Iranian Journal of Nursing and Midwifery Research1735-906630520250923617624EN1.Doctoral Program in Medical and Health Sciences, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia, 2.Department of Maternity Nursing, Faculty of Medicine, Health of Sciene, Universitas Muhammadiyah Purwokerto, Indonesia,Department of Child Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, IndonesiaPediatric and Maternity Nursing Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, IndonesiaNursing Programme, Faculty of Nursing, University College of MAIWP International (UCMI), MalaysiaPediatric and Maternity Nursing Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia,Department of Maternity Nursing, Faculty of Medicine, Health of Sciene, Universitas Muhammadiyah Purwokerto, Indonesia20250908<p><strong>Background: </strong>The recommendation to breastfeed is based on its numerous benefits. Challenges in breastfeeding success involve both the mother and baby. Immediate skin‑to‑skin contact after birth helps the baby learn to suckle naturally. This review aims to explore breastfeeding interventions and outcomes throughout the breastfeeding journey. <strong></strong></p><p><strong>Materials and Methods: </strong>The research employed a scoping review methodology to assess breastfeeding interventions and outcomes in postpartum mothers. The scoping review followed Arksey and O’Mallee’s (2005) methodological framework, and the literature search was conducted using databases such as PubMed, Scopus, Cochrane Library, and Web of Science. Duplicate articles were removed, and the remaining articles published between 2000 and 2023 were reviewed by multiple authors to ensure alignment with the established criteria. <strong></strong></p><p><strong>Results: </strong>Twenty‑four articles of the review regarding breastfeeding interventions encompass nutritional support for mothers, maternal massage, education, and relaxation techniques. As for the outcomes associated with breastfeeding, the review examined factors such as milk production, postpartum comfort, breastfeeding support, self‑efficacy in breastfeeding, breastfeeding knowledge, duration of breastfeeding, breastfeeding success, and maternal stress levels. <strong></strong></p><p><strong>Conclusions: </strong>This scoping review highlights the potential benefits of maternal massage and educational interventions for improving breastfeeding outcomes in postpartum mothers. Practical applications could include offering maternal massage services or training, comprehensive breastfeeding education programs focused on skills, knowledge, and self‑efficacy, and tailored support for mothers facing low milk supply or breastfeeding challenges. Future research should optimize such interventions’ timing, delivery methods, and cultural adaptations across diverse breastfeeding populations.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2281http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2281/70707871

Iranian Journal of Nursing and Midwifery Research1735-906630520250923625633ENStudent Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR, Iran, 2Department of Military Nursing, Faculty Member, AJA University of Medical Sciences, Tehran, IranNursing Care Research Center, Clinical Sciences Institute, Management Department, Nursing Faculty of Baqiyatallah University of Medical of Sciences, Tehran, IranNursing Care Research Center, Clinical Sciences Institute, Pediatric Department, Nursing Faculty of Baqiyatallah University of Medical of Sciences, Tehran, Iran,Department of Medical Surgical Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, IranBehavioral Sciences Research Center, Life Style Institute, Management Department, Nursing Faculty of Baqiyatallah University of Medical of Sciences, Tehran, Iran20250908<p><strong>Background: </strong>Ethical conflict is an integral part of the clinical environment, and nursing students face similar conflicts. Identifying these conflicts aids their educational development. This study aimed to explore factors influencing the formation of ethical conflicts in nursing students during their training. <strong>Materials and Methods: </strong>This qualitative review and meta‑synthesis, conducted in Iran in 2024, followed Sandelowski and Barroso’s seven‑step model. A comprehensive literature search (2000–2023) was performed to identify qualitative studies on nursing students’ ethical conflicts in educational settings. Databases searched included PubMed, Scopus, Web of Science, and ProQuest, alongside the search engine Google Scholar, using keywords such as ethical conflict, clinical education, and nursing students. The identified studies were assessed using the Mixed Methods Appraisal Tool (MMAT). <strong>Results: </strong>From 3469 primary studies, 11 articles showed that the most important factor was the professional‑educational conflict in an incompatible environment. In this study, we found three main factors related to professional ethics, organizational interactions, and care skills, and different subgroups were identified in each main category. <strong>Conclusions: </strong>This meta‑synthesis identified ethical conflicts in educational environments as a significant factor among healthcare providers. The findings emphasize the need for a deeper investigation of ethical conflicts, particularly in clinical education, using both quantitative and qualitative methods. Additionally, it is recommended that educational programs focus on ethical decision‑making, improve organizational support for interactions, and conduct regular ethical assessments to create a more supportive professional environment and ultimately enhance patient care.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2282http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2282/70707872

Iranian Journal of Nursing and Midwifery Research1735-906630520250923634640ENVocational School, Sebelas Maret University, Central Java, IndonesiaDepartment of Nursing, Health Polytechnic of the Ministry of Health, Sorong, IndonesiaDepartment of Nursing, Universitas Respati Yogyakarta, IndonesiaDepartment of Nursing, Health Polytechnic of the Ministry of Health, Sorong, Indonesia20250908<p><strong>Background: </strong>Breastfeeding is essential for infant health, yet many mothers face difficulties in milk production, often linked to psychological stress. Neuro‑Linguistic Programming (NLP) is a psychological method that may improve emotional wellbeing and lactation outcomes.</p><p><strong>Materials and Methods: </strong>A quasi‑experimental study was conducted in Sorong, Southwest Papua (March–April 2024), involving 70 breastfeeding mothers with infants aged 0–6 months. Participants were randomly assigned to an intervention group (n = 35), which received a 4‑week NLP program, or a control group (n = 35), which received standard breastfeeding education. Each NLP session lasted 60 minutes weekly. Outcomes included daily breast milk volume (measured with calibrated cups), stress (Perceived Stress Scale, PSS), and emotional wellbeing (maternal self‑confidence, emotion regulation, and marital satisfaction). Assessments were conducted at baseline, immediately post intervention, and 1 month later.</p><p><strong>Results: </strong>The intervention group showed a significant increase in milk production (from 450 ml to 600 ml/day; <em>p </em>&lt; 0.05), while the control group remained stable. Stress scores declined in the intervention group (PSS: 22.4 to 14.5), with minimal change in the control group. Emotional wellbeing improved significantly across all domains in the intervention group compared to controls (<em>p </em>&lt; 0.05). <strong></strong></p><p><strong>Conclusions: </strong>NLP significantly enhances emotional wellbeing and milk production among breastfeeding mothers. These findings support incorporating NLP‑based psychological strategies into maternal health programs, particularly in high‑stress or low‑resource settings. Further research with larger and more diverse populations is recommended.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2283http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2283/70707873

