Nursing students' metaphors of first clinical experiences of encountering patients with mental disorders.

BACKGROUND: Psychiatric wards are one of the most stressful medical centers. Apprenticeship in mental health can cause feelings of stress and anxiety among nursing students. Investigating nursing students' beliefs about mental illnesses is very important to improve nursing education. The present study aimed to identify nursing students' metaphors for their first clinical experiences of encountering patients with mental disorders. METHODS: This descriptive qualitative study was conducted on 18 undergraduate nursing students studying in two nursing colleges at Guilan University of Medical Sciences, in the north of Iran, in 2022. The data were collected through semi-structured interviews and analyzed using Critical Metaphor Analysis by the MAXQDA 2007 software. RESULTS: The analysis of nursing students' metaphors led to the emergence of 36 metaphors and 5 categories. These categories were "experience of dealing with a mental patient is similar to fear mixed with excitement", " patient is similar to an errant human", " psychiatric hospital is similar to a prison", "nurse is similar to a prison guard", and "clinical instructor is similar to a supporter, sympathetic and knowledgeable friend". CONCLUSIONS: The results showed their negative attitude towards the psychiatric hospital and health care providers. It is suggested that the findings of this study be taken into consideration in the planning of clinical education of nursing students.

The effect of corrective exercises on musculoskeletal disorders among the older adults residing in a nursing home in Rasht, Guilan, Iran.

BACKGROUND: Ageing causes changes in the function of musculoskeletal systems and disability, and injury among older adults. This study aimed to determine the effect of corrective exercises on musculoskeletal disorders among older adults residing in a nursing home in Iran. METHOD: This controlled clinical trial study was conducted on 58 older adults (29 samples in each group). The intervention group performed corrective exercises for 8 weeks and three sessions per week and each session lasted for one hour. The pre-test was performed one week before intervention and the post-test one week after the 8-week intervention. The research instruments included Nordic Musculoskeletal Questionnaire (NMQ), and the pain visual analog scale (VAS). Descriptive and inferential (Chi-square, Mann-Whitney, Wilcoxon, and McNemar test) statistics were used to analyze the data using SPSS software version 19. RESULTS: the majority of the participants were males (67.2%) and in the age range of 60-74 years (82.8%). The mean age of samples in intervention and control groups was 68.45 (SD = 5.38) and 69.17 (SD = 5.86), respectively. The results showed that the prevalence of musculoskeletal disorders (MSDs) was decreased in the intervention group after the intervention (%Δ = -34.68, p < .05). The results also showed a statistically significant decrease in pain intensity of musculoskeletal in the intervention group, after the intervention (%Δ = -68.34, p < .001). CONCLUSIONS: Corrective exercises reduce the prevalence of MSDs and the pain intensity among older adults. It is recommended to pay attention to these exercises to improve physical health and reduce the prevalence of MSDs among older adults.

Mobile Health Applications in the COVID-19 Pandemic: A Scoping Review of the Reviews.

Background: Mobile health (m-Health) is a combination of electronic communications and medical information technology that has helped patients and health care workers during the COVID-19 outbreak. This study aimed to aggregate and highlight findings from existing review studies about applications of m-health to prevent COVID-19. Methods: This scoping review was conducted based on the Arksey and O'Malley framework after searching the PubMed, Web of Science, and Scopus databases from March 2020 to February 2022. Keywords for the search included the English words "Mobile health";" mobile apps"; "corona disease"; "COVID-19"; and "review." Screening of articles was done in 4 stages. Results: Out of 37,569 papers found in the search, after the screening and review process, 22 articles were finally selected. From the analysis of the studies, 2 main categories emerged with the titles of "primary preventive applications" and "secondary preventive applications." Conclusion: M-health is used in both primary and secondary prevention. The m-health tools can be effective in controlling the spread of COVID-19 and improving the treatment process of this disease by providing various pieces of training related to COVID-19 as well as installing various programs to monitor the condition of patients. Also, m-Health can provide services through the exchange of treatment data between health care providers or between patients and health care providers, as well as provide appropriate training for the remote care needs of patients with COVID-19.

