Iranian Journal of Nursing and Midwifery Research最新文献

{"title":"Identifying Research Gaps in the Diagnosis and Treatment of Hypertension: Evidence from a Guideline Update.","authors":"Nizal Sarrafzadegan, Shahla Shahidi, Fahimeh B Kholenjani","doi":"10.4103/ijnmr.ijnmr_274_24","DOIUrl":"10.4103/ijnmr.ijnmr_274_24","url":null,"abstract":"<p><strong>Background: </strong>The development of clinical practice guidelines presents a unique opportunity to identify research gaps systematically. This study aimed to uncover such gaps in the hypertension field while updating the Iranian hypertension guideline.</p><p><strong>Materials and methods: </strong>This study was conducted as part of the systematic review component of the 2021 Iranian hypertension guideline update. An extensive search of electronic databases was performed to identify evidence relevant to PICO (Population, Interventions, Comparisons, Outcomes) questions. Any topic without evidence with high certainty of effect was considered a knowledge gap.</p><p><strong>Results: </strong>A total of 227 studies were reviewed and appraised. Nine topics, such as non-pharmacological treatment, treatment thresholds, visit and follow-up intervals, laboratory tests, drug immunotherapy, adherence to treatment, complementary medicine, telehealth, COVID-19 were identified as research gaps.</p><p><strong>Conclusions: </strong>The identified research gaps can be examined and prioritized by policymakers in the research field, and actions can be taken to plan for addressing them.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"771-774"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explaining the Lived Experiences of Children in Single-child Families: A Qualitative Study.","authors":"Mina Iravani, Parvin Esfandiarinezhad","doi":"10.4103/ijnmr.ijnmr_198_24","DOIUrl":"10.4103/ijnmr.ijnmr_198_24","url":null,"abstract":"<p><strong>Background: </strong>Given Iran's decreasing fertility rate and the increasing number of single-child families in this country, a comprehensive examination of the unique experiences and challenges faced by only children is warranted. Therefore, this study aimed to explain the lived experiences of children in single-child families.</p><p><strong>Materials and methods: </strong>In this qualitative study, a phenomenological approach was used to explain the lived experiences of children in single-child families in Ahvaz, Iran, between November 2023 and March 2024. Participants aged 18 and older were recruited to ensure they had sufficient life experience as a single child to meaningfully share their perspectives. Participants were selected through purposive sampling until data saturation was reached. Data were collected through in-depth, semistructured interviews with 18 eligible individuals who met the inclusion criteria. Data analysis was performed using Colaizzi's seven-step analysis method.</p><p><strong>Results: </strong>Two main categories emerged: a) positive experiences, which included three subcategories of \"no competition,\" \"financial well-being,\" and \"intimacy with parents,\" and b) negative experiences, involving five subcategories of \"parents' excessive sensitivity,\" \"parents' excessive expectations,\" \"loneliness and emotional dependence,\" \"inability to understand certain feelings,\" and \"negative societal views of only children\".</p><p><strong>Conclusions: </strong>Based on the results of this study, it is evident that being an only child is associated with a range of challenges for individuals, families, and society at large. To mitigate these challenges, health service providers should undertake initiatives to educate and inform families and communities about the potential consequences of single-child families and offer evidence-based counseling interventions.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"739-745"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iranian Nurses' Perceptions of the Consequences of Horizontal Violence for Nurses: A Qualitative Content Analysis Study.","authors":"Parisa Rasouli, Masoud Fallahi-Khoshknab, Narges Arsalani, Mohammadali Hosseini, Kian N Tabrizi","doi":"10.4103/ijnmr.ijnmr_316_24","DOIUrl":"10.4103/ijnmr.ijnmr_316_24","url":null,"abstract":"<p><strong>Background: </strong>Horizontal Violence (HV) in healthcare settings is any type of violence among healthcare providers. It has many different negative consequences for nurses. This study aimed at exploring Iranian nurses' perceptions of the consequences of HV for nurses.</p><p><strong>Materials and methods: </strong>This qualitative content analysis study was conducted in 2022-2023 on twelve nurses purposively selected from five hospitals affiliated with Hamadan University of Medical Sciences in the west of Iran. In-depth semi-structured interviews were conducted for data collection. The main interview question was, \"Have you ever experienced HV in your relationships with your colleagues?\" Graneheim and Lundman's conventional qualitative content analysis was used for data analysis.