Context: Patient-centered care is associated with a higher rate of patients' satisfaction, better outcomes as well as more cost-effective care. On the other hand, the aim of the patient's bill of rights is to ensure that patients are adequately cared for which in turn increase the quality of medical care. Aims: This study aimed at explaining the experiences of health-care providers about providing patient-centered care in hospitalized patients based on patient's bill of rights. Setting and Design: This qualitative study was conducted in 2018 using content analysis approach. Participants were 21 clinical nurses, nurse managers, and other health-care managers who worked in Iranian hospitals. Materials and Methods: Data were collected purposefully using in-depth semi structured interviews and continued until data saturation. Interviews were recorded, immediately transcribed, and analyzed using Graneheim and Lundman's conventional content analysis. Statistical Analysis Used: Frequency table was applied for Describing data by using. statistical analysis was done by SPSS software version 26. Results: Data analysis resulted in the extraction of three main themes (value-based care, accountability in providing information, and providing suitable amenities) and five categories (providing sensitive care, providing ethical care, professional support, in seeking of information, and responding to informational needs)., Conclusions: The findings of the present study showed that health-care providers have satisfactory understanding and experience in providing patient-centered care in hospitalized patients, based on the patient's bill of rights. Understanding patient-centered care barriers, especially by health-care providers, can secure the patient's legal rights and provide a better and more quality service for patients and their families.

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Context: Parents' competence has the most important role in the education of healthy sexual behavior to children under age 12 years. Aims: This study was conducted to evaluate the knowledge and competence of parents in response to their children's sexual behavior. Setting and Design: This population-based survey was conducted in Mazandaran Province, the province in the northern region of Iran, from October to January 2015. Materials and Methods: In this cross-sectional study, 600 parents were selected by a cluster random sampling technique. To assess parents' sexual knowledge and competence, the “Children's Sexual Behavior Questionnaire (CSBQ)” was used to collect data. Mothers and fathers completed the questionnaire separately. Statistical Analysis Used: Descriptive statistics and multiple linear regressions were used for data analysis. Results: Of the total 600 participants (mothers or fathers), 41.3% were fathers. The mean age of fathers and mothers was 34.12 ± 6.32 and 32.24 ± 85.5, respectively. The majority of the parents (66.7%) had an average level of knowledge in response to their children's sexual behavior, whereas only 5% of the parents had appropriate competence in response to sexual behavior of their children. There was a positive association between parents' competence in response to children's sexual behavior and their education (P < 0.001, β = 0.13), and a significant inverse association was observed between parents' competence and their economic status (P = 0.02, β = −0.18). Conclusion: In groups with low education, skill-building training courses are essential. Furthermore, appropriate interventions should be designed for groups with high economic status who do not have a high competence.

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Context: Enormous workrelated pressure following COVID19 pandemic might lead to a decline in persistence and commitment to the organization among nurses. Aims: This study aimed to determine factors influencing job retention and organizational commitment among Iranian nurses working during COVID19 pandemic. Setting and Design: This descriptivecorrelational study was performed between April and May 2020 in Imam Khomeini educational hospital, Sari, Iran. Materials and Methods: All nurses worked in COVID19 wards were invited to participate in our study, of whom 172 accepted to participate in the present study. The inclusion criteria were nurses working in the COVID19 wards of Imam Khomeini Hospital and willingness to participate in the study. Data were gathered through three questionnaires: demographic characteristics, Anticipated Turnover Scale, and Allen organizational commitment. Effect of age, gender, level of education, marital status, work shifts, and work experience were evaluated with both variables. Statistical Analysis Used: The collected data were analyzed in SPSS software (version 16) using statistical tests such as Pearson's correlation, independent sample ttest, oneway ANOVA, and linear regression analysis. Results: The mean ± standard deviation of job retention and organizational commitment were 37.70 ± 3.35 and 75.96 ± 8.37, respectively. Job retention and organizational commitment were positively and significantly correlated with each other (P < 0.001, r = 0.33). Of evaluated factors, the only factor that had a positive and significant relationship with job retention (P = 0.04, F = 1.22) and organizational commitment was working experience (P = 0.04, F = 2.89).

