فهرست مطالب امیررضا صالح مقدم

Chronic and prolonged illnesses and disorders, such as addiction, lead to a crisis in the lives of people with disabilities and can lead to a decrease in their quality of life. Therefore, in this study, we decided to compare the quality of life of individuals with substance use disorders who participate in Narcotics Anonymous, therapeutic Community session with Methadone-treated groups.

This cohort study was conducted on detoxified patients attending Narcotics anonymous, therapeutic community sessions and Methadone-treated place. Quality of life of subjects measured at baseline and 1.5 months after the start of treatment. Data were analyzed by SPSS19 software using ANOVA, paired t-test, Chi-square analysis.

The mean score of quality of life between three groups was not significantly different at the beginning of the study, but the mean score of quality of life among individuals with substance use disorders participating in the sessions of Narcotics anonymous and therapeutic community group increased significantly (P <0.001) 1.5 months after the start of treatment.

The results of this study indicate that the presence of detoxified persons in sessions of Narcotics anonymous and therapeutic community was effective in improving their quality of life. However, this effect is greater in Narcotics Anonymous. Therefore it was suggested that individuals with substance use disorders participate in these meetings.

 Privacy is one of the essential human needs and respecting the patient' territory is one of the important duties of nurses. Most patients are not aware of their rights and nurses’ awareness and performance regarding the patient's privacy is at a moderate level in different hospitals. On the other hand, providing training programs for nurses leads to the promotion of respect for patients' privacy and their satisfaction. Therefore, the present study was conducted with the aim of comparing the effects of in-person and virtual narrative ethics training on nurses’ respect for the patient’s privacy.

 This quasi-experimental three-group study was conducted on 93 nurses working at three internal wards of Imam Reza Hospital in Mashhad. The samples were selected using the random sampling method, through a lottery. Nurses of each ward were invited to participate in the study based on the inclusion criteria and using convenience sampling method. The instruments used in the study included a patient privacy questionnaire and a demographic information form. In the first intervention group, the nurses were divided into five groups and three one-hour in-person sessions were held for each group. In these sessions, standard narratives of the dimensions of privacy were presented. In the second intervention group, the nurses received training on privacy through a virtual messaging network. No training was provided to the control group. The patient privacy questionnaire was completed by all three groups both before the intervention and one month after it. The data were analyzed with SPSS2 using descriptive statistical tests, Wilcoxon and paired t-test.

Ethical Considerations:

 The present study was approved by the Ethics Committee of Mashhad University of Medical Sciences (IR.MUMS.REC.1398.079).

 Before the intervention, there was no significant difference in the mean and the standard deviation of respect for privacy among the three groups (P=0.952). After the intervention, the mean and the standard deviation of respect for privacy had increased in both in-person and virtual training groups compared to the control group (P<0.001). The study findings showed that there was no significant statistical difference between in-person and virtual training (P=0.256).

 The findings of the present study showed that in-person and virtual narrative ethics training have similar effects on the respect for the patient's privacy. Therefore, in situations where it is not possible to hold in-person sessions, the necessary training on patient privacy can be provided virtually.

Conflict is a phenomenon that has positive and negative effects on the performance of individuals and organizations. This study aimed to investigate the effect of implementing a conflict management program on job conflict and nurses' conflict resolution styles.

This experimental-interventional and before-after study was performed on 60 nurses in the Kamyab Hospital of Mashhad, Iran, in 2020. A conflict management workshop was held for the intervention group for 6 hours. Then, one week after the workshop, two intra-departmental sessions were held. In both intervention and control groups, Dubrin Job Conflict Questionnaires and Thomas-Kilman conflict mode instrument were completed at the beginning, fifteen days, and one month after the end of the inpatient sessions. Data were analyzed using SPSS software version 16.

Fifteen days and one month after the intervention, the mean score of job conflict in the intervention group significantly decreased compared to the control group and before the intervention (p = 0.003, p = 0.008, and p<0.001, respectively). Implementing a conflict management program increased the tendency to use a collaborative style compared to the control group (p = 0.02). Tendency to this style in the intervention group increased fifteen days and one month after the workshop compared to before the course (p <0.001).

