مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و ششم شماره 3 (پیاپی 63، امرداد و شهریور 1397)

  Anxiety is one of the prevalent events before and after surgery which occurs in patients due to the waiting time for heart surgery, hospitalization, fear of death, and in general the fear of unknowns. This study was conducted to investigate and compare the effect of multimedia education on anxiety before and after surgery in patients undergoing coronary artery bypass graft surgery. In this randomized clinical trial where the data collector and the data analyzer were blinded, 110 patients undergoing coronary artery bypass graft surgery in 2016 were divided into two experimental and control groups (each group of 55) using quadruple blocking. For patients in experimental group, training through multimedia method was done and for the control group routine training was done. Patients’ anxiety was evaluated using Spilberger’s State-Trait Anxiety Inventory 5-7 days before surgery, and the day before surgery and the post-operative after extubation. Data was analyzed using descriptive and analytical statistics (Chi-square, and repeated measures analysis of variance). Both intervention and control groups were homogeneous in terms of demographic variables (P<0.05). There was no significant difference between the mean of State-Trait Anxiety scores between two groups at three times (P<0.05). The mean anxiety score of patients over time was significantly different, so the State, Trait, and total anxiety scores decreased significantly in the time of extubation compared to the previous two stages (P<0.05). Since, by using educational interventions the anxiety of patients was reduced compared to the preoperative situation, preoperative educational interventions are recommended to reduce the anxiety of these patients

Nursing interventions have a direct impact on patients’ clinical status. Nurses should be aware of the dangers of intubation tube suction and have continuous training in this field. The aim of this study was to determine the effect of education standard suction with small group on nurses’ performance in intensive care unit. This was a quasi-experimental study which was conducted before and after intervention in 2017. The statistical population included 40 nurses working in the intensive care unit who were selected by convenience sampling. First, nurses’ performance in the suction process was evaluated by a standard checklist in an imperceptible way. Then, standard suction training was performed in three sessions of one hour using the small group discussion method. One month after training, nurses’ suction function was evaluated again and analyzed by SPSS16. The mean of standard suction score after training (64.4 ± 3.7) was significantly different from the pre-training (58.5 ± 3.5), which is statistically significant (t-test) (P>0/05). The results showed that nurses’ function in the area of suction needs more attention. In order to improve the clinical performance of nurses, the use of training in small groups is useful. Therefore, training courses in small groups should be offered in the form of in-service nursing courses

Storytelling is one of the appropriate methods to reduce anxiety in children admitted to hospital. The aim of this research was to investigate the effectiveness of storytelling in anxiety among 4-7 year old children who were admitted to hospital. This research is a clinical trial. The samples were 40 children aged 4 to 7 years which were admitted at Ahvaz educational hospitals for different medical reasons. Prior to the intervention, the researcher examined the anxiety level of children according to the anxiety scale of the preschool children of Spence (parental form). After completing a research tool by mothers in both groups, the samples were randomly (Classified block) divided into two groups. Intervention group had 4 sessions of treatment (storytelling) for 20 minutes per each session at separate days. In the control group, only daily conversation was performed. The data analysis was done using descriptive and inferential statistical tests (Chi-square, independent t-test, and paired t-test). Then, the data were analyzed using SPSS20 at a significant level of (P<0.05). The findings showed that there is a statistically significant difference between mean anxiety in two groups after intervention and storytelling caused anxiety reduction among hospitalized children compared to the children who had not received intervention (P ≤ 0.01). Storytelling can reduce anxiety among 4-7 year old hospitalized children

Education seems to get more attention than before. Maintenance of individuals’ function and independency and their lifestyle promotion is a result of education. This is more important for patients with chronic diseases who are under treatments such as hemodialysis. The aim of this research was to study the effect of education on hemodialysis patients’ life style promotion. This was a quasi-experimental study with two groups of 70 hemodialysis patients who referred to Besat Hospital in Hamadan. The patients were put into two groups using simple randomized sampling. 6 sessions of 30 minutes were held for the intervention group through speech on their bedside and individually during their dialysis treatment. Walker lifestyle questionnaire was filled by both groups
3 months after the intervention. The data was analyzed by Chi-square, Fischer, independent t-test and paired t-test using SPSS16. There was no statistically significant difference between the average score of all domains and the total score of lifestyle (P>0.05). Though there was a significant difference between the total score of lifestyle and other domains except for sport and nutrition of the two groups (P<0.05). Education has promoted the lifestyle of hemodialysis patients. Therefore since the nature of this disease is chronic, such education can be effective in the patients’ lifestyle promotion

