Current evidence demonstrates the need for nurse education programs to integrate and strengthen CAM content into existing curricula. Similarly, documentation of the nature and extent of nurse use of CAM therapies in the clinical setting, as well as patient-reported use and preferences for CAM therapies, would provide valuable prospective data.

BackgroundGlycaemic control is the main goal of treatment for type 2 diabetic patients. Hyperglycaemia may result in cognitive decline. More family support may increase medication adherence and decrease glycaemic level. The purpose of this study was to determine the impact of family support improvement behavior on anti diabetic medication adherence and cognition in type 2 diabetic patients.MethodThe randomized control trial study was conducted on 91 patients from an outpatient diabetes clinic. They were randomly divided to intervention (n = 45) and control (n = 46) group. Data on the patients’ demographic information and their family gathered using a questionnaire, For two groups Morisky Medication Adherence Scale (MMAS), drug administration part of Diabetes Social Support Questionnaire – family version (DSSQ), Number Connection Test (NCT) were applied and hemoglobin A1C was measured two times in the onset of study and three months later for control group and before and after intervention for intervention group. The key family members of the intervention group were taught according to their educational needs in small groups.ResultIn intervention group mean of NCT score was significantly decreased after intervention (P = 0.006) however in the control group there was no significant difference after three months. In intervention group a significant correlation was noted between DSSQ scores and MMAS scores after intervention(r =0.67, P < 0.001) but, there was no significant correlation in the control group.ConclusionFamily support instruction based on the educational needs of family members, may improve medication adherence through direct effect and cognitive status with indirect effect.

Background: Asthma causes different physical, emotional, and social limitations for the afflicted children and their families and reduces their quality of life. Therefore, the quality of life in families, particularly in mothers, needs to be enhanced through strategies such as empowerment. Objectives: The aim of this study was to assess the effect of the Family-Centered Empowerment Model on quality of life among the mothers of asthmatic children. Methods: A convenience sample of 172 mothers was recruited for this quasi-experimental study. Mothers were alternately allocated either to a control group or an experimental group based on the day in which they referred to the study setting. Accordingly, mothers who referred to the setting in odd and even days of a weak were allocated respectively to the control and experimental groups. A demographic questionnaire and the pediatric asthma caregiver's quality of life questionnaire (PACQLQ) were used for data collection. The validity of the questionnaire was confirmed by a panel of experts (relevance: 0.98; clarity: 0.96; and simplicity: 0.94) while its reliability was confirmed by a Cronbach's alpha of 0.88. A four-step empowerment program was implemented for the mothers in the experimental group based on the Family-Centered Empowerment Model. The four steps included knowledge improvement, self-efficacy, self-esteem, and evaluation. Mothers in the control group received no intervention during the study. Before and after the intervention, the mothers in both groups were asked to complete the study questionnaires. The data were described and analyzed by using descriptive and inferential statistics. Results: There were no significant between-group differences regarding the mothers' demographic characteristics and their baseline quality of life scores. However, after the intervention, the scores of quality of life and its physical limitation and emotional function domains were significantly lower in the experimental group, denoting higher quality of life (P < 0.001). Conclusions: The Family-Centered Empowerment Model significantly improves quality of life among the mothers of children who suffer from asthma. Given the important role of mothers in giving care to their ill children, nurses are recommended to use the model to encourage mothers' active participation in care giving to their children.

Background and Objectives: High moral intelligence in nurses is considered a supportive factor against different pressures and is assumed to promote psychological safety. The present study aimed to investigate the relationship between moral intelligence and psychological safety of nurses in emergency and intensive care units.Methods: This descriptive-correlational study was conducted on 255 nurses working in the intensive care unit and emergency department of tertiary hospitals affiliated to Birjand University of Medical Sciences, Birjand, Iran. Data collection tools included Lennick and Kiel's moral intelligence scale and Edmonson's psychological safety scale. Data were analyzed in SPSS software (version 16) using descriptive statistics and regression. Results:The mean scores of moral intelligence and psychological safety were measured at 73.10±8.13 and 26.91±3.35, respectively. The results of regression analysis indicated that among the dimensions of moral intelligence, compassion (β=0.21) and responsibility (β=0.19) had the power to predict nurses' psychological safety. In doing so,the predictor variables (i.e., compassion and responsibility) could explain 12% of the variance in the response variable (psychological safety). Conclusion:As evidenced by the obtained results, it can be concluded that moral intelligence as an intrinsic supportive factor can improve nurses' psychological safety and reduce work-related injury by reinforcing positive psychological factors.