</p><p><strong>Results: </strong>Iranian nurses' perceptions of the consequences of HV for nurses fell into three main categories, namely erosive tension (with four categories), professional repulsion (with two categories), and low-quality patient care (with two categories). The subcategories of these categories were, respectively, psychoemotional tension, mental tension, physical tension, social tension, low organizational belongingness, low professional interest, hesitation in performing care measures, and endangered patient safety.</p><p><strong>Conclusions: </strong>The main consequences of HV for nurses are erosive tension, professional repulsion, and low-quality patient care. Nurse leaders can prevent HV by providing strong support and quality education to nurses. Interventional studies are recommended to determine the most effective methods to reduce HV in nurses' workplace.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"765-770"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of FRIENDS Educational Program on Resilience and Health-related Quality of Life in Adolescents with Hemophilia.","authors":"Fatemeh Keshavarz, Zohreh Karimi, Mohammad Malekzadeh, Mohammadreza Bordbar, Mohammad Zoladl","doi":"10.4103/ijnmr.ijnmr_142_24","DOIUrl":"10.4103/ijnmr.ijnmr_142_24","url":null,"abstract":"<p><strong>Background: </strong>Improving resilience and health-related quality of life (HRQOL) is one way to adapt to psychological problems in adolescents with hemophilia. One of the educational programs that can probably be effective in improving these factors is the FRIENDS educational program. This study was conducted with the aim of determining the effect of \"FRIENDS\" educational program on resilience and quality of life in adolescents with hemophilia.</p><p><strong>Materials and methods: </strong>This clinical trial was conducted on 60 adolescents with hemophilia selected using a convenience sampling method who visited the Comprehensive Hemophilia Center of Ayatollah Dastgheib Hospital, affiliated with Shiraz University of Medical Sciences, Iran, from August to October 2022; they were divided into two groups of intervention and control based on block random allocation. The data were completed before and immediately after the intervention. The interventions were carried out in 10 weekly 1-hour sessions. The collected data were analyzed using Chi-square, independent <i>t</i>-test, and paired <i>t</i>-test.</p><p><strong>Results: </strong>After the intervention, there was a significant difference in the total mean (SD) score of resilience between the intervention group [3.32 (0.14)] and the control group [2.72 (0.14)] (<i>t</i> ₅₈ = 31.87; <i>p</i> < 0.01). Furthermore, after the intervention, there was a statistically significant difference (<i>t</i> ₅₈ = 20.54; <i>p</i> < 0.01) in the mean (SD) score of HRQOL between the intervention group [3.66 (0.20)] and the control group [2.68 (0.15)].</p><p><strong>Conclusions: </strong>FRIENDS educational program has positive effects on the resilience and HRQOL of adolescents with hemophilia.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"726-731"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of an Information-motivation-behavioral Skills Program on Grandparents' Behaviors to Promote Child Development among Young Children.","authors":"Phonphimon Prakopchanya, Sudaporn Payakkaraung, Somsiri Rungamornrat","doi":"10.4103/ijnmr.ijnmr_66_24","DOIUrl":"10.4103/ijnmr.ijnmr_66_24","url":null,"abstract":"<p><strong>Background: </strong>Grandparents aiming to efficiently promote child development must first acquire the necessary knowledge, motivation, and skills. This study sought to examine the effects of an information-motivation-behavioral skills program on grandparents' promotion of child development among young children.</p><p><strong>Materials and methods: </strong>This quasi-experimental study includes a sample of grandparents who serve as the primary caregivers of children aged 2-4 years at the child development center in Nakhon Ratchasima province, Thailand, which was conducted in 2023. Six child development centers were randomly assigned to experimental and control groups (three centers each), with 37 participants per group. The experimental group participated in a four-week program, while the control group received routine care from their centers. Data were collected using a questionnaire on child development promotion behaviors. Descriptive statistics, independent <i>t</i>-test, and Wilcoxon signed-rank test were used to analyze the data.</p><p><strong>Results: </strong>The mean (SD) of grandparents' behaviors to promote child development after the experiment in the experimental group, 58.49 (3.81), was higher than those of the control group, 47.73 (7.31), with statistical significance (<i>t</i> ₅₄ = -7.94, <i>p</i> < 0.001). Additionally, the experimental group's scores in child development promotion behaviors after participating in the program were statistically significantly higher than before they underwent the program (<i>z</i> = -5.12, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This study effectively encouraged grandparents to adopt appropriate behaviors that promote child development. Future studies should investigate the sustainability of grandparents' behaviors in promoting child development after program completion to inform reminder strategies and maintain behavioral efficiency.