Background: Nursing and midwifery students experience high levels of stress, particularly during their clinical education. High levels of stress negatively affect general health. Reality therapy (RT) is a method with potential effects on stress. Objectives: The aim of this study was to evaluate the effects of group RT on general health among nursing and midwifery students. Methods: This quasi-experimental study was conducted in Autumn 2015 using a pretest-posttest design. Forty-six students were randomly allocated to an intervention (n = 23) and a control (n = 23) group. Participants in the intervention group received group RT in eight weekly sessions. The General Health Questionnaire was used for general health assessment both before and 1 month after the study intervention. The paired and the independent samples t- test and the Chi-square test were used for the data analysis. Results: There was no significant difference between the intervention and the control groups respecting the pretest mean score of general health (33.05 ± 14.91 vs. 30.34 ± 14.32; P = 0.528). However, the posttest mean score of general health in the intervention group was statistically significantly less than the control group (19.08 ± 10.27 vs. 29.39 ± 12.38; P = 0.004). Conclusion: Group RT can significantly improve general health among nursing and midwifery students.

Background: Rapid changes in communities necessitate the use of new-teaching methods in universities. Objectives: This study aimed to determine and compare the effects of traditional lecture and flipped classroom (FC) on learning, learning retention, and satisfaction among operating room students. Methods: This two-group quasi-experimental study was conducted in 2018–2019 in the Faculty of Nursing and Midwifery of Isfahan University of Medical Sciences, Isfahan, Iran. Forty-four operating room students who had enrolled in anesthesiology course were selected and randomly allocated to a lecture and a FC group. Data were collected using a researcher-made satisfaction questionnaire and two researcher-made knowledge examinations. Data analysis was performed using the Chi-square, independent-samples t, and paired-samples t-tests. Results: The mean scores of knowledge in the first and the second examinations in the FC group (i.e. 18.85 ± 0.83 and 17.47 ± 1.42, respectively) were significantly greater than the corresponding mean scores in the lecture group (i.e., 16.21 ± 1.99 and 12.90 ± 2.64, respectively) (P < 0.05). Moreover, the mean score of satisfaction in the FC group was significantly higher than the lecture group (169.44 ± 17.82 vs. 115.56 ± 17.57;P < 0.05). Conclusion: FC is more effective than traditional lecture in promoting students' satisfaction and short- and long-term learning.

Background: Nurses have distressing experiences during care provision, especially end-of-life care, which might lead to secondary traumatic stress (STS). The Accelerated Recovery Program (ARP) intends to decrease STS and promote recovery from trauma. Objectives: The aim of the present study was to determine the effect of ARP on recovery from STS among nurses.Methods: The study was carried out in Narayana Medical College Hospital, India. A pretest–posttest design with control group was adopted for the study. In the present study, 120 nurses who had STS were recruited and allocated to the intervention and control groups. Data were collected using the Trauma Recovery Scale. ARP with routine activities was implemented for nurses in the intervention group and routine activities for nurses in the control group for 5 weeks. Posttests I (5^th week), II (3^rd month), III (6^th month), IV (9^th month), and V (12^th month) were conducted. Descriptive and inferential statistics were used to analyze the data. Results: A statistically significant difference was observed between the intervention and control groups in the mean score of trauma recovery (P < 0.001) (Z value: 0.102, 9.511, 9.483, 9.51, 9.439, and 9.471). The repeated measures analysis of variance revealed a statistically significant difference in trauma recovery over a period of time among nurses (F: 201.54,P < 0.001) in the intervention (F: 101.126,P < 0.001) and control groups (F: 39.29,P < 0.001). Conclusions: The results show that ARP had a significant impact on the nurses and facilitated their recovery from trauma.

