A direct relationship between challenge to self-concept and adherence to prescribed regimen was noted (P < .01); threat to self-concept had an inverse relationship to adherence (P < .01). In other words, patients who faced more challenge and less threat to self-concept adhered more to the prescribed therapeutic regimen. Through education and counseling, nurses can empower their patients to perceive HF as a challenge to better adhere to the prescribed therapeutic regimen.

Background. Alopecia areata (AA) is an autoimmune condition, in which hair is lost from some areas of the body. Though its etiopathogenesis is not fully understood, there are claims that imbalance of trace elements may trigger the onset of AA, by distorting immune functions. In this study, we tried to investigate the relationship between AA and iron, zinc, and copper levels of serum and hair. Materials and Methods. Sixteen female patients with AA (14–40 years old) and 27 healthy female controls were enrolled in this study. Serum and hair level of iron, zinc, and copper were measured by flame emission spectroscopy. The resulting data was analyzed with SPSS15. Results. We did not detect a significant difference in the serum and hair level of iron, zinc, and copper between patients and controls. There was a significant correlation between serum and hair level of iron (r = 0.504,  P = 0.001), zinc (r = 0.684,  P = 0.0001), and copper (r = 0.759, P = 0.0001) in patients and controls. Discussion and Conclusion. According to this study, there was no statistically significant difference between trace elements among AA patients and controls. So the trace elements level in hair and serum may not be relevant to the immunologic dysfunction that exists in AA patients.

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Background and Objectives: Among ultimate goals in the nursing profession are health promotion, disease prevention, and respect for patient rights. In case they are not fulfilled, it can lead to nurses' moral distress, which can have adverse effects on nurses, patients, and the health system. On the other hand, awareness of this concept and its management can help nurses to solve and manage ethical issues in order to be able to continue nursing. Therefore, this study was conducted to obtain the necessary knowledge and to investigate the factors affecting moral distress among nurses in the context of Iran.. Methods: This narrative review was conducted using English and Persian keywords separately and in combination in valid domestic and international databases. Among the retrieved articles, 31 articles with accessible full-texts published in Persian and English that specifically focused on the context of Iran were incorporated. Results: Some of the factors associated with moral distress included organizational and institutional barriers, communication problems, medical and treatment errors and malpractice, neglect and irresponsibility in treatment, and inappropriate allocation of responsibilities, resources, and competencies. Conclusion: Managers can control and resolve this problem through modifying and enhancing organizational policies and taking measures such as nurse support, stress management training, and sessions to recount stressful events.