Background and Purpose: The students studying at the universities of medical sciences deal with numerous stressors during their educational experiences in the healthcare settings, which lead to poor mental health status and low performance. These stressors include the psychological pressures of the environment, the hospital settings, diseases, patients, heavy course load and training, economic and family problems, and no hope for the future career. Regarding this, the present study aimed to investigate the relationship between mental health and academic performance among the students of Golestan University of Medical Sciences, Iran, in 2015. Methods: This descriptive-analytical cross-sectional study was conducted on the undergraduate students of Golestan University of Medical Sciences using quota sampling method. For the purpose of the study, a total of 270 students were entered into the study from the medicine, nursing and midwifery, health, and paramedical schools. The data collection was performed using a demographic form and the 28-itemed General Health Questionnaire. Additionally, the academic performance was determined using the grade point average (GPA). The data were analyzed using the Spearman correlation coefficient and Chi-square test through the SPSS version 16. Results: According to the results of the study, the GPA was found to be 15.9±1.54. The means of the somatic symptoms, anxiety/ insomnia, social dysfunction, severe depression domains, and total mental health were 3.52±6.57, 6.99±3.97, 8.61±2.95, 4.24 ±4.12, and 27.47±10.55, respectively. The Spearman correlation test demonstrated a positive correlation between the mental health and age (P<0.001, r=0.289). Furthermore, the Chi-square test revealed that the total mental health had a significant relationship with the gender (P=0.013) and field of study (P=0.013). However, no significant relationship was observed between the total mental health and GPA (P=0.76). Conclusion: Considering the importance of the mental health issue in the students of medical sciences, the authorities should pay more attention to solving the students' mental health problems and provide them with more student counseling centers.

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Background and Purpose: Heart failure (HF) is a chronic, debilitating disease, and physical limitations and progressive symptoms of which associated with this condition can reduce quality of life (QOL). Patient education regarding heart HF is one of the main components of self-care. In this respect, peer education is significant in improving health and creating a learning environment. This study was performed to determine the effect of peer education on QOL in HF patients. Methods: In this quasi-experimental study performed during 2016, 60 HF patients affiliated to Tehran University of Medical Sciences were randomly divided into intervention and control groups (n=30). After preparing the peer group, four peer-to-peer training sessions were conducted during one month. The Persian version of Ferrans and Powers' Quality Of Life Questionnaire was used for data collection, which was completed by both groups before, just, and one month after the intervention. SPSS version 21 was employed for data analysis. Results: No significant difference was observed between the two groups in overall QOL score and its domains before the intervention (P=0.31). The mean scores of QOL immediately after the intervention were 126.2±6.7 and 163.1±1.6 in the case and control groups, respectively. The mean scores of QOL one month after the intervention were 134.5±0.7 and 169.9±2.3 in the case and control groups, respectively. After the intervention, paired t-test showed that peer education had a significant relationship with QOL of the HF patients (P<0001). Conclusion: Based on this study, peer education intervention can be a beneficial educative-supportive approach, which might enhance QOL in HF patients.

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Background and Purpose: Post-traumatic stress disorder (PTSD) is identified as the risk factor for functional difficulties in most of the survivors. The aim of this study was to investigate the current evidence-based literature on the area of self-care and ADL status in the veterans with combat-related PTSD. Methods: This review was conducted on the studies published within 2005-2015. The search was performed using such databases as SID, Iran Medex, Magiran, Science Direct, ProQuest, and PubMed. The searches were initially carried out using single keywords, and then continued with using OR/AND for combining words such as “self-care activity, instrumental activities of daily living, physical functioning, post- traumatic stress disorder in war veterans, etc”. Finally, a total of 783 papers were retrieved, out of which only 15 publications were considered relevant to the subject under discussion and investigated in-depth. Results: According to the findings of the reviewed articles, there is a relationship between the self-care status and PTSD severity; as a result, greater PTSD symptoms are accompanied by poorer self-care practices and ADLs. Furthermore, in all the studies, the physical functioning (self-care or ADLs) was lower in the PTSD population in comparison to the non-PTSD population. Conclusion: As the findings of the retrieved articles indicated, it can be conclude that the self-care practices and ADLs were poor among the veterans suffering from PTSD. Therefore, it is necessary that nurses develop a comprehensive care planning for this population to facilitate their achievement of independence in ADLs.

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Background and Purpose: Floating on water provides the opportunity for the elderly to exercise and take positions that may not be possible for them on the ground. The aim of this study was to explore the experiences of elderly women regarding barriers to hydrotherapy and how they can be ruled out. Methods: This qualitative study was performed using content analysis method in Guilan, north of Iran. A total of 23 elderly women undergoing hydrotherapy based on physician's order were chosen through purposive sampling. Semi-structured interviews were conducted for data collection, which were analyzed using the method suggested by Graneheim and Lundman (2004). The study's rigor was ensured and ethical considerations were considered during data collection and analysis. Results: Three main categories and nine subcategories, including internal barriers (lack of interest, insufficient knowledge, and doubt about its effectiveness), high expenses (expensive entrance fee, as well as expensive equipment and transportation), and environmental drawbacks (challenges of access, limited number of pools, and no companions), were developed during data analysis. Conclusion: Various factors were reported as barriers to hydrotherapy. The assessment of these barriers and resolving them can help improve quality of life in elderly women.

