Context: Chronic kidney disease refers to one of the chronic diseases highly affecting the quality of life (QoL) of patients. Aim: The present study investigated the effectiveness of resilience training on self-efficacy, empowerment, and social adjustment of renal transplant patients. Setting and Design: This study was a quasi-experimental interventional pre-test-post-test research with control group conducted at Shahid Modarres Hospital in 2020. Materials and Methods: From all kidney transplant patients admitted to Shahid Modarres Hospital and Shohada Tajrish Hospital who underwent kidney transplant surgery in 1398, 30 people were selected and randomly divided into two experimental groups (15 kidney transplant patients in Shahid Modarres Hospital in Tehran) and Witnesses (15 kidney transplant patients were admitted to Shohada Tajrish Hospital in Tehran). The experimental group participated in 12 sessions of 45 minutes in the resilience training program. Both groups completed the Scherer and Maddox (1982) self-efficacy questionnaires, the Spritzer (1995) psychological empowerment questionnaire, and the Wissman and Pickel (1974) social adjustment questionnaires before and after the intervention. Statistical Analysis Used: Data were analyzed using Kolmogorov–Smirnov test, t-test, and paired t-test using SPSS software version 18. Results: Resilience training was effective on self-efficacy, social adjustment, as well as the empowerment of renal transplant patients. Conclusion: The findings showed that resilience training in renal transplant patients enhances self-efficacy, empowerment, and social adjustment, thus promoting their physical, general, and psychological health. Also, it seems that the designing andresilience training can facilitate the process of empowerment, accompanied by increasing self-efficacy and social adjustment of patients.

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Context: Sleep problems may lead to attention disorders, irritability, anxiety, and fatigue in individuals. Fatigue, which is a result of insufficient sleep, may lead to the absence of energy, restlessness, impairment of concentration, and predisposition to accidents in individuals. Aims: The aim of this study was to determine sleep quality, fatigue, and related factors in nursing students. Setting and Design: This study was carried out as a cross-sectional, descriptive, and relationship seeker. This study was carried out with students who study in the Nursing Department of Health College of a University in Southeastern Turkey between May and June 2018. Materials and Methods: The population of the study consisted of 380 students and the sample consisted of 281 students who met the criteria for taking. Data were collected using Personal Information Form, Pitssburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Statistical Analysis Used: Percentage, Shapiro–Wilk test, spearman correlation test, Mann–Whitney U-test, and Kruskal–Wallis test were used for data analysis. Results: The mean PSQI score of the participants was 8.50 ± 2.70, and the mean score of FSS was 4.99 ± 1.40. Correlation analysis revealed a positive moderate correlation between PSQI and FSS at 0.01 level. With PSQI total score, the difference among age, economic status, current location, working status, chronic disease, smoking status, caffeinated beverage consumption status, being late to class, and drowsiness during the lesson of students was found out to be significant (P < 0.05). Conclusion: In this study, poor sleep quality is common among nursing students and fatigue severity of students with low sleep quality increases. This may affect the success level of students negatively. Thus solution-oriented strategies should be developed based on factors which affect the sleep quality and fatigue level of nursing students.

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Context: It has been known that parents leave their newborn babies under government protection due to various social, cultural, and economic reasons, unwanted pregnancies being one of the most important reasons. Aims: The aim of the study was to examine the sociodemographic and life characteristics of mothers who had to leave their newborn babies to social services after giving birth. Settings and Design: Using a qualitative research approach, this research was conducted in the qualitative document analysis design. Materials and Methods: The data were obtained from the social review reports (electronic) of 66 mothers who gave birth and left their newborn babies to social services between 2010 and 2019 in a hospital in the city center of Izmir, Turkey. Statistical Analysis Used: The electronic data (number: 1–66) in these reports were analyzed by descriptive and content analysis methods. Results: Most of the mothers were had 2 years of education (n = 17), were not officially married (n = 31), and worked in an environment open to abuse (n = 6). Six themes were obtained from the data analysis including family status and living with the spouse/partner, pre- and post-pregnancy residence, the process of abandoning the infant, pregnancy process and health problems, sharing pregnancy news and safety, and the conception of pregnancy and the legal process. Conclusions: This study revealed that mothers who leave their infant to social services have several high-risk sociodemographic and life characteristics, predominantly related to lifestyle, residence, pregnancy experience, and sexual violence. Midwives and other healthcare professionals can help improve mother/infant health by considering these risk groups, while providing the prepregnancy, pregnancy, delivery, and postpartum care services and by providing support to mothers who want to leave their infant to social services.