A meta-synthesis study of literature review and systematic review published in nurse prescribing.

BACKGROUND: Prescribing represents a new aspect of practice for nurses. To make qualitative results more accessible to clinicians, researchers, and policy makers, individuals are urged to synthesize findings from related studies. Therefore this study aimed to aggregate and interpret existing literature review and systematic studies to obtain new insights on nurse prescription. METHODS: This was a qualitative meta synthesis study using Walsh and Downe process. In order to obtain data all Digital National Library of Medicine's databases, search engines and several related sites were used. Full texts with "review and nurs* prescri* " words in the title or abstract in English language and published without any time limitation were considered. After eliminating duplicate and irrelevant studies, 11 texts were selected. Data analysis was conducted using qualitative content analysis. Multiple codes were compared based on the differences and similarities and divided to the categories and themes. RESULTS: The results from the meta synthesis of the 11 studies revealed 8 themes namely: leading countries in prescribing, views, features, infrastructures, benefits, disadvantages, facilitators and barriers of nursing prescription that are discussed in this article. The results led to a schematic model. CONCLUSION: Despite the positive view on nurse prescribing, there are still issues such as legal, administrative, weak research and educational deficiencies in academic preparation of nurses that needs more effort in these areas and requires further research.

Applying Parse's Human Becoming Theory for Caring of an Elderly with Spontaneous Pneumothorax Following the COVID-19: A Case Study.

Introduction: The elderly are one of the main groups at risk of contracting COVID-19. Using Parse's human becoming in practice can lead to important changes in a person's health. This study aimed to apply this theory in caring of an elderly patient with spontaneous pneumothorax following COVID-19. Methods: This research was a case study which was conducted in 2023 in Guilan (Iran). This study was conducted based on the three principles of Parse's theory (meaning, rhythmicity, and transcendence) using Purposive sampling. Nursing interventions were performed based on the PRISM model (presence, respect, information, services, and movement). The data analysis was done based on the qualitative analysis-synthesis process of Parse's research methodology (2011). Results: Findings based on the first principle of Parse's theory showed that the meaning of COVID-19 changed from "lethal" to "curable disease". In the second principle, the paradoxes of "disbelief/shock-active participation for recovery", "despair-hope", and "ignorance- searching for knowledge" were identified. According to the third principle, the patient and her daughter had learned how to take the path of transcendence and deal with disease conflicts and create the necessary change in dealing with paradoxes. Conclusion: The results showed that Parse's theory could be used to improve health status and deal with paradoxes in elderly patients suffering from spontaneous pneumothorax. It is suggested that this theory will be used in future studies in the care of other patients.

Undergraduate Nursing Students' Experiences of Virtual Learning during the COVID-19 Pandemic: A Qualitative Study.

Background: With the emergence of the COVID-19 pandemic, schools and universities were closed, and virtual education replaced face-to-face classes. This learning method was a new and different experience for nursing students. Perceiving their experiences could help improve the quality of medical education. Therefore, the present study aimed to describe nursing students' experiences of virtual learning during the COVID-19 pandemic. Materials and Methods: This study involved qualitative descriptive research that was conducted in 2022. The participants included 25 undergraduate nursing students studying at the School of Nursing and Midwifery in East Guilan in northern Iran who had experienced virtual learning due to the COVID-19 pandemic. Purposeful sampling was applied until data saturation. Qualitative content analysis with a conventional approach was performed based on the model proposed by Graneheim and Lundman (2004). Coding was performed with MAXQDA 2007 software. Results: The data analysis led to the emergence of 110 primary codes and two main categories entitled "positive experiences" and "negative experiences." The first main category was "positive experiences" (included 1 subcategory (benefits of virtual learning) with 3 subsubcategories (saving time, saving money, and increasing the possibility of daily planning)). The second main category was "negative experiences" (included 4 subcategories (reducing quality of education, physical effects, psychological effects, and different exams)). Conclusion: Nursing students had both positive and negative experiences with virtual learning during the COVID-19 pandemic and were facing multiple educational challenges. The findings of this study could be considered by managers and relevant officials in educational planning to improve the quality of nursing education.

