Background: Caring for children with Autism Spectrum Disorder (ASD) is demanding, especially where access to services and support are inadequate. The present study aimed to systematically review the challenges associated with the caregivers whose children have autism. Materials and Methods: A systematic review design was utilized. The searches were conducted from February 2019 to January 2020. A qualitative analysis that was based on meta-aggregation approach and thematic analysis was used. Thereafter, data was presented into themes. The quality of all included studies was assessed using the Critical Appraisal Skills Program (CASP). Results: The search generated 909 articles of which only 9 met the inclusion criteria. The main findings were discussed under the following three thematic domains: 1) Stigma, 2) Financial burden, and 3) Caregiving burden. Conclusions: Evidence from the data reviewed showed financial burden faced by the caregivers whose children are diagnosed with ASD. This was manifested through both direct and indirect cost of treatment. Another key finding was that majority of the caregivers faced stigma from the community. This implies the low level of awareness of the ASD within the community. The present study calls for more programs on the present research problem within the community so as to increase awareness. Furthermore, the current advocacy of Universal Health Coverage programs in the country should incorporate ASD children.

Background: Palliative research studies seem to be limited and disperse in Iran. The present study was therefore conducted to review and categorize the Palliative Care (PC) studies performed in Iran in terms of the research type, the type/focus of PC, the measured outcomes in interventional palliative studies and their related results, the disease type, and their geographical distribution. Materials and Methods: This narrative review was conducted in 2021 in which both Iranian and international databases including PubMed, Scopus, Web of science, CINAHL, ProQuest, Magiran, SID, Noormags, ISC were searched. The inclusion criteria were original articles conducted in Iran and results published in Persian or English journals ab initio in which PC was assessed as a variable (dependent or independent) or the main concept. Results: A total of 1096 articles were identified from which only 44 articles were reviewed. The research studies were mainly focused on cancer and majority conducted in Tehran. Majority of studies were quantitative-interventional leading to a variety of positive changes in dependent variables, including reduce in pain severity, change in life pattern, a good response to therapy, increase life expectancy, improve in dysphagia, improve quality of life, reduce patients' metastasis, and increase in nurses' self-efficacy. Conclusions: The PC studies distributed across different fields and cities in Iran resulted to a number of positive outcomes for patients. More focused and robust research studies with different patients need to be conducted in this emerging field in Iran.

Background: Critically ill patients face challenges in hypercatabolism due to crisis states, as it may lead to malnutrition. An early Enteral Nutrition (EN) within 24–48 h is recommended to use in order to improve clinical outcomes. This systematic scoping review is examined recently with the evidence of the early EN protocol led by nurses to drive and achieve the daily calorie target and improve clinical outcomes. Materials and Methods: The database of CINAHL, MEDLINE via PubMed and Scopus, Web of Science, and Embase through Ovid from January 2019 to September 2020, comprised of 221 articles which four articles are chosen and entered into the final analysis. Results: The findings show the benefits of the early EN to guide nurses to start the EN as soon as possible after admitted to the Intensive Care Unit or when hemodynamic is stable in order to achieve a daily calorie target regarding the reduced hospitalization, duration of mechanical ventilation, morbidity, and mortality. Conclusions: The synthesized results show the early EN led by a nurse to address the specific needs and the vital role of nutritional support, and also drive the enteral feeding for critically ill patients to reach the calorie target goals in short times to enhance clinical outcomes.

Background: Health literacy (HL) is considered a cancer-preventive strategy. In addition, success in early diagnosis of cancer largely depends on individuals' knowledge, attitude, and performance regarding cancer warning signs. The aim of the present study was to investigate the potential relationship between HL and Knowledge, Attitude, and Performance (KAP) regarding cancer warning signs. Materials and Methods: This descriptive-correlational study was conducted on 280 adults who were referred to 3 health centers in Tehran, Iran, from January to March 2020. Data were collected using the Health Literacy Instrument for Adults (HELIA) and the researcher-made KAP regarding cancer warning signs questionnaire. Data were analyzed using the Pearson correlation test and linear regression in an adjusted model in the statistical package for social sciences software. Results: Total HL score was positively and significantly correlated with knowledge (r = 0.35; p < 0.001), attitude (r = 0.17, p = 0.003), and performance (r = 0.46, p < 0.001). Moreover, after controlling for potential confounders, a significant and positive relationship was found between HL and knowledge (β = 0.48; t₂₇₅ = 4.45; p < 0.001), attitude (β =0.17; t₂₆₅ = 4.64; p < 0.001), and performance (β = 0.62; t₂₆₅ = 8.23; p < 0.001). Conclusions: It seems that adults' KAP regarding cancer warning signs can be promoted by increasing their HL. Therefore, greater attention should be paid to individuals' HL at community health centers when designing and performing programs to improve their KAP regarding cancer warning signs.

