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The present study was carried out to explore Iranian nurses' use of placebos in clinical practice and their knowledge and attitude towards its use. A cross-sectional, descriptive study was conducted using self-report questionnaires. All nurses working in a university hospital in Arak (n=342) were invited to participate in the study. Among 295 respondents, 221 (75%) reported that they had used at least one placebo within the past year and 179 (81%) told patients they were receiving actual medication. The most common reason and symptom for placebo use were after unjustified demand for medication and pain, respectively. Only 60 (20.33%) of the nurses believed that placebos should never be used. Results showed that most nurses in our study had used placebos and probably will continue to use them. Placebo use is viewed as ethically permissible among nurses. Some patients benefit from the placebos, but their use raises ethical questions. The role of placebo treatment, its mechanisms, and its ethics issues should be taught to nurses.

Background: Clinical reasoning plays an important role in the accurate diagnosis and treatment of diseases. Script Concordance test (SCT) is one of the tools that assess clinical reasoning skill. This study was conducted to determine the reliability and concurrent and predictive validity of SCT in assessing final lessons and gynecology exams of undergraduate midwifery students. Methods: At first, 20 clinical scenarios followed by 3 questions were designed by 2 experienced midwives. Then, after examining the content validity, 15 scenarios were selected. The test was used for 55 midwifery students. The correlation of SCT results with grade point average (GPA) was measured. To evaluate the concurrent validity of SCT, the correlation between SCT scores and the final exam of the gynecology course was measured. To measure predictive validity, the correlation of SCT scores with comprehensive exams of midwifery was calculated. Data were analyzed using SPSS software. Descriptive statistics, Pearson correlation, and coefficient Cronbach's alpha were used for analysis. The test’s item difficulty level (IDL) and item discriminative index (IDI) were determined using Whitney and Sabers’ method. Results: The internal reliability of the test (calculated using Cronbach’s alpha coefficient) was 0.74. All questions were positively correlated with the total score. The highest correlation coefficient was related to GPA and comprehensive test with the score of 0.91. The correlation coefficient between SCT and the final test (concurrent validity) was 0.654, and the correlation coefficient between SCT and comprehensive test (predictive validity) was 0.721. The range of item discriminative index and item difficulty level in this exam was 0.39-0.59 and 0.32-0.66, respectively. Conclusion: SCT shows a relatively high internal validity and can predict the success rate of students in the comprehensive exams of midwifery. Also, it showed a high concurrent validity in the final test of gynecology course. This test could be a good alternative for formative and summative tests of clinical courses.

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Background and Objectives: Patients’ beliefs about medicines can affect their adherence to the medicines. The aim of this study was to determine beliefs about medicines and medication adherence and its associated factors in patients with chronic diseases. Methods: In this cross-sectional descriptive study, 268 patients with chronic diseases in 2019-2020 were included by convenience sampling method. The beliefs about medicines questionnaire and the Medication Adherence Scale were used for data collection. Data were analyzed in SPSS version 20 using One-Way Analysis of Variance (ANOVA), independent t-test and Pearson correlation coefficient at the significance level of α = 0.05. Results: The Mean±SD score of beliefs about medicines in terms of harms of medicines was 2.53±0.71, in benefits of medicines was 4.27±0.49 and overdose of the medicines was 3.23±0.79.There was a relationship between all three dimensions of beliefs about medicines with medication adherence (P<0.05). There was a direct relationship between the use of herbal medicine and belief in the harms of medicines (P<0.05). In addition, there was a relationship between gender and education level with belief in the benefits of the medicines (P<0.05). Conclusion: Some chronic patients’ beliefs about the drug were not appropriate and they believed that the drugs were harmful and that the drugs were over-prescribed by doctors. Belief in the harms of the medicines, the benefits of the medicines, and the overdose of the medicines are associated with medication adherence in patients with chronic diseases. Patients should be encouraged to express their views on medications in order to improve patients’ beliefs about medication.