Findings showed that the implementation of conflict management programs for nurses leads to a reduction in job conflicts among them. Further studies are suggested to explain the role of conflict management program implementation in the functioning of the health system.

Nursing practice is highly dependent on head nurses’ effectiveness. And one of their most important missions is to maintain the continuing clinical competence of nurses in line with real professional needs .Development of nursing competence will be accomplished during the time when a newly graduated nurse moves towards being a professional nurse. The aim of this study is to determine changes in the clinical competence of beginner nurses in terms of Leadership Competencies of theirs Head Nurses. The present study is done via cohort method; it was conducted in educational hospitals of Mashhad University of Medical Sciences from 2014 to 2015. 37 nurse managers, 72 beginner nurses were chosen by census method and who in addition to 283 non-beginner nurses participated in this study. In order to assess the superiority of the head nurse, the Ezeukwu leadership empowerment tool was used. The qualifications of the nurses were evaluated in three stages: the beginning of the study, two and four months after the start of the study via self-assessment and peer-assessment using the Mortojja qualitative study questionnaire. The change in beginner nurses, clinical competency were evaluated in terms of their head nurses, leadership competencies. Data were analyzed using SPSS16 by Chi-Square , Fisher exact, ANOVA, Kruscal Wallise, Repeated Measure, Pearson linear correlation and relative risk calculation. Average score of clinical competency of beginner nurses based on their head nurses, leadership competency in second and third evaluation stages have significant difference (P<0/05). The Relative Risk of second stages with CI=0/92-2/13, RR=1/40, P=0/141 was no significant but relative risk of third stages with CI=1/38-2/66, RR=1/92, P<0/001 was significant. There was significant positive relationship between leadership competency of nurses and clinical competency of beginner nurses based on their head nurses, leadership competencies.

Psychological disorders have created many problems for students as the most prestigious and chosen sectors of society and have greatly affected students’ academic performance and also disturb their mental, emotional and social developments. This study was conducted to determine the mental health of entrance students in Mashhad University of Medical Sciences from the national university entrance exam in the academic year 2014-2015.
This descriptive-analytical study was performed on 973 first year students (340 males and 633 females) from Mashhad University of Medical Sciences. Data were collected by General Health Questionnaire (GHQ-28) and analyzed with descriptive and inferential statistics using SPSS software version 22.
The prevalence of mental disorders among students was 12.2%. This ratio was 11.8% in men and 12.5% in women. There was a significant correlation between student's mental health and gender as well as the place of study variable (P Attention to the mental health of students is important because of the prevalence of mental disorders among students in this study and that mental disorder reduces one's ability to perform activities and educational affairs and given the important point that many of these disorders can be evaluated and predictable

The global prevalence of diabetes exceeded the estimated value of 30 million in 1985 and rose to 177 million in 2000. It is estimated that the total number of diabetic patients will increase to 439 million in 2030.
The therapeutic regimen is valuable in managing the type II diabetes patients. It seems that e-learning is essential for all the patients to guarantee the access to the instructions. Nowadays, multimedia instructions by using compact disks are deemed as a modern way of learning to convey the concepts in a broad sense.
Material and This quasi-experimental study was conducted on 85 patients with type II diabetes referred to Shahid Qodsi health center in Mashhad, Iran. The samples were selected using convenience sampling method and they were placed in two groups, namely, the intervention and control groups who were educated by electronic and routine learning, respectively. The intervention period was considered to be two month. Data obtained by completing the questionnaire pre- and post-intervention and taking blood samples to measure the glycated hemoglobin. Data analysis was performed using SPSS version 17, paired and independent t-tests, and repeated measures ANOVA.
According to the results, the intervention group revealed a significant increment in average value of regimen compliance in comparison to the control group (P Regarding the results, e-learning has a great effect on adherence to the therapeutic regimen and reduction in costs and traffic. This procedure could be used with the least facilities and is affordable. Therefore, it is recommended to train the nurses and encourage them to use this method to educate the diabetic patients.

