Family interactions in childhood leukemia: an exploratory descriptive study.

BACKGROUND: A child's cancer not only affects the child in question, but also their family members and even closes relatives and friends. The nature of this disease is such that, while imposing a high level of care workload on the family, it also affects various family aspects including personal, familial, and social interactions and relationships, as well as family functioning. This study aims to describe family interactions in childhood leukemia. METHODS: This study was an exploratory descriptive study, conducted on 58 participants (40 family members and 18 members of the health team), with purposeful sampling and semi-structured interviews-63 personal interviews and four group interviews-in the research context of the Cancer Hospital in Isfahan, 2016-2017. Data analysis in this study was carried out with qualitative content analysis using the Graneheim method. RESULTS: In the data analysis, four main categories and 13 subcategories were revealed. The first category, changes in roles, included the subcategories of super caregiver mother, supportive super father, role shift, self and others' forgetfulness, and confusion in roles and tasks; the second category, changes in interpersonal relationships, included the subcategories of changes in spousal relationships, changes in parent-child relationships, and changes in relationships between children; the third category, changes in social interactions, included the subcategories of changes in relationships with relatives, changes in relationships with peers, changes in relationships with the therapy team, and changes in interaction with supportive social networks; and the fourth category, changes in relationship with God, included the subcategories of spiritual bond and spiritual illness. CONCLUSION: Regarding the findings of this study, it is expected that health system policymakers in the country, while striving to strengthen the positive aspect of changes in family relationships and interactions, will develop and execute operational, comprehensive, and society-based plans in order to eliminate the barriers and problems of relationships within the family, as well as in relation to the larger community, taking into consideration the family's cultural and social beliefs.

Rise and fall: two sides of a coin of middle aged women's perceptions of reproductive: a qualitative study.

The present study was conducted to determine the perceptions of middle-aged women of reproductive changes. The present study was a qualitative research with a content analysis approach. The participants were 30 middle-aged women whose perceptions of reproductive changes had been collected on in-depth semi-structured interviews. The data were analyzed using the Graneheim and Lundman's inductive content analysis method. The main themes extracted from the data were a sense of "fall" and "the beginning of a new life cycle." A feeling of fall was formed from the subthemes "deterioration of youth," "the dusk of femininity," and "fade-out of the gender roles." The theme "beginning of a new life cycle" was formed from the subthemes of "acceptance," "sophistication," and "maturity." Middle-aged women had a wide range of emotions experienced from the reproductive changes ranging from a feeling of decline to that of excellence and rise.

Oral Health and Oral Health-Related Quality of Life among Elderly People in Iran.

Background: The study aimed to investigate oral health status and its relationship with oral health-related quality of life in the elderly in Isfahan, Iran, in 2022. Materials and Methods: This cross-sectional study was conducted in Isfahan, with 460 elderly participants. During interviews with the participants, their demographic information, their medical and dental history, oral health-related behaviors, self-perceived oral health, and clinical examinations were collected, and the Geriatric Oral Health Assessment Index (GOHAI) was completed. The final conclusions were made using the Generalized Linear Model (GLM) test. Results: The mean (sd) scores were 45.05 (8.62) for GOHAI, 5.44 (2.96) for self-perceived oral health, and 18.11 (5.76) for DMFT (Decayed, Missing and Filled teeth). Moreover, the number of remaining teeth on average was 11.78 (11.89), 39.56% of the participants did not brush their teeth, 40% of the elderly had complete dentures, and 27.17% had dental insurance. After adjusting and modifying the variables, the GLM test revealed that strong predictors for higher GOHAI scores were the higher levels of education (p < .001), the higher frequency of remaining teeth (p = 0.002), more pleasant self-perceived oral health (p < .001), and dental insurance (p = 0.04). Conclusions: According to the findings, the elderly's oral health-related quality of life in Isfahan was low, which was caused by the following factors: edentulism, few numbers of remaining teeth, high DMFT score, elderly' non-adjustment with dentures and their low quality, inappropriate oral health-related behaviors, lack of complementary insurance for dentistry, and non-using dental services, and low levels of education.

