Background: Many nurses experience job stress in their workplace. Given the wide range of differences in the statistics about job stress among nurses, the question that arises is what is the general prevalence of job stress among Iranian nurses? Objective: The present study aimed to evaluate the prevalence of job stress among Iranian nurses through meta-analysis. Persian and English databases including SID, MagIran, IranMedex, Google Scholar, Sciencedirect, and PubMed were searched by using the keywords such as “job stress, occupational stress, work-related stress, job related stress” and their combinations and 30 articles were finally selected. All the observational research articles that had information regarding the prevalence of job-related stress, sample size, and job stress instruments were entered into the meta-analysis. The form used to extract information included variables such as the first author's name, publication year, the place where the study had been carried out, type of the study, sample size, data collection instruments, and the most important findings. Results: The general prevalence of job stress was estimated to be 69% (confidence interval [CI] 95%: 0.58–0.79) based on the report of 30 papers with sample size of 4630. By region, type of hospital and the type of study, the highest prevalence of nurses' job stress was 90% (CI 95%: 0.85–0.96) in region one (Provinces of Alborz, Tehran, Qazvin, Mazandaran, Semnan, Golestan, and Qom), 70% (CI 95%: 0.60–0.80) in public and private hospitals, and 79% (CI 95%: 0.58–1.01) in studies where the type of study had not been mentioned. Conclusion: Given the high prevalence of job stress among nurses, developing programs to reduce nurses' job-related stress seems to be essential.

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Background: Menopause is associated with alterations in women's behaviors and sexual function. Altered sexual function can in turn causes serious health problems for women and negatively affect their marital relationships. Objective: This study aimed to investigate the effects of melatonin on the sexual function of postmenopausal women. Methods: This randomized double-blind placebo-controlled clinical trial was made in 2012–2013 on 240 postmenopausal women who aged 40–60 and referred to public obstetrics and gynecology clinics affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Participants were randomly divided into a melatonin and placebo group. Women in the melatonin and the placebo groups, respectively, received melatonin (3-mg tablets) and placebo for 3 consecutive months. Before and every 1 month during the intervention, participants' sexual function was assessed using Female Sexual Function Index. The repeated measures analysis of variance, the least significant difference, the independent sample t test, the Chi-square, and Fisher's exact tests were done for data analysis. Results: Sexual function mean score in the melatonin and placebo groups significantly increased from 12.49 ± 7.07 to 20.72 ± 8.57 and from 12.11 ± 7.82 to 15.55 ± 9.06, respectively. Yet, the amount of increase in the melatonin group was significantly higher than the placebo group. Moreover, there were significant differences between the groups regarding the variations of sexual function mean score across the four assessment points (P < 0.001). In addition, except for the baseline assessment point, the mean score of sexual function in the melatonin group was significantly greater than the control group at all other assessment points (P < 0.05). Conclusion: Melatonin significantly improves sexual function among postmenopausal women.

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Background: Oral health-related quality of life (OHRQOL) means the subjective perception of oral health and its impacts on the quality of life. It is an important indicator in oral surveys. Objectives: The aim of this study was to evaluate OHRQOL in older people in Kashan city (Iran) in 2015. Methods: In this cross-sectional study, 500 elders aged <60 years were evaluated. The Geriatric Oral Health Assessment Index (GOHAI) was used for data collection along with demographic and oral cavity characteristics. Mann–Whitney U, Kruskal–Wallis test, and multiple logistic regression were used for data analysis. Results: The 58.6% of participants were male. Mean age was 73.79 ± 10.13 years. The 284 (56.8%) participants were edentulousness. The GOHAI total score was 43.08 ± 8.35 that showed the above average scores of measurements. Statistical tests showed that the OHRQOL was significantly better in married persons, with negative history of smoking, and those who used mouthwash, toothpicks, regular tooth brush, and tooth floss (P < 0.05). In multiple regression analysis, the age, gender, education, the history of smoking, color of gum, number of decayed teeth, the firmness of gum, having denture, and frequency of tooth brushing could explain 38.7% of OHRQOL. Conclusion: The physical indicators of the oral cavity in older people of Kashan were not satisfactory although the OHRQOL was above medium level. In Kashan, it seems that use of full dentures is more common than other treatments such as filling caries or using implants.

