1 24764132 Iran University of Medical Sciences 235 General Professional Image Perceptions in First-year Nursing Students Yılmaz Dilek b b Department of Nursing, Faculty of Health Sciences, Bursa Uludag University, Bursa, Turkey. 1 8 2019 5 3 141 146 10 01 2019 23 06 2019 Background: Determining the professional image perceptions of the first-year nursing students who have recently chosen the nursing profession is of great importance in delineating the profession profile. The present study aimed to determine the image perception of first-year nursing students and its related factors. Methods: This descriptive cross-sectional research was conducted in the Fall semester of the 2019-2020 academic year. In total, 105 first-year nursing students were selected from the Nursing Department of the Faculty of Health Sciences of Bursa Uludağ University in Turkey. The study subjects were recruited randomly. A Student Identification Form and the Image Scale for the Nursing Profession were used as data collection tools. Mann-Whitney U and Kruskal-Wallis tests were applied for analyzing the obtained data in SPSS. Results: The Mean±SD score of the Image Scale for the Nursing Profession was achieved as 149.06±11.19. Students who had willingly selected the nursing profession gained higher scores than those of other students in professional qualifications, education, professional status, and appearance scale sub-dimensions and total scale mean scores (P<0.05). In addition, the mean scores of the female students in the sub-dimensions of education, gender, and total scale were significantly higher than those of their male counterparts (P<0.05). Conclusion: The nursing students indicated a good image perception of the nursing profession. Conducting a similar study is recommended for senior nursing students and staff nurses. 
228 General Investigating Gestalt-based Play Therapy on Anxiety and Loneliness in Female Labour Children With Sexual Abuse: A Single Case Research Design (SCRD) Khodabakhshi-Koolaee Anahita c Akhalaghi-Yazdi Reihaneh d Hojati Sayah Maryam e c Department of Psychology and Educational Sciences, Faculty of Humanities, Khatam University, Tehran, Iran. d Department of Psychology and Educational Sciences, Faculty of Humanities, Khatam University, Tehran, Iran. e Department of Psychology and Educational Sciences, Faculty of Humanities, Khatam University, Tehran, Iran. 1 8 2019 5 3 147 156 15 12 2018 10 05 2019 Background: Sexual abuse and harassment are among the major threats to labor children, especially girls, which can be associated with anxiety and loneliness. The current study aimed to investigate the effect of Gestalt play therapy on anxiety and loneliness in Afghan female labor children with sexual abuse histories. Methods: This was a Single Case Research Design (SCRD) study of the AB model. The statistical population of the study consisted of all 8-11-year-old sexually-abused Afghan children in Karaj City, Iran, in 2018. Three 8-11-year-old female labor children with a sexual abuse history supported by Imam Ali Society (AS) were selected using a random sampling method. The intervention was performed in ten 45-minute sessions for 3 months, and the follow-up phase was conducted one month after the treatment. The required data were collected using the Child Abuse Scale, Asher Loneliness Scale, and Spence Children's Anxiety Scale. Graphical analysis, recovery percentage, and reliable change index were used to analyze the collected data.  Results: The loneliness posttest scores improved, compared to the baseline values in the study participants. Their total recovery frequency was 0.56% in the loneliness, and the scores of reliable change index were >1.96 for all 3 study participants. In addition, the obtained results represented that this therapy decreased anxiety in these children and was clinically significant. Their total recovery frequency was equal to 0.57% in the loneliness, and the scores of reliable change index were >1.96 for all 3 study participants. Moreover, the follow-up test results indicated that the effects of intervention continued one month after the last session of play therapy.  Conclusion: Gestalt play therapy has effectively reduced loneliness and anxiety in sexually-abused children. Thus, this therapy could be used as a therapeutic intervention in health centers to improve the feeling of loneliness in labor children and reduce their stress and psychological problems. 225 Special The Knowledge, Attitudes, and Practices of Healthcare Providers About Colorectal Cancer Screening by Health Belief Model Khakbaz Alvandian Elham f Farahaninia Marhamat g Masror Daryadokht h Haghani Hamid i f Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences and Health Services, Tehran, Iran. g Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences and Health Services, Tehran, Iran. h Department of Medical-Surgical Nursing, , School of Nursing and Midwifery, Iran University of Medical Sciences and Health Services, Tehran, Iran. i Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences and Health Services, Tehran, Iran. 1 8 2019 5 3 157 166 19 02 2019 25 06 2019 Background: Colorectal Cancer (CRC) is a serious health problem, and its early detection is crucial for treatment and reducing mortality. Beliefs related to colorectal cancer are an affecting factor in a person’s decision about the CRC Program. The current study aimed at assessing the knowledge, attitude, and practice of healthcare providers regarding colorectal cancer screening based on the Health Belief Model (HBM) in Hamedan City, Iran, in 2018. Methods: This was a descriptive cross-sectional study. A total of 330 healthcare workers employed in comprehensive centers of urban and rural services in Hamedan were recruited by the census method. The required data were collected by demographic characteristics form and HBM scale of CRC. To analyze the obtained data, frequency, mean, standard deviation, Independent Samples t-test, Analysis of Variance (ANOVA), linear regression, and logistic regression analyses were used in