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PURPOSE: This study aimed to explore barriers related to the healthcare system (HCS) in implementing quality intravenous (IV) chemotherapy (CT) from the perspectives of cancer patients, family caregivers, and healthcare professionals (HCPs). METHODS: Using an explanatory descriptive qualitative method, this study was conducted in 2019. Forty-one participants (6 patients, 5 family caregivers, 12 oncologists, and 18 nurses) were selected through purposive sampling. In-depth semi-structured interviews and field notes were conducted to collect the data, which were analyzed using qualitative content analysis. Lincoln and Guba's criteria of rigor were employed to ensure the trustworthiness of the study. RESULTS: Data analysis showed two categories, each with three subcategories: barriers related to healthcare professionals (HCPs) comprised of "educational and communication barriers," "failure to establish trust," and "unskilled healthcare professionals"; barriers related to the health care system management (HCSM), which consists of "inadequate physical and care infrastructures to provide services," "lack of support in the disease trajectory from diagnosis to rehabilitation," and "mismanagement of CT wards/procedures." CONCLUSION: The identification and removal of the barriers related to HCPs and HCSM in routine care are crucial. Education of and communication with cancer patients and their family caregivers are two important pillars in the quality of intravenous chemotherapy (IV CT) and this education and communication should be based on individualized care and tailored to the unique needs of each patient.
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Atenção à Saúde , Pessoal de Saúde , Cuidadores , Comunicação , Humanos , Pesquisa QualitativaRESUMO
OBJECTIVE: Searching for health information is an important strategy in dealing with cancer that contributed to the improved management of cancer. This qualitative study aimed to explore the experiences of cancer patients seeking health information using the conventional content analysis approach. METHODS: The 18 participants were selected by purposive sampling and data were collected through semi-structured in-depth interviews. Data were analyzed by software MaxQDA 10 based on conventional content analysis. RESULTS: Data analysis led to the emergence of three central categories, including "optimal cancer management," "poor information dissemination system," and "perceived health literacy." CONCLUSION: Knowing how cancer patients obtain health information can form the basis to promote patients' health literacy and design a health information dissemination system tailored to the patients' needs.
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Letramento em Saúde , Neoplasias , Humanos , Neoplasias/terapia , Pesquisa QualitativaRESUMO
BACKGROUND: Transition from a clinical expert nurse to a part time clinical nursing instructor (PTCNI) poses several challenges. Designing a professional development curriculum to facilitate the transition from a clinical expert nurse to a PTCNI is critical to effective education. A comprehensive competency-based curriculum was developed and implemented with structured mentoring to prepare clinical expert nurses as PTCNIs. METHODS: A mixed-methods study with a sequential-exploratory approach was conducted in Iran in 2019. In the qualitative phase, Saylor et al.'s (1981) seven-step model was used, consisting of (1) collecting evidence from a systematic review, (2) conducting interviews with learners, (3) setting goals and objectives, (4) design, (5) implementation, (6) evaluation, and (7) feedback. In the quantitative phase, curriculum domains were evaluated. Additionally, the effective professional communication skills module was implemented using a quasi-experimental study with a pre-test post-test single-group design for 5 PTCNIs in a pilot study. RESULTS: After integrating the findings of the literature review and field interviews in the analysis stage, a curriculum was developed with a total of 150 h, six modules, and 24 topics. Results of the pilot study showed a significant improvement in the confidence of PTCNIs as a result of the implementation of the effective communication skills module using the mentoring method (t = - 16.554, p = 0.0005). CONCLUSIONS: This competency-based curriculum was based on the evidence and needs of PTCNIs and provides a complete coverage of their clinical education competencies. It is suggested that managers of educational institutes that offer nursing programs use this curriculum to prepare them in continuing education programs. Further studies are needed to thoroughly evaluate the learning outcomes for students.