The Effect of the Family-Centered Self-Care Program on the Health Literacy Level and Self-Efficacy of Patients with Acute Coronary Syndrome During Discharge from Hospital.

Background: One of the factors effective in controlling acute coronary syndrome (ACS) symptoms, such as heart failure, is sufficient knowledge of the disease, factors effective on its occurrence, and its prevention. Moreover, the improvement of self-efficacy, which is a predictor of important life factors in these patients, such as treatment process and quality of life (QOL), must be considered as one of the main goals of nursing care for these patients. The aim of this study was to determine the effect of the family-centered self-care program on the health literacy level and self-efficacy of patients with ACS during hospital discharge. Materials and Methods: The present study was a quasi-experimental study performed with a pretest-posttest design. The statistical population of the study consisted of all patients with ACS hospitalized at Shahid Chamran Hospital in Isfahan in 2020. Through the convenience sampling method, 50 patients were selected and randomly divided into intervention and control groups. For the intervention group, 6 sessions of 45-60 minutes of family-centered self-care intervention were held. The subjects completed the Health Literacy for Iranian Adults (HELIA) questionnaire before and after the intervention. Data were analyzed using Chi-square test, independent t-test, and paired t-test in the SPSS statistical software. Results: The mean score of health literacy did not significantly differ between the intervention and control groups before the intervention (p > 0.050). However, after the intervention, this rate was equal to 82.16 (7.94) and 60.85 (15.71) in the intervention and control groups, respectively, which was significantly higher in the intervention group compared to the control group (p < 0.001). Furthermore, there was no significant difference between the two groups in terms of the mean self-efficacy score before the intervention (p > 0.05). However, after the intervention, this score was significantly higher in the intervention group 34.71 (10.11) compared to the control group 35.22 (13.30). Conclusions: Family-centered self-care program after discharge, as a simple, applicable, and efficient method can improve the health literacy level and self-efficacy of patients with ACS.

A cross-sectional study on the reasons for vaccine hesitancy in children under seven years of age in Isfahan, Iran.

Introduction: The diminution in vaccination coverage in recent years has contributed to the reappearance of infectious diseases, and vaccine hesitancy is one of the main causes. As a result, we investigated the causes of vaccine hesitancy in children. Materials and methods: This descriptive-analytical study was conducted cross-sectionally in 27 comprehensive health service centers in Isfahan City from June to October 2022. This study included Iranian families living in Isfahan who did not vaccinate their children by the due date. A researcher-made questionnaire collected data on children's vaccine hesitancy after verifying validity and reliability over the phone and in person by the researcher. The mothers completed informed consent. Independent T-tests, Pearson's correlation coefficient, analysis of variance, and a generalized linear model were used to analyze the data. Findings: Finally, 298 families participated in the study, 34.3% refused, and 65.7% delayed their child's vaccination. Vaccination was hesitant due to the child being sick at the time of injection (57.3%), believing that vaccination is not necessary to prevent uncommon diseases (49%), and being concerned about severe side effects caused by the vaccine (48.7%). Vaccine hesitancy among mothers with bachelor's degrees and families less than one kilometer from the health center was significantly less than among others. Additionally, Vaccines at birth, four, six, twelve, and eighteen months, and six-year-old vaccines were associated with vaccine hesitancy. Conclusion: Children's illness at the time of vaccination, the belief that vaccination is unnecessary to prevent uncommon diseases, and the worry about severe complications were among the most common reasons for vaccine hesitancy. Mother's education, distance to the health center, and vaccine type were associated with vaccine hesitancy.

Active aging needs from the perspectives of older adults and geriatric experts: a qualitative study.

