Application of "Partnership Care Model" in chronically ill adults and children: A systematic review and dose-response meta-analysis of randomized controlled trials.

BACKGROUND: "Partnership Care Model (PCM)", which is the first partnership conceptual framework founded on the Iranian culture to control chronic diseases, has been recently used in different fields of nursing research with no levels of valid evidence to support its application. Therefore, this systematic review and meta-analysis sought to clarify the impacts of interventions developed based on PCM on quality of life (QoL), sleep quality, anxiety, and depression among adults and children with chronic diseases. METHODS: International data sources (e.g., PubMed, Web of Science, Scopus) and national databases (e.g., SID, MagIran, IranDoc, IRCT) were searched from 2001 to September 23, 2023, to find Randomized Controlled Trials (RCTs) on PCM-driven interventions for the experimental groups versus no intervention or standard care groups. The studies' methodological quality and evidence quality were rated utilizing the Cochrane risk of bias instruction and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Data were pooled by a random-effects approach employing STATA (vers. 11.2). RESULT: Eighteen RCTs, reported in 22 publications, were qualified. The PCM compared to the standard care significantly improved the QoL among both adults (10 effect sizes [ESs], mean difference [MD]: 3.17, P < 0.001) and children (4 ESs, MD: 4.45, P < 0.001). Likewise, the intervention enhanced adults' sleep quality (3 ESs, MD: 7.15, P < 0.001). The anxiety of adults and children was also significantly lower in the PCM group (4 ESs, MD: -4.52, P = 0.001; 2 ESs, MD: -4.04, P < 0.001, respectively). However, regarding depression, a significant effect of PCM was found only among children (3 ESs, MD: -7.99, P = 0.011). The methodological quality of the studies and the evidence quality were undesirable. CONCLUSION: The PCM had a promising influence on the caring of adults and children suffering from chronic diseases. However, additional high-quality RCTs are needed to generate a higher quality of evidence concerning the clinical benefits of the PCM. PROSPERO NO: CRD42021253790.

The Effect of Aloe Vera on the Healing of Diabetic Foot Ulcer: A Randomized, Double-blind Clinical Trial.

BACKGROUND: Diabetic foot ulcer (DFU) is a prevalent complication of diabetes that can result in severe consequences. The cost of treating DFUs is high, and there is a lack of new therapies available in developing countries. This has created a demand for complementary and alternative treatments. The objective of this study was to assess the impact of aloe vera gel on the healing process of diabetic foot ulcers. METHODS AND MATERIALS: The study was a double-blind, randomized, controlled clinical trial. The study samples were 66 patients with diabetic foot ulcers who were randomly assigned to two groups (intervention and control). All ulcers in both groups were washed with normal saline and dressed in sterile gauze. The ulcers in the intervention group were covered with a thin layer of Aloe Vera gel before the dressing. The Bates-Jensen Wound Assessment Tool (BWAT) was used on three occasions, including before the intervention period and at the end of each week. Data were analyzed using SPSS 16. RESULTS: After three weeks, there was a notable contrast in the recovery pattern of the two groups. The patients who had aloe vera gel added to their dressing showed a more substantial decrease in the mean scores of their BWAT. CONCLUSION: These findings are promising and suggest that Aloe vera may be a safe and effective adjunctive treatment for diabetic foot ulcers. However, further research is needed to confirm these results and to investigate the underlying mechanisms of aloe vera's therapeutic effect on diabetic foot ulcers.

Psychometric analysis of Persian version of patient safety competency self-evaluation in psychiatric wards.

BACKGROUND: Assessment of the patient safety competency is necessary for the growth of nursing and safe care profession as well as evaluation of the nurses' educational needs. The present study was conducted to determine psychometric properties of the Persian version of the patient safety competency self-evaluation (PSCSE) tool in Iranian psychiatric wards. MATERIALS AND METHODS: All nurses (n = 209) working in two psychiatric hospitals of Kerman, Iran, were included in the present cross-sectional study using census method. This tool contains 41 items: six items are related to knowledge, 14 items deal with attitude, and 21 items are about skill dimension. Psychometric properties of the questionnaire including its content and face validity were also examined. The factor structure of the questionnaire was evaluated using exploratory factor analysis. The internal consistency and reliability were assessed by test-retest method with an interval of 14 days. Cronbach's alpha and corrected item-total correlation were used to measure reliability. RESULTS: The content validity index was 0.65 and the content validity ratio was 0.89. Item 14 was removed from the skill domain because it was not related to the psychiatric ward. According to the results of factor analysis, there was a significant relationship between the questions and the relevant factors. The correlation coefficient for test-retest with 14 days interval was intraclass correlation coefficient = 0.92 for the whole instrument and 0.89, 0.89, and 0.92 for the domains of knowledge, attitude, and skill, respectively. The internal consistency coefficient (Cronbach's alpha) of the whole tool was 0.95 and 0.95, 0.79, and 0.95 for the domains of knowledge, attitude, and skill, respectively. Finally, PSCSE Questionnaire was obtained with 40 items in dimensions of knowledge (6 items), attitude (14 items), and skills (20 items). CONCLUSION: Persian version of the nurses' competency tool in ensuring patient safety in psychiatric wards has acceptable psychometric characteristics.