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BACKGROUND: Self-medication by older adults has been always a public health concern. The present study aimed to modify the psychological constructs of Health Belief Model (HBM) in relation to self-medication behaviors using Freire's Adult Education Model (FAEM) among older adults in Khorramabad, Iran, from 2017 to 2018. METHODS: The mean age of the older adults was 66.28 ± 7.18 years. This was a randomized controlled trial study conducted on 132 individuals older than 60 who were referred from different health care centers. The participants were selected using multistage sampling method and randomly divided into two groups of intervention and control. The data collection instruments included a questionnaire which was designed based on both HBM and self-medication behaviors questionnaire. The phase of adult education model (AEM) was used to modify the psychological constructs of HBM and self-medication behaviors. Data were analyzed using SPSS software version 20 with a significant level of 0.05. Descriptive statistical tests, chi-squared test, paired t-test, independent t-test, and univariate modeling were employed for the purpose of analyzing data. RESULTS: There was no significant difference between groups in terms of self-medication. Unawareness of the effects of medicine were the most important reason for self-medication (p = 0.50). The two groups were not significantly different in terms of knowledge, HBM constructs, and self-medication behaviors (p > 0.05). However, they came up to be considerably different for the above variables after the intervention was implemented (p < 0.05). When the findings were adjusted for the effects of confounding variables, there were significant differences between the two groups in almost all constructs of HBM and their behaviors (p < 0.05). However, the perceived barrier modality of HBM did not reach to a significant level of difference between two groups. CONCLUSION: The educational intervention, which was based on Freire's AEM, had positive effects on the constructs of HBM and consequently on self-medication behaviors. The psychological constructs of HBM were affected at the phases of listening to problems. Self-medication was tempered at the action-reflection phase with shared creation and evaluation of the action plan geared toward the achievement of the behavioral objectives. The results might be of importance to healthcare professionals involved in care of older patients. TRIAL REGISTRATION: Current Controlled Trials IRCT2013091814512N2. Registered on January 2 - prospectively registered, the trial was registered in the Iranian Clinical Trials Registry http://www.irct.ir .
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Modelo de Crenças de Saúde , Educação em Saúde/métodos , Conhecimentos, Atitudes e Prática em Saúde , Automedicação/psicologia , Idoso , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Human instinctively desire to have offspring. Infertility can cause painful emotional experiences throughout the life mainly known as quality of life impairment. This study aimed to investigate the impact of infertility on a woman's quality of life. METHODS: A number of 180 infertile and 540 fertile women participated in this matched case-control study. The cases were selected through a combination of multistage stratified and cluster sampling methods. For each infertile woman three fertile women were randomly selected. The data gathering instrument consisted of demographic variables and the WHOQOL-BREF questionnaire. Data collection was conducted through interview with participants. The multivariate marginal model and SPSS software 21 were used for data analyses with a significance level of 0.05. RESULTS: The results of the multivariate modeling show infertility can potentially affect various aspects of women's quality of life such as physical health (p < 0.001), mental health (p < 0.001), social health (p < 0.001) and the total score of quality of life (p < 0.001) significantly. CONCLUSION: An infertile woman practice a relatively lower scores in QOL sub-scales of mental, physical and environmental health; while they experience a higher social health score than a fertile woman.
