Background and Purpose: To create a positive attitude towards communication skills training, experimental methods are preferred over theoretical approaches since they encourage the practical use of these skills among different health staff. This study aimed to compare the effects of role play and video feedback on the attitude and knowledge of midwives towards communication training skills. Methods: In this study, 47 midwives were randomly selected from educational hospitals of Mashhad, Iran and divided into two groups of role play (N=24) and video feedback (N=23). Intervention consisted of a two-day training workshop for each group. Role play and video feedback training were performed at four stages of acceptance, labor, delivery, and postpartum. Level of knowledge and attitude was evaluated in the subjects before and after the intervention using questionnaires. Data analysis was performed using independent and paired t-test, Mann-Whitney and Wilcoxon test. Results: In this study, mean score of knowledge and attitude had a significant increase after the intervention in both groups (P=0.001) (P=0.03). Additionally, mean of difference in the scores of knowledge and attitude was not considered significant before and after the intervention (P>0.05). Conclusion: According to the results of this study, video feedback and role play could be equally effective in raising the awareness and improving the attitude of midwives towards communication training skills.

Background and Purpose: Birth outcomes and fertility measures are commonly evaluated in Maternal and Child Health Integrated Program (MCHIP) in the field of public health. Given the key role of time- trend study in the projection of current data to the future, this population-based study aimed to describe the significant changes of birth outcomes and fertility measures in the rural population of East Azerbaijan Province, Iran. Methods: In this time-trend analysis, primary data of several birth outcomes and fertility measures were collected from the vital statistics of rural populations in the East Azerbaijan, recorded during 2001 - 2013. Data analysis was performed using simple linear regression to examine linear trends in these indicators. Results: In this study, upward linear trends were observed in crude birth rate (R² = 0.92, P<0.001), fertility rate of women aging> 35 years (R² = 0.74, P<0.001), and low birth weight (R² = 0.67, P<0.001). In addition, a downward linear trend was documented for neonatal mortality rate (R² = 0.92, P<0.001).For other indicators such as stillbirth rate and adolescent fertility rate, non-linear trends were recorded. Conclusion: Despite the noticeable reduction in the rates of neonatal mortality and stillbirth, maternal and child health is still at risk in the rural population of East Azerbaijan due to the pregnancies outside the typical childbearing age and increased rate of LBW.

Background and Purpose: Experience and clinical competence are the important factors affecting the level of dignity and respect for nurses. This study aimed to evaluate the observance rate of respect for nurses from physicians, colleagues, patients and their family members. Methods: This study was conducted on 200 nurses selected by census sampling from hospitals of Sanandaj, Kurdistan, Iran in 2014. Data collection was performed using self-report questionnaires with 15 questions on different variables, such as respect, communication, capability and independence. Validity and reliability of the questionnaires was determined by subjects and expert comments, and using Spearman's correlation coefficient (r=0.80). Data analysis was performed using SPSS V.20. Results: Significant differences were observed between the viewpoints of experienced and inexperienced nurses regarding independence, self-confidence for consultation with physicians (P<0.04), communication with physicians (P<0.03), capability and sufficient skills (P<0.04), respect by physicians (P<0.04), and physicians' and colleagues' trust (P<0.001, P<0.003) in their capabilities. However, no statistically significant difference was observed in the comparison of the observance rate for dignity from patients and their family members in the viewpoint of the subjects. Conclusion: The highest levels of violation to the dignity of nurses came from physicians, while the lowest level was from patients and their family members. This study could be used for the promotion of dignity and respect among the nursing community.

Background and Purpose: Pregnant women are at a higher risk of influenza infection, and influenza vaccination is recommended for these women to reduce the associated complications. This study aimed to determine the knowledge and practice about influenza vaccination and identify the factors influencing compliance with influenza immunization among pregnant women. Methods: This cross-sectional study was conducted on 384 pregnant women referring to six health care centers and six obstetric clinics in 2013 in Sari, Mazandaran, Iran. After the random selection of health care centers, samples were collected using convenience sampling. The objectives of the study were explained to the participants, and questionnaires were completed on the demographic characteristics, knowledge and practice in influenza vaccination. Data analysis was performed using frequency, mean, standard deviation, Chi-square test, Friedman test and T-test in SPSS V.14. Results: In this study, general knowledge of pregnant women about influenza vaccination was relatively poor. Approximately 31% of the studied subjects had low awareness, while 52% and 18% had moderate and high levels of knowledge about influenza immunization. In addition, rate of influenza vaccination was estimated at 5.5%, and the most common reason for avoiding vaccination during pregnancy was the concern about the possible risks of the vaccine for the fetus (34.9%). Conclusion: According to the results of this study, pregnant women are not adequately informed about influenza vaccination and its benefits; therefore, the overall rate of influenza vaccination is low. In this regard, educational programs on influenza complications, benefits of maternal vaccination and vaccine safety should be implemented for pregnant women by health professionals.

