This paper reports the use of activity-oriented focus group discussions in a study that aimed to explore perceptions of youth violence among school-age adolescents of grade 6 to 8 in Pakistan. To engage students in active participation during focus group discussions, questions were asked in the form of activities like free listing, ranking, role-playing, and drawing. This paper explains how activity-oriented methods can help in the process of asking questions and retrieving information from adolescents to best energize the participants for optimum information. Furthermore, we explain the method of merging data from the activity-oriented questions for analysis and optimum understanding of participants’ perspectives.

Background & Aim: Diabetes is one of the most common chronic metabolic disorders, and one of the most important health-related challenges in today’s world. In addition to different kind of disabilities, diabetes complications can severely impact the quality of life of patients. The present systematic review and meta-analysis is aimed at examining the quality of life of Iranian patients suffering from type 2 diabetes based on the World Health Organization Quality of Life-BREF.
Materials & Methods: A total of 16 articles published in Persian and English were reviewed without any time limitation. The search was conducted in Iranian databases, including Scientific Information Database, Magiran, and IranMedex; and international databases, including Google Scholar, Web of Science, Pub Med, and Scopus. The data was examined using the meta-analysis method and the random effects model. Heterogeneity was assessed using the I² statistic. The analyses were conducted in stata, version 11.
Results: The mean quality of life score for patients with type 2 diabetes was 61.90 (95% confidence interval: 54.40-69.40). The highest and lowest quality of life scores were for social support (49.19) and mental health (42.96) dimensions, respectively. No significant association was found between the mean quality of life score and year of publication, methodological quality, and mean age of participants (P>0.05).
Conclusion: Given that patients with type 2 diabetes have a lower quality of life, especially in terms of mental health, it seems necessary to better understand psychological problems common in this group of patients and design strategies to overcome them.

Background & Aim: It is necessary to have a valid, reliable and socio-cultural appropriate questionnaire for evaluation of women' sexual self-efficacy. Therefore, the objective of the study was the development and psychometric evaluation of the context-based questionnaire for women' sexual self-efficacy.
Methods & Materials: The study was conducted during two phases on clients visiting the healthcare centers of Tehran university of medical sciences in 2018. In the first phase, Iranian women' sexual self-efficacy, and its dimensions was explored through a thematic analysis and it was compiled in 24 items by deductive-inductive method. In the second phase, the psychometric properties of the questionnaire were tested using face, content, construct, and criterion validity and reliability of the questionnaire was assessed by intra correlation and intraclass correlation coefficient.
Results: Iranian women' sexual self-efficacy was defined as "women' ability to make sexual relationship which leads to mutual orgasm or sexual satisfaction". Sexual relationship, proper level of sexual self-expression, women' ability in management of her and husband' sexual response cycle and having necessary skills to make a delightful sexual relationship were explored as the dimensions of definition of women’s sexual self-efficacy. Questionnaires were prepared with 24 items. The content validity index and content validity ratio (CVI and CVR) were found as 0.92 and 0.84, respectively. The results of qualitative and quantitative face validity and criterion validity were acceptable. Construct validity through exploratory factor analysis led to identifying four factors explained 66.68% of the variance. The items of questionnaire were reduced from 24 to 21 after construct validity. The results of Cronbach’s alpha coefficient (0.94) and ICC (0.50) supported to the acceptable stability of the questionnaire.
Conclusion: The psychometric properties of developed sexual self-efficacy questionnaire-women (SSEQ-W) has good validity and reliability. Therefore, it can be used as useful tool in future studies.

Background & Aim: The caregivers of hemodialysis patients experience a heavy caregiving burden. More caregiving pressure and burden has been reported of the women than men insofar as they are encountered with more physical and psychological problems. This paper explores the challenges faced by women living with husband on hemodialysis.
Methods & Materials: The study followed a conventional content analysis method. The participants were selected through purposive sampling method in hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2017-2018. The first author performed semi-structured, individualized interviews with 14 participants.
Results: By analyzing the data, the main category "Immersing in problems" was extracted with two following categories: 1- Inadequate support network (subcategories: inadequate informational support, inadequate instrumental support, inadequate emotional support) and 2- Difficult coexistence with problems (subcategories: role overload, worry and anxiety, fear and hope for the future, suffering of frequent dialyses).
Conclusion: The findings of the study showed that women living with the husband on hemodialysis have been encountered with challenges and numerous stressing factors in the course of caregiving. Given the challenges experienced by participants, telenursing and community health nurses can play an important role in eliminating the many problems of hemodialysis patients and their caregivers.

