Background:The manner in which healthcare professionals deliver bad news affects the way it is received, interpreted, understood, and dealt with. Despite the fact that clinicians are responsible for breaking bad news, it has been shown that they lack skills necessary to perform this task.Objectives:The purpose of this study was to explore Iranian mothers’ experiences to receive bad news about their children cancer and to summarize suggestions for improving delivering bad news by healthcare providers.Materials and Methods:A qualitative approach using content analysis was adopted. Semi-structured interviews were conducted with 14 mothers from two pediatric hospitals in Iran.Results:Five major categories emerged from the data analysis, including dumping information, shock and upset, emotional work, burden of delivering bad news to the family members, and a room for multidisciplinary approach.Conclusions:Effective communication of healthcare team with mothers is required during breaking bad news. Using multidisciplinary approaches to prevent harmful reactions and providing appropriate support are recommended.

This study assessed the effect of foetal movement counting on maternal anxiety. In a randomised, controlled trial, 208 primigravida women with a singleton pregnancy were allocated either to perform daily foetal movement counting (n100) from 28 weeks ’ gestation or to follow standard Iranian antenatal care (n108). Maternal anxiety was measured by Spielberger State-Trait Anxiety Inventory. Statistical analysis was performed by SPSS (16.0). There was no significant difference in mean state and trait anxiety scores at 28 weeks ’ gestation; the difference was significant at 37 weeks ’ gestation in state anxiety score between the intervention and control groups (35.34 9.98 vs. 38.25 9.63, respectively, P0.001). A significant difference was found in mean trait anxiety score at 37 weeks ’ gestation between the two groups (35.88 8.19 vs. 39.15 9.25, respectively, P 0.008). Women who performed foetal movement counting from 28 to 37 weeks ’ gestation reported less anxiety compared with those in control group.

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Pregnancy outcome was similar in the two groups of fetal movement counting and control. Further studies are needed to evaluate the effect of fetal movement counting on the major outcomes of pregnancy such as intrauterine fetal death.

IntrOductIOnHigher education is an important type of investment in human resources which provides the knowledge, attitudes and skills required for students. The higher education plays a very critical role in the development of societies [1], and the educational services must be provided so that the students feel they are in a safe environment and thus providing more mental preparation for learning [2]. The educational institutions should teach the people who are responsible to take care of health in future generations and any neglect of duty, will create problems for societies [3].The universities have many clients whose consent depends on to student satisfaction [4], including their parents as the clients paying cost for the students' education, the companies as the clients employing them, and the faculty members as the clients teaching the students what they need for employing [5]. Among these clients, the students have attracted the most attention as the main customers of higher education and during the higher education they receive a variety of services including registration, course selection and other related services [6]. Therefore, the students' viewpoints toward the offered educational services can be considered a quality index of universities [7]. Knowing the students views about the educational services provided, is the essential factor for assessment of academic education quality [8]. Determination of what the students perceive and expect can provide valuable information for planners to promote the quality of educational services [9]. If the education officials are not aware of the students' expectations, it can cause dissatisfaction for them [10], besides, the lack of a direct relationship with the students makes the decision-makers fail to set the right priorities and the educational services are unable to meet the expectations of students and therefore, a gap in quality can be created. The lower gap between the expectations of students and education provided services represents the high quality of educational services provided.By determining the gap between the students' expectations and perceptions from the educational provided services, the planners can improve the quality of service and meet the students' needs [9].Several studies have examined the attitudes of students from the educational services. The studies which conducted in other countries, have reported that there is a negative gap between the students' expectations and perceptions from the quality of educational services, and the highest gap has been related to the assurance area [11]. A study in Iran reported that the students' expectations from the provided educational services were not met [12]. Another study of Iran reported that the students' expectations from the educational services were higher than their perceptions of these conditions. This study recommended that workshops on customer services, communication skills and personnel's technical skills development must be planned for and held. Moreover, allocating more resources to...

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Background:Development of practical skills in the field of nursing education has remained a serious and considerable challenge in nursing education. Moreover, newly graduated nurses may have weak practical skills, which can be a threat to patients’ safety.Objectives:The present study was conducted to compare the effect of concept mapping and conventional methods on nursing students’ practical skills.Patients and Methods:This quasi-experimental study was conducted on 70 nursing students randomly assigned into two groups of 35 people. The intervention group was taught through concept mapping method, while the control group was taught using conventional method. A two-part instrument was used including a demographic information form and a checklist for direct observation of procedural skills. Descriptive statistics, chi-square, independent samples t-tests and paired t-test were used to analyze data.Results:Before education, no significant differences were observed between the two groups in the three skills of cleaning (P = 0.251), injection (P = 0.185) and sterilizing (P = 0.568). The students mean scores were significantly increased after the education and the difference between pre and post intervention of students mean scores were significant in the both groups (P < 0.001). However, after education, in all three skills the mean scores of the intervention group were significantly higher than the control group (P < 0.001).Conclusions:Concept mapping was superior to conventional skill teaching methods. It is suggested to use concept mapping in teaching practical courses such as fundamentals of nursing.

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