A quick look at the published literature on COVID-19 disease reveals predictions that indicate more infected patients will be admitted to hospitals and clinics. Although much attention has been paid to the challenges of caring for a sharp increase in the number of infected people, less attention has been paid to patients who are at the beginning of their recovery. Accepting the responsibility of treatment by patients not only benefits them but also helps hospitals. Patients' cooperation can prevent the spread of disease, both in terms of cross-contamination and control and treatment. The literature points to the positive role of clients and their impact, which can be called co-creation, and considers it effective in organizational development. Co-creation improves patients' therapeutic outcomes and increases their respect and value for the organization. In situations such as the COVID-19 pandemic in health care organizations, the perceived shared value of patients is effective in their participation in self-care.

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Background & Aim: Routine treatment of burn injuries is dressing with Nitrofurazone ointment. It has several complications including sensitivity. Aloe vera is a traditional treatment for wound healing.  This study aimed to compare the effectiveness of Aloe Vera gel with Nitrofurazone ointment in the healing of superficial partial-thickness burns.
Methods & Materials: The present study was a split body controlled clinical trial which was carried out on 30 patients with superficial partial-thickness burns. The study was conducted in the Shafa Hospital in Kerman, Iran in 2016. The sample was recruited from patients who had at least two burns, each burn on an alternate side of the body. Samples were allocated to two groups that received Aloe Vera gel or 2% Nitrofurazone ointment on their burns. Bates-Jensen Wound assessment tool was used to evaluate the healing of burns. Statistical analysis was conducted by SPSS-16 and using the repeated measure ANOVA.
Results: The repeated measure ANOVA showed that there was a significant change in the score of BWAT in all areas during the intervention period ( p=0.001), but The trend of healing in the two groups during the intervention period was not significantly different( p=0.098).
Conclusion: Based on this study it looks like Aloe vera gel is as effective as  2% Nitrofurazon ointment in healing wounds.

Background & Aim: Pressure ulcers have been identified as one of the most important and challenging issues in patient^’s well-being. Based on the evidence, rosemary extract compounds can affect wound healing. The aim of this study was to determine the effect of rosemary ointment on pressure ulcer healing in patients admitted to the Intensive Care Unit.
Methods & Materials: In this single-blind randomized parallel clinical trial, 70 patients who met the inclusion criteria were selected purposefully and assigned to the groups by stratified randomization method. In the intervention group, rosemary ointment was applied once a day for seven days. The control group received routine care. Data were collected using the Pressure Ulcer Scale for Healing (PUSH) before the intervention and on the third and seventh days after the intervention. Data were analyzed using independent t-test, chi-square test, and two-way repeated measurements ANOVA with SPSS 18 software.
Results: The mean scores of PUSH decreased significantly in the intervention group while remained unchanged in the control group (P=0.001) one week after the intervention. The effect of time and interaction effect was also significant (P=0.001). Comparison of the ratio of complete ulcer healing in the two groups showed a significant difference between the two groups (p=0.004).
Conclusion: Rosemary ointment facilitated healing and prevented the progression of grade І pressure ulcers in the Intensive Care Unit. Therefore, the use of this ointment, as a low-risk, uncomplicated, available, and inexpensive intervention, is recommended in such patients.

Background & Aim: Self-care is one of the challenges of the health care system in patients with schizophrenia. It has been less studied due to these patients have no insight into the symptoms. This study aimed to determine the effect of cognitive-behavioral group training of self-care skills on self-care in patients with schizophrenia.
Methods & Materials: This single-blind randomized controlled clinical trial (blinding of data analysts) was performed on 50 hospitalized schizophrenia patients by convenience sampling method and random block allocation to the intervention (n=26) and control (n=24) groups in Ebn-Sina Psychiatric Hospital of Mashhad, Iran from late July 2020 to mid-January 2021. The intervention group received cognitive-behavioral group training of self-care skills based on the protocol by Kashani Lotfabadi et al. (2020) in 10 sessions (two sessions per week). The control group was placed on a waiting list. Data collection tools included the Self-Care Requisites Scale (SCRS-H) and the Positive and Negative Syndrome Scale (PANSS). The data were analyzed by SPSS 25 version, repeated measures of ANOVA test.
Results: 60 % (n=30) of participants were female, and 40% (n=20) were male with a mean age of 32.98±8.35 years. The results of repeated measures of ANOVA indicated that there was a significant difference between the intervention and control groups in terms of descending mean score of total self-care during the test stages (p=0.001).
Conclusion: Cognitive-behavioral group training of self-care skills could promote self-care behaviors in patients with schizophrenia. Therefore, we suggest using this intervention to strengthen self-care skills in patients with schizophrenia.

Background & Aim: Anxiety related to the COVID-19 is prevalent amongst the nursing workforce potentially affecting nurses’ well-being and their organizational commitment. The nurse manager’s caring behavior has been recognized as a crucial indicator of nurses' resilience with the COVID-19 pandemic. This study aimed to investigate the effect of COVID-19 anxiety on frontline nurses’ organizational commitment and their perception of nurse managers' caring behavior.
Methods & Materials: This study utilized an explanatory research design; hence, a convenient sample consisted of 60 registered nurses working at three selected medical intensive care units located in one of the Cairo University Teaching hospitals, Egypt was selected. Data were collected using the Coronavirus Anxiety Scale, Nursing Staff Organizational Commitment Questionnaire, and Nurse Managers' Caring Behavior Questionnaire. Statistical Package for the Social Sciences (SPSS) version 20 was used for the data analysis where the descriptive statistics, Simple Linear, and Stepwise multiple regression analysis were applied.
Results: The highest-rated anxiety problem of COVID-19 was appetite loss (x ̅=3.03, SD = ±0.88). Human respect as one of the perceived nurse managers caring behaviors emerged as a strong predictor (Partial R2 = 0.104, p= .017) in increasing the frontline nurses’ organizational commitment, while COVID-19 anxiety has a significant decreasing effect (Partial R2 = 0.435, p<0.001) on it.
Conclusion: COVID-19 anxiety has affected the frontline nurses’ organizational commitment and their perceived nurse managers' caring behavior. COVID-19 anxiety should be addressed and rectified by providing appropriate managerial caring behavior and support to boost nurses ‘organizational commitment.

