Status of age-friendly city indicators in Iran cities: a systematic review.

BACKGROUND: The global phenomena of an increasing older population within the total population and the rise in urban older residents have prompted numerous studies on the indicators of an age-friendly city in various Iranian cities. The insights obtained from these studies can aid policymakers in promoting social justice for older adults. Thus, this study aimed to investigate the status of age-friendly city indicators across different cities in Iran. METHOD/DESIGN: A systematic review was conducted by searching for studies in Persian and English databases until March 2024, including Pubmed, Web of Science, Scopus, Cochrane, Google Scholar, and ScienceDirect, using keywords such as "age-friendly", "elderly-friendly", "cities", "older adults", "aging", "elderly", "indicators", "components", "criteria", "features", "characteristics", "indexes", "Iran", and "urban space", along with their MeSH equivalents, employing "AND" and "OR" operators. Additionally, Persian databases such as Magiran and SID were extensively searched using keywords like "elderly-friendly", "city", "urban spaces", "Iran", "indicators", "components", "features", and "criteria". The references of the final articles were also examined to ensure search accuracy. The results from the studies on the indicators of an age-friendly city were reviewed, summarized, and ultimately reported. RESULTS: The initial search yielded 2857 articles, of which 34 were included in the systematic review. Only two studies addressed the indicators based on the needs of the older adults, with the majority reporting unfavorable urban conditions for the older adults. Despite these unfavorable conditions, the index of open spaces and buildings received the highest rank among the examined indicators. However, two indicators-respect for older adults, social acceptance, civic participation, and employment- did not perform well in any study. CONCLUSION: The findings indicated that Iran failed to meet the required standards for age-friendly cities. Therefore, it is recommended that policymakers in the field of geriatric health take measures to identify and mitigate environmental risk factors for older adults. TRIAL REGISTRATION: This systematic review was registered on the Prospero database with the number CRD42023475657 on date 8 November 2023.

Missed nursing care and its relationship with nurses' moral sensitivity: a descriptive-analytical study.

BACKGROUND: Missed care rates are an indicator of healthcare quality. Missed nursing care can reduce patient safety and lead to adverse events. Moral sensitivity enables nurses to interpret and respond to clients' needs according to ethical principles. Despite the importance of moral sensitivity and its role in the quality of care, the relationship between nurses' moral sensitivity and missed nursing care has not been extensively studied. This raises the question of whether there is an association between nurses' moral sensitivity and missed care. This study was conducted to investigate the relationship between nurses' moral sensitivity and missed nursing care in the medical and surgical departments of Imam Khomeini Hospital in Urmia, Iran. METHODS: A cross-sectional study was conducted in 2022, on 202 nurses working in the medical and surgical departments of Imam Khomeini Medical Education Center, Urmia, Iran. Stratified random sampling was used to select the participants. A questionnaire on demographic characteristics, Kalisch's missed care questionnaire, and Lutzen's moral sensitivity questionnaire were used to collect data. Data were analyzed using the Pearson correlation test and linear regression analysis. RESULTS: Most participants (52.97%) showed moderate moral sensitivity. Nurses' mean moral sensitivity and total missed care scores were 149.07 ± 21.60 and 59.45 ± 4.87, respectively. Pearson correlation test showed no significant correlation between moral sensitivity scores and the total missed care scores (r = 0.041, p = 0.152). However, in the regression analysis, moral sensitivity (ß = 0.213, p < 0.001), age (ß = 0.131, p < 0.001), working in rotating shifts (ß = 0.183, p < 0.001), monthly income (ß = 0.079, p = 0.004), work experience (ß = 0.030, p = 0.010), and monthly work hours (ß = 0.247, p = 0.010) influenced missed care. Approximately, 0.98% of the variance in the missed care was explained by these variables. CONCLUSION: Our nurses reported moderate levels of moral sensitivity and a concerning level of missed care. Missed care can have detrimental effects on patient safety. Therefore, nursing managers must address this issue promptly.

