Background: This integrative review was aimed to examine in literature and integrate the determinants of nurses' organizational commitment in hospital settings. Materials and Methods: In this study, an integrative review of the literature was used. The search strategy began with six electronic databases (e.g. CINAHL and Medline). Considering the inclusion criteria, published studies that examined the factors influencing nurses' organizational commitment in the timeframe of 2000 through 2013 were chosen. Data extraction and analysis were completed on all included studies. The final sample for this integrative review comprised 33 studies. Results: Based on common meanings and central issues, 63 different factors contributing to nurses' organizational commitment were integrated and grouped into four main categories: Personal characteristics and traits of nurses, leadership and management style and behavior, perception of organizational context, and characteristics of job and work environment. Conclusions: In general, categories emerged in this study could be useful for formulating initiatives to stimulate nurses' OC. However, little is known about the relative significance of each identified factor among nurses working in different countries. Qualitative research is recommended for narrowing this gap. Future research should be directed to examine the psychometric properties of the organizational scales for nurses in different cultures.

Background: Motivation to academic achievement is critical for students of medical sciences, particularly nursing students. It is directly related to high levels of achievement and quality of life. Accordingly, diminished motivation would result in academic decline, study and work desertion and exhaustion. Therefore, this study aimed to investigate the effect of cognitive behavioural intervention on the motivation for academic achievement of the nursing students. Materials and Methods: This study was conducted on 64 female nursing students who were recruited to study based on the inclusion criteria. After sampling, the subjects were randomly assigned to study and control groups. Then, cognitive behavioural intervention was administered in study group during 60 days. Academic motivation scale was filled before, after and one month after the intervention. Data were analyzed by descriptive and inferential statistical tests (Chi-square, t-test). Results: After the intervention, mean scores of academic motivation were significantly increased in study group, compared to control group (P < 0.001). Comparison of the mean scores of academic motivation in two groups revealed a significant increase in mean score of academic motivation 151.50 (20.22) after cognitive behavioural intervention (P < 0.001). Conclusions: The findings suggested that cognitive behavioural intervention was a valuable psychotherapy technique to improve academic achievement motivation among nursing students.

Background: Childhood cancers are fatal diseases which cause intense stress and traumatic situations for the ones who experience those diseases. This kind of an emotionally hard life may create some hardships for developing self-concept. The aim of the study is to put forth the self-exposure of a school-age child by using plays. Materials and Methods: Six play sessions had been carried out in June-August 2011. As a searching pattern, interpretive case study method was used. The research consisted of six children with cancer, aged between 9 and 12 years. The research was conducted in a public hospital in children oncology service. Results: The assessment of data was realized in two stages. The first one was examining the data; the other stage was the content analysis that has been constructed after the play sessions as "Nursing Intervention: Play Model." In the newly formed model, nine themes had been found: (a) expressing good memories, (b) control, (c) problem-solving ability, (d) relations, (e) aggressive behaviors, (f) regression, (g) good-bad, (h) trauma, and (i) anxiety. Conclusions: The self-concept of the school-age child needs to be supported. It has been submitted that the themes can be supportive for the prospective nursing models concerning child's self-exposure. It has been suggested that the themes produced by "Nursing Intervention: Play Model" can be used while planning, implementation, and assessment of the nursing care.

Background: Osteoporosis is the most common metabolic bone disease. The purpose of this study is to investigate the health belief model (HBM) and social cognitive theory (SCT) for osteoporosis preventive nutritional behaviors in women. Materials and Methods: In this quasi-experimental study, 120 patients who were women and registered under the health centers in Fasa City, Fars Province, Iran were selected. A questionnaire consisting of HBM constructs and the constructs of self-regulation and social support from SCT was used to measure nutrition performance. Bone mineral density was recorded at the lumbar spine and femur. The intervention for the experimental group included 10 educational sessions of 55-60 min of speech, group discussion, questions and answers, as well as posters and educational pamphlets, film screenings, and PowerPoint displays. Data were analyzed using SPSS 19 via Chi-square test, independent t-test, and repeated measures analysis of variance (ANOVA) at a significance level of 0.05. Results: After intervention, the experimental group showed a significant increase in the HBM constructs, self-regulation, social support, and nutrition performance, compared to the control group. Six months after the intervention, the value of lumbar spine bone mineral density (BMD) T-score increased to 0.127 in the experimental group, while it reduced to −0.043 in the control group. The value of the hip BMD T-score increased to 0.125 in the intervention group, but it decreased to −0.028 in the control group. Conclusions: This study showed the effectiveness of HBM and constructs of self-regulation and social support on adoption of nutrition behaviors and increase in the bone density to prevent osteoporosis.

