مجله علوم مراقبتی نظامی
سال یازدهم شماره 4 (زمستان 1403)

This article explores the role of nurses in public policymaking through a constructivist lens. As the largest workforce in the healthcare system, nurses—positioned on the front lines of patient care and in close contact with patients and their families—develop a profound understanding of how public policies affect community health. This unique perspective equips them with valuable nursing insights that not only contribute to enhancing healthcare policies but also support broader health-focused public policies. However, systemic barriers, limited political awareness, inadequate education and motivation, and a lack of representation in political and policy-making processes often prevent this potential from being fully realized. As a result, the expertise and advocacy skills of nurses remain underutilized. To empower nurses in this crucial area, it is essential to expand their knowledge of politics and policy, foster interdisciplinary collaboration, remove obstacles to participation, and unlock their capacity to influence public policy. These efforts can strengthen healthcare policies while also improving the overall management of public policies' impact on community health.

Schizophrenia is a severe mental disorder characteristics by abnormal thoughts, patterns, cognitive impairments, and either a diminished or exaggerated expression of emotions. This disorder follows a chronic clinical course, with many many individuals experiencing symptoms over extended periods. Patients with schizophrenia often lack insight into their condition, leading to frequent relapses and multiple hospitalizations. mental disordrs Mental disorders, in general, impose a significant burden on caregivers; however, schizophrenia presents unique challenges. Beyond the decline in individual and social functioning of patients and the direct impact of symptoms on caregivers’ quality of life, the early onset and debilitating nature of schizophrenia further exacerbate the strain on family caregivers. This policy brief outlines strategies aimed to reducing the caregiving burden for for families of individuals with schizophrenia.

Moral courage is a key characteristic of nurses, especially in emergency departments (EDs). Effective training can help to strengthen this trait.

This study aimed to compare the impact of two educational methods–peer teaching and storytelling–on the moral courage of emergency  department nurses in selected military hospitals in Kermanshah.

A randomized control trial with a pre-test–post-test design was conducted in 2023-04. Forty fine nurses working in the emergency department of three military hospitals in Kermanshah, Iran, were recruited by purposive sampling and randomly assigned to peer education (n=15), narrative training (n=15), and control (n=15) groups. Six educational sessions on moral principles were held for the peer education and narrative training groups. Data were collected through personal characteristics and moral courage questionnaires and analyzed at a significance level of less than 0.05.

In the peer education group, the mean scores of moral courage before (58.60±7.47), immediately after (58.60±7.47), one month after  (42.13±16.39), and two months after the intervention (54.20±12.66) showed a significant difference (P=0.011). The mean scores of moral courage in the narrative training group before (66.40±2.23), immediately after (66.40±2.23), one month after (49.13±12.86), and two months after the intervention (65.67±5.11) had a statistically significant difference (P<0.001). The mean scores of moral courage in the control group, before (47.27±3.35), immediately after (47.27±3.35), one month after (49.33±16.95), and two months after the intervention (58.07±8.60) had not statistically significant difference (P=0.051). In addition, the average scores of moral courage between the three groups immediately after the intervention were significantly higher in the narrative training group than in the peer and control groups. (P<0.001).

Considering the positive impact of peer education and narration, these methods can be used in nursing education programs to teach ethical principles.

One of the common problems among hemodialysis patients is poor oral hygiene, which requires  urgent nursing interventions due to its impact on their quality of life.

This study compared the effects of curcumin lozenges and ginger mouthwash on oral hygiene in  hemodialysis patients.

This clinical trial included all hemodialysis patients admitted to Aja-affiliated hospitals in Tehran in 2023. A total of 99 patients were selected using a convenience sampling method and randomly assigned to three groups: curcumin lozenge, ginger mouthwash, and control. All three groups continued to receive routine oral health care, including flossing, proper tooth brushing techniques, rinsing the mouth after every meal, and instructions on using mouthwash. Patients in the ginger mouthwash group used the mouthwash in the morning and at night, swishing 15–20 cc for 30 seconds to one minute. Patients in the curcumin lozenge group took two tablets twice daily, allowing them to dissolve slowly in the mouth. Data were collected using a patient demographic information form and an oral examination scale.

Before the intervention, the mean oral health scores were 9.21±2.39 in the curcumin group, 9.69±2.21 in the ginger group, and 8.87±2.20 in the control group, with no statistically significant difference (P=0.343). After the intervention, the mean scores changed to 6.39±1.67 in the curcumin group, 7.81±2.00 in the ginger group, and 8.06±2.23 in the control group, indicating a significant difference (P=0.002). The oral hygiene status improved most notably in the curcumin lozenge group. Post-intervention comparisons showed a significant difference between the curcumin lozenge and ginger mouthwash groups (P=0.018), as well as between the curcumin lozenge and control groups (P=0.004).

Nurses working in hemodialysis departments should enhance their knowledge of medicinal plants and consider recommending curcumin to improve the oral health of these patients.

Administering medication is a key responsibility of nurses, necessitating proper training for the safe handling of high-alert drugs that can cause significant harm if misprescribed.

This study aimed to evaluate the effectiveness of training in root cause analysis of errors related to high-risk medications on the performance of emergency nurses, employing multimedia and role-playing methods.

