Background and Purpose: Post-traumatic stress disorder (PTSD) is a kind of psychiatric disorders, which is related to trauma and stress and created as a result of direct experience, observation, or hearing. The avoidance of trauma reminders is a perpetuating factor of this disorder. Regarding this, the aim of the present study was to compare the efficacy of cognitive processing therapy (CPT) and schema therapy (ST) in marital satisfaction and avoidance coping among the war veterans with chronic PTSD. Methods: This semi-experimental study was conducted on 34 Iran-Iraq war veterans with PTSD, living in Kermanshah province, Iran. The participants of the study were selected using the purposive sampling technique, and then randomly assigned into two experimental groups, including the CPT and ST groups, and a control group. The data were collected by the PTSD Checklist-Military Version, escape-avoidance subscale from the Coping Styles Questionnaire, Golombok Rust Inventory, and Structured Clinical Interview for DSM-IV-TR Axis I Disorders. The data analysis was performed using the multivariate repeated measures analysis of variance with 95% confidence level through the SPSS version 22. Results: Acceding to the results, there was a significant difference between the experimental groups and control group in terms of the marital satisfaction and avoidance coping (P<0.05). Accordingly, the administration of the CPT and ST resulted in the enhancement of marital satisfaction in the experimental groups, compared to that in the control group. The post-test mean marital satisfactions were 31.58±6.28 and 33.80±11.60 in the CPT and ST groups, respectively, while this value was 52.08±12.87 in the control group. Furthermore, CPT was observed to be more effective in reducing the avoidance coping, compared to the ST. Conclusion: As the findings indicated, CPT, which is exclusively focused on trauma, and ST can encourage the clinicians to utilize an effective treatment for the recovery of PTSD.

Background and Purpose: Privacy is one of the most important humanitarian principles, respecting of which is regarded obligatory in the health care and nursing organizations. This study aimed to investigate the effect of nursing staff training on respecting the patient privacy in the emergency department. Methods: This interventional study was conducted on 400 patients referring to the emergency departments of the Imam Khomeini and Shariati hospitals using a pretest-posttest design with inequivalent control group. For the purpose of the study, the patients of the Imam Khomeini and Shariati hospitals were assigned into the intervention (n=200) and control (n=200) groups, respectively. The data were collected using the privacy baseline questionnaire, which was filled out by the patients in both intervention and control groups. After the implementation of a virtual learning course about respecting patient privacy for 90 clinical staff working in the emergency department of the Imam Khomeini Hospital, the privacy questionnaire was again completed by the patients in both groups. The data were analyzed using descriptive statistics and independent t-test in the SPSS software version 19. Results: According to the results, there was no statistically significant difference between the two groups in terms of the age, gender, education level, and other demographic information. Furthermore, the two groups were similar regarding the mean scores of patient privacy prior to the intervention. However, after online education, the intervention group showed a significant increase in the mean score of patient privacy as compared to the control group (P<0.001). Conclusion: The findings of the present study revealed that nursing staff virtual training could improve the patient privacy. Therefore, this measure can be applied in the emergency departments as an important step to holistic nursing care.

Background and Purpose: Burn injury is one of the most common accidents that leads to mortality and disability. The elderly are more vulnerable to burns, compared to the youth; accordingly, a higher percentage of the elderly are at the risk of death due to burn injuries. Regarding this, the present study was conducted to determine the prevalence of burns and its subsequent mortality among the elderly. Methods: This retrospective study was conducted on the burn patients aged ≥ 60 years who were admitted to the specialized burn centers of the Shahid Motahari and Shohadaye Yaft Abad hospitals in Tehran, Iran, during 2008-2012. Data collection was performed using a form covering both demographic and burn-related data, such as burn percentage, cause and time of burn incidence, burn site, underlying diseases, and time of discharge or death. The data were collected from the medical records of the patients. Results: According to the results, the incidence of burn injuries in the elderly men was two times higher than that in the elderly women. The total mortality rate was 21.9%, which was uniformly distributed across the two genders. The demographic variables affecting the mortality risk were older age (OR=1.1, 95% CI: 1.09-1.19) and no psychological burden or other diseases (OR=9.9, 95% CI: 3.9-24.0). Furthermore, the best therapeutic approach for burn injuries with the lowest mortality (3.2%) was grafting/flap/amputation, followed by fasciotomy/grafting (7.4%) (OR=2.0, 95% CI: 0.5-8.7). Conclusion: Several factors, such as surgery, no history of disease, age, and burn percentage were identified as the predictive factors of survival rate of the elderly with burn injuries. Therefore, it seems necessary to develop prevention strategies for burn injuries among the elderly population.

