Introduction: The purpose of this study was the assessment of family-centered empowerment program on knowledge, attitudes and self-efficacy of mothers of children with asthma. Methods: This clinical trial study was performed during year 2012. In this study, 172 mothers of children aged 6 to 12 years with asthma, who had the inclusion criteria were selected from an available sample. The samples were selected and divided to two groups of case and control. This study was conducted in three phases: pre-intervention, intervention and post-intervention. Tools used in this study included questionnaires on knowledge, attitudes, self-efficacy regarding administration of drugs for children, control attacks of asthma, and identifying triggers of asthma. Data were collected and the SPSS software version 20 was used for analysis of descriptive statistics and inferential statistics (analysis of variance and independent t test). Results: The results related to the impact of the intervention indicated significant differences in knowledge (21.33 ± 2.23), attitude (53.94 ± 9.45), and self-efficacy (137.62 ± 11.32) in mothers before and after the intervention, with the difference being significant (P < 0.01). Confidence was detected as 95%. Conclusions: This study indicated that the application of family-centered empowerment model influences knowledge, attitudes and self-efficacy of parents regarding control and better asthma management of their young children. Therefore, health care providers should encourage the participation of patients and their families to reduce complications in controlling the disease. Finally, this model can be proposed for other diseases.

Background: Moral distress and moral courage among healthcare professionals have received considerable attention in recent years. However, there is a paucity of studies investigating these topics among nurses. Thus, the present study aimed to evaluate the association between moral distress and moral courage among nurses in an Iranian sample population. Materials and Methods: The present cross-sectional study was conducted during February–December 2018. Corley's Moral Distress (MDS-R) and Sekerka's moral courage scales were used to collect the data. MDS-R is a 21-items scale which includes frequency and intensity ranges from 0 (never) to 4 (very frequently) and 0 (none) to 4 (great extent), respectively. In addition, the moral courage scale contains 15 items ranging from “never true” (1 point) to “always true” (7 points). In total, 225 eligible nurses were entered into this study. Finally, SPSS-16 was used for statistical analysis at the α = 0.05 level. Results: The mean scores of the frequency and intensity of moral distress and moral courage were 45.41 (95% CI = 43.37-47.45), 44.24 (95% CI = 42.98-45.42), and 59.63 (95% CI = 58.50-60.87), respectively. Eventually, a significant relationship was found between the moral courage and frequency of moral distress ( r = 0.46, p < 0.001) and the intensity of moral distress ( r = 0.73, p < 0.001). Conclusions: In general, encouraging healthcare managers and administrators is considered as crucial for developing supportive structures and highly sensitive management which promotes moral courage while reducing moral distress in nurses' work setting.

Hypertension is one of the most important risk factors for heart diseases today. The effect of hypertension in the elderly is higher than other age groups and it may lead to changes in their quality of life. By the increase of age, the amount of self-care behaviors of patients with hypertension decreased. Therefore, control and self-care behaviors are so important. This study has been conducted to study self-regulation behaviors and Associated Factors in elderly patients with hypertension. This study was a cross sectional, descriptive analytic study, which was conducted using multistage sampling on the elderly 60 years and above with hypertension. The sample size was calculated 365 and the final sample size of 380 people was considered by possible losses. The instruments include of demographic and self-regulatory behaviors questionnaire. The results showed that self-regulation of behavior was 42.3% of the total score. In terms of quality, only 7.4% of the elderly had good behavior, 46.6% of poor performance, and the rest were mediocre performance. Age (p = 0.03), gender (p = 0.02), education (p = 0.001), income level (p = 0.03) and marital status (p = 0.001) significantly associated with behaviors of self-regulation. The results generally indicate unfavorable self-regulation of elderly patients with hypertension. Some variables such as gender, age, marital status, education and income levels were associated with these behaviors. So paying attention to the education of the elderly in care centers is essential.

Background: One of the best approaches to promote clinical reasoning in nursing education is Virtual Patient (VP). The purpose of this study was to design and implement VPs for nursing student's education in caring for cancer patients. Materials and Methods: In the first stage, through a descriptive-exploratory qualitative study using a focus group method, topics with higher priority in cancer nursing were identified. Then, based on the VP Nursing Design Model (VPNDM) for each of these topics, a scenario and then an interactive VP was designed and implemented in the Open Labyrinth application. The content validity of VPs was evaluated by eight experts and then the face validity was examined in the pilot group including 15 nursing students. Results: Topics with higher priority in cancer nursing courses were mastectomy, chemotherapy, radiotherapy, hypercalcemia, spinal cord compression, cardiac tamponade, and superior vena cava syndrome. For five scenarios based on the nursing process in three sequences (signs and symptoms, diagnosis and interventions) the VPs were designed. In this process, learning objectives, determining the critical path, adding branches at the decision point, adding feedback, completing the clinical course and related data, and adding multimedia were considered. VPs were revised based on the proposed modifications following face and content validity. Conclusions: This article presents VP design steps for use in a nursing student training course. The researchers were able to provide and validate five VPs to care for cancer patients based on the VPNDM.