Due to their job nature, nurses are the first group whose time is mostly associated with dying patients and their families. The aim of this study was to determine the role of attitude to the care of a dying patient in prediction of clinical anxiety and sleep quality of nurses in Zahedan city. This is a descriptive-correlational study. The statistical population of the study included all nurses working in medical sciences hospitals of Zahedan. 130 nurses were selected by available sampling method; they completed the Clinical Anxiety Scale of Thyer & Westhuis (1989), Scale for the End of Life Caregiving Appraisal of Lee, Yoo & Kim (2009) and the Pittsburgh Sleep Quality Questionnaire (1989). Data were analyzed using Pearson correlation and stepwise regression and SPSS19. Findings showed that in components of attitude to patient care there was a positive correlation between physical suffering and burden with clinical anxiety (P<0.01); there was also a negative correlation between maturation with clinical anxiety (P<0.01) and social support pursuit with clinical anxiety (P<0.01). There was a positive correlation between physical suffering and burden with quality of sleep (P<0.01), and there was a negative correlation between maturation and sleep quality (P<0.01). Also, in stepwise regression analysis, two components of burden and maturation of 0.165 variance of clinical anxiety and components of physical suffering and burden a 0.254 predicted the variance of sleep quality.   Due to their job nature, nurses are the first group whose time is mostly associated with dying patients and their families. The aim of this study was to determine the role of attitude to the care of a dying patient in prediction of clinical anxiety and sleep quality of nurses in Zahedan city. This is a descriptive-correlational study. The statistical population of the study included all nurses working in medical sciences hospitals of Zahedan. 130 nurses were selected by available sampling method; they completed the Clinical Anxiety Scale of Thyer & Westhuis (1989), Scale for the End of Life Caregiving Appraisal of Lee, Yoo & Kim (2009) and the Pittsburgh Sleep Quality Questionnaire (1989). Data were analyzed using Pearson correlation and stepwise regression and SPSS19. Findings showed that in components of attitude to patient care there was a positive correlation between physical suffering and burden with clinical anxiety (P<0.01); there was also a negative correlation between maturation with clinical anxiety (P<0.01) and social support pursuit with clinical anxiety (P<0.01). There was a positive correlation between physical suffering and burden with quality of sleep (P<0.01), and there was a negative correlation between maturation and sleep quality (P<0.01). Also, in stepwise regression analysis, two components of burden and maturation of 0.165 variance of clinical anxiety and components of physical suffering and burden a 0.254 predicted the variance of sleep quality. According to the results, the positive attitude to the care of a dying patient can help to reduce the level of clinical anxiety and increase the quality of sleep in nurses

Proper nutrition during pregnancy is very important. The purpose of this study was to determine the effect of education on knowledge and nutritional behavior of pregnant women referring to Hamadan health centers in 2016. The present study is a quasi-experimental study. 100 pregnant women referred to selected health centers of Hamadan who fit the criteria for entering the study, participated in the study after obtaining informed consent and were randomly assigned to intervention and control groups. In the experimental group, in addition to routine care, nutritional behaviors training was carried out in four sessions of 45-60 minutes in two weeks. The data collection tools were demographic information and nutritional behaviors questionnaire. The validity and reliability of the questionnaires were measured. In both groups, the questionnaires were completed before, immediately and 6 weeks after the intervention. Data analysis was performed using SPSS16 and descriptive and analytical statistics (independent and paired t-test, chi square and repeated measures analysis). According to Chi-square test, there was no significant difference between the two groups in terms of age, occupation, education, BMI, sport, and family income, and were homogeneous. Before the intervention, the two groups were homogeneous in terms of the mean scores of components of Pender Health Promotion Model. After the intervention in the experimental group, the nutritional behavior scores and components of Pender Health Promotion Model increased significantly (P<0.001) compared to the control group. Results of this study showed that using the principled education based on the Pender Health Promotion Model, women’s awareness of proper nutrition during pregnancy can be increased

Infertility is one of the bitter experiences of life. Several psychological problems result from infertility for the individual. The purpose of this study was to investigate the direct and indirect effects of coping strategies with stress on adaptation to infertility through the quality of marital relationships in infertile women. This was a correlation study, a path analysis type. The statistical population incuded 120 women who were chosen from women referred to infertility clinics and private and government based hospitals in the city of Ahvaz. Tools used in this research were: Scale Coping with infertility (AIS), marital quality questionnaire (QMI) and a coping strategies questionnaire (CISS). The proposed model was evaluated using structural equation modeling. The indirect relationships were tested using Bootstrap (AMOS-21). The results showed that the proposed model fit was acceptable and all direct routes are statistically meaningful. Also all indirect routes (the relationship between problem-focused coping strategies, emotion and avoidance of compatibility with the disease through the quality of the marital relationship) were significant. Infertility is a stress and coping with stress had an impact on the quality of their marital relationship and their marital status affects the compatibility with infertility

Knowledge management in health care system can reduce medical errors, increase the quality of care, organizational learning and promote cooperation, innovation and cause cost reduction. The success of successful organizations lies in the organizational culture and employees’ beliefs. The aim of this research was to investigate the relationship between organizational culture and knowledge management in Hamadan educational-therapeutic hospitals. The present study was a correlational study-related survey which was carried out in a cross-sectional way on 300 nurses in Hamadan’s educational-therapeutic hospitals in 2017. Robbins organizational culture questionnaires and Nanoka Knowledge Management have been used to collect information. Data were analyzed using SPSS24 and descriptive (mean, deviation and variance) and analytical (Pearson correlation coefficient) methods were used. In this study, the organizational culture of nurses (with a score of 2.5) and knowledge management (with score of 3.16) were in appropriate conditions. There was a positive and significant relationship between organizational culture and knowledge management (r = 0.639, P=0.001). All components of organizational culture with knowledge management have a positive and significant correlation. According to the results of the study, if organizational culture and its components are improved, the progress and improvement of knowledge management will increase the quality of health care services. It is suggested that in the process of establishing knowledge management in medical centers, attention should be paid to the structural and cultural dimensions of the organization, in particular the development of individual creativity and leadership style, coherence and integrity