Background: Patients with heart valve disease need to receive long-term care from their family members after surgical valve replacement. Thus, family caregivers should have adequate self-efficacy for patient care. Objectives: This study examined the effects of the family-centered empowerment model (FCEM) on self-efficacy and self-esteem among the family caregivers of patients with prosthetic heart valve. Methods: In this quasi-experimental study, forty patients together with one of their family caregivers were consecutively recruited and allocated to an intervention or a control group. The FCEM was used in three to five sessions for patients in the intervention group. Besides, we sent their family caregivers educational cards containing the same educations provided to their patients. Finally, an educational session was held for family caregivers in which their questions were answered and each of them was provided with an educational booklet containing the same materials as the educational cards. Patients and their family members in the control group received routine care. Self-efficacy and self-esteem of family caregivers were assessed before, 1 week, and 1.5 months after the intervention. Data analysis was performed through the independent-samples t- test and the repeated measures analysis of variance. Results: Before the intervention, the mean scores of self-efficacy in the control and the intervention groups were 26.68 ± 4.79 and 26.79 ± 5.49, whereas the mean scores of self-esteem in these groups were 33.74 ± 4.55 and 33.84 ± 4.72, respectively. None of the between-group differences were significant. After the intervention, the mean scores of self-efficacy and self-esteem in the intervention group were significantly greater than the control group (37.32 ± 2.68 versus. 29.89 ± 2.20 and 36.26 ± 3.66 versus. 29.26 ± 5.84; P < 0.05). Conclusion: The use of the FCEM promotes self-efficacy and self-esteem among the family caregivers of patients with prosthetic heart valve.

Background: Poor treatment adherence among patients with chronic conditions is a major global health-care problem. Objectives: The aim of this study was to compare the effects of interactive and noninteractive education using short message service (SMS) on treatment adherence and blood pressure among patients with hypertension (HTN). Methods: This single-blind pretest–posttest randomized controlled clinical trial was conducted on 63 adult patients with HTN who were consecutively recruited from a military hospital in Tehran, Iran, and were randomly allocated to an interactive SMS (ISMS), a non-ISMS (NISMS), and a control group. Initially, all patients in all groups were individually trained about HTN and adherence to its treatments in a 45-min session. Then, four messages were weekly sent for four consecutive months to those in the ISMS and the NISMS groups. The Treatment Adherence Questionnaire for Patients with Hypertension was used to assess treatment adherence both before and after the study intervention. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were also measured before and every 1 month during the study. Data were analyzed using the paired sample t, the Chi-square, and the Fisher's exact tests as well as the one-way and the repeated-measures analysis of variance. Results: At baseline, the mean score of treatment adherence was 81.43 ± 9.15 in the ISMS group, 81.14 ± 7.21 in the NISMS group, and 83.38 ± 14.43 in the control group. After the intervention, the mean score of treatment adherence in the ISMS group significantly increased to 89.67 ± 4.47 (P = 0.003), while it insignificantly changed to 83.24 ± 7.18 in the NISMS group (P = 0.15) and to 87.86 ± 6.62 in the control group (P = 0.16). The among-group difference respecting the posttest mean score of treatment adherence was statistically significant (P = 0.004). Although the means of SBP and DBP significantly decreased in both the intervention groups (P < 0.05) and did not significantly change in the control group (P > 0.05), the among-group differences respecting the variations of SBP and DBP across the four measurement time points were not statistically significant (P > 0.05). Conclusion: ISMS-based education is effective in significantly promoting treatment adherence, while neither interactive nor NISMS-based educations are effective in significantly reducing blood pressure among patients with HTN.

Background: Oral hygiene is a crucial nursing care in the intensive care unit (ICU) that can prevent ventilator-associated pneumonia. Objectives: This study compares the effect of mouthwash with Boswellia extract and chlorhexidine on the prevention of dental plaque formation in ICU patients having an endotracheal tube. Methods: A clinical trial was performed on 90 patients under mechanical ventilation in the ICU of Ayatollah Kashani Hospital in Isfahan, Iran, in 2018. The study data were collected using a demographic information form, a checklist, and the O'Leary dental plaque index (ODPI). The patients were randomly divided into two groups to receive mouthwash using solutions containing Boswellia or chlorhexidine. Data were analyzed using the Kolmogorov–Smirnov test, analysis of variance, independent samples, and paired t-tests. Results: Most of the patients were male (76.67%), with a smoking background (60%) and in the age range of 18–38 years. The two groups did not significantly differ in terms of demographic characteristics (P > 0.05). The mean ODPI was 0.89 ± 0.07 at baseline in the Boswellia group and changed to 0.67 ± 0.05 after the intervention (P < 0.001). Furthermore, the mean ODPI was 0.93 ± 0.03 in the chlorhexidine group and change to 0.77 ± 0.09 after the intervention (P < 0.001). Conclusions: Both Boswellia and chlorhexidine mouthwashes were effective in the prevention of dental plaque in patients under mechanical ventilation.