Nurses' patient safety competency, a predictor for safe care in psychiatric wards?

PURPOSE: This study examined the relationship between patient safety competence and safe care from the viewpoints of nurses working in psychiatry wards. DESIGN AND METHODS: The present descriptive correctional study was conducted in two psychiatry hospitals in Iran in 2020. All the nurses were selected as the study participants using the census sampling method (N = 209). FINDINGS: Nurses' patient safety competency was at a low level (2.54 ± 0.52), but nurses' safe care was at a moderate level (242.08 ± 61.32). A strong positive relationship was found between the patients' safety competency and nurses' safe care (p = 0.001, r = 0.84). PRACTICE IMPLICATIONS: Nursing managers should support nurses by providing the required resources and operational strategies to improve their competency and safe care in providing quality care.

The Effect of Patient Safety Education on Undergraduate Nursing Students' Patient Safety Competencies.

Patient safety is influenced by a set of factors in various levels of the healthcare system. One of the factors affecting patient safety is safety competencies of the nursing students. The current study aimed to evaluate the effect of patient safety education on patient safety competencies of the nursing students. This quasi-experimental study was conducted with a pretest-posttest deign. The levels of patient safety competencies of 50 nursing students were investigated in a nursing school affiliated to large university of medical sciences in the south of Iran in 2019. Data were collected using Health Professional Education in Patient Safety Survey (H-PEPSS). The data were analyzed in SPSS 21 using descriptive statistics and repeated measures ANOVA. The three investigated intervals were significantly different in terms of the total H-PEPSS dimensions, while the lowest was attributed to the dimension "managing safety". Mean scores of "how broader patient safety issues are addressed in health professional education" and "comfort speaking up about patient safety" significantly increased during the follow-up periods. The educational intervention was partially effective in improving patient safety competencies of the nursing students over long term.

Effect of Rosa damascena on improvement of adults' sleep quality: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Recent studies have reported inconclusive results regarding the potential effects of Rosa damascena on sleep quality. Therefore, this review aimed to summarize the findings of parallel-group and cross-over randomized controlled trials (RCTs) on the effects of aromatherapy and oral intake of Rosa damascena on adults' sleep quality. METHODS: The electronic data sources of PubMed, Scopus, Web of Science Core Collection, Embase, CENTRAL, ProQuest, CINAHL, SID, and MagIran were searched from inception to June 30, 2021. Out of 1341 publications found in the initial search, 10 RCTs were considered eligible for this review. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. Sufficient data were statistically pooled by a random-effects model using Stata software (version 11.2); otherwise, a narrative summary was presented. RESULTS: Based on the systematic review, the inhalation and oral intake of Rosa damascena could improve some sleep-related outcomes. The pooled analysis of seven effect sizes revealed that inhalation aromatherapy with Rosa damascena significantly improved sleep quality (standardized mean difference: 2.24; 95% confidence interval: 1.01-3.48; P < 0.001). Most RCTs had fair methodological quality, and two RCTs reported the adverse effects of treatment, including headache, nausea, vomiting, and frequent sneezing. CONCLUSIONS: The administration of Rosa damascena seems to be a promising approach in complementary and alternative medicine for the improvement of adults' sleep quality. However, considering the fair methodological quality of most RCTs and reported adverse effects, it is required to perform further high-quality RCTs to draw an evidence-based conclusion on the use of Rosa damascena for the improvement of adults' sleep quality. PROSPERO NO: CRD42020211778.

Rosa Damascena mill for treating adults' anxiety, depression, and stress: A systematic review and dose-response meta-analysis of randomized controlled trials.

