Psychosocial Experiences of Older Women in the Management of Urinary Incontinence: A Qualitative Study.

Introduction: Urinary incontinence is a prevalent disorder amongst older women. Identifying the psychosocial experiences of older women in disease management can improve the patient care process. Hence, the present study aimed to determine the psychosocial experiences of older women in the management of urinary incontinence. Methods: This qualitative study was conducted using conventional content analysis. The study data were collected via unstructured in-depth face-to-face interviews with 22 older women suffering from urinary incontinence selected via purposive sampling. Sampling and data analysis were done simultaneously and were continued until data saturation. The interviews were recorded, transcribed, and analyzed using the method proposed by Graneheim and Lundman. Results: The results indicated that the older people with urinary incontinence had various psychosocial experiences while living with and managing this disease. Accordingly, four main themes were extracted from the data as follows: "problem incompatibility with the disease," "mental impasse," "facing social restrictions," and "concealment and social escapism." Conclusion: The findings demonstrated that older people with urinary incontinence experienced significant psychosocial pressures while living with this disorder, which affected their psychosocial well-being. Thus, paying attention to these psychosocial experiences while supporting and taking care of these patients can positively impact their psychosocial health and quality of life.

Experiences of Urinary Incontinence Management in Older Women: A Qualitative Study.

INTRODUCTION: Older women have various experiences regarding the management of urinary incontinence depending on the societies they live in and their cultural backgrounds. The present study aimed to determine older women's experiences in urinary incontinence management. METHODS: The present qualitative study employed a conventional content analysis approach and was conducted in Iran from 2019 to 2020. In this research, the data were collected through face-to-face unstructured in-depth interviews with 22 older women suffering from urinary incontinence selected via purposeful sampling. The interviews were continued until reaching the data saturation point. Data analysis was performed simultaneously with data collection. The interviews were recorded, transcribed, and analyzed through Graneheim and Lundman style content analysis, and data management was done using the MAXQDA software. In order to achieve the accuracy and validity of the study, the Four-Dimensions Criteria (FDC) by Lincoln and Guba, namely credibility, dependability, conformability, and transformability, were considered and used. RESULTS: This study was conducted on 22 older women suffering from urinary incontinence with the mean age of 66.54 ± 5.76 years. The acquired data were put in four main categories of "resilience" with three subcategories, "change in lifestyle" with six subcategories, "attempt for treatment of the condition" with three subcategories, and "receiving support" with two subcategories. CONCLUSION: The study results indicated that the older women suffering from urinary incontinence were resilient against the condition, had changed their lifestyles to manage the condition, and sought treatment. In addition, receiving support from the family and the society played a significant role in the follow-up and management of the condition. The present study findings can help healthcare team members focus on urinary incontinence, design care programs for older women with this condition, and improve their quality of life. Furthermore, focusing on young and middle-aged women's health, providing them with the necessary training for taking care of the genitourinary system, and raising their awareness for preventing urinary incontinence during old ages can be helpful. Moreover, increasing the healthcare team's sensitivity and following the patients up can help diagnose, manage, and treat the condition before exerting adverse impacts on their quality of life.

The Association Between Body Mass Index and Comorbidity, Quality of Life, and Cognitive Function in the Elderly Population.

BACKGROUND: Debate still exists regarding physical and cognitive factors associated with Body Mass Index (BMI) in the elderly population. This study aimed to determine the association between BMI and comorbidity, Quality of Life (QOL), and cognitive function in the elderly population. METHODS: This cross-sectional study was conducted from October 2017 to January 2018. The participants included 246 old people who referred to Imam Reza elderly clinic, Shiraz, Iran. The data were collected using Leipad Quality of Life Questionnaire and Mini-Mental State Examination (MMSE). Indeed, weight and height were measured to assess the BMI. The data were entered into SPSS, version 21, and analyzed using ANOVA, Chi-square test, Pearson correlation coefficient, and multiple regression analysis. RESULTS: This study showed that 104 (47%) of the participants were overweight and obese. The mean±SD score of QOL was 46.14±12.01. Additionally, 93 (37.8%) of the participants had cognitive impairment. The results showed a significant difference among normal weight, overweight, and obese groups regarding the mean scores of QOL (P<0.001) and cognitive function (P<0.001). Moreover, 29% of the changes in BMI was explained by QOL, cognitive function, and having hypertension and cancer. Among these variables, the associations between BMI and QOL (r=-0.52, P<0.001) and cognitive function (r=-0.28, P<0.001) were significant. CONCLUSION: The results showed that half of the old people suffered from overweight and obesity. Moreover, roughly one-third had cognitive impairment. In addition, BMI was associated with QOL and cognitive function in the elderly. Therefore, healthcare workers might use these findings to design prevention and treatment programs targeting the elderly population.