Background: Emotional disorders and depression make cancer patients reluctant about adherence to their treatment. The present study was conducted to determine the relationship between self-compassion and adherence to treatment in cancer patients. Materials and Methods: This cross-sectional study was conducted on 214 patients with cancer in 2019. They were inpatients aged over 18 years. Two months had passed since their cancer was diagnosed, and they had undergone a course of chemotherapy. Data were collected using a personal details form, Neff's Self-Compassion Scale and the Modanloo Adherence to Treatment Questionnaire and were then analyzed using the mean, frequency, Pearson's correlation coefficient and linear regression analysis. Results: The mean (SD) total score of self-compassion was 80.07 (15.68), and the mean (SD) total score of adherence to treatment was 134.44 (38.37). Pearson's correlation coefficient showed a direct relationship between the total score of self-compassion and the total score of adherence to treatment (p < 0.05). The linear regression analysis showed that the score of suffering as a common humanity (β = 0.47, p ≤ 0.001) and the variable of education (β = 0.27, p ≤ 0.001) were significant predictors of the total score of adherence to treatment (R² = 0.33). Conclusions: According to the results, suffering as a common humanity and education were significant predictors of adherence to treatment. Oncology nurses are therefore recommended to get further educated about self-compassion, so that they take this concept more seriously in providing patient care. Nurses should also educate the patients with low levels of education about the consequences of not adhering to their treatment.

Background: Knowing about sexual issues and substance abuse is crucial for girls in preventing high-risk behaviors in the medical, social, cultural, and evolutional levels. The aim of this study was to determine the self-care needs of adolescent girls in the domains of knowledge, attitude, and performance with regard to drug use and risky sexual behaviors. Materials and Methods: This cross-sectional study was conducted in the secondary schools located in the third district of Isfahan. Data were collected from 384 female students by systematic random sampling on 2019, and using a four-part questionnaire including demographic characteristics and self-care needs (knowledge, attitude and performance), drug addiction and unsafe sexual behaviors were measured and then were analyzed using descriptive and inferential statistics. Results: According to the adolescents, “familiarity with infectious diseases caused by drug addiction”, “alcohol consumption, drugs and smoking as a way of forgetting problems” and “learning the skills of excitement control,” were their first self-care priorities in terms of awareness, attitude, and performance, respectively. Additionally, “understanding the social and mental effects of relationships with the other sex”, “separating the children's bedrooms from that of parents” and “ways of caring for personal hygiene in menstruation period and travel time” were considered as their first self-care priorities in terms of knowledge, attitude, and performance with regard to sexual behaviors, respectively. Conclusions: Based on the results, more effective interventions to protect the adolescents from being involved in substance use and sexual harmful behaviors are recommended through the training of self-care needs in adolescents.

Background: Nursing is one of the most important areas of medical sciences whose developments including its scientific publications can influence health care. Therefore, the aim of this study was to investigate nursing articles published from 2013 to 2018, and to provide a comprehensive view of common topical clusters in this research area. Materials and Methods: In this practical research, bibliometrics method and co-word analysis technique are used. The study population included all the articles in nursing area indexed in Web of Science from 2013 to 2018. The bibliometrics software, including BibExcel, UCINET, and SPSS was used to analyze the data. Results: Results indicated that the most frequently used nursing words in nursing research articles were “Quality of life,” “Aged,” “Education,” and “Nursing.” Moreover, the pairs such as “Anxiety-Depression”, “Education, Nursing-Students, Nursing” and “Depression--Quality of life” were the most frequent co-occurrences. The use of hierarchical clustering led to the formation of seven topical clusters in Nursing: “Nursing care for the Aged,” “Self-care,” “Physical, emotional, and social support, “Mother and child health,” “Preventing nursing care,” “Nursing profession Research,” and “Quality of nursing care.” Conclusions: The growth of nursing scientific productions is an indicative of the importance of this subject area in healthcare services; however, there is no balanced growth in various subjects.

