The nursing process is defined as a standard of care; however, its implementation in actual clinical settings is very limited, which reduces the quality of care.Objective: To determine the barriers to the implementation of the nursing process from the viewpoint of the faculty members, nursing managers, nurses, and nursing students of the Mashhad University of Medical Sciences. Materials and Methods:This analytical cross-sectional study was carried out in 2014 on 90 nursing lecturers and students of the Mashhad Nursing and Midwifery Faculty, and 134 nurses and nursing managers of the educational hospitals of the Mashhad University of Medical Sciences. The participants were selected by the convenient sampling method using a research-oriented questionnaire (validity and reliability confirmed) to investigate the barriers to the implementation of the nursing process. The data was analyzed by using descriptive statistics (mean±SD, and absolute and relative frequencies), one-way ANOVA, and the Pearson correlation coefficient. Results:The most significant barrier to implementing the nursing process according to 90% of the lecturers was the lack of a checklist for recording the process in the medical records of the patients; according to 90% of the managers, it was the high number of patients under care of each nurse, and according to 90% of the nurses and 93.5% of the students, it was the lack of a principal training of the nursing process during their studentship. There was a significant difference in the views of the four groups (P=0.03). Conclusion:The health system authorities of the country should make changes in the clinical and educational areas, such as including a nursing process record sheet in the medical records of the patients, getting advice and assistance from the experts in the field of nursing education and technology, and facilitating the implementation of the nursing process in the clinical field.

Inflammatory bowel disease (IBD), including Crohn's and ulcerative colitis diseases, is characterized by clinical periods of remission and relapse. Excessive care stress can have long-term negative physical and psychological consequences not only for caregivers but also for the recipients of care. This integrative review aims to identify, describe, and synthesize the results of current available research focused on the burdens of IBDs on family caregiver. An integrative review was performed using Whittemore and Knafl methodology. A systematic search of electronic databases including Web of Science, PubMed, Embase, and Scopus from January 2000 to October 2019 was conducted. Articles were included if published in English and focus on IBD burden on family caregivers. Of 730 records, 16 articles with quantitative, qualitative, and Q methodology study designs were eventually included in the review. The synthesis of these articles led to the identification of four key types of effects: biopsychosocial, daily life activities, physical health, and financial. The chronic and relapsing nature of IBD exposes family caregivers to considerable risk. Thus, the care burden of IBD patients' caregivers needs to be evaluated continuously and relieved through family-centered interventions.

Inflammatory bowel disease (IBD) is an unpredictable chronic recurrent gastrointestinal disorder (Mohsenizadeh, Manzari, Vosoghinia, & Ebrahimipour, 2020). The etiology of IBD is not fully understood, although thought to involve genetic and environmental factors and a poorly regulated gut immune response (Kabir et al., 2020). Patients experience IBD differently based on the severity of the disease and the coexistence of other autoimmune diseases or extraintestinal manifestations. Treatment for these conditions varies according to diverse patterns of clinical practice (Louis et al., 2020).