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Infertilidade Feminina/psicologia , Qualidade de Vida , Estresse Psicológico , Saúde da Mulher , Adulto , Estudos de Casos e Controles , Feminino , Disparidades nos Níveis de Saúde , Humanos , Infertilidade Feminina/epidemiologia , Irã (Geográfico)/epidemiologia , Saúde Mental/estatística & dados numéricos , Comportamento Social , Inquéritos e QuestionáriosRESUMO
BACKGROUND: According to the World Health Organization, palliative care is one of the main components of healthcare. As the incidence of cancer is increasing in the world, home-based palliative care can be beneficial for many patients. This study was designed to explore health care providers' perceptions about home-based palliative care in terminally ill cancer patients. METHODS: This qualitative study was carried out using the conventional content analysis from October 2016 to September 2018 in Iran. Participants were home care providers who were selected using purposive sampling. The data were collected through 18 individual interviews, and a focus group meeting. Data were analyzed based on the method proposed by Lundman and Graneheim. RESULTS: from the data analysis, 511 initial codes were extracted, which were categorized into the two main categories of challenges and opportunities for home-based palliative care and 10 subcategories. The subcategories of challenges included deficiencies in inter-sectoral and inter-professional cooperation, lack of infrastructures for end-of-life care, challenges related to the management of death, challenges of transferring patients to home, providing non-academic palliative care, lack of political commitment of the government and Spiritual vacuum. The category of opportunities included subcategories of cost-effectiveness, moving towards socializing health, and structure of the health system. CONCLUSIONS: Home-based palliative care requires government and health system support. Structural and process modification in the healthcare can provide conditions in which terminally ill cancer patients receive appropriate care in home and experience death with dignity through support of family, friends and healthcare.
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Pessoal de Saúde/psicologia , Serviços de Assistência Domiciliar/normas , Cuidados Paliativos/normas , Percepção , Adulto , Idoso , Feminino , Grupos Focais , Pessoal de Saúde/estatística & dados numéricos , Serviços de Assistência Domiciliar/organização & administração , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Pesquisa Qualitativa , Doente Terminal/psicologiaRESUMO
BACKGROUND: The self-efficacy of educators plays a crucial role in their professional competence and subsequent provision of care. The present study aims to explain the main sources contributing to the development of self-efficacy beliefs among healthcare providers in delivering health education. METHODS: This qualitative study was conducted from 2015 to 2016 in various settings of Isfahan such as hospitals, doctor's offices, and healthcare centers. Twenty three health educators with an average of 10-year work experience in healthcare participated in the study. Data were collected using semi-structured in-depth individual interviews and were analyzed through conventional content analysis. Prolonged engagement with the participants, maximum variation in the participants' characteristics, sampling, and member check were among the factors enriching the research. RESULTS: The six main categories extracted during data analysis included: 1) Quantity and quality of their experience; 2) Encountering unexpected events; 3) Client trust; 4) Self-concept; 5) Professional knowledge and skill; 6) Vicarious experiences. CONCLUSIONS: The study results show two new findings, including "encountering unexpected events" and "client trust", affecting professional self-efficacy beliefs among healthcare providers in the delivery of health education. The other main findings were extremely similar to Bandura's theory. These results can be used as a basis in planning and implementing health development educational models for human resources.
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Educação em Saúde/normas , Pessoal de Saúde , Competência Profissional/normas , Autoeficácia , Atitude do Pessoal de Saúde , Humanos , Entrevistas como Assunto , Modelos Educacionais , Moral , Pesquisa QualitativaRESUMO
BACKGROUND: Mental disorders of adulthood can be traced to childhood and adolescent disorders so attention to the mental health of young people is important. OBJECTIVES: We aimed to determine the mental health status of high-school students in Khorramabad and the factors that may affect it. METHODS: This cross-sectional study included 1 202 high-school students in Khorramabad in the 2015-2016 academic year. Students were selected using stratified and multistage cluster random sampling. Data were collected on sociodemographic characteristics of the students, and the General Health Questionnaire (GHQ-28) was used to assess symptoms of mental disorders. Logistic regression analysis was used to evaluate the relationship between the presence of symptoms of mental disorder and sociodemographic characteristics. RESULTS: The mean age of the students was 16.1 (SD 0.9) years and 52.7% were girls. Overall, 481 (40%) students (34% of males, 46% of females) had symptoms of mental disorders. Most had mild symptoms; 5% had severe symptoms. Symptoms of anxiety, depression and social impairment were seen in 40%, 33% and 32% of the students respectively; significantly more girls had these symptoms (P < 0.05). Female students, those in higher school grades, and those whose fathers were unemployed and mothers were housewives were significantly more likely to have symptoms of mental disorders (P < 0.05). CONCLUSIONS: This study found a high prevalence of symptoms associated with mental disorders in the adolescents in Khorramabad. Counselling centres in schools are needed to offer psychiatric counselling services to students and to implement regular mental health training programmes.
