Causes of incivility in Iranian Nursing Students: a qualitative study

Background: Incivility among nursing students is a common academic problem. Knowing the causes of students' incivility will enable the faculty members and academic institutions to select correct strategies to deal with this problem. This study was conducted to explore the causes of incivility among nursing students from both educators' and students' points of view

Methods: This qualitative content analysis study was applied in order to explore experiences and insights of 17 nursing lecturers and 9 nursing students who were selected through purposeful sampling and interviewed on the causes of incivility. Participants were selected among students and lecturers of nursing schools in Khorasan Razavi. The inclusion criteria for the students were having passed one educational term and for the lecturers having one year experience of teaching respectively. Data gathering was done using deep semi-structured interviews starting from March 2014 to March 2015

Results: Three main categories extracted from the data were student related factors, teacher related factors, and organizational factors. Non-educational engagement, attracting attentions, lack of motivation, students' personality, and lack of experience were the subcategories of student related factors. Subcategories of teacher related factors included lack of skills, teachers' personal qualities, lack of experience, and incivility of teachers. Finally, the subcategories of organizational factors included no evaluation system for teachers and lack of understanding the organizational rules and regulations

Conclusion: The results of this study indicated that factors related to students, teachers, and organization may lead to nursing students' incivility and clarified its dimensions. In order to develop a civil environment in nursing college, managers and educators' awareness should be promoted via various ways such as workshops

Melatonin effects on sleep disorders in children with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder is one of the most commonpsychiatric disorders in childhood. Around 25-50% of these childrensuffered from some kind of sleep disorder especially with chronic form ofinsomnia. The physicians usually have a plan for improving hyperactivityand attention deficit of this disease but unfortunately, they forget tomanage the sleep disorders, which are a major part of patients' problems.Nowadays, we know that there is a noticeable relationship betweenattention deficit hyperactivity disorder and sleep disorders and byimproving these children's sleep, not only the daily functions improve,but also the symptoms of attention deficit hyperactivity disordermaybe become better. Thus, it is needed to avoid the administration ofpsychostimulants, which have recognized side effects. Moreover, havingbetter sleep, we will see a better relationship between children and theirparents and finally a rise in the standard of life of family members, whichis a very important goal in our treatment. This review article evaluatesavailable evidence on sleep medication in children with attention deficithyperactivity disorder to present an appropriate guidance for this highprevalence problem

[ evaluation of efficacy of the positive parenting for parents in order improvement of relationship with their adolescents]

Parenting style has significant impact on the growth and development of adolescents. Family factors like inappropriate parenting, parents, disagreements and loss of positive relationship between parents and children are considered as strong predictors to cause and maintain adolescents' emotional-behavioral problems. This study aims to evaluate the effect of the Positive Parenting Program on the parenting styles, adolescents' behavioral problems and improving the relationship between parents and their adolescents. In an interaction with control group study [pre-test, post test] 60 mothers of female students of Varesan-Nour high school of Mashhad [6th zone], were evaluated in case and control groups. Data were collected before and after sessions using Demographic Questionnaire, Parenting Scale, Being a parent Scale, Parenting Problem Checklist, Depression-Anxiety-Stress Scale, Strengths and Difficulties Questionnaire [SDQ] and Client Satisfaction Questionnaire. Positive Parenting methods were taught in 6 two-hour sessions. Data were analyzed using descriptive statics, variance analysis and the SPSS 16. The mean age of mothers, fathers and adolescents in two groups had no statically significant difference. The results related to SDQ in adolescents showed that a change in the mean total score at the end of the intervention is statistically significant [p<0.001]. The mean scores related to Parenting Scales [p<0.001], Being a Parent [p<0.001], and total score of Stress-Anxiety-Depression score [p<0.001] were statistically significant in case group in comparison with control group. Positive parenting education can be effective in improvement of different aspects of parenting styles, parents' adequacy, adolescents' behavioral problems and relationship between parents and adolescents

[On the relationship between perceived childhood/adolescent attachments and identity status in 15-17 years adolescents]