Background & Aim: Self-care in patients with heart failure can improve multiple outcomes and reduce mortality. Measuring self-care requires valid and reliable tools. This study aimed to determine the psychometric properties of the 9-items European Heart Failure Self-Care Behavior Scale.
Methods & Materials: The present study is a psychometric evaluation. The original version of the tool was translated from English to Persian using the standard Backward-Forward method. The questionnaire's validity was assessed using face, content, criterion (the Self-Care of Heart Failure Index v.6 as a criterion), and construct validity.  An exploratory factor analysis approach was used to construct validity with a sample of 216 patients with chronic heart failure referred to Dr. Shariati and Imam Khomeini Hospital's heart clinics in Tehran; and Ayatollah Mousavi Hospital in Zanjan. The reliability of the questionnaire was evaluated by internal consistency and stability methods.
Results: After the validation process (validity and reliability), all 9 items of the questionnaire were approved and remained. The content validity index of the total content of the questionnaire was calculated to be 0.96. Based on factor analysis, only one factor was confirmed for the questionnaire. The correlation between the present questionnaire and the Self-Care of Heart Failure Index v.6 was positive and significant (p<0.001, r=0.753). Internal consistency (α=0.728) and stability (0.897) of the questionnaire were also confirmed.
Conclusion: The European Heart Failure Self-Care Behavior Scale is valid and reliable for measuring Iranian patients' self-care behaviors with heart failure.

Background & Aim: Parents of neonates hospitalized in the neonatal intensive care unit may experience a high level of stress. Although many approaches were applied for reducing their stress, however little is known about the effect of a comprehensive support program. The aim of this study is to investigate the effect of a comprehensive supportive program on maternal stress levels in a neonatal intensive care unit.
Methods & Materials: In a quasi-experimental study, 62 mothers whose premature neonates were hospitalized in a neonatal intensive care unit, were selected and assigned into experimental and control groups. A comprehensive support program was applied for the mothers in the experimental group, whereas the mothers in the control group received the standard routine care. Data were collected and analyzed using SPSS software and the p-value was considered at P≤0.05.   
Results: It was found that the maternal stress level in the experimental group (mean=2.95±.72) was significantly lower than those in the control group (mean=3.74±.82) (p=0.001). The effect magnitude of the change in the maternal stress level in the experimental group (d=1.20) was significantly higher than that of mothers in the control group (d=.36).
Conclusion: A comprehensive support program is significantly effective in reducing maternal stress levels. So, it is highly recommended that nurses use these comprehensive approaches in practice and especially support mothers by facilitating interaction between parents experiencing similar problems. Further research can focus on the effect of group training on the stress level of mothers.

Background & Aim: Patient decision aids are detailed and personalized health education materials that assist patients in decision making. According to expert viewpoints, this study aimed to determine important factors in implementing the prenatal screening decision aid in Iran.
Methods & Materials: In this qualitative study, 24 experts, including seven obstetricians, four information scientists, five managers or policymakers, and eight midwives, were selected using purposive and snowball sampling approaches. Semi-structured interviews were conducted to collect the data between January 2020 and June 2020 in Tehran, Iran. A prenatal screening decision aid was presented to the participants, and we asked them to raise their concerns and thoughts regarding the factors influencing the implementation of patient decision aids. We used MAXQDA 10 and applied conventional content analysis for data analysis.
Results: Two organizational and personal factors themes were identified to implement Iran's prenatal screening decision aids.
Conclusion: We identified the viewpoints of experts regarding major factors in patient decision aids implementation for prenatal screening. Before implementing prenatal screening decision aids in Iran, it would be helpful to consider these organizational and personal factors. Prenatal screening decision aids can provide better information for pregnant women and strengthen their decision-making ability.

Background & Aim: The current study aimed to investigate workplace bullying, specifically verbal abuse of working nurses, and its consequences on the physical and psychological levels.
Methods & Materials: A cross-sectional study was designed and implemented in 151 nurses working at a university hospital. The survey was conducted in 2018 at a university hospital in Greece, and the Verbal Abuse Scale (G-AVQ v.0/2015) was used to assess the verbal abuse level. Multiple linear regression analysis was applied, and distributions were tested for their symmetry using Blom's method (QQ plot).
Results: 88.1% were women as the mean age of all was 41.7 years and 16.1 years the mean length of employment. Almost all nurses (94.7%) reported experiencing verbal abuse, as 77.6% reported that the perpetrator was a patient's relative (p<0.05). Among Cognitive Assessment, Coping, Severity of Effects, and Strength of Feeling, Coping had the highest mean value the highest mean value, while Severity of Effects had the lowest (2.52 vs. 1.83, p<0.05). Multiple linear regression analysis showed that frequency of verbal abuse type has a significant correlation with higher Coping (β=0.28, p=0.007) and Strength of Feeling values (β=0.29, p=0.010). Similarly, the severity of verbal abuse type has a significant correlation with higher Strength of Feeling values (β=0.30, p=0.014).
Conclusion: Almost all the nurses reported experiencing verbal abuse as the 'patients' relatives were the main perpetrators. Although the nurses seem to cope with verbal abuse successfully, this fact is described as stressful. Moreover, the frequency, severity of verbal abuse, and consequences are correlated to the emotions that arise from it.