No abstract

Background: Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major. Materials and Methods: The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software. Results: Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients’ experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'. Conclusion: According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.

Introduction: Musculoskeletal disorders are one of the most common and costly occupational injuries. Nursing profession, considering the nature of the work, is one of the occupations in hospital in which work-related musculoskeletal disorders are highly prevalent. This review study was conducted to determine the prevalence of musculoskeletal disorders among Iranian nurses. Materials and methods: The present study was conducted on the basis of the PRISMA checklist for systematic review and meta-analysis. To access eligible articles, domestic and foreign databases such as Web of Science, Scopus, Science Direct, PUBMED, Magiran, SID, Medlib Irandoc, and the Google scholar search engine and keywords of musculoskeletal disorders, ergonomics, nurses, and Iran were used. In this review, two researchers reviewed the relevant articles published from 2000 to 2017. At first, 1349 papers were entered but finally, 33 eligible articles were analyzed. Data analysis was carried out using STATA software (ver. 11.5). Findings: The results of the review of 33 eligible articles showed that the prevalence of musculoskeletal disorders and low back pain in nurses were 0.84 (95% CI: 0.83-0.95) and 0.60 (95% CI: 0.60-0.61) respectively. Conclusion: The results of the previous studies revealed that the prevalence of musculoskeletal disorders, especially low back pain in nurses, is high. Therefore, planning and intervention should be performed to prevent and reduce musculoskeletal disorders in nurses.

Background: Breast cancer is the most common cancer among Iranian women. However, early detection of this cancer leads to a timely treatment and better prognosis, which significantly improves the survival rate in patients. Objectives: The purpose of this study was to predict the breast cancer screening behavior of women who referred to health centers in Dezful, Iran, using the health belief model (HBM). Patients and Methods: This descriptive-analytical study was conducted on 226 women who were selected with cluster sampling method from those referred to Dezful health centers. Data collection tool was a researcher made questionnaire based on the constructs of the HBM. Data analysis was performed using SPSS software and through methods of descriptive statistics, Pearson correlation, and regression. Results: According to the findings of the study, the knowledge and performance of women were poor, and there was a significant relationship between women's performance and variables of knowledge, perceived sensitivity, perceived benefits, perceived barriers, selfefficacy, and cues to action. In addition, variables of knowledge (P = 0.001), perceived sensitivity (P = 0.022), and self-efficacy (P = 0.001) were predictors of performance in women participating in this study. Conclusions: Poor knowledge and performance of women indicates a crucial need for formal educational programs to sensitize women regarding the importance of breast cancer screening. These educational programs should consider factors affecting breast cancer screening behaviors.

Background: Cancer is one of the most common diseases in children. Cancer in children can cause many problems for parents, and impose heavy care burden on them, which can lead to negative health consequences. The aim of this study was to determine caregiving burden and relevant influential factors among parents of children with cancer. Materials and Methods: This cross-sectional descriptive study was done on 125 parents of children with cancer in oncology department of Shohada Hospital, Tehran, Iran, during March to August 2017. Caregiving burden was measured using the Caregiver Burden Scale. Descriptive statistics, independent-samples T test, one-way ANOVA, Pearson’s correlation analysis, and multivariate linear regression analysis (stepwise method) were used in data analysis with SPSS software (v.19). Results: The mean score of parents’ care burden was 52.76 ± 10.  Moreover, 17.6%, 71.2% and 11.2% of parents had low, moderate, and high care burden, respectively. Regression analyses indicated that the factors associated with care burden were cancer type (Acute myeloid leukemia (β=0.36, p<0.001) and Ewing sarcoma (β=0.16, p=0.007)), the number of hospitalization (β=0.38, p<0.001), duration of disease (β=-0.31, p<0.001), parent’s age (β=-0.29, p<0.001), parent’s income (β=-0.23, p<0.001), and child’s age (β=0.24, p<0.001). These variables accounted for 65% of the variance in care burden. Conclusion: The result of this study demonstrated that most of parents of children with cancer had moderate levels of care burden. Different variables increased care burden in parents. Therefore, planning for holistic interventions to reduce care burden in parents and improve quality of care is necessary.