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.

Effect of Yoga on the Quality of Life of Nurses Working in Intensive Care Units. Randomized Controlled Clinical Trial.

OBJECTIVES: The work, herein, sought to determine the effect of yoga on the quality of life of nurses working in intensive care units (ICU). METHODS: This was a randomized controlled clinical trial of a preventive intervention of three weekly sessions of yoga exercises, which included aspects of meditation, breathing control, and slow body movements. The study selected 70 nurses working in ICU and assigned them to two groups: experimental (n = 35) and control (n = 35). The World Health Organization Quality of Life brief questionnaire (WHOQoL-Bref) was used to evaluate on four moments (baseline, one, two, six months after the start of the study); this scale has 26 items with Likert-type response options ranging from 1 to 5; higher total score indicates better quality of life. RESULTS: The baseline score of quality of life in the experimental group was 62.3, which increased to 70.7 on the first month and continued improving in the evaluations on the second month (72.8) and sixth month (74.1), with this change being statistically significant. Instead, the control group showed no differences in scores of the different moments of evaluation (baseline = 62, first month = 61.9, second month = 62.4, and sixth month = 60.4). In the four domains of the WHOQoL-Bref (physical, psychological, social relationships, and environment), it was also noted that the experimental group obtained better scores over time compared with the control group. CONCLUSIONS: The intervention of yoga exercises was effective in improving the quality of life of nurses working in ICU.

Effect of Yoga on the Quality of Life of Nurses Working in Intensive Care Units. Randomized Controlled Clinical Trial

Objective. The work, herein, sought to determine the effect of yoga on the quality of life of nurses working in intensive care units (ICU). Methods. This was a randomized controlled clinical trial of a preventive intervention of three weekly sessions of yoga exercises, which included aspects of meditation, breathing control, and slow body movements. The study selected 70 nurses working in ICU and assigned them to two groups: experimental (n = 35) and control (n = 35). The World Health Organization Quality of Life brief questionnaire (WHOQoL-Bref) was used to evaluate on four moments (baseline, one, two, six months after the start of the study); this scale has 26 items with Likert-type response options ranging from 1 to 5; higher total score indicates better quality of life. Results. The baseline score of quality of life in the experimental group was 62.3, which increased to 70.7 on the first month and continued improving in the evaluations on the second month (72.8) and sixth month (74.1), with this change being statistically significant. Instead, the control group showed no differences in scores of the different moments of evaluation (baseline = 62, first month = 61.9, second month = 62.4, and sixth month = 60.4). In the four domains of the WHOQoL-Bref (physical, psychological, social relationships, and environment), it was also noted that the experimental group obtained better scores over time compared with the control group. Conclusion. The intervention of yoga exercises was effective in improving the quality of life of nurses working in ICU.

Objetivo. Determinar el efecto del yoga en la calidad de vida de las enfermeras que trabajan en Unidades de Cuidados Intensivos (UCI). Métodos. Ensayo clínico controlado aleatorizado de una intervención preventiva de 3 sesiones semanales de ejercicios de yoga que incluyeron aspectos de meditación, control de la respiración, y movimientos corporales lentos. Se seleccionaron 70 enfermeras que trabajan en UCI y se asignaron aleatoriamente a dos grupos: experimental (n=35) y de control (n=35). El cuestionario de Calidad de Vida de la Organización Mundial de la Salud -WhoQol-Bref- se utilizó para la evaluación en cuatro momentos (basal, uno, dos y seis meses posinicio del estudio), esta escala tiene 26 items con opciones de respuesta tipo Likert de 1 a 5, a mayor puntaje total se considera que es mejor la calidad de vida. Resultados. La puntuación basal de calidad de vida en el grupo experimental fue de 62.3, la cual se incrementó a 70.7 en el primer mes y continuó mejorando en las evaluaciones del 2º mes (72.8) y 6º mes (74.1), cambio estadísticamente significativo. Por el contrario, en el grupo control no se encontraron diferencias en el puntaje en los diferentes momentos de evaluación (basal =62, primer mes =61.9, segundo mes =62.4 y sexto mes =60.4). En los cuatro dominios de WhoQol-Bref (físico, psicológico, relaciones sociales y ambiente), también se apreció que el grupo experimental obtuvo mejores puntajes en el tiempo comparado con el grupo control. Conclusión. La intervención con ejercicios de yoga mejoró la calidad de vida de las enfermeras que trabajan en UCI.