A model for older adults' coping with the death of their child: a grounded theory study.

BACKGROUND: Losing a child at an old age while also facing health problems and physical limitations can have significant negative impacts on parents' lives such as anxiety, depression, and impairment in social functions. The process of coping with the death of a child is particularly unknown among older adults. Therefore, this study aimed to explore how older adults cope with the death of their child. METHOD: This qualitative study was conducted in 2020-2021, using Corbin and Strauss (2015) approach to the grounded theory method. The sampling began purposefully and continued theoretically until theoretical saturation was achieved. Semi-structured interviews were conducted to collect data from Iranian older adults who had experienced the death of their child. To ensure data trustworthiness, the Guba and Lincoln (1985) criteria were utilized. A qualitative data analysis software, MAXQDA2020, was used to manage the data. FINDINGS: The results of this study were obtained from 27 participants. The main concern of older adults was the fear of their lives collapsing following the death of their child. Participants utilized three main strategies to address their concerns: attempting to rebuild themselves, connecting to a higher power, and searching for positivity amidst grief. The central category that emerged from the analysis was "improving physical, mental, and spiritual capacities," resulting in personal growth and improved social relationships. CONCLUSIONS: Through the use of the three aforementioned strategies, older adults were able to overcome their primary concern of the fear of their lives collapsing following the death of their child. Further development of the theory is suggested in order to design a model that can facilitate older adults' coping with this difficult life event.

Rationing of nursing care: A concept analysis.

Rationing of nursing care (RONC) refers to necessary nursing tasks that nurses refuse or fail to do because of limited time, staffing level, or skill mix. As an important process factor, it affects the quality of patient care. The concept of rationing of nursing care has not yet been clearly defined and analyzed and there are different views regarding this issue. Using Walker and Avant's eight-step method, this concept analysis was conducted to analyze the meaning, attributes, dimensions, antecedents, and consequences of nursing care rationing. The literature was collected by searching in electronic databases including PubMed, ScienceDirect, Web of Science, Scopus, and Google Scholar with no date limitation. Both qualitative and quantitative studies on rationing of nursing care, which were open-access and published in English, were included in this study. Thirty-three articles were investigated in the present study. The four defining attributes of RONC included the duty of performing nursing care, dealing with problems of doing nursing care, decision-making and prioritizing, and outcome. The antecedents included nurse-related, organization-related, care-related, and patient-related antecedents. A theoretical definition and a conceptual model of RONC were developed. The attributes, antecedents, and consequences of RONC identified in this study can be used in nursing education, research, and managerial and organizational planning.

Human Caring: A Concept Analysis.

Introduction: Human caring combines science, art, and humanity. Humanity is the heart of care and interpersonal interactions. Despite the critical emphasis on human caring and concern for nursing care without humanity, there is no clear definition for human caring in nursing. This study aimed to analyze the concept of human caring. Methods: Walker and Avant's strategy for concept analysis was used. Electronic databases such as PubMed, Scopus, Ovid, Google Scholar, Magiran, Iran Doc, SID, and a number of dictionaries were searched without any limitation in date. Search keywords were "care", "caring", "human caring", "humanization", "patient care", "comprehensive care" and "nursing care". We searched all documents published before September 2020. In the initial search, 1637 articles were found but finally, 39 relevant articles remained in the study. Results: The nine defining attributes of human caring were establishing therapeutic communication, presence at the patient bedside, empathy, providing scientific care, subjectivity, dynamicity, respecting the patient's rights and ethics of care, helping the patient achieve a feeling of well-being, and art and creativity. Antecedents of human caring were categorized into three categories namely, human, personal, and organizational factors. The consequences were also categorized into consequences related to nurse, profession, patient, and organization. Conclusion: A theoretical definition and a conceptual model of human caring were developed. This concept should be included in the nursing curricula at all undergraduate and graduate levels and even in nurses' in-service training programs.