pre-operative anxiety is one of the prominent psychological problems among people who are going to have open-heart surgeries. If it is not controlled properly, this problem can cause negative effects on the operation results and the physical status of the patients. Various training tools and methodologies have been proposed till now, but there is no single agreement among researches about the best one. The present research wants to determine the effect of educational videos on pre-operation anxiety among patients undergoing open-heart surgery without pump.
This study was single bind and random clinical trial which conducted by the participation of 60 patient’s candidate for open-heart surgery in the cardiovascular ward of Imam Reza Hospital of Mashhad in 2015. The patients were divided into control and intervention groups randomly and assigned to two groups of 30. 15-minute of educational movie in 2 sessions was shown for patients in the intervention group, but pamphlets and face to face education was applied to those in the control group one day prior to the operation. The anxiety levels in both groups were measured before and after the intervention using Spiel Berger state-trait anxiety inventory. SPSS version 11.5, independent t tests, Mann-Whitney test, paired t test, Wilcoxon test, chi-square test and exact chi-square test were used to analyze the data.
the average age of the patients was years and the highest school degeree among 53.3% of them was elementary school. In pre-intervention phase, no statistically significant difference was observed between the average score of the concealed and obvious anxiety in both control and intervention group members (p>0.05). After the invention, the average obvious anxiety score of those patients in the control group ( ) was significantly less than what was observed in the control group ( ) (p As a result, the educational movie was more effective than pamphlets and face to face training in reducing the pre-operation anxiety of the patients. Therefore, it is recommended that the educational movies were used based on factors such as: the educational status of the patient, the conditions, and the equipments of the ward.

Patients with type two diabetes mostly struggle with increased fasting blood sugar (FBS) and glycosylated hemoglobin HbA1c, mainly associated with irrecoverable complications. Self-care education and considering different types of learning among patients are regarded as some of the most important issues in this regard. Therefore, this study aimed to evaluate the effect of self-care education based on VARK learning style on HbA1c and FBS in patients with type two diabetes.
This clinical trial was conducted on patients with type two diabetes, referring to Parsian Clinic in Mashhad, Iran in 2015. In total, 72 samples were selected through randomized convenience sampling and divided into two control and intervention groups of 36 cases. Subjects of the intervention group were also divided into subgroups of visual, aural, read/write, and kinesthetic based on the results of VARK inventory. Self-care education was carried for the intervention group in two 60-minute session once every two weeks, tailored to learning styles of patients. Meanwhile, traditional lecture method was used for the control group. HbA1c and FBS were evaluated in all the participants before and a month and a half after the intervention to assess the self-care of patients. Data analysis was performed in SPSS version 21 using Mann-Whitney U, Chi-square, independent t-test and Wilcoxon.
In this study, mean score of HbA1c was decreased from 7.7±0.8 to 7.0±5.7 (P According to the results of this study, application of VARK learning style led to a reduction in HbA1c and FBS levels, contributing to improved self-care in patients with type 2 diabetes. Therefore, before initiation of training programs, determining learning style of patients is suggested using VARK learning style inventory. In addition, it is recommended that training materials be presented based on learning style of patients.