Objetivo. Determinar o efeito da yoga na qualidade de vida das enfermeiras que trabalham em Unidades de Tratamentos Intensivos (UTI). Métodos. Ensaio clínico controlado aleatorizado de uma intervenção preventiva de 3 sessões semanais de exercícios de yoga, que incluíam aspectos de meditação, controle da respiração, e movimentos corporais lentos. Se selecionaram 70 enfermeiras que trabalham em UTI e se designaram aleatoriamente a dois grupos experimentais (n=35) e de controle (n=35). O questionário de Qualidade de Vida da Organização Mundial da Saúde -WhoQol-Bref- se utilizou para a avaliação em quatro momentos (basal, um, dois e seis meses pós início do estudo), esta escala tem 26 itens com opções de resposta tipo Likert de 1 a 5, a maior pontuação total se considera que é melhor a qualidade de vida. Resultados. A pontuação basal de qualidade de vida no grupo experimental foi de 62.3, a qual se incrementou a 70.7 no primeiro mês e continuou melhorando nas avaliações do 2º mês (72.8) e 6º mês (74.1), sendo este câmbio estatisticamente significativo. Em câmbio, no grupo controle não se encontraram diferenças na pontuação nos diferentes momentos de avaliação (basal =62, primeiro mês =61.9, segundo mês =62.4 e sexto mês =60.4). Nos quatro domínios de WhoQol-Bref (físico, psicológico, relações sociais e ambiente), também se apreciou que o grupo experimental obteve melhores pontuações no tempo comparado com o grupo de controle. Conclusão. A intervenção de exercícios de yoga foi efetiva no melhoramento da qualidade de vida das enfermeiras que trabalham nas UTIs.

Pattern of Internet Use by Iranian Nursing Students. Facilitators and Barriers.

OBJECTIVES: To evaluate the pattern of internet use and factors that facilitate or dissuade its use among nursing students from a university in Urmia, Iran. METHODS: A cross-sectional, descriptive study was conducted with 162 nursing students selected through simple random sampling. RESULTS: The findings indicated that 49.1% of the students used the internet from 15 to 60 min per day. The principal use of the internet was to search for scientific content in the Web. Factors that facilitated internet use were "ease of use" and "Access to experts to solve problems and answer questions", while the dissuasive factors were "lack of concentration", "cost of internet services", and preference for information provided by professors or available directly in textbooks. Internet use by the students was related with the use of this tool in classroom activities and with English fluency. CONCLUSIONS: Students have an internet use pattern aimed at self-study that should be strengthened with knowledge of English, assignments online, familiarization with the use of electronic databases, and other strategies to motivate them to use this technology with greater frequency.

Pattern of Internet Use by Iranian Nursing Students. Facilitators and Barriers

Abstract Objective. To evaluate the pattern of internet use and factors that facilitate or dissuade its use among nursing students from a university in Urmia, Iran. Methods. A cross-sectional, descriptive study was conducted with 162 nursing students selected through simple random sampling. Results. The findings indicated that 49.1% of the students used the internet from 15 to 60 min per day. The principal use of the internet was to search for scientific content in the Web. Factors that facilitated internet use were "ease of use" and "Access to experts to solve problems and answer questions", while the dissuasive factors were "lack of concentration", "cost of internet services", and preference for information provided by professors or available directly in textbooks. Internet use by the students was related with the use of this tool in classroom activities and with English fluency. Conclusion. Students have an internet use pattern aimed at self-study that should be strengthened with knowledge of English, assignments online, familiarization with the use of electronic databases, and other strategies to motivate them to use this technology with greater frequency.

Resumen Objetivo. Evaluar el patrón de uso del Internet y los factores que facilitan o disuaden su uso entre los estudiantes de enfermería de una universidad en Urmia, Irán. Métodos. Se realizó un estudio descriptivo de corte transversal en 162 estudiantes de enfermería seleccionados a través de un muestreo aleatorio simple. Resultados. Los hallazgos indicaron que el 49.1 % de los estudiantes usaron Internet de 15 a 60 minutos por día. El principal uso del Internet fue la búsqueda de contenido científico en la Web. Los factores que facilitaron el uso de internet fueron la "facilidad de uso" y el "acceso a expertos para resolver problemas y responder preguntas", mientras que los factores disuasivos fueron la "falta de concentración", el "costo de los servicios de Internet" y la preferencia por la información suministrada por profesores o disponible directamente en los libros. El uso del Internet por los estudiantes estuvo relacionado con empleo de esta herramienta en las actividades del salón de clase y con el dominio del idioma inglés. Conclusión. Los estudiantes tienen un patrón de uso del Internet encaminado al auto-estudio que debe fortalecerse en conocimiento del idioma inglés, asignaturas en línea, familiarización con el uso de bases electrónicas y otras estrategias para motivarlos a usar esta tecnología con mayor frecuencia.