Iranian Journal of Nursing and Midwifery Research1735-906630520250923641645ENNursing Department, Universitas Muhammadiyah Surakarta, Indonesia,Sub-acut Unit Mental Health Hospital of Surakarta, Indonesia,Faculty of Medicine, Universitas Muhammadiyah Surakarta, IndonesiaFaculty of Medicine, Universitas Muhammadiyah Surakarta, IndonesiaNursing Department, Universitas Muhammadiyah Surakarta, Indonesia,Nursing Department, Universitas Muhammadiyah Surakarta, IndonesiaNursing Department, Universitas Muhammadiyah Surakarta, Indonesia20250908<p><strong>Background: </strong>Delusions are common positive symptoms in schizophrenic patients. Individuals with delusional disorders have different experiences in memory and beliefs. Exploring patients’ delusional beliefs is crucial to ascertaining appropriate psychotherapy programs. A few studies have explored the meanings of delusions for delusional patients. This study explores how schizophrenic patients lived experiences about their delusional beliefs. <strong></strong></p><p><strong>Materials and Methods: </strong>The study was carried out at a psychiatric hospital in Indonesia in 2021. The participants included 30 adult schizophrenic patients who had delusional life experiences and were able to communicate. Open‑ended questions and probes were applied during in‑depth interviews. We interviewed family members as well to improve the rigor of the research. Interpretative Phenomenological Analysis was used in this study. <strong></strong></p><p><strong>Results: </strong>The patients’ clinical history revealed the experiences of failure and loss. Two main themes shaping their delusional experiences included demonic forces and magical powers. <strong></strong></p><p><strong>Conclusions: </strong>Patients with delusions had similar themes, but each had a different specific experience. The findings suggest that each patient may require a unique cognitive therapy based on their experience.</p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2284http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2284/70707874

Iranian Journal of Nursing and Midwifery Research1735-906630520250923646652ENNursing Management Department, Nursing and Midwifery Care Research Center, Health Management Research Institute, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran,Nursing Management Department, Nursing Care Research Center, Health Management Research Institute, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, IranDepartment of Epidemiology and Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran20250908<p><strong>Background: </strong>Nurses play a crucial role in providing care in Intensive Care Units (ICUs). This study aimed to compare the time spent and types of direct and indirect nursing care provided to patients during COVID‑19 pandemic.</p><p><strong>Materials and Methods: </strong>This observational study was conducted in the ICU of Hafthome‑Tir Hospital, Tehran, in 2022. The activities of 42 randomly selected nurses were continuously observed and recorded, focusing on direct and indirect care as per the revised International Classification for Nursing Practice checklist. Data were analyzed using dependent <em>t</em>‑test (<em>p </em>&gt; 0.05). <strong></strong></p><p><strong>Results: </strong>The data showed that the highest average time for direct care spent on cardiopulmonary resuscitation was 27.30 (6.10) minutes, while the least time for deltoid injections was 4.8 (2.9) minutes. In indirect care, the most time was spent writing reports, 34.90 (10.50) minutes, and the least time spent removing personal protective equipment was 6.11 (3.19) minutes. During data collection, 19 procedures were added to the nursing care checklist due to COVID‑19. A dependent <em>t</em>‑test showed a significant difference between direct and indirect ICU nursing care (t= -6.62, df = 41, <em>p </em>&lt; 0.001), indicating more time was spent on indirect care. <strong></strong></p><p><strong>Conclusions: </strong>The findings showed indirect care was provided more frequently than direct care, highlighting the need to reassess nursing care delivery methods. The increased demand for indirect care is attributed to time and staffing shortages, along with a rise in patient numbers and hospitalizations compared to pre‑COVID conditions.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2285http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2285/70707876

