https://ebcj.mums.ac.ir/ Evidence Based Care en daily 1 Wed, 01 Apr 2026 00:00:00 +0330 Wed, 01 Apr 2026 00:00:00 +0330 https://ebcj.mums.ac.ir/article_27474.html Background: Hypertension is highly prevalent and a major contributor to cardiovascular diseases, imposing significant economic and social burdens. Effective, theory-based interventions are required to improve clinical and behavioral outcomes.Aim: This study aimed to investigate the effect of the Family-Centered Empowerment Model on social support, medication adherence, and blood pressure control in patients with hypertension .Method: This randomized controlled clinical trial was conducted on 80 patients with hypertension and their family caregivers from a comprehensive health center in Mashhad, Iran. The selected center was affiliated with Mashhad Health Center No. 1 which has 20 comprehensive health services centers. Participants were randomly assigned to intervention and control groups using block randomization (blocks of four) with concealed allocation via sealed opaque envelopes. The intervention group participated in six weekly sessions grounded in the family-centered empowerment model, while the control group received standard verbal education and pamphlets. Data collection tools included a demographic questionnaire, Sherbourne–Stewart Social Support Questionnaire, Morisky Medication Adherence Scale, and a calibrated mercury sphygmomanometer. Measurements occurred before and two months post-intervention. Statistical analyses were conducted using independent t-test, Mann–Whitney, and Wilcoxon tests via SPSS version 25.Results: At baseline, no statistically significant differences were observed between the two groups in social support, medication adherence, or systolic and diastolic blood pressure (p>0.05). After the intervention, the intervention group showed significantly higher levels of social support and medication adherence, as well as significantly lower systolic and diastolic blood pressure compared to the control group (p<0.001).Implications for Practice: Family-centered empowerment-model education can improve social support, adherence, and blood pressure control in hypertensive patients and is recommended for patient and family education. Integration of this structured family-based approach into primary care settings is recommended. https://ebcj.mums.ac.ir/article_27473.html Background: Adolescent girls face unique challenges regarding body appreciation and loneliness, often intensified by developmental changes like puberty.Aim: This study was conducted with aim to investigate the impact of pubertal signs on body appreciation and loneliness among middle school girls.Method: This cross-sectional study was conducted on 281 middle school girls aged 13–15 years in Neyshabur. The statistical population included all female middle school students in Neyshabur during the 2023–2024 academic year. A school was selected using two‑stage simple random sampling, and all available students who met the inclusion criteria were included. Eligible participants were unmarried girls with normal body mass index, willing to participate, and no psychiatric history. Pubertal signs were identified based on menstrual experience reported in the demographic questionnaire. Data were collected using a demographic questionnaire, the Body Appreciation Scale‑2(BAS‑2), and the UCLA Loneliness Scale‑Version 3(LS3). Data were analyzed by SPSS-25 software. p<0.05 was considered statistically significant.Results: A significant difference was found between groups with and without signs of puberty in terms of age and BMI (p<0.001). However, after controlling for these factors, no significant difference was observed in body appreciation or loneliness (p>0.05). A significant negative correlation was identified between loneliness and body appreciation in both groups.Implications for Practice: Puberty alone may not determine body appreciation or loneliness, emphasizing the need to explore social and environmental influences. Supportive family interactions and school based educational, counseling, and peer programs may reduce loneliness and enhance body appreciation, contributing to better adolescent mental health. https://ebcj.mums.ac.ir/article_27536.html Background: Despite advancements in the treatment of chronic obstructive pulmonary disease (COPD), it is an irreversible disease with poor prognosis. Individuals with COPD not only experience progressive shortness of breath and physical limitations, but also face psychological and social challenges.Aim: This study was conducted with aim to determine the impact of the continuous care model on the lifestyle and self-care of patients with COPD.Method: This randomized controlled clinical trial was conducted on 70 patients with chronic obstructive pulmonary disease at Sina Respiratory Hospital at Zabol, southeastern Iran in 2023-2024. The participants who met the inclusion criteria were randomly allocated into intervention and control groups. The Miller Lifestyle