Resumo Objetivo. Avaliar o padrão de uso da Internet e os fatores que facilitam ou dissuadem seu uso entre os estudantes de enfermagem de uma universidade em Urmia, Irã. Métodos. Se realizou um estudo descritivo de corte transversal em 162 estudantesde enfermagem que foram selecionados através de uma amostra aleatória simples. Resultados. As descobertas indicaram que 49.1% dos estudantes usaram Internet de 15 a 60 minutos por dia. O principal uso da Internet foi a busca de conteúdo científico na Web. Os fatores que facilitaram o uso de internet foram a "facilidade de uso" e o "acesso à especialistas para resolver problemas e responder perguntas", enquanto que os fatores dissuasivos foram a "falta de concentração", o "custo dos serviços de Internet" e a preferência pela informação subministrada por professores ou disponíveis diretamente nos livros. O uso da Internet pelos estudantes esteve relacionado com emprego desta ferramenta nas atividades da aula e com o domínio do idioma inglês. Conclusão. Os estudantes têm um padrão de uso da Internet encaminhado ao auto-estudo que deve fortalecer-se em conhecimento do idioma inglês, matérias em linha, familiarização com o uso de bases eletrônicas, e outras estratégias para motivá-los a usar com maior frequência esta tecnologia

Efecto de la tele-enfermería en el mejoramiento de los hallazgos ecográficos de pacientes con enfermedades de hígado graso no alcohólico: Ensayo clínico controlado / Effect of tele-nursing in the improving of the ultrasound findings in patients with nonalcoholic fatty liver diseases: A Randomized Clinical Trial study

Objective. To establish the effect of tele-nursing in the improving of the ultrasound findings in patients with non-alcoholic fatty liver disease. Methods. In this clinical trial, 60 patients with non-alcoholic fatty liver referring to specialized gastroenterology clinics affiliated to Shiraz University of Medical Sciences (Iran) were selected were randomly assigned to control or intervention group. All patients received necessary trainings on diet and physical activity. The subjects in the intervention group were followed up via phone by nurses for 12 weeks (twice a week during the first month and once a week during the following two months). The control group participants did not receive any interventions and were only followed up as usual by a specialist. Before and after the intervention, the liver size and histological status of their liver were examined using ultrasound in all the participants. Results. After 12 weeks of start of the study, the mean of liver size decreased in the group followed up via phone by a nurse (13.15±1.22 cm to 12.90±1.16 cm, p=0.013), but this did not change significantly in the control group (12.55±1.56 cm to 12.56±1.57 cm, p=0.326). The greater difference in the mean liver size between the evaluations was in the intervention group with 0.26±0.53 cm versus -0.003±0.018 cm in the control group (p=0.012). Additionally, the fatty infiltration status of the liver tissue improves in the 66.6% of the intervention group versus 6.6% in the control group (p<0.001). Conclusion. The results of this study showed that tele-nursing led to improvement in liver size and liver histology in patients with Non-alcoholic fatty liver.(AU)

Objetivo. Establecer el efecto de la tele-enfermería en la mejoría de los hallazgos ecográficos en pacientes con hígado graso no alcohólico. Métodos. En este ensayo clínico, 60 pacientes con hígado graso no alcohólico referidos a servicios de Gastroenterología especializada afiliadas a la Universidad de Ciencias médicas de Shiraz (Irán) se dividieron aleatoriamente en los grupos de control y de intervención. Todos los pacientes recibieron capacitaciones sobre aspectos de la dieta y la actividad física. Los pacientes del grupo de intervención tuvieron seguimiento telefónico por enfermera (dos veces a la semana en el primer mes y una vez por semana los otros dos meses), y los del grupo control no recibieron atenciones diferentes a las consultas usuales al especialista. Tanto al ingreso al estudio como a las 12 semanas, a todos los participantes se les evaluó con ultrasonografía el tamaño y el estado histológico del hígado. Resultados. Después de 12 semanas de inicio del estudio decreció el tamaño del hígado en el grupo con seguimiento telefónico por enfermera (13.15±1.22 cm a 12.90±1.16 cm, p=0.013), mientras que no se observó diferencia significante en el grupo control (12.55 1.56 cm a 12.56±1.57 cm, p=0.326). La más grande diferencia entre las dos evaluaciones fue en el grupo de intervención con 0.26±0.53 cm versus -0.003±0.018 cm en el grupo control (p=0.012). Adicionalmente, el estado de infiltración grasa del tejido hepático mejoró en el 66.6% del grupo de intervención versus 6.6% en el grupo de control (p<0.001). Conclusión. Los resultados de este estudio mostraron que la tele-enfermería condujo a la mejoría del tamaño de hígado y la histología hepática en pacientes con hígado graso no alcohólico.(AU)