Iranian Journal of Nursing and Midwifery Research1735-906630520250923653660ENDepartment of Nursing, Arsanjan Branch, Islamic Azad University, Arsanjan, Iran,2Department of Mental Health and Psychiatric Nursing, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Mental Health and Psychiatric Nursing, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Public Health Nursing, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran,Department of Educational Psychology, Faculty of Islamic Education, Islamic Azad University, Islamshahr Branch, Tehran, Iran20250908<p><strong>Abstract</strong></p><p><strong>Background: </strong>Self‑efficacy of care is based on health‑promoting behaviors that are formed through dealing with disease conditions and the ability to treatment adherence and management of complications. This study was conducted to design and validate an assessment tool for adolescents with mental disorders. <strong></strong></p><p><strong>Materials and Methods: </strong>This study employed a mixed‑methods approach to develop a questionnaire aimed at measuring self‑efficacy of care among adolescents with mental disorders. Content validity was assessed using both qualitative and quantitative methods, while exploratory and confirmatory factor analyses, convergent validity, and reliability were evaluated through quantitative approaches. Participants, including nurses, psychologists, and adolescent patients, were selected through convenience sampling. The data was analysed using SPSS (version 25.0, Chicago: SPSS Inc.) and LISREL (version 8.72, Jöreskog and Sörbom, 2005) software. <strong></strong></p><p><strong>Results: </strong>Initially, an item pool consisting of 87 items was generated based on findings from the original research. Following face and content validation, and subsequent exploratory factor analysis, 28 items across four factors were identified: “health information seeking behavior”, “adaptation of life to disease conditions and treatment”, “adaptive coping”, and “social self‑care”. The factorial structure of the questionnaire was confirmed through confirmatory factor analysis. Convergent validity, assessed using the General Self‑Efficacy Scale, was positive and statistically significant (<em>P </em>&lt; 0.01). The reliability of the questionnaire was high, with a Cronbach’s alpha coefficient of α =0.93. Test‑retest reliability also confirmed the instrument’s stability (<em>r </em>= 0.92). Finally, all indicators specified in the COSMIN checklist were confirmed. <strong></strong></p><p><strong>Conclusions: </strong>The questionnaire demonstrated strong internal consistency and confirmed construct validity. Therefore, this instrument can be reliably used in both clinical and research practices.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2286http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2286/70707875

Iranian Journal of Nursing and Midwifery Research1735-906630520250923661666ENDepartment of Adult Nursing, College of Nursing – University of Baghdad, Baghdad, Iraq,Department of Adult Nursing, College of Nursing – University of Karbala, Karbala, IraqDepartment of Adult Nursing, College of Nursing – University of Baghdad, Baghdad, Iraq,Department of Adult Nursing, College of Nursing – University of Baghdad, Baghdad, Iraq,Department of Adult Nursing, College of Nursing – University of Baghdad, Baghdad, Iraq,Department of Adult Nursing, College of Nursing – University of Baghdad, Baghdad, Iraq,1Department of Adult Nursing, College of Nursing – University of Baghdad, Baghdad, Iraq20250908<p><strong>Background: </strong>Obesity among girls can cause physical, psychological, or social problems. Different cultures have different lifestyle and dietary habits which affect people’s experience about obesity. This study aimed to assess girls’ experience toward obesity. <strong></strong></p><p><strong>Materials and Methods: </strong>In 2023, a qualitative conventional content analysis method was used in this study to meet the study’s objective in Baghdad and Babylon, Iraq. A probability purposive sampling method was used to gather the sample from three high schools in two cities across Iraq. The main question of the interview was follows: how do girls think about their body weight? A total of 29 girls participated in the study. Four girls withdrew, so 25 girls were included in data analysis using Saldana’s coding method. <strong></strong></p><p><strong>Results: </strong>The data revealed three themes: perceptions about body weight, community insight toward features of the body, and attitudes about body weight. <strong></strong></p><p><strong>Conclusions: </strong>Iraqi teenage girls have different perceptions regarding obesity. Even their satisfactions about their body weight varies. Increasing teenage girls’ awareness about obesity can play a crucial role in changing their perceptions toward obesity. Conducting further studies is recommended to find out the relationships between Iraqi girls’ experience and factors that lead to obesity.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2287http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2287/70707877

Iranian Journal of Nursing and Midwifery Research1735-906630520250923667675ENDepartment of Anesthesiology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Anesthesiology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Anesthesiology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranDepartment of Anesthesiology, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran20250908<p><strong>Background: </strong>Clinical competence in detecting complications is crucial for anesthesia nurses working in the Post‑Anesthesia Care Unit (PACU). This study utilized the Delphi method to identify essential core competency‑based learning objectives for this specialized nursing role. The research also aimed to develop a practical and implementable training program, encompassing appropriate pedagogical approaches and defining the required duration of training. <strong></strong></p><p><strong>Materials and Methods: </strong>This qualitative study employed a two‑round Delphi method, with invitations extended to 50 faculty members and clinical anesthesia instructors in Iran. During the first round, participants assessed the learning objectives using a 5‑point Likert scale. Subsequent to the initial Delphi round and data analysis, all items reaching a median score of at least four, in conjunction with newly proposed objectives, were categorized and presented for re‑evaluation. To ascertain suitable teaching methods and the necessary number of sessions, two multiple‑choice questions were posed at the conclusion of each round. Descriptive statistics, including median, interquartile range, frequency, and percentages, were used for data analysis. <strong></strong></p><p><strong>Results: </strong>A total of 37 out of 50 panel members (74%) participated in both rounds of the Delphi study. Consensus was reached on 95 learning objectives. To achieve the learning objectives in each group, specific teaching methods were selected. The proposed number of sessions to achieve the objectives totaled 10 sessions, equivalent to 15 hours. <strong></strong></p><p><strong>Conclusions: </strong>A supplementary training program for PACU care was developed using the Delphi method to enhance the clinical competence of anesthesia nurses.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2288http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2288/70707878