Recent studies have reported conflicting findings on the antianxiety, antidepressant, and anti-stress properties of Rosa Damascena Mill (RDM). Therefore, the present systematic review and meta-analysis were conducted on the effects of RDM for treating anxiety, depression, and stress amongst adults. The online data sources of Cochrane Central Register of Controlled Trials, PubMed, Scopus, Web of Science, Embase, ProQuest, and Scientific Information Database were searched from inception to June 30, 2021. The randomized controlled trials (RCTs), which examined the effects of RDM (in any form of administration) on adults' anxiety, depression, and stress, were included. A random-effects model was applied to pool the data, and a total of 32 publications were included. The results of the meta-analysis revealed that administration of RDM significantly reduced state anxiety (effect size [ES]: 24, standardized mean difference [SMD]: -1.74, 95% confidence interval [CI]: -2.29, -1.20; p < .001), depression (ES: 7, SMD: -0.87, 95% CI: -1.47, -0.28; p = .004), and stress (ES: 4, SMD: -1.33, 95% CI: -1.98, -0.69; p < .001). However, the treatment had no significant effect on trait anxiety (ES: 6, weighted mean difference: -0.75, 95% CI: -1.93, 0.43; p = .214). The association between the total administration dosage and/or duration of RDM and the changes in state anxiety and depression was not dose-dependent. Most RCTs had a fair methodological quality based on the Cochrane risk of bias assessment tool. Besides, the quality of evidence ranged from very low to moderate according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Hence, further high-quality RCTs are needed to draw reliable conclusions regarding the use of RDM for treating adults' anxiety, depression, and stress.

Spiritual Well-Being and Purpose in Life Among Conscripts: A Case Study in Iran.

BACKGROUND: Spiritual Well-Being (SWB) is an important aspect of health. Since soldiers, as members of community, are faced with numerous spiritual, psychological, and physical problems, belief in spirituality can play an important role in explaining their purpose in life (PIL). Therefore, this study aimed to evaluate SWB, PIL, and the relationship between these two concepts in conscripts. In this cross-sectional study, 301 soldiers were selected by available sampling method from one of the military barracks in Iran 2019. Data were collected using the demographic, SWB, and PIL questionnaires. The results showed that SWB of the soldiers were at the high level (100.6 ± 12.30) and their PIL were at the moderate level (112.92 ± 13.70). Furthermore, a direct and intermediate relationship was observed between the soldiers' SWB and PIL (P <0.001, r = 0.50). Based on the findings, increased SWB enhanced PIL in soldiers and vice versa. To increase generalizability of the data, studies over a larger statistical population are recommended in different cultures. Findings of this study can also identify the interventional strategies to increase the soldiers' purpose in life.

Effect of aromatherapy with Damask rose on alleviating adults' acute pain severity: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND PURPOSE: Although recent studies have investigated the analgesic activity of Damask rose using aromatherapy in different painful conditions, the results are inconclusive. Hence, this systematic review and meta-analysis aimed to clarify the effect of aromatherapy with Damask rose on adults' acute pain. MATERIAL AND METHODS: The online databases of MEDLINE/PubMed, Scopus, ISI web of science, Embase, ProQuest, CENTRAL, CINAHL, SID, and MagIran were searched up to August 10, 2020. The aim of this study was to find randomized controlled trials on the effect of aromatherapy with Damask rose in any form of administration (inhalation, vapor diffusion, and massage) on different types of acute pain in adults. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. Moreover, the quality of the evidence was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects model was applied to pool data using Stata. RESULTS: A total of 16 studies met the inclusion criteria, of which only one was not included in the meta-analysis. Pooled analysis revealed that aromatherapy with Damask rose reduced the pain severity significantly (WMD: -2.12; 95% CI [-2.85, -1.40]; P < 0.001). Inhalation aromatherapy (WMD: -2.39; 95% CI [-3.31, -1.48]; P < 0.001) and aromatherapy massage (WMD: -1.16; 95% CI [-1.57, -0.75]; P < 0.001) also had significant effects on pain reduction. The quality of evidence was low. CONCLUSION: Aromatherapy with Damask rose had a favourable effect on reducing the severity of acute pain in adults. However, there is insufficient evidence for the clinical benefits of aromatherapy with Damask rose due to the low-quality evidence. Accordingly, more high quality randomized clinical trials are needed to make an evidence-based conclusion.

Correction to: The effect of transactional analysis on the self-esteem of imprisoned women: a clinical trial.

Following publication of the original article [1], the authors advised that the name of the 4th author had been submitted incorrectly; the author has the family name 'Pouraboli', however, their article was originally published with the family name (mis) spelled as 'Pouraboili'.

The effect of transactional analysis on the self-esteem of imprisoned women: a clinical trial.

