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  Background and Objective : Neurologic patients' care givers are faced with many challenges and stresses, affecting on their health if they cope with an inappropriate style. The awareness of the care givers about coping strategies is necessary to prevent from their psychological problems, therefore the present study was conducted to determine the coping strategies of men and women care givers of Neurologic patients at home.

  Material and Methods : This descriptive-Analytical study was conducted on 200 subjects selected by convenience sampling method. The instrument was Jawiloice coping strategy scale­ having two dimensions of problem-focused­ part (15 ­questions) and
emotion-focused (24 questions). The data analysis was performed using estimates of central tendency, Chi-Square, Kruskal-Wallis, Mann-Whitney test and Anova (P<0.05) by spss 16.

  Results: The participants were men (N=120) and women (N=80). The problem-focused subscale in men is 51.86 ± 6.3 and in women 52.86 ± 7.63, whereas in emotional-focused the result is 72.86 ± 13.89 in men and 69.68 ± 11.65 in women. In latter dimension, the difference is not statistically significant. ­In problem-focused between men and women, the difference is significant (p≤0.05). Considering coping levels to low, moderate, and high, there is no meaningful difference between males and females. Duration of involvement with patients is significantly correlated with emotional-focused (p≤ 0.05) and income status with problem-focused (p≤ 0.03).

  Conclusion: According to the findings, the care givers must be educated about effective coping strategies skills to decrease stresses due to care of the patients and to improve mental health.

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  Background and Objective : Anemia is one of the most common complications of end stage renal diseases. Inadequate production of erythropoietin is the main cause of anemia in these patients, and iron deficiency is the other important factor. We designed this study to survey the prevalence of iron deficiency anemia in hemodialysis patients referred to hemodialysis ward of Panje Azar hospital in Gorgan, Iran.

  Material and Methods: The subjects of this descriptive and cross-sectional study were all 97 patients undergone permanent hemodialysis. Hemoglobin, Serum Iron, Ferritin, Transferrin saturation and Hemoglobin index were measured to assess iron deficiency anemia. We did data analysis by using chi square, fisher exact test and independent T test in spss 13 environment.

  Results: The prevalence of anemia and iron deficiency anemia were 57.6 and 31.1 percent, respectively. Tranferrin saturation in 29.16 percent of the patients is less than 20%. There was no significant correlation between signs of anemia and variables such as, duration of dialysis, causes of the disease and iron- deficiency anemia (p=0.06). But signs of anemia were significantly correlated (p<0.0001) with erythropoietin. In comparison with patients consumed iron orally, those who used injectable iron had higher serum iron, Hemoglobin and Transferrin saturation (p<0.001).

  Conclusion: Because of high frequency of iron- deficiency that may results in resistance to erythropoietin therapy and leads to inappropriate treatment of iron deficiency. We recommend first treating of ID to prevent from useless administering of erythropoietin.

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  Background and Objective: Chronic neurologic diseases due to associated disabilities and high cost of ­their medical services are considered as a crisis for patients and family. The stress caused by these problems can jeopardize the health of the caregivers. Thus, the aim of this study was to determine the general health status of neurologic patients’ caregivers and the related factors.

  Material and Methods: In this cross-sectional study conducted in 2009, the caregivers of the patients with neurological disorders (n=200) were selected via convenience sampling.­ The data was gathered by a demographic checklist and general health questionnaire (GHQ-28) completed by caregivers and analyzed by descriptive statistic­, Pearson correlation coefficient and chi square, using SPSS-16.

  Results: The mean age is 31.78±9.94 and 59.5% of the subjects are males. The caregivers (72.5%) general health is disturbed (Score more than 23 based on GHQ-28 cut of point). General health of male and female caregivers is significantly different (P<0.05). Between the subscales of GHQ-28, female caregivers compared to males have higher depression score, which is significant (P<0.05).­ ­The caregivers’ general health are correlated with (P<0.05) the patient’s care dependency and the income of family. ­There is no significant relationship between general health and demographic variables such as marital status, history of the disease and educational level.