Background and Purpose: Fear of death is commonly experienced by humans and most people prefer not to think about their own mortality. Dialysis patients just as other chronic patients experience a great amount of stress. Use of coping mechanisms and promoting spirituality can help with accepting the inevitable reality and enhancing quality of life. Spiritual attitudes (spiritual intelligence and spiritual health) determine one's manner of dealing with life events, viewpoints, and perceptions of death. In this study, we sought to explore the relationship of spiritual health and intelligence with quality of life and death anxiety. Methods: In this cross-sectional study, we studied death anxiety, spiritual intelligence, spiritual health, and quality of life in 123 Iranian hemodialysis patients at Imam Reza Hospital, Amol, Iran, during July 2015-January 2016. We also utilized Templer Death Anxiety Scale and King Spiritual Intelligence questionnaire and Paloutzian and Ellison's Spiritual Health questionnaire and McGill Quality of Life questionnaire (MG-QOL). The validity and reliability of the Persian version of the employed questionnaires were assessed by previous studies. The data was analyzed using Pearson correlation coefficient in SPSS, 19 version. Results: Spiritual health was associated with death anxiety in hemodialysis patients. The linear regression analysis was conducted between the study variables and personal characteristics. There was a significant relationship between gender and death anxiety (P=0.03), economic status and death anxiety (P=0.02), religious beliefs and spiritual intelligence (P=0.01), level of education and quality of life (P=0.01), as well as age at diagnosis and spiritual health (P=0.01). Conclusion: This study showed a close relationship between spiritual intelligence and death anxiety and between spiritual health and quality of life in hemodialysis patients. It seems that by enhancing spirituality, internalizing spiritual values and beliefs, and promoting health and spiritual intelligence, death anxiety can be assuaged in hemodialysis patients.

Background and Purpose: Mothers' knowledge of newborn care can significantly affect the neonatal morbidity and mortality. This study was conducted on parturient mothers to assess their knowledge about post-discharge newborn care. Methods: This cross-sectional study was conducted on 200 mothers who gave birth in Shahid Beheshti Hospital of Kashan, Iran, in 2015. A questionnaire was used, which consisted of 27 multiple-choice questions regarding mother's knowledge of basic neonatal care, breast feeding and proper nutrition, neonatal jaundice monitoring and care, and umbilical cord care. A score of one was given to each correct answer. Descriptive statistics, Kolmogorov-Smirnov test, t-test, analysis of variance, and analysis of covariance were used to analyze the data. Results: The mean maternal age was 27.74±5.63 years. The mean knowledge score of the mothers was 16.96±3.47 (range: 4 to 23). A direct correlation was found between mothers' age and their knowledge scores (r=0.19, P=0.02). The mean overall score of employed mothers was higher than housewives (18.39±3.27 vs. 16.77±3.46, P=0.036). In covariance analysis, the mothers' education level (P<0.001), age (P=0.027), and place of residence (P<0.049) could predict their knowledge of neonatal care. On the other hand, parity, the route of delivery, and the spouses' job had no significant effect on the mothers' overall knowledge. Conclusion: Mothers' knowledge of newborn care was not at optimal level, which might put the newborns at risk. A comprehensive maternal educational program should be established to train all mothers on newborn care both before and after the parturition.