Background: Primary dysmenorrhea may lead to severe anxiety and pain relief during menstruation may reduce the anxiety levels. This study was aimed to determine the effect of acupressure at third liver and placebo points on the anxiety level in patients with primary dysmenorrhea. Materials and Methods: This clinical trial was conducted in parallel in the control and treatment groups for three menstrual periods at the dormitory of Kashan University of Medical Sciences between March and June 2012. Students with pain score equal to or greater than 4 were selected and divided into groups based on severity of pain using a randomized block design with the allocation ratio of 1:1. Acupressure was applied in two acupoints including third Liver point (Liv3) and placebo points. Spielberg (STAI) anxiety questionnaire was completed before and after intervention. Randomization, subjects, and data analyzer were blinded to the analysis. Chi-square tests, t-test, Mann-Whitney, paired sample t-test, and univariate analysis of variance were used for statistical analysis. P values <0.05 were considered statistically significant. Results: Mean [standard deviation (SD)] values of apparent anxiety levels before and after intervention for liv3 were 45.100 (9.769) and 38.100 (10.608), respectively. For the control group, they were 41.200 (9.795) and 38.900(10.140), respectively. Difference was significant only in the intervention group (P < 0.001). Hidden anxiety did not show a significant change before and after intervention. There was no difference between groups in apparent or hidden anxiety after intervention. Conclusions: Pressure on liv3 point reduces anxiety. As there are no previous studies on this topic, further studies with more samples are recommended.

Background: Poor nutrition habits in adolescent girls endanger their health and are followed by serious systemic diseases in adulthood and negative effects on their reproductive health. To design health promotion programs, understanding of the intra- and interpersonal associated factors with treatment is essential, and this was the aim of this study. Materials and Methods: This cross-sectional study was conducted on 193 adolescent girls of age 11-15 years. Random cluster selection was used for sample selection. Food group consumption pattern was assessed by food frequency questionnaire. Also, perceived susceptibility/severity and nutritional attitude as intrapersonal factors and social support as interpersonal factor were assessed. The relationship between food group consumption level and nutritional attitude and perceived treat (susceptibility/severity) as intrapersonal factors and perceived social support as interpersonal factor were assessed by linear multiple regression and analysis of variance (ANOVA). Results: Results showed that the level of sweetmeat food consumption was related to perceived social support (P = 0.03) and nutritional attitude (P = 0.01) negatively. In addition, an inverse and significant association was found between the level of junk food intake and informational perceived social support (P = 0.004). The association between the level of fast food intake and the perceived parental social support for preparation of healthy food was negatively significant (P = 0.03). Breakfast consumption was related to nutritional attitude (P = 0.03), social support (P = 0.03), and perceived severity (P = 0.045). Conclusions: Results revealed that perceived social support and nutritional attitude are the important and related factors in dietary intake among girls, and promotion of social support and modification of nutritional attitude may lead to healthy nutritional behaviors among them.

