The contribution of the nursing profession to the establishment of social justice: A grounded theory study.

BACKGROUND: Social inequities in the healthcare system threaten global health. Efforts to establish equity in healthcare is a key goal of healthcare systems worldwide. Social justice is a basic value of the nursing profession that always merits attention. OBJECTIVE: This study aimed to identify and explain the processes of the nursing profession's participation in establishing social justice in healthcare system. RESEARCH DESIGN AND METHODS: This qualitative study was conducted using the grounded theory method. PARTICIPANTS AND RESEARCH CONTEXT: Data were collected through in-depth, semi-structured, individual interviews with 26 participants, 23 of whom were members of the nursing profession. Sampling started purposefully and, then, continued with theoretical sampling. Field notes were also taken for data collection. Data analysis was performed using Corbin and Strauss' 2015 method. ETHICAL CONSIDERATIONS: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. FINDINGS: The "Professional Dynamics in the Path of Justice" was the study's core category. This theory is the result of nine main categories: "inefficient professional authority," "social justice, a neglected component in education," "clinical concerns, barriers to nurses' presence in society," "individual input reserves to facilitate social justice," "inadequate maturity of the profession in the path of equity in health," "promoting justice in clinical practice," "a tendency to community-oriented profession," "use of personal approaches for justice promotion," and "emerging justice-expanding nursing." These categories cover the underlying factors, strategies, and outcomes of the nursing profession's participation in establishing social justice process in healthcare. CONCLUSION: The theory of professional dynamics in the path of justice can be used as a practical guide to describe the role of nurses in establishing social justice. Further studies with a quantitative approach to applying this theory are recommended.

Nurses' Lived Experiences of Moral Courage Inhibitors: A Qualitative Descriptive Study.

Introduction: Moral courage (MC) has been characterized among the vital strategies, adopted by nurses, for dealing with moral distress; even though there are some factors hindering the development of this behavior in clinical settings. Objective: The present study accordingly aimed to shed light on Iranian nurses' lived experiences regarding MC inhibitors. Methods: This qualitative descriptive study was fulfilled, using conventional content analysis. For this purpose, the participants comprised of 15 nurses were recruited purposively from teaching hospitals in Iran. As well, in-depth, individual semistructured interviews in a face-to-face mode were held for data collection. The data were further analyzed by Graneheim and Lundman's method. Results: The analysis of the interviews revealed some MC inhibitors, including the individual factors (viz., personality traits, fear of job loss, poor scientific/practical skills, lack of ethical knowledge, and phobia of unpleasant experience recurrence), and the organizational ones (namely, no reward system, lack of power at work and physician dominance, inadequate organizational support, and suppressive environment). Conclusion: The study findings demonstrated that the MC inhibitors in the nursing practice could be split into two general themes, that is, the individual and organizational ones. Accordingly, organizations could motivate nurses to make ethical decisions courageously, using supporting strategies, such as giving importance to nurses and empowering them, applying appropriate evaluation criteria, and appreciating ethical performance in these frontline healthcare workers.

Educating ethics codes by lecture or role-play; which one improves nursing students' ethical sensitivity and ethical performance more? A quasi-experimental study.

