فهرست مطالب

Journal of Holistic Nursing and Midwifery
Volume:27 Issue: 3, Autumn 2017

  • تاریخ انتشار: 1396/07/03
  • تعداد عناوین: 9
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  • Sanaz Amini, Mohammad Taghi Moghadamnia*, Ezzat Paryad, Ehsan Kazem Nezhad Leyli Pages 1-7
    Introduction
    Cardiovascular disease is considered as the most important cause of mortality among men and women throughout the world. This condition causes sudden cardiac arrest in more than half of the cases. To reduce mortality due to this disease, cardiopulmonary resuscitation (CPR) and the determinants of its success are the focus of researchers.
    Objective
    The aim of this study was to determine the survival rate of CPR and its associated factors in patients with in-hospital cardiac arrest in a teaching medical center in Rasht.
    Materials And Methods
    The present descriptive-analytic cross-sectional study investigated 100 patients undergoing CPR during spring-summer 2014 at Specialized Cardiology Center in Rasht. The instrument of this study was the standard checklist of Utstein-Style that included information on age, gender, cause of cardiac arrest, rhythm, work shift, CPR place, interval of cardiac arrest until arrival of CPR team, interval of cardiac arrest until shock, interval of cardiac arrest until intubation, interval of cardiac arrest until CPR termination, short-term and long-term outcomes of CPR, and brain function status until discharge from the hospital. Data was analyzed using descriptive statistics (mean, standard deviation) and analytic analyses (T-test, Fisher’s exact test, analysis of variance, and logistic regression).
    Results
    A total of 53% of subjects were male and mean age of the patients was 68.6 ± 14.4 years; 30% of patients who underwent CPR had short-term survival, and 11% were discharged with appropriate brain status with Glasgow Coma Scale (GCS=15). Multiple logistic regression (Backward LR method) revealed that only gender (p=0.008, OR=6.46, CI95%: 1.63-25.5) and electric shock (p=0.03, OR=4.1, CI95%: 1.1-15.14) were statistically significant predictors of short-term survival.
    Conclusion
    According to the results of this study, time is an important factor in CPR outcome and increasing the survival rate and timely use of electric shock can be an effective measure in shockable rhythms. Appropriate planning, training staff, and using appropriate facilities, as well as establishment of a primary warning system for calling CPR team in health centers can increase the success rate of CPR.
    Keywords: Heart Arrest, Cardiopulmonary Resuscitation, Survival Rate, Inpatients
  • Mahasti Emami, Kobra Salami Kohan*, Asieh Sedighi Chafjiri, Ehsan Kazem Nezhad Leyli, Pardis Rahmat Poor Pages 9-16
    Introduction
    The demand for organ donation has increased in most countries of the world, while the number of donors remains relatively stable.
    Objective
    The aim of this study was to determine the attitude and performance of physicians and nurses in Rasht city.
    Materials And Methods
    This cross-sectional descriptive analytical study was conducted to investigate the attitude and performance of physicians and nurses working in educational centers in Rasht. The sample size was 423 people (296 nurses and 94 physicians), who were selected using stratified random sampling in December 2014. The research instrument was a researcher-made questionnaire, including socio-demographic characteristics and attitude questions that were analyzed using Independent t-test, ANOVA and Chi-square.
    Results
    The findings indicated that 62.5% of the samples responded to the questionnaire using ‗no idea‘ option (no agreement, no disagreement). Blood donation card recipients (P=0.05) and those whose relatives had donation card (P=0.035) along with those with organ donator card (P=0.05) had a more ‗agreed‘ attitude. There was also a statistically significant relationship among the those with blood donation card and blood donation history (P 0.008), people having relatives with organ donation card (p=0.001), the presence of a member among close relatives (P=0.024), and having experience of taking care of the donor or recipient (P=0.002) with the performance of subjects (having organ donation card).
    Conclusion
    The results of this study show that the role of physicians and nurses in encouraging people for organ donation and, therefore, promoting health in the community is not at a desirable level. Therefore, health practitioners and policymakers had been asked to propose solutions for correcting the culture of post-mortem organ donation in order to promote good attitudes and take basic measures in managerial, research, and care areas.
