Context: Pain and anxiety due to the dressing change make it hard to care for children with burn injuries. Aims: This study aims to compare the effect of active and passive distraction techniques on the pain intensity and anxiety related to burn dressing change. Setting and Design: The participants of this quasi-experimental study were 120 children aged 3–6, referred to the clinic in Shahid Motahari Hospital. Materials and Methods: Convenience sampling was used, and the children were allocated into three groups: active distraction technique (game), passive distraction technique (music), and control. The intervention in the two experimental groups started 10 min before entering the dressing room and continued during dressing change, while the control group received routine care. The Visual Analog Scale was applied to measure pain, and their anxiety level was evaluated using the Observational Scale of Behavioral Distress-Revised. Statistical Analysis Used: Data were analyzed with independent t-test, ANOVA test, and ANCOVA test. Results: The mean ages of patients in the control, game, and music groups were 4.30 ± 1.36, 4.01 ± 1.22, and 4.23 ± 1.30 years (P = 0.79), respectively. The mean of the difference in pain intensity scores during dressing change compared to before in the game, music, and control groups was 2.80 ± 3.22, 3.27 ± 3.71, and 4.30 ± 2.42, respectively (P = 0.1). Finally, the mean of differences during dressing change anxiety scores compared to before in the game, music, and control groups was 0.60 ± 0.95, 0.50 ± 1.01, and 0.96 ± 1.06, respectively (P = 0.10). Conclusion: Given that, playing game positively affected pain decrease and music had a positive effect on reducing anxiety during a burn dressing change.

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Context: Decreasing the outpatients' symptoms of COVID-19 is essential. For relieving symptoms, some complementary approaches are suggested. Aims: This study aimed to evaluate the effects of yoga-based breathing techniques and meditation on outpatients' symptoms of COVID-19 and anxiety scores. Setting and Design: This interventional study was conducted on 110 women with positive results of polymerase chain reaction (PCR) test for SARS-COV2 virus referred to PCR testing centers in Rafsanjan city, Iran, in 2021. Materials and Methods: The participants were assigned into intervention (n = 53) and control (n = 57) groups by simple randomization according to a computer-generated assignment list. In this study, the intervention group practiced 20-min yoga-based breathing techniques and 20-min meditation daily for a 6-day period, control group did not receive any contact till 6^th day. The symptoms' severity and headache, myalgia, and anxiety scores were evaluated on the 1^st and 6^th days via call interview by demographic and disease symptoms' checklist and the Spielberger State–Trait Anxiety Inventory. Statistical Analysis Used: The obtained data were then reported as descriptive statistics and were analyzed using Fisher's exact test, Chi-square test, Wilcoxon signed-rank test, t-test, McNemar's test, Mann–Whitney U-test, and multivariate analysis of covariance. Results: At six days after intervention, the group that practiced yoga-based breathing techniques and meditation had lower scores of headache (P < 0.001), myalgia (P < 0.001), and anxiety (P < 0.001) and lower severity of cough (P < 0.001), dyspnea (P = 0.019), and weakness (P = 0.006) than the control group. Conclusion: It appears that yoga-based breathing techniques (pranayama) and meditation could be considered effective and easy complementary therapies in COVID-19 patients for reducing the symptom severity and anxiety level.