Background: Caring is the essence of nursing, and nurses who are dissatisfied with their job are not able to perform optimal patient care. This study was conducted with the aim to determine the effect of education based on human care theory on nurses' caring behaviors and job involvement. Materials and Methods: In this clinical trial, a total of 110 intensive care unit nurses from Nemazee Hospital, Shiraz, Iran, were randomly allocated to control and intervention groups. The intervention group received a 6-h workshop based on Watson's human care theory using a collaborative and role-playing approach and 1-month follow-up period through presenting weekly preplanned care and caregiving scenarios. The control group received routine hospital trainings. The data collection tools used were included in a demographic information form, and the Larson Caring Assessment Questionnaire, and Kanungo Job Involvement Questionnaire. Data were analyzed using Chi-square test, and independent and paired t-test in SPSS software. Results: Majority of the participants were married women and had Bachelor of Science degree in Nursing. The participants' age ranged from 21 to 52 years. After the education, caring behaviors and job involvement scores significantly increased in the intervention group compared to the control group (p < 0.001). Conclusions: The findings suggest that a care workshop can be effective in improving care behaviors and job involvement. Therefore, we recommend more extensive research to determine the effectiveness of long-term intervention on nursing care behaviors.

Background: Violence against children is a serious global phenomenon. The severity of the injuries caused due to violence toward a child is sometimes so great that it sends them to the hospital. Nurses have the first contact with Child Violence Victims (CVVs). These nurses experience different challenges. This study was aimed at exploring nurses' experiences of challenges in care provision to CVVs. Materials and Methods: This conventional content analysis and qualitative study was conducted in 2018–2019. Using a purposive sampling method, 17 nurses with experience in care delivery to CVVs were recruited from among those working in Children's Medical Center, Tehran, Iran, and Bu-Ali Subspecialty Hospital, Ardabil, Iran. In-depth semi-structured interviews were conducted to collect the required data. Data were analyzed through the conventional content analysis method. Results: During data analysis, the 3 main categories of role conflict, lack of continuity of care, and emotional resentment and 9 subcategories were identified. Nurses experience challenges in care provision to CVVs. They do not have enough knowledge about CVVs, are unable to maintain the continuity of care, and experience role conflicts and emotional resentment. Conclusions: Nurses experience some difficulties and challenges in the process of care delivery to CVVs. They tried to overcome emotional resentment, different conflicts, and concerns about the lack of continuity of care without adequate support and resources. Thus, planning to support nurses in this regard seems essential.

Background: Violence against women is a health problem that poses an additional threat to the mother and fetus during pregnancy. Therefore, the present study was conducted to investigate the effect of Gestalt counseling on self-esteem and Intimate Partner Violence (IPV) in pregnant women. Materials and Methods: This clinical trial was carried out on 60 pregnant women who were referred to health-care centers in Kerman, Iran, in 2018. Simple random sampling was performed through lottery. The intervention group (n = 30) received counseling in eight weekly sessions of 45 min using the Gestalt approach. The control group was placed on a waiting list. There was no blinding during the study. Data were collected using a demographic questionnaire, the Domestic Violence Questionnaire designed by Mohseni Tabrizi, and the Rosenberg Self-Esteem Scale before and after counseling. Results: Differences between the groups in terms of mean score of violence (intervention: t₃₄ = 1.81, p = 0.08; control: t₃₄ = 1.41, p = 0.16) and self-esteem (intervention: t₃₄ = 1.87, p = 0.07; control: t₃₄ = 1, p = 0.32) in the pretest and posttest were not significant. Analysis of covariance results showed a significant difference between the intervention 21.79 (10.62) and control groups 21.79 (10.62) in terms of mean (SD) violence (F_1,67 = 1.97, p = 0.049) after the counseling sessions. It also showed a significant difference between the intervention 74.47 (14.61) and control groups 66.28 (15.14) in terms of self-esteem after the intervention (F_1,67 = 5.02, p = 0.01). Conclusions: Considering the impact of the Gestalt approach on IPV and self-esteem, it is recommended that health-care providers be educated about using the Gestalt approach and apply it in communication with women.

Background: Nowadays, virtual social networks are among the most essential communication tools in the exchange of science, knowledge, and technology and are very popular among different peoples of the society, especially nursing students. They can also influence academic success. The present study was aimed to investigate the use of social networks among nursing students of Tabriz University of Medical Sciences. Materials and Methods: This study adopts a descriptive cross-sectional design and employed 406 nursing students in 2018 by means of the convenience sampling method. For data collection, a researcher-made questionnaire consisting of demographic characteristics and social network usage was used. Descriptive and inferential statistics were used to analyze the data. Results: The mean (SD) of social networking usage was 116.81 (17.20) out of the achievable score range of 38 to 190, where the highest and lowest scores were related to dimensions of content sharing (73.56%) and unconventional issues (51.00%), respectively. There was a significant statistical relationship between total score of social networking usage which included the variables of grade point average (r = -0.17, p = 0.000), average daily study hours in non-exam periods (r = -0.10 and p < 0.04), family income (F_2,375 = 6.28, p < 0.001), number of siblings (F_4,350 = 4.98, p < 0.001), and academic semester (F_6,376 = 2.12, p < 0.05). Conclusions: Given the high percentage of students enrolled and the aim of using these networks, proper planning for the management of cyberspace is necessary to take advantage of the benefits of social networks and reduce their disadvantages.

