Comparing sexual self-concept in women with obesity pre- and post-bariatric surgery.

BACKGROUND: Obesity leads to increased disease burden, decreased life expectancy, and disrupted sexual life. One of the most effective ways of obesity treatment is bariatric surgery. This study was conducted aiming to determine and compare sexual self-concept in women with obesity pre- and post-bariatric surgery. METHOD: A longitudinal study comparing sexual self-concept pre and post- surgery was conducted on women with obesity referring to obesity clinics in the city of Tehran in 2020-2021. Data collection was performed using Snell's Multidimensional Sexual Self-Concept Questionnaire (MSSCQ), which was completed online. Data were analyzed using SPSS version 16 statistical software and Fisher's exact test, chi-square, Mann-Whitney, independent t, and logistic and linear regression tests. A p-value of less than 0.05 was considered significant. RESULTS: According to the findings, the mean (standard deviation) score of sexual self-concept was 240.26 (26.82) in the post-surgery group and 200.26 (32.24) in the pre-surgery group (P = 0.001), and the highest mean (standard deviation) score of sexual self-concept both in the pre-surgery group (13.06 [4.00]) and in the post-surgery group (15.46 [2.16]) was related to the area of sexual depression (P = 0.05). Also, with increasing educational level, the odds of bariatric surgery increased by 33%, and those who had no private bedroom had lower odds of bariatric surgery by 65%. In those who did not have other individuals living in their house and their spouse was not a smoker, the self-concept score was 52.35 and 23.11 units higher. CONCLUSION: In general, bariatric surgery can improve sexual self-care. Considering the issue of sexual self-concept in bariatric surgery, it is recommended to design appropriate counseling and planning before surgery according to the culture of each country.

Sexual function among women with vaginismus: a biopsychosocial approach.

BACKGROUND: Vaginismus is known as a type of sexual pain disorder. Regarding the multifactorial nature of vaginismus, the biopsychosocial model is one of the best models to describe this sexual disorder. AIM: The present research was conducted to study the determinants of sexual function in women with and without vaginismus based on the biopsychosocial model. METHODS: This case-control study was conducted in Iran on 420 women with and without primary vaginismus who met the inclusion criteria. All eligible people were included in the research once their eligibility was verified and their informed permission was acquired; convenience and purposive sampling techniques were used continually. Data collection tools included the demographic and obstetric information form and multiple published scales and questionnaires. Structural equation modeling with LISREL 9.2 software (Scientific Software International) was used to evaluate the determinants of the sexual function of vaginismus. OUTCOMES: Participants rated their determinants of sexual function based on the biopsychosocial model. RESULTS: The mean ages of the case and control groups were 27.67 and 28.44 years, respectively. The direct, indirect, and total effects of the dimensions of sexual health on sexual function and the diagnostic score of vaginismus of the women with vaginismus were significant (P < .001). Furthermore, based on the results, the diagnostic score of vaginismus in women with vaginismus was significantly affected by the direct, indirect, and cumulative impacts of vaginal penetration cognition and fear of sex (P = .016, P = .005). Women with and without vaginismus were able to accept the models' excellent fit. CLINICAL IMPLICATIONS: This study helps inform health planners and policy makers about the sexual function of women with vaginismus, the factors related to this disorder, and the multidimensional nature of this sexual problem. STRENGTHS AND LIMITATIONS: This study attempted to offer a more comprehensive and complete view of present knowledge via surveying different aspects of sexual health and by means of valid and reliable tools and path analysis. The study's merits include the use of the biopsychosocial model to evaluate sexual function in women with vaginismus, the use of a variety of questionnaires to compare women with and without vaginismus, and the size of the sample. The research was limited by the fact that electronic sampling was conducted because of the COVID-19 epidemic. CONCLUSION: Based on the findings of the present study for the group of women with vaginismus, the direct, indirect, and overall effects of the majority of dimensions of sexual health were significantly correlated with sexual function and vaginismus.

The relationship between social determinants of health and fear of contracting infectious diseases in pregnant women presenting to health centers in Kashan, Iran: a path analysis study.