This semi-experimental comparative study involved 75 nurses from selected Aja hospitals' emergency departments in Tehran during 2023-2024. Participants were randomly assigned to three groups: multimedia, role-playing, and control, based on inclusion criteria. Data were collected using a valid and reliable researcher-made questionnaire before and two weeks after the intervention, and analyzed with SPSS version 21. The significance level was set at less than 5%.

There was no significant difference in average performance scores between the test and control groups before the  intervention (P<0.05). After training, the role-playing and multimedia groups showed significant improvements in performance scores (P<0.05), while the control group did not show a significant difference (P=0.039).

Training in error root analysis through multimedia methods and role-playing can help emergency nurses prevent medication errors when using high-risk drugs.

Drug addiction is characterized by motivational dysregulation, including compulsive substance use and episodes of intense craving for drugs.

This study aimed to investigate the impact of a mindfulness-based cognitive therapy training program on self-efficacy and self-control in individuals with substance dependence and recurrent relapse.

The methodology employed in this study utilized a quasi-experimental design with a pre-test–post-test configuration and a control group. The statistical population comprised individuals with substance use disorders in a non-residential community treatment center in 2023. From this population, 30 participants were selected through voluntary sampling and subsequently randomized into experimental and control groups (15 participants per group). The data collection instrument employed was the Self-Efficacy and Self-Control Scale. The implementation of mindfulness-based cognitive therapy training was conducted over eight sessions, each lasting 90 minutes. Data analysis was performed using multivariate analysis of covariance (MANCOVA) with SPSS version 25 software, employing a significance level of 0.05. 

The mean self-efficacy score following the intervention in the experimental group was 103.33±14.49, while in the control group it was 58.40±8.01. The mean self-control score post-intervention in the experimental group was 28.33±6.56, and in the control group it was 20.11±3.74. Analysis of the results was conducted using a multivariate covariance test. The findings indicated that, after controlling for the effects of the pre-test, there was a statistically significant difference between the mean scores of the experimental and control groups in the total score of the self-efficacy variable (P<0.001; F=93.373) and the self-control variable (P<0.001; F=8.944).

Considering the results of the present study and the effectiveness of mindfulnessbased cognitive therapy in increasing self-efficacy and self-control in individuals with drug dependence and frequent relapse, the use of this treatment method is recommended by specialists in this field.

Individual desires and motivations vary among individuals based on their distinct temperaments.

This study aimed to examine the relationship between temperament and academic motivation in medical students at Shahroud in the academic year 2021-2022. University during the 2021–2022 academic year.

This descriptive-analytical study was conducted using a simple random sampling method on 300  medical students at Shahroud University during the 2021–2022 academic year. Data were collected through demographic, temperament and academic motivation questionnaires. After data collection, the information was entered into SPSS 18 and analyzed using descriptive and analytical statistics, with a significance level set at (P<0.001).

The findings of this study indicated that among the 300 participating students, the majority belonged to the 18–21 age group (61.3%)184, were female (62%)186, resided in dormitories (68%)204, and were single (93% ) 279. Additionally, 136 students (45.3%) were studying medical subjects. A significant relationship was found between gender and academic motivation. Regarding students' temperament, in the cold and hot spectrum, the majority (60%, n =180) had a moderate temperament, with a mean score of 16.56 ± 24. and In the dry and moist spectrum, 36.7% (n = 110) had a moderate temperament, with a mean score of 4.15 ± 6.The overall academic motivation score of students was 117.06±24.36. A positive and significant correlation was observed between hot and cold temperament and academic motivation. Whereas a negative but non-significant correlation was found between dry temperament and academic motivation. (R=-0.248)

The findings of this study indicate that temperament can play a crucial role in determining an individual's level of academic motivation. It is recommended health policymakers and education officials utilize traditional medicine principles and temperament strategies to enhance academic motivation among students.

Neglect primarily affects the right posterior parietal cortex, particularly the inferior parietal lobe, or the temporoparietal junction. Research indicates that patients with parietal lobe lesions, especially in the right hemisphere, exhibit impairments in sound localization.

This study was conducted to evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) on auditory attention in stroke patients with unilateral spatial visual neglect.

This experimental study included both an experimental group and a sham group. A total of 60 stroke patients with unilateral visuospatial neglect, who were referred to Tabsom Clinic in Tehran, were selected using purposive sampling and randomly assigned to two groups: 30 patients in the experimental group receiving rTMS and 30 patients in the sham group. The intervention consisted of inhibitory rTMS administered at a frequency of 0.9 Hz for 15 sessions, three times per week, with each session lasting 15 minutes. In the sham group, the rTMS device was deactivated after 30 seconds; however, participants remained unaware of this and believed they were receiving active rTMS treatment.

The findings indicated a significant difference between the two groups in auditory selective attention and auditory response control. Bonferroni's post-hoc test revealed a statistically significant difference between the pre-test and post-test scores of auditory selective attention and auditory response control in the rTMS group (P≤ 0.05).

The results demonstrated a significant improvement in selective auditory attention and auditory response control in the rTMS group. This finding suggests that rTMS may be an effective intervention for enhancing auditory attention in individuals with unilateral visuospatial neglect.