Effect of Jacobson's Progressive Muscle Relaxation on Anxiety and Happiness of Older Adults in the Nursing Home.

Background: Older adults encounter serious psychological challenges in addition to physical problems. Reducing stress and anxiety, along with promoting happiness, is critical to maintaining the mental health of the elderly. Jacobson's Progressive Muscle Relaxation (JPMR) will lead to peace of mind by relieving physical stress. The present study aimed to investigate the effect of JPMR on the anxiety and happiness of older adults. Materials and Methods: A single-group pretest-posttest design as a type of quasi-experimental study was conducted on 34 older adults living in a nursing home in Rasht, the north of Iran, in 2021. The intervention was performed one session per week, for 8 weeks. The research instruments included the Geriatric Anxiety Inventory (GAI) and the Oxford Happiness Inventory (OHI). Descriptive statistics and the Wilcoxon test were used for data analysis. Results: After the intervention, the Mean (Standard Deviation [SD](of anxiety was 4.91 (1.96), and the Mean (SD) (of happiness was 37.18 (7.92). The mean score of anxiety among older adults after the intervention was significantly lower compared to the before intervention (Z = -4.73, p < 0.001). In addition, the mean score of happiness of the samples after the intervention was significantly higher compared to the before intervention (Z = -5.09, p < 0.001). Conclusions: JPMR has a positive effect on reducing anxiety and promoting happiness in the elderly. Developing training programs and allocating time to non-pharmacological treatments such as JPMR for the elderly living in nursing homes will help make them happier and healthier.

The older adults' experiences of living in the nursing home during the COVID-19 pandemic: A qualitative study in Iran.

AIM: This study aimed to describe the experiences of older adults living in a nursing home during the COVID-19 pandemic. DESIGN: A qualitative descriptive study. METHODS: In present study, 20 older adults living in a nursing home in Rasht, northern Iran, participated. Purposeful sampling was applied until data saturation. The qualitative content analysis was done according to the steps proposed by Zhang and Wildemuth. RESULTS: The central theme was "Intensification of life problems in the nursing home", which emerged from the 115 primary codes, 4 main categories and 7 subcategories. The main categories included "feelings about COVID-19," "intensification of isolation and loneliness," "imprisonment and feeling forgotten" and "difficulty in adapting". CONCLUSION: Quarantine and special protocols have aggravated the hardships of life for older adults, and they experienced negative emotions in the nursing home. However, the older adults hoped that the situation would improve, and the pandemic would end.

Explaining the features of patient education in home care units in Iran: A qualitative study.

BACKGROUND: In recent years, health policies have emphasized accelerating patients' discharge from hospitals and receiving health care at home. The present study aimed to identify the characteristics of patient education in home care units in Iranian hospitals in 2021. MATERIALS AND METHODS: This descriptive, qualitative study was conducted on eight supervisors, 15 clinical nurses, and four home care nurses working in East Guilan hospitals. Semi-structured interviews were used to collect data. Interviews were conducted using guiding questions. Data were analyzed using conventional qualitative content analysis by MAXQDA 2007 software. RESULTS: Data analysis led to the emergence of 58 primary codes and six categories with the titles of "Education based on the expertise and clients' needs," "Emphatic nature of education," "Empowering clients to perform self-care programs," "Increasing the quality of clinical services," "Cost-effective education," and "Requirements for promoting the educational performance of home care units." The sixth category consists of four subcategories (tariffing insurance, continuous education of clients from the time of hospitalization not merely at the time of discharge, the existence of a monitoring system, and advertising and media coverage of the educational performance of the home care unit). CONCLUSIONS: The analysis of data showed that the education provided to patients in home care units is economically viable and empowers clients to self-care and increases the quality of clinical services. Due to the novelty of home care in Iran, it is necessary to pay more attention to the issues mentioned in this paper by managers and health policymakers.

Lived experiences of Iranian nursing managers in organizing and confronting the COVID-19 pandemic.

