Mohammad Haddadi, Davood Movahedzadeh, Elaheh Jaghouri, Hamid Robat Sarpooshi,
Volume 24, Issue 2 (5-2021)
Abstract
Background and Aim: Topical supplements and vitamins have often been used to accelerate the healing of burn wounds. This study investigated the effects of topical application of vitamin C solution on burn wounds.
Methods & Materials: This research was performed on 30 patients with extensive second-degree burns on one or two organs with similar burns. The study subjects were randomly divided into the intervention and control groups. The intervention group received topical application of vitamin C solution in addition to silver sulfadiazine ointment in the burn area; however, only silver sulfadiazine ointment was applied in the burn area in the control group. The wounds were examined and scored on days 1, 3, 7, and 14 using the Bates-Jensen Wound Assessment Tool. The collected data were analyzed in SPSS using repeated-measures Analysis of Variance (ANOVA).
Ethical Considerations: This study was approved by the ethics committee of sabzevar university medical sciences. (Code: IR.MEDSAB.REC.1394.60).
Results Eighteen of the 30 examined patients were male and 12 were female. Their Mean±SD age and body mass index were 43.03±11.90 years and 27.82±4.08 kg/m2, respectively.
Conclusion: The repeated-measures ANOVA data indicated that the study groups were significantly different concerning the final mean scores given to the wounds (P=0.047). In other words, the research groups significantly differed in wound healing; thus, topical application of vitamin C significantly improved wound healing in the study participants.
Zeynab Beiranvand, Mahbobeh Sajadi, Majid Taheri, Soheila Shamsikhani,
Volume 25, Issue 1 (3-2022)
Abstract
Background and Aim Moral stress happens when a person makes a moral decision but cannot accomplish it, mainly due to internal and external organizational limitations. Problem-solving skills training as one of the principles of stress management may be effective in controlling nurses’ moral stress. This study was conducted to investigate the effect of problem-solving skills training on the moral stress of novice nurses.
Methods & Materials This study was a clinical trial performed on 70 novice nurses working in Shohaday Khorramabad Hospital, Khorramabad City, Iran. The samples were selected by convenience sampling and randomly divided into intervention (n=36) and control (n=35) groups. The study data were collected by demographic questionnaire and Corley’s moral distress scale. Before the intervention, participants of both groups completed those questionnaires. Then for the intervention group, a problem-solving skills workshop was held in six 2-hour sessions. After training, the Corley moral distress scale was completed again by participants of both groups. Finally, the data were analyzed by the Chi-square test, paired, and independent t tests in SPSS software v. 16.
Ethical Considerations This study has been approved by the Research Ethics Committee of Arak University of Medical Sciences with the ethical code IR.ARAKMU.REC.1395.449. Informed consent was taken from all participants, and they were assured of keeping their information confidential.
Results In this study, most participants were around 25 years old. Also, 98.5% had Bachler’s degrees, and 1.5% had Master’s degrees. The study results showed that the mean of moral distress in the intervention was significantly different from before the intervention (P<0.05).
Conclusion This study showed that applying problem-solving skills has a significant effect in decreasing the moral distress of novice nurses in the clinical setting.
Fatemeh Kermanshahi, Mehdi Zare Bahramabadi, Hasan Heidari, Hossain Davoodi,
Volume 25, Issue 2 (5-2022)
Abstract
Background and Aim Old age is a critical period in life. Due to advances in technologies and improvement in healthy conditions, the number of aged population is increasing. Hence, it is necessary to pay attention to their life satisfaction and attitudes towards aging. The present study aims to assess the effectiveness of a psychological empowerment program on life satisfaction and attitude towards aging in older women living in Tehran, Iran.
Methods & Materials The study population consists of all women aged 60-70 years referred to a charity foundation in Tehran, Iran in 2020. Of these, 24 women were selected by a convenience sampling method. They were randomly assigned to the intervention (n=12) and control (n=12) groups. Using a pre-test/post-test design, the elderly first completed the life satisfaction index-Z and the attitude towards aging questionnaire. Then, the experimental group received the psychological empowerment program at 8 sessions. After the intervention, the questionnaires were completed again by both groups. Multivariate analysis of covariance was used to analyze the collected data in SPSS software, version 19.