Background: As adolescents spend much time on playing computer games, their mental and social effects should be considered. The present study aimed to investigate the association between playing computer games and the mental and social health among male adolescents in Iran in 2014. Materials and Methods: This is a cross-sectional study conducted on 210 adolescents selected by multi-stage random sampling. Data were collected by Goldberg and Hillier general health (28 items) and Kiez social health questionnaires. The association was tested by Pearson and Spearman correlation coefficients, one-way analysis of variance (ANOVA), and independent t-test. Computer games related factors such as the location, type, length, the adopted device, and mode of playing games were investigated. Results: Results showed that 58.9% of the subjects played games on a computer alone for 1 h at home. Results also revealed that the subjects had appropriate mental health and 83.2% had moderate social health. Results showed a poor significant association between the length of games and social health (r = −0.15, P = 0.03), the type of games and mental health (r = −0.16, P = 0.01), and the device used in playing games and social health (F = 0.95, P = 0.03). Conclusions: The findings showed that adolescents' mental and social health is negatively associated with their playing computer games. Therefore, to promote their health, educating them about the correct way of playing computer games is essential and their parents and school authorities, including nurses working at schools, should determine its relevant factors such as the type, length, and device used in playing such games.

Background: Premenstrual syndrome (PMS) can cause problems in daily work and relationships. Materials and Methods: Eighty-six women were randomly assigned to two intervention groups and one control group. Patients were asked to fill out the PMS Daily Symptoms Record for 2 months, and then the participants were randomly assigned to one of the three study groups. Medical intervention was carried out for 2 months with the participants in each group receiving either a tablet containing 200 mg vitamin D, 100 mg vitamin E, or a placebo each day, respectively. After 2 months, the results of pre- and post-intervention were compared. P < 0.005 was considered significant. Results: After the intervention, the mean score of the syndrome significantly decreased in all the three groups (12, 16, and 8 participants had decreased scores in vitamin D, vitamin E, and placebo, respectively). The differences between groups were not significant (P > 0.05). Conclusions: Supplemental therapy with vitamins D and E is an effective and affordable treatment for PMS.

Background: Formation of biofilm and bacterial colonization within the endotracheal tube (ETT) are significant sources of airway contamination and play a role in the development of ventilator-associated pneumonia (VAP). This study was conducted to examine the effect of nebulized eucalyptus (NE) on bacterial colonization of ETT biofilm. Materials and Methods: We performed a randomized clinical trial in three intensive care units (ICUs) of an educational hospital. Seventy intubated patients were selected and randomly divided into intervention (n = 35) and control (n = 35) groups. The intervention group received 4 ml (5%) of eucalyptus in 6 ml normal saline every 8 h. The placebo group received only 10 ml of normal saline in the same way. On extubation, the interior of the tube was immediately sampled using a sterile swab for standard microbiological analysis. Chi-square and Fisher's exact tests were used for statistical analysis in SPSS. P values less than 0.05 were considered statistically significant. Results: In both samples, Klebsiella pneumoniae and Acinetobacter baumannii were the most frequently isolated bacteria. In the control group, heavy colonization was greater than in the intervention group (P = 0.002). The frequency of isolation of K. pneumoniae in the intervention group was lower than in the control group (P < 0.001). However, there was no difference between the two groups in other isolated bacteria. Conclusions: NE can reduce microbial contamination of the endotracheal tube biofilm in ventilated patients. Moreover, K. pneumoniae was the most sensitive to NE.

Background: Cardiac self-efficacy is an essential factor in persistence of healthy behaviors in patients with coronary artery disease (CAD). Today, telenursing methods have numerous applications in health care. Therefore, this study aimed to determine the effect of a text message and telephone follow-up program on cardiac self-efficacy of patients with CAD. Materials and Methods: This was a randomized controlled trial on 70 patients with CAD who were hospitalized in Shahid Chamran Hospital (Isfahan, Iran). The participants were randomly assigned to the experimental and control groups. Collection of data on cardiac self-efficacy was performed before, 3 months after, and 4 months after the beginning of the intervention using Cardiac Self-Efficacy Scale designed by Sullivan et al. During the 3 months of intervention, six messages were sent to the subjects each week and calls were made twice a week in the first month and once a week during the second and third months. The statistical analysis of data was performed using independent t-test, Chi-square, Mann-Whitney U test, and repeated measures analysis of variance (ANOVA). Results: Before the intervention, there was no significant difference between the mean scores of cardiac self-efficacy of the two groups. However, 3 months and 4 months after the beginning of the intervention, the mean score of cardiac self-efficacy in the experimental group was significantly higher than in the control group (P < 0.001). Conclusions: The text message and telephone follow-up program is effective in promoting the cardiac self-efficacy of patients with CAD.