Background: Older adults who receive hemodialysis face different physiological and psychosocial stressors. Management of physiological and psychosocial stressors is among their basic needs for a desirable life. Objectives: This study aimed to evaluate the effects of telephone-based telenursing on perceived stressors among older adults receiving hemodialysis. Methods: This quasi-experimental study was conducted in 2018 on sixty older adults who were receiving hemodialysis. Participants were conveniently recruited from the hemodialysis centers of Shahid Beheshti and Imam Khomeini hospitals, Babol and Behshahr, Iran, and were randomly allocated to a control and an intervention group. A 3-month telephone-based telenursing program was implemented for participants in the intervention group. Physiological and psychosocial stressors were assessed before and after the study intervention. Data were analyzed using the Chi-square, paired-samples t, and independent-samples t-tests. Results: The mean score of physiological stressors in the intervention group statistically significantly reduced from 17.33 ± 1.74 at pretest to 11.96 ± 3.16 at posttest (P < 0.001), whereas it statistically insignificantly changed in the control group from 17.30 ± 1.66 to 17.16 ± 3.03 (P = 0.747). Moreover, the mean score of psychosocial stressors in the intervention group statistically significantly reduced from 57.80 ± 8.17 at pretest to 32.53 ± 5.84 at posttest (P = 0.001), but statistically insignificantly changed in the control group from 61.2 ± 9.03 to 62.53 ± 6.04 (P = 0.416). Although the between-group differences respecting the pretest mean scores of physiological and psychosocial stressors were not statistically significant (P > 0.05), there were significant between-group differences respecting the posttest mean scores and the pretest-posttest mean differences of both physiological and psychosocial stressors (P < 0.05). Conclusion: Telenursing is effective in significantly reducing perceived stressors among older adults receiving hemodialysis. Nurses can use telenursing to reduce stressors among this patient population.

Background: Striae gravidarum (SG) is one of the most common skin changes during pregnancy. Objectives: This study aimed to compare the effect of almond oil and sesame oil on the incidence of SG. Methods: A randomized controlled trial was conducted on 165 pregnant women referring to community health centers of Kashan, Iran. The participants in the two intervention groups received sesame oil or almond oil twice a day, from the 16^th week to the end of the 36^th week of gestation. The manifestations of SG and its severity were recorded at the end of the study. Data analysis was performed using descriptive statistics, Chi-square, one-way analysis of variance, and logistic regression analysis. Results: SG occurred in 63.60%, 60%, and 58.20% in the almond, sesame oil and control groups, respectively. No significant difference was found in the incidence of striae between the three groups in the 36^th week of gestation (P = 0.837). None of the confounding variables could predict the occurrence of striae (P > 0.05). Conclusion: Neither sesame oil nor almond oil could significantly affect the occurrence of SG. Given the controversies between the studies, further studies are required to evaluate the effect of almond oil and sesame oil in the prevention of the SG.

Background: Patients with cancer suffer from different symptoms which can cause discomfort, reduce quality of life, necessitate frequent hospitalization, and impose heavy costs. Health-care providers sometimes overlook symptom management, and hence, patients resort to self-treatment. Objectives: This study sought to assess the use of chemical drugs and medicinal plants for the symptom management among patients receiving chemotherapy. Methods: This cross-sectional study was conducted in 2017 on 186 cancer patients who referred to two chemotherapy centers in Kashan, Iran. Data were collected using a researcher-made instrument consisted of items on demographic characteristics, symptoms, symptom severity and duration, use of chemical drugs and medicinal plants, and their perceived effectiveness. Data were presented using the measures of descriptive statistics and were analyzed using the Spearman's correlation analysis. Results: The most common symptom was fatigue (89.2%), with moderate severity in 51.2% of participants. The least common symptom was vomiting (24.2%), with mild severity in 62.2% of participants. Vitamins and supplements were the most commonly used chemical drugs (40.3%). Chemical drugs had mostly been recommended by health-care providers. Only, 50% of patients with pain and 12.2% of patients with dry mouth and oral ulcer used chemical drugs. Medicinal plants were used by 87.4% of participants, without medical prescription. Conclusion: Cancer patients suffer from many symptoms which need careful assessment and effective management by health-care providers. These patients use medicinal plants more commonly than chemical drugs for symptom management, whereas chemical drugs are more effective. Symptom management among cancer patients is not effective enough, and hence, most of them resort to over-the-counter medicinal plants.