Ethical Considerations This study was approved by the Research Ethics Committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1400.027).
Results There was a significant difference in life satisfaction (F=9.673, P=0.006) and attitudes towards aging (F=8.385, P=0.009) between the two groups. The psychological empowerment program significantly improved life satisfaction and attitudes towards aging in older women.
Conclusion The psychological empowerment program is effective in improving life satisfaction and attitude towards aging in older women living in Tehran. It can be used by experts in the fields of counseling, geriatrics, psychology, and health.
Mahmood Haghiri, Vahab Habibpour, Nahal Moharekpour, Morteza Ghasemi,
Volume 25, Issue 2 (5-2022)
Abstract
Background and Aim This study aims to investigate the effect of nurses’ autonomy on the quality of patient care based on Kramer and Schmalenberg’s model
Methods & Materials This is a causal-comparative study. Participants were 101 nurses of Imam Khomeini Hospital in Arak, Iran from the intensive care unit and internal medicine, surgery, pediatrics, gynecology, orthopedics, and emergency departments. The data collection tools were Moghimi and Ramazan’s patent care quality questionnaire and an autonomy assessment questionnaire based on Kramer and Schmalenberg’s autonomy model. The data were analyzed in SPSS software.
Ethical Considerations This study was approved by the ethics committee of Islamic Azad University of Arak Branch (Code: IR.IAU.ARAK.REC.1397.66).
Results The mean autonomy score of nurses was 3.16 ±0.35, indicating a desirable level. Nurses of all departments had limited autonomy. In the internal department, nurses had unsanctioned autonomy, while in the surgical department, they had autonomous nursing care action. The regression models were significant for all departments except for the internal department. With an increase of one unit in limited autonomy in the intensive care unit, autonomous nursing care in the surgical department, and limited autonomy in pediatrics, gynecology, orthopedics, and emergency departments among the nurses, the quality of care can be increased by 0.253, 0.187, 0.522, 0.205, 0.466 and 0.129, respectively.
Conclusion Nurses’ autonomy can increase the quality of patient care. The nursing managers need to empower nurses and provide an environment for them to apply their knowledge in practicing autonomy.
Mr Mohammad-Mehdi Khashmin, Mrs Farahnaz Hosseini, Mrs Samira Jafari, Mrs Sepideh Najafzade, Mr Human Ghasemi, Mrs Niloufar Darvishi, Mrs Asal Golchin,
Volume 25, Issue 4 (9-2022)
Abstract
Introduction: Depression is an injury to the central nervous system that is caused by several factors that affect a large number of people around the world. Emotion regulation refers to the processes by which we influence what emotions we experience, when we experience them, and how we express them. The aim of this study was to investigate the role of emotion regulation in predicting depressive symptoms in students of Kermanshah University of Medical Sciences.
Methods: The present study is a descriptive correlational study. Participants were all students of the School of Nursing and Midwifery of Kermanshah University of Medical Sciences during 2020-2021. Three hundred and five participants were selected by available sampling method and randomly. Informed consent forms got from the participants, then they completed the Beck Depression Inventory - Second Edition (BDI-II) and the Cognitive Emotion Regulation Scale (CERQ-18). This research was reviewed in the ethics committee of Kermanshah University of Medical Sciences and approved with the ID IR.KUMS.REC.1400.623.