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Background: Involving patients to make decision is a fundamental principle of patient's rights. It is also one of the components of cultural rights. Health professionals have undeniable role in this field through patient participation. “Power” is something that highlights this role. Objectives: This study aimed to explore the existing power imbalance between patients and practitioners and its influence on patient autonomy and cultural rights, based on cultural safety perspective. Methods: A critical ethnography was conducted in a nephrology ward. Data collection was started by observation to build a primary record undertaken over 7 months and continued by interview about 6 months. Data were analyzed using the reconstructive analytical approach, developed by Carspecken. Results: Two main themes from high-level coding were emerged one: suspense of uncertainty, information desperation, and alienation by the health care. Two: misunderstanding of patient participation, professional centrism, and abstract participation. Conclusion: The medical praxis has drawn a glass wall between patients and health professionals and divided them into two groups of “self” and “others”. The current dominant culture of medical centers could not provide an appropriate setting for ethical decision-making based on cultural right. This paternalistic view is a threat to the public discursive ethics and the cultural safety of patient as well in the medical and health-care settings.

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Background: No study is available on the effect of cognitive behavioral therapy (CBT) on self-esteem and quality of life (QOL) of amputee elderly patients. Objectives: This study aimed to examine the effects of CBT on self-esteem and QOL of hospitalized amputee elderly patients. Methods: A randomized controlled trial was carried out on a sample of 64 amputee elderly patients. The subjects were selected consecutively and then were randomly assigned into either the experimental or the control groups (32 patients in each group). The data collection instrument consisted of a demographic data form, the Rosenberg self-esteem scale, and the short form of the World Health Organization QOL Questionnaire (WHOQOL). Patients in the intervention group participated in six sessions of CBT and the control group received routine care. At the start and after the 3^rd week, all patients answered the Rosenberg self-esteem scale and the WHOQOL-short form. Descriptive statistics, Chi-square, Fisher's exact, and t- tests were used to analyze the data. Results: No significant differences were found between the intervention and the control groups regarding their baseline mean scores of self-esteem and QOL. The observed changes in the QOL and self-esteem of the control group were not statistically significant. However, significant statistical differences were observed between all mean differences in the two groups that indicate the positive effect of the intervention. Conclusion: The CBT employed in the present study could significantly improve the self-esteem and QOL in amputee elderly patients. The same protocol is suggested to be added into the rehabilitation process for amputee elderly patients.

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Background: Physical activity is among the most significant factors behind sleep quality. However, there are limited data on the effects of different types of physical activity on sleep quality. Objectives: This study aimed to compare the effects of aerobic and anaerobic exercise on sleep quality among male nonathlete students. Methods: As a three-group randomized controlled trial, this study was done on ninety male nonathlete nursing students of Zahedan Islamic Azad University, Zahedan, Iran. Students were randomly assigned to an aerobic exercise, an anaerobic exercise, and a control group. For 10 consecutive weeks, students in the aerobic and the anaerobic groups respectively attended aerobic and anaerobic exercise programs thrice a week. Data were collected using a demographic questionnaire and the Pittsburgh Sleep Quality Index and were analyzed using the one-way analysis of variance, the Tukey's post hoc, the Chi-square, and the paired-sample t-tests. Results: At baseline, the mean scores of sleep quality in the aerobic exercise, anaerobic exercise, and control groups were 4.06 ± 3.62, 4.56 ± 4.93, and 4.50 ± 4.01, respectively (P = 0.98). However, after the intervention, these values significantly changed to 2.03 ± 2.96, 1.96 ± 3.60, and 4.66 ± 4.16, respectively (P = 0.008). Pairwise between-group comparisons showed that the mean scores of sleep quality in both intervention groups were significantly lower than the control group (P < 0.05) while the difference between the intervention groups was not statistically significant (P > 0.05). Conclusion: Exercise, either aerobic or anaerobic, significantly improves sleep quality among male nonathlete students.