It is important for health care organizations that they knowing about effective factors on improving newly nurse's competencies. Improving their clinical competencies and highly supportive to them are basic newly nurse's needs and also, it is one of the important nurse manager's duties.
Aim: The aim of this study was determine of relationship between head nurse's technical-clinical competency and organization competency and newly nurse's clinical competencies.
Methods and Materials: This study was cohort study that was done in teaching hospitals of Mashhad University of Medical Sciences in 2014-2015. In this study 37 head nurses, 72 newly nurses by census method and, 283 non-newly nurses participated. Head nurse's technical-clinical and organization competencies; who supervised newly nurses, evaluated by staff nurses (non-newly). Newly nurses, clinical competency evaluate in three stages, beginning of the study, two and four months after that. For data gathering head nurse's competencies was used modified questionnaire; Empowerment of Nurse Leader (Ezeukwu 2012) and for clinical competencies newly nurses was used (Meretoja 2004). Data were analyzed using SPSS11.5 by Chi-Square, Fisher Exact, ANOVA, Kruscal -Wallise, Repeated measurement, Pearson linear correlation tests and calculation of Relative Risk.
Average score (mean) of newly nurse's clinical competencies based on their head nurses in second and third evaluation stages were different significantly (P0.001) and in (organization competency) with (RR=1.82, P>0.001) was significantly different.
based on findings suggested that nurse manager's stress on in-service education for head nurses strongly, for improving their managerial competencies.

Self-regulating learning is an important educational and research process which is influenced by the motivational beliefs. Some of the educational methods are more effective on the motivational beliefs and self-regulating. This work was accomplished for comparing the effects of cooperative learning method to lecture method on the motivational beliefs and self-regulating learning strategies among students. This quasi-experimental research was accomplished on BA students of nursing and midwifery passing their management course in 6th semester in Faculty of Nursing and Midwifery of Mashhad University of Medical Sciences (n=50) during the second semester of 2009-2010 academic years. This course was held for 6 sessions and each session took 2 hours. Students were placed into cooperative learning and lecturing training groups based on random block plan. The measuring tools of the study were the demographic information and Pinterich and Degrout’s (1990) reliable and valid questionnaires for motivational beliefs and self-regulating learning strategies (MSLQ). Data was analyzed using t-tests, Mann-Whitney test, K-Square, variance analyzing and covariance analyzing. The average of the subscales of motivational beliefs and self-regulating strategies in the cooperative learning group was significantly more than that of lecture group (p<0.05) and the mean of test anxiety in the cooperative learning group was significantly lower than that of lecture group (p<0.05). With regard to the results of the study, it is suggested apply the active training methods that can ground for more cooperation by students with the educational topics in order to be prepared for increasing motivated beliefs and self-regulating strategies.

The public image of the profession of nursing is one of challenges in the long term. So، recognition sources of shaping this image would be enabling nurse managers and leaders that accurate planning for confronting to this challenge. The aim of this study was to compare the perspective of nurses who worked in teaching hospitals and general public in Mashhad city to resources that shaping the public image of nursing and their importance. This study descriptive cross sectional was done in 2012 in the city of Mashhad and Mashhad University of Medical Sciences hospitals. The sample size for the urban population was (1،100) people who selected cluster randomly and (520) nurses who worked in teaching hospitals and they selected non-random sampling method stratified. Data collection tool was questionnaire including demographic information and eight shaping the public image resources for nursing. Its reliability by using Alpha-Chronbach was (0. 86). Data were analyzed using SPSS، version 11. 5 by the Man-Whitney test. Data showed that (78. 3%) of the nurses were female and (21. 7 %) of them were males; and also (50. 3%) people in public were women and (49. 7%) of them were male. Mann-Whitney test results showed that the most important resources in shaping the public image of nursing were hospitalization (as the patients)، the kin of patients، television series and movies، respectively. There was no significant difference between the views of nurses'' and people in public in importance of these resources. But resources such as the employment of relatives، stories، news and newspapers were low importance in general public views. And there was difference between their views and nurses'' views significantly (p<0. 001). Based on finding nurse managers must be accurate planning for effective role nurses in clinical setting and also، effective interaction with the media group would be prevent distorted and unreal image of nursing in video production.