Questionnaire and the Miller Self- Care Questionnaire were completed for data collection. For the intervention group, the continuous care model was implemented over 3 months in 4 stages: familiarization, sensitization, control, and evaluation. The statistical analysis was conducted by SPSS software (version 26). p<0.05 was considered statistically significant.Results: The mean lifestyle score after the intervention decreased in both groups (control: 76.40 ± 4.55 to 75.71 ± 6.62; intervention: 71.23 ± 4.65 to 48.05 ± 4.97); however, only the decrease in the intervention group was statistically significant compared with the pre-intervention value (p<0.05), and the mean self-care after the intervention significantly increased compared to the mean before the intervention in the intervention group (p<0.05).Implications for Practice: The continuous care model can improve self-care behaviors and lifestyles of patients. Therefore, the use of this model is recommended in clinical settings and after discharge for respiratory patients, especially those with COPD, which is a chronic disease.  https://ebcj.mums.ac.ir/article_27568.html Background: Children with tracheostomies rely on airway patency and respiratory function, but obstruction and discomfort can reduce quality of life for both the child and family. Non-pharmacological options, like laughter, may offer benefits.Aim: This study aims to investigate the impact of laughter on airway patency in hospitalized children with tracheostomies, emphasizing the potential non-invasive therapeutic benefits in enhancing respiratory outcomes.Method: This quasi-experimental study enrolled eighty children aged 6–12 with tracheostomies in Tehran (March 2021–July 2022). Participants were convenience-sampled and randomly assigned to intervention or control groups. The intervention: two 15-minute laughter sessions over two consecutive days. The laughter-based intervention consisted of watching a comedic animation ("The Adventures of Oscar") and engaging in puppet play. Airway patency was monitored via SpO₂, respiratory rate, and suctioning frequency thrice daily for two days post-intervention. Data were collected with a demographic–clinical questionnaire and validated monitoring devices. Analyses used t-tests, Mann–Whitney, Chi-square, Friedman's test, and GEEs (p<0.05) in SPSS v20.Results: About 88.8% of participants breathed spontaneously. No significant baseline differences between groups. SpO₂ rose significantly at the 5th and 6th measurements (p=0.026, p=0.016). The intervention group had a lower respiratory rate across all six time points (p<0.05). Suctioning frequency declined significantly in the intervention group only at the 6th measurement (p=0.011). GEE showed a significant time-by-group reduction in respiratory rate for the intervention group (p=0.003); no between-group differences were found for SpO₂ (p=0.218) or suctioning frequency (p=0.504).Implications for Practice: Laughter-based interventions are feasible non-pharmacological strategies to improve respiratory function in pediatric tracheostomy care and can be integrated into routine care. https://ebcj.mums.ac.ir/article_27552.html Background: Kidney transplantation is the preferred treatment for end-stage renal disease, yet its long-term success depends heavily on sustained post-transplant care. Much of this responsibility falls on family members who serve as home caregivers.Aim: This study aimed to explore and describe the challenges experienced by home caregivers of kidney transplant recipients from their lived perspectives using a qualitative content analysis approach.Method: A qualitative study with a conventional content analysis design was conducted in Urmia, Iran. Eighteen primary home caregivers of adult kidney transplant recipients were recruited through purposive sampling from transplant clinics and follow-up centers. Data were collected through in-depth, semi-structured interviews conducted in Persian. Interviews were audio-recorded, transcribed verbatim and analyzed inductively using the Graneheim and Lundman method. MAXQDA software was used for data management.Results: Analysis revealed one overarching theme, “A Vortex of Enduring Burdens,” reflecting the cyclical and overwhelming nature of caregiving. This theme comprised four main categories: (1) The Overwhelming Weight of Care Responsibilities, (2) Psycho-Emotional Erosion, (3) The Crushing of Personal and Social Identity, and (4) Socio-Economic Precarity, encompassing eleven subcategories. Caregivers reported persistent stress related to regimen management, emotional exhaustion, identity loss, social isolation, and financial and occupational instability.Implications for Practice: Home caregivers of kidney transplant recipients experience profound, multidimensional burdens that extend beyond medical care. Addressing these challenges requires comprehensive caregiver-centered interventions, including education, psychological support, and policy-level support to promote sustainable family caregiving and improved transplant outcomes.  