Support Received and Provided by Older Adults who Lost a Child: A Qualitative Content Analysis.

Background: Despite the vulnerability of older adults and the importance of social support following the death of a child, little research has been conducted on the Iranian older population. This study aimed to explore perceived support among older adults after the death of a child. Materials and Methods: This study was carried out in Iran in 2020-2021 using a qualitative content analysis method. Semi-structured interviews with older adults who had experienced child death were used to collect data. To ensure the data's trustworthiness, Guba and Lincoln's criteria were applied. The Graneheim and Lundman method was used to analyze the data. Results: The participants' mean age was 70.41 years. The findings were organized into one theme, two main categories, and five subcategories based on 352 initial codes. Two main categories emerged from the participants' experiences: "supporting networks" and "giving support to others" with the theme of "healing emotional pain." Following the death of a child, the older parents perceived support as recuperation from their hurt feelings. Conclusions: Receiving support from family, entourages, and society, as well as providing support to the family and parents with the same experience were protective factors against the effects of child death among older parents. To reduce the consequences of child death, older parents' health should be monitored through home care provided by nurses.

Nurses' experiences of the role of organizational and environmental factors in the development of love of the profession: a qualitative study.

BACKGROUND: Love of the profession has significant relationship with nurses' job motivation and care quality. However, there is limited information about organizational and environmental factors affecting love of the profession among nurses. AIM: This study aimed at exploring nurses' experiences of the role of organizational and environmental factors in the development of love of the profession. METHODS: This qualitative study was conducted in 2020-2021 using the conventional content analysis approach. Participants were Fifteen Iranian nurses with deep love of the profession, nursing instructors, and nursing managers purposefully selected from different healthcare and academic settings in seven large cities of Iran. Data were gathered via semi-structured interviews and were analyzed via the conventional content analysis method proposed by Graneheim and Lundman. RESULTS: Organizational and environmental factors affecting the development of love of the profession were grouped into three main categories: The social context of the profession (with two subcategories), family support (with two subcategories), and organizational health (with four subcategories). Subcategories were respectively historical context of the profession, the evolving context, emotional family support, instrumental family support, quality of interpersonal relationships in the organization, level of organizational justice, level of authority delegation to nurses, and level of organizational support. CONCLUSION: Different organizational and environmental factors can affect nurses' love of the profession development. Improving public image of nursing, providing nurses with stronger support, improving organizational climate, and strengthening interpersonal relationships in healthcare settings are recommended to develop nurses' Love of the profession.

Frequency of cast-related complications and influencing factors in patients with casts.

BACKGROUND: Casting is a common procedure in the treatment of extremity fractures, but it can lead to serious complications if applied improperly. However, there are few studies on the prevalence of cast-related complications. PURPOSE: To assess the frequency of cast-related complications and influencing factors in patients referred to medical centers affiliated with a University of Medical Sciences. METHODS: A descriptive study was conducted on 120 patients with limb fractures in need of casting. The study was conducted from November 1, 2020, to June 1, 2021. A checklist was used to assess complications, and complications were monitored by regular telephone contact. Each patient was followed up for 3 months. Descriptive and inferential statistics were used to analyze the data. RESULTS: Pain, impaired mobility, numbness, swelling, and a burning sensation inside the cast were the most common complications in the first week after cast application and occurred in 94.2%, 72.5%, 60.8%, 60%, and 54.2% of patients, respectively. Patients whose casts were applied by a nurse experienced more pain (p = 0.002), numbness (p = 0.02), and swelling (p = 0.05). The incidence of numbness was significantly higher in patients who were more active during convalescence (p = 0.04). CONCLUSIONS: Due to the importance of cast-related complications, in-service training programs for casting staff are needed. Furthermore, patient education and follow-up should be taken more seriously.

Nursing students' perceptions and experiences of learning and using nursing theories: A qualitative study.

