Mohammad Ali Mohammadi

Background: Despite the importance of self-management in preventing post-stroke complications, the combined association of nursing care competence and family collaborative care with self-management behaviors has not been fully investigated. Objectives: This study aimed to examine the associations between nursing competence and family participation and self-management behaviors among patients after stroke. Methods: This descriptive, correlational, cross-sectional study was conducted from April 2025 to April 2026 at Alavi Educational and Medical Center in Ardabil, Iran. The study included 71 nurses recruited using census sampling and 306 discharged stroke patients and their primary family caregivers selected using random sampling. Data were collected using the Stroke Care Competence Questionnaire, Family Collaborative Care Questionnaire, and Stroke Self-Management Behaviors Questionnaire. Independent-samples t tests, analysis of variance, Pearson correlation, and linear regression analyses were performed using SPSS version 27.0. Results: Most nurses (83.1%) reported a moderate level of nursing competence, and most caregivers (63.1%) reported a moderate level of family collaborative care. Family collaborative care was positively correlated with patient self-management (r = 0.22, P = 0.001). In the adjusted multiple linear regression model, family collaborative care was the strongest positive predictor of self-management (β = 0.630, P < 0.001), and nursing competence was also independently and positively associated with self-management (β = 0.222, P = 0.027). The model explained 63.3% of the variance in self-management (R2 = 0.633). In the family-participation dimension model, monitoring health status was the strongest predictor (β = 0.25, P = 0.001). Nursing competence scores were significantly higher among nurses with a master’s degree and those working in intensive care units (P = 0.001). Conclusions: Family collaborative care and nursing competence were both positively associated with post-stroke self-management, with family collaborative care demonstrating the stronger association. Family-centered transitional care strategies that strengthen caregiver involvement while supporting nurses’ competencies in patient and caregiver education may help improve self-management after discharge.

Background: Treatment compliance is a cornerstone of effective heart failure management; however, it remains suboptimal. Identifying modifiable psychosocial factors, such as social support, is crucial for improving patient outcomes. Objectives: This study examined the association between perceived social support and treatment compliance in patients with heart failure. Methods: In this cross-sectional correlational study, 260 hospitalized patients with heart failure were recruited through convenience sampling from a tertiary hospital in Ardabil, Iran. Participants completed the Multidimensional Scale of Perceived Social Support and the Revised Heart Failure Compliance Questionnaire. Data were analyzed using descriptive statistics, correlation coefficients, and hierarchical multiple regression. Results: Participants had a mean age of 65.9 ± 9.3 years; 58.5% were male, and 74.2% were married. Demographic factors significantly associated with higher treatment compliance included being married, having a higher educational level, and living with family (all P < 0.001). Longer disease duration was associated with lower compliance (P < 0.001). Perceived social support was strongly and positively correlated with overall treatment compliance (r = 0.67, P < 0.001) and with all compliance domains. In regression analysis, social support was the strongest independent predictor of compliance (β = 0.58, P < 0.001), explaining an additional 25% of the variance after controlling for demographic factors. Conclusions: Perceived social support, particularly family support, is strongly associated with better treatment compliance in patients with heart failure, underscoring its importance in self-care. Nursing interventions should prioritize family-centered and community-based support strategies to strengthen long-term compliance and improve clinical outcomes.