Introduction: With an increasing rate of population aging and its consequences, preparation for active aging based on older adults' needs is an unavoidable priority. Active aging needs must be identified to help strategic planning for older adults' health and wellbeing. This study aimed to explore the active aging needs from the perspectives of older adults and geriatric experts. Methods: This exploratory-descriptive qualitative study was conducted in four provinces with the oldest populations in Iran. Semi-structured and focus group interviews were conducted with 41 participants (20 older adults and 21 geriatric experts), who were chosen through purposive and snowball sampling. Data were analyzed using the conventional content analysis. Results: This study identified three themes and thirteen categories from the data: (1) basic individual needs with three categories of physiological, psycho-emotional, and spiritual needs; and (2) managerial needs with seven categories of political-legal, socio-economic, and cultural-spiritual infrastructures, academic strategies, an age-friendly environment; technological services, and provision of specialized services and daycare for older adults, and (3) educational needs with three categories of training self-care and self-efficacy, empowering the health care workers; and empowering the family. Conclusion: The results revealed personal, managerial, and educational needs for active aging and could assist policymakers and geriatric experts to promote and meet active aging needs successfully.

Adaptation of Practice Guidelines to Prevent Functional Decline in Hospitalized Elderly in Iran.

Background: In Iran, many efforts have been made to improve the Quality of Life (QOL) of the elderly; however, despite the efforts made, there is no practice guideline based on the consensus of experts that can be used to prevent the functional decline of hospitalized elderly. Accordingly, the present study was conducted with the aim of adaptation of a practice guideline to prevent the functional decline of hospitalized elderly. Materials and Methods: This study is a developmental study based on the adaptation steps of the practice guideline. First, a search was conducted in 8 databases. The only practice guideline that met the inclusion criteria was then evaluated by the research team using the Appraisal of Guidelines for REsearch and Evaluation (AGREE II) tool. After content analysis of this guideline, the recommendations were categorized in the Canadian Senior Friendly Care (sfCare) Framework and according to the community conditions. Relevant evidence was used to supplement the content. The draft practice guideline was evaluated and modified in two expert panels through the RAND technique. Results: The categorized recommendations were developed in the eight chapters of introduction to the prevention of functional decline of the elderly, general practice guideline, organizational support, care processes, physical ecology, emotional and behavioral environment, ethics in care, and evaluation of function. Conclusions: To prevent functional decline in hospitalized elderly individuals according to the adaptive practice guideline, the hospital and health team need to be aware of support, care processes, and effective function appraisal to be able to provide care with coherent and coordinated solutions.

Nurses' experiences of the ethical values of home care nursing: A qualitative study.

Objective: Considering the importance of out-of-hospital services, the emergence of home care nursing, and the need for an ethical framework in nursing practice, the present study aimed to explore the nurses' experience of ethical values of home care nursing. Methods: The data of the study was collected using face-to-face individual interviews. Through purposive sampling, 20 nurses who worked in the home care centers in four cities of Iran in 2020 were interviewed. They shared their experiences of the ethical values of home care nursing. Then, the interviews were analyzed based on the content analysis approach and using Graneheim and Lundman method. Results: In the present study, 416 codes were extracted. Merging these codes based on the similarity, seven main themes, and 16 sub-themes were extracted. The themes included perception of the professional identity, respect for the client's autonomy, respecting privacy, establishing human interaction, maintaining mutual safety, observance of justice, and cultural-religious competence. The sub-themes included responsibility, development of professional and inter-professional interactions, maintaining the professional status at home, providing the holistic artistic care, patient's privacy, nurse's privacy, and maintaining the confidentiality of information, respect for the client's choice, honestly informing, empathetic interaction, adjusting the power positions, client's safety, nurse's safety, establishing justice, respect for the religious beliefs at home and cultural sensitivity. Conclusion: The participants stated that due to entering the patient's privacy in the home care cases, the ethical values such as perception of the professional identity, privacy, family interactions' management, mutual security, and cultural-religious competence became doubly important compared to the hospital caring.

Development and Psychometric Evaluation of the Gerontological Nursing Competence Questionnaire in Iranian Hospitals.