SPSS. Results: The achieved results suggested that the mean knowledge score of the study subjects was 10.19; it was higher than that of 7.5 in the structure of HBM. The mean score of perceived sensitivity, perceived severity, perceived benefits, and perceived self-efficacy was higher than that of the perceived tool, and the barriers were less. Test performance was satisfactory in people aged >50 years (68.2%), and more than 90% of individuals recommended screening to their clients. They received the most information during training sessions. Conclusion: Although the level of knowledge of CRC was higher than the average, more education is required for people to receive regarding HBM. On-job training classes should be more precise. Furthermore, considering the favorable performance of the sample, integrating the CRC screening program into the healthcare program has provided desirable results and could be a starting point for other programs.  201 Special Nurses' Level of Awareness and Observance of Patients' Rights Sookhak Fatemeh j Bazrafshan Mohammad Rafi k Ahmadi Alireza l Kavi Esmaeil m j Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran. k Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran. l Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran. m Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran. 1 8 2019 5 3 167 174 10 03 2019 27 07 2019 Background: Patient's rights as one of the basic pillars in defining the standards of clinical services indicate that the patient's biopsychosocial and spiritual needs are met in the form of standards, rules, and regulations. This study aimed to evaluate the level of awareness and observance of patients' rights by nurses working in hospitals affiliated to Larestan University of Medical Sciences. Methods: In this descriptive cross-sectional study, 83 clinical nurses were recruited by convenience sampling method. To collect the research data, researcher-made questionnaires, including Patient's Rights Awareness and "Patient's Rights Observance were used. The reliability of the two parts of the questionnaire was reported using Cronbach's alpha coefficients as 0.51 and 0.69, respectively. The obtained data were analyzed in SPSS using descriptive and Chi-squared tests.  Results: The knowledge of patient rights was poor, moderate, and good in 81.9%, 16.9%, and 1.2% of the nurses, respectively. Additionally, nurses’ performance regarding patients' rights was reported as moderate in 83.1%, poor in 13.3%, and good only in 3.6% of them. Chi-squared test results revealed that among the demographic variables, only gender and education were significantly correlated with the knowledge and practice of nurses regarding the observance of patients' rights (P<0.05). Conclusion: The study participants' knowledge of patients' bill of rights was poor, and their observance of patients' rights was moderate; thus, interventions should be performed to prevent the violations of patients' rights. Continuing education programs and in-service training about the observance of the patients' bill of rights should be considered more seriously.  219 General The Effect of Benson Relaxation Technique on the Fatigue Severity of Patients With MS Mirhosseini Saeed n Mohammadi Abouzar o Rezaei Mahboobeh p Mirbagher Ajorpaz Neda n Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran. o Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran. p Department of Nursing and Midwifery, Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran. Department of Nursing and Midwifery, Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran. 1 8 2019 5 3 175 182 03 01 2019 07 06 2019 Background: Fatigue is a frequent symptom in Multiple Sclerosis (MS) that can interfere with the daily functioning of the patient. The present study aimed to determine the effect of the Benson relaxation technique on the fatigue severity of MS patients. Methods: This was a clinical trial study. A total of 60 MS patients with <5 degrees of disability were enrolled and randomly assigned into two groups (n=30 per group). The intervention group performed the Benson relaxation technique twice daily, and for 20 minutes during one month. No intervention was provided to the control group. Before and after the study, the fatigue questionnaire was completed by the patients, and the two groups were compared. The obtained data were analyzed in SPSS using the Chi-squared test, Independent Samples t-test, and Paired Samples t-test. Results: Benson relaxation exercises significantly reduced the average fatigue severity of patients with MS (P≤0.05). Conclusion: Benson relaxation technique can be used as a cost-benefit, safe, and ordinary complementary therapy to reduce fatigue in patients with MS. 230 General The Prevalence of Drug-Drug Interaction and Inappropriate Drug Prescription Among the Elderly in Kashan Dianati Mansour Mirbagher Ajorpaz Neda Lotfi Mohammad Sajjad Najarzadeh Maryam Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran. Department of Nursing and Midwifery, Autoimmune Diseases Research Center, Kashan University of Medical Sciences, Kashan, Iran. Iranian Research Center on Ageing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Registration Center of Adverse Drug Reaction, Kashan University of Medical Sciences, Kashan, Iran. 1 8 2019 5 3 183 192 04 02 2019 25 06 2019 Background: Drug-Drug Interaction (DDI) among the elderly is one of the major healthcare challenges worldwide. The present study assessed the rates of DDI and inappropriate drug prescription among the elderly in Kashan City, Iran.  Methods: This descriptive-analytical study was designed, conducted, and reported according to the guideline of Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). A random sample of 368 elderly who lived in Kashan City, Iran, was selected through cluster sampling technique. Data collection tools were a demographic questionnaire and a drug checklist. The obtained data were analyzed by the Chi-squared test, logistic regression analysis, and Odds Ratio (OR) in SPSS.  