Results: In this study, the study population was 305 people, 9 of whom were excluded from statistical analysis due to incomplete answers. Total mean age was 50.08 ± 191.30 Of these, 198 (66.9%) were female and 98 (33.1%) were male. Self-blame strategies (β = 0.31, P≤0.001), positive reassessment (β = -0.26, P≤0.001), catastrophic (β = 0.26, P≤0.001), numerical importance (β = -0.12, P≤ 0.001) and positive refocus (β = -0.10, P≤0.001) in five steps predict 40% of the variance of depression. Inconsistent strategies such as self-blame and catastrophe directly and positive reassessment, insignificance and positive refocus inversely predict depression. Mahalanobis distance was used to investigate multivariate throw values. Statistical assumptions were tested by performing an initial regression analysis and evaluating the scatter plot of residues. After confirming the regression assumptions, the data were analyzed using Pearson correlation and stepwise regression. The findings of our study showed that there is a significant direct relationship between self-blame and catastrophic thinking as maladaptive strategies of cognitive emotion regulation with depression. Also in our study among adaptive emotion regulation strategies; Positive refocusing, positive reassessment, and a small number had a significant negative correlation with depression.
Conclusions: The results of our study showed that emotion regulation strategies play an important role in predicting the occurrence of depression. Therefore, it is necessary for health policy makers to strengthen adaptive emotion regulation strategies in designing and modifying interventions related to depression.
Volume 26, Issue 0 (8-2023)
Abstract
Mrs Fatemeh Jahanshahi, Dr. Morteza Ghasemi, Mr. Pooyan Falahi, Mrs Neda Ghasemi,
Volume 26, Issue 1 (4-2023)
Abstract
Introduction: The current research was conducted with the aim of "investigating the role of medical staff in health policies during the corona virus pandemic".
Methods: This research is practical in terms of purpose and exploratory research in terms of method.
Results: The statistical population of this research is all the medical staff of Arak city Since access to all these people is not possible; Therefore, the sampling method is used. The data collection tool in this research was a questionnaire. This research was done using the factor analysis model.
Conclusions: The data and information extracted from the factor analysis test showed that: establishing proper communication with patients, interacting with citizens and the government, paying attention to the laws and encouraging others to comply with them, learning specialized training to contain the corona virus, explaining the situation to worried people, Adhering to health protocols and informing others, perception of organizational justice, alignment between individual and organizational goals, transfer of sense of responsibility to the work environment, existence of an efficient evaluation system and encouragement to inject vaccines are the most important role of the medical staff in health policies. They were during the corona disease pandemic.
Dr Minoo Motaghi, Dr Behzad Hamedani, Dr Parvaneh Khorasani, Mr Ahmad Bahrami,
Volume 26, Issue 1 (4-2023)
Abstract
Introduction: Today, the increasing prevalence of diabetes and its complications in the elderly is one of the most challenging problems in the health sector. One of the most important strategies for managing diabetes in the elderly is teaching self-care behaviors, which requires competent nurses in the field of diabetes education. The present study was conducted with the aim of determining the effect of empowering nurses on self-care and HbA1c control of elderly people with type 2 diabetes living in nursing homes.
Methods: This quasi-experimental study was conducted as a single group on 32 nurses and 30 elderly people with type 2 diabetes residing in nursing homes by convenience sampling. Nurses participated in a one-day empowerment workshop on type 2 diabetes. Data collection tools were a researcher-made questionnaire of workshop content to measure nurses' empowerment, Tobert and Glasgow self-care questionnaire and laboratory index HbA1c for the elderly. Data were analyzed using Spss version 20 at the 0.05 level. The present research has been registered with the ethics code IR.IAU.KHUISF.REC.1398.190 in the Ethics Committee of Islamic Azad University - Isfahan Branch (Khorasgan).
Results: Based on the findings, there was a significant difference between nurses' empowerment after the workshop compared to before (P=0.001). The mean scores of elderly before and three months after nurses' empowerment were significant in terms of self-care behaviors (P=0.000) and HbA1c index (P=0.000).
Conclusions: The results showed that the empowerment of nurses has desirable potential to change the outcomes of self-care in elderly people with type 2 diabetes resident in nursing homes, and by focusing on the approach of empowering nurses, positive steps can be taken in the management of diabetes and HbA1c of this group.