BACKGROUND: This study evaluated the Gerontological Nursing Competence Questionnaire-Farsi version (GNCQ-F) in Iranian hospitals. METHOD: This exploratory sequential study used a mixed-methods design. The questionnaire items were developed based on a qualitative descriptive exploratory study and a review of the literature. The psychometric properties of the initial questionnaire including face validity, content validity, construct validity, internal consistency, and stability were evaluated. RESULTS: Exploratory factor analysis resulted in the extraction of 42 items in five factors including care competence and patient/older adult and family empowerment, ethical and compassionate care competence, patient safety competence, continuous professional development and self-care competence, and collaborative and team care competence. Cronbach's alpha coefficient confirmed the internal consistency of each subscale and the entire tool (0.942). The stability reliability was 0.973 and was determined by calculating the intra-cluster correlation coefficient. CONCLUSION: Nurses can use this self-evaluation instrument to assess their gerontological nursing competence. [J Contin Educ Nurs. 2021;52(7):335-343.].

The Effect of an Educational Intervention based on Pender's Health Promotion Model on Treatment Adherence in the Patients with Coronary Artery Disease.

BACKGROUND: Increasing of hospitalization rates of Coronary Artery Disease (CAD) management have created major challenge for the health system. Poor adherence to treatment is one of the main reasons for treatment failure, prolongation of treatment, and increase care costs. The aim of this research was to determine the effect of educational intervention based on Pender's Health Promotion Model (HPM) on adherence in patients with CAD. MATERIALS AND METHODS: This randomized controlled clinical trial was held in an educational hospital in Isfahan, Iran, February 2018-May 2019. Data were collected from 64 patients with CAD, before, 1 and 3 months after the intervention. The instrument used included treatment adherence questionnaire and a checklist Pender's HPM. The study group received dietary, exercise, and medication education based on Pender's HPM in four sessions which were held in 4 weeks. The control group received the routine educational program of the hospital. The data was analyzed using descriptive statistics, repeated measures ANOVA, independent t, Chi-square, and Mann-Whitney tests via SPSS software. RESULTS: The mean score of treatment adherence was significantly different between two groups in one (z = 5.28, df = 2, p < 0.001) and three (z = 4.51, df = 2, p < 0.001) months after the intervention. The mean (SD) of treatment adherence in the study group was 139.82 (27.44) 3 months after the intervention. CONCLUSIONS: Educational intervention based on Pender's HPM is more effective on treatment adherence than the routine method in the patients with CAD. It is recommended to integrate the Pender's HPM as a nursing care program for these patients.

Investigating the Effect of Family-Centered Self-Care Program based on Home Visits Regarding Dietary and Medication Regimen Adherence of Discharged Patients with Acute Coronary Syndrome.

BACKGROUND: Dietary and medication regimen adherence in patients with history of Acute Coronary Syndrome (ACS) is very important in preventing readmission and reducing the complications of the disease. The objective of the present study was to investigate the effect of the family-centered self-care program based on home visits dietary and medication regimen adherence in patients with ACS discharged from Shahid Chamran Hospital during 2017-2018. MATERIALS AND METHODS: This clinical trial was conducted on 80 ACS patients. The samples by using the random numbers table, were randomly divided into control and experimental groups. The routine interventions were administered for the control group, and family-centered self-care was conducted on patients of the experiment group. In order to obtain the quantitative data of this study, three questionnaires were used including demographic characteristics, Morisky questionnaire, and dietary adherence. RESULTS: The difference between the mean score of medication and diet regimen adherence in both groups before the intervention was not significant (p > 0.05). data was demonstrated that scores of medication and diet regimen adherence were significantly higher immediately and 6 weeks after the intervention; (f = 64.06, p < 0.001). CONCLUSIONS: Family-centered self-care program based on home visits can be used as an effective method to increase the dietary and medication regimen adherence in ACS patients.