BACKGROUND: The prevalence of the new infectious disease is a global health issue and a threat to nurses and other health care workers. In addition to nurses who have been directly involved in the care of patients with coronavirus disease 2019 (COVID-19), nursing managers have also played a key role in the management and control of this disease. The present study aimed to investigate the lived experiences of nursing managers in organizing and confronting COVID-19 in Iran. MATERIALS AND METHODS: This study was a qualitative research design conducted by descriptive phenomenology based on Husserl philosophy. Participants consisted of 32 nursing managers working in general public hospitals in East Guilan, north of Iran, selected using purposive sampling. In-depth and semi-structured interviews were used to collect data. Colaizzi's strategy was used to analyze the data. Coding was done with MAXQDA 2007 software. Lincoln and Guba trustworthiness criteria were used to achieve accuracy and reliability of the data. RESULTS: Data analysis led to the emergence of a main theme called "Management in the COVID-19 Crisis" and three sub-themes: "Dealing with the unknown", "Managing deficiencies and assets" and "Structural challenges". CONCLUSION: In this study the nursing managers experienced how to deal with the COVID-19 crisis. By examining the experiences of managers involved in the COVID-19 pandemic, a rich set of managerial experiences can be gathered that prepare them for other infectious diseases in the future.

Investigation of Caring Behavior and Caring Burden and Their Associated Factors among Nurses Who Cared for Patients with COVID-19 in East Guilan, the North of Iran.

Background: Nurses experience caring burdens, which can affect their caring behaviors. Caring for highly infectious patients, in particular COVID-19, is a new phenomenon and little is known about it. Considering that caring behaviors can be influenced by various factors and cultural differences of the society, it is necessary to conduct studies about caring behaviors and caring burdens. Thus, this study aimed to determine caring behavior and caring burden and their relationship with some associated factors among nurses who cared for patients with COVID-19. Materials and Methods: This cross-sectional, descriptive design study was conducted by census sampling on 134 nurses working in public health centers in East Guilan, the north of Iran, in 2021. The research instruments included the Caring Behavior Inventory (CBI-24) and the Caregiver Burden Inventory (CBI). Descriptive and inferential statistics were used to analyze the data using SPSS software version 20 with a significant level of 0.05. Results: The mean score of caring behavior and caring burden in nurses was 126.50 (SD = 13.63) and 43.65 (SD = 25.16), respectively. There was a significant relationship between caring behavior and some demographic characteristics (education, place of living, and history of COVID-19) and between caring burden and some demographic characteristics (housing status, job satisfaction, intention to change job, and history of COVID-19) (p < 0.05). Conclusions: Findings showed that despite the new emergence of COVID-19, the caring burden on nurses was moderate and they had good caring behavior. Despite these results, it is necessary for the relevant managers to pay special attention to protecting health workers during a national crisis such as COVID-19 so that they experience less caring burden and improve caring behavior.

The effect of communication using Peplau's theory on satisfaction with nursing care in hospitalized older adults in cardiac intensive care unit: A quasi-experimental study.

BACKGROUND: Patient satisfaction helps healthcare organizations to improve their quality level and nurse-patient relationship is effective in increasing satisfaction. The aim of this study was to determine the effect of communication using Peplau's theory on satisfaction with nursing care in hospitalized older adults' patients in cardiac intensive care unit. MATERIALS AND METHODS: This quasi-experimental study was conducted by available sampling method on 78 hospitalized older adults (39 interventions, 39 control) in cardiac intensive care unit of Guilan hospitals in north of Iran in 2021. In the intervention group, Peplau's communication theory (four stages of orientation, identification, exploitation, and resolution) was implemented and the control group received routine care. At the time of discharge, patient satisfaction questionnaire of quality of nursing care was completed for both groups. Data were analyzed through descriptive and inferential statistics (independent t test, Chi-square test). RESULTS: The mean score of nursing satisfaction in the intervention group (5.4 ± 93.0) was significantly higher than the control group (6.8 ± 75.7) (t (64) = 11.54, P < 0.001, d = 2.84). In other words, the mean satisfaction scores of nursing care in the intervention group were 17.4 units (95% confidence interval: 14.4-20.4) more than the control group. CONCLUSION: Using Peplau's communication theory in the care of hospitalized older adults in cardiac intensive care unit can lead to improvement of satisfaction, so it is suggested to use this communication method in the care of these patients to improve the level of satisfaction, quality of care, and functional independence.