BACKGROUND: Promoting ethical and professional principles through education is the major way to build and maintain people's trust in the nursing. However, despite remarkable efforts in this area, sensitivity to these principles and their application in clinical practice remain low. PURPOSE: This study aimed to compare the effect of educating codes of nursing ethics through methods of role-playing and lecture on the Ethical Sensitivity and Ethical Performance of nursing students. METHODS: A single-blinded quasi-experimental study conducted on 114 nursing students of Urmia University of medical sciences, which recruited using convenience sampling and assigned to two groups of intervention (role-paly and lecture) and one group of control, so that the sixth-, seventh- and eighth-semester nursing students were allocated to the control, role-play and lecture groups, respectively. Data were collected using the Nurses' Ethical Performance Questionnaire (EPQ) and the Lutzen's Moral Sensitivity Questionnaire (MSQ) at three time-points of before, immediately after, and two months after the intervention. The same educational content was provided for both intervention groups, so that the role-play group received the intervention over an eight-day period and the lecture group received it in five sessions. RESULTS: The results showed there was a significant difference in the mean scores of ethical sensitivity and ethical performance between the three groups immediately (p < .001) and two months after the intervention (p < .001), so the mean scores were significantly higher in the role-play and lecture groups compared to the control group after the intervention (p < .001). In addition, after the intervention, the mean scores of ethical sensitivity and ethical performance in the role-play group were higher than the lecture group (p < .001). CONCLUSION: Educating codes of ethics by role-playing method had a greater positive effect on the promotion of the ethical sensitivity and ethical performance compared to the lecture.

Nurses' perceptions of their supportive role for cancer patients: A qualitative study.

AIM: Supporting cancer patients is one of the integral, ethical and professional components and concepts of nursing care. Given the prominence of nurses' understanding of their supportive role in providing quality and humane nursing care for cancer patients, it is crucial for them to acquire sufficient knowledge to achieve a positive attitude towards patient support. DESIGN: Qualitative conventional content analysis approach was used. METHODS: This study was conducted with a qualitative approach and conventional content analysis in 2020. Participants consisted of 18 nurses of different oncology wards of teaching hospitals in Northwestern Iran recruited using the purposive sampling method. Data were collected through semi-structured interviews and analysed simultaneously with data collection (22 july - 20 june 2020). FINDINGS: The analysis of interviews showed that the main theme of "a canopy as a supportive role for cancer patients" was formed. In this theme, related subcategories included patient's psychological support (compassionate care with emotional support, having an intimate/friendly relationship with the patient and communicative behaviour facing patient needs), patient training (need-based training, having good theoretical knowledge about the patient and having a role model for playing a supportive role for the patient) and supporting the patient with clinical self-efficacy (being responsible with clinical competency, understanding the patient's behaviour and attempt to provide extra-duty care).

The Role of Beliefs and Psychological Factors in Caring of Patients With Cancer: The Lived Experiences of Informal Caregivers.

Cancer affects not only the patient but also family members as informal caregivers. In order for family caregivers to achieve balance and improve their caregiving roles, it is essential to identify the beliefs and psychological aspects affecting them. The present study was carried out qualitatively with a descriptive phenomenological design in 2020. The main participants in this study were selected from one of the major referral centers for cancer patients in West Azerbaijan Province, located in northwestern, Iran. Twenty-two family caregivers were selected through a purposive sampling method. Data analysis showed that the 3 main themes of "emotional and religious preconceptions," "feeling committed to caring for beloveds," and "resilience" played a prominent role in family caregivers. These factors led to caregivers' commitment to and responsibility for care. Holistic care necessitates consideration of all aspects of human life. The results of this study led to an understanding of the complex tendencies and feelings of family caregivers. Based on the results, it was found that care is influenced by beliefs, religious preconceptions, sociocultural, and psychological factors. Identifying these variables helps medical staff share planning, interventions, and counseling with family caregivers and address issues that affect them.

Using Newly Developed Software to Enhance the Efficiency of the Nursing Process in Patient Care: A Randomized Clinical Trial.

The nursing process is a systematic decision-making method of problem-solving that increases the quality of patient care. Implementation of modern technology in nursing can reduce documentation time, make nursing care safer, and improve the quality of patient care. This study aimed to determine the effectiveness of applying newly developed nursing process software on the efficiency of the nursing process in patient care. In this randomized clinical trial, 80 nursing students were randomly allocated into intervention (n = 40) and control (n = 40) groups. The student in the intervention group used the software to care for patients for two semesters. Students in the control group used routine hospital protocol to care for their patients. Modified Brooking nursing process measuring scale was used to evaluate the effectiveness of software before and after the intervention. The results showed a statistically significant difference in the mean efficiency score of the nursing process in the two groups after the intervention (P < .001). Using nursing process software leads to increasing the efficiency of the nursing process in patient care. Thus, providing executive support and electronic resources with relevant training for nursing students can be beneficial in students' education and be a practical application of the nursing process in caring for patients.

