Intensive Care Units In Iran Research Articles

Clinical and Laboratory Factors Associated with Mortality in ICU-Hospitalized COVID-19 Patients in a Western Center of Iran

Introduction: The purpose of this study was to investigate the demographic, clinical, and laboratory risk factors associated with mortality in Coronavirus disease 2019 (COVID-19) patients who were admitted to the intensive care unit (ICU) in Iran. Material & Methods: This retrospective study analyzed data from 867 COVID-19 patients admitted to the ICU of Shahid Beheshti Hospital in Hamadan (west of Iran) from September 2020 to March 2022. The association between demographic, clinical, and laboratory factors and mortality rates was assessed using univariable and multiple logistic regression analysis. Results: During the study period, 512 (59.1%) patients were deceased from Covid-19. According to the adjusted logistic regression, the odds of death in patients with an age higher than 60 years were 1.12 (95% CI: 1.01- 1.24; p=0.026). The OR estimate of death in patients with bradycardia and tachycardia was 2.32 (95% CI: 1.72- 3.12; p < 0.001) and 2.40 (95% CI: 1.67- 3.42; p < 0.001), respectively. Moreover, SPO2 lower than 88%, WBC over 11 ×1000μL, K over 5.2 mEq/L, and LDH above 942 U/L were significantly associated with increased odds of death (p < 0.05). Conclusion: The study identified several demographic, clinical, and laboratory risk factors associated with mortality in COVID-19 patients admitted to the ICU in Iran. These findings can help healthcare providers identify patients at higher risk of poor outcomes and tailor interventions accordingly.

Clinical Pharmacy Services in a Neurosurgical Intensive Care Unit in Iran: A Focus on a Comprehensive Medication Management Model

Background: Critically ill patients treated in the intensive care unit (ICU) are at risk of drug-related problems (DRPs), clinical pharmacists are specifically trained in pharmacotherapy evaluations with the abilities to identify and manage drug-related complications. This study aims to identify areas where clinical pharmacists can be effective in the ICU. The primary outcomes of this study were determining the clinical aspect of clinical pharmacists in the ICU, type, and number of clinical pharmacist interventions. Methods: This was a prospective, interventional study in a teaching hospital in Iran. A clinical pharmacist was dedicated to implement comprehensive medication management (CMM); All Pharmacotherapy Problems were categorized. Results: During the monitoring of 162 patients by the clinical pharmacist, 1524 interventions were conducted. The most frequent pharmacotherapy-related problems identified were drug selection (33.3%), dose adjustment (17.3%), and fluid and electrolyte management (12.9%). Conclusion: Clinical pharmacists’ interventions could reduce the rate of DRPs by pharmacotherapy evaluation and may have important role in many aspects of patient’s management.

Comparison of the effect of licorice and chlorhexidine mouthwash on the oral health of intubated patients in the intensive care unit

BackgroundChlorhexidine mouthwash is a common oral hygiene product used in intensive care units, but it may have some adverse effects. Licorice, a natural herb, could be a potential alternative to chlorhexidine. However, the effect of licorice mouthwash on the oral health of intubated patients has not been studied yet. Therefore, this study aimed to compare the effects of licorice and chlorhexidine mouthwash on the oral health of intubated patients.MethodsThis was a triple-blind clinical trial. The sample included 130 intubated patients admitted to an intensive care unit in Iran. The samples were selected by convenience sampling and randomly assigned to two groups: A and B. In group A, the main researcher applied 15 ml of 0.2% chlorhexidine mouthwash after each brushing (twice a day for 5.5 days) and suctioned it after 30 s. In group B, 20% licorice mouthwash was used instead of chlorhexidine. The demographic information questionnaire and the Beck Oral Assessment Scale (BOAS) were completed by one of the nurses before and on the sixth day of the study.ResultsFinally, 60 patients in each group completed the study. There was no significant difference between the groups in terms of demographic variables or oral health before the intervention (P > 0.05). The oral health of patients in both the chlorhexidine and liquorice mouthwash groups improved significantly after the intervention (P < 0.05). However, there was no significant difference in oral health between the two groups at postintervention (P = 0.06).ConclusionThe results demonstrated that both mouthwashes exerted a comparable effect on dental and oral health. However, the chlorhexidine mouthwash showed a greater impact on the reduction of dental plaque and the thinning of saliva compared to licorice mouthwash. In essential cases, licorice mouthwash can be employed as an alternative to chlorhexidine.