INTRODUCTION: Pregnancy is one of the most critical times in a woman's life that is accompanied by a lot of worry, fear, and stress for the mother, and fear of contracting diseases and losing the children are among the most important of them. The present study investigated the relationship between the social determinants of health and fear of contracting infectious diseases in pregnant women using path analysis. METHODS: This cross-sectional study was conducted on 330 pregnant Iranian women in Kashan from September 21th, 2021, to May 25th, 2022, using a multi-stage method. Data were collected through demographic and obstetric details, fear of COVID-19, perceived social support, socioeconomic status, and pregnancy-related anxiety questionnaires. The collected data were then analyzed using SPSS-21 and Lisrel-8 software. RESULTS: According to the path analysis results, among the variables that have a causal relationship with fear of contracting infectious diseases through only one path, pregnancy anxiety (B = 0.21) had the highest positive relationship and social support had the highest negative relationship (B=-0.18) in the direct path. Among the variables that have a causal relationship with fear of contracting infectious diseases in both paths, socioeconomic status (B=-0.42) had the highest negative causal relationship with fear of contracting infectious diseases. CONCLUSION: According to the path analysis results, the fear of contracting infectious diseases in pregnant women in Kashan is moderate and prevalent, which indicates the necessity of screening pregnant women for such problems during epidemics. Moreover, to prevent this fear and its adverse consequences, the following strategies are recommended: helping promote mothers' and women's awareness, offering social support through healthcare providers, and taking measures to mitigate pregnancy-related anxiety in high-risk individuals and groups.

Relieving care burden and promoting health-related quality of life for family caregivers of elderly people with Alzheimer's disease via an empowerment program.

BACKGROUND: Effective strategies should be adopted to reduce care burden (CB) and improve health-related quality of life (HRQoL) in family caregivers (FCGs) of elderly people with Alzheimer's disease (AD). Therefore, the purpose of this study was to determine the impact of empowerment program (EP) on CB and HRQoL of FCGs. METHODS: The present two-group experimental study was conducted on 70 FCGs of the elderly with AD who were selected by convenience sampling and randomly assigned to the empowerment program group (EPG, n = 35) and control group (CG, n = 35). Data collection tools were 12-item Short Form Health Survey and Zarit Burden Interview. The EP was held for 5 weeks, one session of 20 to 30 min each week. Data were collected before, immediately and 3 months after EP and analyzed by SPSS version 25 software at a significance level of 0.05. RESULTS: The results showed a significant decrease in the mean CB score in FCGs of elderly with AD in EPG before, immediately and 3 months after EP (p < 0.001). The result also revealed that there was a significant increase in the mean HRQoL score in EPG immediately and 3 months after EP (p < 0.001). CONCLUSIONS: According to the results of this study, EP can reduce CB and increase HRQoL in FCGs of elderly with AD. Policymakers and planners active in the field of healthcare for the elderly can benefit from the results of our study to improve the health of FCGs of the elderly with AD.

The relationship between coping strategies with sexual satisfaction and sexual intimacy in women with multiple sclerosis.

BACKGROUND: Multiple sclerosis profoundly affects the sexual aspects of patients' life, especially in women. Various coping strategies are used by women with multiple sclerosis to overcome, tolerate, or minimize these sexual effects. The present study aimed to assess the relationship between sexual satisfaction, sexual intimacy, and coping strategies in women with multiple sclerosis. METHODS: This cross-sectional study was performed on a sample of 122 married women who were members of Iran's MS society in Tehran, Iran. The study was conducted from December 2018 to September 2019. Data were collected using the Index of Sexual Satisfaction (ISS), the Sexual Intimacy Questionnaire (SIQ), and the Folkman and Lazarus Coping Strategies Questionnaire. Frequency, percentage, mean and standard deviation were used to explore the observations. Independent t-test and logistic regression were applied to analyze the data using the SPSS-23. RESULTS: The majority (n = 71, 58.2%) used an emotion-focused coping strategy with the highest score for the escape-avoidance subscale [mean (SD): 13.29 (5.40)]. However, 41.8% of the patients (n = 51) used a problem-focused coping strategy with the highest score for the positive reappraisal strategy subscale [mean (SD): 10.50 (4.96)]. The sexual satisfaction in women with problem-focused coping strategies was significantly higher than women who used emotion-focused coping strategies (95.6 vs. 84.71, P-value = 0.001). There was a negative association between sexual intimacy and higher emotion-focused coping strategy (OR = 0.919, 95% CI 0.872-0.968, P = 0.001). CONCLUSIONS: Problem-focused coping strategy in women with multiple sclerosis increases sexual satisfaction, while the emotion-focused coping strategy has a significant negative relationship with sexual intimacy.