Background: Growing demands on healthcare systems necessitate streamlined nursing practices. Two interrelated competencies, time management and professional self-efficacy, play a decisive role in determining nursing performance and patient care outcomes. This study investigated the impact of these abilities on nursing care quality, providing evidence-based recommendations for professional development. Methods: A descriptive–correlational survey was conducted in 2024 at teaching and healthcare facilities affiliated with Ardabil University of Medical Sciences, Iran. Using stratified random sampling, 350 nurses were selected. Data were gathered through validated instruments: the Time Management Questionnaire, the Professional Self-Efficacy Scale, and the Quality of Nursing Care Inventory. Analyses were performed using SPSS version 24, applying t-tests, one-way ANOVA, Pearson’s correlation, and multiple linear regression. Results: Most respondents reported moderate levels of time management (80.3%), self-efficacy (61.7%), and nursing care quality (57.1%). Notable associations emerged between these competencies and demographic characteristics, including age, gender, work tenure, and prior training in time management. Regression analysis identified age, work experience, self-efficacy, coordination, and organizational ability as significant predictors, jointly accounting for 30% of the variance in care quality. Conclusion: The findings reveal scope for improvement in nurses’ time use and self-efficacy. Structured educational initiatives targeting these skills could substantially enhance the quality of inpatient care.

Introduction: All nursing care must be performed without harming the patient. Medication errors pose a significant threat to patient safety. This study aimed to determine the relationship between medication safety competence (MSC) and clinical nurses’ perceptions of medication administration errors (MAEs). Methods: This descriptive-correlational study was conducted among 300 clinical nurses. Participants were selected using stratified random sampling in 2024. Data were collected using a demographic characteristics form, the Medication Safety Competence Scale (MSCS), and the Medication Administration Error Reporting Survey. Data were analyzed using SPSS version 13, employing descriptive and inferential statistics. Results: The results indicated that the mean (SD) scores for MSC and MAEs were 294.22 (26.61) and 135.48 (15.14), respectively. Scores ranged from 36 to 185 for MSC and 65 to 425 for MAEs. Statistical analysis revealed significant correlations between MAEs and gender, marital status, Work experience, and participation in the MSC workshop. Simple linear regression analysis showed that the "Underreporting of MAEs" domain was the strongest predictor of MSC among the variables examined. Conclusion: The nurses who participated in this study reported moderate levels of MSC and perceived a moderate frequency of MAEs. Healthcare policymakers and decision-makers should implement strategies such as conducting ideation sessions and practical workshops to reduce medication errors and enhance nurses’ MSC.

Background: Confidence in ethical decision‐making is a critical factor for the success of nurse leaders. This confidence impacts the quality of nurse care and influences the work environment and the morality of health workers as a team. Aims: This study aimed to determine the relationship between the ethical decision‐making confidence of nursing managers and the ethical behavior of nurses. Methods: This study used a cross‐sectional and correlational design. In total, 532 nurses and 178 nursing managers from 12 hospitals affiliated with Ardabil University of Medical Sciences in Northwestern Iran participated in the study. The measuring tools used were Birkholz et al.’s Ethical Decision‐making Scale and Orathai’s Ethical Behavior Scale. Results: The mean values of ethical decision‐making confidence in nurse managers and ethical behavior in nurses were 75.51 ± 7.27 and 130.56 ± 29.16, respectively. Additionally, 62.4% of nursing managers and 74.1% of nurses reported their ability to make ethical decisions and ethical behavior at a high or average level. There was a significant positive relationship between managers’ ethical decision‐making confidence and nurses’ ethical behavior ( r = 0.9, p = 0.001). The regression model indicated that the managers’ ethical decision‐making confidence could predict 81% of nurses’ ethical behavior variance. Furthermore, female nurses and participants in an ethics workshop demonstrated higher ethical decision‐making confidence and behavior ( p < 0.001). Conclusion: The confidence of nursing managers in their ethical decision‐making significantly influences the ethical behavior of nurses on these managers’ respective units. Continuous training in ethical strategies is essential for managers, as decisions in true ethical dilemmas require a team approach. Managers should serve as role models and not make independent decisions when the choices lack clear right and wrong options.