The diabetes mellitus is a disease with the disability to metabolize carbohydrates. The global prevalence of diabetes has estimated to be 439 million in 2030. Modification to the diet is an important factor in curing diabetes. Virtual learning is an important tool to guarantee the access of all patients to the dietary instructions. To determine the effect of E-learning education on dietary regimen in type 2 diabetic patients. This semi-experimental study was conducted on 85 patients suffering from diabetes type-2 admitted to ShahidQodsi health center in Mashhad. They were divided into two groups. Pre-and post-intervention questionnaire data and blood samples were recorded. The data were analyzed using SPSS Ver. 11. 5. The results showed that after the intervention، there was a significant increase in average value of adherence to the diet in group receiving virtual learning، compared to the group with face-to-face instructions (p<0. 05). The average and df were statistically significant in both groups in terms of glicosyled hemoglobin (p=0. 001). Considering the results of the present study، as virtual learning has a significant effect on adherence to the diet and several elements such as facilities، it is recommended for the nurses to get familiar with this type of learning method and instruct the patients in diabetes centers.

Substance abuse is a universal problem. Iranian Addicts، on average، spend 15 percent of the oil revenue on drugs. Addiction is the cause of crisis and decreased quality of life. The Nurse can support care- giver to select the effective method. The purpose was to compare detoxified addicts’ life quality participating in narcotics anonymous، therapeutic community and who refer to methadone therapy clinics in Mashhad، Iran. This three-group pretest-posttest study was conducted on the subjects، selected via convenience sampling، including 27 patients in narcotics anonymous، 27 in therapeutic community and 23in methadone treatment. The baseline and after 1. 5 months data were collected، using a questionnaire، and analyzed by SPSS software. the results show that participating in the sessions of all groups led to increased quality of life. In all eight aspects of program، the scores of Narcotics Anonymous group were significantly higher than those of other groups. because of significant effect on quality of life، we recommend applying these approaches، especially Narcotics Anonymous.

Endotracheal intubation is a process that typically done in intensive care unit and emergency rooms by physicians، nurses and health care personnel. Because several factors such as positive pressure ventilation، duration of intubation، temperature and body movements can cause the cuff pressure changes، this study was done to evaluate the relationship between temperature and cuff pressure of endotracheal tube. This single-group correlation study was performed in the middle 6 months of 2011 in intensive care units and emergency departments’ patients of local hospitals of Mashhad University of Medical Sciences and 70 patients with an endotracheal tube or tracheostomy (with cuff) connected to mechanical ventilation were enrolled. Inventory data collected from the endotracheal tube cuff pressure and temperature were recorded. The collected data were analyzed by SPSS 11. 5 software using Pearson and Spearman correlation، general linear model coefficients، Kruskal Wallis and Mann-Whitney U tests. Endotracheal cuff pressure was abnormal in 80% of cases. There was a positive significant difference between endotracheal tube cuff pressure which was measured at 10 different times and the temperature change (p=0. 001). No interactive effects were observed in every 10 measurements، between temperature and inspiratory oxygen percentage and endotracheal cuff pressure (p>0. 05). Endotracheal tube cuff pressure of most patients is outside the standard range. The temperature affects the endotracheal tube cuff pressure.

Endotracheal intubation is a procedure that normally used in the intensive care and emergency units by physicians, nurses and health care team. Various factors, including positive pressure ventilation, intubation time, position of head relative to body, body temperature, body movement, and gas emission can change the amount of cuff pressure but in fact there is no scientific evidence to indicate the efficient program to control these factors for patient who receives mechanical ventilation. Therefore, present study was conducted to determine the effect of inspiratory oxygen fraction as well as body temperature on the endotracheal tube cuff pressure in this group of patients. Seventy patients that were randomly selected from the hospital belong to Mashhad university medical sciences, participated in this correlation study. Endotracheal tube cuff pressure and body temperature measurements were done hourly (per hour) for ten times with standard thermometer and special sphygmomanometer. Recorded data were analyzed in SPSS version 11.5 with using Pearson and Spearman correlation coefficient, t- test, Kruskal wallis and Man-Witni test. Results showed that the cuff pressured for 80% of patient were out of standard (30 ml water). There was (p< 0.001), while inspiratory oxygen fraction was not significantly associated with pressure. In addition, no interaction was found between cuff pressure and temperature as well as oxygen fraction. Regarding the fact that the abnormal cuff pressure leads to the patient’s return with complications of intubations the precise and periodical control of cuff pressure and also it’s impressive variable such as temperature and inspiratory oxygen fraction required to be considered as necessary issues.

