Background: Labor pain (LP) is one of the most severe types of pain among women, and hence, effective LP management is a main goal of maternity care. Objectives: The aim of this study was to compare the effects of heat therapy (HT) and cold therapy (CT) on LP intensity among primiparous women. Methods: This randomized controlled trial was conducted in 2017–2018 on 99 primiparous women purposively selected from a teaching hospital in Iranshahr, Iran. Participants were allocated, through simple randomization, to an HT, a CT, and a control group. Participants in the HT group received HT using a warm-water bottle with a temperature of 38°C–40°C, and participants in the CT group received CT using an ice pack with a temperature of 0°C–5°C. HT and CT were applied to the lumbar area in the first phase of labor and to the perineal and suprapubic areas in the second phase. LP intensity was measured using the Visual Analog Scale at five time points, namely at a cervical dilation of 4 cm (i.e., before intervention onset), at a cervical dilation of 4–5, 6–7, and 8–9 cm (i.e., during the active labor phase), and in the second stage of labor. The SPSS software (v. 16.0) was used to analyze the data through the Chi-square test, the one-way analysis of variance, and the repeated measures analysis of variance. Results: A total of 93 participants completed the study. There was no significant difference among the groups respecting LP intensity at different measurement time points, except at the cervical dilation of 8–9 cm in which LP intensity in the CT group was significantly less than both the HT and the control groups (P < 0.05). Conclusion: CT is effective in significantly reducing LP intensity among primiparous women.

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Background: Fear of childbirth (FOC) is a common and complicated problem among nulliparous pregnant women. Objectives: The aim of this study was to compare the effects of expressive writing and neutral writing on FOC in nulliparous pregnant women. Methods: A randomized controlled trial was conducted on 90 nulliparous pregnant women referred to selected comprehensive health centers in Isfahan for prenatal care from May 1 to September 30, 2021. The participants were recruited consecutively and randomly allocated to two groups to perform either expressive writing or neutral writing at home for 20 min daily for 7 days. Before and after the intervention, FOC was measured using the Wijma Delivery Expectancy/Experience Questionnaire. Paired t-test, independent t-test, and Chi-square were used for statistical analysis. Results: The mean age of pregnant women was 29.93 ± 5.20 and 29.18 ± 5.65 years in the usual and expressive writing groups, respectively. The mean FOC scores of the women in the neutral writing and expressive writing groups were 36.31 ± 7.35 and 35.96 ± 6.80, respectively, at baseline (P = 0.81) and changed to 34.98 ± 8.18 and 31.58 ± 7.99, respectively, at the end of the study (P < 0.04). The paired t-test showed that the mean FOC score of the expressive writing group decreased significantly at the end of the study (P < 0.001), whereas it did not change significantly in the neutral writing group (P = 0.11). Conclusion: Expressive writing can reduce FOC in nulliparous pregnant women and can be used as an effective, low-cost, simple, and accessible method.

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Background: It is important to investigate the effectiveness of various educational methods in different cultural, educational, and clinical contexts. Objectives: This study aimed to compare the effects of task-based learning (TBL) and mentorship on clinical perioperative competence and clinical education condition of surgical technology students. Methods: A quasi-experimental study was conducted on 50 undergraduate surgical technology students of Hamadan University of Medical Sciences in 2021. Students were selected by the convenience sampling method and were randomized into one of the two groups of TBL or mentorship. Students completed a Perceived Perioperative Competence Scale-Revised questionnaire and a Clinical Education Conditions questionnaire before and after the intervention. Chi-square, independent, and pair samples t-tests were used for data analysis. Results: The pretest mean scores of perceived clinical competence and clinical education condition were, respectively, 106.56 ± 18.34 and 55.56 ± 9.45 in the TBL group and 99.72 ± 16.08 and 53.64 ± 6.89 in mentorship group. No significant difference was found between the two groups in mean overall clinical competence and mean clinical education condition (P > 0.05). After the intervention, the mean scores for perceived clinical competence and clinical education condition increased significantly to 128.92 ± 12.49 and 69.80 ± 6.38 in the TBL group (P < 0.001) and 120.24 ± 16.75 and 69.04 ± 7.23 in the mentorship group (P < 0.001). The posttest mean score of perceived clinical competence was significantly greater in the TBL group than in the mentorship group (P < 0.001). Conclusions: Both the TBL and mentorship methods are effective in improving the clinical competence and clinical education condition of undergraduate surgical technology students.