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Transtornos Mentais/epidemiologia , Saúde Mental , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , PrevalênciaRESUMO
Hepatitis C virus (HCV) infection is considered one of the most important causes of chronic liver diseases. Many reports have shown that the proteins of the HCV via interactions with gene expression regulatory networks such as cellular pathways and microRNAs can contribute to the development of chronic liver diseases. The present study aimed to investigate the effects of the HCV NS3 protein on the expression of miR-150 miR-199a, miR-335, miR-194, miR-27a in a cell culture model. Plasmids expressing the full length of the HCV NS3 protein were transfected into the LX-2 cell line, while at the same time a plasmid expressing empty GFP (green fluorescent protein) was used as a negative control group. Subsequently, total RNA was extracted and real-time PCR was performed to measure microRNA expression levels. Additionally, the trypan blue exclusion test was performed to examine the effect of the expressing NS3 protein plasmid on cellular viability. The analysis of microRNA gene expression in LX-2 cells indicated that the NS3 protein, which is endogenous to HCV, can significantly upregulate the expression of miR-27a and downregulate the expression of miR-335 and miR-150 in comparison with the control plasmid expressing GFP and normal cells (p < 0.01). These results suggest that the HCV NS3 protein may play a role in the pathogenesis of chronic hepatic diseases such as liver fibrosis via interaction with cellular microRNAs and modulation of microRNA gene expressions.
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Hepacivirus/fisiologia , Interações Hospedeiro-Patógeno , MicroRNAs/biossíntese , Proteínas não Estruturais Virais/metabolismo , Linhagem Celular , Sobrevivência Celular , Perfilação da Expressão Gênica , Hepatócitos/virologia , Humanos , Plasmídeos , Reação em Cadeia da Polimerase em Tempo Real , Proteínas não Estruturais Virais/genéticaRESUMO
BACKGROUND: Unwanted pregnancy not intended by at least one of the parents has undesirable consequences for the family and the society. In the present study, three classification models were used and compared to predict unwanted pregnancies in an urban population. METHODS: In this cross-sectional study, 887 pregnant mothers referring to health centers in Khorramabad, Iran, in 2012 were selected by the stratified and cluster sampling; relevant variables were measured and for prediction of unwanted pregnancy, logistic regression, discriminant analysis, and probit regression models and SPSS software version 21 were used. To compare these models, indicators such as sensitivity, specificity, the area under the ROC curve, and the percentage of correct predictions were used. RESULTS: The prevalence of unwanted pregnancies was 25.3%. The logistic and probit regression models indicated that parity and pregnancy spacing, contraceptive methods, household income and number of living male children were related to unwanted pregnancy. The performance of the models based on the area under the ROC curve was 0.735, 0.733, and 0.680 for logistic regression, probit regression, and linear discriminant analysis, respectively. CONCLUSION: Given the relatively high prevalence of unwanted pregnancies in Khorramabad, it seems necessary to revise family planning programs. Despite the similar accuracy of the models, if the researcher is interested in the interpretability of the results, the use of the logistic regression model is recommended.