Nursing care is an important part of health services. Optimal nursing care can be divided into various roles. The purpose of this study was to assess the role of professional nurses in hospitals of Mashhad University of Medical Sciences. In this descriptive study، 154 nurses who were working in educational hospitals affiliated to Mashhad University of Medical Sciences were selected using cluster and randomized methods. Data were collected using a self-structured questionnaire including educational role (14 items)، supportive role (17 items)، protective role (11 items)، coordinating role (6 items) and caring role (17 items). The questionnaire was filled through observation and self-expressing methods. The nurses were observed in a complete working shift in morning by two observers. The self-expressing questionnaire was filled by the nurses. Most of the participants (70. 8%) were female. The mean age of the nurses was 32. 6 years. The mean years of work experience was 8. 5 years. The mean scores for the nurses professional roles were as follows: educational role: 42%، supportive role: 57%، protective role: 63. 2%، coordinating role: 58%، and caring role: 72. 4%. The percent of nurses who were «good» in their professional role were as follows: in the educational role: 9. 7%، in the supportive role: 12. 3%، in the protective role: 33. 8%، in the coordinating role: 27. 4%، and in the caring role: 43. 5%. There were significant direct correlations between age and work experience with the professional role scores. The level of educational role conducted by the nurses was not appropriate. It seems that nursing managers should develop professional nursing roles and improve the quality of nursing care with planning appropriate programs and creating required educational and motivational platforms.

Stress and stressful situations can be a prelude to fatal diseases such as cardiovascular diseases and hypertension. The aim of this study was to investigate the relationship between perceived stress with five major characteristics of the heart disease in patients with myocardial infarction. In this cross sectional descriptive-analytical study that was conducted from May 2005 till October 2009, a total of 3,200 patients with myocardial infarction, from cardiovascular care unit of Ghaem and Imam Reza hospital, Mashhad, were randomly selected. A demographic questionnaire, an instrument for recording laboratory and electrocardiograph finding, and the Perceived Stress Scale were used for data collection. The results of this study show that while 35% of all cases suffer from moderate stress, 65% percent of them suffer from high level of stress. The level of perceived stress in different categories of variables such as gender, educational level, hypertension, history of hypertension, depression, cigarette smoking, exercising, job, level of incoming, location of living, and family history of cardiovascular disease was significantly different from each other. Considering the high levels of stress among patients with myocardial infarction, design and implementation of interventions for identifying stressors, as well as their management seem to be crucial.

IntroductionThe world witnesses addiction crisis along with atomic bomb, environmental degradation and poverty. One of the most common problems in most of the addict clients is low self-esteem. Self-esteem increases flexibility against changes and reinforces positive attitudes in order to improve sense of self-sufficiency. The researches about addiction and its non-drug treatment strategies, specially increasing self-esteem, is a very important issue. The present study aimed to assess the effect of family-centered problem solving teaching method upon the self esteem in drug-dependent clients. Materials and MethodsThis research was an experimental, two-group pretest-posttest design. After approval of research tool's validity and reliability, 60 addictive clients were randomly divided into 2 tests and one 30-person control group. The participants completed the questionnaires before and after the intervention. The test group received family-centered problem solving teaching method in 8 45-minute sessions for 2 months in additional to common treatment.ResultsFamily-centered problem solving teaching method led to statistically significant increase in test group’s self-esteem. Self-esteem scores rate in test group was 4.5 times more than control group.ConclusionApplying the family-centered problem solving teaching method can be useful in improving and completing the treatment process of clients’ addiction quitting in these clinics as a non-drug method.