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Background: Premenstrual syndrome (PMS) is one of the most common causes of poor performance in girls and women. Objectives: The aim of this study was to examine the effect of group resilience counseling on PMS severity in adolescent girls. Methods: A randomized controlled trial was conducted on 120 high school girls in Hamadan, Iran. Participants were recruited conveniently and randomly assigned to an intervention group (n = 60) and a control group (n = 60). The intervention group participated in eight 1-h resilience counseling sessions, whereas the control group received no intervention. Data were collected using a demographic characteristics form, the Premenstrual Symptoms Screening Tool, and the Connor-Davidson Resilience Scale. The primary and secondary outcome measures were PMS severity and resilience score. The independent samples and paired samples t-tests were used to analyze the data. Results: Most of the participants in the intervention and control groups had severe PMS symptoms at baseline (61.7% and 63.3%, respectively). However, after the intervention, the majority of the intervention group reported mild (36.7%) or moderate (46.4%) symptoms (P < 0.001). No significant changes occurred in the control group. The mean total resilience score in the intervention group increased from 50.5 ± 14.9 to 67.3 ± 15.2 (P < 0.001). Conclusion: Resilience counseling for girls with PMS can reduce the severity of PMS.

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Background: Adolescent–parent conflict (APC) has damaging effects on both adolescents and parents and hence effective strategies for its management are necessary. Objectives: The aim of this study was to evaluate the effects of positive thinking (PT) education for adolescent girls on their conflicts with their mothers. Methods: This randomized controlled trial was conducted in 2019–2020. Participants were 48 adolescent girls conveniently selected from two high schools in Kashan, Iran, and randomly allocated to a control and an intervention group through block randomization. Participants in the intervention group received PT education in eight 90 min sessions held twice weekly. A demographic questionnaire and the APC questionnaire were used for data collection. Data were analyzed through the Chi-square, Fisher's exact test, independent-sample t-tests, and the repeated measures analysis of variance. Results: There was no significant difference between the intervention and the control groups respecting the pretest mean scores of APC frequency (244.250 ± 43.353 vs. 234.042 ± 36.218) and APC intensity (24.665 ± 14.244 vs. 27.220 ± 21.829). However, the mean scores of APC frequency and intensity in the intervention group were significantly less than the control group at the end of the study intervention (155.625 ± 28.740 vs. 240.458 ± 35.234 and 13.248 ± 10.660 vs. 35.670 ± 18.998) and 1 month later (122.708 ± 12.302 vs. 241.958 ± 34.719 and 9.693 ± 7.040 vs. 40.258 ± 19.001) (P < 0.05). Conclusion: Group PT education significantly reduces APC. Nurses, midwives, and mental health specialists can use PT education to reduce APC and improve the mental health of communities.

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Background: Despite frequent recommendations from the World Health Organization (WHO), hand hygiene compliance (HHC) is an ongoing challenge among health care workers (HCWs). Objectives: This study aimed to evaluate the HHC in Iranian nurses and midwives during the COVID-19 pandemic. Methods: This observational study was conducted on 200 nurses and midwives working in two hospitals in Jiroft, Iran in 2021. Data were collected using a demographic information checklist and the WHO Hand Hygiene Observation Form. Data analysis was performed using the MannWhitney U, Chi-square, Kruskal-Wallis, and Spearman correlation coefficient tests. Results: The average percentage of HHC in the nurses and midwives was 51.3%. HHC before touching the patient and before doing a clean/aseptic procedure was at the lowest rate (33.5% and 49%, respectively) but was at the highest rate (81.8%) after a body fluid exposure risk. Conclusions: The HHC rates were low among nurses and midwives during the COVID-19 pandemic. It is essential to implement interventions to promote HHC in HCWs, especially in pandemic conditions.