Mrs Elham Mohammadi, Dr Akram Bayati, Dr Sharare Khosravi, Dr Fakhredin Shariat Madari,
Volume 26, Issue 2 (7-2023)
Abstract
Introduction: Seizure due to fever is the most prevalent neurological condition in children aged 6 to 60 months. A child's seizure can cause significant distress for parents, particularly the mother. Anxiety control and the well-being of the mother are crucial elements in managing child seizures.
Methods: In this clinical trial, 70 mothers with children experiencing febrile convulsions were divided into two groups: an experimental group and a control group. The division was done using an available sampling method. The mothers in the experimental group received an intervention based on Orem's self-care model, while the mothers in the control group received the usual care. Mothers' anxiety was assessed one day after the child's hospitalization and again three weeks later using the Spielberger questionnaire. The data was analyzed using descriptive statistics, Chi-square test, Fisher's test, and analysis of covariance in SPSS software version 25.
Results: The study showed that after one day of hospitalization, the anxiety score of mothers in the test group was 101.68, compared to 106.25 in the control group. Three weeks later, the test group's anxiety score decreased to 68.97, while the control group's score was 96.34. Importantly, the decrease in the test group was statistically significant compared to the control group (P = 0.000).
Conclusions: Engaging in self-care activities results in a decrease in maternal anxiety. Hence, it is recommended to employ this approach when caring for children who are hospitalized.
Ali Rahimi, Behzad Hamedani, Nasrin Rasoulzadeh,
Volume 27, Issue 1 (3-2024)
Abstract
Introduction: Nurses have a prominent position in providing healthcare services. There is an undeniable relationship between nurses' professional self-concept and providing care to patients. This study was conducted to investigate the relationship between professional self-concept and the lifestyle of nurses in selected hospitals of Mazandaran cities.
Methods: This descriptive study was conducted using a stratified sampling method with a proportional allocation of 200 nurses working in hospitals affiliated with Mazandaran University of Medical Sciences in 2015. Data collection tools included a demographic information form, a nurse professional self-concept questionnaire, and a nurses' lifestyle questionnaire. Data analysis was done with a significance level of P ≤ 0.05. Pearson's correlation coefficient was used to determine the relationship between professional self-concept and nurses' lifestyle.
Results: The mean score of nurses' professional self-concept and a lifestyle was 156.55 ± 19.37 and 216.42 ± 5.88, respectively. There was also a significant direct relationship between professional self-concept and nurses' lifestyle.
Conclusions: Considering the confirmation of positive correlation between professional self-concept and the lifestyle of nurses, nursing managers can promote healthy lifestyles in nurses by promoting professional self-concept.
Ali Jadidi, Soleiman Zand, Mr Ali Khanmohamadi Hezave, Negin Hosseini,
Volume 27, Issue 1 (3-2024)
Abstract
Introduction: Quality of life is one of the most influential issues that can encourage a person to continue a happy and healthy life. On the other hand, spiritual health is one of the dimensions of health and a sense of harmonious connection between oneself, others, nature, and beyond, and leads to understanding the ultimate purpose and meaning in life. The purpose is to determine the relationship between spiritual health and quality of life in university students in Arak. The results of this study can be used to formulate strategic plans improve spiritual health and the quality of students' lives.
Methods: First, the population of each university in Arak city was measured, and taking into account their population and establishing a ratio between the sample size of the study and the population of each university, people who had the characteristics of entering the study were included in the study. The sample size was 400 people and was conducted on students who have been studying at the university for at least six months. After obtaining the consent of the participants, the researchers filled out the questionnaire through interviews with the students. The questionnaires included two instruments: a spiritual health questionnaire and a quality of life questionnaire with 36 questions.
Results: No significant relationship was observed between spiritual health and demographic variables. Likewise, spiritual health had no statistically significant relationship with demographic variables. The analysis of the study data showed that there is a positive correlation between the quality of life and spiritual health of students. (P < 0.05).
Conclusions: According to the horoscope results, there is a relationship between the quality of life and the spiritual health of the students of Arak universities. By improving the quality of students' lives, we can increase their spiritual health, and even by increasing their spiritual health, we can witness the improvement of students' quality of life.