Educating fathers to improve exclusive breastfeeding practices: a randomized controlled trial.

BACKGROUND: Fathers' involvement is crucial for promoting breastfeeding. There are a few studies on the effectiveness of fathers' educational programs to promote exclusive breastfeeding. This study aims to assess the effectiveness of a fathers' educational program on their support for breastfeeding, mothers' breastfeeding practice, and exclusive breastfeeding status. METHODS: This was a randomized controlled trial on 76 fathers who were randomly assigned to two groups of intervention and control, in a selected health center in Iran, 2018. The tools for data collection were: 1) a questionnaire for "Demographic and Maternal-Infant Information"; 2) a questionnaire to assess "Fathers' support for Breastfeeding", and 3) an observational checklist to assess "Mothers' Breastfeeding Practice"; and 4) a questionnaire to assess "Exclusive Breastfeeding Status". The questionnaires were filled up through an interview. The checklist was completed through observation by the researcher. The fathers (with the mothers) of the intervention group were educated using individual face-to-face education and counseling, in two sessions, with the duration of about 40 min and one-week interval, whereas, the fathers of the control group did not receive any education and only mothers were educated with the same instruction. The content of the education was: fathers' education about "benefits of breast milk" and "the supporting ways for breastfeeding including the women encouragement". Then, the scores of "father's support for breastfeeding", "mothers' breastfeeding practice" and "exclusive breastfeeding status" were compared before and after 4 months of intervention in each group, and also between groups. Data were analyzed using SPPS-23, and t- and paired-tests, Chi-square, and Generalized-Estimating-Equations (GEE) tests. RESULTS: The results showed two groups were not significantly different regarding the demographic and any other possible confounding variables before the intervention (P < 0.05). The before and after comparisons also demonstrated significant improvements in the two variables including "father's support for breastfeeding", and "mothers' breastfeeding practice after 4 months, in the intervention group (Paired t-test: P<0.001 and P<0.0001, respectively) however, there was a significant decrease in "father's support for breastfeeding" and no improvement in "mothers' breastfeeding practice" after 4 months in the control group (Paired t-test: P < 0.001 and P = 0.07, respectively). Between groups comparison showed also significant higher scores for "father's support for breastfeeding", "mothers' breastfeeding practice" and "exclusive breastfeeding status" in the intervention group comparing to the control group, after 4 months (T-test: P < 0.001 and P < 0.0001; Chi2: P < 0.001, respectively). The interaction effects of time and group were significant in the GEE test for the fathers' support for breastfeeding (B-group = 31.93, B-time = 22.15, p < 0.001) and mothers' breastfeeding practice (B-group = 26.32, B-time = 12.86, p < 0.0). CONCLUSION: The results showed that the father's education improves mothers' breastfeeding practice and increases the rate and continuity of exclusive breastfeeding. TRIAL REGISTRATION: IRCT201508248801N10. "31/08/2016".

The impact of the evaluations made by Mini-CEX on the clinical competency of nursing students.

INTRODUCTION: Clinical competency is defined as one's capabilities in terms of knowledge, attitude and practice, and is a necessity for nursing practice. Evaluation is the inseparable part of the education process, without which the quality of education could not be measured. Considering the characteristics of clinical education and its impact on the clinical competency of students, as well as the importance of making precise evaluations of them using scientific, modern and efficient approaches, this study aims to investigate the impact of the evaluation made using Mini-Clinical Evaluation Exercise on the clinical competency of the nursing students of the School of Nursing and Midwifery Shahid Behesti University. METHODS: This is a quasi-experimental study with a control group conducted on students who were taking courses "Nursing care for a sick child". The students were classified into the intervention and control groups using complete enumeration. The evaluations were made using Mini-Clinical Evaluation Exercise in the intervention group and the portfolio approach in the control group. The skills regarding patient (mother-child) education, IV therapy and medication were evaluated by checklists. FINDINGS: The results showed that the mean score of clinical competency in the intervention group was significantly higher than that of the control group. CONCLUSION: Considering the improvement of clinical competency in the intervention group, it is recommended to use Mini-Clinical Evaluation Exercise for the evaluation of students.