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Background: Varicose vein (VV) is a common problem that mostly occurs in legs. This medical condition can influence the quality of life and working condition of nurses. Objectives: The objectives of this study were to assess the prevalence and severity of VV and its related factors in nurses working in Shahid Beheshti Hospital, Kashan, Iran, in 2020. Methods: This cross-sectional study was carried out on 157 nurses. The participants were recruited in the study using systematic random sampling. The Occupational Sitting and Physical Activity and Aberdeen Varicose Vein Questionnaires were used for data gathering. The frequency of varicose and the mean score of the severity were calculated. The related factors were analyzed using Chi-square, Mann–Whitney, Spearman's correlation, and binominal logistic regression statistical tests. SPSS software version 16 was used for data analysis. Results: The prevalence of VV was 42% (66 nurses), the duration of varicose was 4.4 ± 3.6 years, and its severity score was 32.7 ± 9.5. In bivariate analysis, the female gender (P = 0.015), age (P = 0.002), work experience (P = 0.006), hyperlipidemia (P = 0.017), number of children (P = 0.007), regular exercise (P = 0.001), family history of varicose (P = 0.0001), hours of working overtime (P = 0.018), duration of standing (P = 0.002), walking (P = 0.039), and heavy work (P = 0.038) per day had a significant relation with the prevalence of varicose. In binary logistic regression, family history of varicose (odds ratio = 5.672), number of children (odds ratio = 2.462), and minutes of heavy working during a shift (odds ratio = 1.012) showed a significant relation with VV. No variable showed a significant relation with the severity of varicose. Conclusion: The prevalence of VV in the nurses working in Kashan was high, and many factors showed a significant relation with this problem. Nurses should be informed about preventive measures and treatments for this medical condition.

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Background: As the population ages, the impact of age-related diseases on health is becoming more apparent. Frailty is one of the most important issues faced by older adults. Objectives: This study aimed to determine the prevalence of frailty and the factors affecting it among older adults admitted to teaching hospitals in Ilam in 2020. Methods: This cross-sectional study was performed on 270 older adults admitted to teaching hospitals in Ilam. Participants were selected through consecutive sampling. Data were collected using the Tilburg Frailty Indicator and analyzed by the Chi-square test and logistic regression analysis. Results: The mean age of the older adults participating in the study was 71.97 ± 8.42 years. Overall, 18.1% of older adults were frail, and frailty was significantly associated with having a chronic disease, being accompanied by a close relative, hospitalization, age, sex, marital status, and education level (P < 0.05). The most important predictors of frailty in older adults were age, sex, history of stroke, and being accompanied by a close relative (P < 0.05). Conclusion: About one-fifth of the older adults participating in this study were frail. The prevalence of frailty was higher among women, those with chronic diseases or a history of stroke, single people, and those with low education levels. Therefore, these people need special attention.

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Background: Many nurses are uncertain when making clinical decisions, and this can lead to burnout and professional dissatisfaction. However, no study has addressed facilitators of uncertainty in clinical decision-making among Iranian nurses. Objectives: This study aimed to explore Iranian nurses' experiences of facilitators of uncertainty in decision-making. Methods: This qualitative content analysis study was conducted from June to December 2020. Participants were 17 nurses with bachelor's or higher degrees who were purposively recruited from three hospitals affiliated with Tabriz University of Medical Sciences. Data were collected through semi-structured interviews and analyzed through a content analysis method. Results: Participants' experiences were categorized into three main categories, namely, an unconfident nurse, complex situations, and unclear guidelines and policies. Each category included three to four subcategories. Conclusion: Nurses may experience uncertainty in clinical decision-making when confronted with ambiguous clinical situations or lack sufficient decision-making skills. Nurse leaders are suggested to develop educational programs and support interventions to promote nurses' decision-making skills and help them manage ambiguous situations.

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