Iranian Journal of Nursing and Midwifery Research1735-906630520250923676681ENRayat Bahra College of Nursing, Mohali, Punjab, IndiaMata Sahib Kaur College of Nursing, Mohali, Punjab, IndiaCollege of Nursing, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India,RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE20250915<p><strong>Background: </strong>Anemia during pregnancy is a global public health concern that can negatively impact maternal and fetal outcomes. It is a major health concern among antenatal mothers in India, and there is substantial variation in the prevalence of anemia in different parts of India. Understanding the problems in the regions of the country can help devise locally viable plans to mitigate the problem, and this study aimed to assess the prevalence of anemia among antenatal women in north‑western India.</p><p><strong>Materials and Methods: </strong>A cross‑sectional study involving convenient selection of antenatal women was conducted in selected hospitals in Punjab, India, between July 2022 and December 2022. The data were collected using structured questionnaires. The prevalence of anemia and its contributing factors were ascertained using descriptive statistics as well as bivariate and multivariate statistical analyses. <strong></strong></p><p><strong>Results: </strong>Out Of 300 pregnant women evaluated for anemia, 70.7% had anemia; 35.71%, 27.33%, and 7.75% had mild, moderate, and severe anemia, respectively. Educational level (<em>χ</em>2 = 21.90, df = 299, <em>p </em>= 0.01) and family income level (<em>χ</em>2 = 12.46, df = 299, <em>p </em>= 0.006) were associated with anemia among antenatal women. Parity (<em>χ</em>2 = 15.58, df = 299, <em>p </em>= 0.01), gestational age (<em>χ</em>2 = 14.95, df = 299, <em>p </em>= 0.02), and consumption of iron and folic acid tablets (<em>t</em>299 = 60.56, <em>p </em>&lt; 0.001) were pregnancy‑related factors significantly associated with anemia. <strong></strong></p><p><strong>Conclusions: </strong>According to this study, anemia in pregnant women is highly prevalent in north‑western India and has a number of modifiable contributing factors. These factors should be considered for the prevention and control of anemia in pregnant women during antenatal care and visits.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2289http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2289/70707879

Iranian Journal of Nursing and Midwifery Research1735-906630520250923682691EN1.Assistant Professor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran, 2.Assistant Professor,Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,BSc Nursing Graduate, School of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Razavi Khorasan, Iran1.Assistant Professor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran, 2.Assistant Professor,Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,20250920<p><strong>Background: </strong>The aim of this study was to apply Machine Learning (ML) algorithms to predict the impact of care burden on the psychological well‑being of caregivers of patients with Chronic Kidney Disease (CKD). <strong></strong></p><p><strong>Materials and Methods: </strong>This cross‑sectional study employed an ML approach to analyze data from 200 primary family caregivers of CKD patients undergoing hemodialysis. The caregivers were selected through convenience sampling from hospitals affiliated with Mashhad University of Medical Sciences. Caregivers completed the demographic form, the Novak and Guest Pressure Care Questionnaire, and Ryff’s Scales of Psychological Well‑being. Four ML algorithms: Random Forest (RF), logistic regression, decision tree (DT), and Support Vector Machine (SVM) with Linear, Polynomial, and Sigmoid Kernels, were evaluated using Python and the Scikit‑Learn module in the Anaconda environment. <strong></strong></p><p><strong>Results: </strong>The RF model achieved the highest accuracy score of 0.70, followed by the polynomial SVM model with 0.68. The SVM linear model scored 0.62, logistic regression and DT models both scored 0.58, and the SVM sigmoid model had the lowest accuracy score of 0.54. The RF algorithm also achieved superior levels of the Area Under the Curve (AUC) (0.72) and sensitivity (0.72%). Eight key predictors of psychological well‑being were identified: caregiver burden, age, education, economic situation, number of care days, family members, dialysis days, and the amount of assistance offered by family members to the caregiver. <strong></strong></p><p><strong>Conclusions: </strong>The RF algorithm, a robust ML tool, effectively analyzed datasets to reveal insights into the relationship between caregiver burden and caregiver well‑being in CKD patients.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2290http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2290/70707880

Iranian Journal of Nursing and Midwifery Research1735-906630520250923692697ENDepartment of Midwifery, Faculty of Nursing, Khon Kaen University, ThailandCommunity and Family Health, Faculty of Nursing, Khon Kaen University, Thailand,Obstetrics and Gynecology Nursing Department, Postpartum Care Ward, Khon Kaen Hospital, Khon Kaen Province, Thailand,Department of Pediatrics, Faculty of Nursing, Khon Kaen University, Meung Khon Kaen District, Khon Kaen Province, Thailand20250920<p><strong>Background: </strong>The transition to motherhood is a critical developmental milestone in a woman’s life, influenced by various factors, including gender role attitudes, which shape maternal behaviors and identity formation. However, the relationship between gender role attitudes and maternal identity remains underexplored. <strong></strong></p><p><strong>Materials and Methods: </strong>This descriptive cross‑sectional study examined the association between gender role attitudes and maternal identity among 263 postpartum adolescent mothers in northeastern Thailand. Participants were purposively selected between July 2021 and August 2022. Data were collected using a self‑administered questionnaire with strong psychometric properties, including sociodemographic data, the Gender Role Attitude Scale (Cronbach’s α = 0.94), and the Maternal Identity Scale (Cronbach’s α = 0.95). Descriptive and bivariate statistical analyses were conducted to assess potential associations.</p><p><strong>Results: </strong>The mean age of participants was 18.7 (1.29) years, and the mean age of their infants was 4.89 (0.39) months. Participants exhibited predominantly egalitarian gender role attitudes, with a mean score of 3.57 (0.48) and reported a high level of maternal identity, with a mean score of 4.57 (0.64). A statistically significant positive correlation was found between egalitarian gender role attitudes and maternal identity (Pearson’s <em>r </em>= 0.45, <em>p </em>&lt; 0.001). <strong></strong></p><p><strong>Conclusions: </strong>This study highlights the significant association between egalitarian gender role attitudes and a strong maternal identity among adolescent mothers. These findings suggest that fostering egalitarian gender role attitudes may support maternal identity development and improve maternal and child wellbeing.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2291http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2291/70707881