BACKGROUND: The imprisoned women usually have low self-esteem and suffer from various physical and mental complaints; they may suffer from feelings of emptiness, isolation, and depression. Transactional analysis (TA) is part of a comprehensive system attributed to the individual and social psychiatry for personal development of self-esteem among the imprisoned women. Therefore, the present study aimed to investigate the effect of TA group-training on the self-esteem of imprisoned women. METHODS: This clinical trial was conducted among the imprisoned women in a prison in Southeastern Iran using pretest-posttest design. In this regard, 76 women were randomly allocated to the intervention (n = 35) and control (n = 41) groups. The TA group-training program was held for eight 90-min sessions for the intervention group. Data were collected using a demographic questionnaire and the Rosenberg's self-esteem scale (RSES). Later, all participants were evaluated before and 1 month after the intervention. RESULTS: In pre-test, the mean scores of self-esteem were 11.8 ± 4.67 and 7.97 ± 4.52 for the intervention and control groups, respectively. These scores showed low levels of self-esteem and the difference between the two groups was significant (p = 0.001, t = - 3.61). In the post-test, the mean scores of self-esteem improved to the moderate level (22 ± 2.52) in the intervention group compared to the control group (8.92 ± 4.04). This indicates the significant improvement of self-esteem in the intervention group (p = 0.001, t = 17.15). CONCLUSIONS: The results showed that TA group-training had a significant effect on self-esteem. Therefore, the experienced and expert counselors and psychologists are recommended to hold transactional analysis group-training courses to enhance self-esteem among women prisoners. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT20170725035289N5 Date registered: 25/08/2018.

Cognitive Behavioral Therapy for Occupational Stress among the Intensive Care Unit Nurses.

BACKGROUND AND AIMS: Nurses working in the intensive care units (ICU) are faced with numerous stressors that can pose a serious threat to their self-efficacy and affect the quality of care. The aim of this study was to evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) on the ICU nurses' occupational stress. METHODS: This interventional study was conducted in a hospital in southeast of Iran. The participants included 120 nurses, who were randomly assigned into the control (n = 60) and intervention (n = 60) groups. In the pre-test, the occupational stress was assessed using Osipow questionnaire. Later, the intervention group attended the CBT course conducted in six 90 minute sessions. One month after the intervention, the post-test data were collected from both groups. RESULTS: The means of occupational stress and its dimensions were not significant before the intervention between the intervention and control groups (P = 0.47). The means of occupational stress and its dimensions were moderately high at pretest for all nurses. In the post-test, the stress level and all its dimensions reduced from moderate-high to moderate-low (P < 0.001), except for the physical environment dimension that remained at the moderate-high level (P = 0.32). CONCLUSION: The findings showed that CBT was effective on the nursing stress. Therefore, CBT training is suggested in in-service training programs for nurses.

Nurses' perspectives regarding the relationship between professional ethics and organizational commitment in healthcare organizations.

Nurses' professional and ethical performances are influenced by the health organizations' environment, and high quality and holistic care can only be provided by observing the principles of professional ethics and organizational commitment. Therefore, this study aimed at investigating the relationship between professional ethics and organizational commitment in nurses. This descriptive-analytic study was conducted in hospitals affiliated to Shiraz University of Medical Sciences (SUMS) in 2019 in Iran. The study participants included 210 public ward nurses selected using the stratified random sampling method. Data were collected using Petty Professional Ethics and Allen-Meyer Organizational Commitment questionnaires, and then analyzed by SPSS V.25. Both the mean score of the nurses' professional ethics (102.21 ± 10.89) and the mean score of the nurses' organizational commitment (95.30 ± 16.54) were at high levels. Moreover, a direct and significant relationship was found between professional ethics and organizational commitment (P= 0.009, r = 0.179). In other words, a positive correlation was found between professional ethics and organizational commitment. Considering the relationship between professional ethics and organizational commitment in nurses, managers should enhance nurses' level of adherence to ethical principles, organizational commitment and organizational attachment. Additionally, training courses can help improve nurses' professional capabilities, and hence enhancing the quality of providing healthcare services.

Relationship between adaptation and self-esteem in addicted female prisoners in the south east of Iran.

Background Reduction of the adaptation and self-esteem can be the consequence of opium addiction and imprisonment. Drug use causes inappropriate behaviors in women, which are quite different from those in men. Social deviations, prostitution, high-risk sexual behaviors, abortion, divorce and imprisonment followed by loss of self-esteem are the consequences of women's addiction. The present study was conducted to assess the relationship between adaptation and self-esteem in addicted female prisoners. Methods In this descriptive analytical study, 130 addicted female prisoners were selected from a prison in the south east of Iran using census sampling. The data were collected by a demographic questionnaire, the Rosenberg's self-esteem scale and the bell adjustment inventory (BAI). Results According to the results, women's adaptation fell into the 'very unsatisfactory' range. The highest mean was related to the emotional dimension, while the lowest mean was in terms of the health dimension. In total, 96.4% of the participating women had low adaptation. The mean total self-esteem fell into the low range; in fact, 84.6% of the women had a low self-esteem. The results showed no significant relationships between adaptation and self-esteem in these women; however, self-esteem was significantly and inversely related to health and emotional adaptation. Conclusion The findings showed that the majority of the women had unsatisfactory adaptation as well as poor self-esteem. No significant relationships were observed between adaptation and self-esteem in the addicted female prisoners.