Aim To assess nurses’ perceptions of systems thinking, safe nursing care and the correlation between them. Background Systems thinking and safe nursing care are the key elements of quality improvement approaches, such as accreditation and patient safety programmes. However, these two variables have not been well studied in different health care settings. Methods In this cross‐sectional study, 300 nurses were selected using the stratified random sampling method. The data were collected using a demographic data form, systems thinking scale and assessment of safe nursing care questionnaire. Results The scores of nurses’ perceptions of systems thinking (63.25 ± 9.20) and safe nursing care (4.13 ± 0.60) were above average. A positive correlation was found between systems thinking and safe nursing care (r = .66, p < .001), and its dimensions: nursing skills (r = .61, p < .001), psychological needs (r = .56, p < .001), physical needs (r = .51, p < .001) and teamwork (r = .56, p < .001). Conclusion Regarding the correlation between systems thinking and safe nursing care, nurses and other medical professionals, especially novices, are recommended to strengthen their systems thinking skills to improve the safe nursing care. Implications for Nursing Management Nurse managers should deal with organisational condition and factors affecting some poor aspects of systems thinking and safe nursing care. They must lead, support and allocate resources to the foundations of systems thinking to achieve safe nursing care.

Background Female sex workers and addicted women are among the vulnerable groups who impose high costs on the health system of every society. They are prone to psychological problems such as anxiety, stress, and reduced resilience due to their lifestyles. Since mindfulness-based stress reduction (MBSR) has been applied frequently by many psychotherapists to treat stress and anxiety, the present study investigated the effectiveness of MBSR on resilience of the vulnerable women. Methods The statistical population of this quasi-experimental study consisted of all eligible women who referred to the drop-in centers in Kerman in the southeast of Iran. Followed by random sampling, 63 vulnerable women were randomly assigned into the intervention (n = 30) and control (n = 33) groups. The MBSR intervention was conducted for the intervention group in eight 90-min sessions. Demographic information questionnaire and Connor-Davidson resilience scale were administered to collect data prior to and one month after the MBSR intervention. Results The pre-test resilience score was not significantly different between the intervention (53.40 ± 10.49) and the control (54.5 ± 9.27) groups (t = 0.43, p = 0.66). However, the posttest resilience score in the intervention group (60.66 ± 6.71) was significantly higher than the control group (53.88 ± 7.54) (t = 3.58, P = 0.001). Moreover, a comparison between the pretest and posttest scores revealed a significant decrease in resilience scores of the control group (t = 2.81, p = 0.009). Conclusion Since MBSR intervention increased resilience of the vulnerable women in the intervention group, researchers, managers, counselors, community health nurses, and psychiatric nurses are suggested to implement related interventions to promote the health of women, especially vulnerable ones.

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BackgroundNowadays, drug abuse is one of the most important health problems that can affect the quality of life of people in mental, psychological, physical, and social dimensions. Theory-based education can help the adolescents to promote their drug abuse preventive behaviors.ObjectivesThe aim of this study was to determine the effectiveness of education based on the health belief model (HBM) on drug abuse preventive behaviors in adolescent students.MethodsThis study was an interventional quasi-experimental study with a pre-test/post-test design conducted in two high schools in the southeast of Iran. A two-step cluster sampling method was used and 120 students were randomly selected and categorized into the control (n = 60) and intervention (n = 60) groups. The intervention group participated in an education program based on the HBM in four 75-min sessions. Data were collected using demographic and drug abuse preventive behavior questionnaires based on the HBM.ResultsIn the pre-test stage, the mean scores of drug abuse preventive behaviors and its dimensions were not significantly different between the intervention and control groups (t = −2.597 p = 0.641). In the post-test stage, the mean scores of the intervention and control groups were significantly different; the drug abuse preventive behaviors and its dimensions improved in the intervention group (t = 14.57, p < 0.001).ConclusionThe findings showed that education based on the HBM had a significant effect on drug abuse preventive behaviors and its dimensions. Therefore, educational packages based on the HBM are recommended to improve these behaviors in adolescents.

Background: The imprisoned women usually have low self-esteem and suffer from various physical and mental complaints; they may suffer from feelings of emptiness, isolation, and depression. Transactional analysis (TA) is part of a comprehensive system attributed to the individual and social psychiatry for personal development of selfesteem among the imprisoned women. Therefore, the present study aimed to investigate the effect of TA grouptraining on the self-esteem of imprisoned women. Methods: This clinical trial was conducted among the imprisoned women in a prison in Southeastern Iran using pretest-posttest design. In this regard, 76 women were randomly allocated to the intervention (n = 35) and control (n = 41) groups. The TA group-training program was held for eight 90-min sessions for the intervention group. Data were collected using a demographic questionnaire and the Rosenberg's self-esteem scale (RSES). Later, all participants were evaluated before and 1 month after the intervention. Results:In pre-test, the mean scores of self-esteem were 11.8 ± 4.67 and 7.97 ± 4.52 for the intervention and control groups, respectively. These scores showed low levels of self-esteem and the difference between the two groups was significant (p = 0.001, t = − 3.61). In the post-test, the mean scores of self-esteem improved to the moderate level (22 ± 2.52) in the intervention group compared to the control group (8.92 ± 4.04). This indicates the significant improvement of self-esteem in the intervention group (p = 0.001, t = 17.15). Conclusions:The results showed that TA group-training had a significant effect on self-esteem. Therefore, the experienced and expert counselors and psychologists are recommended to hold transactional analysis grouptraining courses to enhance self-esteem among women prisoners.

Background Reduction of the adaptation and self-esteem can be the consequence of opium addiction and imprisonment. Drug use causes inappropriate behaviors in women, which are quite different from those in men. Social deviations, prostitution, high-risk sexual behaviors, abortion, divorce and imprisonment followed by loss of self-esteem are the consequences of women's addiction. The present study was conducted to assess the relationship between adaptation and self-esteem in addicted female prisoners. Methods In this descriptive analytical study, 130 addicted female prisoners were selected from a prison in the south east of Iran using census sampling. The data were collected by a demographic questionnaire, the Rosenberg's self-esteem scale and the bell adjustment inventory (BAI). Results According to the results, women's adaptation fell into the 'very unsatisfactory' range. The highest mean was related to the emotional dimension, while the lowest mean was in terms of the health dimension. In total, 96.4% of the participating women had low adaptation. The mean total self-esteem fell into the low range; in fact, 84.6% of the women had a low self-esteem. The results showed no significant relationships between adaptation and self-esteem in these women; however, self-esteem was significantly and inversely related to health and emotional adaptation. Conclusion The findings showed that the majority of the women had unsatisfactory adaptation as well as poor self-esteem. No significant relationships were observed between adaptation and self-esteem in the addicted female prisoners.

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