Introduction: Due to the long-term and progressive nature of Alzheimer's disease, these patients need caregivers who will be responsible for their long-term care and who may then experience an increasing burden related to the progressive disease course, so it is important to understand the experiences of caregivers. The aim of this study was to explain the experience of family caregivers regarding care of Alzheimer's patients.Methods: The present qualitative study employed a conventional content analysis approach and was conducted in Iran in 2020. This research was done through in-depth and semi-structured interviews with 11 qualified caregivers enrolled in a purposive sampling method. Interviews continued until data saturation. Data analysis was performed simultaneously with data collection. Interviews were recorded, transcribed and analyzed through Graneheim and Lundman style content analysis and data management was done with MAXQDA software. In order to achieve the accuracy and validity of the study, the Four-Dimensions Criteria (FDC) by Lincoln and Guba, credibility, dependability, confirmability, and transformability were considered and used.Results: A total of 11 caregivers with mean age and standard deviation 48, ±26.12 participated in the study. The acquired data were put in two main categories of “burnout and exhaustion” with six subcategories and “excellence and personal growth” with three subcategories.Conclusion: In this study, we found that perceptions of caregivers' role were not the same among study participants, who experienced both positive and negative dimensions of care provision to AD patients. The care experience has a spectrum that, in some people, leads to positive outcomes such as growth. A major part of caregiver challenges is related to the burden of caregiving strain and the erosive nature of the disease. Therefore, health planners should identify the challenges, pain and suffering of caregivers and seek to address them through appropriate strategies.

Background: Osteoporosis is one of the most common metabolic bone diseases and is the silent epidemic of this era. Objectives: This study evaluates the effect of education that is based on the health belief model on promoting osteoporosis prevention behaviors among female high school students. Methods: In this two-group interventional study, 172 students age 11 to 14 years (experimental group = 86 subjects; control group = 86 subjects) were randomly selected from Khorramshahr high schools using multistage sampling. Data were collected before the intervention and two months after its completion using a researcher-made questionnaire with four parts: demographic questions, knowledge questions, questions related to the health belief model constructs, and questions regarding preventive behaviors. Data was analyzed using SPSS 22 software and by applying the Mann-Whitney test, the analysis of covariance procedure, and the Wilcoxon statistical test. Results: After the intervention, significant statistical differences were seen between the experimental and control groups in mean scores of knowledge, health belief model constructs, and preventive behaviors. Conclusions:The education based on health belief model plays an important role in increasing knowledge and improving osteoporosis prevention behaviors in students.

Background: Lifestyle is a key issue in the concept of health promotion. Lifestyle includes all activities that encourage optimum physical, spiritual, and mental functions. The aim of this study was to determine the effect of a training program based on PRECEDE-PROCEED Model on lifestyle of adolescents with beta thalassemia. Materials and Methods: In this clinical trial study, 64 adolescents (age 16-20) who referred to the Thalassemia Center of Ahvaz (2015) were selected and randomly divided into two groups: experimental and control group. The components of the PRECEDE-PROCEED Model were used for planning, implementation and evaluation of the program. Changes in predisposing, reinforcing, enabling factors and lifestyle were immediately and a month after the intervention were assessed by a questionnaire based on PRECEDE-PROCEED Model and the Health-Promoting Lifestyle Profile. Results: The intervention had significantly positive effect on predisposing, enabling and reinforcing factors immediately and a month after the intervention (P < 0.05). Repeated measures analysis of variance showed a significant positive increase in the six dimensions of lifestyle score in the experimental group from baseline to one-month follow-up (P < 0.05). Conclusion: This study showed that the theory-based training program in adolescents suffered from beta thalassemia disease could improve the adolescent’s awareness and attitude of healthy lifestyle.