Iranian Journal of Nursing and Midwifery Research1735-906630520250923698703ENDepartment of Pediatric Nursing, Faculty of Nursing, Mahidol University, Bangkoknoi, Bangkok, ThailandDepartment of Pediatric Nursing, Faculty of Nursing, Mahidol University, Bangkoknoi, Bangkok, ThailandDepartment of Pediatric Nursing, Faculty of Nursing, Mahidol University, Bangkoknoi, Bangkok, Thailand20250920<p><strong>Background: </strong>Grandparents aiming to efficiently promote child development must first acquire the necessary knowledge, motivation, and skills. This study sought to examine the effects of an information–motivation–behavioral skills program on grandparents’ promotion of child development among young children. <strong></strong></p><p><strong>Materials and Methods: </strong>This quasi‑experimental study includes a sample of grandparents who serve as the primary caregivers of children aged 2–4 years at the child development center in Nakhon Ratchasima province, Thailand, which was conducted in 2023. Six child development centers were randomly assigned to experimental and control groups (three centers each), with 37 participants per group. The experimental group participated in a four‑week program, while the control group received routine care from their centers. Data were collected using a questionnaire on child development promotion behaviors. Descriptive statistics, independent <em>t</em>‑test, and Wilcoxon signed‑rank test were used to analyze the data. <strong></strong></p><p><strong>Results: </strong>The mean (SD) of grandparents’ behaviors to promote child development after the experiment in the experimental group, 58.49 (3.81), was higher than those of the control group, 47.73 (7.31), with statistical significance (<em>t</em>54 = −7.94, <em>p </em>&lt; 0.001). Additionally, the experimental group’s scores in child development promotion behaviors after participating in the program were statistically significantly higher than before they underwent the program (<em>z </em>= −5.12, <em>p </em>&lt; 0.001). <strong></strong></p><p><strong>Conclusions: </strong>This study effectively encouraged grandparents to adopt appropriate behaviors that promote child development. Future studies should investigate the sustainability of grandparents’ behaviors in promoting child development after program completion to inform reminder strategies and maintain behavioral efficiency.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2292http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2292/70707882

Iranian Journal of Nursing and Midwifery Research1735-906630520250923704711ENSpecial Care Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranSpecial Care Nursing Department, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Shahid Ashrafi Hospital, Isfahan University of Medical Sciences, Isfahan, IranChild Growth and Development Research Center, Research Institute for Primordial Prevention of Non Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran20250920<p><strong>Background: </strong>Early Mobilization (EM) after a myocardial infarction is an effective strategy to reduce complications associated with immobility. However, heart‑focused anxiety (HFA) can hinder exercise capacity and negatively impact self‑reported physical health. Consequently, we aimed to evaluate the effect of the current EM program on HFA in patients who have experienced an acute myocardial infarction (AMI). <strong></strong></p><p><strong>Materials and Methods: </strong>In this randomized controlled trial, patients with AMI were selected using a convenience sampling method and were randomly assigned to either the intervention group (n = 30) or the control group (n = 30). The measurement tools included a section on demographic information, a patient activity checklist, and the Cardiac Anxiety Questionnaire (CAQ). The intervention group underwent a six‑stage EM program, while the control group received standard care. Data analysis was performed using SPSS Version 20, employing independent and paired t‑tests. <strong></strong></p><p><strong>Results: </strong>The comparison of the average HFA score and its components before the intervention showed no significant differences (<em>p </em>&gt; 0.05). After the trial, the HFA score showed a significant decrease (t = ‑3.065, <em>p </em>= 0.003) compared to the control group. Its components, including attention (t = ‑2.040, <em>p </em>= 0.046) and fear (t = ‑2.259, <em>p </em>= 0.028), also decreased significantly, while avoidance (t = ‑1.608, <em>p </em>= 0.114) did not show a significant change. <strong></strong></p><p><strong>Conclusions: </strong>This EM program, initiated about 6 hours after admission to the CCU, decreased the CAQ score. Thus, this program is an affordable and nondrug approach recommended to prevent complications from immobility.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2293http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2293/70707883

Iranian Journal of Nursing and Midwifery Research1735-906630520250923712717ENDepartment of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IranDepartment of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IranDepartment of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, IranDepartment of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran20250920<p><strong>Background: </strong>Care burden is one of the consequences of caring for schizophrenic patients, caregivers need high resilience to have their best performance in caring for these patients and reduce their care burden. Psychiatric nurses should implement coherent programs to support these caregivers. Therefore, this study aimed to determine the effect of telenursing on the care burden and resilience of family caregivers of schizophrenic patients. <strong></strong></p><p><strong>Materials and Methods: </strong>This research was a before‑after quasi‑experimental study with a control group. Participants included 44 family caregivers of schizophrenic patients referring to the Razi Educational and Therapeutic Psychiatric Center in Tehran in 2023–2024. Participants were included via purposive sampling method and based on inclusion criteria. Data collection tools included demographic questionnaire, standard Zarit Burden Interview (ZBI), and Connor–Davidson Resilience Scale (CD‑RISC). In addition to routine care, the intervention group also received telenursing care. <strong></strong></p><p><strong>Results: </strong>Findings of this study showed that between intervention and control group, except for dimensions of positive acceptance of change, secure relationships (<em>p </em>= 0.007) and trust in one’s instincts, tolerance of negative affect, and strengthening effects of stress (<em>p </em>= 0.02) of resilience, there were no statistically significant differences in other discussed variables such as care burden and resilience.</p><p><strong>Conclusions: </strong>In this study, telenursing did not have a positive effect on all dimensions of resilience and care burden, but considering its potential and its positive effect on some dimensions of resilience, it is recommended that studies with longer intervention periods be conducted on other problems of family caregivers.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2294http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2294/70707884