Drug addiction is amongst c urrent crisis of the world including nuclear crisis, environmental degradation, poverty, and social crisis. Drug addiction is a major health problem in many countries worldwide. One of the most common characteristics of addicted individuals is low self-esteem. Self-esteem increases flexibility and reinforces progression of positive attitudes toward self-sufficiency. There are limited studies on non-medical treatment strategies for drug-users. The aim of the present study was to assess the effects of a family-centered problem solving education on self-esteem of drug-users. This study had a pretest-post test experimental design. First, validity and reliability (r=0.85) of the self-esteem Cooper-Smith questionnaire was confirmed. After completing the consent forms by the participant (n=60), they were randomly assigned into two equal experimental and control groups. At baseline, questionnaires were completed. The education was performed using family-centered problem solving teaching method in a two months period within eight 45-minute sessions in the intervention group. The Cooper smith self-esteem questionnaire was completed at the follow up. The paired t-test showed that family-centered problem solving education method led to a significant increase (p=0.001) on the self-esteem scores in the intervention group. Although self-esteem scores of the control group increased significantly either after two months, the increase was 4.5 times more in the intervention group. To sum up, using the family-centered problem solving education method with family centered approach could improve the process of addiction treatment in addiction clinics.

Background and

Clinical competency is one of the requirements in nursing profession, for which nurses have recently been criticized. For this reason, health educational systems always intend to discover and improve factors that affect clinical competency. On the other hand, spiritual intelligence is considered as a significant factor in nurses’ success and efficacy. Therefore, the present study was designed to determine the spiritual intelligence status and its relationship with nurses’ clinical competency.

This descriptive correlational study was conducted on 250 nurses of Mashad educational hospitals selected by multi-stage sampling. Demographic, clinical competency and spiritual intelligence questionnaires were used for data collection; the obtained data were analyzed in SPSS 11.5 using ANOVA, Kruskal Wallis, t-test, correlation and simple linear regression and covariate analysis.

The results showed that %53.3 of the nurse's scores on spiritual intelligence were above the mean, and %46.7 below the mean. Most nurses’ (%53/8) scores of clinical competency scores was reported good (by self-assessment), %48.2 of the scores in the average range (by matron assessment), and %53.3 of them in the average range (by the overall assessment). A significant positive correlation was observed between spiritual intelligence and clinical competency, as Pearson correlation coefficient indicated (p<0.001).

A positive significant correlation was observe between spiritual intelligence of nurses’ clinical competency.

One of the main problems with intravenous injection is high prevalence of phlebitis. The duration of staying the patients in the hospital and mortality have been significantly reduced in the hospitals with less side effects of intravenous injection. The aim of this study was to evaluate the effect of 2% nitroglycerin ointment application on the phlebitis intensity, induced by intravenous catheter.

This is a single-blind clinical trial study in which 300 hospitalized patients Ghaem hospital in Mashhad city, Iran were selected by purposive-sampling method. Patients were randomly divided into two experimental (150 patients) and control (150 patients) group. In experimental groups, after intravenous insertion of catheter, we applied 2% nitroglycerin ointment (0.5 inch) in the distal part of the catheter and in control group, we did not use nitroglycerin ointment. The catheter areas were evaluated for phlebitis every 12 hours after catheter insertion in both groups. In experimental group, replacement of nitroglycerin ointment was repeated after 24, 36, 48, 60 and 72 hours. Data were statistically analyzed using student-t test, Chi-square analysis and Fisher test.

The phlebitis intensity in experimental group was less than control group (P<0.001). According to the MADOX criteria, the degree of 0 (for no phlebitis) and 1 of phlebitis intensity was significantly more in the experimental group compared to the control group (P<0.05). On the other hand, the degree of 2 of phlebitis was significantly more in control group than the experimental group (P<0.05).

The results of this study suggest that the local application of 2% nitroglycerin ointment can reduce the phlebitis intensity, induced by intravenous catheter.