Background & Aim: Desirable bishop score is necessary for having a successful delivery. Prostaglandins are effective on cervical ripening and primrose contains precursors of these materials. Therefore, the present study was conducted to evaluate the effect of vaginal Evening primrose on the bishop score among term nulliparous women.
Methods & Materials: The present double-blind randomized clinical trial was conducted on 86 nulliparous women who referred to the comprehensive health service centers of Rafsanjan from November 2017 to May 2018. The samples were selected through convenient sampling method and allocated into two intervention and placebo groups with simple random assignment. The intervention group used a daily dose of 1000 mg vaginal capsules of Evening primrose from the 38th week of pregnancy until delivery and the placebo group received similar placebo with similar administration method. The Information about the women’s bishop score was gathered from the participants’ medical files in the hospital and then was analyzed using SPSS software version 16 and Kolmogorov-Smirnov test, Chi-square test and independent t-test.
Results: The total mean and standard deviation of the bishop score in the intervention and placebo groups was respectively 7.83 ± 2.09 and 4.46 ± 2.39 and the simplified bishop score in the intervention and the control groups was respectively 5.93 ± 2.42 and 2.81 ± 2.02. The difference between the two groups considering both of the bishop scores was statistically significant (p = 0.001).
Conclusion: Vaginal Evening primrose is effective to ripen the cervix of term nulliparous women and so, it could be administered for this purpose.

Background & Aim: One of the main concerns in patients with myocardial infarction is that there is no return to sexual activities. Sexual counseling is an interaction between patient and nurse that requires appropriate performance, responsibility, and confidence. The present study aimed to determine nurses' performance, responsibility, and confidence in sexual counseling of myocardial infarction patients.
Methods & Materials: This descriptive/analytical cross-sectional study was carried out on 180 nurses from the cardiac care unit (CCU) at the hospitals located in southeastern Iran in 2018. Sampling was performed with the census method; and the data collection tool was a demographic information form and questionnaire, involving nurses' performance, responsibility, and confidence in sexual counseling of cardiac patients. Information was analyzed using SPSS software (ver.18) through descriptive and inferential statistics, including t-test, ANOVA, and Pearson correlation coefficient. The significance level was considered as 0.05.  
Results: The mean of total performance scores in the nurses was 14.54 ± 4.4, indicating the average performance of nurses in the sexual counseling of myocardial infarction patients. The total mean score of responsibility was 14.32±2.7, indicating their average responsibility in sexual consultation. The total mean score of confidence was 12.86±2.35, indicating their average confidence in the sexual counseling of cardiac patients.
Conclusion: The present research showed that nurses’ performance and confidence were not high or acceptable in the sexual counseling of patients with a myocardial infarction, which can lead to some dangerous events such as recurrent myocardial infarction or sudden death. Thus, holding some workshops or training related to the sexual counseling of the patients can assist nurses to be better in this case.

Background & Aim: Nurses often work in problematic work environments, characterized by various difficulties and stress-factors that can undermine nurses’ full capacity to provide excellent care. In addition, the nurse practice environment can have an impact on the quality of work life, nurse recruitment and retention and quality patient outcomes. Thus, the study assessed the relationship between practice environment and work-related quality of life as perceived by nurses in a selected hospital in Zamboanga City, Philippines.
Methods & Materials: A descriptive correlational design was used in the study and the total population of nurses were recruited as participants.  The Practice Environment Scale of the Nursing Work Index and Work-Related Quality of Life Scale were used to gather the needed data. Data were analyzed using mean, standard deviation and spearman rank-order correlation.
Results: A total of 103 nurses were surveyed in the study. In the perceived practice environment scale, it was revealed that the nursing foundation for quality of care was the highest (M=3.01, SD=0.20) and staffing and resource adequacy was the lowest (M=2.56, SD=0.45). On the other hand, job career satisfaction was the highest (M=3.64, SD=0.57) and stress at work was the lowest (M=2.55, SD=0.22) in the perceived work-related quality of life scale. The study showed a significant relationship between the perceived practice environment and perceived the work-related quality of life (rho=0.287, p=0.003).
Conclusion: The study revealed that nurses have a favorable work related quality of life and practice environment. However, formulating and enhancing programs for nurses such as incentive and professional development should be done as this can help foster and sustain a positive practice environment and job satisfaction.

Background & Aim: Since women experience numerous physical and psychological changes after childbirth, the postnatal period is a sensitive stage for mothers and they should have access to special information to cope with these changes. This study aims to determine the predicting factors of postnatal information needs of immigrant Afghan women living in Iran.
Methods & Materials: The present research is a cross-sectional study performed on 280 Afghan pregnant women referred to the selected perinatal health clinics in the southeast of Tehran province from May 22 till July 22, 2018. Using continuous sampling, data were collected by a questionnaire asking for demographic, midwifery and postnatal information needs. Descriptive statistics and ANOVA, independent t-test and multiple linear regressions were used for data analysis in SPSS version 21.
Results: The findings revealed that the highest and lowest postnatal information needs consisting of having information about postnatal problems (M=3.40, SD=0.3) and initiation of sexual intercourse after childbirth (M=3.08, SD=1.15). According to the multiple linear regression model, receiving routine pregnancy care (P=0.01) and age (P=0.04) were both significantly correlated with the mean of postnatal information needs so that these two variables predict 24% of the total score of postnatal information needs.
Conclusion: Women must receive postnatal training and information based on their needs; the demographic and midwifery characteristics of Afghan women should also be considered too.