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Background and Purpose: Responsibility among adolescents is of great significance, and families can influence sense of responsibility by creating purpose in life and developing social competence. Herein, we aimed to investigate the structural model of the relationship of family functioning and social competence with sense of responsibility and mediating role of purpose in life in this relationship among female junior high school students. Methods: This correlational study has practical objectives. The participants were 384 female junior high school students of District 2 of Sari, Mazandaran province, Iran. Cluster random sampling was used for sample selection. The instruments included four questionnaires: 1) responsibility scale of the California Psychological Inventory (CPI), 2) family functioning of MacMaser, 3) social competence of Felner, and 4) purpose in life of Crumbaugh and Maholick. Pearson correlation coefficient and path analysis were used to analyze the data. Results: The results indicated that family functioning, social competence, and purpose in life have a positive significant relationship with responsibility, and in the relationship of family functioning and social competence with responsibility, purpose in life plays a mediating role (P<0.05). Conclusion: Adolescents spend a considerable amount of time in family and school; therefore, students' family functioning and social competence can be by providing appropriate training courses for their families and teachers. Furthermore, sense of responsibility can be reinforced among adelescents by creating purpose in life.

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Background and Purpose: Spiritual well-being plays an important role in the mental and physical health, and is considered as a common strategy to cope with problems. Given the importance of promoting spiritual well-being in the nursing and midwifery students, we must first determine the level of this state in this population. Regarding this, the present study aimed to examine the spiritual well-being and its related factors in the nursing and midwifery students of Mazandaran University of Medical Sciences, Sari, Iran. Methods: This descriptive analytical study was conducted on 183 nursing and midwifery students studying at the Mazandaran University of Medical Sciences in 2015. The sampling was performed using the systematic random sampling technique. The research instruments included a demographic form and the Spiritual Well-Being Scale developed by Palotzian and Ellison. The data were analyzed through the SPSS version 16 using the descriptive and analytical tests, including frequency, percentage, t-test, and Pearson correlation coefficient. Results: According to the results of the present study, the mean spiritual well-being was 69.70±11.62. In addition, the means of religious and existential well-being were 35.77±6.80 and 34.04±6.19, respectively. The results demonstrated no significant correlation between the demographic variables and spiritual well-being in the participants (P>0.05). However, spiritual well-being had a significant relationship with the religious and existential well-being (P< 0.001). Conclusion: As the findings of the present study indicated, the majority of the nursing and midwifery students had a moderate level of spiritual well-being. Furthermore, religious well-being was found to be slightly higher than the existential well-being, which could be due to the cultural issues.

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Background and Purpose: Nosocomial infection is a threat to patient safety. In this study, we aimed to investigate the effect of alcohol-based handrub solutions recommended by the World Health Organization on skin integrity of health care providers. Methods: This experimental study was carried out on 40 healthcare personnel of 17 Shahrivar Hospital, Amol, Iran, in 2016. The subjects were selected through convenience sampling method. The participants used the recommended solution for one month. The participants' skin condition was evaluated by using two questionnaires filled out by the observer and participants in the first week and after one month. To analyze the data, the phi coefficient and Cochran's Q test were used in SPSS, version 19. Results: The results of the objective skin evaluation showed that there was no significant difference between the evaluations regarding skin redness (P=0.846), scaliness (P=0.276), and visual scoring of the skin (P=0.5). However, a significant difference was observed in terms of skin tears (P=0.05). The visual skin evaluation (P=0.001), skin disorders (P=0.006), moisture content (P=0.001), sensation (P=0.004), and overall skin integrity (P=0.023) showed a significant change after the use of the solution. Conclusion: The results indicated that the recommended solution was compatible with the hand skin of the participants. We highly recommend the authorities to provide the necessary education for health personnel to improve compliance.

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Background and Purpose: Childbirth is a normal physiological process and a family event. Women in various societies with different cultural backgrounds have diverse reasons for childbearing. Understanding the reasons behind childbearing might help overcome some issues associated with early/late reproduction, or lack of desire to give birth. This study was an attempt to develop, validate, and standardize a scale for measuring the childbearing orientations. Methods: To this purpose, 30 items related to the childbearing orientations were collected based on the related theories and literature. The reliability of the developed scale was confirmed, showing Cronbach's alpha reliability index of 0.95. In addition, the validity was approved by three correlated components. The content and face validities of the scale were confirmed for all the 30 items using the opinions of five experts in the fields of psychology, nursing, and midwifery. The developed questionnaire was distributed among 215 participants to be filled out. The participants were selected out of the students studying five different majors, including human sciences (n=123), engineering (n=48), medical sciences (n=18), agriculture (n=8), and basic sciences (n=18) using the quota sampling technique. The participants were categorized based on their age, educational level, and marital status. Results: Based on results of the factor analysis, four items with loading below 0.5 were discarded and the rest 26 items formed three components, including intrinsic motivation (14 items), developmental motivation (7 items), and extrinsic motivation (5 items). The developed instrument proved to be both valid and reliable (r=0.95). Conclusion: Researchers in the fields of nursery, midwifery, and psychology may find the developed instrument and the related discussion useful.

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Background and Purpose: Cutaneous leishmaniasis is an endemic disease in different parts of Iran. The aim of this study was to investigate the epidemiology of cutaneous leishmaniasis in Zarrin Dasht, Fars, Iran, during 2013-2015. Methods: This descriptive, cross-sectional study was performed on 266 patients selected through census sampling method. Data such as gender, age, occupation, disease season, location of scar on the patient's body, and place of residence were gathered using a checklist and analyzed through descriptive statistics and nonparametric methods. Results: In this study, the majority of the patients were female (58.3%) within the age group of 0-5 years (66.2%), living in rural areas (53%). The highest incidence rate was observed in autumn (49.2%). The majority of lesions (49%) were observed in face. Conclusion: The results of this study showed that cutaneous leishmaniasis is an endemic disease in Zarrin Dasht, and it annually infects numerous people. Although the disease process has been declining during 2013-2015 in this region, this disease is still a health hazard and needs to be managed.

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