Background: Workplace violence (WPV) is a detrimental factor affecting nurses' health and performance. Individual protective factors such as resilience can assist nurses in coping with and adapting to workplace adversity. Objectives: The present study was aimed to determine the relationship between resilience and exposure to WPV in emergency nurses. Methods: This cross-sectional study was carried out on 118 emergency nurses in Tabriz educational hospitals, Iran. The participants were selected through a convenience sampling method. A demographic questionnaire, the Conner-Davidson Resilience Scale, and the Modified Questionnaire of Workplace Violence in the health sector were used for data collection. The data were analyzed using descriptive statistics, logistic regression analysis, t-test, and one-way analysis of variance. Results: The mean resilience score of nurses was 25.05 ± 5.79 in the possible range of 0–40. Most of the cases of violence were verbal threats (80.5%), and 56.7% of the exposures occurred during the night shift. Logistic regression showed that lower resilience predicted verbal threats (P = 0.001) and physical attacks (P = 0.038) against the individual. In addition to resilience, working on the night shift significantly predicted verbal threats (P = 0.008) against nurses. Conclusion: The resilience score was lower in nurses who exposed to violence. Empowerment programs are suggested to improve the resilience of nurses.

Background: Aging is associated with declines in individuals' physical and mental abilities. Technological assistance can improve older adults' independence, functional performance, and health. Objectives: The purpose of this study was to explore experiences regarding barriers to use technology in daily life among older adults. Methods: This qualitative study was conducted on twenty older adults referred to Urban Comprehensive Health Service Centers, Kashan. The main interview questions were “What does the word technology bring to your mind? Which electrical household appliances do you use during your daily life? and What are the barriers you experience during the use of technology?” Data were collected through semi-structured interviews and analyzed using conventional content analysis. Results: Three main themes emerged: aging-related barriers (physical and mental limitations), individual barriers (educational limitations, limited access to technology, and unfavorable attitudes toward technology), and barriers related to the appliances. Conclusion: Older adults experience multiple barriers to use technology in their daily life. Educational interventions may enhance older adults' utilization of technology in daily life of this population.

Background: Caregiving to patients with schizophrenia is burdensome for family caregivers and has profound effects on them. Objectives: This study aimed to explore the impacts of informal caregiving among the family caregivers of patients with schizophrenia. Methods: This qualitative study was conducted on a purposive sample of 12 family caregivers of patients with schizophrenia and 3 health-care providers. Semi-structured interviews were held for data collection, and conventional content analysis was used for data analysis. Results: Four main subthemes were developed during data analysis, namely threatened health, helplessness, patient abandonment, and personal growth. Together with their eight subcategories, these subthemes were grouped into the main theme of the “Consequences of caregiving burden.” Conclusion: Caregiving to patients with schizophrenia imposes heavy burden on family caregivers and has different consequences for them. The findings of this study can improve the knowledge and awareness of mental health and psychiatric nurses about schizophrenia and its consequences for family caregivers and can help them identify family caregivers who are at risk for negative consequences and design proper family-based interventions to reduce the effects of these negative consequences.

Background: Coronary artery bypass graft (CABG) surgery is commonly used to treat coronary artery disease. However, it is associated with significant physical and psychological problems. Objectives: This study was conducted to examine how body image changes after CABG surgery. Methods: This descriptive-correlational study was conducted on 140 patients consecutively recruited from Shahid Beheshti Medical Center, Kashan, Iran. The Multidimensional Body-Self Relations Questionnaire was used to assess the body image (BI) before, 2 weeks, and 4 weeks after the surgery (T1–T3). The independent-samples t- test and one-way and the repeated measures analyses of variance were conducted for data analysis. Results: Participants' possessed 60.69 ± 5.74, 67.67 ± 4.48, and 69.67 ± 3.37 percent of the BI scores at T1 to T3, respectively. The variations of BI scores were statistically significant across the measurement time points (P = 0.01). Male participants' BI was significantly better than females only at T2 (P < 0.01). BI had significant relationships with age, marital status, and educational status at T1, and employment status at T1 and T2 (P < 0.05). Similarly, single patients had better BI than their married counterparts (P = 0.02). Conclusions: CABG surgery improves BI. Considering the effects of BI on the patients' self-care behaviors, nurses should assess the cardiac patients BI, especially before surgery and employ programs for improving the patients BI.