    Keywords: Tissue, Organ Procurement, Organ Transplantation, Attitude, Professional Practice
  • Maryam Esmaeili, Mohammad Ali Cheraghi*, Mahvash Salsali Pages 17-26
    Introduction
    Patient-centered care refers to care with respect for and responsiveness to patients‟ preferences, needs, and values; in this type of care, it is ensured that a patient's values are valued in clinical decision-making. Achieving Patient-centered care is not simple and needs a proper context to be provided.
    Objectives
    The purpose of this study is to explain the context of Patient-centered care in critical care units.
    Materials And Methods
    This study is of a qualitative nature with a content analysis approach. A total of 26 deep, semi-structured interviews were used in this study. The research setting included critical care units of selected hospitals of the Tehran University of Medical Sciences. Participant's speeches were recorded with a tape recorder and immediately transcribed word-by-word. After reading the interviews, the resulting data were coded and then classified according to the similarities and differences in order to understand the general text of the interviews; the sub-categories and the sub- categories were extracted.
    Results
    The study data led to the identification of three categories: specialized nature of care, individual factors, and organizational factors. The third category consisted of three subcategories such as hardware, attention-to-model experiences, and the actual performance of managers.
    Conclusion
    Patient-centered care is a multidimensional and subjective concept focused on nurse's perceptions. In order to achieve Patient-centered care, not only the effectiveness of the nurse's efforts but up-to-date knowledge, the hardware structure of care, and the performance of managers at a wider level are also important.
    Keywords: Patient-Centered Care, Critical Care Units, Hospital, Nursing Staff
  • Leila Feizi Nazarloo, Mitra Sedghi Sabet*, Fatemeh Jaafar-Aghaii, Ehsan Kazem Nezhad Leyli, Morteza Rahbar Taromsari, Avinish Jolly Pages 27-36
    Introduction
    Forensic nursing makes the relation between medical profession and judicial system using the forensic science in prevention, intervention and treatment guidance. Increasing the nurses‟ knowledge of forensic nursing will provide high quality, safe and holistic nursing.
    Objective
    This study aimed to determine the level of emergency nurses‟ knowledge about forensic nursing.
    Materials And Methods
    This descriptive cross-sectional study was conducted on 195 nurses working in emergency department of educational hospitals in Rasht city by census sampling. Data was gathered by a researcher-made questionnaire. The responses had been scored from 0 to 17. Scores had been categorized as 0-5= poor, 6-11= medium, 12-17= good and in three levels of poor (0-33% of total scores), medium (34-66% of total scores) and good (67 100% of total scores). Data was analyzed using descriptive (means and standard deviation) and Inferencial (statistical tests of Man Whitney, Kruskal-Wallis, Friedman, Logistic Regression) statistics. Significance level was considered less than 0.05.
    Results
    Findings showed that work shifts of 87.2% of subjects were rotated, 89.7% were clinical nurses, with work experience of mean 6.66 years in nursing profession and mean 3.73 years in emergency department. 95.4% of subjects had no education about managing the forensic patients, 92.3% had stated that there was no documented guideline in caring of forensic patients and 95.9% had educational needs for managing the forensic patients. Data showed that only 0.51%, 54.36% and 45.13% of the subjects had good, medium and poor knowledge on forensic nursing, respectively. The most and least level of knowledge was on identification of forensic patient and protection of forensic evidences respectively. There was a significant relationship between knowledge on forensic nursing and sex (P=0.015) and organizational position (P=0.021).
    Conclusion
    In order to provide holistic care to forensic patients, the role of forensic nurses in emergency departments is especially important. Findings emphasis that there is a need to specialized education about forensic nursing in Iran. Keywords: Emergency Nursing, Knowledge, Forensic Nursing.