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Context: One of the most important facilitating elements for increasing access to quality maternity care is compassionate and respectful maternity care (CRMC). Aims: This study assessed factors associated with CRMC among laboring mothers during childbirth in Ethiopia. Settings and Design: A cross-sectional study was employed in Adama Hospital Medical College, Ethiopia from August 01 to September 30, 2020. Materials and Methods: Three hundred and ninety-nine postpartum mothers were selected using a systematic random sampling technique through a demographic, obstetric, and respectful maternity care questionnaire. Statistical Analysis Used: Frequencies, percentages, means, and standard deviation were computed. Binary logistic regressions were carried out to identify factors associated with CRMC. Results: The overall magnitude of CRMC accounts 169 (42.4%) with (95% confidence interval [CI]; 37.3–47.4). Primary and secondary level of education (adjusted odds ratio [AOR]: 5.29, 95% CI [1.92, 14.57], P = 0.028), discussion with health-care provider (HCP) on place of delivery during antenatal care (AOR: 9.13, 95% CI (4.85, 17.18), P = 0.023), multigravida (AOR: 3.75, 95% CI [1.17, 11.99], P = 0.013), history of previous institutional delivery (AOR: 3.306, 95% CI [1.026, 10.65], P = 0.001), day time (shift) of delivery (AOR: 3.52, 95% CI [1.85, 6.72], P = 0.017) asking for consent before the procedure (AOR: 3.49, 95% CI [1.821, 6.72], P = 0.000) and two or less number of health workers during labor (AOR: 4.68, 95% CI [2.495, 8.77], P = 0.002) were significant determinants of CRMC. Conclusion: The proportion of CRMC was low. As a result, we recommend that HCPs who provide maternity care give friendly treatment, abuse-free care, timely care, and discrimination-free care as the pillars for improving the low rate of institutional delivery.

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Context: Professional ethics are less understood in the literature and refer to the complex decision-making processes made by nurses as they deliver care. Aims: This study aimed to add new information to the growing body of evidence around professional ethics and explore the experiences of Iranian nurses who work in the hospital setting. Setting and Design: This is a qualitative study that was carried out from January 2017 to August 2017, utilizing conventional content analysis. Materials and Methods: In this qualitative study, data were collected using semi-structured interviews. Twenty-eight participants with various occupational backgrounds and positions were interviewed. All participants work in educational hospitals in the North West of Iran. Data were analyzed using the conventional content analysis. Statistical Analysis Used: Statistical methods were not used in this study. Results: One overarching category and three sub-categories emerged during data analysis. The overarching category was “the road to professional ethics,” which was supported by the following sub-categories: ethical development, spirituality and values development, and promoting ethical competencies. Conclusions: Professional ethics are difficult to separate, which may be why it is less understood in the empirical literature. Multiple factors contribute professional ethics, and these ethical principles motivate nurses to provide safe care. Professional ethics in nurses' performance can help managers in the recruitment and ongoing supervision of nurses to improve their professional performance.

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Context: The adolescence is a period of fabulous changes made in growth as physically, emotionally, and socially; because of deprived nutrition, these changes become declined and more complicated for an adolescent diagnosed with HIV. Aim: The study aims to evaluate the effectiveness of nurse-initiated nutritional counseling with Hatha yoga on nutritional status of HIV-infected adolescents. Setting and Design: This was randomized controlled trial research with a wait-list control group design adopted in selected antiretroviral therapy centers in Chennai, Tamil Nadu. Materials and Methods: Through simple random technique, a total of 388 HIV-infected adolescents were divided into experimental (195) and control (193) groups. The data were collected from samples/caregivers through a structured nutritional assessment questionnaire, and anthropometric measurements were also noted. The nutritional counseling was given to experimental group alone and asanas were demonstrated by a researcher. The data were collected from both groups at 0, 3^rd, and 6^th month intervals. Statistical Analysis Used: Data were analyzed using descriptive statistics of mean and standard deviation and inferential statistics such as Chi-square, ANOVA “F”-test, and Bonferroni t-test. Results: According to the “Z” score, the baseline assessment showed that 28% in the experimental and 29% in the control group of HIV-infected adolescents were malnourished, and the remaining percentage was within normal. However, on 6^th month evaluation, it reduced to 19% and 28%, respectively. Hence, nutritional gain score was increased to 9.3% in the experimental and 1.5% in the control group with 95% confidence interval. Conclusion: The motivational counseling along with Hatha yoga has effectiveness to increase nutritional status of HIV-infected adolescents in the experimental group than in the control group.

