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Background: Stroke survivors have residual neurological impairment, which requires long-term support and care. In this situation family involvement in care process is necessary. However, as the family caregivers of stroke survivors are not necessarily supported by the health-care professionals, and they often feel inadequately prepared to deal with the physical, cognitive and emotional needs of the stroke survivors. Aim: The aim of this study was to investigate the effects of a family-centered care program on stroke patients' adherence to their therapeutic regimens. Methods: This is a posttest-only randomized controlled trial study, conducted on stroke patients and their family care-givers. The control group (n = 30) received only routine hospital services and the experimental group (n = 30) received routine hospital services plus a family-centered care program consisting of four steps; need assessment, educating families based on patients' needs, follow-ups by short phone interviews, and referral service. The data were collected via a demographic data form and "Adherence to the therapeutic regimens" Questionnaire between July 2011 to March 2012 and lasted two months for each subject. Data were assessed and analyzed with SPSS version 18. Findings: Study findings showed that the levels of adherence to the different components of the therapeutic regimens, including rehabilitations, medications and dietary regimen are significantly higher in the experimental group compared to the control group (P value< 0.001). Conclusion: By empowering patients' families and improving their adherence to the therapeutic regimens, family-centered care programs will be able to play an important role in management of physical and mental health of stroke patients.

Aim Adolescence is a developmental period often associated with high-risk behaviors. While some risk-taking behavior is considered normative in adolescents, research has indicated an association between risky behaviors and mental ill-health. The current research aimed to examine the relationship between anxiety and depression with the occurrence of high-risk behaviors in adolescents and also determine the predictive factors of these main variables. Methods A descriptive, cross-sectional, correlational design was used to collect data from 399 adolescents between the ages of 14 and 19 residing in Qazvin, Iran using the Revised Child Anxiety and Depression Scale (RCADS) and the Iranian Adolescents Risk-taking Scale (IARS) between the period of October and November 2015. Data analysis included descriptive and inferential statistics powered by SPSS (v. 23). Results Mean scores for anxiety, depression and risky behaviors were 37.70 ± 21.11 and 80.76 ± 31.30, respectively. Participants' frequency of suicidal thoughts (β = 0.126, p < 0.05) positively predicted anxiety and depression, while age (β = -0.126, p < 0.01) and self-confidence (β = -0.307, p < 0.001) negatively predicted anxiety and depression. Moreover, having friends that smoke (β = 0.366, p < 0.001), suicidal thoughts (β = 0.127, p < 0.01), and the strength of suicidal thoughts (β = 0.100, p < 0.05) were positive predictors of occurrence of risky behaviors. Furthermore, religious belief (β = -0.204, p < 0.001) negatively predicted occurrence of risky behaviors in Iranian adolescents. Male respondents were more likely to have higher level of occurrence of risky behaviors than females (β = -0.193, p < 0.001). Conclusion Findings of the present study suggest that anxiety and depression positively and significantly predict the occurrence of risky behaviors in addition to having friends that smoke, suicidal thoughts, and strong suicidal thinking. The implications of these findings have relevance for screening, prevention, and treatment interventions targeting mental health in adolescents.

Background Pulmonary disorders and poor functional capacity are common complications in patients under hemodialysis. Although breathing exercise is frequently prescribed to improve respiratory function, its efficacy in this patient community is not well established. Purpose Our study was designed to determine the effectiveness of a breathing exercise on respiratory function and 6-minute walk (6MW) distance in patients under hemodialysis. Methods A randomized controlled trial approach was used. The sample consisted of 52 patients under hemodialysis from a university teaching hospital in Iran. The experimental group (n = 26) received the breathing exercise program and was encouraged to perform incentive spirometry for 2 months. The control group (n = 26) received only routine hospital care. The respiratory function test and 6MW test were performed at baseline and at 2 months after the intervention (posttest). Results The two groups were homogeneous in terms of respiratory function parameters, 6MW distance, and demographic characteristics at baseline. Forced expiratory volume in 1 second and forced vital capacity were significantly better in the experimental group compared with the control group at 2 months after intervention. No significant difference was found in 6MW distance between the groups at the 2-month posttest. Conclusions/Implications for Practice The 2-month breathing exercise effectively improved pulmonary function parameters (forced vital capacity, forced expiratory volume in 1 second) in patients under hemodialysis but did not affect 6MW distance. Hemodialysis nurses should strengthen their clinical health education and apply breathing exercise programs to reduce the pulmonary complications experienced by patients under hemodialysis.

Objectives: Iran is facing a big challenge controlling the COVID-19 outbreak and it is unclear to how individuals are engaging in preventive behaviors. This study aimed to investigate changes in preventive behaviors during the first three months of the COVID-19 outbreak in Iran. Method: This cross-sectional survey was conducted on 1477 adults aged 18years and older in 31 provinces of Iran. Data was collected by an anonymous online questionnaire. Result: Overall, engagement in preventive behaviors was relatively acceptable and more than 45% of subjects always carried out all preventive behaviors. Engaging in the all preventive behaviors had a peak in the second month and obviously declined during third month. Engagement in some preventive behaviors such as “wearing a face mask” and “keeping a safe distance from others” observed less than other behaviors. There was statistically significant difference in the engagement in preventive behaviors by gender and occupation (P<0.001). Conclusion: Although engagement in preventive behaviors was relatively acceptable at first two months of the outbreak, it has declined gradually. This is a warning for public health decision makers. COVID-19 is still a crucial issue in Iran and it is necessary that government decision be based on the fact that Iranian people must live with a coronavirus for months, with full caution and compliance toward all preventive care protocols.

Discourse analysis (DA) is an interdisciplinary field of inquiry and becoming an increasingly popular research strategy for researchers in various disciplines which has been little employed by health-care researchers. The methodology involves a focus on the sociocultural and political context in which text and talk occur. DA adds a linguistic approach to an understanding of the relationship between language and ideology, exploring the way in which theories of reality and relations of power are encoded in such aspects as the syntax, style, and rhetorical devices used in texts. DA is a useful and productive qualitative methodology but has been underutilized within health-care system research. Without a clear understanding of discourse theory and DA it is difficult to comprehend important research findings and impossible to use DA as a research strategy. To redress this deficiency, in this article, represents an introduction to concepts of discourse and DA, DA history, Philosophical background, DA types and analysis strategy. Finally, we discuss how affect to the ideological dimension of such phenomena discourse in health-care system, health beliefs and intra-disciplinary relationship in health-care system.

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Introduction:Understanding how academic dominant discourse is implicated in the shaping of nursing identity, professional aspirations and socialization of nursing students is useful as it can lead to strategies that promote nursing profession.Materials and Methods:This is a qualitative research conducted through discourse analysis approach. Semi-structured interviews, focus group, and direct observation of undergraduate theoretical and clinical courses were used to collect the data. Participants were 71 nursing students, 20 nursing educators, and 5 nursing board staffs from five universities in Iran.Results:Data analysis resulted in the development of four main themes that represent essential discourses of nursing education. The discourses explored are theoretical and scientific nursing, domination of biomedical paradigm, caring as an empty signifier, and more than expected role of research in nursing education discourse.Conclusions:The results indicated that academics attempt to define itself based on “scientific knowledge” and faculties seek to socialize students by emphasizing the scientific/theoretical basis of nursing and research, with the dominance of biomedical discourse. It fails to conceptually grasp the reality of nursing practice, and the result is an untested and impoverished theoretical discourse. The analysis highlights the need for the formation of a strong and new discourse, which contains articulation of signifiers extracted from the nature of the profession.