    Keywords: Emergency Nursing, Knowledge, Forensic Nursing
  • Mina Golestani, Ataollah Asadi Louyeh*, Farzaneh Sheikholeslami, Ehsan Kazem Nezhad Leyli, Shiv Kumar Pages 37-45
    Introduction
    The basic needs of a patient and his/her family members are to be supported during health care and especially during critical situations. One such support is required during cardiopulmonary resuscitation (CPR).Hence knowing the perspective of medical persons about “Family member’s Presence during Resuscitation” (FPDR) in the Intensive Care Unit (ICU) is important.
    Methods and Materials: This research was a descriptive-analytic cross-sectional study. The population consisted of 360 members of the medical team in the ICUs of educational hospitals in Rasht during 2014–2015. Data were collected by means of census sampling using a two-part questionnaire, which included demographic information and the medical team’s perspective. Fischer exact test, spearman’s coefficient, logistic regression, and the Kruskal Wallis test were used to analyze the results of the study.
    Results
    The findings showed that 156 (43%) medical team members had experience of FPDR. Only 71 (19.7%) stated that they would invite family members to be present during the resuscitation process. The Fisher test showed a significant difference between the medical team’s perspective of FPDR (P=0.033), with the majority of the emergency specialists 40%) and anesthesiology (4.2%) showing the highest and lowest agreement respectively about FPDR. The logistic regression model showed that the perspective of the medical team with a Bacheler's Degree (BS). In nursing degree (OR=4.3, p
    Conclusion
    Considering the medical team’s perspective of the importance of FPDR, it is necessary to formulate an instruction in ICUs to provide the grounds for it.
    Keywords: Cardiopulmonary resuscitation, Family, Intensive Care Unit
  • Zobeydeh Dehghan Manshadi, Mohammad Bagher Kajbaf, Susan Hamedi*, Marieh Dehghan Manshadi, Safoora Nowroozi, Javad Mollazadeh Pages 47-56
    Introduction
    Plastic surgery and its acceptance have been increasing in recent years. People have different psychological problems. In recent years, studies have emerged on this group of people. However, there is no tool that can assess the acceptance of plastic surgery.
    Objectives
    The aim of this study is to determine the factor structure and psychometric properties of the Iranian version of the Acceptance of Cosmetic Surgery Scale (ACSS).
    Materials And Methods
    In this cross-sectional study, 226 students were selected through convenience sampling among students of Hormozgan University during the academic year 2014–2015. In order achieve the aims of this study, the Iranian version of the ACSS was completed. The data was analyzed using internal consistency, composite, Pearson’s correlation coefficient, exploratory factor analysis, and confirmatory factor analysis.
    Results
    The reliability of the scale was obtained by calculating the internal consistency of Cronbach’s alpha as 0.94 and using the spelling method as 0.81. The results of the exploratory factor analysis reveal that two factors, “intrapersonal” and “social attention and consider”, in this scale explain 65.57% of the total variance of the test. The confirmatory factor analysis confirms the existence of these two factors. The correlation coefficients of the subscales with the whole test were 0.89 and 0.97.
    Conclusion
    The findings of this study suggest that the ACSS can be an appropriate tool for assessing the tendency of individuals to perform plastic surgery and can be used as a valid scale in Iran.
    Keywords: Plastic Surgery, Statistical Factor Analysis, Psychometrics
  • Roghayeh Khorram, Maryam Hasani, Mahmood Karimy*, Atefeh Mohammadi, Mehdi Ranjbaran Pages 57-66
    Introduction
    Over the past few decades, we have seen a major decline in fertility in Iran and in the world. A wide range of social, economic and personality factors, including delayed marriage, fertility behavior, educational and economic goals have affected fertility intent. The rational action theory that determines the relationship among attitude, intent and behavior can be used to explain women's fertility intent.
    Objective
    The aim of this study was to determine the factors related to fertility intent based on rational action theory.
    Materials And Methods
    In this analytical cross-sectional research, the study’s population includes 480 married women covered by Saveh health centers which were selected by cluster sampling in 2015 and became subjects of the study. Data was collected by self-report and using a questionnaire designed on the basis of the constructs of the theory of rational action, marital satisfaction variable and demographic factors. It was analyzed by independent t test and Pearson’s correlation.