BACKGROUND: No study has addressed the experiences of Iranian nursing students learning and using nursing theories. PURPOSE: We investigated the experiences of Iranian postgraduate nursing students learning and using nursing theories. METHODS: A qualitative study was conducted on 25 Master's degree nursing students who had completed the course of nursing theories in three selected nursing schools in Iran. Semistructured interviews were conducted. Data analysis was performed using a content analysis approach. RESULTS: Most of the students had positive experiences of learning and using nursing theories. Three main categories emerged from the data namely "a refreshing opening," "needing support," and "clinical usefulness." Nursing theories refreshed the students' view of the nursing profession, strengthened their professional values, helped them recognize professional boundaries, and practice a comprehensive care. CONCLUSION: The nursing education system should prepare expert teachers for teaching nursing theories. Nursing managers should support nurses to implement these theories.

Health literacy and quality of life in Iranian persons with COPD.

BACKGROUND: Chronic obstructive pulmonary disease is a progressive disorder with significant physical, psychological, and social consequences and adversely affects the persons' quality of life (QOL). OBJECTIVES: This study aimed to determine the health literacy (HL) and QOL of persons with COPD and some of the contributing factors. METHODS: A cross-sectional study was conducted from May to December 2019 on 270 persons with COPD referring to Shahid-Beheshti Hospital of Kashan, Iran. Data were collected using a demographic questionnaire, the 33-item Health Literacy Questionnaire of the Urban Population of Iran (with a total score ranging from 33 to 165, higher score indicates higher HL) and the 50-item St. George's Respiratory Questionnaire for assessing the QOL (with a total score ranging from zero to 100, greater score means lower QOL). Descriptive statistics, Pearson and Spearman correlation coefficient, Chi-square test, t-test, analysis of variance, and linear regression analysis were used to analyze the data. RESULTS: The mean age and the mean duration of COPD were 59.48±13.31 and 3.85±3.47 years, respectively. The mean HL score and the mean QOL were 81.44±23.89 and 57.41±10.70, respectively. A significant correlation was found between HL and QOL (r=-0.21, p<0.001). CONCLUSION: Participants had moderate levels of HL and QOL. There was a significant correlation between HL and QOL. Health care providers are recommended to take effective steps to improve the HL of persons with COPD by developing comprehensive educational programs for them.

Effective interventions for reducing moral distress in critical care nurses.

Moral distress (MD) has received considerable attention in the nursing literature over the past few decades. It has been found that high levels of MD can negatively impact nurses, patients, and their family and reduce the quality of patient care. This study aimed to investigate the potentially effective interventions to alleviate MD in critical care nurses. In this systematic review, a broad search of the literature was conducted in the international databases including PubMed/MEDLINE, Web of Science, and Scopus, as well as Google Scholar search engine using keywords such as moral distress, intensive care unit, ICU, nurses, and critical care nurses from 1984, when the concept of MD was first introduced in the nursing literature, up to 29 October 2020. Studies focusing on the interventions for managing MD in critical care nurse were evaluated. The quality of eligible papers was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 8 studies fulfilled the eligibility criteria. Three studies had RCT design and five studies had quasi-experimental design. All studies were conducted in the United States or Iran. Educational workshop, moral empowerment program, social work intervention, nursing ethics huddles, and multifaceted resiliency bundle intervention were effective interventions for managing of MD among critical care nurses. There is limited but promising research evidence evaluating the efficacy of educational interventions for managing of MD among critical care nurses. Although some positive results have been reported, there is limited generalizable evidence due to the variability of interventions. These findings highlight the need for further studies to validate the efficacy of these interventions or develop more potent and efficient interventions for reducing MD in critical care nurses.

A Systematic Review of Potentially Effective Nonpharmacological Interventions for Reducing Fatigue among Iranian Patients Who Receive Hemodialysis.

