Background & Aim: The population of older adults is dramatically increasing in the world. This increase results in more demand for health care services from older adults. So, nurses’ and nursing students’ willingness to care for older adults gain importance. The aim of the study was to determine the willingness of nursing students to care for older adults and the factors affecting this in Turkey.
Methods & Materials: This descriptive cross-sectional study was conducted between November-December 2019 in the nursing faculty of a public university. 299 students were randomly selected and data were collected by using a demographic student form and the Willingness to Care for Older People scale. Data were analyzed via the SPSS version 25 program.
Results: The great majority (90.3%) of the students were female and the mean age was 21.3±1.2 years. The mean score of the students' willingness to care for the elderly was 36.82±5.96. The willingness to care for the older adults was found to be affected by caring for the older adults in clinical practice (B=2.136, β=0.174, p=0.008) and wanting to live with an elderly relative (B=2.022, β=0.168, p=0.016).
Conclusions: The experience of caring for an older adult in clinical practice and to be willing to live with an older relative in the same house is positively associated with the willingness of student nurses to consider geriatric nursing as an option.

No Abstract

Background & Aim: The importance of breastfeeding and its exclusivity in the first six months of the child’s life, is worldwide recognized. Despite that, adherence to exclusive breastfeeding is far from international standards. Therefore, updating evidence on this topic is essencial to demonstrate to parents and health professionals, the benefits of exclusive breastfeeding, demystifying ideas and promote adherence.
Materials & Methods: An  integrative  review  was  conducted  with  a  search  in Medline,  SciELO  and  CINHAL  databases,  with  the  descriptors  “breast feeding", "breast", "feeding", "breastfeeding", "exclusive" and "benefits",  combined  with  the  Boolean  operator  "AND" and “OR”,  from  studies  published  between  2014  and  2019. Of the 221 studies identified, eight were included for review.
Results: Short-term and long-term benefits of exclusive breastfeeding for children were identified, such as healthier eating habits, reduced length of hospital stay, favorable weight increase, lower body mass index, lower adiposity, lower total cholesterol values, better cognitive and behavioral development, as well as stability of metabolic levels in children with metabolic disorders.
Conclusion: There are benefits for exclusive breastfeeding that must be explained to parents. Nurses must incorporate the best available evidence into their practice to enable parents to realise the impact of the choice of exclusive breastfeeding on the child's health, increasing their adherence.

Background & Aim: Proper assessment of the quality of sexual life requires having access to psychometrically sound instruments. The present study aimed to develop an instrument to assess Iranian women’s quality of sexual life.
Methods & Materials: This was a mixed-method study with exploratory design; at first, the Iranian women’s perception of the quality of sexual life was explored. An initial 73-item version of the questionnaire was generated according to qualitative findings and the review of the literature. Then, psychometric characteristics consist of face, content, construct, convergent validity, and internal consistency were assessed. A total of 450 women completed the developed questionnaire, ENRICH scale, and sexual quality of the life-female questionnaire.
Results: The results of face validity were satisfactory. The content validity index and content validity ratio were found to be .92 and .80, respectively. Exploratory factor analysis identified six factors accounted for 51.92% of the variance. The identified six factors that were also confirmed by confirmatory factor analysis with acceptable goodness of fit indices. Correlations between the total scores and the dimensions of sexual quality of life-female questionnaire and ENRICH ranged from .414 to .747. Total and the range of Cronbach’s alpha coefficient for the explored subscales were 0.94 and 0.94 to 0.60 respectively.
Conclusion: This study provided a valid and reliable 36-items questionnaire to holistically assess Iranian women’s quality of sexual life. It will be useful as a self-reported measure in research and clinical practice of women’s sexual health.

Background and Objective: Clinical handoff is the process of transmitting information, responsibility and accountability among the health care team members. Lack of standard protocols may result in the loss of essential information and also may lead to medical errors. The purpose of this study was to evaluate the impact of using a  standard checklists on clinical handoff in coronary care unit (CCU).
Method: This quasi-experimental study was performed based on pre- and post-test design at Afshar Hospital in Yazd. There were a total of 564 handoffs with the participation of 24 nurses in two coronary care units in 2017. Prior to the intervention, 282 clinical handoffs were recorded and implemented. Nurses were informed about the ISBAR standard checklist and were encouraged to use it for one week. Then, 282 clinical handoffs were again recorded and implemented. Frequency of providing information during clinical handoff was determined based on ISBAR checklist and the data were analyzed using descriptive statistics and chi-square test.
Results: Prior to the intervention, frequency of providing information during clinical handoff was reported as follows: patient identity (86.9%), current position (75.1%), clinical history (52.8%), system status review (59.9%), and recommendations (92.9%). The results showed that the indexes significantly increased (P <0.001) after the intervention in all these five domains: patient identity (100%), current situation (94%), clinical history (80.1%), system status review (92.2%) and recommendations (100%).
Conclusion: Transition of information based on standard checklists with a specific framework can increase the frequency of information provided during clinical handoff. Therefore, it is recommended to train nurses and nursing  students about standard handoff and related tools such as ISBAR in hospitals and universities.

Background & Aim: Reproductive health services utilization is an important component of health services in preventing adolescents’ sexual and reproductive hedgies & take corrective measures. The main purpose of this study is to determine reproductive health services utilization status and associated factors among adolescents at public schools in Adama town Ethiopia.
Methods & Materials: Institution based cross-sectional study design was used with a total sample size of 367 adolescents in the schools. The sample size was proportionally allocated to grade nine, ten, eleven, and twelfth. The study subjects were selected by simple random sampling. A Standard pre-tested self-administered questionnaire was used to collect data after getting informed consent from the study participants. Data were entered and analysed using SPSS version 20 software. Descriptive statistics and Logistic regression were done to describe and identify factors associated with reproductive health services utilization. A P-value of less than 0.05 was considered to declare a level of significance.
Results: The magnitude of reproductive health service utilization in this was 122(34%). Discussion with a sexual partner and peer, student’s educational status, sex, knowledge about the availability of reproductive health service were among the factors associated with the use and non-use of RH service.
Conclusion: Utilization of Reproductive Health services among adolescents in the study area was low. Therefore, interventions such as advancing adolescents’ knowledge, encouraging open discussion forum, strengthening of youth centers, and school reproductive health clubs are important.