Background and Purpose: Organizational ethical climate (EC) refers to the shared perceptions of the ethical issues and the way of practicing these issues in the organization. Ethical values play an important role in the nurses' behavior; moreover, the performance of the nurses may be affected by the EC of the nursing sectors. Regarding this, the present study was conducted with the aim of investigating the nurses' perceptions of the EC in the training and medical centers of Hamedan University of Medical Sciences, Hamedan, Iran, in 2016. Methods: This descriptive cross-sectional study was carried out on 259 nurses, working at the training and medical centers of Hamedan University of Medical Sciences in 2016. The research instruments included a demographic form and the standard Ethical Climate Questionnaire. Results: According to the results, the age range of the nurses was 24-60 years. The highest and lowest dimensions of the EC perceived by the nurses were the individual self-interest and global benevolence, rendering the mean values of 2.33±0.52 and 2.00±0.61, respectively. Additionally, the mean total EC was 2.10±0.27. Conclusion: As the findings of the present study indicated, it is essential to strengthen the benevolence and ethical principles at the global level in the nursing organizations. This can be achieved through the codification of the relevant strategies in nursing. The role of middle nurse managers is very important in the promotion of the benevolence and ethical principles at the global level.

Background and Purpose: Clinicians and other health care providers should consider association of acute medical conditions and motor vehicle collision. This study was performed to determine the role of acute medical conditions, drugs, and alcohol in motor vehicle accidents. Methods: This study was a narrative review performed during 2006 to 2016 through searching electronic databases (PubMed, Ovid Medline, EMBASE, Transport Research International Documentation [TRID], Scopus, and Global Health). The following keywords were applied: “acute medical conditions”, “driver”, “drugs”, “alcohol”, “motor vehicle accident”, and “collision”. Relevant articles were selected after evaluation and full text articles were assessed. Results: In this study, among the 35279 retrieved articles, 20 were selected. The articles were divided into three main categories of impaired driving due to acute medical conditions, impaired driving caused by medications, and alcohol-impaired driving. Conclusion: Results of studies indicated that medicines and acute medical conditions render the driver at significant risk of accidents. Therefore, clinicians should be aware of this problem, educate their patients, and/or consider safer alternatives for some medications. Medical evaluation forms are necessary in support of licensing decisions for medically at-risk drivers. In addition, screening programs should be implemented for high-risk drivers to minimize unsafe driving due to acute medical conditions.

Background and Purpose: Delirium is a clinical syndrome with cognitive disorder, which occurs within a short time in the admitted patients, specially the elderly. Regarding the fact that one third of the delirium incidences is preventable, applying nursing preventive measures is an issue of fundamental importance. The present study aimed to perform a systematic review over the nursing preventive measures and their impacts on delirium incidence in the critically ill patients. Methods: This review was conducted on the studies published within early 1999 to late December 2014. The search was performed using the available databases including Google Scholar, Scopus, Science Direct, PubMed, Medline, and Persian databases including Magiran, IranMedex, and SID. The keywords used during the searching process entailed delirium, confusion, non-pharmalogical, multi-component, nursing preventive measures, adult patient, as well as education and nursing measures. A total of 2499 articles were obtained based on the inclusion criteria; however, 19 articles were found to be completely relevant to the topic of interest. Results: The review of the retrieved studies demonstrated that the rate of delirium incidence is different depending on the severity of the disease, applied delirium assessment scales, and causes of hospital stay. A combination of multifactorial interventions including drug administration, preventive care, and modification of risk factors can prevent delirium, reduce the intensity of this medical condition, and decrease the duration of hospital stay. Conclusion: Some measures should be taken in the surgical, elderly, and intensive care units in terms of the prevention and immediate diagnosis of delirium. Since the nursing personnel have the most patient contact, they have a strategic role in preventing and managing this medical condition. Accordingly, it is possible to reduce the delirium incidence and its complications by educating the nurses and spending little expenses.