Background: Induced abortion is an important medical issue. Knowledge and attitude of midwives regarding legal and religious commandments on induced abortion can be useful in confronting this issue. The aim of this study was to assess the knowledge and attitudes of midwives of Isfahan regarding these rules and to find their relationship with demographic characteristics. Materials and Methods: This was a cross-sectional, descriptive, and analytical study. The study participants consisted of 189 midwives working in hospitals, health centers, private gynecology clinics, and university. Random quota sampling method was used. Data were collected using a researcher-made questionnaire. Data were analyzed using mean, frequency distribution tables, Pearson correlation, and Spearman's coefficient. For all tests, an error of less than 0.05 was considered. Results: The majority of the participants had extremely low to moderate (73%) knowledge about the subject of the study. Their attitudes toward effective implementation of these rules were mostly extremely weak to moderate (68.72%). No correlation was observed between knowledge, age, work experience, and education. However, there was a relationship between the level of knowledge about these rules and the location of service. There was no significant correlation between attitude and demographic characteristics. Conclusion: Due to less knowledge of the midwives and their low attitude score in this regard, training them, improving their attitude toward these issues, and effective implementation of these laws are necessary. Therefore, by identifying the factors affecting the formation of attitudes and the level of knowledge, more constructive proceedings can be taken to promote them.

Background: Self-regulation is one of the current psychological concepts that have been known as a determinant of leisure time physical activity. Due to cultural and social diversity in different societies and age groups, application of specific questionnaires is essential to perform investigations about physical activities. The aim of this study is development and evaluation of psychometric properties of a self-regulation questionnaire about leisure time physical activity in Iranian male adolescents. Materials and Methods: This cross-sectional study was conducted in 2013, and data of 603 male students from 12 high schools in Isfahan were collected. A comprehensive literature review and similar questionnaire review were conducted and 25 items were selected or developed to measure self-regulation. Comprehensibility of items was evaluated in a pilot study and an expert panel evaluated face and content validity. Exploratory factors analysis (EFA) was used for evaluation of construct validity and extraction of sub-constructs of self-regulation. Leisure time physical activity was assessed using International Physical Activity Questionnaire (IPAQ). Results: The mean age of the participants was 16.3 years (SD =1.0) and the range was 15-19 years. Cronbach's α coefficient of the questionnaire in the pilot and main study was 0.84 and 0.90, respectively. EFA resulted in four sub-constructs including "enlistment of social support," "goal setting," "self-construction," and "self-monitoring," which explained 63.6% of the variance of self-regulation. Conclusions: Results of this investigation provide some support to the validity and reliability of the 16-item questionnaire of self-regulation abut leisure time physical activity in the target group.

Background: Today, the rate of surgeries is increasing, but surgeries are canceled due to various reasons. Unexpected cancellation of surgeries not only results in disorder in the operating room schedule, but also causes stress for patients and their family and increases costs. We determined the number and causes of surgery cancellations and areas for improvement. Materials and Methods: This outcome evaluation of Six Sigma program was conducted on 850 cases after the implementation of the program and compared to that of 850 cases which received routine care before the program. Cases were selected through easy sampling during the study. Before the implementation, the number of cancellations was recorded daily and their reasons were investigated. Then, Six Sigma program was implemented in accordance with the reasons for each category and necessary steps were taken to prevent the cancellation of surgeries. Data were collected for 3 months using a three-section data collection form. For data analysis, distribution and relative frequency and chi-square test were used. Results: The three categories of patient, physician, and hospital system were identified as the main causes. The highest rate of cancellation was related to ENT surgeries (74.19%). No cancellations were made in orology surgeries. The implementation of the Six Sigma program caused a significant difference in surgery cancellation (P = 0.003); 31 (3.6%) cases of cancellation were reduced to 12 (1.4%) cases. Conclusions: The results showed that Six Sigma program is a pre-surgery care quality improvement program. Patient education and the implementation of the 6 sigma program can be effective in reducing the rate of cancellation of operations.