Background: The use of tourniquet is very common in orthopedic surgeries. By obstructing blood flow in the limb, tourniquet may result in muscle ischemia and skin flap hypoxia. This study aimed at determining and comparing the effects of tourniquet release time on wound healing in patients undergoing tibia fracture plating surgery. Methods: This study was a randomized clinical trial, wherein 40 patients with acute extra-articular tibia fractures were randomly assigned to 2 groups of A (releasing the tourniquet after fracture fixation and before wound closure) and B (releasing the tourniquet after wound closure and application of compression dressing). Duration of surgery in each group was recorded and independent t test was utilized to compare the 2 groups. The wound healing rate was investigated in the patients 24 hours and 14 days after surgery using the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale. In this tool, 0 represents "lack of the variable" and 3 indicates "maximum variable score". The scores in this scale range from 0 to 15. The Mann-Whitney test was used in order to compare the wound healing rates between the 2 groups. Results: There was no significant difference between the 2 groups concerning the average duration of surgery. Wound redness, edema, ecchymosis, discharge, approximation, and the general condition of wound healing showed no significant difference in the 2 groups 24 hours after surgery, while there was a significant difference 14 days after surgery with the aforementioned parameters being greater in group B than group A. Conclusions:The results showed that releasing the tourniquet before wound closure in group A led to improved wound healing. Wounds need oxygen for restoration and prevention from infections. As the use of tourniquet occludes blood flow to the limb for a while, it can result in increased wound hypoxia after surgery and delayed healing process; hence, less tourniquet time is more desirable for oxygenation of tissues and wound dryness.

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This study aimed to determine the causes of chronic kidney disease (CKD) in Iranian children. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID, Magiran) databases were searched for articles published through December 30, 2017. The quality of the studies was determined using the Hoy instrument. Out of 2,117 initial studies, 13 studies performed on a total of 3,596 children were included in the final stage of the study. Based on the results of the random effects method (95% CI), the main causes of chronic kidney disease in stages 1-4 (CKD) were CAKUT (37%) and glomerulonephritis (19.96%); in stage 5 (ESRD) they were CAKUT (40.82%) and urological disorders (27.44%). Considering the high prevalence of CAKUT, glomerulonephritis and urinary problems, the use of comprehensive approaches can be very effective in enhancing the knowledge of patients about the causes of kidney disease. The results obtained from the present study can assist policymakers in more accurately planning screenings of the causes of CKD in Iranian children.

Background: Staff's level of empowerment plays a significant role in the success of hospitals as complex systems. Therefore, using effective leadership styles by head-nurses is necessary to create an ideal clinical environment to make the most from nurses' abilities and potential capabilities. Objectives: The current study aimed to evaluate the relationship of nurses and head-nurses' psychological empowerment with head-nurses' leadership style. Methods: This correlational study was conducted on nurses and head-nurses working in Valiasr (PBUH) hospital, Birjand, Iran, recruited through the census method. All participants held bachelor's degree with a minimum work experience of two years. The data were collected by a demographic questionnaire, the leader behavior description questionnaire and the Spreitzer psychological empowerment questionnaire. The questionnaires were given to the participants in different working shifts. Finally, thirteen head-nurses and 170 nurses completely filled their questionnaires. The SPSS software ver. 16.0 was employed to analyze data through conducting the Fisher exact, the Spearman and the Mann-Whitney U test, in addition to the independent-samples T-test, at a significance level of 0.05. Results: All head-nurses were married and above 35 years old and 84.6% of them were female. Moreover, most of the nurses were female (75.9%) and married (82.4%) and aged 26 -30 years. Most of head-nurses (69.2%) believed that they used the selling leadership style while most of the nurses (76.9%) noted that their head-nurses' used the telling style. All these nurses and head-nurses had higher levels of empowerment compared with other nurses. Conclusions:The study findings revealed that the nurses who were empowered had perceived their managers' leadership style to be the telling style. This finding showed that managers' leadership style was not congruent with staff's level of empowerment, denoting managers' poor familiarity with leadership styles. Therefore, educating managers about leadership styles seems crucial to enhance staff's empowerment, working motivation and efficiency and promoting organizational dynamism.