Background & Aim: cancer stigma is one of the Psycho-social consequences of a cancer diagnosis. It seems that spiritual intelligence training can reduce cancer stigma by enhancing spiritual intelligence. Therefore, the purpose of the present research was to determine the effect of the components of King's spiritual intelligence group training on stigma in patients with cancer.
Methods & Materials: This randomized controlled clinical trial was carried out in Omid Oncology Hospital of Mashhad, Iran in 2018-19. The statistical population of the study included 54 patients with cancer who were then randomly divided into an intervention group (23 individuals) and a control group (27 individuals). The patients in the intervention group received King's spiritual intelligence group training (2008) for ten (90-minute) sessions, while the patients in the control group received routine care. The data collection instrument was Cancer Stigma Scale (patient version). The data were analyzed by SPSS-22 software using independent t-test, Man Whitney, paired t-test, and Wilcoxon statistical test.
Results: The findings showed that there is no statistically significant difference between the intervention and control groups in terms of stigma total mean score for the pre-intervention phase (p>0.05). However, in terms of stigma total mean score changes between the post and pre-intervention phases, there was a significant difference between the scores of the intervention and the control group (p<0.001).
Conclusion: Spiritual intelligence training is effective in reducing stigma among patients with cancer. 

Background & Aim: Reducing readmissions is a major goal of health care systems. This study aimed to identify readmission risk factors following coronary artery bypass graft surgery.
Methods & Materials: This case-control study analyzed 540 patients who underwent coronary artery bypass graft surgery between January 2016 and December 2019 at Shahid Beheshti Hospital in Qom, Iran. The case group contained 270 patients who were readmitted to the hospital during the 30-day after discharge and the control group comprised 270 non-readmitted patients.
Results: Readmit patients suffered from higher rates of cardiac failure, myocardial infarction, hypertension, myocardial dysrhythmia, and using antiplatelet coagulant medication (P<0.05). Compared with non-readmitted patients, readmitted patients were more likely to have emergency surgery (OR 1.62; CI 1.11-2.38), cardiac arrest (OR 2.52; CI 2.39-2.85), and massive intraoperative hemorrhage during surgery (OR 2.36; CI 2.13-2.67). Postoperative disorders such as surgical site infection, pleural effusion, dysrhythmias, and myocardial infarction were independent risk factors for readmission (P<0.05).
Conclusion: Patients at risk for readmission should be closely monitored. Furthermore, careful decision-making about surgical criteria by a multidisciplinary team can help improve outcomes as well as reduce readmissions.

Background & Aim: Due to many negative aspects of the educational environment students’ have not well attained their professional demands that affect their perception and qualities of nursing care delivered to the community. The study was aimed to assess nursing students’ perception and associated factors towards their educational environment in governmental universities of Southwest Ethiopia.
Methods & Materials: Institution based cross-sectional study was employed on 422 study subjects from April 9 to 23/2019. Proportionally allocated a simple random sampling technique was used to select the participants. The data was collected using a validated self-administered Dundee Ready Educational Environment Measure (DREEM) questionnaire and entered by Epi data 3.1 and exported to SPSS version 23 for analysis. Simple and multiple linear regressions were used and a total DREEM mean score, sub scores, and SD were computed.  A P-value < 0.05 was considered as statistically significant.
Results: Overall mean perception of nursing students was 124.76/200 with Standard deviation (SD) of 0.065 which implies that more positive than the negative educational environment. The DREEM subscales mean scores of students’ perception of learning, perception of teachers, academic self-perception, perception of atmospheres and students’ social self-perception were 31.64/48, 25.4/44, 22.52/32, 29.17/48 and 16.08/28 with SD of (0.204,0.098,0.075,0.060 and 0.101) respectively. The multiple linear regressions revealed that there was statistically a significant relationship between students’ perception with study years, support system, learning facilities; and memory, learning motivation, satisfaction, academic status, gender, marital status receptively.
Conclusion: Even though nursing students’ perception of their educational environment was more positive than negative, it is not most satisfactory. Thus, to make it more attractive and an excellent university should adopt different strategies.

Background & Aim: Due to the chronic nature of heart failure, it is necessary to observe and maintain self-care behaviors accordingly. Tele-monitoring using smartphone applications can be effective in this regard. This study aimed to determine the effect of using smartphone applications on self-care behaviors in patients with heart failure.
Methods & Materials: This randomized controlled clinical trial was conducted between August and March in 2018. Using consecutive sampling, 120 patients were selected and were allocated to the two groups by a random quadruple block approach. The participants in both groups completed the European heart failure self-care questionnaire before and after the intervention. Patients in both groups received routine hospital care; however, patients in the intervention group used an Android smartphone application for three months daily as well. Via the application, there were ongoing interactions between patients and researchers, depending on the needs of patients and their conditions. The data were analyzed using SPSS V.16 software.
Results: There was a statistically significant difference between groups in terms of the mean score of self-care after the intervention where the mean score in the intervention group was lower (p<0.001), which indicates better self-care. Based on the results, the intervention effect was reported at 0.787.
Conclusion: The findings of this study showed that using a smartphone application can improve self-care in patients with heart failure. Therefore, it is recommended to health care providers to use this mobile application to care and monitor remote patients with HF.