Background: Care is one of the essential metaparadigms of nursing. The personal and professional character of the nurse, along with attention to human, financial, and communication factors, can provide an essential part of standard care. Moral sensitivity, as a part of professional ethics, offers responsible and accurate care. Objectives: This study was conducted with the aim of predicting missed nursing care based on moral sensitivity and care-related factors in 2021. Methods: In this cross-sectional-analytical study, 345 nurses working in medical education centers in Ardabil were selected by stratified random sampling from internal, surgical, special care, emergency, and pediatric departments. Data were collected using the modified Lutzen Moral Sensitivity Questionnaire, Kalish's Missed Nursing Care, and Blackman's Missed Care Related factors. The collected data were analyzed using SPSS 19 with descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (ANOVA, regression, and Pearson). Results: The results of the present study showed that nurses had an average level of moral sensitivity (70.75 ± 10.83). The mean and standard deviation of missed nursing care were (33.93 ± 10.35), which was less than the median of the questionnaire. The components of moral sensitivity (0.32) and related factors (0.08) explain missed care. There was a significant relationship between age, work experience, overtime, and second job with missed care (P < 0.001). Conclusions: Identifying influential factors in reducing missed care is crucial in care, education, and management. It can be said that the dimensions of moral sensitivity and related factors such as human, financial, and communication resources are predictors of missed care. Increasing workload and having a second job increase forgetfulness in caregiving. It is suggested to utilize the experiences of nurses with expertise in care, education, and management, in addition to enhancing moral sensitivity, to ensure comprehensive care while reducing overtime and avoiding second jobs.

Background: The evaluation of geriatric care in the emergency departments is necessary to improve the quality of care. This study aimed to determine the status of geriatric nursing care from the perspective of nurses working in the emergency department of hospitals. Materials and Methods: This study was a cross-sectional research study. Through census sampling, 252 nurses working in the emergency departments of hospitals of Ardabil Province were selected. The status of elderly care was assessed using the Geriatric In-Hospital Nursing Care Questionnaire. Data were analyzed using independent and one-sample t-tests and analysis of variance. Results: The mean (GerINCQ) score of the participants [mean (SD): 237.30 (75.30)] was significantly higher than the criterion score (201) (p = 0.001). The scores of the sub-scales of perception of elderly care [mean (SD): 45.42 (7.53)], aging-sensitive care delivery [mean (SD): 41.55 (10.25)], professional responsibility [mean (SD): 39.62 (9.86)], and attitude toward caring for elderly [mean (SD): 56.14 (12.53)] were significantly higher than the standard score (p = 0.001). However, the score of performed intervention [mean (SD): 38.36 (8.42)] was significantly (p = 0.02) lower than the criterion score (39). The score of professional responsibility and attitude toward elderly care was higher in women than men, and this difference was statistically significant (p < 0.05). Conclusions: The results showed that aging-coordinated care delivery, professional responsibility, and attitudes and perceptions of nurses toward elderly care were satisfactory, but performed intervention was unfavorable. According to the results of this study, nursing service managers can improve the quality of elderly nursing care through appropriate policies, fixing the workforce shortage, and closely monitoring elderly care in the emergency departments.

Background: Preparedness is one of the important and effective pre-crisis management stages and involves all actions and programs that enable the organization to respond quickly and effectively in critical situations. To this end, this study aimed to explore the experiences of crisis managers and experts in hospital disaster preparedness. Methods: This qualitative study was conducted using conventional content analysis in 2019. The research population included hospital managers and crisis specialists in Ardabil Province. The participants were 14 managers and crisis specialists who were selected using purposive sampling. The data were collected through semi-structured interviews and analyzed using Griesheim and Landman’s qualitative content analysis approach. Results: The analysis of the data revealed four main categories including management and planning, infrastructural development, human resources, and intersectoral coordination. Conclusion: The findings of the present study highlighted the significance of preparedness for emergencies, management and planning, having codified instructions, and implementation and evaluation to increase the preparedness of hospitals to deal with emergencies.

Background & Aim: Drug therapy is an important part of the patient's care process which its proper and safe observance is of standard emphasis and its neglecting may give rise to errors and unrecoverable complications for the patient. Evaluation of medication error is necessary for error management and providing safe ...