Investigating Causes of Medical Errors in Intensive Care Units in Iran: A Cross-sectional Study.

Medical errors cause disability and mortality in intensive care units (ICUs). We aimed to determine the occurrence and causes of medical errors in the ICUs of Iran. In this cross-sectional study, data from the family complaint files referred to The disciplinary authority of Iran Medical Council was retrospectively reviewed to explore the causes of medical errors. Statistical analysis was performed in SPSS Version 26.0. A total of 293 complaint files were referred to the disciplinary commission from 2014 to 2019, of which 95 files were related to medical errors in ICUs. The median age of patients was 62 years (46-74 years) and 52 (54.7%) patients were men. Also, 37 (38.9%) patients had decreased levels of consciousness and 42 (42.2%) patients had cardiovascular disease. A total of 40 (42.1%) patients experienced a single medical error and 55 (57.9%) patients experienced more than 1. Causes of medical errors in patients were physician's or nurse's negligence in 53 (55.8%) patients, weak interaction of physician and nurse with the patient and family members in 11 (11.6%) patients, weak interprofessional interaction among physicians in 7 (7.4%) patients, equipment and structure of ICUs in 7 (7.4 patients, nature of ICUs and patients in 6 (6.3%) patients, weak physician-nurse interprofessional interaction in 5 (5.2%) patients) patients, low attention of the physician and the nurse to medication safety in 6 (6.3%) patients. Patient safety is impacted by a variety of medical mistakes. Interprofessional strategies can be developed and put into action to mitigate medical errors in ICUs.

Evaluation of parental stress in neonatal intensive care unit in Iran: a national study

BackgroundMore attention is paid to the survival and treatment of the sick infant in the neonatal intensive care unit (NICU) and parental stress is not considered. The purpose of this study was to determine samples of the level of parental stress in the NICU.MethodThis study is a descriptive-analytical study in which Parental Stress and General Health were used in an analytical national survey in Iran. The research sample consists of 2456 parents of infants admitted to NICU. The sampling method was multi-stage random. We used 11- item parental stress questionnaire and 28-item general health questionnaire for the data collection.ResultBaloch ethnicity with an average of 11.52 had the highest level of stress. The mean stress score of mothers was higher than fathers. The mean score of all dimensions of physical symptoms, anxiety, social functioning, depression, and total mental health score in mothers was higher than fathers. There was a statistically significant difference in the length of hospitalization in terms of different levels of parental stress scores (p < 0.002). Lack of decisive response to parents was one of the most stressful issues (8.1%).ConclusionOur result shows mothers' stress was higher than fathers. So that health policymakers should pay attention to stress risk factors to provide appropriate interventions according stress risk factors Future studies should design appropriate interventions to reduce parental stress, especially in high-risk mothers.

Clinical Characteristics and Complications of Mechanically Ventilated Children in a Pediatric Intensive Care Unit in Iran: Comparing Different Modes

Background: Mechanical ventilation (MV) is among the most common therapeutic modalities in pediatric intensive care units (PICU), which works based on a defined ventilation mode. Nowadays, conventional and alternative modes including adaptive pressure control (APC) and non-APC modes are frequently employed. Although MV can be helpful in many cases, it may cause some complications resulting in significant morbidity and mortality. Objectives: This study aimed to investigate the demographic features and complications of mechanically ventilated children in a PICU in Iran, as well as to compare different ventilation modes. Methods: A retrospective case-control study was conducted in PICUs of children’s medical center hospital - a tertiary referral pediatric hospital. Results: Of 66 patients included in this study, 33 patients were treated with APC modes, whereas 33 patients were treated with non-APC modes. The most common indications for intubation were respiratory failure (53%) and loss of consciousness (13.6%). The mean duration for intubation in patients with and without underlying disorder were 11.7 and 5.2 days, respectively (P-value &lt; 0.01). The means of time for intubation in the APC and non-APC groups were 10 and 11.9 days, respectively (P-value = 0.145). A total of 23 (34.8%) patients had complications, including death, misplacement of the endotracheal tube, atelectasis, unplanned extubation, etc. There was no significant difference between groups regarding the rates of complications, except for atelectasis. Thirteen (19.7%) patients had atelectasis (2 patients in APC group (6%) and 11 patients in non-APC group (33.3%)) (P-value = 0.022). The mortality rate was the same for the both groups (P-value = 1). Conclusions: In sum, the most common indication for intubation was respiratory failure. No significant difference was observed among patients treated with the APC, and non-APC modes in terms of the complications occurred, except for atelectasis which occurred more frequently in the non-APC group. Therefore, it was concluded that there was no difference between conventional and alternative modes of mechanical ventilation in terms of morbidity and mortality.