Background: Simulation and skill development facilities are essential for the training and preparation of nursing students, which aids in their clinical readiness and professional development. The aim of the study was to assess simulation and skill training facilities, their utility in selected nursing institutes at Uttarakhand. Materials and Methods: This descriptive cross-sectional study was conducted in conveniently selected 16 nursing institutes at Uttarakhand (India). Data were collected from Nov. to Dec. 2019, through a face-to-face interview using a validated self-structured questionnaire. Descriptive and inferential statistics were used to analyze the data. Results: There were 16 institutes from four districts that participated in the study. Of these, five (31%) were government, and 11 (69%) were private. All nursing institutes (100%) had a nursing foundation lab, midwifery, and child health nursing lab, while only 44% of institutes had a medical surgical nursing skill lab. Among skill development facilities, the overall average number [mean (SD)] of mannequins was 3.90 (7.10); and high-fidelity simulators were 2.47 (7.1). In private institutes, the average period [mean (SD)] of laboratory usage was significantly higher than in government institutes [35.82 (6.57) vs 27.40 (5.22); p = 0.025]. The duration of lab usages was significantly associated with the age of the institute (p = 0.04). Conclusions: This study found inadequate simulation and skills training facilities and less utilization of those facilities. There is a great need to find out the key issues that lead to the unavailability and limited use of the required nursing skill development facilities.

Background: It is important to assess the provision of care in a humane framework to achieve patients' holistic needs in Critical Care Units (CCUs) and to promote health outcomes. The aim of the current study was to determine patients' satisfaction with humane care in CCUs. Materials and Methods: In the current descriptive–analytical study, data were collected from 225 patients admitted to the CCUs of seven teaching hospitals in Lorestan Province, Iran, in 2017. The Persian version of the Revised Humane Caring Scale (P-RHCS) was used in this study. Data were analyzed using descriptive statistics and inferential statistics (independent t-test and one-way ANOVA). Results: The mean (SD) overall score of the P-RHCS was 4.61 (0.53), which indicated that patients were highly satisfied with humane care. The patients were most satisfied with “professional performance” [mean (SD) 4.72 (0.60)] and “interdisciplinary collaboration” [mean (SD) 4.72 (0.65)], and the least satisfied with “awareness of and contribution to self-care” [mean (SD) 4.23 (0.78)]. The findings revealed that patients' satisfaction with humane care depends on their demographic and clinical characteristics. Conclusions: Generally, patients were satisfied with humane care provided in CCUs; however, it is recommended that nurses' skills be reinforced, especially regarding information provision and effective communication with patients to improve health outcomes.

Background: Uncivil student behavior is one of the challenging issues in the nursing schools that disrupts the learning process and teacher-student interactions. Planning to control student's incivility requires knowing the condition using valid tools. The purpose of this study was to investigate the validity and reliability of the incivility occurrence's questionnaire among Iranian students. Materials and Methods: This methodological study was conducted on 358 nursing students and 122 nursing faculty members. The samples were selected from the nursing students of second to fourth year from September to October 2019. McDonald's omega, Cronbach's alpha coefficients and composite reliability were calculated. Exploratory and confirmatory factor analysis were used to investigate the construct validity of tool. Results: Content validity index was 0.94 for the whole instrument. In factor analysis, three factors of irresponsible, violent, and unsound behaviors were identified. These factors explained more than 50.52% of the variance. Model fit indices Parsimonious Normed Fit Index) = 0.74, Root Mean Square Error of Approximation = 0.05, Parsimonious Comparative Fit Index = 0.78, Goodness-of-Fit Index = 0.92, Comparative Fit Index ( CFI) = 0.92, Adjusted Goodness-of-Fit Index) = 0.89, CIMN=2.58) indicated the proportion of factors. Internal consistency was 0.77 to 0.89. Conclusions: This questionnaire is a three-dimensional tool with appropriate validity and reliability that can be used to evaluate occurrence rate of nursing student incivility in Iran.