https://ebcj.mums.ac.ir/article_27654.html Background: Electronic health literacy, the ability to seek, evaluate, and apply digital health information has become essential for improving care quality. Nurses, as frontline providers, must possess strong eHealth literacy skills. Previous research suggests nurses’ literacy levels are influenced by access to educational resources, experience, and demographic characteristics.Aim: This study aimed to evaluate eHealth literacy and its demographic and occupational determinants among nurse.Method: This descriptive cross-sectional study was conducted from November 2024 to February 2025. Using stratified random sampling, 334 nurses were selected from public hospitals affiliated with medical universities in Tehran, Iran. Data were collected via a demographic and occupational form and Norman and Skinner’s validated eHealth Literacy Scale (eHEALS). Statistical analyses included descriptive statistics, Spearman’s correlation, Kruskal–Wallis, Mann–Whitney tests, and multiple linear regression using SPSS version 24, with significance set at p<0.05.Results: The mean eHealth literacy score was 26.08 ± 6.1 (out of 40), indicating a moderate level. Only 10.5% of nurses showed high literacy. eHealth literacy was significantly associated with age, education, work experience, marital status, and work shift (p<0.05). Higher literacy was found among younger nurses, those with higher education, and morning-shift workers, while lower scores were seen among older, married, and rotating-shift nurses.Implications for Practice: The moderate eHealth literacy level was significantly associated with younger age, higher education, morning shifts, and single status, emphasizing the importance of demographic and occupational determinants. Given the cross-sectional nature of the study, these associations do not imply causation. Targeted training for older and rotating-shift nurses, combined with strategies to bolster digital infrastructure, is recommended. https://ebcj.mums.ac.ir/article_27659.html Background: Given the conflicting results of three previous systematic reviews, drawing definitive conclusions about the effect of primrose oil on cervical ripening remains challenging.Aim: This meta-analysis aimed to identify and evaluate studies that have examined the effects of oral and/or vaginal evening primrose oil on cervical ripening and birth outcomes.Method: A comprehensive search of English and Persian articles from May 1990-March 2023 was performed in the PubMed, Web of Science, Cochrane Library, Scopus, SID and Magiran databases to identify randomized, placebo, controlled trials (RCTs) of primrose oil.Results: In the review of 16 RCTs, the results revealed a significant difference in the duration of the second phase of labor in the oral EPO capsule (mean difference (MD) = -9.68, 95% confidence interval (CI): -17.23, -2.14, I2 = 0%). Three studies reported significantly higher Bishop scores for the vaginal capsule in the EPO group than in the placebo group (MD=1.81, 95% CI: 0.24; 3.38, I2=100%). Three studies reported significant improvements in 5-minute Apgar scores with the use of the EPO vaginal capsule (MD = 0.60; 95% CI: 0.49, 0.71). Cesarean section rates were significantly lower in the group given vaginal EPO (odds ratio (OR) = 0.62; 95% CI: 0.40–0.96; I2 = 0.1%).Implications for Practice: Oral EPO shortens the duration of the second phase of labor and reduces cesarean section rates but does not yield a noteworthy increase in the Bishop score. Vaginal EPO seems to affect cervical ripening, reduce cesarean section rates, and improve 5-minute Apgar scores.  https://ebcj.mums.ac.ir/article_27475.html Background: Medication errors (MEs) are a major worldwide concern associated with significant clinical consequences for patients.Aim: The purpose of this research was to determine the prevalence of MEs in hospitals in the Eastern Mediterranean Region (EMR) through a meta-analysis.Method: We conducted a systematic literature search up to January 2, 2024, using PubMed, Web of Science, Scopus, and Google Scholar to identify all observational studies conducted in EMR hospitals that reported the prevalence of medication errors. The total ME rate was calculated using a random-effects model, and heterogeneity was assessed using the I² statistic. The Comprehensive Meta-Analysis software (Version 2.2.064) was used for data analysis.Results: A total of 22 studies were included in this meta-analysis. The overall ME rate in EMR hospitals was estimated at 0.1%. The highest rate was observed in Iran in 2015 at 5.1% (95% CI: 4.0%–6.2%). Moreover, sample size and publication year were significantly correlated with ME rate (p<0.05).Implications for Practice: Based on the synthesis of the research findings, the prevalence of MEs in EMR hospitals is low. However, preventive and corrective actions remain necessary, given that MEs are not only costly but also harmful to patients.