Improving Families’ Perceptions of Nursing Care of Patients in Intensive Care Units in Iran: A Non-randomised Controlled Trial

Aim: The aim of this study was to evaluate families’ perceptions regarding nursing care provided to patients in intensive care units (ICUs) at a district hospital in Iran. Methods: A non-randomised controlled trial was done in the ICU of a hospital located in Sari, Iran, in 2019. The eligible families of patients were assigned into two groups (N=80) through convenience sampling. The families in the experimental group were allowed to present in the ICU in a planned way. In the control group, the families just followed the restricted hospital visiting policy. The families’ perceptions of nurses’ caring behaviours in both groups were measured using the Caring Behaviour Inventory. Independent and paired t-tests were used for comparing families’ perceptions between and within the groups, respectively. Data were analysed by SPSS. Results: A significant positive increase was found in the families’ perceptions in the experimental group after intervention (84.90 7.87), P&lt;0.0001). The mean difference between the two groups was statistically significant, with a higher positive perception in the experimental group (33.78 (1.04), P&lt;0.0001). Conclusion: Planned presence in the ICU has an effective role in improving families’ positive perceptions of nurses’ caring behaviours. Therefore, reconsidering a restricted visiting policy is recommended.

Provision of spiritual care in the neonatal intensive care unit in Iran in healthcare providers’ perspective: a qualitative study

Provision of spiritual care in the neonatal intensive care unit in Iran in healthcare providers’ perspective: a qualitative study

Health Care Providers' Experiences of the Non-Pharmacological Pain and Anxiety Management and Its Barriers in the Pediatric Intensive Care Units

ObjectivesChildren in the intensive care unit experience a high level of pain and anxiety. This study aimed to reveal the health care providers experience of non-pharmacological pain and anxiety management and its barriers in the pediatric intensive care unit. MethodsThis qualitative-descriptive study was conducted with thirteen nurses and five physicians in the pediatric intensive care unit in Iran. Individual, in-depth and semi-structured interviews were conducted, which were analyzed by conventional content analysis. ResultsFive main categories were identified from data analysis: 1) The importance of parents' presence, 2) Disturbance in the presence of parents and communication during the COVID-19 pandemic, 3) Choosing non-pharmacological approaches according to the child's interests and conditions, 4) Building trust in the child through non-pharmacological interventions 5) Barriers to non-pharmacological pain and anxiety management in the pediatric intensive care unit. ConclusionHealth care providers implement some non-pharmacological methods to manage pain and anxiety in the pediatric intensive care unit. Facilitating the open presence of parents, using innovative methods to communicate with children, and training and psychological support for nurses and parents, especially during the COVID-19 pandemic are recommended.

Development of an educational module for mothers of premature infants admitted to the neonatal intensive care unit in Iran: a narrative review

Introduction: Mothers of preterm infants, as the primary caregiver, need to learn more about their infants and the complex environment of neonatal intensive care. This study aimed to develop and evaluate the educational module for the mothers of premature infants admitted to the neonatal intensive care unit (NICU) in Iran.Method: The online databases (SID, Magiran, Google Scholar, ScienceDirect, PubMed, Elsevier, and Scopus) were accessed from 2009 to 2019, using the keywords ‘mother’, ‘neonatal intensive care’, ‘program’, ‘intervention education,’ and ‘empowerment’. In general, 275 articles were retrieved and a total of 12 studies was retained for appraisal, after screening the titles, abstracts, and full-text reviews. Finally, the qualitative module validity and face validity were determined, using the opinions of 11 experts and 10 mothers of premature infants, respectively.Results: Eight themes were identified based on thematic analysis, including orientation with the NICU, characteristics of premature infants, premature infants’ problems, needs of premature infants, preparation of premature infant’s environment, behavioral symptoms of premature infants, the positioning of premature infants, and preparation for discharge and measures were developed after the discharge of the premature infant. Considering all acquired interventions for all items, a content validity ratio of 0.59 and content validity index of 0.79 based on the opinions of experts at two levels of specialists and mothers.Conclusion: Due to the lack of enough nursing staff and a high workload in the NICU, this review offers nurses to spend less time educating mothers and focusing more on premature infants. Moreover, supporting mothers can help to provide better care. The educational module can help nurses and mothers have more effective care for premature infants.

