2026-08-08T13:43:52+03:30 http://jccs.yums.ac.ir/browse.php?mag_id=28&slc_lang=en&sid=1

28-441 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 B. Hamidi H.A. Ghanadzadegan B. Mirzaian Aims: Anxiety disorders profoundly impair children’s mental health and social functioning, manifesting in symptoms, such as inattention, cognitive deficits, and behavioral avoidance. Early intervention is crucial to mitigate these effects. This study comparatively evaluated the efficacy of solution-focused child skills training and acceptance and commitment-based play therapy in enhancing social competence among anxious children. Materials & Methods: This quasi-experimental clinical trial was conducted with a pre-test, post-test, and three-month follow-up design, incorporating a control group. The sample consisted of anxious children aged 9-12 years from schools in Tehran’s District 5 during the 2024-2025 academic year. Sixty female students, diagnosed by specialists and meeting inclusion/exclusion criteria, were selected and randomly allocated to three equal groups (n=20 each), including solution-focused child skills training, acceptance and commitment-based play therapy, and control. Interventions involved eight 60-minute weekly sessions tailored to each experimental group. Social competence was assessed via the parent-rated Social Competence Scale. Data were analyzed using repeated-measures ANOVA in SPSS 26. Findings: There were significant intergroup differences in social competence (p<0.001). Solution-focused child skills training yielded markedly greater improvements than acceptance and commitment-based play therapy, demonstrating superior efficacy. No significant differences emerged between post-test and follow-up scores across groups, indicating sustained intervention effects. Conclusion: Solution-focused child skills training outperforms acceptance and commitment-based play therapy in bolstering social competence in anxious children.   Anxiety Acceptance and Commitment Therapy Play Therapy Social Skills Child 2025 10 01 177 183 http://jccs.yums.ac.ir/article-1-441-en.pdf 10.58209/jccs.6.4.177

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 L. Zarshenas Z. Mehri M. Rakhshan Z. Khademian M. Mehrabi Z. Jamshidi Aims: This study aimed to conduct a systematic review of professional competence standards for nurses based on literature and nursing organization guidelines. Information & Methods: This systematic review assessed nursing professional competence standards in 2023, based on articles from national and international nursing organizations, and utilized the preferred reporting items for systematic reviews and meta-analyses guidelines. The databases reviewed included PubMed, MEDLINE, Embase, Scopus, Cochrane, ProQuest, Web of Science, Google Scholar, SID, IranMedex, IranDoc, and Magiran. Search strategies were performed using keywords, such as “Nurse,” “Professional Competence,” and “Competence Standard,” based on Medical Subject Headings, employing the syntax and operators “AND” and “OR.” Inclusion and exclusion criteria were applied in the selection of studies. The handling of the results was carried out using Mendeley software, and screening and quality control were conducted based on appropriate checklists. Finally, data extraction and synthesis of results were performed, and the standards were presented. Findings: A total of 2,078 documents from scientific articles and national Iranian and international nursing organizations were reviewed, resulting in a final total of 50 included documents. There were 428 standards as standards of professional competence for nurses. The synthesis of these standards led to the identification of five domains of professional competence standards for nurses. Conclusion: Clinical competence, educational and research competence, ethical competence, communication and interpersonal competence, and management and leadership competence are five domains of competence based on articles and guidelines from nursing organizations. Nurses Professional Competence Systematic Review 2025 10 01 185 202 http://jccs.yums.ac.ir/article-1-442-en.pdf 10.58209/jccs.6.4.185

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 F. Sabeti Sh. Tofigh Aims: Assessing parental satisfaction is essential as a key indicator for evaluating the quality of care in the pediatric intensive care unit. This study aimed to determine parental satisfaction based on the components of environment, care, and communication in the pediatric intensive care unit. Materials & Methods: This cross-sectional study included 120 parents of children admitted to the PICUs of teaching hospitals affiliated with Iran University of Medical Sciences. Participants were selected via proportional sampling based on inclusion criteria. Data were collected using a demographic/clinical information questionnaire and the Parent Satisfaction Survey. Findings: The mean parental satisfaction score was 85.28±7.49 (range: 24-120), which was above the median and considered satisfactory. The mean scores for each domain were also satisfactory; environment (14.74±2.08; range: 4–20), care (38.66±4.42; range: 10-50), and communication (32.23±4.03; range: 10-50). No statistically significant association was found between parental satisfaction and demographic or clinical parameters (p>0.05).  Conclusion: Professional care, effective physician-parent communication, accurate information provision about the child’s condition and treatment, and a clean environment are key factors in parental satisfaction. Parents Health Personnel Intensive Care Units Pediatric Personal Satisfaction 2025 10 01 203 209 http://jccs.yums.ac.ir/article-1-443-en.pdf 10.58209/jccs.6.4.203