BACKGROUND AND PURPOSE: Fatigue control in hemodialysis (HD) patients requires a multidisciplinary approach. This study aimed to comprehensively review the available research literature regarding the nonpharmacological interventions used for reducing fatigue among Iranian HD patients. METHODS: In this systematic review, an extensive search of the literature was conducted on PubMed, Web of Science, and Scopus databases, using the keywords related to the purpose. Also, the Persian equivalent of these keywords was searched in Iranian databases, such as Iranmedex and Scientific Information Database (SID) from the inception to June 16, 2020. RESULTS: Of 2,761 articles, 25 studies were included in the review. Among a total of 1,748 Iranian HD patients with a mean age of 54.17 (SD = 12.27) years, 61.38% were male. Interventions such as educational-based programs (n = 5), nutrition-based programs (n = 2), massage therapy (n = 3), exercise-based programs (n = 4), relaxation technique (n = 3), combination of relaxation technique and inhalation aromatherapy (n = 1), energy therapy (reflexology and acupressure) (n = 3), and mind-guided imagery (n = 1) were effective in reducing fatigue in Iranian HD patients. DISCUSSION/CONCLUSION: These simple, low-cost, and practical interventions can be used for the reduction of fatigue among HD patients by nurses. However, future well-designed studies are recommended to confirm the efficacy of these and other potentially effective interventions for reducing fatigue in HD patients.

Nurses' Perceptions of the Factors Contributing to the Development of the Love of the Profession: A Qualitative Content Analysis.

As a professional value, the love of the profession can significantly affect nurses' professional practice, behaviors and commitment. Many different factors can affect the love of the profession. The exploration of nurses' experiences of these factors can provide valuable data for development of the love of the profession. The aim of this study was to explore nurses' perceptions of the factors contributing to the development of the love of the profession. This qualitative study was conducted in 2020-2021 using the conventional content analysis approach. The participants were thirteen nurses with different organizational positions purposively recruited from different settings in Iran. The data were collected via semi-structured interviews, and were analyzed via the conventional content analysis approach proposed by Graneheim and Lundman. The factors contributing to the development of the love of the profession were categorized into four main categories, namely the public perception of the profession (with three subcategories), educational variables (with two subcategories), the characteristics of the profession (with four subcategories), and nurses' self-evaluation (with three subcategories). The love of the profession is affected by a wide range of personal, educational, professional and social factors. The manipulation of these factors would help to develop nurses' and nursing students' love of the profession, and encourage people to choose nursing as a career.

The meaning of losing a child in older adults: a qualitative study.

BACKGROUND: After losing their child, elderly parents look for a meaning in this phenomenon. This meaning comes out from their experiences, and their responses to and actions in life are shaped based on this meaning. Therefore, this study was conducted with the aim of "understanding the meaning of losing a child in older adults." METHODS: This qualitative study was conducted using conventional content analysis method. Using semi-structured face-to-face interviews, data were collected from 15 older adults who had experienced of losing their adult child. Data analysis was performed according to the steps proposed by Graneheim and Lundman, 2004. To prove the trustworthiness of the data, credibility, dependability, confirmability and transferability were used. RESULTS: The age range of participants was between 61 and 83 years and 73.3% of them were female. The two main categories of "tasting the bitter flavor of life" and "searching for a positive meaning in losing a child" together with the theme of "finding hope in the heart of darkness" were extracted from the participants' experiences. CONCLUSIONS: Despite the grief of losing a child, which had cast a dark shadow over the parents' lives, the child's liberation from worldly sufferings, his/her presence in a better world, and being hopeful about the grace of God had caused the elderly parents to find hope in the heart of darkness. After identifying the parents with a deceased child, they should be helped through psychological counseling and care of the healthcare team so that they can adapt to this situation by finding a positive meaning in losing their child.

The effect of occupational stress on marital satisfaction and mental health in Iranian nurses.