Validation of Pediatric Index of Mortality 3 in a Single Referral Pediatric Intensive Care Unit in Iran

Objectives: The research aimed to evaluate the Pediatric Index of Mortality 3 (PIM-3) for determining the risk of mortality among pediatric intensive care unit patients. Methods: A retrospective analysis was conducted on case records, as well as patient data from all admissions to the PICU of Mofid Children’s Hospital, Tehran, from October 2017 to February 2018. Employing an android calculator application, the PIM-3 score was estimated early within the first PICU admission. Then, the PIM-3 score and mortality rate were analyzed using the Mann-Whitney U test. In addition, calibration and discrimination were assessed by the Hosmer-Lemeshow goodness-of-fit test and a receiver operating characteristic curve method, respectively. Finally, the Standardized Mortality Ratio (SMR) was calculated. Results: In this study, 365 young infants, ranging from 10 to 29-months-old, were included. The overall mortality rate was 10.4%. Further, the patients’ PIM-3 scores ranged from 0.06% to 2.37% (95% confidence interval), with a mean of 1.45% (4.16% in non-survivors and 1.14% in survivors). The SMR was estimated at 7.18, demonstrating the underprediction of the death rate. The AUC of 0.714 (95% CI: 0.626 to 0.801) demonstrated a fair to good discrimination power of PIM-3 as an international standard risk-adjusted mortality indicator. Moreover, this score underpredicted the risk of mortality in young infants admitted to our ICU in 2017. Generally, the prediction was weak among low-risk patients. Therefore, the Pediatric Index of Mortality-3 score has the potential to be implemented in our PICU by modifying the expected probability of death by multiplying the original PIM-3 score by 7.12.

Standardization of Full Outline of Unresponsiveness Scale to Assess the Level of Consciousness of the Patients Hospitalized in the Intensive Care Unit in Iran

Standardization of Full Outline of Unresponsiveness Scale to Assess the Level of Consciousness of the Patients Hospitalized in the Intensive Care Unit in Iran

Causes of mortality in a neonatal intensive care unit in Iran: one year data

BACKGROUND Neonatal mortality rate is a major health index. Approximately, 65% of all deaths in the first year of life occur during this 4-week period. The present study was conducted to investigate the mortality rates and causes of death in a neonatal intensive care unit (NICU) in Ahvaz, Iran in a year. &#x0D; METHODS This cross-sectional study was conducted in the NICU of Sina Hospital in Ahvaz. Medical records were studied, and data from 1,040 newborns admitted to the NICU within one year (March 2016 to March 2017) were collected following a checklist. Of these newborns, 123 died, and their relevant data were collected. Data were analyzed using SPSS, version 20 (SPSS Inc., USA). &#x0D; RESULTS The mortality rate was 11.82% (123 cases) out of 1,040 newborns admitted to NICU. Most of the newborns (48.8%) died on days 1–7. The causes of death were respiratory distress syndrome (RDS) (34.1%), asphyxia (25.2%), anomalies (10.6%), sepsis (7.3%), intracerebral hemorrhage (8.1%), pulmonary hemorrhage (7.3%), and other causes (6.4%), such as hydrops, severe pneumothorax, severe renal failure, and others. &#x0D; CONCLUSIONS The mortality rate in the NICU of this center was similar to that in other Iranian provinces. The most common causes of NICU mortality included prematurity and its complications, such as asphyxia and RDS. Thus, a strategic plan for reducing preterm delivery and asphyxia are necessary.