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 S.J. Sadat F. Shirazi M. Zoladl M.R. Koohpeyma Aims: Sleeve gastrectomy is a widely performed bariatric procedure with long-term benefits; however, it is often accompanied by postoperative complications such as pain, nausea, and vomiting. Early mobilization has been shown to improve recovery and reduce complications in other surgeries; yet, evidence regarding the optimal timing and approach to ambulation after sleeve gastrectomy remains limited. This study aimed to compare the effects of early and gradual ambulation on postoperative complications after sleeve gastrectomy. Instrument & Methods: In this randomized clinical trial, 132 patients undergoing sleeve gastrectomy were allocated to three groups: early ambulation, gradual ambulation, and control. Early ambulation patients began mobilization 4 hours after entering the ward following a structured protocol, gradual ambulation patients started 7 hours post-surgery according to a gradual protocol, and the control group ambulated based on personal willingness. Postoperative pain intensity was measured using a 10-cm Visual Analog Scale, and vomiting frequency was recorded at admission, immediately after mobilization, and at 6, 12, and 24 hours. Findings: Early ambulation significantly reduced pain intensity (p<0.001) and vomiting frequency (p<0.01) compared to both the gradual ambulation and control groups. Gradual ambulation also decreased pain compared to the control group (p=0.036) but had no significant effect on vomiting. Conclusion: Early ambulation is more effective than gradual or conventional ambulation in reducing postoperative complications, particularly pain and vomiting, after sleeve gastrectomy. Ambulation Postoperative Complications Gastrectomy Pain Vomiting 2025 10 01 211 218 http://jccs.yums.ac.ir/article-1-445-en.pdf 10.58209/jccs.6.4.211

28-428 2026-08-08 10.1002

Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 F. Rad A. Hadinia S. Masoudifar Aims: Despite numerous studies on the prevalence of alloimmunization, its exact rate remains uncertain in many populations. In light of the Iranian Blood Transfusion Organization’s recent national program to reduce alloantibody formation, this study investigated the prevalence of alloimmunization among thalassemia patients in Kohgiluyeh and Boyer-Ahmad Province, Iran, and explored associated factors, such as donor-recipient antigen homogeneity and early transfusion initiation. Instrument & Methods: This cross-sectional study was conducted on 134 beta-thalassemia major patients registered at Shahid Beheshti Hospital, Yasuj, Iran. Antibody screening was performed using both the standard tube method and the gel method in the immunohematology laboratory of Yasuj University of Medical Sciences. Findings: Out of 134 cases, 73 (54.48%) were female and 61 (45.52%) were male, with a mean age of 19.51±8.50 years. A high donor-recipient antigen homogeneity is suggested by the fact that 132 (98.5%) patients were native to Yasuj. All patients received ABO and Rh (D)-matched, leukodepleted blood transfusions at intervals ranging from 14 to 60 days (mean: 22.7±6.3 days); 65.7% were splenectomized. Alloantibodies were detected in two patients (1.49% prevalence; one with anti-K and one with anti-C), both of whom had undergone splenectomy. No autoantibodies or positive direct antiglobulin test results were observed. Conclusion: There is a low prevalence of RBC alloimmunization among BTM patients in Kohgiluyeh and Boyer-Ahmad Province. Beta-Thalassemia Blood Transfusion Splenectomy 2025 10 01 219 223 http://jccs.yums.ac.ir/article-1-428-en.pdf 10.58209/jccs.6.4.219

