reveal valuable information on the process of moral practice formation in nurses.

Evaluating the efficacy of educational programs is a good way to assess the current situation, which requires the use of valid tools in this area. Therefore, the purpose of this study was to translate and evaluate the psychometric properties of the Persian version of the Nursing Student Satisfaction Scale (NSSS).

The NSSS was translated from English to Persian using the standard forward‑backward method. After face validity, content validity was performed with qualitative method and quantitative method with CVR and CVI calculation for each item. Using convenience sampling, 297 nursing students were selected and completed the questionnaire. Exploratory factor analysis (EFA) and Confirmatory Factor Analysis (CFA) in SPSS and AMOS software were used to evaluate the construct validity of the scale.

In face validity, some items were modified based on the opinion of the target group. Item impact score for each item was at least 1.7 to 2.5. Moreover, S‑CVI/Ave = 0.966, S‑CVI/UA = 0.706, and the content validity ratio for each of the items was 0.87‑1. According to the results of factor analysis, the three factors introduced in the main tool were approved with acceptable values. All indices of CFI = 0.906, ÷2/df = 1.572, and RMSEA = 0.0609 confirmed the fit of the final model. In addition, the reliability of the instrument obtained using the internal matching method (Cronbach’s alpha) for the whole instrument was 0.90.

The Persian version of the NSSS has acceptable psychometric indicators in the population of Iranian nursing students.

Cancer during the novel coronavirus disease 2019 (COVID‑19) pandemic has changed, leading to challenges in the management of the two serious health conditions of cancer and COVID‑19. This study was conducted to explore the experiences of cancer care among hospitalized patients with cancer and oncology nurses in the COVID‑19 pandemic environment.

This descriptive qualitative study included interviews with patients with cancer and oncology nurses. Observations and field notes were recorded. In this study, we purposively recruited 11 patients and 10 oncology nurses from a tertiary referral hospital affiliated with the Tabriz University of Medical Sciences, northwest Iran. Face‑to‑face interviews were conducted between June and July 2021. The interviews were recorded, transcribed verbatim, open‑coded, and analyzed thematically. All these steps were managed using MAXQDA 10.

Three themes were generated regarding patients’ and nurses’ experiences of cancer care during the COVID‑19 pandemic: 1) feeling scared and neglected, 2) appearance of fundamental changes in all aspects of life, and 3) facing challenges beyond routine cancer care.

This study demonstrates the experiences of a “vulnerable” population during the COVID‑19 pandemic. Understanding the experiences of patients with cancer and frontline healthcare providers during this unprecedented time of COVID‑19 can help provide guidance and support for health policymakers in evidence‑informed decision‑making for cancer care beyond the COVID‑19 pandemic era.

Due to its unknown nature, multifaceted symptoms, and rapid spread, the coronavirus has become a public health emergency, leading to international concerns. Therefore, this study aims to investigate the community’s educational needs during the COVID‑19 pandemic.

This qualitative research was conducted between 2020 and 2021 using a conventional content analysis approach. The research sample comprised 340 recorded calls from individuals who contacted the emergency hotline of Isfahan University of Medical Sciences during the COVID‑19 pandemic to express their concerns and anxieties. Sampling was conducted randomly and purposively until data saturation was achieved. Additionally, Graneheim and Lundman’s approach was utilized for data analysis.

After analyzing the interviews, codes related to the reasons for contact were presented in five main categories, including awareness of the nature of the disease, awareness of preventive methods, awareness of diagnostic methods, awareness of treatment methods, and awareness of caring for high‑risk groups and 15 subcategories.

The results of this study highlighted various concerns regarding the coronavirus disease during pandemic conditions, which can serve as a foundation for appropriate educational and counseling programs based on community needs during future infectious pandemics.

Red blood cell Distribution Width (RDW) can help diagnose blood diseases and predict mortality in heart disease. Fatigue is one of the common symptoms of Acute Myocardial Infarction (AMI) and can affect the quality of life of patients. This study aimed to investigate the link between RDW at admission and fatigue severity 2 weeks after AMI.

This cross‑sectional study examined 250 consecutive patients with AMI during 2023–2024. The patients were assessed for RDW and other laboratory and demographic variables within 24 h of admission. The Fatigue Severity Scale (FSS), which is a 9‑item and 7‑point scale, was completed for patients. A score >36 was considered as Post‑AMI Fatigue (PAF) and lower as non‑PAF. Data analysis was performed by SPSS version 22 and R version 4.2.2 software.

Our findings indicated that 71.20% of patients experienced fatigue after AMI. There were no significant differences between age, gender, laboratory parameters, past medical history, underlying diseases, and blood pressure of patients with and without fatigue (p > 0.05). RDW distribution for non‑PAF and PAF was 13.30% [12.50, 14.60%] and 13.30% [12.80, 14.00%], respectively, (p = 0.726). Multivariable regression results based on three models did not show any significant findings.

The present study is the first study, designed to determine the predictive value of RDW on post‑AMI fatigue, as far as we searched the recent literature. We did not find any significant relation between RDW and PAF. Therefore, it cannot be used to predict fatigue in patients with AMI until definitive results are found.

Dear Editor,Mobile health (mHealth) has many advantages and has become much more prominent in health systems due to the rapid development of artificial intelligence. However, Rahimi et al. (2022)[1] showed that the use of mHealth software is not common among Iranian nurses and patients. Considering that nurses are the largest part of the healthcare workforce, the effect of using mHealth programs by nurses is very important for the future of modern healthcare. The absence of an appropriate information technology infrastructure, weakness culturalization of the use of mHealth services, the high expenses of maintaining health information technology, and inadequate budget allocation are among the challenges in the field of mHealth.