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Context: Self-regulated learning is a process by which learners choose goals for themselves and then try to regulate, control and manage their cognition, motivation, and behavior. The COVID-19 pandemic faced students to numerous educational challenges. Rapid transition of the traditional classroom to the virtual environment affected E-learning acceptance of the students in the age of the COVID-19 pandemic. Aim: The present study aimed to determine the relationship between online self-regulated learning and E-learning acceptance among Mazandaran University of medical sciences during the COVID-19 pandemic. Settings and Design: This descriptive-analytical study was conducted on 234 Mazandaran University of medical sciences students. Materials and Methods: The nonprobability quota sampling method was used for data collection. Inclusion criterion was experience E-learning at least one semester in the age of COVID-19 pandemic. Internship medical sciences students were excluded. The online questionnaire consisted of three parts: Sociodemographic questionnaire, online self-regulated learning and E-learning acceptance. Statistical Analysis Used: Descriptive statistics, one-way ANOVA, Pearson test, and univariate and multivariate linear regression model were utilized. Results: According to the univariate linear regression model, E-learning acceptance explored 19.8% variance of the online self-regulated learning. The multivariate linear regression showed age, gender, marital status, medical students, another job and E-learning acceptance explored 47.1% variance of the online self-regulated learning. Conclusion: The results showed that E-learning acceptance was correlated with online self-regulated learning. The faculty members and university managers can use strategies to enhance the E-learning acceptance to improve online self-regulated learning and facilitate barriers in the age of mandatory online learning.

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Context: The infectious disease caused by the novel coronavirus has spread all over the world for the first time. A key factor in containing infectious diseases is compliance with health recommendations such as social distancing and home quarantine. Aims: This study aimed to analyze the public perception of noncompliance with home quarantine during the coronavirus disease 2019 (COVID-19) pandemic. Settings and Design: This qualitative study was conducted in Iran (Ardabil and Kermanshah) in 2020. The research data were collected from 15 participants living in urban communities by conducting in-depth, semi-structured, and face-to-face individual interviews. Materials and Methods: The purposive sampling technique was used with maximum variation in this study. Statistical Analysis Used: Data were analysed using content analysis and MAXQD-10 software was used to manage data. Results: A total of 15 participants comprised the final sample after data saturation. They were aged 18–51 years old. Regarding the research purposes, data analyses resulted in three categories and six subcategories: uncertainty (uncertainty about the News and uncertainty about job security), the need for serious governmental interventions (supportive interventions and legal interventions), and the fear of quarantine consequences (financial livelihood consequences and physical-psychological consequences). Conclusion: Compliance with home quarantine requires the support of people and officials to contain infectious diseases. Home quarantine is not complied by the public for various reasons such as distrust, the need for supportive governmental interventions, and the fear of negative consequences. Apparently, governmental support plays a central role in solving livelihood problems.

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Context: Schizophrenia is a severe mental disorder in which the individual's relationship with the reality is interrupted. Families can play an important role in the improvement of this disorder and help reduce its recurrence and ensure its better control and the patient's return to the society. Aims: This study was conducted to explore the experiences of family caregivers of patients with schizophrenia. Setting and Design: This study used the qualitative content analysis method proposed by Elo and Kyngäs. The study was carried out from 2019 to 2021 in the psychiatric wards of 5 Azar Hospital in Gorgan, Northern Iran. Materials and Methods: A total of 16 family caregivers of patients with schizophrenia were examined. The participants were selected by purposive sampling. Sampling continued until data saturation was reached. Semistructured interviews were held to collect data. The data were analyzed with the support of MAXQDA 10 software. Statistical Analysis Used: data were analyzed using conventional content analysis according to the technique described by Elo and Kyngäs. Their technique involves open coding, coding sheets, grouping, categorization, and abstraction. Results: Two main themes were extracted from the data, including “family's committed and compassionate care for the patients' integrity” and “inadequacy of care,” with a total of seven subcategories. Conclusion: Providing care to a family member with schizophrenia is a task with several contradictory dimensions. Due to the chronic nature of the disorder, most family caregivers experience a kind of paradox in areas such as providing comprehensive care, protection, support, and inadequacy of care.

