Background and Purpose: Distress is an important issue with significant effects on nurses and patients in the nursing profession. This study aimed to investigate the effects of mindfulness-based cognitive therapy (MBCT) on the distress tolerance of nurses with job burnout. Methods: This quasi-experimental study was conducted with a pretest-posttest design and a control group. Study population consisted of 202 female nurses employed at Fatemeh Zahra Hospital (heart center) of Sari, Iran in 2015. Collected data were indicative of job burnout in 70 participants. In total, 30 nurses were selected as eligible subjects and equally divided into two groups of intervention and control. Pretest was performed on both groups. Nurses in the intervention group received eight sessions of training (two hours each) twice per week, while the control group had no intervention. Both groups were evaluated after the intervention (posttest). Data were collected using Maslach Burnout Inventory (MBI) and Simons and Gaher's Distress Tolerance Scale (DTS). Data analysis was performed in SPSS version 21 using analysis of covariance. Results: In this study, use of MBCT was observed to positively affect the distress tolerance of nurses with job burnout. Conclusion: According to the results of this study, factors such as prompt decision-making, job difficulty, long working shifts, and stressful environments were significantly involved in the psychological and physical stress of nurses, and MBCT could effectively enhance distress tolerance in the participants.

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Background and Purpose: Ethical climate is hinged upon organizational culture, rules, and policies; nurses' perception of this concept varies according to the ward they are working on and the new rules of the treatment system. This can exert adverse impact on their care method and performance. Thus, this study aimed to determine nurses' perceptions of the ethical climate governing the hospital environment. Methods: This descriptive, cross-sectional study was conducted on 168 nurses working in a teaching hospital. The data were collected through census method, using a demographic form and Olson's Hospital Ethical Climate Survey (HECS). For data analysis, descriptive (percentage, frequency, mean, and standard deviation) and inferential statistics (independent t-test and ANOVA for the establishment of the relationship between ethical climate and demographic factors, as well as Friedman's test for ranking the factor) were used. Results: Mean ethical climate scores of nurses for managers, hospital, physicians, patients, and colleagues factors were 3.87±0.71, 3.39±0.68, 3.00±0.67, 3.68±0.57, and 3.82±0.54, respectively. The total mean score of ethical climate was 3.5±0.51. The comparison among the mentioned factors indicated that managers (P=0.000) factor acquired the highest score. In addition, organizational ethical climate did not show any significant association with gender, marital status, education level, working shift, and employment status, whereas there was a statistically significant relationship between job title and income (P=0.000). Conclusion: The highest score of ethical climate belonged to managers/ factor, while the minimum score was related to physicians. Regarding the role of ethical climate in the improvement of nurses' performance, planning for enhancing the ethical climate seems to be mandatory.

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Background and Purpose: Attendance of nursing students in clinical settings is an inherent element of nursing education. This study aimed to evaluate the attitudes of nurses toward the attendance of nursing students in clinical settings in Shahrekord, Iran. Methods: This descriptive study was conducted in Hajar teaching hospital of Shahrekord city, Iran in 2015. Using convenience sampling, 150 eligible nurses were selected for this study. Data were collected using demographic questionnaires and Stagg's attitude scale. In addition, we assessed the viewpoints of nurses regarding the advantages and disadvantages of the attendance of nursing students in clinical environments using two open questions. Data analysis was performed using Chi-square, Student's t-test, and Pearson's correlation-coefficient. Results: Negative attitude toward the attendance of nursing students in clinical settings was observed in 82% of the participants. Moreover, 80.7% of the nurses believed that nursing students are not able to acquire sufficient clinical experiences in clinical environments. On the other hand, no significant correlation was observed between age, work experience, marital status, and attitude toward the attendance of nursing students in clinical settings (P>0.05). However, this difference was only significant in terms of the ward of employment (P=0.004), so that nurses engaged in the psychiatric ward had a more positive attitude toward this concept compared to other nurses. Conclusion: According to the results of this study, special attention must be paid to the clinical education of nurses with regard to their experiences and viewpoints toward improving clinical learning.

