Because of the ostomy nature, there is not the possibility of full control over life with an ostomy and this issue is causing concerns in their family and social life.

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Background: Fatigue is among the most common, yet least understood symptoms of Multiple Sclerosis (MS). The debilitating symptoms of MS can have adverse effects on the sufferer's self-esteem. We report the effect of a short-term self-managed graded exercise programme on fatigue and self-esteem of patients with MS. Methods: Thirty-four (age range: 20-50, mean: 29.7 years; M:F 0.7:1.0) patients with MS who lived in Tehran and were not physically disabled entered the study. Self-esteem score was measured with the Persian translation of the Coopersmith Self-Esteem Inventory. Fatigue was evaluated with a visual analogue scale. The patients performed the self-managed techniques for 6 weeks. Self-esteem and fatigue were evaluated once more after the self-managed graded exercise programme. Results: On paired sample test, the self-esteem score of the patients was significantly different before (53.9) and after (68.1) the self-managed graded exercise programme (P < 0.0001). The score of fatigue was also significantly different before (4.59) and after (5.76) the intervention (P < 0.0001). Conclusions: This study can provide us with important insights into our understanding of the potential for developing self-care training as an alternative in rehabilitation of the patients with MS. Self-managed graded exercise programme may be considered as an alternative to direct nursing services for patients with MS.

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Introduction: One of the most important factors that can enhance the efficiency and success of hospitals for achieving the objectives is the communication competency of nursing managers. Due to the lack of a local questionnaire to measure the communication competency of nursing managers, the present study has been conducted aimed to design and validate the Nursing Manager Communication Competency Questionnaire (NMCCQ). Method: First, after designing the questionnaire (production of primary items), based on the definition of the results of the study, the analysis of Schwartz, Barcott, and Kim's hybrid concept was performed and then it was evaluated. According to the definitions of the results of Schwartz, Barcott, and Kim's Hybrid concept analysis study, the questionnaire was designed and then it has been assessed psychometrically. Face validity with the opinion of 15 participants and content validity have been assessed using the opinion of 15 experts. Construct validity has been assessed by 300 nurses via completing the questionnaire using factor analysis. Results: First, a questionnaire with 83 items of qualitative data was made. After confirming content validity, the number of items reduced to 62 items. Exploratory factor analysis included five constructs of non-verbal communication skill, negotiation, reporting, communication ethics, and the application of communication knowledge, which consisted of 56 items that together accounted for 61.410% of the observed variance. Cronbach's alpha coefficient for constructs ranged from 0.862 to 0.987 and the intra-class correlation coefficient (ICC) ranged from 0.969 to 0.994. Conclusion: The results showed that nursing managers' communication competency questionnaire is a valid and reliable scale that can help managers select, assess, and appoint nursing managers. As a result, this tool can be used in future studies.