Social justice in health system; a neglected component of academic nursing education: a qualitative study.

BACKGROUND: In recent decades, increasing social and health inequalities all over the world has highlighted the importance of social justice as a core nursing value. Therefore, proper education of nursing students is necessary for preparing them to comply with social justice in health systems. This study is aimed to identify the main factors for teaching the concept of social justice in the nursing curriculum. METHOD: This is a qualitative study, in which the conventional content analysis approach was employed to analyze a sample of 13 participants selected using purposive sampling method. Semi-structured interviews were conducted to collect and analyze the data. RESULTS: Analysis of the interviews indicated that insufficient education content, incompetency of educators, and inappropriate education approaches made social justice a neglected component in the academic nursing education. These factors were the main sub-categories of the study and showed the negligence of social justice in academic nursing education. CONCLUSION: Research findings revealed the weaknesses in teaching the concept of social justice in the nursing education. Accordingly, it is necessary to modify the content of nursing curriculum and education approaches in order to convey this core value. Since nursing educators act as role models for students, especially in practical and ethical areas, more attention should be paid to competency of nursing educators, specially training in the area of ethical ideology and social justice.

Attitude of nursing students following the implementation of comprehensive computer-based nursing process in medical surgical internship: a quasi-experimental study.

BACKGROUND: The nursing process is the core and the standard of practice in nursing profession. Nowadays, the use of information technology in the field of nursing processes, education and practice has been emphasized. Since nurse's attitudes towards clinical information systems are considered as an indicator of the success rate of information systems, and nurse's attitudes about the nursing process can affect their execution of the process. So the purpose of this study was to evaluate nursing students' attitudes towards the nursing process software. METHODS: In this quasi-experimental study, 160 undergraduate nursing students (terms 4-8) in Tabriz University of Medical Sciences were selected by convenience sampling. To evaluate the effectiveness of nursing process software in this study, Mazlom and Rajabpoor (IJME 14(4):312-322, 2014) a questionnaire consisting of 21 components based on a five-point Likert scale was completed by students after using the software. Data were then analyzed by SPSS 19 software. RESULTS: The mean score of students' attitude toward nursing process software was high (80.70 ± 5.58). The nursing students' highest scoring attitudes were respectively related to "Effectiveness of software in prioritizing patient care and problems", "Completeness of patient's electronic information compared to handwritten mode" and "Software's effectiveness in saving your time". The lowest scoring attitudes towards the software was respectively related to the "feeling of fairness in labor division", "the effectiveness of the software in determining your workload" and "the feeling of satisfaction in labor division". There was a statistically significant relationship between gender and age, and student's attitude toward nursing process software. CONCLUSIONS: According to the results and analysis of nursing student's attitudes toward nursing process software, the use of such software would be welcomed by students. It seems that changing policies in the educational and clinical substructure of nursing in order to develop, adapt and use the nursing process software is an important responsibility for nursing authorities to consider. Providing educational and clinical technology equipment, periodic evaluation of software by stakeholders and promoting the use of this software, can be fundamental steps in operationalizing the findings of this research.

Factors Affecting Nurses' Impact on Social Justice in the Health System.