Objetivo. Estabelecer o efeito da tele-enfermagem na melhora das descobertas ecográficos em pacientes com fígado grasso não alcoólico. Métodos. Neste ensaio clínico, 60 pacientes com fígado grasso não alcoólico referidos a serviços de Gastrenterologia especializada afiliadas à Universidade de Ciências médicas de Shiraz (Irão) foram divididos aleatoriamente nos grupos de controle e de intervenção. Todos os pacientes receberam capacitações sobre aspectos da dieta e a atividade física. Os pacientes do grupo de intervenção tiveram seguimento telefónico por enfermeira (duas vezes por semana no primeiro mês e uma vez por semana os outros dois meses), e os do grupo controle não receberam atenções diferentes às consultas usuais ao especialista. A todos os participantes ao ingresso ao estudo e às 12 semanas se lhes avaliou com ultrassonografia o tamanho e o estado histológico do fígado. Resultados. Depois de 12 semanas de início do estudo diminuiu o tamanho do fígado no grupo com seguimento telefónico por enfermeira (13.15±1.22 cm a 12.90±1.16 cm, p=0.013), enquanto que não se observou diferença significante no grupo controle (12.55 1.56 cm a 12.56±1.57 cm, p=0.326). A maior diferença entre as duas avaliações foi no grupo de intervenção com 0.26±0.53 cm versus -0.003±0.018 cm no grupo controle (p=0.012). Adicionalmente, o estado de infiltração grassa do tecido hepático melhorou em 66.6% do grupo de intervenção versus 6.6% no grupo de controle (p<0.001). Conclusão. Os resultados deste estudo mostraram que a tele-enfermagem conduz à melhora do tamanho de fígado e a histologia hepática em pacientes com fígado grasso não alcoólico.(AU)

The Barriers and Challenges of Applying New Strategies in the Clinical Evaluation of Nursing Students from the Viewpoints of Clinical Teachers.

BACKGROUND: Numerous studies have emphasized the use of new approaches in clinical evaluation. However, there are some challenges and barriers to applying these new approaches. The aim of the present study was to investigate the barriers and challenges of applying new strategies in the clinical evaluation of nursing students from the viewpoints of clinical teachers. MATERIALS AND METHODS: This cross-sectional study was conducted among 151 clinical teachers. A researcher-made questionnaire was used to collect data. The questionnaire was validated using library references and a variety of texts, as well as thorough consulting with 15 clinical teachers. The questionnaire's reliability was approved with a Cronbach's alpha of 78%. Data analysis was conducted using Pearson's correlation coefficient, one-way analysis of variance (ANOVA), and descriptive statistics in SPSS software. RESULTS: The highest score was related to the "students and clinical environment" domain [24.05 (8.10)], and the lowest to the "facilities" domain [13.31 (1.50)]. One-way ANOVA results showed a significant relationship between the mean scores of academic degree and the two domains of "tests" (F = 9.66, p < 0.001) and "facilities" (F = 8.26, p < 0.001). CONCLUSIONS: The implementation of a new approach for evaluating clinical training requires infrastructure and overcoming executive obstacles. Educating students and clinical teachers on new evaluation methods requires their familiarity with the implementation process as well as encouragement and support by their educational institution and administrators.

Effect of tele-nursing in the improving of the ultrasound findings in patients with nonalcoholic fatty liver diseases: A Randomized Clinical Trial study.

OBJECTIVES: To establish the effect of tele-nursing in the improving of the ultrasound findings in patients with non-alcoholic fatty liver disease. METHODS: In this clinical trial, 60 patients with non-alcoholic fatty liver referring to specialized gastroenterology clinics affiliated to Shiraz University of Medical Sciences (Iran) were selected were randomly assigned to control or intervention group. All patients received necessary trainings on diet and physical activity. The subjects in the intervention group were followed up via phone by nurses for 12 weeks (twice a week during the first month and once a week during the following two months). The control group participants did not receive any interventions and were only followed up as usual by a specialist. Before and after the intervention, the liver size and histological status of their liver were examined using ultrasound in all the participants. RESULTS: After 12 weeks of start of the study, the mean of liver size decreased in the group followed up via phone by a nurse (13.15±1.22 cm to 12.90±1.16 cm, p=0.013), but this did not change significantly in the control group (12.55±1.56 cm to 12.56±1.57 cm, p=0.326). The greater difference in the mean liver size between the evaluations was in the intervention group with 0.26±0.53 cm versus -0.003±0.018 cm in the control group (p=0.012). Additionally, the fatty infiltration status of the liver tissue improves in the 66.6% of the intervention group versus 6.6% in the control group (p<0.001). CONCLUSIONS: In the hospitalization services, nurses care for patients but without being with them. Nurses during their daily work transformed their caregiver role to adapt to diverse demands from the contexts, especially the institutional context.