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Context: Midwives provide intensive emotional labor for women and their families during periods of emotional changes, such as pregnancy and childbirth. Aims: The relationship between midwives' job stress, job satisfaction, and emotional labor was investigated. Setting and Design: This cross-sectional study included 198 midwives from public hospital in Turkey in 2019 Material and Methods: In this study, 198 participants were selected through simple random sampling. The data collection tools used were a sociodemographic questionnaire, the Emotional Labor Scale, the Perceived Stress Scale, and the Minnesota Job Satisfaction Scale. Statistical Analysis Used: Descriptive data are presented as mean, standard deviation, number, and percentage. In the statistical analysis of the data, an independent sample t-test, multiple regression analysis, and Pearson correlation analysis were used. Results: In the multiple regression analysis, there was a significantly negative correlation (β: −0.144, P = 0.025) between the surface acting subscale of emotional labor and job satisfaction, a positive correlation with deep acting (β: 0.148, P = 0.038), a positive correlation with emotional effort (β: 0.371, P < 0.025), a negative and significant relationship with a lack of staff (β: −0.227, P < 0.001) and a positive correlation with the number of patients (β: 0.244, P < 0.001). In addition, there was a positive and significant relationship with deep acting, a positive and significant relationship with perceived stress (β: 0.146, P = 0.036), a positive and significant relationship with surface acting (β: 0.246, P = 0.001) and a positive and significant relationship with emotional effort (β: 0.358, P < 0.001). There was a statistically significant positive correlation between the emotional effort and deep acting (β: 0.415, P = 0.001) and surface acting (β: 0.317, P = 0.001) scores. Conclusions: It was found that the emotional labor subscales affect each other, and a positive correlation between surface acting, deep acting, and emotional effort was found. A slightly positive and significant correlation between emotional effort and job satisfaction was found. A positive correlation was found between surface acting and perceived stress.

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Context: Anxiety is common among patients undergoing coronary angiography. Aims: The aim of this study was to examine the comparative effects of eye masks and music on anxiety levels and hemodynamic indices of patients undergoing coronary angiography. Setting and Design: This is a single-blind randomized clinical trial conducted on 300 patients undergoing coronary angiography. Materials and Methods: Patients were recruited using convenience sampling and then randomly allocated to one of the four groups. Ten minutes before the coronary angiography, baseline anxiety levels were measured using the state-trait anxiety inventory. Patients' hemodynamic indices were also measured and recorded immediately before they entered the cath-lab operating room, as soon as, they were in bed in the cath-lab operating room, 5 min after the start of coronary angiography, and immediately and 20 min after the completion of coronary angiography. Anxiety levels were measured again 20 min after coronary angiography. Statistical Analysis Used: All statistical analyses were conducted using SPSS 22 Software. Mean and SD indices were used. The normality of both overt and covert anxiety variables was confirmed using Kolmogorov–Smirnov test. The presence of intervening variables was examined using analysis of variance, the final analysis was performed using analysis of covariance. For all analyses, a P < 0.05 was considered to be statistically significant. Results: The mean scores on overt and covert anxiety decreased after intervention. A statistically significant difference was observed among the four groups on overt and covert anxiety (P < 0.001). Compared to before coronary angiography (P < 0.001) and routine care only group (P < 0.001), hemodynamic indices had a decreasing trend during coronary angiography in the intervention groups. Conclusion: The results of the present study revealed that nonverbal, relaxing, and classical music significantly reduced anxiety and hemodynamic indices of patients undergoing coronary angiography. Future studies should examine the effectiveness of other music genres on anxiety and hemodynamic indices in patients undergoing coronary angiography.