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Background: The purpose of this study was to use the health belief model (HBM) to predict the adoption of preventive behaviors against COVID-19 using the structural equation modeling approach. Methods: As a descriptive-analytical study, this research was conducted on 831 men and women who were under the coverage of comprehensive health service centers in the Lorestan province of Iran in 2021. A questionnaire based on HBM was used to collect data. Data were analyzed by the SPSS software version 22 and AMOS version 21. Results: The mean age of participants was 33.0 ± 8.5, with a range of 15-68 years. The constructs of the HBM explained about 31.7% of the variance in COVID-19-related preventive behaviors. The greatest total effect on preventive behaviors against the COVID-19 disease belonged to the constructs of perceived self-efficacy (0.370), perceived barriers (-0.294), and perceived benefits (0.270), in descending order of impact. Conclusion: Educational interventions can be useful in promoting COVID-19 preventive behaviors by bringing about a correct understanding of self-efficacy, barriers, and benefits.
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COVID-19 , Academias de Ginástica , Masculino , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Irã (Geográfico)/epidemiologia , COVID-19/prevenção & controle , Análise de Classes LatentesRESUMO
OBJECTIVE: Herpes simplex virus (HSV), as a common infection in healthy individuals, is treated symptomatically, but drug resistance and the side effects of drugs have drawn the attention of researchers to complementary medicine. Olive Leaf Extract (OLE) has antiviral effects that may treat HSV. The current study aimed to compare the clinical effects of OLE and Acyclovir on HSV-1. METHODS: This randomized double-blind clinical trial was conducted on 66 patients who had already been diagnosed with HSV-1. The participants were randomized into two groups, receiving 2% OLE cream or 5% acyclovir cream five times a day for six days. The symptoms were evaluated before, and three and six days after the interventions. Data were analyzed using the SPSS software through the Kolmogorov-Smirnov test, chi-squared, t-test, and repeated measures ANOVA. RESULTS: The results showed clinical symptoms decreased in both groups during the study and both medications were effective in the treatment of HSV-1. However, the OLE group experienced less bleeding (P = 0.038), itching (P = 0.002), and pain (P = 0.001) on the third day as well as less irritation (P = 0.012), itching (P = 0.003) and color change (P = 0.001) on the sixth day compared to the acyclovir group. The treatment course for participants in the OLE group was shorter than in the acyclovir group (P = 0.001). CONCLUSION: The evidence from these trials suggests the OLE cream is superior in the healing of episodes of HSV-1 over the acyclovir cream. Future studies are recommended to investigate if OLE could be an adjunct to acyclovir treatment.
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Herpes Labial , Aciclovir/efeitos adversos , Administração Tópica , Método Duplo-Cego , Herpes Labial/induzido quimicamente , Herpes Labial/tratamento farmacológico , Humanos , Olea , Extratos Vegetais , Prurido/tratamento farmacológico , SimplexvirusRESUMO
OBJECTIVES: This study aimed to compare home visits and telephone follow-up effectiveness on patients' self-efficacy undergoing Coro-nary Artery Bypass Graft Surgery -CABG- and caregivers' burden. METHODS: In this randomized clinical trial, 114 patients undergoing CABG were assigned to the three groups of home visits, telephone follow-up, and control based on the stratified block randomization. The self-management program of the home visit group included four face-to-face 60-minute training sessions once a week, and for the telephone follow-up group, four 30-minute telephone counseling sessions twice each week for a month. The control group received routine care. Data were collected using the cardiac rehabilitation self-efficacy questionnaire and the caregiver burden scale before and after the interven-tion. RESULTS: Before the study, there were no statistically significant differences between the three groups in terms of the means of self-efficacy and caregiver burden scores. However, there was a statistically significant difference between the home visit and control groups (p<0.001) and between the telephone follow-up and control groups (p<0.001) after the intervention, with in-creased self-efficacy and reduced caregiver burden reported. In contrast, there was no significant difference between the home visit and telephone follow-up groups regarding self-efficacy and caregiver burden scores. CONCLUSIONS: Both methods of self-management education have similar effectiveness in increasing self-efficacy and reducing the care-giver burden after discharge for patients who have undergone CABG.
