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The concept and meaning of futile care depends on the existing culture, values, religion, beliefs, medical achievements and emotional status of a country. We aimed to define the concept of futile care in the viewpoints of nurses working in intensive care units (ICUs). In this phenomenological study, the experiences of 25 nurses were explored in 11 teaching hospitals affiliated to Social Security Organization in Ghazvin province in the northwest of Iran. Personal interviews and observations were used for data collection. All interviews were recorded as well as transcribed and codes, subthemes and themes were extracted using Van Manen’s analysis method. Initially, 191 codes were extracted. During data analysis and comparison, the codes were reduced to 178. Ultimately, 9 sub-themes and four themes emerged: uselessness, waste of resources, torment, and aspects of futility. Nurses defined futile care as “useless, ineffective care giving with wastage of resources and torment of both patients and nurses having nursing and medical aspects”As nurses play a key role in managing futile care, being aware of their experiences in this regard could be the initial operational step for providing useful care as well as educational programs in ICUs. Moreover, the results of this study could help nursing managers adopt supportive approaches to reduce the amount of futile care which could in turn resolve some of the complications nurses face at these wards such as burnout, ethical conflicts, and leave.

BACKGROUND: In chronic diseases such as osteoporosis, understanding the factors that improve prevention, such as health literacy (HL), is essential in reducing the incidence of these diseases. This study aimed to determine the association between HL and adoption of osteoporosis-preventive behaviors among students in Qazvin. SUBJECTS AND METHODS: This is a cross-sectional study in which 375 female students (aged 15–18 years) at high schools (grades 10 th , 11 th , and 12 th ) in Qazvin city were selected, in 2019. Sampling method was multistage. To collect data, the standardized questionnaire for measuring HL in adolescents (health literacy measure in adolescents), in addition to another questionnaire for assessing osteoporosis-preventive behaviors, was used. Data were analyzed using SPSS 22 by descriptive statistics and logistic regression. The association considered significant when P < 0.05. RESULTS: The mean scores of adoption of osteoporosis-preventive behaviors and HL were 22.43 ± 5.60 and 70.84 ± 12.58, respectively. Logistic regression showed that there was a significant association between the adoption of osteoporosis-preventive behaviors and HL ( P = 0.001). In addition, the association between the adoption of osteoporosis-preventive behaviors and age was also significant ( P = 0.048 and odds ratio = 3.35). CONCLUSIONS: Young students and those of low HL showed less adoption of osteoporosis-preventive behaviors. Therefore, it is necessary to pay more attention to design educational programs that may raise the knowledge and awareness of those students about such these diseases, mainly prevention.

Background Yoga can reduce the risk of preterm delivery, cesarean section (CS), and fetal death. The aim of the present study was to investigate the effects of Yoga on pregnancy, delivery, and neonatal outcomes. Methods This was a clinical trial study and using the random sampling without replacement 70 pregnant women entered Hatha Yoga and control groups according to the color of the ball they took from a bag containing two balls (blue or red). The data collection tool was a questionnaire pregnancy, delivery, and neonatal outcomes. The intervention in this study included pregnancy Hatha Yoga exercises that first session of pregnancy Yoga started from the 26th week and samples attended the last session in the 37th week. They exercised Yoga twice a week (each session lasting 75 min) in a Yoga specialized sports club. The control group received the routine prenatal care that all pregnant women receive. Results The results showed that yoga reduced the induction of labor, the episiotomy rupture, duration of labor, also had a significant effect on normal birth weight and delivery at the appropriate gestational age. There were significant differences between the first and second Apgar scores of the infants. Conclusion The results of the present study showed that Yoga can improve the outcomes of pregnancy and childbirth. They can be used as part of the care protocol along with childbirth preparation classes to reduce the complications of pregnancy and childbirth. Trial registration IRCT20180623040197N2 (2019-02-11).

This protocol was registered in the Iranian Registry of Clinical Trials (IRCT2014042017361N1).