The Effects of Education Based on the Nursing Process on Ostomy Self-Care Knowledge and Performance of Elderly Patients with Surgical Stoma.

Background: Patients with surgical stoma experience problems, which can lead to their impaired adaptation and self-efficacy. The nursing process provides a framework for planning and implementing nursing care. This study aimed to investigate the effect of education based on the nursing process on ostomy self-care knowledge and performance of elderly patients with intestinal stoma. Materials and Methods. In this quasi experimental study, 52 elderly patients with intestinal ostomy who were referred to Razi Hospital in Rasht and met the inclusion criteria were invited to participate in research. Sampling was done by a simple random method. The intervention group received an educational programme based on the nursing process, whereas the control group received traditional training. The research instruments included a questionnaire to assess the level of ostomy self-care knowledge and ostomy self-care performance. Data were analyzed by SPSS software version 21 using descriptive and inferential statistics at a significant level of p < 0.05. Results: The mean scores of ostomy self-care knowledge and performance in both groups (intervention and control) were increased. However, the improvement in self-care knowledge and performance of the intervention group was significantly greater than that in the control group (p < 0.001). Conclusions: The educational programme based on the nursing process compared to the routine patients training caused more improvement in ostomy self-care knowledge and performance of older adult patients with surgical stoma. Therefore, an educational programme based on the nursing process can be used as an educational model for these patients.

The Relationship Between Health Literacy, Self-Efficacy, and Self-Care Behaviors in Older Adults With Hypertension in the North of Iran.

BACKGROUND: Hypertension is the main risk factor for cardiovascular disease. Low level of health literacy is more common in people with hypertension. Evidence suggests that hypertension is preventable and can be controlled by modifying lifestyle and improving self-care behaviors. OBJECTIVE: This study aimed to determine the relationship between health literacy, self-efficacy, and self-care behaviors in older adults with hypertension. METHODS: The present study was a cross-sectional study conducted with 150 older adult patients with hypertension admitted to the Cardiac Care Unit (CCU) and post-CCU wards in East Guilan public hospitals in the north of Iran in 2020. Sampling was conducted using a convenience method based on inclusion criteria (age 60 years and older, high blood pressure and taking antihypertensive drugs for at least 6 months, ability to speak and communicate, having the suitable physical condition (not ill) to participate in research and answer questions, and having informed consent to participate in the study). The research instruments included a Health Literacy Questionnaire for Iranian Adults, a self-efficacy questionnaire in patients with hypertension, and a self-care behavior questionnaire for patients with hypertension. Descriptive statistics and multiple linear regression were used to analyze the data using SPSS software version 19. KEY RESULTS: The results showed that most patients had adequate health literacy with a mean score of 116.77 (standard deviation [SD] = 8.34), excellent self-efficacy with a mean score of 23.06 (SD = 1.99) and relatively desirable self-care behaviors with a mean score of 51.79 (SD = 4.37). Findings also indicated that health literacy can predict self-efficacy (beta = 0.262, p = .001) and self-care behaviors (beta = 0.639, p = .000). CONCLUSIONS: Based on results, health literacy is a predictor of self-efficacy variables and self-care behaviors. Therefore, planning to improve the health literacy of the older adult to promote self-efficacy and self-care behaviors and ultimately their health is recommended. [HLRP: Health Literacy Research and Practice. 2022;6(4):e262-e269.] Plain Language Summary: This study sought to determine the role of health literacy in predicting self-efficacy and self-care behaviors in older adults with hypertension admitted to CCU and post-CCU wards in East Guilan public hospitals in the north of Iran. Findings of this research demonstrate health literacy can predict self-efficacy and self-care behaviors.

The Correlation and Agreement of Montreal Cognitive Assessment, Mini-Mental State Examination and Abbreviated Mental Test in Assessing the Cognitive Status of Elderly People Undergoing Hemodialysis.