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BACKGROUND: The available evidence has increasingly demonstrated that a combination of genetic and epigenetic factors, such as DNA methylation, could be considered as causing leukemia. Epigenetic changes and methylation of the suppressor of the cytokine signaling 1 promoter (SOCS1) CpG region silence SOCS1 expression in cancer. In the current study, we evaluated the impact of epigallocatechin gallate (EGCG) and RG108 on SOCS1 promoter methylation and expression in U937 cells. METHODS: In the current study, U937 leukemic cells were treated with EGCG and RG108 for 12, 24, 48, and 72 h and SOCS1 promoter methylation and its expression were measured by methylation-specific PCR (MSP) and quantitative real-time PCR, respectively. RESULTS: The outcomes indicated that the SOCS1 promoter is methylated in U937 cells, and treatment of these cells with either EGCG or RG108 reduced its methylation. Moreover, we observed that SOCS1 expression was significantly upregulated in a time-dependent manner by both EGCG and RG108 in U937 cells compared with control cells. In the RG108-treated group at 12, 24, 48, and 72 h, SOCS1 expression was upregulated by 1, 4.2, 16.6, and 32.6 -fold respectively, and in the EGCG-treated group, by 0.5, 3.2, 10.8, and 22.3 -fold, respectively. CONCLUSION: Treatment with either EGCG or RG108 reduced SOCS1 promoter methylation and increased SOCS1 expression in U937 cells in a time-dependent manner, which may play a role in leukemia therapy.
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BACKGROUND: Fatigue and pain are prevalent symptoms of multiple sclerosis (MS) and frequent complaint in MS patients, which reduce their quality of life. This study aimed to assess the effect of massage therapy on pain and fatigue in MS Patients. METHOD: The original and Persian databases were searched included PubMed, web of science, embase, ovid, scopus, and the Cochrane Library, SID, and Iranedex from inception to November 2020. Studies that reported the effect of massage on fatigue and pain were included. Two investigators extracted all relevant data, independently. For deriving analysis, mean difference (MD) and standardized mean difference (SMD) were used. RESULT: Ten studies were eligible acoording criteria. The effect of massage on fatigue showed significant improvement (-1.62; 95% CL -2.40, -0.83; p < .00001), also results of the systematic review showed a significant reduction in pain severity. CONCLUSION: Massage as a complementary and non-pharmacological therapy might have been associated with alleviating fatigue and pain in M.S. patients. Based on the current study, massage intervention for MS patients could have possible clinical value for palliating pain and fatigue and improving quality of life; however, this matter needs further and more significant trial studies.
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Echinococcosis is among the most underestimated parasitic diseases that have universal distribution. The primary treatment is surgery. Hence, the development of new and more effective scolicidal agents with lower side effects is crucial. This study evaluated the therapeutic effects of Urtica dioica and Cassia fistula extracts as a scolicidal herbal drug in vitro. Suspension of protoscoleces was obtained from the infected livers of sheep in Khorramabad, Iran. Hydro-alcoholic solution was extracted from the leaves and stems of Urtica dioica and the fruit of Cassia fistula. Echinococcus granulosus protoscoleces were treated with the essential oils at concentrations of 10, 25, 50, and 100 mg/mL for 10, 20, 30, and 60 min and their viability was evaluated by the eosin staining test. The extract of Urtica dioica at a concentration of 100 mg/mL killed 90.51% of protoscoleces after 60 min. Cassia fistula also killed 67.74% of protoscoleces after 60 min. This study obtained satisfactory results. Urtica dioica and Cassia fistula extracts are promising protoscolicides and can be used in the treatment of hydatid cysts and pre-surgically to prevent secondary infections.