Iranian Journal of Nursing and Midwifery Research1735-906630520250923718725ENDepartment of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, IranDepartment of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran1.Psychosomatic Research Center, Mazandaran University of Medical Sciences, Sari, Iran, 2.Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, IranDepartment of Nursing, Shahid Beheshti School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran20250920<p><strong>Background: </strong>Resilience is a multidimensional concept that explains why some individuals who face adversity, stress, and health‑threatening factors are able to adapt and achieve positive outcomes. This study aims to “explain the experience of resilience in informal caregivers of patients with Gastrointestinal cancer.” <strong></strong></p><p><strong>Materials and Methods: </strong>This qualitative study was conducted using the conventional content analysis method. Data were collected through semi‑structured interviews between March and September 2023. The participants included 11 informal caregivers of patients with Gastrointestinal cancer, selected through purposive sampling. Data analysis followed the three‑step method proposed by Elo and Kyngäs. <strong></strong></p><p><strong>Results: </strong>The data analysis revealed five main themes, including emotional self‑regulation, care competency, spiritual health, social intelligence, and flourishing.</p><p><strong>Conclusions: </strong>Informal caregivers, when faced with the caregiving experience, endure and grow through hardships by possessing traits such as optimism, hopefulness, and acceptance, and skills like problem‑solving and relationship management.</p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2295http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2295/70707885

Iranian Journal of Nursing and Midwifery Research1735-906630520250923726731ENSchool of Nursing, Yasuj University of Medical Sciences, Yasuj, IranDepartment of Operating Room, School of Paramedicine, Yasuj University of Medical Sciences, Yasuj, IranSocial Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, IranHematology Research Centre, Shiraz University of Medical Sciences, Shiraz, IranSocial Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran,20250920<p><strong>Background: </strong>Improving resilience and health‑related quality of life (HRQOL) is one way to adapt to psychological problems in adolescents with hemophilia. One of the educational programs that can probably be effective in improving these factors is the FRIENDS educational program. This study was conducted with the aim of determining the effect of “FRIENDS” educational program on resilience and quality of life in adolescents with hemophilia. <strong></strong></p><p><strong>Materials and Methods: </strong>This clinical trial was conducted on 60 adolescents with hemophilia selected using a convenience sampling method who visited the Comprehensive Hemophilia Center of Ayatollah Dastgheib Hospital, affiliated with Shiraz University of Medical Sciences, Iran, from August to October 2022; they were divided into two groups of intervention and control based on block random allocation. The data were completed before and immediately after the intervention. The interventions were carried out in 10 weekly 1‑hour sessions. The collected data were analyzed using Chi‑square, independent <em>t</em>‑test, and paired <em>t</em>‑test. <strong></strong></p><p><strong>Results: </strong>After the intervention, there was a significant difference in the total mean (SD) score of resilience between the intervention group [3.32 (0.14)] and the control group [2.72 (0.14)] (<em>t</em>58 = 31.87; <em>p </em>&lt; 0.01). Furthermore, after the intervention, there was a statistically significant difference (<em>t</em>58 = 20.54; <em>p </em>&lt; 0.01) in the mean (SD) score of HRQOL between the intervention group [3.66 (0.20)] and the control group [2.68 (0.15)]. <strong></strong></p><p><strong>Conclusions: </strong>FRIENDS educational program has positive effects on the resilience and HRQOL of adolescents with hemophilia.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2296http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2296/70707886http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2296/70707887

Iranian Journal of Nursing and Midwifery Research1735-906630520250923732738ENDepartment of Nursing, Social Determinants of Health Research Center, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, IranDepartment of Internal Medicine, Metabolic Diseases Research Center, School of Medicine, Qazvin University of Medical Sciences, Qazvin, IranDepartment of Nursing, Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, IranDepartment of Surgery, School of Medicine, Qazvin University of Medical Sciences, Qazvin, IranDepartment of Nursing , Non-communicable Diseases Research Center, Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran20250920<p><strong>Background: </strong>Vitamin D deficiency in patients with type 2 diabetes (T2D) is recognized as a risk factor for developing vascular complications and poor disease control. This study aimed to determine the effect of vitamin D supplementation on ankle‑brachial index (ABI) in patients with T2D.</p><p><strong>Materials and Methods: </strong>This two‑group clinical trial was conducted among 56 patients with T2D. Participants were recruited through sampling conducted in the diabetes clinic of Velayat Hospital in Qazvin, Iran. They were allocated to the intervention and control groups using a simple blocked randomization method. The intervention group received an oral dose of 1000 IU/day of vitamin D. Data were collected using a checklist that included demographic information, laboratory measurements, and ABI. <strong></strong></p><p><strong>Results: </strong>After the intervention, the score in the intervention group (ABI &lt; 0.9: t32 = 4.082, <em>p </em>&lt; 0.001) was significantly different from the control group (ABI ≥ 1.3: t20 = −2.711, <em>p </em>= 0.013). After the intervention, significant differences were also observed regarding the mean ranges of vitamin D (t54 = 10.07, <em>p </em>&lt; 0.001), fasting blood glucose (FBG) (t54 = −2.97, <em>p </em>= 0.004), 2‑hour post‑prandial blood glucose (2hpp) (t54 = −2.55, <em>p </em>= 0.013), and hemoglobin A1c (HbA1c) (t54 = −3.02, <em>p </em>= 0.004) between the two groups.</p><p><strong>Conclusions: </strong>The results of this study revealed that a daily intake of 1000 IU of vitamin D significantly improved the ABI, serum concentration of vitamin D, FBG, and HbA1c in patients with T2D. These findings suggest that vitamin D supplementation may be considered an effective approach for preventing arterial diseases and improving blood sugar control.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2297http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2297/70707888