Results: In total, 308 (88%) participants used at least one drug. The Mean±SD scores of daily consumed drugs and the number of inappropriate drugs taken daily by the study participants were 6.21±3.52 and 0.28±0.62, respectively. Most of the study participants were taking more than two drugs (n=267, 86.68%) and more than four drugs (n=200, 64.9%) per day. The OR of DDI among the study participants who were taking ≥2 drugs per day was 2.49 times greater than those who were taking one or two drugs (OR=2.49, 95% confidence interval=1.20-5.18). The most frequent DDIs were between non-steroidal anti-inflammatory drugs and beta-blocker agents (n=84, 18.22%) and between non-steroidal anti-inflammatory drugs and nitrates (n=46, 9.9%).  Conclusion: The rate of inappropriate drug use among the elderly living in Kashan, Iran, is low, however, polypharmacy and DDIs are highly prevalent among them. To reduce the rates of DDI and polypharmacy, educational programs for different healthcare providers are required to improve their knowledge. Moreover, further studies are needed to assess the effects of polypharmacy and DDI preventive measures, like drug history cards. 227 Special Nurses’ Perspectives on the Barriers and Facilitators of Pain Management in Hospitalized Patients Amiri Roya Safa Azadeh Dianati Mansour Izadi-Avanji Fateme Sadat Azizi-Fini Ismail Izadi-Dastjerdi Elham Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran. Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran. Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran. Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran. Trauma Nursing Research Center, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran. Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. 1 8 2019 5 3 193 202 05 01 2019 21 05 2019 Background: Pain management is among the key tasks of nurses. Numerous studies have investigated the barriers and facilitators of pain management with conflicting results. The current study investigated the Iranian nurses’ perspectives in terms of the barriers and facilitators of pain management in hospitalized patients. Methods: This was a cross-sectional study. A total of 321 nurses working in a large general teaching hospital were recruited by the census method. A two-part, self-report questionnaire, including questions on nurses' characteristics and barriers and facilitators of pain management, was applied to collect data. The questionnaire was developed by researchers using a literature review. The questionaries’ reliability was assessed through a test-retest with a correlation coefficient of 0.89. SPSS was used for statistical data analysis. Descriptive statistics (frequency, percentage, mean, and standard deviation) were applied to analyze the data.  Results: Insufficient nurse/patient ratio (Mean±SD: 3.31±0.87), excessive demand for pain medications by the patients (3.12±0.95), the spoken language difference between physician and patient (3.01±0.85), the ignorance of pain as a priority in care (2.94±0.98), and failure to precise pain assessment (2.90±0.89) were determined by the nurses, as the main barriers to pain management, respectively. The studied nurses also perceived the attendance of in-service courses of pain management (3.39±0.63), having sufficient pain management skills (3.24±0.76), motivation for relieving the patient’s pain (3.24±0.81), effective nurse-physician relationship (3.26±0.68), proper supervision of the organization on a timely patient visit by the physician (3.12±0.92), and patient cooperation in pain management (3.21±0.75), as the main facilitators of pain management, respectively. Conclusion: The establishment of in-service education programs on pain management and strengthening the managerial processes, such as staffing and supervision, can facilitate pain management in hospitalized patients by nurses.  234 Special The Satisfaction of Ischemic Heart Disease Patients With Nursing Care in Emergency Department Mousavi Masoumeh-Sadat Adib-Hajibagheri Mohsen Azizi-Fini Ismail Izadi-Avanji Fatemeh Sadat Department of adult health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran. Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran. Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran. 1 8 2019 5 3 203 210 27 12 2019 05 04 2019 Background: Emergency department congestion is among the major barriers to receiving nursing care for high-priority conditions, like ischemic heart disease. Therefore, it can affect patients’ satisfaction with the quality of care. This study aimed to investigate satisfaction with emergency care among patients with ischemic heart disease. Methods: This cross-sectional study was conducted on 600 randomly-selected patients with ischemic heart disease who were admitted to the emergency department of Shahid Beheshti Hospital in Kashan City, Iran, from April to October 2017. The required data were collected, applying the Patient Satisfaction Instrument (PSI). The obtained data were analyzed using descriptive and analytical statistics, including Independent Samples t-test, Analysis of Variance (ANOVA), Multivariate Regression, and Pearson’s correlation analysis in SPSS software. Results: In total, 50.7%( 304) of the studied patients were male. The Mean±SD score of patient satisfaction with nursing care was 71.90±14.76. The highest and lowest scores of patient satisfaction were related to technical-professional care (4.40±1.09) and patient education (3.17±0.74) subscales, respectively. Patient satisfaction was significantly correlated with previous experience of hospitalization and educational level (P=0.03). Pearson’s correlation analysis results suggested a positive and significant correlation between age and satisfaction (P<0.01; r=0.310). Conclusion: In this study, patient satisfaction of technical-professional care was at an acceptable level; however, it was low on the subscale of patient education. Nevertheless, nursing managers should create conditions to promote patient education for more patient satisfaction. Additionally, devoting more time for patient education is required by nurses.