BACKGROUND: Social inequities in health systems are threats to global health. Considering the important role of nurses in establishing social justice, identification of factors affecting nurses' participation in this area can contribute to the development of social justice. OBJECTIVE: This study aimed to identify factors affecting nurses' participation in establishing social justice in the health system. RESEARCH DESIGN AND METHODS: The study was conducted using conventional qualitative content analysis approach. Purposive sampling was used to select 14 participants in 2019. The data were collected through semi-structured interviews and analyzed concurrently with data gathering. PARTICIPANTS AND RESEARCH CONTEXT: In total, six faculty members, five nursing managers, and three clinical nurses from three different universities were interviewed. ETHICAL CONSIDERATIONS: The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran. FINDINGS: Four main themes were found, including inadequate professional authority, insufficient attention to social justice in the area of education, clinical concerns as barriers to professional presence in society, and reflection of personality traits in the profession. These are the main factors affecting nurses' participation in establishing social justice in the health system. DISCUSSION: Authorities need to take effective steps to establish social justice through reforming the health system's policy-making and power-acquisition domains, promoting nurses' involvement in social factors in health issues, and adding professional values as a part of nursing curriculum. The clinical practice environment can also be helpful through providing quality, safe, and cost-effective services. In addition, fair and efficient recruitment process for new nurses can contribute to the establishment of social justice in the health system. CONCLUSION: Macro-level managerial factors such as policy, education, and clinical environment, along with personal factors, play a significant role in the participation of nursing profession in establishing social justice.

Nurses' Strategies for Conscience-based Care Delivery: A Qualitative Study.

INTRODUCTION: Conscience is the core of ethical values. It helps nurses protect patients' rights and provide quality dignified care. Therefore, assessing nurses' strategies for conscience-based care may help facilitate conscience-based care delivery. AIM: This study aimed to explore nurses' strategies for conscience-based care delivery. METHODS: This qualitative study was conducted in 2018 on twelve hospital nurses purposively recruited from four teaching hospitals in Urmia, Iran. Data were collected through in-depth interviews and inductively analyzed through conventional content analysis. ETHICAL CONSIDERATIONS: This study was approved by the Ethics Committee of Urmia University of Medical Sciences. All the participants were informed of the aim of the study and a written consent was obtained from each of them. Participation in the study was entirely voluntary and the participants could withdraw at any stage of the study. RESULTS: Participants' strategies for conscience-based care delivery were grouped into two main themes, namely self-empowerment for clinical role performance and attempt to deliver care beyond the routines. CONCLUSION: Clinical self-empowerment and attempt to deliver care beyond the routines are nurses' main psychosocial strategies for conscience-based care delivery. Mentorship programs are recommended for the development of nurses' time management and clinical skills and thereby, empower them for conscience-based care delivery. Moreover, continuing education programs and curricular revisions are recommended to strengthen their religious beliefs.

Factors affecting conscience-based nursing practices: A qualitative study.

BACKGROUND: Conscience is a guiding factor in nursing practice for delivering the ultimate care. In order to expand the concept of conscience-based care, factors affecting conscience in nursing practice need to be identified. OBJECTIVES: The current study assessed nurses' experiences to explore factors affecting conscience in nursing practice. RESEARCH DESIGN: This qualitative content analysis study employed purposive sampling to reach 14 nurses working at educational hospitals in Tabriz and Urmia, Iran. Data were analyzed using inductive and conventional analysis. ETHICAL CONSIDERATIONS: This research was approved by the Ethics Committee of Urmia University of Medical Science. Voluntary participation, anonymity, and confidentiality were considered. FINDING: Two themes emerged from our analysis for enhancing conscience in nursing practices, including environment of professional performance and personal factors. DISCUSSION: The two important factors for enhancing conscience in nursing practice are environment and personal factors. CONCLUSION: It is necessary to emphasize on religious beliefs, professional commitment, and communication skills in educational training structure. Also, establishing appropriate management systems will help nurses to provide moral care.

The Effect of Smartphone-Based Application Learning on the Nursing Students' Performance in Preventing Medication Errors in the Pediatric Units.