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Background and Purpose: Maternal request for cesarean section is a major influential factor in the rising trend of this childbirth mode. Lack of knowledge and negative attitudes toward natural delivery are the main causes of this issue. This study aimed to review the strategies to increase the knowledge and change the attitudes and request of Iranian pregnant women for caesarean section. Methods: In this narrative review, all interventional studies conducted on Iranian pregnant women with the objective of enhancing the knowledge and attitudes toward natural delivery were identified via searching in databases such as Google Scholar, ScienceDirect, Scopus, SID, MedLib, Magiran, and PubMed for articles published during 2000-2015. Results: In total, 22 articles were reviewed in this study. In these studies, systematic and planned educational interventions were carried out, including group education and discussion, question and answer and role-playing (n=10). Other intervention methods were based on various models and theories, such as the health belief model (n=3), behavioral intention model (n=4), theory of reasoned action (n=1), theory of planned behavior (n=2), and cognitive-behavioral consultation (n=2). Reviewed findings were indicative of the significant improvement of knowledge, attitudes and intentions toward natural delivery following the interventions (P<0.05). Conclusion: According to the results of this review, various education and consultation programs are effective in enhancing the knowledge and changing the attitudes and intentions of pregnant women toward natural childbirth. Nevertheless, high rate of cesarean section suggests that these interventions are not implemented consistently. It is noteworthy that effects of other confounders must be considered in this regard.

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Background and Purpose: Surgery is a stressful situation and this study aimed to evaluate the effect of negative emotions coping styles training on mental health of the patients undergoing open-heart surgery. Methods: This study was conducted with a pretest-posttest design on the patients undergoing open-heart surgery during a course of six months in Mazandaran Heart Center, Sari, Iran in 2014. In total, 30 patients were selected using non-random sampling method, who were randomly assigned into intervention and control groups (15 cases in each group). In the intervention group, seven training sessions of coping strategies (inc. stress and anger management, dealing with anxiety, and depression) were individually held for the participants. Data collection was performed, using General Health Questionnaire by Goldberg and Hiller (1970) and coping strategies scale by Lazarus and Folkman (1985), which showed the Cronbach's alpha coefficient of 0.84 and 0.80, respectively. Data analysis was performed, using ANOVA and Conflicting t. Results: In this study, the results of ANOVA were indicative of a significant difference between the groups, which suggest the positive effects of coping strategies on mental health (P=0.05). Conclusion: According to the findings of the present study negative emotions coping styles training had a positive impact on mental health of the patients, which was more significant in the intervention group.

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Adrenal gland cysts are rare indications of adrenal diseases, which are commonly asymptomatic. In radiological studies, these cysts, known as incidentalomas, are often detected by coincidence accounting for 6% of the population. Adrenal incidentalomas are commonly detected, and autonomous cortisol hypersecretion is the most prevalent abnormality associated with these masses. Since this complication is recurrent, it requires intermittent morphological and hormonal evaluation for several years. In this paper, we aimed to present the case of a 52-year-old woman with complaints of vague abdominal pain. After laparotomy, the tumor was removed, and umbilical herniorrhaphy was performed on the patient. Laparoscopic adrenalectomy is the first-line surgical treatment for this type of incidentaloma. Ultrasonography revealed an echogenic mass (diameter: 4 cm) in the left adrenal gland of the patient, which was not associated with hernia. In addition, CT-scan showed that the adrenal lesion was hypodense and heterogeneous (diameters: 81*53 mm) with sharp, irregular borders.

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Background and Purpose: Subjective well-being plays a crucial role in human life given the positive impacts it has on mental and physical health, longevity, and quality of life. Therefore, it is important to evaluate and promote subjective well-being and its relevant factors. This study aimed to assess the role of social capital in subjective well-being among Iranian adolescents. Methods: This cross-sectional, analytical study was performed on high school students (10^th to 12^th grades) residing in Birjand city, center of the Southern Khorasan Province, Iran, in 2015. The main inclusion criteria were being a student of public high schools and living with parents. Using multi-stage cluster sampling, 400 students were selected. A demographic characteristics form, the Social Capital Index, and the Adolescent Subjective Well-Being Scale were employed for data collection. The data were analyzed using descriptive statistics (including mean, frequency, and standard deviation) and inferential statistics (e.g., Pearson and Spearman's coefficients, step-wise multiple regression, Mann-Whitney U test, and Kruskal-Wallis test). Results: The participants reported a high level of social capital (89.06±12.87) and a moderate level of subjective well-being (29.82±6.91). There was a significant positive correlation between social capital and subjective well-being scores (r=0.5,P<0.001). Furthermore, 32% of the variance of subjective well-being was explained by social capital and gender (girls; R²=0.32, F=95.24, P <0.001). Conclusion: Improving social capital among social institutions such as family, school, and other youth-related networks can result in enhanced subjective well-being in adolescents.

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