BACKGROUND: Work and family life are the two basic components of the individuals' life and each one affects the other. OBJECTIVE: This study aimed to investigate the relationship between occupational stress, mental health and marital satisfaction among Iranian nurses. METHODS: A cross-sectional study was conducted on 200 randomly selected nurses. The 35 items hospital stress scale, Enrich Marital Satisfaction questionnaire and Scl-25 mental health questionnaire were used. Descriptive statistics, Pearson correlation coefficient, independent sample t-test and analysis of variance and regression analysis were used. RESULTS: Inverse correlations were observed between the scores of job stress and mental health (r = -0.468, p = 0.001) and marital satisfaction (r = -0.517, p = 0.001). More than 0.74% of variation in marital satisfaction is explained by the components of occupational stress. CONCLUSION: The results revealed that occupational stress plays a decisive role in nurses' marital satisfaction and mental health. Due to the destructive effects of occupational stress on the people's mental health, interpersonal relationships and on their efficacy in their job, establishment of some counseling services for nurses to be used by them periodically or by need, can help them to manage their stress level and better management of their family life problems. Moreover, in-service courses or workshops on stress management may help nurses to possess appropriate knowledge and skills on stress management.

The effect of curcumin ointment on knee pain in older adults with osteoarthritis: a randomized placebo trial.

BACKGROUND: Some studies have shown the effect of oral administration of curcumin on knee pain. However, limited studies are available on the effect of topical curcumin. This study aimed to investigate the effect of curcumin ointment on knee pain in older adults with osteoarthritis. METHODS: This double-blind randomized placebo trial was conducted on 72 older adults with knee pain associated with osteoarthritis. The subjects were randomly assigned into an intervention and a placebo group to apply either curcumin 5% ointment or Vaseline ointment twice daily for 6 weeks. Using a Visual Analog Scale, the severity of knee pain was measured at the beginning of the study, at the end of the fourth and sixth week. Data were analyzed using descriptive and inferential methods. RESULTS: The mean baseline knee pain intensity was not significantly different between the two groups (P = 0.15). The mean pain intensity was significantly lower in the intervention group than in the placebo group at the third measurement (P = 0.02). The repeated-measures analysis showed that over time, the curcumin significantly decreased the mean pain intensity in the intervention group (P = 0.001). The mixed model showed an absolute difference of 1.133 (i.e. 11.33 mm) score which signifies a medium effect size and that the patient in the intervention group achieved the minimal clinically important difference. CONCLUSION: Topical administration of curcumin 5% ointment can significantly reduce knee pain in older adults with knee osteoarthritis. Curcumin ointment can be used as an alternative treatment in older adults with knee pain associated with osteoarthritis. TRIAL REGISTRATION: Retrospectively registered in the Iranian Registry of Clinical Trials (IRCT) (IRCT20100403003618N6, 2019-03-08), https://en.irct.ir/trial/37155.

Nurses' Job Burnout: A Hybrid Concept Analysis.

Introduction: Job burnout can significantly affect nurses' physical and mental health and the quality of the care services they provide. Yet, there is no clear definition for job burnout in nursing. This study aimed to analyze the concept of nurses' occupational burnout. Methods: This concept analysis was conducted, using the three-phase hybrid model. In the theoretical phase, online databases, namely Iranmedex, Scientific Information Database (SID), Science Direct, MagIran, ProQuest, Web of Sciences, Scopus, and PubMed were searched to retrieve studies published from 2007 to 2018. In the fieldwork phase, twelve semi-structured interviews were conducted with nurses and head-nurses selected from teaching hospitals in Isfahan, Iran. The interviews were transcribed and analyzed through thematic analysis. In the final analytic phase, the findings of the first and the second phases were combined. Results: Based on the findings of the theoretical and the fieldwork phases, job burnout can be defined as, "a state of physical, mental, emotional, and social exhaustion resulting from the negative effects of unmanaged occupational stress and inadequate managerial and social support, which reduces interest in and motivation for work, affects care quality, and results in negative attitudes and behavior towards self, clients, and the work". Conclusion: This study provides an in-depth understanding of the concept of job burnout in the nursing context of Iran. Managers need to develop strategies for job burnout prevention and management based on its contributing factors.