Reducing care burden and improving adherence to health-promoting behaviors among family caregivers of patients with multiple sclerosis through a healthy lifestyle empowerment program.

BACKGROUND AND AIM: The chronic, progressive nature of multiple sclerosis (MS) demands long-term family-centered care for patients. In view of that, inadequate education and support provided for the family caregivers (FCGs) of MS patients increase their care burden (CB) and affect their lifestyle. This study aimed to investigate the impact of a healthy lifestyle empowerment program (HLEP) on CB and adherence to health-promoting behaviors (HPBs) in the FCGs of patients suffering from MS. METHODS: In this experimental study with parallel groups, conducted in Iran in 2020, a total of 60 FCGs of MS patients were recruited, and then randomized into intervention (n = 30) or control (n = 30) groups. The intervention program, the HLEP, was thus implemented virtually via WhatsApp in the intervention group upon coordinating with the MS Association in the city of Yasuj, Iran, and selecting the participants. The data were collected at three stages, including baseline, follow-up 1 (immediately after the HLEP), and follow-up 2 (three months after HLEP). The research tools were a 14-item demographic survey questionnaire, the 24-item Caregiver Burden Inventory, and the 52-item Health-Promoting Lifestyle Profile-II. Independent-samples t-test, repeated measures analysis of variance, and a linear mixed model were further used for statistical analyses, considering the significant level of 0.05. RESULTS: The study results revealed a significant decrease in the CB scores from the baseline to the follow-up 2 (77.03 ± 15.76 to 42.33 ± 12.37), and a significant increase in the values of adherence to HPBs from the baseline to the follow-up 2 (123.53 ± 14.01 to 148.06 ± 15.04) were obtained in the intervention group (p < 0.001). The linear mixed model also showed that the significant absolute changes in the scores of CB and adherence to HPBs during the follow-ups in the intervention group, compared to those in the controls, were - 8.92 and 16.47 units, respectively (p < 0.001). CONCLUSION: Health care managers, planners, and providers are highly recommended to start developing and implementing various HLEPs for reducing CB and improving adherence to HPBs among the FCGs of patients with MS.

Predictors of Perceived Family Sense of Coherence in Parents of Children with Cancer.

Objectives: Despite improvement in childhood cancer survival in recent decades, it is still an extremely challenging health condition for parents. The impacts of childhood cancer on the family as a whole are recently interested by researchers. Family coherence is one of these concepts and health-care providers need to understand the perception of parents of family coherence. This study aimed to assess the correlation between perceived family sense of coherence (SOC) in parents of children with cancer; with socio-demographic, psycho-emotional and family-related variables. Materials and Methods: This cross-sectional correlational study recruited 125 parents of children with cancer attending hospitals in Tehran in 2020, selected by convenience sampling method. The correlation between family SOC and demographic variables, chronic sorrow, coping behaviours, family functioning and social support was investigated using regression analysis. Results: The mean score perceived sense of family coherence in parents of children with cancer was higher in fathers (Beta = 0.17, P = 0.02), urban residents (beta = -0.2, P = 0.01) and homeowners (beta = -0.27, P = 0.001). The sense of family coherence had positive correlations with income grade (beta = 0.27, P = 0.006), coping behaviours (beta = 1.28, P = 0.002), social support (beta = 0.67, P = 0.001), negative correlations with the disturbance in family problem-solving (beta = -0.28, P = 0.006) and chronic sorrow (beta=-0.39, P = 0.001). Conclusion: The present study expanded the concept of family SOC in nursing knowledge and attracted the attention of the providers of family-centred care to the parents of children with cancer and their concerns, which directly and indirectly affect the entire family's health.

The effect of PLISSIT based counseling model on sexual function, quality of life, and sexual distress in women surviving breast cancer: a single-group pretest-posttest trial.