Leila Ghanbari-Afra, Mina Gaeeni, Jafar Shahbazpour,
Volume 27, Issue 4 (10-2024)
Abstract
Introduction: The fundamental role of marital satisfaction is vital in family formation and marriage survival. Marital dissatisfaction can make couples fail to solve their conflicts. Marital discontent, combined with job-related stress such as pre-hospital emergencies, can lead to heightened conflict in job responsibilities. It leads to the effect on personnel, patients, and their families. Therefore, this study aimed to investigate the marital satisfaction of pre-hospital emergency personnel at Qom University of Medical Sciences in 2023.
Methods: This cross-sectional study was conducted on 200 pre-hospital personnel of Qom University of Medical Sciences in May 2023. The sampling method was a stratified cluster. The data collection tool included the "Demographic Information" checklist and Enrich's "Marital Satisfaction" questionnaire. Data analysis was done using descriptive tests, Independent T-test, and Regression.
Results: The average age of the participants was 37.3 ± 7.06. More than half of the participants had a bachelor's degree. Most people had rotating shifts. The average score of marital satisfaction was 145.94 ± 22.21. Based on the results of the multivariate regression test, the variables of education, employment status, work experience, type of shift, having a second job, and having a job other than medical staff explain 63% of the variance of marital satisfaction of pre-hospital personnel.
Conclusions: According to the findings of the present study, in general, the marital satisfaction of pre-hospital emergency personnel of Qom University of Medical Sciences is at an average to high level. People with a fixed shift, with a second job, high work experience, without a fixed job status, and bachelor's and associate's degrees had less marital satisfaction than others. Therefore, managers and policymakers in the health field must pay more attention to the quality of family life, especially the married life of pre-hospital emergency workers with the mentioned conditions.
Sara Derakhshan, Fateme Ganjeh, Korosh Rezaei, Elaheh Noroozi ,
Volume 27, Issue 6 (1-2025)
Abstract
Introduction: Diabetic foot ulcer is the most common cause of hospitalization in diabetic people, while one of the prominent sources of anxiety in patients is the time of discharge from the hospital. This study aimed to determine the effect of the SMART discharge protocol on the anxiety of diabetic foot ulcer patients.
Methods: In this semi-experimental study, 50 patients with diabetic foot ulcers Were divided equally into two control (25 patients) and intervention (25 patients) groups, randomly and based on the Inclusion criteria. In the intervention group, the SMART discharge protocol was implemented from their admission to the day of discharge. The Demographic information questionnaire and Spielberger questionnaire were used to determine patients' anxiety. The data were analyzed at two descriptive and inferential levels.
Results: There was no statistically significant difference in the mean score of anxiety for diabetic foot ulcer patients in the two groups before the intervention. In contrast, after the intervention, the mean anxiety score in the two groups showed a statistically significant difference (P = 0.0001).
Conclusions: According to the results of the present study, it seems that the smart discharge protocol was effective in reducing the anxiety of diabetic foot ulcer patients. Therefore, it is recommended that nursing officials and managers implement this protocol.
Hamidreza Zeraatkhah, Atye Babaii, Leila Ghanbari-Afra, Hanieh Ziabakhsh,
Volume 28, Issue 1 (3-2025)
Abstract
Background and Purpose: Emergency medical technicians (EMTs) are the frontline medical personnel who often face stressful and critical situations. Job hardiness can enhance their capacity to withstand challenging circumstances and both physical and mental pressures. Therefore, this study was conducted to identify the level of job hardiness among EMTs and its associated factors.
Materials and Methods: This study employed a cross-sectional descriptive design involving 216 EMTs from Qom University of Medical Sciences in 2024. A stratified random sampling method was utilized. Data were collected using a demographic and occupational information checklist and a job hardiness scale. Data analysis was conducted employing ANOVA, independent t-tests, and regression analyses. A significance level of less than 0.05 was deemed statistically significant.