Medication errors (MEs) are potentially harmful patient safety events in all age groups. MEs are particularly hazardous in the pediatric population, especially with patients who require special attention due to the high incidence and severity of disease. This study aimed to determine the effect of a smartphone messenger application on nursing students' learning regarding the prevention of MEs in pediatric patients. METHODS: We performed this quasi-experimental study with 80 nursing students who were randomly divided into intervention and control groups. We collected the data using a researcher-made checklist. We conducted learning through Telegram, a smartphone messenger application (app), for 3 weeks. We analyzed data using SPSS version 16.0 by utilizing descriptive and inferential statistics, and P < 0.05 was considered to be significant. RESULTS: The mean age of the students was 23.5 ± 2.9 years. The majority of mistakes related to MEs in the control groups included the lack of proper control of the following: high risk medication administration, medication incompatibility interactions, medication administration card, medication dose calculations, adverse drug event recognition, pharmaceutical name recognition during drug selection, aseptic and sterile technique adherence, microbore IV tubing flush practices, IV drip rate adjustment, and medication administration schedules. The mean scores of students' performance were significantly different in the knowledge of preventing MEs between the 2 groups. (P = 0.022). CONCLUSIONS: Smartphone learning with the Telegram messenger app improves nursing student knowledge regarding the prevention of MEs in pediatric patients. We recommend that this form of learning be used in nursing schools to prevent errors related to medication ordering, dosing, and administration.

Are workplace-based assessment methods (DOPS and Mini-CEX) effective in nursing students' clinical skills? A single-blind randomized, parallel group, controlled trial.

Background: Evaluation of clinical skills is critically important for nursing students. However, the quality of evaluation tools is poor.Objectives: To evaluate the effectiveness of Direct Observation of Procedural Skills (DOPS) and Mini-Clinical Evaluation Exercise (Mini-CEX) on clinical skills of nursing students.Methods: This study was conducted among 108 senior nursing students. Mini-CEX and DOPS were utilized to evaluate clinical skills in the intervention group.Results: The mean of students' scores in all of the five procedures was significantly higher in the intervention group compared to control group.. Students' scores for the procedures significantly raised through the first stage of DOPS and Mini-CEX to the third stage.Conclusions: Utilization of DOPS and Mini-CEX for evaluation of clinical skills in nursing students effectively enhance their learning ability. Implementing of such assessment methods lead to promoting clinical skills of students which eventually help them to provide high quality care for their patients.

Challenges in the clinical education of the nursing profession in Iran: A qualitative study.

INTRODUCTION: Clinical education is an important part of nurse training. It provides students with the opportunity to gain useful experience and has a key role in their professional preparation. The importance of clinical education in nursing students' professional performance means that identifying the challenges in this field is crucial. AIM: The goal of this study is to identify challenges in the field of clinical nurse education. DESIGN: A qualitative content analysis study. SETTING: A faculty of Nursing and Midwifery, in Iran 2017. PARTICIPANTS: Nine student nurses, three qualified nurses and two nursing educators. METHODS: This study has been applied to various depths of interpretation. Semi-structured interviews were used to collect the data. Nine student nurses, three qualified nurses and two nursing educators were interviewed. RESULTS: The analysis of the interviews generated five categories. Two main themes were extracted as challenges in the clinical training of nursing professionals: 1. Inefficient educational structure and 2. Inefficient professional performance environment. CONCLUSION: Considering the inadequate professional performance environment and defective educational structure, designing and delivering lessons with clear goals is essential. Using objective and measurable scales for evaluating educational standards, the use of empowered instructors with high communicational skills is useful for increasing students' motivation and interest toward clinical education and solving existing challenges.

Social participation, social support, and body image in the first year of rehabilitation in burn survivors: A longitudinal, three-wave cross-lagged panel analysis using structural equation modeling.