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 S. Mohsenian I. Yazdanpanah N. Hashemimohammadabad Z. Sadat Z. Hashemimohammadabad Aims: This study aimed to investigate the effect of reducing frontal head temperature on visual attention accuracy and cognitive performance in patients with schizophrenia. Materials & Methods: This double-blind clinical trial was conducted on 42 hospitalized patients with schizophrenia at Shahid Rajaee Hospital in Yasuj, Iran. Participants were selected through convenience sampling and randomly assigned, using block randomization, to equal intervention and control groups. In the intervention group, prefrontal cortical temperature was lowered, whereas the control group received a sham intervention. The Rapid Visual Information Processing test was used to assess visual attention, and the Flicker Fusion test was applied to evaluate cognitive function. Measurements were obtained before and immediately after the intervention. Data were analyzed using SPSS 25 with independent t-tests and repeated-measures ANOVA at a significance level of p<0.05. Findings: The mean age of participants was 22.16±2.18 years. No significant demographic differences were found between the groups. After the intervention, the intervention group showed significant improvements in both visual attention and cognitive performance compared with the control group (p<0.001). Conclusion: Cooling the prefrontal cortex effectively modulates cerebral blood flow and neurophysiological activity, leading to improved attention and cognitive function in patients with schizophrenia. Attention Cerebrovascular Circulation Cognition Prefrontal Cortex Schizophrenia Visual Perception 2025 10 01 225 232 http://jccs.yums.ac.ir/article-1-454-en.pdf 10.58209/jccs.6.4.225

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 Z. Alizadeh F. Zadehbagheri S. Jokar Aims: Postoperative hypotension is a common and potentially life-threatening complication, typically accompanied by compensatory tachycardia. The occurrence of persistent hypotension with relative bradycardia is unusual and suggests distinct mechanisms, such as conduction abnormalities, medication effects, electrolyte disturbances, or hypothermia. Prompt recognition of the underlying cause is essential to avoid adverse outcomes. This study reported an unusual case of preventable hypothermic shock. Patients & Methods: This study described a 54-year-old woman who developed persistent hypotension (70/40mmHg) with relative bradycardia (55bpm) following a total abdominal hysterectomy under general anesthesia. Laboratory workup, electrocardiography, and echocardiography were unremarkable. Despite the administration of 2 liters of intravenous fluids, no improvement was observed. Her core temperature was 35.3°C. Upon reassessment, a wet surgical drape was found underneath her back, causing hypothermia. Removal of the drape and active rewarming restored hemodynamic stability (blood pressure 110/70mmHg, heart rate 75bpm, temperature 36.3°C), which was maintained throughout her hospitalization. Findings: Hypothermia can impair cardiovascular stability through bradycardia, reduced myocardial contractility, vasodilation, and diminished catecholamine responsiveness. In this case, inadvertent perioperative hypothermia due to a wet drape was the sole cause of refractory hypotension with relative bradycardia. This highlights the importance of considering environmental and physical factors in the differential diagnosis when standard investigations are inconclusive. Conclusion: Persistent hypotension with relative bradycardia in the postoperative setting should raise suspicion for hypothermia after excluding common causes. Hypotension Bradycardia Hypothermia Shock Perioperative Care 2025 10 01 233 236 http://jccs.yums.ac.ir/article-1-444-en.pdf 10.58209/jccs.6.4.233

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Journal of Clinical Care and Skills J Clinic Care Skill 2645-7687 2645-7687 10.58209/jccs 2025 6 4 Kh. Hatamipour H. Nabizadeh M. Sadafizadeh Aims: Among psychological factors, emotional intelligence and attachment styles can directly affect the quality of interactions and communication skills of nurses. The present study aimed to determine the relationship between emotional intelligence, attachment styles, and communication skills among nurses. Instrument & Methods: This descriptive-correlational study was conducted among nurses working in hospitals affiliated with Tehran University of Medical Sciences in 2024. Using convenience sampling, 291 nurses were selected as the research sample. The research tools included the Bradbury and Graves’ Emotional Intelligence Questionnaire, the Collins and Reed’s Attachment Style Questionnaire, and the Barton’s Communication Skills Questionnaire. Data were analyzed using correlation coefficients and regression analysis to examine the relationships between the study parameters. Findings: The relationships between attachment styles and nurses’ communication skills and their related parameters were significant at the 95% confidence level (p<0.05). A positive correlation (r=0.396) was observed between secure attachment and nurses’ communication skills. Additionally, attachment styles and emotional intelligence together predicted 36.5% of the variance in nurses’ communication skills. A negative correlation was found between avoidant and anxious attachment styles and communication skills, indicating an inverse relationship. All components of emotional intelligence, except for self-management, were significantly correlated with nurses’ communication skills (p<0.05). Conclusion: Emotional intelligence and secure attachment are prerequisites for effective interactions of nurses in clinical settings and seem to play a decisive role in shaping nurses’ communication behaviors, which are fundamental to mental and social health. Emotional Intelligence Self-management Communication Nurses 2025 10 01 237 242 http://jccs.yums.ac.ir/article-1-447-en.pdf 10.58209/jccs.6.4.237