  Conclusion: Based on the results, significant percent of caregivers of the patients with neurological disorders suffer from disrupted general health. Thus, the presence of supportive resources and effective coping skills can be effective in improving the health.

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Background and Objective: Nurses should be so determined and competent that, in the dynamic and changing conditions of the patients, they could use their technical skills and professional knowledge to make a rigorous clinical judgment about the patient's health status. Accordingly, a study was conducted to assess the health status of patients and nurses in the hospitals affiliated  with  the social security organization in Tehran, Iran.

Material and Methods: This descriptive – analytical study was conducted  on 96 nurses working in ­medical-surgical and emergency wards of the hospitals affiliated with Social Security Organization in Tehran. The instrument was a questionnaire including two parts of demographic data and 11 questions for assessing nurses' performance. To analyze the data, we useddescriptive and inferential statistics.

Results: The mean age is 7.15 ± 32.8 and  75% of the patients are females. Their (53.1%) work of experience is between 73-96 months and their (52.1%) performance is observed poor. There is significant correlation between nurses' performance and variables such as gender, age, marital status, work experience and ward of hospital.

Conclusion: Because of low performance of the nurses, it is important for nurses to assess the  health status of patients , the same as physicians using screening forms on the file of patients.

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Background: Dialysis adequacy is one of the determining factors for survival in elderly patients. Improving the dialysis adequacy highly affects the remission and prognosis of old dialysis patients. Current study was conducted to evaluate the effects of Jacobson relaxation technique on dialysis adequacy in elderly people, who are under dialysis treatment.
Methods: ods: This is a clinical trial performed on 80 hemodialysis patients in two hemodialysis centers of Gonabad and Yazd, Iran, in 2013. The patients were selected through purposive sampling method, and randomly assigned into the two groups of control (n=40) and intervention (n=40). The participants in intervention group were provided by three sessions of relaxation training, and were asked to perform the relaxation daily for six weeks, while the control group just received the routine cares. Afterwards, the adequacy of dialysis was compared between the two groups. The data was collected using the demographic information, and the dialysis adequacy was calculated by KT/V equation.
 Results: A significant statistical difference was found between groups regarding the mean difference of dialysis adequacy in pre- and post-intervention (P<0.001).Besides, dialysis adequacy increased post-intervention in the case group and decreased slightly in the control group compared to pre-intervention.
Conclusion: Training and performing the relaxation method lead to an  improved dialysis adequacy in elderly patients under hemodialysis.

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Background: Recirculation is a phenomenon in hemodialysis where purified blood re-enters the dialyzer and is cleaned again, which can negatively impact the adequacy and quality of hemodialysis. As quality hemodialysis is crucial for the treatment of hemodialysis patients, this study aimed to determine the prevalence of recirculation and its related factors in patients undergoing hemodialysis in medical centers in Golestan province, Iran in 2019.
Methods: A cross-sectional study was conducted in 2019 on patients with end-stage renal disease (ESRD) undergoing hemodialysis in medical centers in Golestan province, northeastern Iran. The study included 324 patients, selected using a stratified sampling method. Demographic and clinical data were recorded, and recirculation was measured by assessing urea levels based on the two-needle method, with a cut-off point of 10%. Patients were categorized into two groups based on recirculation percentage, with and without recirculation. Data were analyzed using SPSS (version 16) with descriptive statistics (mean, standard deviation, frequency) and inferential statistics (chi-square test and Fisher's exact test for low frequency cases, and t-test to compare quantitative variables) at a confidence level of 0.05.
Results: The study found that the prevalence of recirculation in hemodialysis patients in Golestan province, Iran was 22.5%. There was a significant relationship between pump speed, arterial needle location (above the venous needle), venous-arterial needle distance from each other, and recirculation. The mean pump speed was 251.64 rpm, and the venous-arterial needle distance was 4.12 cm significantly lower in the recirculation group than in the no-recirculation group. There was also a significant relationship between recirculation and the way catheter lines were connected (arterial line connected to venous line) (P=0.0001).
Conclusion: Given the high prevalence of recirculation, and the ability to modify some of its related factors, nurses should take strategies and create suitable conditions for efficient hemodialysis for patients undergoing hemodialysis.

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