BACKGROUND: Diagnosis and treatment of breast cancer potentially leads to sexual dysfunction and sexual distress in women and negatively affects their quality of life (QoL). This study aimed at determining the effect of PLISSIT based counseling on sexual function, sexual distress, and QoL in women surviving breast cancer. METHODS: In this pre-test, post-test, single-group semi-experimental study, 65 women surviving breast cancer who were referred to the selected centers were included in the study via the available sampling method. Data gathering tools included a researcher-made demographic questionnaire, female sexual function index, beck depression inventory-II, State-Trait Anxiety Inventory, World Health Organization QoL-Brief, and Female Sexual Distress Scale-Revised. The counseling program (7 sessions 60 min each) was designed based on the PLISSIT model. The sexual function, sexual distress, and QoL were evaluated before, and 2 and 4 weeks after the intervention. To compare the mean scores of variables before and after the intervention, repeated-measured ANOVA was used. RESULTS: The findings showed that PLISSIT based counseling significantly reduced sexual distress and increased the scores of QoL and all its domains, as well as sexual function and all its domains in women surviving breast cancer (p < 0.05). There was no significant difference in the mean scores of variables 2 and 4 weeks after the intervention. CONCLUSIONS: It seems that PLISSIT based counseling reduces sexual dysfunction and sexual distress and improves the QoL of women surviving breast cancer. So, it is recommended that these counseling programs be integrated into the health care program of this group of women. TRIAL REGISTRATION: TCTR202103170010, 17 March 2021, Retrospectively registered, at https://www.thaiclinicaltrials.org/ .

Bio-psychosocial factor of vaginismus in Iranian women.

BACKGROUND AND AIM: Various physical, psychological, social and cultural factors contribute to vaginismus. Therefore, given the multidimensionality of this disorder and the need to pay more attention to all biological, psychological and social dimensions in its treatment, the present study was conducted to investigate the bio-psychological factors contributing to vaginismus. METHODS: This descriptive cross-sectional study was conducted on 180 Iranian women with vaginismus who had been referred to sexual health clinics of Tehran province in 2020. Multistage random sampling method was used in this study, and vaginismus was diagnosed in women by a specialist through using a questionnaire. Data collection tools included demographic and obstetric information form, valid and reliable Sexual Function Questionnaire, Depression Anxiety Stress Scales (DASS), Sex Fear Questionnaire, Vaginal Penetration Cognition Questionnaire, Sexual Self-Efficacy Scale, Sexual Knowledge and Attitude Scale, Sexual Quality of Life-Female, Inventory of Sexual Satisfaction, ENRICH Marital Satisfaction Scale, Sexual Intimacy Scale and Questionnaire for Diagnosis of Vaginismus. In order to determine the factors related to vaginismus, multiple linear regression model was used through SPSS software version 25 (SPSS Inc., Chicago, IL). RESULTS: Based on the results of the present study, the mean age of women and the mean duration of their marriage were 27.77 ± 5.36 and 4.07 ± 3.87 years respectively. As the results of multiple linear regression revealed, the variables of fear of sex (B = 0.141, P = 0.036), positive cognition (B = 0.197, P = 0.046), self-image (B = 0.651, P = 0.001), sexual intimacy (B = -0.116, P = 0.021), quality of sexual life (B = 0.115, P = 0.002) and education (B = 2.129, P = 0.024) from the bio-psychosocial model were the final predictors of vaginismus diagnosis score in women with this disorder. According to the results of multiple linear regression, 45.5% of the variance of vaginismus diagnosis total score was explained by these variables (R = 0.706, R2 = 0.498 and ADJ.R2 = 0.455). CONCLUSION: The results of the present study showed that the variables of fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education were the final predictors of vaginismus diagnosis score. This disorder is, thus, considered to be multidimensional.

As a sexual dysfunction, Vaginismus prevents sexual penetration through involuntary and frequent spasms of the muscles in the one-third of vagina's outer part. Factors such as negative beliefs about sex, cultural factors, fear of pain, injury, bleeding and so forth play significant roles in the prediction of vaginismus. Therefore, given the multidimensionality of vaginismus and the need to pay attention to all biological, psychological and social dimensions in treating it, and since the bio-psychosocial model is a strong framework for the factors contributing to sexual problems whose recognition will lead to the design of multidimensional treatments, the present study was conducted on 180 Iranian women with vaginismus to investigate the bio-psychological factors associated with vaginismus. The present study showed that the fear of sex, positive cognition and negative self-image, sexual intimacy, quality of sexual life and education from the bio-psychosocial model were the final predictors of vaginismus diagnosis score. Therefore, this model can be used in designing interventions for the treatment of vaginismus, especially in the psychological and interpersonal domains.