The aim of this research was to determine the relationship between perceived childhood attachment and adolescent attachment with identity status. This was a descriptive-analytic, cross sectional study. The sample was consisted of 106 females and 104 males' high school students [15-17 years] in Torbat-e-Jam city, north east of Iran, which was selected through randomized and multistage sampling in 2008-2009. Attachment to parents measured by Attachment to Each Parents Scale and attachment in adolescents measured by Revised Adult Attachment Scale and identity status measured by Extended Objective Measure of Ego Identity Status-2 Version Scale [EOM-EIS-2]. Data were analyzed through chi square and liner regression analysis. Findings show that secure, non secure-ambivalence and non secure-avoidance attachment styles had the most effect on the achieved identity, respectively. Non secure-avoidance, non secure-ambivalence and secure attachment styles had the most effect on the foreclosure identity, respectively too. Moreover non secure-ambivalence and avoidance attachment styles [positive relationship] and secure attachment style [negative relationship] had the most effect on the moratorium identity respectively and Non secure-avoidance and secure attachment styles [negative relationship] and ambivalence attachment style [positive relationship] had the most effect on the diffused identity respectively. Findings indicated that there are meaningful relationships between perceived childhood attachment style and identity status and between different attachment styles and identity status in high school students

[Frequency of comorbid disorders and their impact on response to methylphenidate treatment in children with ADHD]

Attention Deficit Hyperactivity Disorder [ADHD] is a common neurobehavioral disorder that affects the educational, social and familial functions of children. ADHD has many comorbid psychiatric disorders which increase the future problems in these children. This study aimed to evaluate the effect of comorbid psychiatric disorders on the response to Methylphenidate in children with ADHD. This study was a descriptive research in the first step and a clinical trial, in the second step. Fifty children with ADHD [aged 6 to 12] referred to child psychiatry clinic of Sheikh Hospital were recruited in the study through consecutive sampling. The diagnosis of ADHD and comorbid psychiatric disorders were made by a board certified child psychiatrist based on DSM-IV-TR criteria via the clinical interview and Kiddie-Schedule for Affective Disorders and Schizophrenia [K-SADS]. After obtaining informed consent from mothers Methylphenidate was started based on their age and weight and continued for four weeks. ADHD Rating Scale was completed by mothers before starting the medication and after four weeks. The level of improvement and treatment response was estimated based on test results and clinical judgment of psychiatrist. Statistical analysis was done by McNemar and chi square tests using SPSS version 19. 60% of total 50 patients with the disorder had a good response to treatment. 72% of children with ADHD had at least one comorbid psychiatric disorder. The most common comorbidities were: Anxiety disorders in 58%, Disruptive behavior disorders in 54%, Tic disorders in 12% and elimination disorders in 10% of children. Children with ADHD without any comorbidity had better treatment response than children with comorbidities [p<0.05]. In evaluation of treatment response in each comorbidities, there were significant differences between children with good and poor response in anxiety and disruptive behavior disorders [p<0.05]. These differences were not significant in tic and elimination disorders [p>0.05]. Regarding treatment response, there was no significant difference between age, sex, and subtype of ADHD in children with and without comorbidities [p>0.05]. Presence of ADHD psychiatric comorbidities leads to changes in response to Methylphenidate and reduces the treatment response. Response to this treatment may be related to the type of comorbidities

[Effect of the positive parenting program on parents of children with attention deficit hyperactivity disorder]

The efficacy of the positive parenting program for parents of children with behavior problems was confirmed in several studies. Yet, such studies have not been conducted for children with attention deficit hyperactivity disorder [ADHD] in Iran, so we decided to evaluate it because of high frequency of the problem. In this clinical trial study, sixty mothers [30 in each control and intervention groups] who had at least one child with clinically diagnosed ADHD and aged between 6 to 12 years old were recruited from the consecutive referrals to the child and adolescent psychiatric clinic of Ruzbeh hospital, Tehran, Iran. The mothers in two groups were matched in some demographic variables. Mothers in both groups completed the battery of self-report questionnaires of study at the beginning and after the 8[th] session. The discrepancies of pre and post intervention were compared between two groups by SPSS software using repeated measure ANOVA statistical method. Intervention group was associated with significantly lower levels of child behavior problems in Conners' scale and ADHD rating scale [P<0.001]; here, parents reported lower levels of dysfunctional parenting than the control group [P<0.001]. The parents in intervention group had significant improvement on measures of depression, anxiety and stress in comparison with the control group [P<0.001]. They also showed significant improvement in all items in strengths and difficulties questionnaire [SDQ] scale except conduct problems in comparison with the control group [P<0.001]. According to the findings of this study, implication of positive parenting program for parents of children with ADHD is recommended to reduce the problem behavior of kids and to improve their abilities