An evaluation of adherence to ethical codes among nurses and nursing students.

Ethical codes are instructions that shape ethical behavior and determine which values and beliefs should be accepted. These codes act as a practical guideline in the nursing profession. The present study aimed to compare adherence to ethical codes between the nursing students and working nurses of Valiasr Hospital, affiliated with Fasa University of Medical Sciences in Fars Province, Iran. In this descriptive-analytical study, the data collection tool was nurses' self-reporting questionnaire on adherence to ethical codes devised by Mahdavi Lenji and Ghaedi Heidari, who have also confirmed its validity and reliability. This questionnaire consisted of 3 sections: personal information, ethical codes related to clinical service provision (23 items), and relationship with the treatment team (8 items). A total of 400 individuals (178 nursing students and 222 nurses) were selected through census sampling method. Data were analyzed through descriptive, ANOVA and t-test statistical methods using SPSS 22 software. There was no significant difference between nurses and nursing students in terms of adherence to ethical codes related to clinical service provision, but the latter achieved a significantly higher score in codes on relationship with the treatment team (P = 0.04). Although the score of nursing students was higher than nurses in comparison to the treatment team, they lacked the necessary technical competency to adhere to ethical codes. Therefore, we recommend that nursing instructors and educational managers pay more attention to teaching nursing ethics and supervise their implementation and practicality in clinical environments.

The effect of telenursing on self-efficacy in patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial.

AIM: This study aimed to assess the effect of telenursing on nutritional behavior and physical activity self-efficacy in patients with non-alcoholic fatty liver disease (NAFLD). BACKGROUND: NAFLD is the most common liver disorder, which has a chronic course. Therefore, routine monitoring of these patients by medical staff helps them actively participate in the healing process and promote their self-efficacy. METHODS: In this randomized controlled clinical trial, 60 patients were chosen through convenience sampling among patients with NAFLD. After obtaining written informed consents, the participants were randomly divided into an intervention and a control group (each containing 30 subjects). The participants received diet consultation individually and were taught how to perform physical activities. Telephone intervention was conducted in the intervention group for 12 weeks. The study questionnaires were completed by the participants before and after the intervention. The data were analyzed using the SPSS statistical software. RESULTS: Based on the results, the mean score of nutritional behavior and physical activity self-efficacy increased in the study groups after the intervention. This increase was statistically significant only in the intervention group. Additionally, the two groups were significantly different regarding the mean scores of nutritional behavior and physical activity self-efficacy. CONCLUSION: Telenursing could improve self-efficacy and physical activity in patients with NAFLD.

The Effect of Follow up (Telenursing) on Liver Enzymes in Patients with Nonalcoholic Fatty Liver Disease: A Randomized Controlled Clinical Trial.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is characterized by macro vesicular steatosis in the absence of alcohol. Patients with (NAFLD)need extensive education and support in their treatment. Our aim was to investigate the effect of telenursing on liver enzymes (ALT and AST) in patients with NAFLD. METHODS: Our study is a randomized controlled clinical trial. In this study, 60 patients were enrolled from patients who referred to subspecialty gastrointestinal clinics affiliated to Shiraz University of Medical Sciences. Specialists confirmed their diseases by ultrasound and laboratory test. Simple randomization, based on random number table, was used to randomize the participants into intervention (N=30) and control (N=30) groups. Patients in both groups received dietary advice from a nutritionist and were trained to perform physical activities. Telephone intervention in the intervention group lasted for 12 weeks, in order to see the effect of follow up on the recommended diet and physical activities given by the specialist, while; the control group subjects were only followed up as usual by their physician. RESULTS: The result of an independent t-test showed that the mean difference of liver Enzymes between the two groups was statistically significant (P<0.001). The difference of AST and ALT in the intervention and control groups was 18.03, -1.27 and 40.70, 1.52, respectively. CONCLUSION: We found out that; telenursing could have a positive effect on reduction of liver enzymes (ALT, AST) in patients with NAFLD. TRIAL REGISTRATION NUMBER: IRCT2015040411691N5.

Comparing the effect of swaddling and breastfeeding and their combined effect on the pain induced by BCG vaccination in infants referring to Motahari Hospital, Jahrom, 2010-2011.