Body image before and after coronary artery bypass graft surgery: comparison and its contributing factors.

BACKGROUND: Cardiovascular diseases are the leading cause of death in the world. Coronary artery bypass graft (CABG) surgery is among the treatment options for coronary artery disease. However, it is associated with significant physical and psychological problems. This study sought to compare body image before and after the surgery and to determine its contributing factors. METHODS: This comparative study was conducted in 2017 on a sample of 140 patients consecutively recruited from Shahid Beheshti hospital, Kashan, Iran. Body image was assessed before and 4 weeks after the surgery (T1 and T2) using Multidimensional Body-Self Relations Questionnaire. The independent-sample and paired t tests, one-way analysis of variance, Pearson correlation test, and multiple regression were conducted for data analysis. RESULTS: Participants' mean score of body image was 139.60 ± 13.21 at T1 and 160.25 ± 7.75 at T2 and the variation was statistically significant (p = < 0.001). At T1, only the three factors of age (p = 0.005), education at high school diploma and higher levels (p < 0.001), and being housekeeper (P = 0.048) could significantly explain BI (R2 = 0.231). However, at T2, none of the factors were significant predictors for BI (P > 0.05). CONCLUSIONS: Candidates for CABG have poor body image. After the surgery, their body image improves significantly. Healthcare providers need to employ programs to improve body image among these patients.

Love in Nursing: A Concept Analysis.

Introduction: Professional nursing is based on caring. Care is a combination of love and respect in interacting with others. There are many concerns about nursing care without love. However, the concept and meaning of love in nursing have not been paid the due attention. This study analyzed the concept of love in nursing. The aim of this study is to describe and discuss the concept of love in nursing. Methods: A concept analysis was conducted using the 8-step Walker and Avant's model. Databases such as SID, PubMed, Web of Science, CINHAL, SCOPUS and Google Scholar were searched. The terms "love","concept analysis" and "nursing" were used for searching in international sources. No time limit was considered in searching the databases and all studies were published until December 2017. In the initial search, 142 articles were found but finally eight articles remained relevant and entered the study. Results: The authors did not find a special independent tool to measure love in nursing. Therefore, we define love in nursing as follows: the combination of nursing care with a sense of responsibility, benevolence, attention and concern, respect, and understanding of others as a human being, regardless of their negative consequences for themselves. Conclusion: Understanding the meaning of love in nursing can promote nursing practice in two ways. First, the nurses are examining their values and beliefs. Second, they find out how to interact with patients.

Primiparous women's experiences of normal vaginal delivery in Iran: a qualitative study.

BACKGROUND: Childbirth is considered as the most challenging psychological event in a woman's life. It has a major effect on women's lives with long-term positive or negative impacts. Cultural, religious, and socioeconomic differences can affect women's perception about normal vaginal delivery (NVD) experience. Therefore, it is necessary to explore the primiparous women's perception about it. METHODS: This qualitative study, with a descriptive content analysis approach, was conducted in Kashan, a city in the center of Iran. Purposive sampling was used to recruit the participants of the current study. Data was gathered by semi-structured interviews during 24 h after normal vaginal birth among primiparous women. The sampling started from June to October in 2016. Interviews continued until data saturation which was achieved in the 14th interview but for assurance, it continued until the 17th one. RESULTS: The following three main themes were extracted "immersion in stress", "pain, the essence of NVD" and "strategies for situation management". Furthermore, seven subthemes were obtained including 'loss threat', 'stressful context', temporary impairment in physiologic harmony, paradoxical emotions, self-management, emotional support, and spiritual support. CONCLUSIONS: This study showed that stress and pain were two highlighted issues in NVD process. Increasing women's awareness about NVD process, familiarizing the primiparous women with the simulated delivery room, accompanying these women for emotional support, and providing spiritual support can be effective in situation management to make the child delivery a pleasant and satisfying experience.