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Context: The COVID-19 pandemic had consequences such as fear and anxiety in humans. Aims: The present study aimed to adapt the COVID-19 Phobia Scale (C19P-S) into Persian and test the psychometric properties of the adapted scale. Settings and Design: This study was conducted in Iran during December 2020. Materials and Methods: The C19P-S was used to obtain data from 600 Iranian individuals aged 16–65 years. Statistical Analysis Used: Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to evaluate the construct validity. The average variance extracted and construct reliability were used to assess the convergent validity and the maximum shared squared variance and average shared squared variance were used to assess discriminant validity. Cronbach's alpha was used to evaluate the internal consistency. Results: The results of EFA indicated that Kaiser–Meyer–Olkin value (0.831) approved sampling adequacy. The communality of Psy6 and factor loading of Soc5 were lower than 0.4; therefore, they were removed. The cumulative variance explained with 4 factors and 18 items was 69%. The results of the CFA indicated that the measurement model fits the data well (Goodness of Fit Index = 0.891, Tucker–Lewis Index = 0.901, Comparative Fit Index = 0.920, Incremental Fit Index (IFI) = 0.922, Root Mean Square Error of Approximation = 0.065, and χ²/df = 1.807), suggesting construct validity. Further, the results confirmed the convergent and discriminant validity. Cronbach's alpha coefficients of the four dimensions ranged between 0.760 and 0.878, suggesting that the Persian C19P-S is a reliable scale. Conclusions: Persian C19P-S with 4 dimensions and 18 items is reliable and valid in measuring the COVID-19 phobia among the Iranian general population.

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Context: Better health literacy develops the competencies of the individual to assimilate, comprehend and adapt to healthy practices and reduce risk behaviors. Oral health literacy has also proved to be critical in reducing oral health disparities and in promoting oral health. Aim: The study aimed to assess the oral health literacy level and its impact on oral health status among dental nurses. Setting and Design: A cross-sectional study was conducted among 170 nursing students at private nursing college between September 2019 and December 2019. Materials and Methods: Oral health literacy (OHL) was assessed using the Rapid Estimate of Adult Literacy in Dentistry (REALD-30) and dental caries were assessed by decayed, missing, and filled teeth (DMFT) index Statistical Analysis Used: The data were analyzed using descriptive statistics, Kruskal–Wallis test, and multiple linear regression analysis. Results: Among the participants, the IV-year students showed a higher rate of rinsing after meals (77.3%), brushing frequency twice a day (36.4%). A steady increase in the mean OHL scores was observed with an increase in the level of education. Significant association was found between REALD-30 (OHL) and dental caries (b = -0.151, P-value = .049). Conclusion: The current study result demonstrates the correlation between oral health literacy and dental caries. To achieve better outcomes, there is a need to involve inter-professional primary health care providers, such as nurses to raise awareness and promote oral health by incorporating additional cross-cutting actions in training programs aimed at health care, disease prevention, and health promotion.

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Context: There are some discrepancies regarding the association between periodontal disease and preterm in the literature. Considering all periodontal pathogens, Porphyromonas gingivalis (Pg) is the most invasive bacterium in connective tissues, and the impact of its presence in the diverse microbial community of periodontal pathogens with a lower frequency is much greater than expected. Aim: This study investigated the association of Pg in infra-gingival plaque of preterm and low birth weight (PTLBW) mothers. Setting and Design: This descriptive correlational study was conducted on 89 women, who were referred to Imam Khomeini Hospital in Sari, Iran, in 2017. Materials and Methods: The samples were assigned by purposive method with 30 mothers had PTLBW newborns and 59 mothers had normal term and normal birth weight (NTNBW) neonates. The probing depth, bleeding on probing clinical attachment levels, plaque index, and gingival index were measured. A sample from the periodontal pocket was collected to distinguish the Pg in subgingival plaque by polymerase chain reaction. Statistical Analysis Used: The data were analyzed using descriptive statistics and the Mann–Whitney U and Chi-square test. Results: According to the periodontal indexes, 37.3% and 26.7% of the mothers in the NTNBW and PTLBW were diagnosed with periodontitis, respectively. Furthermore, Pg was detected in 30% and 20.3% of the cases in the PTLBW of NTLBW mothers. The amount of Pg in infra-gingival plaque was significantly higher in the PTLBW mothers than in the NTNBW (P = 0.016). Conclusion: The results indicated that the quantity of Pg could be considered a risk factor for PTLBW delivery.

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