BACKGROUND AND AIM: Despite the clinical importance of pain, many neonates are subjected to numerous painful invasive procedures and their complications as part of their care. This study has been designed to investigate the effect of swaddling and breastfeeding, and their combined effect on the pain induced by BCG vaccination in healthy term infants. METHOD: This randomized double-blind intervention study was performed on 131 healthy term neonates in Motahari Hospital of Jahrom. The samples were randomly assigned into three intervention groups and a control group. The infants in the swaddled group were swaddled 2 minutes before and 2 minutes after vaccination. The infants in the breastfed group were breastfed within 45 minutes before vaccination. The infants in the combination group were both breast fed before and swaddled within vaccination but the infants in the control group were vaccinated without any intervention. Heart rate and oxygen saturation level of neonates were recorded in the 3 phases of: baseline, injection and 2 minutes after injection. Furthermore, the neonates' faces were recorded using a video camera. Then pain intensity was measured by Neonatal Facial Coding System (NFCS). Mean Score of pain intensity and physiological responses of subjects were statistically analyzed using non parametrical Kruskal-Wallis test and Mann-Whitney. RESULTS: The mean of pain intensity (NFCS) and changes in the heart rate at injection time to the baseline in the three intervention groups in comparison with the control group showed statistically significant difference (p=0.003 and p=0.002 respectively). However changes in blood oxygen saturation level, were not statistically significant difference between four groups. CONCLUSION: Regarding to the significant impact of both breastfeeding and swaddling on the pain reduction of vaccination, it is recommended to take benefit of these two safe and available non-pharmacological methods in order to relief pain during painful procedures.

The Effect of Health Belief Model-Based Education on Knowledge and Prostate Cancer Screening Behaviors: A Randomized Controlled Trial.

BACKGROUND: Prostate cancer has been reported as the second leading cause of cancer death among men in 2013. Prevention and early detection of cancer are considered as critical factors in controlling the disease and increasing the survival of patients. Therefore, we aimed to investigate the effect of Health Belief Model (HBM)-based education on knowledge and prostate cancer screening behaviors in a randomized controlled trial. METHODS: This study was a non-blinded randomized controlled trial. We enrolled 210 men aged 50-70. Balanced block randomization method was used to randomize the final participants who had inclusion criteria into intervention (n=93) and control (n=87) groups. The participants of the intervention group attended training workshops based on HBM. Data were collected using three questionnaires, i.e. demographic questionnaire, Prostate Cancer Screening-Health Belief Model Scale (PCS-HBMS), and the Knowledge about Prostate Cancer Screening questionnaire, all given before and immediately one month after the intervention. RESULTS: The mean scores of the perceived susceptibility, severity, barriers and benefits increased significantly after the intervention (P>0.05) in the intervention group. In the control group, such a difference was reported only for perceived susceptibility (P>0.05). The rate of participation in prostate cancer screening in the intervention group increased from 7.5% to 24% and 43.3% one month and three months after the intervention, respectively. CONCLUSION: Our findings showed that the health education programs designed based on HBM could positively affect prostate cancer preventive behaviors of individuals by improving their knowledge level and leaving positive effects on perceived susceptibility and severity as well as considering the perceived barriers, benefits and health motivations. TRIAL REGISTRATION NUMBER: IRCT2013090911691N3.

The Effect of Yoga on Balance and Fear of Falling in Older Adults.

OBJECTIVE: To determine the effect of yoga on balance and fear of falling in older adults. DESIGN: Randomized controlled trial. SETTING: Jahandidegan Center in Shiraz, southern Iran. PARTICIPANTS: Forty persons (17 men and 23 women) between the ages of 60-74 years with a Modified Falls Efficacy Scale (MFES) score <8 and a Berg Balance Scale (BBS) score <45. After completing the MFES questionnaire and BBS measurement, the participants were divided into intervention and control groups. BBS measurement and the MFES questionnaire were completed again immediately after the intervention. INTERVENTION: The intervention group participated in 2 yoga practice sessions per week for 8 weeks. The control group received no intervention. MAIN OUTCOME MEASUREMENTS: Fear of falling was measured with the MFES and balance was measured with the BBS. RESULTS: We found significant changes in both variables (P < .0001). Mean differences before and after the intervention for the BBS for yoga and control groups were 10.19 and -1.16, respectively. Mean differences before and after the intervention for the MFES for yoga and control groups were 1.62 and -0.21, respectively. CONCLUSION: Yoga is a potential intervention to reduce fear of falling and improve balance in older adults.

The effects of laughter therapy on general health of elderly people referring to jahandidegan community center in shiraz, iran, 2014: a randomized controlled trial.

