Identifying ethical stressors in the workplace and giving proper feedback to the authorities to eliminate these factors and improve the ethical climate in these workplaces can help enhance job satisfaction in nurses and lead to higher quality care.

BackgroundPatients with heart failure (HF) older than 65 years have a two-fold increased risk of cognitive impairment than elders without HF. Identifying factors affecting cognitive impairment in HF may present targets for intervention.ObjectivesThe aim of the present study was to determine cognitive function and related factors among elderly patients with heart failure.Patients and MethodsIn this cross-sectional study, 184 elderly patients with heart failure were selected from four Mazandaran University of Medical Sciences teaching hospitals using convenience sampling. Data were collected from patients’ medical records and by interview, using the abbreviated mental test, geriatric depression scale, and Charlson comorbidity index.ResultsThere were significant relationships between cognitive status and living arrangement (P < 0.001), education (P < 0.001), hypertension (P = 0.039), anemia (P = 0.046), Charlson comorbidity index (P < 0.001) and geriatric depression scale (P < 0.001).ConclusionsScreening of cognitive impairment in elderly patients with heart failure seems necessary.

Self Care Behaviors (SCB) is one of the most important challenges in controlling readmission and improving the elderly patients outcomes. The aims of this study were to describe the SCB among elderly with heart failure and to assess relationships between SCB, demographic characteristics, age-related characteristics and clinical characteristics. In this cross sectional study, 184 elderly (age 60) with heart failure were selected with convenience sampling from 4 teaching hospitals. To assess SCB, the European Heart Failure Self Care Behavior Scale was used. Its validity and reliability were confirmed (CVI = 0.97 and α = 0.74). Data was collected from patients' medical record and by interviews. The highest percentage of behaviors not performing properly (score > 2), were related to self reported exercise (96.2%), receiving a flu shot (89.7%) and weight monitoring (80.5%), respectively. There was significant relationship between SCB and cognitive impairment (p < 0.001), serum sodium level (p < 0.001), charlson co-morbidity Index (p = 0.001), ejection fraction (p = 0.002), visual impairment (p = 0.002), sleep disorders (p = 0.003), poly-pharmacy (p = 0.004), hearing impairment (p = 0.012) and systolic blood pressure (p = 0.049). Significant relationship between SCB and age-related characteristics suggests the need to design both supportive and preventive programs among elderly with heart failure.

Objective: Cancer is one of the most common life-threatening diseases and a great source of stress in patients. The risk factors of depression differ in elder people compared to other age groups. The present study was designed to determine the relationship between depressive symptoms and demographic-medical characteristics among elder people with cancer. Methods: This cross-sectional correlational study recruited 200 elder people with cancer. The eligible patients completed the demographic-medical characteristics questionnaire, the Geriatric Depression Scale, the Abbreviated Mental Test, the Activities of Daily Living Scale, and the Multidimensional Perceived Social Support Scale. The findings were analyzed in SPSS software version 21.0 using the Kruskal–Wallis and Mann–Whitney tests. Results: A total of 50% of the elder people in this study had mild depression, 18.5% had moderate depression, and 2.5% had severe depression. A significant relationship was observed between depression in the elder people and their marital status ( P = 0.025), living arrangement ( P = 0.013), and income ( P = 0.021). Depression also had a significant relationship with diabetes ( P = 0.044) and respiratory diseases ( P = 0.040). A significant relationship was also observed between depression and colon cancer ( P = 0.007), and the mean depression was lower in the patients with colon cancer compared to those with other cancers. Depression had a significant relationship with complications, including pain ( P = 0.001), nausea ( P < 0.001), vomiting ( P = 0.001), hair loss ( P < 0.001), and shortness of breath ( P = 0.028). Conclusions: Given the high prevalence of depression in this age group, screening and counseling-supportive interventions are recommended for helping prevent depression and come to terms with cancer.

Objectives Stroke is the main health problem of the elderly in the world. The disease may create a spiritual crisis in the person. The purpose of this study was to investigate the relationship between prayer and spiritual health of elderly patients with cerebrovascular accidents (CVA). Methods & Materials In this correlational study, 142 patients with CVA were investigated in the Neurology Department of Bou Ali Sina Hospital in Sari City, Iran. Data collection was done by Ellison and Paloutzian spiritual health questionnaire and Meraviglia prayer questionnaire. The data were analyzed using SPSS 20 with descriptive parameters (mean and standard deviation) and Pearson correlation coefficient, t-test and 1-way ANOVA. Results Of 142 patients, 64 (45.1%) were men and 78(54.9%) were women. The mean age of the elderly was 72.97±7.67 years with the range of 60-95 years. The mean of total prayer scores was 181.62±25.50 and the highest score of prayer was related to prayer frequency with the mean of 96.47±22.3. The mean of total spiritual health scores was high (102.28±18.89), too. The relationship between prayer and spiritual health was direct and significant (P<0.001, r=0.602). There was significant relationship between age and spiritual health, too (P<0.001, r=0.607). There was no significant relationship between spiritual health and education level, job, and the marital status. Conclusion Religious practice and prayer can be a powerful resource for coping with stressful situations and psycho-social support in patients with stroke.