Investigating and Comparing the Effect of Teach-Back and Multimedia Teaching Methods on Self-Care in Patients With Diabetic Foot Ulcers.

This study evaluated the effect of teach-back and multimedia teaching methods versus routine care on the self-care of patients with diabetic foot ulcers. Patients receiving either the teach-back or multimedia interventions had greater improvement in self-care scores than those receiving routine care. Both the teach-back and multimedia teaching methods were found to be effective in enhancing the self-care of people with diabetes.

A sex education program for teachers of preschool children: a quasi-experimental study in Iran.

BACKGROUND: Sex education is an important educational dimension. Together with families, teachers play a significant role in providing sex education to children. However, in most cases, they do not have enough information on this topic. The present study aimed to determine the effects of a preschool sex education program on preschool teachers' knowledge and attitude. METHODS: In this quasi-experimental study, 80 teachers working at preschools in Tehran, Iran, were randomly allocated to experimental and control groups. The educational program was provided in two 90-min sessions for the experimental group while the control group received no intervention. A self-designed knowledge and attitude questionnaire was completed by both groups before and 1 month after the intervention. This questionnaire evaluated knowledge and attitude in six domains of principles of sex education, sexual identity, stages of development and proper methods of sex education, sex-related questions, masturbation, and sexual abuse. Data were analysed in SPSS 18 using descriptive statistics as well as independent samples t-test, paired-samples t-test, chi-squared test, and ANCOVA at p < 0.05. RESULTS: Mean scores of knowledge and attitude in all dimensions showed a significant increase in the experimental group following the educational intervention. However, no difference was observed in the control group. Following the educational intervention, mean scores of teachers' knowledge and attitude in all six domains showed a significant difference with that of the control group (p < 0.001). CONCLUSIONS: Results revealed that the sex education program can promote the knowledge and attitude of preschool teachers in all domains. TRIAL REGISTRATION: Iranian Registry of Clinical Trials: IRCT2016122320854N5. Registered on 9 March 2017. "Retrospectively registered".

Association between ethical leadership, ethical climate and organizational citizenship behavior from nurses' perspective: a descriptive correlational study.

BACKGROUND: Ethical leadership plays an important role in improving the organizational climate and may be have an effect on citizenship behavior. Despite the growing emphasis on ethics in organizations, little attention to has been given this issue. The purpose of this study was to identify ethical leadership, an ethical climate, and their relationship with organizational citizenship behavior from nurses' perspective. METHODS: In this descriptive correlational study, 250 nurses in twelve teaching hospitals in Tehran were selected by multistage sampling during 2016-2017. The data were collected using Ethical Leadership Questionnaire, Hospital Ethical Climate Survey, and Organizational Citizenship Behavior Scale. RESULTS: The findings showed a significant correlation between ethical leadership in managers, organizational citizenship behavior (P = 0.04, r = 0.09) and an ethical climate (P < 0.001, r = 0.65). There was a significant correlation between an ethical climate and nurses' organizational citizenship behavior (P < 0.001, r = 0.61). The regression analysis showed that ethical leadership and an ethical climate is a predictor of organizational citizenship behavior and confirms the relationship between the variables. CONCLUSION: Applying an ethical leadership style and creating the necessary conditions for a proper ethical climate in hospitals lead to increased organizational citizenship behavior by staff. To achieve organizational goals, nurse managers can use these concepts to enhance nurses' satisfaction and improve their performance.

Translation, Cultural, and Age-Related Adaptation and Psychometric Properties of Persian Version of "Quality of Dying and Death" in Nurses Working in Neonatal Intensive Care Units.