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Context: There are many studies on the health effects of dietary advice and physical activity in pregnancy, with only a few describing the effects of the simultaneous use of a combined intervention on preeclampsia in pregnant women with metabolic syndrome (MetS). Aims: This study was designed to examine the effects of motivational interviews, dietary advice, and physical activity on the incidence and symptoms of preeclampsia in pregnant women with MetS. Setting and Design: This randomized, single-blind, controlled clinical trial was performed in two hospitals in Babol, Iran, in 2018. Materials and Methods: The participants included 120 pregnant women with a gestational age of 15–20 weeks with the diagnosis of MetS. The patients were block randomization allocated to two groups of 60 mothers. From the 20^th week of pregnancy edema, blood pressure, proteinuria, and preeclampsia were evaluated and compared between the two groups. The intervention group had one motivational interview, two consultation sessions, and three training sessions for physical activity. The tools used for data collection included demographic fertility characteristics, anthropometric measurements, and a biochemical pregnancy outcomes checklist. Statistical Analyses Used: The data were analyzed using descriptive statistics, independent t-test, ANOVA and logistic regression. Results: The intervention group showed a significant decrease in edema (20.4% and 47.3%), proteinuria (5.6% and 30.9%), BP ≥140/90 mmHg (3.7% and 14.5%), and preeclampsia (1.9% and 12%) compared to the control group. Conclusion: Dietary recommendations and physical activity by pregnant women with MetS in prenatal care can be safe and practical interventions to avoid preeclampsia.

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Context: Individual attitudes are a factor that affects the use of contraceptive methods. It is known that positive or negative attitudes affect the use of contraceptives. Aims: This study aimed to develop an intelligible tool which can measure attitudes toward contraceptive methods that the healthcare personnel in Turkey can easily apply. Setting and Design: This study is a methodological research. A simple random sampling method was used. The sampling of the study was made up of 300 women and men aged 15 and over who were referred to the two family healthcare centers. An information form and the final primary version of Contraceptive Attitude Scale consisting of 35 attitude items were used for data collection. Materials and Methods: This study was conducted in two phases. Developing the items of the contraceptive attitude questionnaire (CAQ) was conducted in Phase I using the deductive method. In phase 2, the psychometric properties of the questionnaire were evaluated. Statistical Analysis Used: Content validity ratio, content validity index, Kaiser-Meyer-Olkin coefficient, Bartlett's test of Sphericity, Pearson Product-Moment Correlation Coefficient, and Cronbach's alpha reliability coefficient were used. Furthermore, fit indices were calculated (Root Mean Square Error of Approximation [RMSEA], normed fit index [NFI], comparative fit index [CFI] non-NFI [NNFI], adjusted goodness of fit index [AGFI], goodness of fit index [GFI]). Results: After the exploratory factor analyses, it was determined that the 25 items in the questionnaire were grouped under three factors. The internal consistency coefficient was found to be 0.90, 0.89, 0.84, and 0.77 for CAQ, Factor 1, 2, and 3, respectively. In the confirmatory factor analyses, it was determined that the Chi-square value of CAQ was significant and that the data were sufficient for the model (χ² = 1080.90, df = 272, χ² /df = 3.97, P = 0.000). Of the fit indices in CFA, the following values were found: RMSEA = 0.059, NFI = 0.95, NNFI = 0.97, CFI = 0.98, AGFI = 0.73, and GFI = 0.78. Conclusion: The CAQ was determined to be a valid and reliable measurement tool in Turkey. The questionnaire is suitable for use to protect and improve the reproductive health of women and men as it determines attitudes toward the use of contraceptive methods.

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Context: Studies demonstrate that it is essential to identify mothers at risk of weaning their babies too early and support their process of breastfeeding in the postpartum period. The impact of maternal personality traits on breastfeeding is not sufficiently well understood. Aims: The objective of this study was to investigate the relationship between breastfeeding success and maternal personality traits. Setting and Design: The research was a descriptive, correlational study and was conducted in the maternity ward of a university hospital located in the East of Turkey between September 2018 and March 2019. Materials and Methods: The convenience sampling method was used in the study and the sample consisted of 208 primiparous women within the first 48 h postpartum. Four forms were used in the collection of data. These were as follows: a demographic information form, a breastfeeding questionnaire, the ten-item personality inventory, and the LATCH breastfeeding assessment tool. Statistical Analysis Used: The data were analyzed using the descriptive statistics (mean, standard deviation, and frequency). The mean scores for the LATCH Breastfeeding Assessment Tool were compared according to mothers' personality traits using Kruskal–Wallis variance analysis. In post hoc analysis, multiple comparison was performed using the Tamhane t²-test. Results: The mean score on the LATCH breastfeeding assessment tool was found to be 5.45 ± 1.44. A statistically significant difference was found between the mean LATCH Breastfeeding assessment success score according to the women's personality traits (KW: 21.929, P < 0.000). The highest and lowest LACTH scores were seen in people with the extraversion (6.2 ± 1.2) and agreeableness (5.0 ± 1.2) personality traits. Conclusions: It was determined that the women's personality traits affected their breastfeeding success and that extraverted individuals had higher breastfeeding success scores.