INTRODUCTION: Psychosocial outcomes of burn survivors in the first year of rehabilitation are not well studied. Considering the interrelationships among psychosocial processes in burn survivors, we assessed three psychosocial variables (i.e., social support, social participation, and body image) simultaneously in a longitudinal study. AIMS: This study aimed at identifying the developmental trajectory of the main study variables and also discovering the causal pathways between social support, body image, and social participation of burn survivors in the first year of rehabilitation. METHODS: One hundred individuals were enrolled in the study. The analysis was based on three waves of data collected at the time of discharge, 6 months after discharge, and 12 months after discharge. We used MSPSS, SWAP, and the p-scale for measuring the variables social support, body image, and social participation, respectively. A repeated-measures analysis of variance (ANOVA) was performed to identify the major differences in the mean levels of the main study variables across the three evaluation times. A structural equation modeling (SEM) approach was implemented in four hypothesized cross-lagged models (M1, M2, M3, and M4) to evaluate the bidirectional relationships among the main variables. All hypothesized models were tested, and their goodness-of-fit indexes were compared to identify the best fitting model. RESULTS: All three main variables worsen during the first six months after burn and then do not return to their earlier level. The M4 (final model) chosen to represent the data showed the best goodness-of-fit indexes (χ2 (9)=51.76, p<.01, RMSEA=0.060, IFI=0.97, and CFI=0.98) among all hypothesized models. The effect of social participation on body image, and vice versa, seems to be relatively constant and steady. Social support at the time of discharge predicted social participation at 12 months after burn, with the relationship mediated by body image at 6 months after burn. CONCLUSION: Our study findings suggest that persistent care should be provided for burn survivors even after discharge.

A Concept Analysis of Holistic Care by Hybrid Model.

PURPOSE: Even though holistic care has been widely discussed in the health care and professional nursing literature, there is no comprehensive definition of it. Therefore, the aim of this article is to present a concept analysis of holistic care which was developed using the hybrid model. METHODS: The hybrid model comprises three phases. In the theoretical phase, characteristics of holistic care were identified through a review of the literature from CINAHL, MEDLINE, PubMed, OVID, and Google Scholar databases. During the fieldwork phase, in-depth interviews were conducted with eight nurses who were purposely selected. Finally, following an analysis of the literature and the qualitative interviews, a theoretical description of the concept of holistic care was extracted. RESULTS: Two main themes were extracted of analytical phase: "Holistic care for offering a comprehensive model for caring" and "holistic care for improving patients' and nurses' conditions." CONCLUSION: By undertaking a conceptual analysis of holistic care, its meaning can be clarified which will encourage nursing educators to include holistic care in nursing syllabi, and consequently facilitate its provision in practice.

Unmet Supportive Care Needs of Iranian Cancer Patients and its Related Factors.

Introduction: Investigation of supportive care needs of cancer patients is important to implement any supportive care programs. There is no relevant studies investigated supportive care needs of Iranian cancer patients and factors affecting such needs. So, the aims of present study were to determine the unmet supportive care needs of Iranian cancer patients and its predictive factors. Methods: In this descriptive- correlational study 274 cancer patients in one referral medical center in North West of Iran participated. For data collection, demographic and cancer related information checklist and Supportive Care Needs Survey (SCNS) was used. Logistic regression was used for data analysis of un-adjusted and adjusted Odds Ratios (ORs) for patients needs and analysis of variables of study based on Backward LR procedure SPSS Ver.13. Results: More than fifty percent of participants reported unmet needs in 18 items of SCNS. Most frequent unmet needs were related to health system and information domains and most meet needs were related to sexuality and psychological domains. The result of logistic regression identified predictors of each domain of supportive care needs. The variable such as sex, age and living situation were most important predictors of unmet needs. Conclusion: The results showed that Iranian cancer patients have many supportive care needs in different domains. In general female cancer patients are at risk of more unmet supportive care needs. So, health care professionals should be more sensitive to fulfillment of supportive care needs of female.

The Effects of Music Therapy on Anxiety and Depression of Cancer Patients.