BACKGROUND: Death and dying care is an area with less attention in nursing. This even is evidenced as more challenging in some populations such as neonates. Neonatal intensive care unit (NICU) nurses should be aware of the quality of care they provide for dying neonates and their families to find the areas which need attention. OBJECTIVE: The aim of this study was to assess the psychometric features of the Quality of Dying and Death (QODD) questionnaire in NICU nurses in Tehran, the capital city of Iran. METHODS: This methodological study was conducted in 2017. For this purpose, using census method, 130 NICU nurses working in selected hospitals participated. After the backward-forward translation, based on the method proposed by the International Test Commission, the psychometric properties of the Persian QODD were examined through the assessment of the face, content and construct validity, internal consistency, and stability. RESULTS: Final Persian QODD's content and face validity were accepted through a qualitative method. In the confirmatory factor analysis, the original version of QODD was not confirmed. Subsequently, an exploratory factor analysis was carried out in which phrases were included in three dimensions (symptom control, preparation for death of neonate, and professional attention) that explained 75% of the variance. Cronbach's alpha values ranged from 0.82 to 0.88 for these three dimensions. The intraclass correlation coefficient (ICC) was ICC = 0.94 between two tests performed with a 2-week interval on twenty eligible nurses. CONCLUSIONS: The Persian version of QODD has acceptable psychometric properties in nurses working with the neonatal population and can be used to investigate the NICU nurses' opinion on the QODD provided in NICU patients.

Levels of unmet needs among adolescents and young adults (AYAs) impacted by parental cancer.

PURPOSE: In this study, we aim to assess types and levels of psychosocial needs in adolescents and young adults (AYAs) who have a parent with cancer. And define and describe the variables analyzing the demographic characteristics. METHODS: This descriptive study with cross-sectional design was conducted on 217 participants from five hospitals in Tehran. By use of the "Offspring Cancer Needs Instrument," in adolescents and young adults who had the inclusion criteria, information about the psychosocial needs were collected. Also, a demographic questionnaire was completed by the participants. Mean and standard deviation calculated for each domain and overall scores. Independent t test and one-way ANOVA was used for the comparison of needs' mean and demographic variables. RESULTS: Total scores' mean was 126 and among domains, the "information" got the highest and the "support from friends" the lowest mean. Among demographic variables, we found a relationship between parent education (p value = 0.007), treatment statue (p value = 0.015), parent gender (p value = 0.018), and parent-child relationship (p value = 0.027) with the level of psychosocial needs. CONCLUSIONS: In this target group of adolescents and young adults, the need for "information" is the strongest domain of psychosocial need during parent cancer trajectory.

Nursing adherence to ethical codes in pediatric oncology wards.

BACKGROUND: The nature of children's cancer comes with lots of ethical issues. Nurses are encouraged to adhere to ethical codes in their practice. OBJECTIVES: This study aimed to compare the perspectives of nurses and mothers of children with cancer regarding the adherence of nurses to ethical codes. RESEARCH DESIGN: In this descriptive-comparative study, a researcher-made questionnaire was used to assess the amount of adherence to Iranian nurses' code of ethics in perspectives of pediatric oncology nurses and mothers. As a convention, the total scores were categorized as optimal, average, and low adherence. PARTICIPANTS AND CONTEXT: A total of 200 mothers and 60 nurses in pediatric oncology wards of five major hospitals in Tehran, Iran, participated in 2016. ETHICAL CONSIDERATIONS: Organizational approval by the university and informed consent were ensured before conducting the research. The principles of voluntariness, confidentiality, and anonymity were respected during the research process. FINDINGS: Results showed the mean score of the adherence to ethical codes by nurses, as per the nurses is 86.71 (12.57) and as per the mothers is 78.67 (16.09). The highest frequency for "Low adherence" and "Optimal adherence" to code of ethics by nurses were "Respect for individual autonomy and decision-making" (mothers, 72% and nurses, 70%) and "Commitment to confidentiality" (mothers, 64% and nurses, 74%), respectively. This revealed a significant difference between the responses of the nurses and the mothers (p = 0.001). DISCUSSION: The results support the other studies in Iran about the difference between the perspectives of patients and nurses about adherence of nurses to ethical codes. CONCLUSION: Integration of family-centered and conventional care in addition to more attention to the education of professional ethical principles could be helpful to improve the ethical performance of nurses in oncology pediatric wards.