Background: Cognitive disorders are one of the most common disorders in elderly people with chronic renal failure. This study aimed to investigate the correlation and agreement of Montreal Cognitive Assessment (MoCA), Abbreviated Mental Test Score (AMTS), and Mini-Mental State Examination (MMSE) tests in assessing the cognitive status of elderly patients undergoing hemodialysis at Guilan University of Medical Sciences in north of Iran. Materials and Methods: This cross-sectional study was conducted on 84 elderly people undergoing hemodialysis. Inclusion criteria was having an age of 60 years old and older, hemodialysis treatment for at least 6 months, and having reading and writing skills. The Pearson correlation test, Intraclass Correlation Coefficient (ICC) test, and Bland-Altman plot were used for data analysis. Results: The majority of samples were in the age group of 60-65 years (28.57%) and the majority of them were male (66.66%). The results showed a significant positive correlation between MoCA and MMSE (r = 0.69, p = 0.001), between MMSE and AMTS (r = 0.64, p = 0.001), and between MoCA and AMTS tests (r = 0.62, p = 0.001). The results also showed a weak agreement between MoCA and MMSE tests (ICC = -0.11, p = 0.633), between MMSE and AMTS tests (ICC = -0.007, p = 0.369), and between MoCA and AMTS tests (ICC = -0.001, p = 0.780). Conclusions: Based on the results, these tools seem to complement each other. The inconsistency between cognitive tests indicates a serious need to develop appropriate instruments for detecting cognitive disorders in elderly.

The relationship between frailty syndrome and self-care ability in the elderly with heart failure.

BACKGROUND: Identification of frailty syndrome in patients with heart failure can affect the process of the disease and their ability to self-care. Considering the lack of a study on the relationship between frailty syndrome and self-care ability in the elderly with heart failure in the Guilan province, the North of Iran, this study was conducted to determine the relationship between fertility syndrome and self-care ability in these patients. MATERIALS AND METHODS: The present cross-sectional correlational study was conducted in 2020. Research settings were the CCU and post CCU wards in the East Guilan public hospitals. The sample size was 125 people who were selected by the convenience sampling method. The research tools include; Self-Care Heart Failure Index and Tilburg Frailty Index Questionnaires. Data were analyzed using SPSS software version 20 using descriptive and inferential statistics with a significance level of 0.05. RESULTS: The results showed that the mean score of frailty syndrome in the elderly with heart failure was 5.44 ± 2.47. In addition, the mean score of self-care in the elderly with heart failure was 67.16 ± 10.96. There was a significant and negative correlation between frailty syndrome and the ability to care in the elderly with heart failure (P < 0.001, r = -0.358). CONCLUSIONS: According to the results, the elderly with fragility syndrome cannot take good care of themselves. This indicates that in the management of heart failure, the assessment of frailty syndrome as a care/treatment goal in the care programs of these patients should be considered.

Survey of stress and coping strategies to predict the general health of nursing staff.

BACKGROUND: Nurses are often faced with the variety of work-related stress which could affect their physical and mental health. Coping strategies play an important role in reducing stress and consequently increasing the health and well-being. This study was conducted to investigate the role of stress and coping strategies to predict the general health of nursing staff. SUBJECTS AND METHODS: An analytical cross-sectional design was carried out on 318 nurses working in governmental health centers of Guilan University of Medical Sciences, the North of Iran, in 2017. Data were collected through multistage cluster sampling using self-report questionnaires and demographic characteristics. The study instruments included Hospital Job Stress, Coping Strategies, and General Health Questionnaires. For analysis of data, descriptive statistics and regression test were applied using SPSS software version 19. RESULTS: The results revealed that the highest mean score (47.71 ± 7.88) of different dimensions of coping strategies was related to task-oriented strategy. Furthermore, the results indicated that stress and coping strategies together could explain around 2.5% of variance of general health (ΔR2= 0.025). However, based on the statistically significant level, the results revealed the coping strategies as the predictor of general health (P = 0.002, beta = 0.094). CONCLUSIONS: The results highlight the importance of considering coping strategies for predicting general health in nurses. Regarding the inevitability of some stressors in the nursing profession and the need to prevent stressful effects, workshops as an effective training method to reduce staff stress should be on the agenda of managers.