Background and Purpose: Lifestyle is defined as the unique behavioral patterns and habits of an individual. If lifestyle is unbalanced, risk of illnesses and burdensome events increases. Lifestyle plays a key role in the modulation of body mass index (BMI) and prevention of obesity. This study aimed to investigate the relationship between lifestyle and BMI in the administrative employees of Bojnourd. Iran in 2014. Materials and Methods: This cross-sectional study was conducted on 380 government employees selected by stratified random sampling with proportional allocation in each stratum. Data were collected using prepared checklists and lifestyle questionnaires. Weight and height of subjects were measured using standardized methods. Data analysis was performed using descriptive statistics and Pearson's correlation coefficient in SPSS V.18. Results: In this study, frequency of lifestyle was 4.58%, 52.48% and 42.94% in scoring scales of favorable, relatively favorable and unfavorable, respectively. Moreover, 6.6% of the subjects were underweight, 34.7% were normal, 36.1% were overweight, and 21.8% were obese. A significant correlation was observed between BMI and age (P=0.000), gender (P=0.03), physical exercise (P=0.04) and nutrition status (P=0.003) of the subjects. Conclusion: According to the results of this study, lack of physical activity and improper diet are the most important causes of obesity among administrative employees. Therefore, modification of lifestyle should be mandatory in order to improve BMI and overall health of these individuals.

Background and Purpose: Organizational commitment has been on a downward trend among medical staff in different sections of the health care system. This study aimed to investigate the level of organizational commitment among the nurses engaged in the intensive care units (ICUs) of Mazandaran Heart Center in Sari, Iran. Methods: This descriptive-analytical study was conducted at the educational hospital of Mazandaran University of Medical Sciences, affiliated to Mazandaran Heart Centre. Data were collected using Allen and Meyer's organizational commitment questionnaire, which was completed by 90 nurses selected by census sampling from different ICUs. Data analysis was performed using SPSS V.21. Results: In this study, 17 participants (18.9%) were male, and 73 (81.1%) were female, with the mean age of 7.25±34.4 years. Among the variables associated with organizational commitment, including age, work experience and working hours, only age and work experience had significant correlations with the rate of commitment (P=0.001). Conclusion: According to the results of this study, medical supervisors and managers need to provide nurses with adequate facilities in order to encourage commitment and motivation among these health professionals.

Background and Purpose: Considering the obstacles against the implementation of ethical decisions by nurses, experiencing moral distress is one of the major issues in this profession. Moral distress could have negative effects on the physical and mental health of nurses, quality of patient care and performance of health organizations. Given the importance of addressing moral distress in working environment of nurses, this descriptive study aimed to evaluate the level of moral distress and the contributing factors among nurses in different hospitals affiliated to Shahroud University of Medical Sciences in 2014. Methods: This descriptive study was conducted on 122 nurses engaged in intensive care units (ICUs), internal medicine wards, surgical wards and emergency sections of different hospitals affiliated to Shahroud University of Medical Sciences. Survey sampling was the method of choice, and all the subjects met the inclusion criteria. Data collection was performed using demographic questionnaires and Corley's Moral Distress Scale-Revised (MDS-R). Data analysis was performed using descriptive statistics, including independent T-test, Pearson's correlation coefficient and one-way ANOVA. Results: In this study, means of frequency and intensity of moral distress were relatively high among the subjects. Considering the significant difference between moral distress in nurses engaged in different wards (P=0.01), the highest and lowest rates of intensity were observed in nurses of ICUs with a mean of 3.29±1.49, and those in surgical wards with a mean of 1.81±0.66. Among professional and demographic variables, feeling supported by the head nurse (P=0.03) and the age of nurses (P=0.001) had a significant correlation with the level of moral distress. Conclusion: According to the results of this study, identification of clinical environments involving high moral distress, as well as the main causes of moral distress in nursing managements, could contribute to the prevention of this problem among the nursing staff.

Background and Purpose: Quality of life is a ubiquitous concept, and improving quality of life plays a pivotal role in the promotion of individual and social health. This parameter requires exclusive attention in case of students since quality of life remarkably affects learning and academic achievement.This study aimed to evaluate quality of life among the students of Islamic Azad University of Yazd, Iran. Methods: This descriptive cross-sectional study was conducted on 400 participants randomly selected from the student population of Yazd Islamic Azad University, Iran. Data were collected via self-report questionnaires about quality of life. Data analysis was performed using SPSS V.16.0. Results: In this study, mean of quality of life score was 16.16±146.91. In addition, a significant difference was found between quality of life and gender (t=2.7, P=0.007), place of residence (t=2.0, P=0.04) and insurance status (t=3.16, P=0.002) of the subjects. However, there was no significant difference between quality of life and field of study, education level and family size (P>0.05). Conclusion: According to the results of this study, student quality of life was at an average level.Therefore, it is recommended that special attention be given to the enhancement of this parameter among students. In this regard, programs focusing on conflict resolution, effective decision-making, self-defense and relationship improvement, as well as provision of recreational facilities, could be beneficial in increasing student quality of life.