فصلنامه حیات
سال بیست و یکم شماره 3 (پیاپی 67، پاییز 1394)

Difficulty in transferring knowledge to clinical practice or knowledge translation has been identified as one of the main barriers for utilizing research in medical sciences. It is estimated that up to 40% of patients do not receive treatment consistent with the best scientific evidence and 20% of health care are not needed or are harmful. The best approach to evidence-based care is the development and implementation of clinical guidelines (1).Variety of clinical evidence may affect patient care outcomes, and the clinical guidelines can help health professionals to provide the appropriate and effective health care. That does not mean that the guidelines can be considered a replacement for professional judgment. Clinical guidelines provide a framework for clinical judgment, patient preferences and exceptions (2, 3). The guidelines make it possible to obtain a clear understanding of the decision-making models for all stakeholders about riddles and great dilemmas of health (4). Clinical guidelines can lead to improve the quality of health, and reduce unnecessary, harmful or wasteful interventions. These guidelines may provide effective recommendations for the management of patients by healthcare providers and develop standards to evaluate the clinical practice of health professionals. Also, guidelines may have effective and useful content to educate healthcare providers and help patients and their families to make informed decisions (5).

Because of the importance of empathy and positive impact on the relationship between patients and health care providers, as well as the lack of valid instrument to assess student's empathy in health domain, this study aimed to examine the factor structure and reliability of the Persian version of JSE-HPS in the students of the School of Nursing and Midwifery, Mashhad University of Medical Sciences in Iran.Methods & Materials: In this cross-sectional study, 398 nursing and midwifery students of Mashhad University of Medical Sciences were selected using stratified random sampling. The data collection instrument was JSE-HP. The confirmatory factor analysis was used to investigate the factor structure of the instrument, and the Cronbach's alpha coefficient was applied to examine its reliability. The data analysis was done using LISREL version 8.8 and SPSS version 20. The results of the confirmatory factor analysis model showed given that fitness model parameters, including CFI, GFI, AGFI and NFI were approximately 1 and RMSEA index was less than 0.1, the fitness of three-factor model is appropriate. The Cronbach's alpha coefficient for the total instrument was 0.63. The current study confirmed the three-factor structure of the Persian version of JSE-HPS (20 items), included perspective taking, compassionate care and standing in patient’s shoes. Thus, this instrument is appropriate to measure empathy for patient in the health service provider students.

Adherence to the principles of appropriate nutrition and diet therapy is one of the most important aspects of diabetes management. The present study aimed to assess the effect of nutrition education based on "MyPlate" Food Guidance on the anthropometric indices and blood profiles in people with type 2 diabetes.Methods & Materials: In this randomized clinical trial study conducted in 2014, 44 people with type 2 diabetes were randomly allocated either into the control group or the intervention group. Anthropometric measurements, blood profiles, energy intake and physical activity data were collected before and three months after the 2 hours face-to-face “MyPlate” nutrition education session for the intervention group or the usual educational sessions for the control group. Paired t-test, independent sample t-test, ANCOVA, and nonparametric tests were utilized to analyze the data. At the beginning of the study, the two groups were similar in terms of the anthropometric indices, glycosylated hemoglobin, blood sugar and physical activity. After intervention, except for physical activity which was higher in the nutrition education group based on "MyPlate" Food Guidance, the other above cases were lower than the control group (P<0.05), but no significant differences were seen in the changes of blood pressure (systolic and diastolic) and energy intake between two groups of education and control. Nutrition education based on "MyPlate" Food Guidance for three months decreases the anthropometric indices and blood profiles in people with type 2 diabetes.

Preterm infants are at increased risk for readmission after discharge from the neonatal intensive care unit. Some factors and characteristics of preterm infants have an effect on their readmissions. This study aimed to determine neonatal factors related to preterm infants’ readmissions to the neonatal intensive care unit.Methods & Materials: This correlational study was conducted on a sample of preterm infants admitted to the neonatal intensive care unit at three teaching hospitals of Shahid Beheshti University of Medical Sciences in 2013. Samples were studied using a questionnaire on possible factors and characteristics related to readmission including sex, gestational age, birth weight, multiple birth and length of stay in the neonatal intensive care unit after discharge. The infants were also followed for readmission thirty days after discharge. The data were initially analyzed by univariate analysis and then by the logistic regression model. The results of univariate analysis revealed that the infants readmitted at the time of follow up were significantly more premature and had lower birth weight and a longer initial hospital stay in the neonatal intensive care units (P<0.001). In the logistic regression model, only gestational age and birth weight had a significant statistical association with infants’ readmission (R: 0.805, P=0.001 and odds ratio: 0.998, P=0.001 respectively). Infants’ gestational age and birth weight were associated with hospital readmission within thirty days after discharge, so that the infants with lower gestational age and birth weight were more likely to be hospitalized again after discharge.