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Background: Heart transplantation has heartened many patients who suffer from end-stage heart diseases. Nonetheless, it is associated with many different outcomes which vary according to the immediate context. Objectives: This study aimed to exploring the outcomes of heart transplantation in a sample of Iranian patients. Methods: This qualitative study was done in 2014–2016 by using Graneheim and Lundman's approach to qualitative content analysis. A purposeful sample of heart recipients was recruited with maximum variation from hospitals of Tehran, Iran. Data were collected by semi-structured interviews. Data collection was continued until the categories were saturated. In total, seventeen interviews were done with fifteen heart recipients. Results: The main theme of the study was “Living under the perfect storm of problems.” The four main categories of this main theme were financial distress (with the subcategories of the shadow of financial strain on life, the inefficiency of financial support systems, struggle for managing the expenses), living with the consequences (with the subcategories of physical crisis, inability to perform roles, psychological problems), greater commitment to one's own health (with the subcategories of accepting responsibility for health, moving from ignorance to search for information), and tendency to spirituality (with the subcategories of reinforcement of religious beliefs and values, and gratefulness to the donors). Conclusion: During the posttransplantation period, heart recipients encounter difficult conditions, and so, they need to receive stronger support from healthcare organization and authorities. Besides, transplantation-associated financial problems make coping with transplantation more difficult, and hence, appropriate measures are needed to alleviate their financial problems.

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Background: Esthetic knowledge is invaluable to enhance nursing practice to high standards. Therefore, it should be clearly operationalized in a way that facilitates its evaluation. Objectives: The purpose of this study was to develop and evaluate the psychometric properties of the Esthetics of Nursing Care Scale (ENCS). Methods: This descriptive methodological study was part of a sequential exploratory mixed methods research carried out in 2014. The primary item pool was developed based on the results of a literature review and an interpretive phenomenological study on 12 nursing clients and 14 nurses purposefully recruited from six general and specialty hospitals in Iran. During psychometric evaluation, the face, content, and construct validity as well as internal consistency and stability of the scale were assessed. Results: The primary item pool contained 75 items while the final scale consisted of 38 items. Scale-level content validity index was measured twice; the results of both measurements were above 0.90. Exploratory factor analysis showed that the 38-item scale consisted of four factors which explained 60.75% of the total variance. Pearson correlation analysis between the score of the scale and the score of the “Caring Behavior Inventory” yielded a coefficient of 0.84 (P < 0.001). The Cronbach's alpha of the scale was 0.96. Moreover, intraclass correlation coefficient for test–retest stability with a 2-week interval was 0.93. Conclusion: The 38-item ENCS has high and acceptable validity and reliability. Therefore, it can be employed as an appropriate instrument for the evaluation of the esthetics and the quality of nursing care from patients' perspectives.

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Background: There is limited data about the effects of smoking cessation (SC) strategies among the candidates for coronary artery bypass graft (CABG) surgery. Objectives: This study aimed to compare the effects of nicotine replacement therapy (NRT) and nursing counseling (NC) on SC among the candidates for CABG. Methods: This randomized controlled trial was made in the heart center of Afshar hospital, Yazd, Iran. Sixty candidates for elective bypass graft were recruited and were randomly allocated either to a NC or a NRT group. Study interventions were implemented from 3 weeks before to 3 weeks after the surgery. Before and after hospitalization for the surgery, patients in the counseling group received telephone counseling while during their 1-week hospital stay, they received face-to-face counseling. Patients in the NRT group received nicotine gums before and after hospitalization and were treated with nicotine patches during their 1-week hospital stay. Data were collected through three questionnaires. The Chi-square and the independent-sample t tests were run to analyze the data. Results: SC rate in the counseling group was significantly higher than the NRT group (63.3% vs. 33.3%; P = 0.038). Moreover, cessation rate among the participants with lower nicotine dependency was significantly greater than those with moderate-to-severe dependency (P = 0.01). Conclusion: NC is more effective than NRT in improving SC rate among the candidates for CABG.

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