The effect of training program of health promotion behaviors on geriatric general health components.

BACKGROUND: Increasing in elderly's population and their individual and social problems especially mental health problem in this group need special attention. The aim of this study was evaluation of health promotion behaviors training program efficacy on general health components in elderlies referring to health centers in Isfahan city. MATERIALS AND METHODS: This study was a tri phasic field trial in 2014 in which 72 elderlies allocated randomly in two case and control groups. Case group participated in 9 training sessions on stress management and interpersonal relationships and the control group participated in 2 sessions with a neutral discussion content. Data collection tools were demographic information questionnaire and general health questionnaire 28. Pretest, posttest, and 2-month follow-up were performed in two groups. Data were analyzed by t-test, analysis of variance with repeated measurement, least significant difference post hoc test, and SPSS 20 software. RESULTS: Findings of this study showed that the average of general health score in case and control groups had not significant difference before the intervention (P > 0.05). However, the mean difference of general health score after intervention and 2-month follow-up was statistically significant in two groups (P < 0.001). CONCLUSIONS: This study showed that interpersonal relationship and stress management training program are effective on promotion of mental health in elderlies. Hence, the findings of this study can be used in the field of treatment and care of the elderly by other health-care categories.

Fitness information-seeking behavior among female university students: A qualitative study.

Obsession with the physique and appearance is a by-product of consumer societies. As such, fitness and slimming have now become major concerns of Iranian females. This study endeavors to elaborate on information-seeking behaviors among female students of Isfahan University of Medical Sciences concerning fitness. This study conducted in 2018, employs a qualitative approach using conventional content analysis. The research population includes female students of Isfahan University of Medical Sciences, 16 of whom were selected with use of purposive sampling. Data were collected through face-to-face semi-structured interviews and their trustworthiness was confirmed by the criteria of 'credibility', 'confirmability', 'dependability', and 'transferability' proposed by Guba and Lincoln. Results reveal four sub-categories and nineteen codes on information-seeking behavior. Sub-categories and codes including information-seeking motivations (achieving physical health, physical appearance, social acceptability, self-confidence, family and friends' pressure) information resources (electronic information resources, social media, printed information resources, doctors and nutritionists, family and friends, traditional & Islamic medicine, radio and TV), information validation (asking the doctors and specialists, matching the information with scientific references, consulting with friends and relatives) and obstacles to seeking information (lack of time, high costs, distrust, access limitation). by increasing the students' informational and media literacy, providing authentic and low-cost online resources of information and specialized TV programs, the damages rooted in using invalid information resources concerning fitness can be substantially diminished.

Design and psychometric analysis of a climacteric adjustment questionnaire for middle-aged women.

OBJECTIVE: The climacteric adjustment questionnaire (CAQ) was developed to assess the adjustment with fertility changes in middle-aged women. The aim of this study was to examine the psychometric properties of the CAQ in a sample of Iranian middle-aged women. METHOD: This study used the impact item method and exploratory factor analysis (EFA) to evaluate the psychometric properties and construct validity of the developed questionnaire. The primary questionnaire was developed based on a qualitative study. A principal componential analysis (34 items) with Varimax rotation was conducted in a cross-sectional study on 277 middle-aged women. RESULTS: In the qualitative section, of the 34 items extracted, those with an impact item index of over 1.5, a content validity ratio of over 0.42, and a content validity index of over 0.79 were considered as valid. EFA reduced the list of the items to 32 with six factors capable of predicting 58% of the variance. The Cronbach's α coefficient for CAQ was 0.863. CONCLUSION: The findings of the present study indicated that the validity and reliability of the questionnaire designed to measure the adjustment to the climacteric period in middle-aged women could be used in related studies.

The relationship between moral distress in nurses and ethical climate in selected hospitals of the Iranian social security organization.

