Background: Pain management is especially important for neonates who are not able to verbally express their pain. Non-pharmacological pain management method as an alternative to pharmacological pain medication has increased nowadays. Objectives: The purpose of this study was to test the effect of leg massage and non-nutritive sucking (NNS) on reducing the pain that neonates experience when undergoing the heel stick procedure for blood testing. Methods: This investigation was a random controlled clinical trial study on ninety neonates who were selected randomly among admitted neonates to NICU in Alavi hospital at Ardabil. The subjects were randomly classified in two case and one control groups. The neonates received leg massage (n=30), NNS (n=30), and no intervention (n=30) respectively. Measurements of HR and SaO2 were taken twice: once before and then again after intervention. Pain response was measured by the PIPP scale. Results:The study showed that the HR of the three groups significantly increased after heel stick compared to before heel stick. The change of SaO2 levels in NNS groups was lower than the control and massage groups. The change of PIPP scores in massage and NNS groups was lower than that of the control group; however, there was not statistically significant differences between NNS & massage groups(p=0.91) Conclusion: pain management and pain relief in the infant is an important issue in neonatal health care. It is suggested that the single or combined use of massage and a pacifier is effective in reducing pain responses in neonates undergoing heel stick.

BackgroundType 2 diabetes mellitus is a chronic disease with severe late complications and high mortality. The increasing prevalence of Type 2 diabetes is mainly due to reduced physical activity and consumption of unhealthy food and larger portion sizes in genetic susceptible individuals [1], and present in every country regardless of their stage of development, and afflicts people in all socio-economic classes [2]. Longterm complications of diabetes include effects on the eyes, kidneys, nerves, and blood vessels that can lead to blindness, neuropathy, and kidney failure [3]. The prevalence of type 2 diabetes in Iran is 4-4.5% and in population aged above 30 years is greater than 14% [4].Further, although glycemic control, the development of complications and mortality represent critical outcomes in people with type 2 diabetes, quality of life (QOL) outcomes are also important. The value of optimizing QOL has increasingly been recognized not only because it represents an important goal for health care in its own right but also because of the associations between poor QOL and adverse outcomes in people with type2 diabetes, including poor response to therapy, disease progression and even mortality [5]. Quality of life represents a broad, multi-dimensional concept that reflects an individual's sense of well-being or satisfaction with life circumstances [5].Furthermore, self concept is one's image of oneself, and involves all of the self-perceptions appearance, value, and beliefs that influence behavior and are referred to when using the words I or me. There are four components of self concept: personal identity, body image, role performance, and self esteem [6]. A positive self concept is essential to a person's mental and physical health. Individuals with a positive self concept are better able to develop and maintain inter personal relationship and resist psychological and physical illness.Research has shown an association between self concept and health practice across the life span, Also some studies show that education program alone improve glycemic control [7], and promote Quality of life in patients with type 2 diabetes. Also research has shown that quality of life and self esteem decreased in clients with chronic obstructive pulmonary disease and arthritis [8].The aim o f this study was to determine the effect of quality of life education on self concept of patients with type 2 diabetes. We hypothesize that patients participating in the case group who receive Quality of life education program will improve their quality of life and will promote their level of self concept. MethodsThis was a random controlled clinical trial study and the subjects were 30 up to 70 years old known type 2 diabetes. 180 individuals were

Background COVID-19 is a public health emergency with a high mortality rate and it reduces the patient’s Health-Related Quality of Life (HRQoL) significantly. This effect is measured in the current study. Methods In a cross-sectional study in Iran, 320 randomly selected treated patients from COVID-19 were studied. To collect the required data, we applied a questionnaire that included socio-demographic factors, clinical characteristics, and questions on the patients’ HRQoL. Time trade-off (TTO) approach was used to measure the lost HRQoL attributed to COVID-19. Besides, we applied a two-limit Tobit regression model to determine the effects of the socio-demographic factors on patients’ health utility and the visual analogue scale approach was used to estimate the perceived total current health status. Results The overall mean (SE) and median (IQR) of the health utility values were 0.863 (0.01) and 0.909 (0.21) respectively. These values for the traders (those who were willing to lose a part of their remaining time of life to avoid the disease) were estimated at 0.793 (0.01) and 0.848 (0.17), respectively. The lowest amount of utility value belonged to the elderly (mean (SE) = 0.742 (0.04); median (IQR) = 0.765 (0.42)) and those living in rural areas (mean (SE)) = 0.804 (0.03); median (IQR) = 0.877 (0.30)). The univariate analysis showed that age, place of residence, and household size had a statistically significant effect on health utility. Moreover, findings of the regression analysis indicated that the participants’ age and hospitalization status were the key determinants of COVID-19 health utility value. Conclusion COVID-19 is associated with a substantial and measurable decrease in HRQoL. This decline in HRQoL can be directly compared with that induced by systemic health states.

Background and Aims: Diabetic foot ulcers require special attention due to their complex and chronic nature and special care and the Nurse-led approach has emerged in the current situation in response to the increasing need for health care as a way to treat chronic patients and provide them with ongoing care. Providing this specialized duty in nursing can be promoted and enhanced the professional independence of nurses and presents challenges. This study has been conducted to make an understanding of the nurses’ experiences about their participation in a nurse-led multidisciplinary team to providing care for patients with Diabetic Foot Ulcer. Methods: This was a qualitative, phenomenological research, carried out with the participation of 8 nurses of Shariaty Hospital of Tehran. Data collection was done through in-depth and semi structured interview. Dieklemann method was used for data analysis. Results: 2 themes and 4 categories emerged during data analysis: antecedents (background and nursing skills) and manifestation of multidisciplinary function (from despair to tranquility, professional worthiness, promotion of self-confidence, preference of multidisciplinary approach). Conclusion: The findings of this study, which were the lived experiences of the participants, indicated that most of them had experienced positive effect of nurse-led multidisciplinary team care, training and development, appropriate skill mix, quality and outcome of care. Therefore, despite working on a multidisciplinary team is complex and demanding, management attributions and communication strategies is well situated to meet the challenge.