    Results
    The results showed that about 62% of the women tended to have a baby. The variable of the fertility intent indicated significant and positive correlation with the constructs of the theory of rational action (attitude p=0.001, r=0.45, mental norms p=0.0001, r = 0.41, obedience motivation, p=0.0001, r = 0.36) and also marital satisfaction variable (p 0.0001, r = 0.37) and significant but a negative correlation with marriage age (r = -0.39, p=0.03).
    Conclusion
    According to the relationship between the constructs of the theory of rational action and the intention of fertility, consideration of these factors is useful for influencing women's fertility. Educational interventions on fertility are also recommended to help couples make informed decisions about fertility and correct false beliefs.
    Keywords: Fertility, Reproductive Behavior, Women
  • Zahra Khoshnodi, Shademan Reza Masouleh*, Seyedeh Fatemeh Seyed Fazelpour, Ehsan Kazem Nezhad Leyli Pages 67-73
    Introduction
    Hospitalization of patients in the critical care units greatly affects their families and their balance. Attention to family needs can affect the treatment process. Identifying the needs of patients’ families and the extent to which they can be fulfilled can affect the treatment process.
    Objectives
    The purpose of this study was to determine the importance of family needs of ICU patients and the extent of meeting their needs.
    Materials And Methods
    This is a cross-sectional and descriptive-analytical study. The research population consisted of the families of patients admitted to the general ICU and neurosurgery department of Rasht Medical Education Center. A standardized tool, Critical Care Family Need’s Inventory (CCFNI), was used to assess the needs of ICU patients’ families. A total of 167 relatives of patients were included in the study. The collected data was analyzed using descriptive statistics (frequency distribution, mean, and standard deviation). The significance of needs was compared with their satisfaction using the Wilcoxon test.
    Results
    Among the five areas of family needs of ICU patients, the area of assurance was the most important (3.46±0.30) of the family needs of ICU patients and the level of satisfaction needs in the area of assurance (3.11±0.30) was higher than in other areas. The average score of the need importance and the level of satisfaction in the family of ICU patients shows that 10%, 7%, 15%, 16%, and 15% of the needs in the reassurance, comfort, information, close contact with the patient, and supportive dimensions were not met by the treatment staff to the extent of their importance.
    Conclusion
    According to the results, the general average satisfaction of family needs in ICU patients is less than the average importance of their needs.
    Keywords: Intensive care units, Inpatients, Family, Need assessment, Personal Satisfaction
  • Oveis Mehriar, Farhad Asghari, Shadman Nemati, Abbas Sadeghi, Ali Faghih Habibi, Ghasem Salehpoor* Pages 75-84
    Introduction
    Rhinoplasty applicants seem to be more susceptible to psychosomatic problems compared to other cosmetic surgery groups and this can affect their decision to go in for surgery.
    Objective
    This study aims to determine the mental health of two groups the control group and the group of rhinoplasty applicants before surgery, based on their gender.
    Materials And Methods
    This case control study was conducted in 2013 at a Hospital of Rasht. A total of 136 rhinoplasty applicants and 136 individuals as the control were selected, using the availability sampling method, and investigated through a checklist of symptoms of the disease Symptom Check List-90-Revised (SCL-90-R). The data analysis was performed using the one-variable and multivariate covariance analyses.
    Results
    The main effect of grouping showed that rhinoplasty applicants had significantly higher mean scores than the control group in the interaction sensitivity components (P 0.017) and anxiety (P=0.009). In this case, the main effect of gender and the interactive effect of group and gender were not significant in any aspect of mental health.
    Conclusion
    Poor mental health among volunteers of cosmetic surgery can be one of the factors behind their tendency toward such surgeries, including rhinoplasty. Therefore, investigation, assessment, and psychological intervention are recommended for these applicants before surgery to improve the image of him or herself as a person and reduce the symptoms of negative psychosis.
    Keywords: Rhinoplasty, Mental Health, Plastic Surgery