The present study was conducted to determine the relation between nurses' moral distress and the ethical climate in selected hospitals of the Iranian Social Security Organization (ISSO). This descriptive-analytical correlational study was conducted in 6 hospitals under the coverage of the Iranian Social Security Organization in 2016. Three hundred nurses were selected by convenience sampling method. Data were gathered using Corley's Standard Moral Distress and Olson's Hospital Ethical Climate Scales. Data were analyzed using SPSS software version 19. The mean score of the nurses' moral distress was 1.94 ± 0.66, which is considered moderate. The mean score of ethical climate was 88.97, indicating desirable ethical climate in these hospitals. The frequency score of moral distress had a unilateral reverse correlation with the total score of ethical climate as well as its dimensions, including colleagues, patients, hospitals and physicians. The score of the intensity of nurses' moral distress also had a unilateral reverse correlation with the total score of ethical climate and the scores of the hospital and physicians dimensions. These results emphasized the importance of creating a positive ethical climate to decrease moral distress as well as the need for professional interventions to increase support in moral issues.

The Components of Nursing Competence in Caring for Older People in Iranian Hospitals: A Qualitative Study.

BACKGROUND: There is limited research on gerontological nursing competence in hospitals. However, there is no comprehensive and integrated description of the gerontological nursing competence requirements in hospitals. The purpose of this study was to explain the components of nursing competence in caring for older people in Iranian hospitals. MATERIALS AND METHODS: This is a qualitative descriptive-exploratory study. The data were collected through a semi-structured interview with nurses, nurse managers, and clinical educators in teaching hospitals and nursing schools affiliated to Arak, Isfahan, and Tehran Universities of Medical Sciences in Iran from September 2015 to July 2016. Participants included 25 people who were selected by purposive and snowball sampling method. Sampling continued until data saturation. Data were analyzed using conventional content analysis method. RESULTS: Data analysis generated three main categories including (1) Patient and family centered care; (2) Process-oriented care; and (3) Self-care and continuing professional development. CONCLUSIONS: Nurses should have competencies such as participation and empowerment of the patient and family; ease of comfort in the elderly; comprehensive geriatric assessment; development, implementation and evaluation of care plan; development of knowledge and clinical proficiency; and coaching so that they can work effectively during the care of the elderly. The results of this study can be used by nursing educators, nursing students, and nurses to develop their individual and professional skills in the field of gerontological nursing.

The Effect of Education Program on Health Promotion Behavior on Successful Aging.

BACKGROUND: A successful aging pattern indicates a change in attitudes toward aging and life quality improvement, which include the components of general health and life satisfaction. The current study aimed to evaluate the effects of an educational program on successful aging components in the elders. MATERIALS AND METHODS: A three-stage empirical study was conducted on 72 individuals of 60-75 years old who were randomly divided into two experimental and control groups. A 9-session educational program presenting health-related behaviors, including stress management and interpersonal relationships, was held for the experimental group. Two sessions of neutral topics group discussion were held for the control group. A Demographic Information Questionnaire, General Health Questionare-28 (GHQ-28), Diener's Satisfaction with Life Scale (SWLS) were used and completed before, immediately after, and two months after the intervention. Independent t-test was used for analysis of obtained data via SPSS software. RESULTS: The mean (SD) score of general health in the two groups had no significant differences before the intervention [32.40 (14.70) vs. 30.8 (10.04)] (p = 0.60). The mean (SD) scores of general health immediately after intervention and two months later in the experimental group [20.2 (8.8) and 24.1 (8.05)] were significantly lower than control group [31 (9.8) and 30.9 (9.8)] (p < 0.05). The mean (SD) scores of life satisfaction in the both groups showed no significant difference before the intervention [16.8 (5.8) vs. 17.3 (5.5)] (p = 0.39), but were significantly different immediately after [20.4 (5.1) vs. 17.03 (5.1)] and two months after [19.8 (5.1) vs. 17.1 (5.1)] (p = 0.004). CONCLUSIONS: This study confirmed the effectiveness of health-related educational programs in improving elders 'general health and life satisfaction'.