BACKGROUND: Aging and its social-biological process naturally impair the functions of different body organs and cause progressive disabilities in managing personal affairs and performing social roles. Laughter therapy is an important strategy which has been recommended by experts for increasing health promotion in older adults. Therefore, we aimed to investigate the effect of laughter therapy program on public health of senior citizens. METHODS: In a randomized controlled trial, we enrolled 72 senior citizens aged 60 and over referring to Jahandidegan (Khold-e-Barin) retirement community center in Shiraz, southwest Iran during January to February 2014. The participants were assigned into experimental (N=36) and control (N=36) groups. Data were collected using General Health Questionnaire (GHQ-28) and demographic questionnaire. The participants of experimental group attended a laughter therapy program consisting of two 90-minute sessions per week lasting for 6 weeks. RESULTS: We found a statistically significant correlation between laughter therapy program and factors such as general health (P=0.001), somatic symptoms (P=0.001), insomnia and anxiety (P=0.001). However, there was no statistically significant correlation among laughter therapy, social dysfunction (P=0.28) and depression (P=0.069). CONCLUSION: We concluded that laughter therapy can improve general health and its subscales in elderly people. TRIAL REGISTRATION NUMBER: IRCT2014061111691N4.

The effect of positive thinking training on the level of spiritual well-being among the patients with coronary artery diseases referred to Imam Reza specialty and subspecialty clinic in Shiraz, Iran: A randomized controlled clinical trial.

BACKGROUND: Positive thinking which is derived from an optimistic view toward the universe and plays an important role in the incidence of better and a more targeted behavior among human beings. It can improve spiritual health in the individuals through increased communication with God and thanksgiving and accelerate the healing process. Accordingly, we aimed to evaluate the effect of positive thinking on the level of spiritual health in the patients with coronary artery disease (CAD) referred to Imam Reza specialty and subspecialty clinic in Shiraz, Iran. METHODS: In this study randomized controlled clinical trial, we enrolled 90 patients with confirmed CAD referred to Imam Reza clinic, Shiraz, during April to July 2013. A blocking randomization method was used to randomize the final 90 participants into intervention (n = 45) and control groups (n = 45). After obtaining written informed consent, the participants were asked to complete two questionnaires. Data were collected using Ellison and Paloutzian's spiritual well-being scale (SWBS) and a demographic questionnaire. The patients in the intervention group participated in 7 training sessions on positive thinking in which several topics were discussed. The SWBS questionnaire was completed two more times by the participants; once immediately after, and once 1 month after the intervention. 16 patients were excluded from the study due to different reasons, and finally the analysis was performed on 74 patients. RESULTS: The mean ± standard deviation (SD) of spiritual well-being (SWB) increased from 88.71 ± 12.5 to 96.63 ± 12.58 in the intervention group; while, it decreased from 93.19 ± 17.55 to 94.45 ± 16.01 in the control group in the interval of before and 1 month after the intervention. We observed a statistically significant difference between the two groups regarding both variables of time and group (P < 0.001). CONCLUSION: SWB is an important factor which should be considered in the treatment process, and nurses could maintain and improve such dimension of health in the patients through their intervention including drawing the patients' attention to optimism and positive thinking.

The effect of conditioning exercise on the health status and pain in patients with rheumatoid arthritis: a randomized controlled clinical trial.

BACKGROUND: Rheumatoid Arthritis (RA) is a systemic and inflammatory disease of unknown etiology which is mostly characterized by inflammation of the synovial joints. Studies have proved that most people with RA avoid doing physical activities due to fear that it may worsen the pain or cause pressure on joints, resulting in decreased muscle strength and ultimately leading to disability of patients. We aimed to investigate the effects of conditioning exercises on the health status and pain in patients suffering from RA. METHODS: In this randomized controlled clinical trial, we enrolled 66 women with confirmed RA referred to the rheumatology clinic of Hafez hospital, Shiraz, southwest Iran during May-July 2013. Balanced block randomization method was used to randomize the participants into case and control groups (two groups of 33 each).Data were collected using visual analog scale (VAS), Arthritis Impact Measurement Scales 2 short form (AIMS2-SF), and demographic questionnaire. After obtaining written informed consent, the participants in the case group were asked to participate in conditioning exercise programs including aerobic, isometric, and isotonic exercises and received a training booklet explaining the exercises that they could do at home after the intervention. RESULTS: There was a statistically significant difference between the health status scores of the patients in the case groups before and after the intervention (P=0.001). The pain score also decreased significantly in the case group compared with the control group after the intervention (P=0.003). CONCLUSION: We concluded that physical training programs, especially conditioning exercises, could improve the health status and reduce pain in patients with RA. TRIAL REGISTRATION NUMBER: IRCT201308187531N3.