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Context: Neurofibromatosis type 1 (NF1) is one of the most common genetic skin disorders that impose significant psychological and social pressure on patients. Aim: The objective of the study was to explore the experiences of patients with neurofibromatosis. Setting and Design: Iran - qualitative study Materials and Methods: This qualitative study was conducted in 2020. Eighteen patients with Neurofibromatosis type 1 (NF1) entered the study with maximum variation through purposeful sampling. Semi-structured interviews were used to collect data. Statistical Analysis Used: Conventional content analysis method was used for the data analysis. Results: Based on analyzed data, five categories including “Feeling defective and incompetent,” “Succumbing”, “Perceived social deprivation”, “Encountering oppression and violation of rights”, and “Rejection” were found. Conclusion: It was shown that patients with NF1 had unpleasant experiences. Besides the challenges that they had to tolerate with the nature and symptoms of the disease, the disease imposed severe social and psychological pressures on them. Based on findings, it is essential to establish supportive strategies that would help patients deal with problems of the disease effectively.

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Context: Cardiovascular disease is one of the leading causes of mortality and disability in the world and its prevalence is increasing. Aim: The aim of the study was to determine the effect of educational program on self-care behaviors of candidates for coronary artery angiography. Setting and Design: This study was a quasi-experimental interventional study conducted at Imam Hossein Hospital in Mehran/Ilam in 2018. Materials and Methods: One hundred and twenty-six candidates for coronary artery angiography were randomly divided into two groups of intervention and control and completed the Cardiac Patients Learning Needs Inventory. The intervention group was trained with cardiovascular care educational program after angiography. After 2 weeks, the questionnaire was completed again by both groups. Statistical Analysis Used: Data were analyzed using Kolmogorov–Smirnov test, t-test, and paired t-test using SPSS software version 18. Results: The educational needs of the subjects were measured in eight areas of self-care (introduction to the cardiac intensive care unit, anatomy and physiology, psychological factors, risk factors, pharmaceutical information, nutritional information, physical activity, and other information). Most of the samples had moderate-to-high educational need (intervention group = 3.46) and (control group = 3.86), and the educational need in intervention group reached 1.62, which was significant (P < 0.001), but there was no significant change (P = 0.871) in the control group (3.31). Conclusion: Promoting self-care behaviors in patients undergoing coronary angiography using educational interventions is important and necessary. The curriculum that is designed and used in this study is recommended as a sample.

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Context: Adolescence is one of the most important periods of a person's life due to physical, mental andsocial maturity. Aim: The aim of this study was to compare the motivational interview and peer groups in promoting mentalhealth and knowledge and performance about puberty health in adolescent girls. Setting and Design: This is a semi-experimental intervention study with two intervention groups and one control group. The study was conducted at the high schools during the academic year of 2018–2019 in Shahroud, Iran. Materials and Methods: In this study, 334 female students (13–15 years old) were allocated to three groupsby assigning the schools to two intervention and one control groups through simple randomization. In intervention Group 1, five motivational interview sessions were held and in intervention Group 2, training was conducted by peers. The tools used in this study was a researcher-made questionnaire designed to assess knowledge and performance about puberty health and Symptom Checklist-25 to measure mental health. Statistical Analysis Used: In this study, data were analyzed using descriptive statistics and analytical statisticaltests include ANOVA, repeated measure, Pearson correlation, Chi-square. Results: Immediately after, and 1 month after the intervention, the two intervention groups had significantlybetter scores in knowledge, performance, and mental health compared to the control group. The scores were better in the peer group compared to the motivational interview group for all threevariables. Conclusions: Both motivational interview and peer group were effective in increasing knowledge and performance in adolescent girls.

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Context: The high incidence of anxiety and depression in patients with corona can be associated with serious complications in recovery and increased mortality. Aim: This study was performed with the aim of determining the anxiety and depression of patients with corona and related factors. Setting and Design: This study was conducted in general and special wards (coronary care unit) in Iran (Imam Khomeini and Bu Ali Sina in Sari and Razi hospitals in Ghaemshahr) in 2020. Materials and Methods: Patients were selected by accessible sampling. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Statistical Analysis Used: This descriptive-analytical study was performed on 150 patients with Covid-19 admitted. Data were analyzed using SPSS software version 21, descriptive statistics and inferential statistics such as t-test, Chi-square, Fisher, Pearson correlation coefficient, and multiple linear regression test. Results: The mean score of patients' anxiety was 6.83 ± 5.16, and the mean score of depression was 7.09 ± 4.37. According to the multiple linear regression test, depression with standard β (ß =0.53) and with standard β (ß =0.21) explore 42% of variance of anxiety. Anxiety (β =0.56), temperature (β =0.2), anorexia (β =0.18), and respiratory rate (β =0.12) explore 45% of variance of depression, respectively. Conclusion: The results of this study indicated a high prevalence of anxiety and depression in hospitalized patients with corona disease. Therefore, further study of related factors and planning appropriate interventions according to the results of the study is recommended.