Designing and Evaluating an Empowering Program for Breastfeeding: A Mixed-Methods Study.

BACKGROUND: Breastfeeding empowerment is a key motivational, psychological and flexible factor influencing the continuance of breastfeeding. The purpose of this mixed-methods study was to design and evaluate the empowering program for breastfeeding. METHODS: We used a mixed-methods study with a sequential exploratory approach. In the qualitative phase, we explored the experiences of women about empowerment for breastfeeding using conventional content analysis. In the intervention phase, we designed and implemented a breastfeeding empowerment program based on the findings of the qualitative phase and evaluated it 2 weeks, 2 months and 4 months after childbirth. This randomized clinical trial is registered under IRCT2015081723657N1. RESULTS: Analysis of data from the interviews in the qualitative phase yielded three main categories, namely "adequate knowledge and skills about breastfeeding", "overcoming breastfeeding problems" and "perception of family support for breastfeeding". In the qualitative phase, after implementing the program, the mean scores of breastfeeding empowerment were significantly higher in the intervention compared to the control group at 2 weeks (mean difference= -25.30; 95% CI = -5.36, -15.23), 2 months (mean difference = -21.71; 95% CI = -31.24, -12.19), and 4 months (mean difference = -17.72; 95% CI = -27.14, -8.30) after childbirth (P<0.001). In addition, exclusive breastfeeding was significantly higher in the intervention group at 2 weeks, 2 months and 4 months after childbirth (P=0.003, P=0.003, P=0.044, respectively). CONCLUSION: To empower women for breastfeeding, the mother, father and key family members should be educated using practical and visual teaching techniques during pregnancy and postpartum period. Moreover, since breastfeeding empowerment is established 2 weeks after childbirth, empowering programs should be implemented prior to this period.

Effective Factors for Development of Gerontological Nursing Competence: A Qualitative Study.

BACKGROUND: Many nurses working in hospitals are not prepared to provide appropriate care for older people. This qualitative study aimed to identify factors influencing the development of gerontological nursing competence in Iranian hospitals. METHOD: Twenty-six participants (nine nurses, 12 nurse managers, four clinical instructors, one physician) who worked in four teaching hospitals and nursing schools were interviewed by semistructured interview method. Conventional content analysis was used. RESULTS: Two main categories emerged from the data: (a) management factors with the subcategories of meritocracy in elderly nursing, leadership style of nursing managers, educational system, the quality of working life, and performance management; (b) organizational factors with the subcategories of organizational learning, and organizational support. CONCLUSION: These findings can help nurse managers and clinical instructors identify, develop, and implement strategies for further development of gerontological nursing competence. [J Contin Educ Nurs. 2019;50(3):127-133.].

The Relationship between Family Functioning and Academic Achievement in Female High School Students of Isfahan, Iran, in 2013-2014.

BACKGROUND: Nowadays, the most important problem of the educational system is the vast spread of school failure. Therefore, detection of the factors leading to or preventing students' academic achievement is of utmost importance. Family function is considered to be a critical component of academic success. This study aimed to investigate the relationship between family functioning and academic achievement in high school female students in Isfahan. MATERIALS AND METHODS: This descriptive correlational study was conducted through random sampling among 237 female high school students in Isfahan during school year 2013-2014. Data were collected by participants' personal characteristics and Bloom family function questionnaires. To analyze the data, descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation and linear regression analysis) were adopted and computed using SPSS software. RESULTS: The results showed a significant correlation between family function (except lack of independence) and students' academic achievement (p < 0.05). Further, among family function dimensions, expressiveness (ß = 0.235, p < 0.001), family socialization (ß = 0.219, p = 0.001), and cohesion (ß = 0.211, p = 0.001) were more reliable predictors of academic achievement. CONCLUSIONS: The results of this study showed that students' academic achievement is highly correlated with the performance of their families. Therefore, to improve students' educational status in cultural and educational programs, which are specified for them, family function centered plans should be at the heart of attention.