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"698-703"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specifying the Objectives and Techniques of a Competency-based Training Program to Improve Post-anesthesia Care Unit Nurse Performance: A Delphi Study.","authors":"Ali Khalafi, Masoumeh Behzadi, Nooshin Sarvi-Sarmeydani, Vahid Saidkhani","doi":"10.4103/ijnmr.ijnmr_373_24","DOIUrl":"10.4103/ijnmr.ijnmr_373_24","url":null,"abstract":"<p><strong>Background: </strong>Clinical competence in detecting complications is crucial for anesthesia nurses working in the Post-Anesthesia Care Unit (PACU). This study utilized the Delphi method to identify essential core competency-based learning objectives for this specialized nursing role. The research also aimed to develop a practical and implementable training program, encompassing appropriate pedagogical approaches and defining the required duration of training.</p><p><strong>Materials and methods: </strong>This qualitative study employed a two-round Delphi method, with invitations extended to 50 faculty members and clinical anesthesia instructors in Iran. During the first round, participants assessed the learning objectives using a 5-point Likert scale. Subsequent to the initial Delphi round and data analysis, all items reaching a median score of at least four, in conjunction with newly proposed objectives, were categorized and presented for re-evaluation. To ascertain suitable teaching methods and the necessary number of sessions, two multiple-choice questions were posed at the conclusion of each round. Descriptive statistics, including median, interquartile range, frequency, and percentages, were used for data analysis.</p><p><strong>Results: </strong>A total of 37 out of 50 panel members (74%) participated in both rounds of the Delphi study. Consensus was reached on 95 learning objectives. To achieve the learning objectives in each group, specific teaching methods were selected. The proposed number of sessions to achieve the objectives totaled 10 sessions, equivalent to 15 hours.</p><p><strong>Conclusions: </strong>A supplementary training program for PACU care was developed using the Delphi method to enhance the clinical competence of anesthesia nurses.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"667-675"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct versus Indirect Nursing Care in Intensive Care Units during COVID-19 (An Observational Study).","authors":"Marzieh Adel Mehraban, Fateme Asvad, Mahboubeh Rasouli","doi":"10.4103/ijnmr.ijnmr_341_23","DOIUrl":"10.4103/ijnmr.ijnmr_341_23","url":null,"abstract":"<p><strong>Background: </strong>Nurses play a crucial role in providing care in Intensive Care Units (ICUs). This study aimed to compare the time spent and types of direct and indirect nursing care provided to patients during COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>This observational study was conducted in the ICU of Hafthome-Tir Hospital, Tehran, in 2022. The activities of 42 randomly selected nurses were continuously observed and recorded, focusing on direct and indirect care as per the revised International Classification for Nursing Practice checklist. Data were analyzed using dependent <i>t</i>-test (<i>p</i> > 0.05).</p><p><strong>Results: </strong>The data showed that the highest average time for direct care spent on cardiopulmonary resuscitation was 27.30 (6.10) minutes, while the least time for deltoid injections was 4.8 (2.9) minutes. In indirect care, the most time was spent writing reports, 34.90 (10.50) minutes, and the least time spent removing personal protective equipment was 6.11 (3.19) minutes. During data collection, 19 procedures were added to the nursing care checklist due to COVID-19. A dependent <i>t</i>-test showed a significant difference between direct and indirect ICU nursing care (t= -6.62, df = 41, <i>p</i> < 0.001), indicating more time was spent on indirect care.</p><p><strong>Conclusions: </strong>The findings showed indirect care was provided more frequently than direct care, highlighting the need to reassess nursing care delivery methods. The increased demand for indirect care is attributed to time and staffing shortages, along with a rise in patient numbers and hospitalizations compared to pre-COVID conditions.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"646-652"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magical Thinking and Mystical Experience: An Exploration of Delusional Disorder in Schizophrenic Patients.","authors":"Arum Pratiwi, Joko Sri Pujianto, Sukardi Sukardi, Erna Herawati, Abi Muhlisin, Sakanti Maulida Farjatulla, Fath Maulfi Putra","doi":"10.4103/ijnmr.ijnmr_18_23","DOIUrl":"10.4103/ijnmr.ijnmr_18_23","url":null,"abstract":"<p><strong>Background: </strong>Delusions are common positive symptoms in schizophrenic patients. Individuals with delusional disorders have different experiences in memory and beliefs. Exploring patients' delusional beliefs is crucial to ascertaining appropriate psychotherapy programs. A few studies have explored the meanings of delusions for delusional patients. This study explores how schizophrenic patients lived experiences about their delusional beliefs.</p><p><strong>Materials and methods: </strong>The study was carried out at a psychiatric hospital in Indonesia in 2021. The participants included 30 adult schizophrenic patients who had delusional life experiences and were able to communicate. Open-ended questions and probes were applied during in-depth interviews. We interviewed family members as well to improve the rigor of the research. Interpretative Phenomenological Analysis was used in this study.