In the view of the importance of evidence-based clinical practice in recent years, clinical disciplines such as nursing and midwifery have found a special need to systematic review and meta-analysis. However, systematic reviews and meta-analysises like any other studies may be poorly designed and implemented. Therefore, certain guidelines have been considered for reporting of such studies. The PRISMA statement is one of the most recent developments to improve the reporting quality of systematic reviews. The present study aimed to assess the reporting quality of systematic reviews and meta-analysises in the Iranian journals of Nursing and Midwifery, based on the PRISMA statement.Methods & Materials: In this study, we conducted a comprehensive search on the Iranian journals of Nursing and Midwifery (Persian and English), indexed by the SID, Magiran, Irandoc, Iranmedex and Google Scholar databases during 2010 to 2015 years. The search was implemented using the key words such as systematic review and meta-analysis. Of the 44 articles found, after considering the inclusion criteria, 16 articles remained that were investigated using the PRISMA statement. Data were analyzed through the descriptive statistics and chi-square test using SPSS software version 16. The compliance rate of studies on the basis of PRISMA statement was estimated to be about 63%. The most common deficiency in the reporting quality was related to methodology estimated to be about 57%. The most visible deficiencies in the reporting of systematic reviews and meta-analysises were related to bias in the primary studies and bias in combining the results of these studies and lack of reporting these biases. In this study, the reporting quality of systematic reviews and meta-analysises in the Iranian journals of nursing and midwifery was in the moderate level. The most probable reason for this may be the lack of enough attention of researchers to the PRISMA statement or not using this statement in reviewing articles. Therefore, it is recommended that an appropriate share of the educational programs on research methodology be allocated to systematic reviews and familiarizing with valid criteria such as PRISMA statement.

One of the assisted reproductive technologies is the use of donated oocyte. Although, the data about medical aspects of this process is available, knowledge of the psychological aspect related to this therapy is limited. Each individual's psychological aspects can be assessed by the self-concept and the self-discrepancy. Therefore, the present study aimed to assess the self-concept and self-discrepancy among women receiving and donating oocyte.Methods & Materials: In this descriptive-analytical investigation, carried out in 2015, given the limited research population, 53 women referred to Royan infertility institute, were investigated in each of the donor and recipient groups using the available sampling method. The data were collected by three questionnaires including demographic questions, Rogers’s self-concept scale and self discrepancy scale (ideal-self discrepancy and ought-self discrepancy). The data were analyzed through the descriptive statistics, Chi-square and t-test using SPSS v.16.

Results showed that the self-concept and self-discrepancy scores were poor in both the donor group and the recipient group. Scores of the recipient women (the questionnaire was reverse scored) were more than scores of the donor women. There was no significant difference between the two groups in the mean scores of self-concept (P=0.53). There was a significant difference between the two groups in the ought-self discrepancy score (P=0.02) but no significant difference was found between the two groups in the ideal-self discrepancy score (P=0.15).

According to the results, it should be noted that in the process of oocyte donation, only physical assessment is not enough but individuals’ psychological needs are necessary to be taken into account. So, the authorities should consider measures to assess the psychological aspects of women receiving and donating oocyte.

Caring viewpoint is a requisite of high quality nursing care. It must be operational through the nursing education program. The present study was conducted to compare the viewpoints of undergraduate nursing students at the first, fifth, and eighth semesters about the importance of caring behaviors during their nursing education.Methods & Materials: The present study is a descriptive-analytical study. In this study, three groups of 40 nursing students (semester one, five and eight) were selected by random sampling from Shahid Beheshti University of Medical Sciences in 2014. Caring Behavior Inventory completed through self-report by the students, was used for collecting data. Data were analyzed by the descriptive and inferential statistics (with the significance level<0.05) using SPSS software (version 20). The mean scores based on Caring Behaviors Inventory in three groups were: semester 1: 148.2, semester five: 123.6, semester eight: 122.05. ANOVA showed statistically significant differences between the mean scores for three groups of students (P<0.001). Also, the scores of students’ viewpoints were different in all instrument domains included respectful deference to the other (P<0.001), assurance of human presence (P<0.001), positive connectedness (P<0.001), professional skills and knowledge (P=0.004), attentiveness to the other’s experience (P<0.001). Considering the lack of homogeneity in the groups in terms of age and sex, analysis of covariance was used to eliminate their confounding effects on main variable, and despite controlling for the confounding role of age and sex, differences were significant (P<0.001). The viewpoints of the higher-year students about the importance of caring behaviors not only had not promoted but also it had decreased compared to the lower-year students. Considering the fact that caring viewpoint is the requisite of high quality nursing care that must be operational through nursing education programs, and due to the fading of emotional aspect of care, more emphasis on clinical instructors and nurses and using mentors in clinical practice are needed to practically and concretely show nursing students the emotional aspect of caring.

Given the importance of mothers’ health and considering that developmental delay in children affects their mothers’ mental health this study aimed to compare stress and perceived social support in mothers of 6-18 month old children with and without developmental delay.Methods & Materials: This cross-sectional, analytical study was performed on 610 mothers and their 6-18 month-old infants in health centers affiliated to Shahid Beheshti University of Medical Sciences. The participants were selected through the multi-stage random sampling. To collect data, the following questionnaires were used: obstetric and demographic characteristics, socio-economic status, infants’ characteristics, the Cohen perceived stress scale, perceived social support, and Ages and Stages questionnaire to determine the children’s development status. The data were analyzed by SPSS v.19 software and using descriptive statistics, Pearson correlation, chi-square, independent t-test and Man-Whitney statistical tests.

The mean age of infants were 10.68±4.5 months. Independent t-test revealed a significant difference between mothers’ perceived stress (P=0.004) and social support (P=0.01) in the two groups. In addition, a relationship was observed between the mother’s social support and stress (P<0.04).

The results showed that mothers of children with developmental delays have more stress and lower perceived social support than mothers of normal children. Therefore, it is recommended to perform developmental screening for further examination and the reduction of mothers’ stress, as well as to provide appropriate social support.