Background: Stress, anxiety, and postpartum depression are the most common problems among women in their childbearing age. Research has shown that aromatherapy administered during labor reduces anxiety in mothers. With regard to the specific biological conditions in postpartum period and the subsequent drop in hormone levels, this study investigated the effect of lavender on prevention of stress, anxiety, and postpartum depression in women. Materials and Methods: In a clinical trial, 140 women admitted to the obstetric and gynecological unit were randomly divided into aromatherapy and non-aromatherapy groups immediately after delivery. Intervention with aromatherapy consisted of inhaling three drops of lavender essential oil every 8 h with for 4 weeks. The control group received routine care after discharge and was followed up by telephone only. After 2 weeks, 1 and 3 months of delivery, women were assessed by the 21-item Depression, Anxiety, and Stress Scale and the Edinburgh stress, anxiety, and depression scale in the two groups. Data analysis was performed by Mann-Whitney, analysis of variance (ANOVA), and post hoc tests. Level of significance was set as 0.05 for all tests. Results: The results showed that the mean stress, anxiety, and depression at time point of 2 weeks (P = 0.012, P < 0.0001, and P = 0.003, respectively) and stress, anxiety, and depression scores at time points of 1 month (P < 0.0001) and 3 months after delivery (P < 0.0001) were significantly lower in the study group compared with the control group. Conclusions: Inhaling the scent of lavender for 4 weeks can prevent stress, anxiety, and depression after childbirth.

Background: Premature neonates' feeding is of great importance due to its effective role in their growth. These neonates should reach an independent oral nutrition stage before being discharged from the Neonatal Intensive care Unit. Therefore, the researcher decided to conduct a study on the effect of palady and cup feeding on premature neonates' weight gain and their reaching full oral feeding time interval. Materials and Methods: This is a clinical trial with a quantitative design conducted on 69 premature infants (gestational age between 29 and 32 weeks) who were assigned to cup (n = 34) and palady (n = 35) feeding groups through random allocation. The first feeding was administrated either by cup or palady method in each shift within seven sequential days (total of 21 cup and palady feedings). Then, the rest of feeding was administrated by gavage. Results: Mean hospitalization time (cup = 39.01 and palady = 30.4; P < 0.001) and mean time interval to reach full oral feeding (cup = 33.7 and palady = 24.1; P < 0.001) were significantly lower in palady group compared to cup group. Mean weight changes of neonates 7 weeks after the intervention compared to those in the beginning of the intervention were significantly more in palady group compared to the cup group (cup = 146.7 and palady = 198.8; P < 0.001). Conclusions: The neonates in palady group reached full oral feeding earlier than those of cup group. Subjects' weight gain was also higher in palady group compared to the cup group. Premature neonates with over 30 weeks of gestational age and physiological stability can be fed by palady.

Background: Different modes of mechanical ventilation are used for respiratory support after coronary artery bypass graft (CABG). This study aimed to compare the effect(s) of using adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) on the length of mechanical ventilation (intubation duration) and hospital stay after coronary artery bypass graft surgery. Materials and Methods: In a randomized control trial, 64 patients were ventilated with ASV as the experiment group or with SIMV as the control group after CABG surgery in Chamran Hospital of Isfahan University of Medical Sciences. The time of tracheal intubation and the length of hospital stay were compared between the two groups. Data were analyzed and described using statistical analysis (independent t-test). Results: The mean time of intubation duration was significantly lower in ASV group compared with SIMV group. (4.83 h vs 6.71 h, P < 0.001). The lengths of hospital stay in the ASV and the SIMV groups were 140.6 h and 145.1 h, respectively. This difference was significant between the two groups (P = 0.006). Conclusions: According to the results of this study, using ASV mode for mechanical ventilation after CABG led to a decrease in intubation duration and also hospital stay in comparison with the SIMV group. It is recommended to use ASV mode on ventilators for respiratory support of patients undergoing coronary artery bypass graft surgery.