Iranian Journal of Nursing and Midwifery Research1735-906630520250923739745ENDepartment of Midwifery, Reproductive Health Promotion Research Center, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IranStudent Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran20250920<p><strong>Background: </strong>Given Iran’s decreasing fertility rate and the increasing number of single‑child families in this country, a comprehensive examination of the unique experiences and challenges faced by only children is warranted. Therefore, this study aimed to explain the lived experiences of children in single‑child families. <strong></strong></p><p><strong>Materials and Methods: </strong>In this qualitative study, a phenomenological approach was used to explain the lived experiences of children in single‑child families in Ahvaz, Iran, between November 2023 and March 2024. Participants aged 18 and older were recruited to ensure they had sufficient life experience as a single child to meaningfully share their perspectives. Participants were selected through purposive sampling until data saturation was reached. Data were collected through in‑depth, semistructured interviews with 18 eligible individuals who met the inclusion criteria. Data analysis was performed using Colaizzi’s seven‑step analysis method. <strong></strong></p><p><strong>Results: </strong>Two main categories emerged: a) positive experiences, which included three subcategories of “no competition,” “financial well‑being,” and “intimacy with parents,” and b) negative experiences, involving five subcategories of “parents’ excessive sensitivity,” “parents’ excessive expectations,” “loneliness and emotional dependence,” “inability to understand certain feelings,” and “negative societal views of only children”. <strong></strong></p><p><strong>Conclusions: </strong>Based on the results of this study, it is evident that being an only child is associated with a range of challenges for individuals, families, and society at large. To mitigate these challenges, health service providers should undertake initiatives to educate and inform families and communities about the potential consequences of single‑child families and offer evidence‑based counseling interventions.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2298http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2298/70707889

Iranian Journal of Nursing and Midwifery Research1735-906630520250923746751ENResearch Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, IranDepartment of Pediatric and Neonatal Intensive Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, IranStudent Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IranStudent Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IranPediatric Respiratory Ward, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran1.Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, 2. School of Nursing, College of Health Sciences, University of Nizwa, Nizwa, Sultanate of Oman20250921<p><strong>Background: </strong>Mandala coloring is effective in reducing anxiety. However, it has received little attention as an adjunctive therapy to manage children’s anxiety. This study aimed to explore the impact of mandala coloring on the anxiety of children with Cystic Fibrosis (CF).</p><p><strong>Materials and Methods: </strong>The participants in this clinical trial study were 120 children aged 6–18 years with CF with mild‑to‑moderate anxiety admitted to Mofid Hospital in Tehran. The children were randomly divided into two groups: intervention and control. The children in the intervention group performed mandala coloring exercises every evening for 30 minutes for 6 consecutive days. The level of anxiety in the children in both groups was measured using the Spielberger State‑Trait Anxiety Inventory before the intervention and 6 days after the first measurement. The collected data were analyzed using the independent <em>t</em>‑test.</p><p><strong>Results: </strong>An analysis of the mean anxiety scores before and after the intervention showed a significant decrease in the anxiety level in the Mandala group (<em>Z = −3.74</em>, <em>p </em>&lt; 0.05). Moreover, a significant decrease was observed after the intervention between the children in the mandala and control groups in terms of average anxiety levels (U = 1206, <em>p </em>&lt; 0.05). An intergroup comparison showed that state anxiety was significantly different between the two groups (<em>U </em>= <em>1143</em>, <em>p </em>&lt; 0.05), but no statistical difference was observed in terms of trait anxiety (<em>p </em>&gt; 0.05).</p><p><strong>Conclusions: </strong>The results indicated that holding six mandala coloring sessions reduced the anxiety of children with CF. Thus, mandala coloring is recommended as a complementary non‑pharmacological method to reduce children’s anxiety.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2299http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2299/70707890

Iranian Journal of Nursing and Midwifery Research1735-906630520250923752757EN1MSc Student in Nursing, Student Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran2Associate Professor in Nursing, Social Determinants of Health Research Center, Nursing Department, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran,Nutritional Health Research Center, Department of Biostatistics and Epidemiology, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran,Associate Professor, Department of Surgery, Clinical Development and Research Center, Shohada-e-Ashayer Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran,Social Determinants of Health Research Center, Department of Surgical Technologist, School of Allied Medical Sciences, Lorestan University of Medical Sciences, Khorramabad, Iran20250921<p><strong>Background: </strong>Visiting patients in special care units can effect depression, anxiety, and stress patients and their families. The present study aimed at evaluating the effects of Scheduled Visitation Policy on depression, anxiety, and stress among the family members of patients with Open Heart Surgery (OHS). <strong></strong></p><p><strong>Materials and Methods: </strong>This randomized, controlled, clinical trial was conducted on 66 family members of patients with OHS. They were randomly allocated to two groups of intervention (<em>n </em>= 33) and control (<em>n </em>= 33) through permuted block randomization. Participants in the intervention group received scheduled visitation policy in three 30‑minute sessions for 3 consecutive days after OHS, and their counterparts in the control group were treated with routine restricted visitation. All participants completed the Depression, Anxiety, and Stress Scale DASS‑21 before and after the intervention. Data were analyzed using Chi‑square, paired‑sample <em>t</em>‑test and the analysis of covariance (ANCOVA) (<em>p </em>&lt; 0.05). <strong></strong></p><p><strong>Results: </strong>The mean [standard deviation (SD)] of depression, anxiety, and stress did not change in the control group, while it significantly decreased in the intervention group [2.27 (4.06) vs 11.97 (7.13), 2.52 (3.26) vs 11.67 (7.36), and 2.45 (4.11) vs 12.93 (6.80), respectively; <em>p </em>&lt; 0.05]. Consequently, ANCOVA test showed the mean posttest scores of depression, anxiety, and stress in the intervention group were significantly less than those in the control group (<em>p </em>&lt; 0.05). <strong></strong></p><p><strong>Conclusions: </strong>Scheduled visitation policy significantly reduced depression, anxiety, and stress among the family members of patients with OHS. Patient‑centered and family‑centered interventions are needed to reduce psychological strains.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2300http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2300/70707891