How is family involved in clinical care and decision-making in intensive care units? A qualitative study

Background: Involving family members in patient care is considered as a significant dimension of family-centered care in intensive care units (ICUs). Aims: To describe family members’ perceptions and experiences regarding involvement in clinical care delivery and decision-making in ICUs in Iran. Design: A qualitative research method using conventional content analysis. Methods: A total number of 24 participants were selected through purposive sampling method between 2018 and 2019. Each interview also lasted between 30 and 60 min and the inductive data analysis was used. Results: The findings revealed that non-agreed involvement in clinical care delivery and family involvement in decision-making is being implemented on a continuum of paternalistic views. Conclusion: Healthcare providers, particularly nurses, and policy makers can thus exploit these findings to strengthen family involvement in this regard and consequently improve quality of care. Impact statement: A non-agreed approach and paternalistic views along with some barriers can affect family members’ involvement in providing clinical care and making decisions in ICUs in Iran.

Implementation of a flexible visiting policy in intensive care unit: A randomized clinical trial.

Visitation is one of the most critical needs of patients in intensive care units (ICUs). Clinicians should enable a more flexible visitation policy to prevent the adverse effects of a restricted approach. This study aimed at investigating the relationship between increasing visitation time and patients' physiological parameters in intensive units. Additionally, nurses' beliefs and attitudes towards visiting is examined in this research. Parallel randomized clinical trial. This study was conducted in four general medical ICUs in Iran. In total, 60 patients and 57 nurses participated in this study. The patients' physiological parameters were measured at particular times in both groups. Moreover, the nurses responded to the questionnaire on beliefs and attitudes towards visitation in intensive units before and after the intervention. Among all the physiological parameters, systolic and diastolic blood pressure and heart rate had a significant decrease within the normal range 10 and 30 minutes after visiting in the intervention group (P < .05), and nurses' beliefs and attitudes score were at the middle of the survey scoring range (0-120). However, no significant difference was found between nurses' belief and attitude score and intervention in any groups (P > .05). The findings indicate that increasing visitation times can lead to a positive effect on the stability and balance of patients' physiological parameters. A more flexible visiting policy can provide a therapeutic environment where not only patients' physiological disorders are minimised as much as possible but also a higher level of patients' health and satisfaction are reached.

The challenges of using physical restraint in intensive care units in Iran: A qualitative study.

Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. This qualitative study was conducted in 2018-2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.

Cross-cultural Adaptation and Validation of Professional Scale in Iranian Nurses

Introduction: Professionalism is a fundamental concept in nursing. Today’s society needs nurses who are able to accept and fulfill their professional roles. Specially, nurses of the Intensive Care Unit (ICU) are one of the most sensitive parts of the hospital and their behaviour is very important. In order to measure their caring professionalism and the leveling of this process, there are instruments used in Iranian culture. Aim: This study was aimed to cross-culturally adapt and validate the Hall’s Professionalism Scale (HPS) in clinical setting for Iranian nurses of ICU. Materials and Methods: Methodological study was carried out with 300 nurses of ICU in Iran. The criteria for selection of the participants was limited to the nurses who worked full time in ICU of the mentioned hospitals, were available and interested to respond to data collection instrument. The cross-cultural adaptation of the Professionalism Scale was performed according to international standards, and its validation was carried out to be used in the Iran context by means of factor analysis and Cronbach’s alpha as a measure of internal consistency. Results: All nurses who participated in the study worked in ICU with average working experience of 6.77±5.99 years and their mean age was 34.03±10.3 years. The results of the factor analysis revealed six factors including factor 1 (the scope of the Professional Association as reference) with a specific amount of 14.04, factor 2 (believing in the continuing competency) with a specific amount of 14.42, factor 3 (believing in self-regulation) 16.06, factor 4 (sense of commitment to the profession) has a special amount of 11.56, factor 5 (independence) with a special amount of 16.81, and factor 6 (believing in serving society) with a specific amount of 14.02. The correlation coefficient of Cronbach’s alpha was used to determine the internal correlation of the instrument, which was 0.89 for all items. Conclusion: This study showed that the translated version of the “Nursing Professionalism Scale” is a useful instrument for helping nurses and nursing authorities to understand the concept of professionalism and its impact on improving the clinical status of nurses, patients and organisations, and even clinical education of nursing students.