Background and Blood samples obtained for blood gas analysis usually contains on air bubble which could be a source of error in blood gas pressure. Therefore, in this study, the effect of extrusion or remaining of air bubble in syringe time delay on analysis of blood gas under different temperature was assessed. Forty samples of arterial blood in seven groups including two groups with 10% & 20% extrude air bubble, two groups with 10% & 20% non extrude air bubble, that sample analyzed immediately after blood letting, two samples without air bubble analyzed 10 minutes after blood sampling, one in room temperature (26°c) and the other in refrigerator (0°c). Results Showed that extrusion of air bubbles leads to a significant decrease in both po2 and pco2. Results of samples contain air bubbles showed a significant increase in pco2 & non significant increase in pao2. Variation in blood gas pressure in samples without air bubbles there variation was not according pressure gradient. In samples with delays analysis results indicate the leakage of gases. From wall of the syringe in both conditions (26°c & 0°c) and continuation cellular metabolism in samples with delay in 26°c. The results of this study suggest that blood samples for gas analysis should be free of air babble when possible, if immediately gas analysis was not available. The samples should be kept in ice crush and glass syringe prefer for blood letting. Immediate gas analysis of blood samples contains air bubbles without extrusion of air bubble is recommended.

Background and Nosocomical infections are of the problems of all societies and the most common way for it s transference is contaminated hands. According to the recommendations of W.H.O on using alcohol–base formulation for hand hygiene and it got used to some hospital sections for some time, this study is done with the aim of comparing alcohol–based hand rub with antiseptic soap and plain soap on colonization of microorganisms on hand of nursing personnel. this study is a randomized, three–group, single blind, clinical trial. 134 nursing personnel including nurses and nurse assistances selected randomly by classified sampling, has been studied. The sample of prevailing hand was provided before, immediately after, and 1 hour hater and one week after intervention by using Agar culture and interpreted after 48 hours incubation in 37c the number and the kind of colonies were counted and the results were interpreted. Furthermore, intervention carried on after teaching hand hygiene based on W.H.O. standards and the study cases were studied concerning possible skin complications and the measure of compliance during one week. Kruskal Wallis, Wilcoxon, Man-withney and Chi–Square statistical tests were used for analyzing data by SPSS software, version 14.5. Based on findings the most common micro-organism was the negative coagulase staphylococcus (92% of cases), the others were antrococus, kurine, Basilus and E-coli, respectively. All independent variables significantly decreased microorganisms immediately after intervention. Among three groups, the alcohol-based hand rub in comparison with two other methods showed more reduction, while two kinds of soaps showed no significant difference. Regarding this fact the on of the most important ways of transferring nosocomical infections is personnel’s hands, as the alcohol- based hand rub is more effective in microorganisms reduction in comparison with soap and regarding its easy application even without water, it is recommended to use it instead if soap for hands as an antiseptic.

Nosocomical infections are of the problems of all societies and the most common way for its transference is contaminated hands. According to the recommendations of W.H.O. on using alcohol-base formulation for hand hygiene and it got used to some hospital sections for some time, this study was done with the aim of comparing skin complications of alcohol-based hand rub with antiseptic and plain soap on hands of nursing personnel. This study is a randomized, three-group, clinical trial. 128 nursing personnel including nurses and nurse assistances selected randomly by classified sampling, has been studied. Three hand hygiene products were tested: alcohol-based hand rub, antiseptic soap and plain soap. Each product was used for a week after teaching hand hygiene based on W.H.O. standards. Finally self assessment tool was completed by nurses and during the week skin condition was monitored by researcher assistance. Kruskal Wallis, Man-Whitney and Chi- Square, were used for analyzing data by SPSS software, version 14.5. Kruskal Wallis test was used for assessment of skin complications in groups with four dimensions: appearance, intactness, moisture content and sensation. Among three groups, the alcohol-based hand rub in comparison with plain soap showed less skin complications in intactness (p=0.04). Regarding this fact that one of the most important ways of transferring nosocomical infections is personnel's hands, as the alcohol-based hand rub has less skin complications in intactness and less cost in comparison with soap and regarding its easy application even without water, it is recommended to use it instead of soap for hands as an antiseptic.