Relationship between ethical leadership and organisational commitment of nurses with perception of patient safety culture.

AIM: To determine the relationship between ethical leadership, organisational commitment of nurses and their perception of patient safety culture. BACKGROUND: Patient safety, organisational commitment and ethical leadership styles are very important for improving the quality of nursing care. METHODS: In this descriptive-correlational study, 340 nurses were selected using random sampling from the hospitals in Tehran in 2016. Data were analysed using descriptive and inferential statistics in SPSS v.20. RESULTS: There was a significant positive relationship between the ethical leadership of nursing managers, perception of patient safety culture and organisational commitment. The regression analysis showed that nursing managers' ethical leadership and nurses' organisational commitment is a predictor of patient safety culture and confirms the relationship between the variables. CONCLUSION: Regarding the relationship between the nurses' safety performance, ethical leadership and organisational commitment, it seems that the optimisation of the organisational commitment and adherence to ethical leadership by administrators and managers in hospitals could improve the nurses' performance in terms of patient safety. IMPLICATIONS FOR NURSING MANAGEMENT: Implementing ethical leadership seems to be one feasible strategy to improve nurses' organisational commitment and perception of patient safety culture. Efforts by nurse managers to develop ethical leadership reinforce organisational commitment to improve patient outcomes. Nurse managers' engagement and performance in this process is vital for a successful result.

Association of dietary inflammatory index with C-reactive protein and interleukin-6 in women with and without polycystic ovarian syndrome.

Considering that interventions related to lifestyle, especially nutrition have been proposed as the first line of prevention and treatment of polycystic ovarian syndrome (PCOS), and regarding the proven relationship between PCOS and inflammation, the present study was designed to find out the possible association of Diet Inflammatory Index (DII) with the inflammatory markers like C-reactive protein (CRP) and Interleukin-6 (IL-6), and compare the obtained results in PCOS and non-PCOS women. This case-control study was conducted on 45 PCOS and 40 non-PCOS women. Food intake and DII were measured using a 147-item Food Frequency Questionnaire. All participants were tested for the serum levels of IL-6 and CRP. Finally, the obtained results were compared between the two groups of PCOS and non-PCOS women. Significant differences were observed between the two groups in terms of age, menstrual status and number of pregnancies (P < 0.05). Comparison of DII values showed no significant difference between the two groups of women (P = 0.68), but IL-6 was significantly higher in the PCOS group than in the control group (4.94 ± 1.97 vs. 3.48 ± 1.77, P < 0.001). Also in terms of CRP, no significant difference was observed between the two groups (P > 0.05). The difference of DII between the case and control groups were not significant and Pearson's correlation test did not show a significant correlation between DII and IL-6 (P˃0.05). This result can be due to the influence of several factors affecting the determination of DII such as education level, health status, physical activity level, age, and calorie intake. It seems that diet, especially consumption of more carbohydrates plays a role in causing chronic inflammation, as well as the occurrence and exacerbation of PCOS.

Application of a Risk Management Program Based on the Health Belief Model for Preventing Home Accidents.

Background: Accidents are the main cause of mortality in children aged less than 5 years throughout the world. The present study was conducted to empower mothers with children aged less than 5 years in preventing home accidents through the implementation of a risk management training program based on the Health Belief Model (HBM). Materials and Methods: The present pretest-posttest, quasi-experimental study was conducted on 70 mothers with children aged less than 5 years who referred to Community Health Centers of Shahid Beheshti University of Medical Sciences, Iran, in 2019. The subjects were selected through multistage random sampling and were randomly assigned to intervention (n = 35) and control (n = 35) groups. The data were collected using a two-part questionnaire for demographic characteristics and HBM constructs before, immediately after, and 45 days after the implementation of the risk management training program at a significance level of <0.05. Results: No significant difference was observed between the two groups before the intervention in terms of HBM constructs (p>0.05). However, they significantly differed between the intervention and control groups after the intervention. Moreover, scores of HBM constructs were significantly different immediately and 45 days after the intervention (p <.05). Conclusions: The study results showed the effectiveness of the HBM-based risk management training program; thus, it is essential to design and implement such programs in community health centers to prevent and reduce injuries caused due to home domestic accidents.