A correlational study of hope and its relationship with spiritual health on hemodialysis patients.

BACKGROUND: One of the main psychological problems in hemodialysis patients is hopelessness. Spiritual health leads the patients toward hope and goal in life. Given the importance of the issue and the little research in this area, this study aimed to assess hope and its relationship with spiritual health on hemodialysis patients in Rasht Razi Hospital of Iran. MATERIALS AND METHODS: This correlational study carried out on 103 patients who admitted in Rasht Razi Hospital Hemodialysis Center by simple random sampling. The data were collected through Snyder's Hope Scale and Spiritual Health. The psychomotricity of these questionnaires has been confirmed in domestic studies. The data were analyzed by using descriptive and inferential statistics (Pearson correlation coefficient). RESULTS: The majority of the patients were male (59.2%), in the age group of above 60 (46.60%), married (83.5%), with low income (60.2%), and under diploma (53.4%). The mean of hope score was 36.36 (±9.10) that showed the high level of hope in the majority of the patients. The mean of the total spiritual health score was 227.93 (±19.01) that indicates the high level of spiritual health in hemodialysis patients. There was a positive and significant correlation between spiritual health and its dimensions and hope (P < 0.05). CONCLUSIONS: The results of this study approve the importance of spiritual health as an effective variable on hope among hemodialysis patients. Hence, health-care providers and clinical experts are recommended to focus on spiritual health to increase hope among such patients.

Can Health Belief Model Predict Breast Cancer Screening Behaviors?

BACKGROUND: Breast cancer is the second cause of cancer-related death among women. Prevention programs insist on the early diagnosis and screening to reduce the mortality rate. AIM: The study was conducted to determine the predictors of breast cancer screening behaviours based on the health belief model. MATERIAL AND METHODS: The present cross-sectional study was conducted by involving 304 women ranging from 20 to 65 years of age, living in East Guilan cities, the North of Iran, in 2015 using two-stage cluster sampling. The research instrument was Champion's Health Belief Model Scale. The data were analysed based on Regression test by using SPSS software version 18. RESULTS: The results showed perceived benefits (ExpB = 1.118, p = 0.009), self-efficacy (ExpB = 1.122, p = 0.001) and the perceived barriers (ExpB = 0.851, p = 0.001) as the predictors of breast self-examination. In addition, the study revealed that the two components of perceived benefits (ExpB = 1.202), and the perceived barriers were the predictors of mammography (ExpB = 0.864) (p = 0.001). None of the health belief model components showed a role to predict clinical breast examination (P > 0.05). CONCLUSION: The present study highlights the need for educational programs, which should focus on increasing breast self-exam skills and understanding the benefits of healthy behaviours and eliminating their barriers.

What are the predictor variables of social well-being among the medical science students?

CONTEXT: Individuals with social well-being can cope more successfully with major problems of social roles. Due to the social nature of human life, it cannot be ignored to pay attention the social aspect of health. AIMS: The purpose of this study was to identify variables that predict the social well-being of medical students. SETTINGS AND DESIGN: A descriptive-analytical study was conducted on 489 medical science students of Gilan Province, the North of Iran, during May to September 2016. SUBJECTS AND METHODS: The samples were selected using quota sampling method. Research instrument was a questionnaire consisting of two parts: demographic section and Keyes social well-being questionnaire. STATISTICAL ANALYSIS USED: Data analysis was done using SPSS software version 19 and with descriptive and inferential statistics (t-test, ANOVA, and linear regression). RESULTS: The results showed that majority of the students had average social well-being. Furthermore, a significant relationship between the academic degree (P = 0.009), major (P = 0.0001), the interest and field's satisfaction (P = 0.0001), and social well-being was seen. The results of linear regression model showed that four variables (academic degree, major, group membership, and the interest and field's satisfaction) were significantly associated with the social well-being (P < 0.05). CONCLUSIONS: The findings demonstrate that the different effects of the demographic factors on social well-being and the need for further consideration of these factors are obvious. Thus, health and education authorities are advised to pay attention students' academic degree, major, group membership, and the interest and field's satisfaction to upgrade and maintain the level of their social well-being.