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A novel method has been proposed to enhance efficiency of cataluminescence reaction by applying a plasma-assisted cataluminescence (PA-CTL) system. The obtained results clearly indicated that the PA-CTL system exhibited substantially higher sensitivity for the detection of benzene, toluene, ethylbenzene, and xylenes (BTEX) on the surface of nanosized ZrO(2). There are two distinctive advantages in the PA-CTL system; on one hand, the plasma activates the BTEX molecules for the detection, and on the other hand, the working temperature range of the catalytic reaction is lowered with the plasma assistance. A detection limit (LOD = 3sigma) of 20 ng mL(-1) was achieved for benzene in air samples. Using a graphite electrode in the designed plasma provides an additional opportunity for solid-phase microextraction (SPME) sampling of volatile organic compounds (VOCs) on its surface followed by PA-CTL detection. This ability has been investigated for detection of m-xylene in air samples.
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A new low-temperature plasma (LTP), based on dielectric barrier discharge (DBD), has been developed as an alternative ionization source for ambient mass spectrometry. For organic samples, the source is able to produce two different fragmentation patterns which are selectable by an electrical switch. The two source modes are different only in the second electrodes: in configuration (A), bar-plate and in configuration (B), coaxial bar-cylinder shapes are used. A disposable graphite probe is used as the first electrode, the same in both configurations, and a copper foil is used as the second electrode. The ionization source is applicable to gas and liquid samples, without any change being necessary in its design. Under optimal conditions, to take ethylbenzene as an example, a detection limit of less than 25 ng was obtained and a relative standard deviation (RSD) of 13.36% has been demonstrated for 50 ng of ethylbenzene (n = 11). We have found several interesting differences in the mass spectra of the tested volatile organic compounds (VOCs) in the two modes, which might be applicable in identification studies. We have investigated the effect of variation of the first electrode material and the second electrode length in mode B. Moreover, in this design the graphite electrode is capable of acting as a sample adsorbent, which is a new sampling method for LTP mass spectrometry (MS). This capability was investigated by adsorption of the selected VOCs onto the surface of the graphite electrode in a headspace solid-phase microextraction (SPME) system, and direct desorption and ionization of the samples by LTPMS.
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BACKGROUND: Awareness of the experiences of students and educators in the educational process plays an important role in facilitating and improving this process. This study aimed to explain and investigate the experiences of nursing educators and students about the presence of students with practical nursing diplomas in the process of undergraduate education. MATERIALS AND METHODS: In this qualitative study conducted from 2016 to 2018, which adopted a content analysis approach, 24 nursing students and educators of Lorestan University of Medical Sciences were selected using the purposive sampling method and were interviewed in depth. The data were manually recorded and analyzed using the Graneheim and Lundman method. RESULTS: The three main themes of "from contrast to alignment with professional competence," "peaceful coexistence in the educational process," and "reflection of the perceived reality of the clinical environment," along with six categories and 30 subcategories were extracted from the interviews. CONCLUSIONS: It seems that monitoring and managing undergraduate courses more thoroughly, as well as raising the awareness of educators about the positive and negative dimensions of the presence of nursing students with practical nursing diplomas in undergraduate nursing courses can make it possible to optimize and improve students' learning process.
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BACKGROUND: Since the first step in meeting the health needs of primiparous women involves understanding their conditions, the present study aimed to determine the health needs of primiparous women from their own viewpoints. METHODS: This study had a qualitative approach based on the conventional qualitative content analysis method, in which the purposive sampling method was used. Data were collected by semi-structured interviews. Data saturation was achieved by interviewing 12 participants. To ensure the study was rigorous, the four criteria of credibility, dependability, confirmability, and transferability were taken into account. RESULTS: The findings of this study consisted of 150 codes, 19 subcategories, and 6 categories, as follows: 1) the intense need for social support, 2) the need for prior preparation for pregnancy, 3) fears and worries, 4) the necessity of the availability of the needed infrastructures and requirements in the health center, 5) falling in love with the baby, and 6) seeking information from appropriate sources. CONCLUSION: The present study showed that primiparous women need to receive more social and psychological support from family members and healthcare workers and that it is essential to improve the available infrastructures and services in healthcare centers and to provide the needed counseling to pregnant mothers to enable them to go through the pregnancy period smoothly.