</p><p><strong>Results: </strong>The patients' clinical history revealed the experiences of failure and loss. Two main themes shaping their delusional experiences included demonic forces and magical powers.</p><p><strong>Conclusions: </strong>Patients with delusions had similar themes, but each had a different specific experience. The findings suggest that each patient may require a unique cognitive therapy based on their experience.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"641-645"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association between Gender Role Attitude and Maternal Identity among Thai-Adolescent Mothers.","authors":"Somsakhool Neelasmith, Darunee Jongudomlarn, Patcharaporn Jearanaithanakit, Uraiwan Haungthaisong","doi":"10.4103/ijnmr.ijnmr_28_24","DOIUrl":"10.4103/ijnmr.ijnmr_28_24","url":null,"abstract":"<p><strong>Background: </strong>The transition to motherhood is a critical developmental milestone in a woman's life, influenced by various factors, including gender role attitudes, which shape maternal behaviors and identity formation. However, the relationship between gender role attitudes and maternal identity remains underexplored.</p><p><strong>Materials and methods: </strong>This descriptive cross-sectional study examined the association between gender role attitudes and maternal identity among 263 postpartum adolescent mothers in northeastern Thailand. Participants were purposively selected between July 2021 and August 2022. Data were collected using a self-administered questionnaire with strong psychometric properties, including sociodemographic data, the Gender Role Attitude Scale (Cronbach's α = 0.94), and the Maternal Identity Scale (Cronbach's α = 0.95). Descriptive and bivariate statistical analyses were conducted to assess potential associations.</p><p><strong>Results: </strong>The mean age of participants was 18.7 (1.29) years, and the mean age of their infants was 4.89 (0.39) months. Participants exhibited predominantly egalitarian gender role attitudes, with a mean score of 3.57 (0.48) and reported a high level of maternal identity, with a mean score of 4.57 (0.64). A statistically significant positive correlation was found between egalitarian gender role attitudes and maternal identity (Pearson's <i>r</i> = 0.45, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>This study highlights the significant association between egalitarian gender role attitudes and a strong maternal identity among adolescent mothers. These findings suggest that fostering egalitarian gender role attitudes may support maternal identity development and improve maternal and child wellbeing.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"692-697"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How is Nursing Care Provided for Cardiovascular Patients with Substance Use Disorders?","authors":"Fatemeh Moghaddam, Narges Arsalani, Kian Norouzi Tabrizi, Masoud Fallahi-Khoshknab, Sadat Seyed Bagher Maddah","doi":"10.4103/ijnmr.ijnmr_253_24","DOIUrl":"10.4103/ijnmr.ijnmr_253_24","url":null,"abstract":"<p><strong>Background: </strong>Patients with cardiovascular diseases who also suffer from substance use disorders face distinct challenges in nursing care. Similarly, nurses encounter various caregiving challenges. Therefore, this study aims to explore the nursing care process for patients with co-occurring cardiovascular diseases and substance use disorders.</p><p><strong>Materials and methods: </strong>This grounded theory study, informed by Strauss and Corbin (2015), was conducted at the University of Social Welfare and Rehabilitation Sciences in 2023. The participants consisted of 23 nurses, patients, and other treatment team members, who were purposefully selected from the cardiac and internal cardiac intensive care units of hospitals in Iran. A total of 25 semi-structured interviews were conducted to collect data, with the primary question being: \"How is nursing care provided to cardiac patients with substance use disorders?\" The primary analysis strategies employed included constant comparison, data questioning, and memo writing.</p><p><strong>Results: </strong>The analysis revealed six main categories: the complexity of care, an inappropriate work environment, and insufficient nurse competency as conditions; discrimination in care and informal care as strategies; and nurse-patient dissatisfaction as consequences. Based on the findings, nurses employ unstructured care to address their most pressing concerns.</p><p><strong>Conclusions: </strong>Nurses encounter various challenges when caring for patients who receive ineffective and unstructured care, which often leads to adverse outcomes. Consequently, developing appropriate care guidelines is essential. Based on the study's findings, nurses, managers, and researchers can collaborate to enhance care quality and improve nurses' professional competence.</p>","PeriodicalId":44816,"journal":{"name":"Iranian Journal of Nursing and Midwifery Research","volume":"30 5","pages":"758-764"},"PeriodicalIF":1.2,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}