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Context: The pace of population aging is increasing around the world. Medication errors are more common among the elderly for a variety of reasons and can lead to serious complications. Aims: The aim of this study was to determine the incidence of errors and related factors in the use of blood glucose control medications in a diabetic elderly population in Qom, Iran. Setting and Design: This descriptive, correlational study was conducted on the elderly with type II diabetes, who were referred to the diabetes centers of Qom. The sample size was measured to be 200, based on the available sampling method. Materials and Methods: Data were collected using a demographic questionnaire, as well as a researcher-made Medication errors questionnaire. Statistical Analysis Used: SPSS version 20 was used to analyze the data. Results: Overall, 69% of the samples were female, and the mean age of the participants was 63.59 ± 4.84 years. The incidence of medication errors was 69% among older patients. There was a significant relationship between medication error and polypharmacy (P < 0.001), comorbidities (P < 0.025), duration of diabetes (P < 0.026), and use of aids (P < 0.038). Forgetfulness (26.33%) and lack of drug information (12.61%) were the most common causes of medication errors in patients. Conclusion: The results showed that the incidence of medication errors, which was influenced by various factors, was high among the elderly. Therefore, to prevent and reduce the incidence of medication misuse, proper measures should be taken.

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Context: Although Middle-east is a region with high population growth, but in some countries such as Iran, the population growth significantly decreased rapidly. Social capital is an important factor in formatting the positive willingness of childbearing among couples. Social capital referred to resources that individuals access them through the personal relationships. Aims: This study aimed to investigate the role of social capital on unwillingness toward childbearing in reproductive-aged women referred to Babol Health Care Centers in 2018. Setting and Design: A cross-sectional study in Babol Health Centers, Iran, in 2018. Materials and Methods: Three hundred reproductive-aged women 18–39 years with maximum of two children were recruited through a systematic sampling method. Demographic fertility characteristics form, Miller's childbearing motivation questionnaire, Onyx, and Bullen social capital questionnaire were used for the data collection. Statistical Analysis Used: Descriptive statistics such as frequency, mean ± standard deviation, the Pearson correlation coefficient, and multiple regression were used for the data analysis. Results: The most reasons of unwillingness for childbearing included “worrying about the health and safety of my child,” (83%) “being responsible for a needy and demanding baby,” (78.8%) and “worrying whether I am raising my child the right way.” (77%) Unwillingness to childbearing was associated with the factors such as social capital (β = −0.259, P = 0.001), being employed (β = 0.207, P = 0.001), and well self-evaluation of socioeconomic status (β = −0.187, P = 0.004). Conclusions: Improving the current conditions of childbearing in the Iranian society requires the involvement of policy-makers in the various domains and levels of decision-making at the family, community, and macrolevels.

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Context: Ethics education in midwifery leads to professionalism and good clinical practice. Lack of standards related to ethical education cause differences in implementation. Aims: This study aims to collect comprehensive data about ethics education in undergraduate midwifery programs in Turkey. Settings and Design: In the cross-sectional descriptive study, the sample of study was consisted of faculty members who gave ethics education in midwifery schools and undergraduate final year midwifery students in 29 universities in Turkey between 2017 and 2018. Materials and Methods: This study was conducted on 17 faculty members and 1138 midwifery students recruited by simple random sampling. Data collection forms consisted of demographic characteristics and questionnaire of knowledge and opinions about the ethics courses. Statistical Analysis Used: Descriptive statistics including mean, standard deviation, frequencies and percentages, and Chi-square were used. Results: It was observed that ethics education was given as a 2-h theoretical course in all midwifery undergraduate schools, and ethics course was compulsory in 87.5% of them. There was statistically significant difference between the views of faculty members and students about necessity of ethics education (P = 0.000), sufficiency of content (P = 0.002), and the expertise of educators (P = 0.000). Conclusions: According to the opinion of participants, there are lacks in ethics education for midwifery students in Turkey. Regarding the difference between opinions of faculty members and students, contents and the aims of the ethics education should be co-determined by the ethics experts, the midwifery teachers, and the midwives.

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