Findings: The average age of participants was 32.26 ± 6.34 years, with over two-thirds having bachelor's degrees and working rotating shifts. The average score for job hardiness was 44.67 ± 5.30. Results from multivariable regression indicated that educational status and a sufficient number of personnel accounted for 42% of the variance in job hardiness among EMTs.
Conclusion: Findings reveal that EMTs exhibit moderate to high job hardiness. Furthermore, adequate staffing levels and higher educational attainment positively correlated with increased job hardiness scores.
Mir Amirhossein Seyednazari, Amir Mohammad Dorosti,
Volume 28, Issue 3 (8-2025)
Abstract
In global healthcare systems, nurses are recognized as the main pillars of care, but their voices, despite their vital role, are often lost amidst a cacophony of loud silences. This silence does not signify tranquility, but rather reflects hidden pressures, unexpressed fears, and an imposed passivity in the face of structures that limit the freedom of expression.
"Organizational silence," a concept recognized for years in the fields of management and organizational psychology, has become a global crisis in nursing. According to a qualitative meta-synthesis, over 91% of nurses have experienced organizational silence at least once in their professional careers [1].
The causes of silence among nurses are multifaceted. Part of it stems from defensive silence, meaning a nurse refrains from speaking up before superiors or in hierarchical structures for fear of negative consequences. At other times, we encounter acquiescent silence, where the nurse believes that speaking out is futile and will not bring about any change. Previous experiences of having concerns ignored or autocratic leadership styles reinforce this feeling [1,2]. Furthermore, in some cultures, such as Japan or Egypt, prioritizing group harmony over individual expression leads to the normalization of silence [3].
Silence is not just an individual reaction but a response to an inefficient work environment. Nurses who feel their voices are not heard eventually experience job burnout, decreased motivation, and ultimately, leave the profession [2,3,4]. In a study from Spain, half of the nurses surveyed had considered leaving the profession [3,5]. Job burnout not only harms the nurse's mental health but also reduces the quality of patient care. Fatigue, reduced concentration, and impaired communication with patients increase the risk of clinical errors [1,6].
This vicious cycle of silence and its consequences creates a downward spiral in healthcare organizations:
Silence on staff or resource shortages → Increased stress and workload → Job burnout → Decreased quality of care → Intensified dissatisfaction → More silence.
If nurses feel that their concerns are ignored even when expressed, silence becomes an adaptive strategy [4].
Meanwhile, the financial impact of nurse turnover is also significant. According to estimates, the turnover cost for a single nurse in the United States is over $44,000, and hospitals lose an average of $3.6 to $6.1 million annually due to nurse turnover [7]. This substantial figure provides an economic incentive for systemic interventions to reduce silence and retain human resources.
Solving this problem is not possible through individual training or psychological resilience alone. Although strengthening skills like professional assertiveness can be effective, it will not be sustainable without structural and cultural support [4]. Creating psychological safety in the workplace—where nurses can freely express their concerns without fear of punishment—is a vital starting point for change [6].
Leaders of healthcare organizations play a key role in shaping or dismantling a culture of silence. When managers interact with nurses with empathy, a listening ear, and responsiveness, trust is built, and the space for expression becomes safer. A transformational leadership style, participation in decision-making, and the creation of professional growth paths are among the most important factors in retaining nurses and reducing silence [8].
There is also a need for macro-level policymaking at national and international levels. Programs like the "Global Nursing Workforce," which focuses on supporting the sustainability of the profession, can be effective in addressing the root causes of the problem [7]. Moreover, new guidelines from bodies such as The Joint Commission on preventing workplace violence (effective July 2024), which define requirements for reporting and accountability, can serve as models for combating silence on other issues as well [8].
Ultimately, organizational silence in nursing is not just a communication issue; it is an alarming indicator of the ethical, psychological, and systemic health of healthcare institutions. This phenomenon should be considered an "organizational vital sign." The healthcare system has a duty not only to listen but to act. The voices of nurses must lead to decisions, policies, and structural reforms, so that their silence is no longer loud, but is transformed into an effective cry on the path to improvement.