Background: Due to the characteristics of their work, nurses experience high levels of stress and burnout. Alexithymia (defined as the inability to identify and express emotions) and personality traits can be risk factors for burnout. However, there is limited information about the relationships of alexithymia and personality traits with job burnout among Iranian nurses. Objective: This study examined the relationships between alexithymia, personality traits, job burnout, and shift work among hospital nurses in Iran. Methods: This cross-sectional study was conducted in 2017 on a random sample of 225 nurses recruited from 10 hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran. Data collection instruments were the Toronto Alexithymia Scale, the Maslach Burnout Inventory, the Neuroticism, Extraversion, Openness Five-Factor Inventory, and a demographic questionnaire. Pearson's correlation analysis, independent-samples t-test, one-way analysis of variance, and multiple linear regression analysis were used for data analysis. Results: The mean scores of alexithymia and burnout were 56.78 ± 8.64 and 49.78 ± 13.67, respectively, and these two variables were significantly correlated (r = 0.258; P < 0.001). Alexithymia also had significant relationships with gender (P = 0.035), employment status (P = 0.045), and personality trait (P < 0.01) but had no significant relationship with shift schedule (P > 0.05). Conclusion: Nurses with higher levels of alexithymia are more at risk for burnout. As alexithymia has significant relationships with gender and employment status, interventions are needed, especially for women, to alleviate their alexithymia and burnout.

Background: Job characteristics (JCs) are an important factor in successful task performance and successful work adjustment (WA). Objectives: This study aimed to evaluate the relationship between JCs and WA among Iranian nurses. Methods: This descriptive correlational study was carried out in 2018 on 190 nurses randomly recruited from Shahid Beheshti University Hospital, Kashan, Iran. Data were collected using a demographic questionnaire, the JCs Questionnaire, and the WA Questionnaire. Data analysis was performed through the independent-samples t-test, the one-way analysis of variance, the Pearson correlation analysis, and the linear regression analysis. Results: The total mean scores of JCs and WA were, respectively, 70.43 ± 45.07 and 3.23 ± 0.43. JCs had significant but weak correlation with WA (r = 0.29; P = 0.001). JCs, age, and employment status were identified as predictors of WA (r² = 0.076; P = 0.001). Conclusion: Nursing managers can promote nurses' WA by paying greater attention to their perception of their JCs and promoting their professional autonomy.

Background: Extensive use of the internet has resulted in the emergence of a phenomenon called internet dependency. Internet dependency is turning into a major global concern due to its growing prevalence. It can negatively affect different personal, familial, occupational, and social aspects of life. Objectives: This study aimed to assess internet dependency and its predictors among faculty members. Methods: This cross-sectional study was conducted in 2014–2015 on 211 faculty members of Guilan University of Medical Sciences, Rasht, Iran. Internet dependency was measured using the Internet Addiction Inventory, an instrument which consists of items on factors related to Internet use. Data analysis was performed using the Kolmogorov–Smirnov, the Chi-square, the Fisher's exact, and the Kruskal–Wallis tests as well as the Spearman's correlation and the logistic regression analysis. Results: Seventy-five participants (35.5%) were at risk for internet dependency and the rest were in normal condition. The significant predictors of internet dependency were gender, main goal of internet use, and main type of internet use. Conclusion: As more than one-third of the faculty members are at risk for internet dependency, educational interventions are needed to broaden their knowledge about the negative effects of internet overuse and to help them modify their internet use behaviors.

Background: The parents of children with cancer suffer from different physical and psychological health problems due to the burden of caregiving to their ill children. The Caregiver Burden Inventory (CBI) is among the most commonly used instruments for caregiver burden assessment. There is no data about its psychometric properties among the parents of children with cancer in Iran. Objectives: This study aimed to evaluate the psychometric properties of the caregiver burden inventory in parents of Iranian children suffering from cancer. Methods: This methodological study was conducted from April to September 2018 in the southwest of Iran. CBI was translated into Persian through the forward–backward method, and its face and content validity were assessed through both qualitative and quantitative methods. Then, its construct validity was assessed using exploratory and confirmatory factor analyses, and its reliability was assessed using the internal consistency and the test-retest stability assessment methods. The data for exploratory and confirmatory factor analyses were obtained from two separate samples of 125 parents. Results: From the 24 items, two items were deleted during content validity assessment due to their incompatibility with the Iranian culture. The impact scores, content validity ratios, and content validity indices of the remaining 22 CBI items were respectively more than 1.5, 0.46–1, and 0.80–1, and the scale-level content validity index was 0.8. Exploratory factor analysis revealed a five-factor structure for the Persian CBI which explained 64.24% of the total variance. Confirmatory factor analysis confirmed the five-factor structure. The Cronbach's alpha and the test-retest intraclass correlation coefficient of the Persian CBI were 0.907 and 0.90, respectively. Conclusion: The Persian CBI has acceptable psychometric properties and can be used to assess caregiver burden among the parents of children with cancer in Iran.

Background: Burnout syndrome (BOS) is a serious issue among nurses due to chronic exposure to work-related stress. Objectives: The aim of this study was to determine the prevalence and associated risk factors of BOS among psychiatric nurses in a hospital in Saudi Arabia. Methods: In this cross-sectional study, 395 nurses were included through simple random sampling at a psychiatric hospital. The Maslach Burnout Inventory was used to measure the burnout. Multinomial logistic regression was used to determine the factors associated with BOS among nurses. Results: The mean age of the participants was 35.43 ± 7.04 years. Most study participants were married (69.1%) Saudi (74.7%) males (68.4%), and the average time of service in the hospital was 13 years. Most of the participants (82.3%) had burnout, ranging from mild to very severe. After adjustment for covariates, we found that severe BOS was reported among Saudi nurses (odds ratio [OR] 3.28 and confidence interval [CI] 1.28–8.37) and among ex-smokers (OR 4.9, CI 1.39–17.5). Single participants reported moderate BOS (OR 2.37 and CI 1.19–4.72). These values were statistically significant. Conclusions: BOS is prevalent among psychiatric nurses. The most common factors associated with BOS were Saudi nationality, single status, and being an ex-smoker. There is a need for counseling services for nurses to address this issue.