Background The outbreak of COVID-19 is an unprecedented challenge to the health systems in Iran. We aimed to assess the psychological impact of this outbreak on nurses in the hospitals of Guilan University of Medical Sciences that is one of the top provinces of incidence of COVID-19. Methods In a web-based cross-sectional study, 441 nurses working were selected from the hospitals, from 7 to 12 April 2020. Anxiety and depression were measured using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9, respectively. Simple and multiple logistic regression models were used to identify the factors related to anxiety and depression. Results The majority were in contact with suspected or confirmed COVID-19 cases (93.4%) and their relatives had been infected with COVID-19 (42%). The mean of anxiety-7 and depression total scores were 8.64 ± 5.60 and 8.48 ± 6.19, respectively. Female (OR = 3.27, 95% CI = 1.01–10.64), working in COVID-19 designated hospital (OR = 1.82, 95% CI = 1.13–2.93), being suspected with COVID-19 infection (OR = 2.01, 95% CI = 1.25–3.26), and insufficient personal protective equipment (OR = 2.61, 95% CI = 1.68–4.06) were associated with anxiety. Depression was significantly associated with female sex (OR = 4.62, %95 CI = 1.24–17.16), having chronic disease (OR = 2.12, 95% CI = 1.20–3.74), being suspected or confirmed with COVID-19 infection (OR = 3.44, 95% CI = 2.11–5.59, and OR = 2.21, 95% CI = 1.04–4.70, respectively), and insufficient personal protective equipment (OR = 1.86, 95% CI = 1.19–2.91). Conclusion The finding declares healthcare workers are at high risk for mental illness. Continuous supervision of the psychological consequences following infectious diseases outbreaks should be a part of the preparedness efforts of health care systems.

Introduction: The development of science and technology has provided more opportunities for patients to live and even receiving futile medical care or treatment with no hope of recovery. This process leads to awkward experiences and moral distress in nurses who frequently deliver with such care. Objective: This study aimed to determine the perception of futile care and its relationship with moral distress in nurses working in intensive care units Materials and Methods: This is a cross-sectional study conducted on 155 nurses working in Intensive Care Units (ICUs) employed in educational-therapeutic centers and hospitals of Guilan Province, Iran. They were selected by convenience sampling method. The study data were collected using the researcher-made questionnaire and Corley moral distress questionnaire. The obtained data were analyzed using descriptive statistics and inferential statistics the Kolmogorov-Smirnov test, nonparametric Mann-Whitney U, Kruskal-Wallis, Fisher exact and Backward logistic regression model. Results: The mean±SD age of the samples was 34.71±6.68 years; their mean±SD work experience was 10.24±5.63 years, and the mean±SD work experience in the ICU was 6.76±4.64 years. The results indicated that their mean±SD perception of futile care was 63±7, and their mean±SD moral distress was 92±54. The score of moral distress showed a low but significant and positive correlation with the legal and organizational aspects of futile care (r=0. 279, P=0.001) and the total score of perception futile care (r=0.2, P=0.012). In the multivariate analysis based on the logistic regression model of futile care, only the relationship between the legal and organizational score in care had a significant relationship with moral distress. So that by increasing one unit in the legal and organizational aspect of care, the chances of scoring above the mean of moral distress increases 1.2 times (P=0.0001, 95% CI; 1.077-1.324). Conclusion: Perhaps by familiarizing nurses with the legal and organizational nature of patient’s care, the moral distress of caring can be reduced.

Objectives: One of the most important problems seen in patients after stroke is that they cannot develop normal muscle strength. In recent years, the use of Mirror Therapy (MT) in the recovery of this condition has been noticed in different studies. This study investigated the effect of MT on motor recovery in patients after stroke. Methods: In this clinical trial, 93 patients were divided into three groups, including MT, non-reflective surface, and control groups. The tools used in this study included the patient’s profile questionnaire, Mini-Mental State Examination Test, and Brunnstrom Recovery Stages. After the routine physiotherapy program, the intervention groups underwent MT for 20 sessions. The analysis of data was performed by SPSS software v. 22. Results: There was a significant difference between the non-reflective surface and MT groups (P=0.043) in pairwise comparison of their motor recovery stages in the 20th session, but the difference between the non-reflective surface and control groups was not significant. There was also a significant statistical difference between the MT and control groups in motor recovery stages in the 20th session, (P=0.0332) Conclusion: The obtained findings suggest that MT can increase patients’ motor recovery after stroke. This method can be used as a simple, cheap, and usable method at home.

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