Background Traumatic brain injury is the second leading cause of death in Iran. Having knowledge of the factors affecting the clinical outcomes of these patients can improve the therapeutic outcomes. Objective The aim of this study was to determine the relationship of phosphorus (P) and magnesium (Mg) serum levels during admission with clinical outcomes of patients with head trauma. Methods This descriptive-analytic study was conducted in the intensive care unit of Shahid Rajaei Hospital in Qazvin, Iran from March to August 2018. Participants were 70 patients with head trauma under mechanical ventilation who had inclusion criteria. They were selected using a convenience sampling technique. Based on admission P level, patients were divided into two groups of hypophosphatemia (P> 3 mg/dL) and normophosphatemia (P≥3 mg/dL); and based on admission Mg level, they were assigned into two groups of hypomagnesemia (Mg <1.5 mg/dL) and normomagnesemia (Mg ≥1.5 mg/dL). Hypomagnesemia group was compared with normomagnesemia group, and hypophosphatemia group with normophosphatemia group in terms of clinical outcomes. Findings There was a significant difference between two Mg groups in terms of successful weaning (P=0.03), mechanical ventilation duration (P=0.01), and death rate (P=0.03), but not in terms of endotracheal extubation and length of hospital stay (P>0.5). The difference between two P groups was significant only in terms of successful weaning (P=0.006). Conclusion Serum levels of phosphorus and magnesium affect the clinical outcomes of patients with head trauma.

Background & aim: Futile care is defined as the medical care with therapeutic effects that is futile and useless for the patient. Nurses play a key role in futile care or its prevention. We aimed to identify the reasons for providing the futile care at the end of life patients from the viewpoints of nurses working in intensive care units. Methods: This study was a descriptive research including 210 nurses working in intensive care units of private, governmental, and educational hospitals in Qazvin province, 2014. All nurses were studied by census method. Data were collected using a socio-demographic questionnaire and a valid and reliable 39-item questionnaire about reasons for providing futile care in ICU. Data analysis was done using SPSS 21 software. Results: This study results showed that the most effective factor of providing futile care was lack of committee for deciding transfer of patients from ICU to home or general wards (4.58±0.61) and the rarest cause, was the tendency of nurses for perpetuating of patient forcibly drug (3.06±1.4). Conclusion: According to the results of this study, the lack of a committee to decide on the transfer of end of life patients to the home or general wards was the most common cause of futile care in ICUs. Therefore, the formation of ethical committees with the presence of medical ethics specialists in health centers can have a significant role in reducing futile care.

Background and aim: Sleep disorders are not innately harmful to quality of life, they can induce or complicate physical and mental sicknesses and increase the risk of mortality. The aim of this study was to determine the association of sleep quality components with socio-demographic characteristics in elderly people in Qazvin, Iran. Materials and Methods: This descriptive cross-sectional study was performed on 400 elderly patients referred to health centers in Qazvin. Data were collected by using a demographic questionnaire and the Pittsburgh sleep quality index (PSQI). Data were analyzed by SPSS 19 software, descriptive and inferential statistics (Mann-Whitney, Chi-square, logistic regression). Results: The prevalence of poor sleep quality was 80%. Statistically significant difference were observed between total global PSQI score and economic condition (p<0.03) and had chronic physical disease (P<0.001). Highest component scores was sleep latency (1.55±1.06) and lowest was habitual sleep efficiency (0.16±0.57). Older women had worse sleep quality compared with older men (P < 0.05). Multivariate logistic regression model indicated that female sex is associated with greater tendency towards poor sleep quality (OR=1.78, 95% CI=1.08-2.94, P=0.022). Conclusion: This study provides evidences that poor sleep quality was high among the elderly of Qazvin. It seems sleep quality assessment of older adults is necessary to identify the factors affecting sleep quality and to adopt appropriate measures and strategies to eliminate or reduce the effect of these factors.