Iranian Journal of Nursing and Midwifery Research1735-906630520250923758764ENNursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, IranIranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, IranIranian Research Center on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, IranNursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran20250921<p><strong>Background: </strong>Patients with cardiovascular diseases who also suffer from substance use disorders face distinct challenges in nursing care. Similarly, nurses encounter various caregiving challenges. Therefore, this study aims to explore the nursing care process for patients with co‑occurring cardiovascular diseases and substance use disorders.</p><p><strong>Materials and Methods: </strong>This grounded theory study, informed by Strauss and Corbin (2015), was conducted at the University of Social Welfare and Rehabilitation Sciences in 2023. The participants consisted of 23 nurses, patients, and other treatment team members, who were purposefully selected from the cardiac and internal cardiac intensive care units of hospitals in Iran. A total of 25 semi‑structured interviews were conducted to collect data, with the primary question being: “How is nursing care provided to cardiac patients with substance use disorders?” The primary analysis strategies employed included constant comparison, data questioning, and memo writing. <strong></strong></p><p><strong>Results: </strong>The analysis revealed six main categories: the complexity of care, an inappropriate work environment, and insufficient nurse competency as conditions; discrimination in care and informal care as strategies; and nurse‑patient dissatisfaction as consequences. Based on the findings, nurses employ unstructured care to address their most pressing concerns.</p><p><strong>Conclusions: </strong>Nurses encounter various challenges when caring for patients who receive ineffective and unstructured care, which often leads to adverse outcomes. Consequently, developing appropriate care guidelines is essential. Based on the study’s findings, nurses, managers, and researchers can collaborate to enhance care quality and improve nurses’ professional competence.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2301http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2301/70707892

Iranian Journal of Nursing and Midwifery Research1735-906630520250923765570ENDepartment of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Iranian Research Centre on Aging, Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, IranDepartment of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IranDepartment of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,20250921<p><strong>Background: </strong>Horizontal Violence (HV) in healthcare settings is any type of violence among healthcare providers. It has many different negative consequences for nurses. This study aimed at exploring Iranian nurses’ perceptions of the consequences of HV for nurses. <strong></strong></p><p><strong>Materials and Methods: </strong>This qualitative content analysis study was conducted in 2022–2023 on twelve nurses purposively selected from five hospitals affiliated with Hamadan University of Medical Sciences in the west of Iran. In‑depth semi‑structured interviews were conducted for data collection. The main interview question was, “Have you ever experienced HV in your relationships with your colleagues?” Graneheim and Lundman’s conventional qualitative content analysis was used for data analysis. <strong></strong></p><p><strong>Results: </strong>Iranian nurses’ perceptions of the consequences of HV for nurses fell into three main categories, namely erosive tension (with four categories), professional repulsion (with two categories), and low‑quality patient care (with two categories). The subcategories of these categories were, respectively, psychoemotional tension, mental tension, physical tension, social tension, low organizational belongingness, low professional interest, hesitation in performing care measures, and endangered patient safety. <strong></strong></p><p><strong>Conclusions: </strong>The main consequences of HV for nurses are erosive tension, professional repulsion, and low‑quality patient care. Nurse leaders can prevent HV by providing strong support and quality education to nurses. Interventional studies are recommended to determine the most effective methods to reduce HV in nurses’ workplace.</p><p> </p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2302http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2302/70707893

Iranian Journal of Nursing and Midwifery Research1735-906630520250923771774ENIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Developing and Updating Guidelines Unit, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranDeveloping and Updating Guidelines Unit, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran20250921<p><strong>Background: </strong>The development of clinical practice guidelines presents a unique opportunity to identify research gaps systematically. This study aimed to uncover such gaps in the hypertension field while updating the Iranian hypertension guideline. <strong></strong></p><p><strong>Materials and Methods: </strong>This study was conducted as part of the systematic review component of the 2021 Iranian hypertension guideline update. An extensive search of electronic databases was performed to identify evidence relevant to PICO (Population, Interventions, Comparisons, Outcomes) questions. Any topic without evidence with high certainty of effect was considered a knowledge gap. <strong></strong></p><p><strong>Results: </strong>A total of 227 studies were reviewed and appraised. Nine topics, such as non‑pharmacological treatment, treatment thresholds, visit and follow‑up intervals, laboratory tests, drug immunotherapy, adherence to treatment, complementary medicine, telehealth, COVID‑19 were identified as research gaps. <strong></strong></p><p><strong>Conclusions: </strong>The identified research gaps can be examined and prioritized by policymakers in the research field, and actions can be taken to plan for addressing them.</p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2303http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2303/70707894

Iranian Journal of Nursing and Midwifery Research1735-90663052025092323042304ENNursing Programme, PAPRSB Institute of Health Sciences, Universiti Brunei DarussalamNursing Programme, School of Health Sciences, Politeknik Brunei, Brunei Darussalam20250921<p>This letter is in response to the article “The challenges of Iranian female nurses caring for male patients: A qualitative study” published in your esteemed journal.[1] The study explores an unsettling topic as female nurses in culturally diverse settings struggle to care for male patients. This commentary examines the value of protecting dignity in intimate nursing care……………</p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2304http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2304/70707895