Factors associated with length of stay in a neonatal intensive care unit in Iran

Background: The length of stay (LOS) is a useful indicator of health and prediction of the LOS in the neonatal intensive care unit (NICU) has drawn increasing attention over the past years. Objectives: To determine factors associated with infant’s LOS in the NICU in Bandar Abbas city, Southern Iran, between 2016 and 2017. Method: This cohort study reviewed 603 medical records of all NICU admitted newborns. Data were collected using data collection forms. The Cox multiple hazards regression model determined the factors associated with the infant’s LOS. Data was analysed using SPSS, version 21. The significance level was set at 0.05. Results: The median LOS in NICU was 9 days. The results of multiple Cox proportional hazards regression model showed that type of feeding, umbilical and central venous catheterization, mechanical ventilation, nosocomial infection, acute renal failure, blood transfusion, and antibiotic therapy were significantly associated with LOS in the NICU (p Conclusions: The type of feeding, umbilical and central venous catheterization, mechanical ventilation, nosocomial infection, acute renal failure, blood transfusion, and antibiotic therapy were significantly associated with LOS in the NICU. Sri Lanka Journal of Child Health, 2019; 48(3): 226-232

Mortality in Neonatal Intensive Care Units in Iran: A Systematic Review and Meta-Analysis

Background: Neonatal mortality rate is an important health index. The present study was conducted to determine the mortality rate and its causes in neonatal intensive care units (NICUS) in Iran. Methods: Online search was done without time limit until June 2018 in several databases, such as PubMed, Web of Science (ISI), Scopus, Magiran, Barakat Knowledge Network System, SID, Iranian National Library, Regional Information Center for Science and Technology (RICST), Google Scholar search engine, and Iranian journals. The articles were qualitatively assessed after evaluating the inclusion and exclusion criteria. The Cochran's Q test and I2 index were used to determine the heterogeneity between studies. Meta-analysis was done based on a random effects model using Comprehensive Meta-Analysis Software (version 2). Results: Thirty-one eligible studies were analyzed. The mortality rate in 24,995 neonates admitted to NICUs in Iran was estimated to be 11.40% (95% CI: 9.10-14.20). The lowest mortality rate reported as 7.70% (95% CI: 6.01-9.82) was related to the Center of Iran, and the highest mortality rate was reported as 19.26% (95% CI: 15.82-23.24) in the west of Iran. In this regard, the difference was statistically significant (P<0.001). The most common causes of mortality in NICUs in Iran were prematurity (44.14% [95% CI: 31.95-57.08]), respiratory distress syndrome (RDS) (31.93% [95% CI: 22.83-42.66]), congenital malformation (16.09% [95% CI: 12.85-19.95]), septicemia (12.66% [95% CI: 8.87-17.75]), and asphyxia (7.58% [95% CI: 4.63-12.19]). Conclusion: The most common causes of mortality in Iranian neonates were prematurity, RDS, and congenital anomalies. We also found the mortality rate to be acceptable (11.4%). To reduce the mortality rate, we recommend performing prenatal screening tests and genetic counseling. In addition, maternal care during pregnancy should be improved to reduce premature delivery.

The association between health literacy, social support and self-efficacy in mothers of preterm neonates

Background Health literacy, social support and self-efficacy are important concepts in mothers of preterm neonates. The purpose of study was to determine the association between health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit. Methods This descriptive correlational study was conducted from November 2017 to January 2019 on 200 mothers of preterm neonates admitted to the neonatal intensive care unit of selected hospitals affiliated with Iran University of Medical Sciences, Tehran, Iran. Data were collected using demographic, maternal health literacy, maternal self-efficacy and multidimensional scale of perceived social support questionnaires. Data were analyzed by descriptive statistics (mean and standard deviation) and inferential tests (Pearson correlation coefficient) using SPSS-PC (v.23) and R software. Results The data showed 23.5% of mothers had high likelihood of low health literacy, 45.5% had possibility of low health literacy and 31% had adequate with mean score 2.57 ± 1.28. Also, 9.5% of participants had low perceived social support, 62.5% moderate perceived social support and 28% high perceived social support. Maternal self-efficacy score was 52.54 ± 8.06. Pearson’s correlation coefficient analyses revealed a statistically significant positive correlation between maternal health literacy and social support (r = 0.304, p < .001). Also maternal health literacy was positively correlated with the self-efficacy (r = 0.292, p < .001) and self-efficacy was positively correlated with social support (r = 0.440, p < .001). Conclusion Health literacy, social support and self-efficacy of mothers of preterm neonates admitted to the neonatal intensive care unit in Iran are related together. Therefore, neonatal care nurses need to note this in care of this clients and adopt strategies to enhance them.