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Pressure ulcers are localized damage to the skin and/or underlying tissue that usually occurs over a bony prominence as a result of pressure. The patient was a 60-year-old male who was admitted to the intensive care unit for 1 month due to decreased consciousness in February 2019. He had a Grade 4 pressure ulcer in the sacrum area measuring 15 cm × 15 cm with 4 cm deep and exudate secretion and discoloration of the ulcer to yellow (ancestral tissue) and necrotic tissue around the ulcer. The ulcer was first bandaged with the daily silver sulfate ointment, but no healing process was achieved. After the patient was conscious and transferred to the inpatient ward, the necrotic tissue was debrided and washed with normal saline every day. Then, the ulcer was coated with 2 g of sucralfate tablets (4 tablets of 500 mg) dissolved in 5 cc of distilled water and mixed with 15 g of silver sulfadiazine ointment and was finally bandaged with sterile gauze. The Pressure Ulcer Scale for Healing instrument was used to evaluate the ulcer healing process. After 40 days, the patient's ulcer changed to a Grade 2 pressure ulcer measuring about 5 cm × 5 cm with pink color (granular tissue enclosed by epithelial tissue) on the skin.

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Context: Effective management of anxiety and depression in older adults undergoing dialysis is essential because of unpleasant consequences. Aims: This study aimed to comparison the effect of multisensory stimulation intervention and lavender aromatherapy on anxiety and depression in the older adults undergoing hemodialysis. Setting and Design: This was an interventional study with two groups with pre and posttest plan (IRCTID: IRCT20170611034454N4). Materials and Methods: This study was conducted on 48 patients in Sari in 2020 that were randomly divided into multisensory stimulation and aromatherapy groups. Anxiety and depression were measured by geriatric anxiety inventory and geriatric depression scale. Patients received interventions 3 days of a week for 4 weeks. Statistical Analysis Used: Data were analyzed using SPSS v.21. Mann–Whitney U test was used to compare the anxiety and depression, as divided by the time intervals to before and after the intervention between two groups. Friedman test was utilized to compare the anxiety and depression over the various measurement times in each group. Results: Significance difference were found in each group in terms of anxiety and depression reduction during various measurement times (P < 0.001). There was a significant difference between two groups in terms of depression one week after the end of the intervention (P = 0.03). Conclusion: According to the results, it seems that multisensory stimulation intervention and aromatherapy can be useful for improving the anxiety and depression but multisensory stimulation was more effective to improve depression.

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Context: Health system managers have a responsibility to prioritize their policies, procedures, and guidelines to ensure patient safety. Aim: Design and evaluation of patient safety management questionnaire in Shahrekord teaching hospitals. Settings and Design: This study was a mixed and exploratory research. Materials and Methods: This study was conducted in 2017–2019 in Shahrekord. To analyze the factor load, the entire study population participated including 450 manager, nurse manager, supervisors, head nurses, and patient safety practitioner. Statistical Analysis Used: The scope and items of the questionnaire were confirmed by examining the face validity, content, and structure and its reliability by internal consistency and stability. After collecting data, SPSS software version 18 was used to analyze and evaluate the information. Results: In the qualitative stage and interview professors and experts and reviewing scientific texts, 116 items were extracted in 8 dimension of patient safety management, which after reviewing the face and content validity, 19 items were removed. In the quantitative stage, in the content validity ratio study, two items were removed due to the ratio of< 0.56 and one item in the content validity index review was removed due to the ratio of <0.78, and 94 items were finalized. Evaluation result of structure validity with Kaiser-Meyer-Olkin index was 0.85 and Bartlett test was 7237.504 (P < 0.001). Conclusions: Result showed that patient safety management questionnaire is an essential tool for use by hospital managers to evaluate patient safety management in the dimensions of planning, guidance and leadership, decision-making, organizing, information, communication, coordination, and control.

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Context: Breast cancer has high morbidity and mortality rates due to late stage at diagnosis as patients usually present at an advanced stage. There is a lack of awareness about the symptoms and signs of breast cancer as well as the screening practices. Aim: This study evaluates the level of knowledge of screening practices and risk factors in breast cancer among the female nursing staff in a teaching hospital. Setting and Design: This was a descriptive cross-sectional study design. Materials and Method: In this cross-sectional study that was performed in 2019, simple random sampling of 184 participants was done, and their responses of a validated questionnaire of breast cancer risk factor were scored. Statistical Analysis Used: Descriptive statistics were used to summarize data. Results: The mean knowledge and awareness score of the nurses who participated in the study with a total score of 35 is 13.059 with a standard deviation of 4.673 (13.059 ± 4.673). Nearly 12.5% of the nurses (n = 23) had good knowledge, 54.3% of the nurses (n = 100) had an average knowledge, while 33.2% of the nurses (n = 61) had poor knowledge scores in the study conducted. Conclusions: Nurses had limited levels of knowledge about breast cancer and methods of early detection. The screening methods in breast cancer should be stressed during their training period at the institutional level with frequent updating of knowledge by conducting workshops and seminars.

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