BACKGROUND AND PURPOSE: Cancer patients often suffer from anxiety and depression. Various methods are used to alleviate anxiety and depression, but most of them have side effects. Music therapy can be used as a noninvasive method to reduce anxiety and depression. This study aimed to examine the effect of music therapy on anxiety and depression in patients with cancer. MATERIALS AND METHODS: This quasi-experimental study was conducted attaching hospitals in Urmia city. A total number of sixty patients with depression and anxiety were recruited using random sampling method and divided into two groups of control and intervention. Patients in intervention group listened to light music at least 20 min per day for 3 days. The degree of patients' anxiety and depression was assessed by Hospital Anxiety and Depression Scale at baseline and 3 days after music therapy. Data were analyzed by SPSS version 13 using t-test, Pearson, and ANOVA tests. RESULTS: The results showed no significant differences between demographic variable of intervention and control groups. Our findings indicated a significant decrease in the level of depression and anxiety among intervention group. There were significant relationships between anxiety, depression, and sex (P < 0.001, r = 0.42) as well as education (P = 0.003, r = 0.37). CONCLUSION: This study revealed positive effects of music therapy on decreasing level of depression and anxiety in patients with cancer. Therefore, it is recommended to include music therapy in the nursing care.

Practice of Iranian Adolescents with Hemophilia in Prevention of Complications of Hemophilia.

BACKGROUND: Prerequisite for management of a chronic disease involves knowledge about its complications and their prevention. Hemophilia in adolescents influences all the aspects of their lives and thier performance. OBJECTIVES: The present study aimed to determine the performance of Iranian hemophilic adolescents in prevention of disease complications. PATIENTS AND METHODS: In this descriptive-analytical study, 108 adolescents with hemophilia were selected through convenience sampling. Their performance in preventing the complications of hemophilia was evaluated by sending a semi-structured questionnaire to their addresses throughout Iran. Then, the data was analysed using the Statistical Package for Social Sciences (SPSS) software (v. 13) and descriptive and interferential statistics were used. RESULTS: Overall, 32.1% of the participants controlled bleeding during the 1(st) hour. Inaccessibility of coagulation products was mainly responsible for inhibiting timely and proper bleeding control. In order to relieve bleeding associated pain, only 39.0% of the adolescents used analgesics. On the other hand, 19.8% of the subjects used nonpharmacological methods to relieve pain. The majority of the adolescents did not participate in sport activities (65.4%) others allocated less than 5 hours a week to physical activities (70.5%). In addition, the participants did not have favorable dietary patterns, exercise habits, and dental care. The results showed a significant relationship between the adolescents' preventive practice with coagulation disorders and utilization of pharmacological pain relief methods. Also, significant relationships were found between severity of the disease; participating in physical activities, number of hours of physical activities; and disease complications. CONCLUSIONS: Iranian adolescents did not exhibit favorable practices towards complication prevention.

Lack of Preparation: Iranian Nurses' Experiences During Transition From College to Clinical Practice.

Graduate nurse transition from college to professional practice is an important matter in a nurse's professional life. In many cases, this period is characterized by unhealthy physical and mental reactions, loss of interest in one's profession, and unacceptable caregiving. By examining the phenomenon from the point of view of experienced nurses, we can recognize the major factors in a successful transition from college life to professional life. This is a qualitative study and was conducted based on conventional qualitative content analysis method; 14 nurses were selected through purposive sampling, and the data were collected using semistructured interviews in teaching hospitals in Iran. Eight subthemes emerged from the analysis of the interviews: lack of practical skills, limited academic knowledge, inadequate social skills, poor self-confidence, lack of independence, frustration, stress, and loneliness. These items, in turn, fall under 3 themes: poor efficiency, low self-assurance, and unhealthy emotional reactions. The findings of this study indicate that the participants were not well prepared to assume their clinical roles, which in turn gives rise to other problems; to eliminate this defect, the curriculum needs to be revised, proper training programs should accompany the students' studies, and management in clinical environments recommended should be improved in order to facilitate nurses' transition from college to practice.