نشریه پرستاری ایران
پیاپی 84 (آبان 1392)

Increasing quality improvement and customer orientation in health services results from continuous feedback of patients'' expectations and enhancement of service delivery. Although most nurses and nursing students are aware of ethical dimensions of their profession and its importance، the main concern is about their ability to respect ethical aspects of clinical act. In this study، nurses'' performance on Iranian nursing code of ethics was studied from patients'' perspective. It was a descriptive study that was conducted in 2012. The sample consisted of 500 hospitalized patients in medical-surgical wards of Tabriz teaching hospitals. Data was collected by a researcher-made questionnaire based on Iranian nursing code of ethics and analyzed using Descriptive and inferential statistics، independent t -test، ANOVA and Pearson correlation coefficient by SPSS -PC (v. 13). The majority of patients were male، married، at high school level of education، and hospitalized in surgical wards، with a history of previous hospitalization. Nurses’ performance on Iranian nursing code of ethics was good (first level) in 41. 8% of cases، moderate (second level) in 51. 8% of cases and low (third level) in 6. 4% of cases from patients’ perspective. The findings would act as a guide for nurse managers to design programs for improving respect to nursing code of ethics، consideration of patients'' rights and patient satisfaction.

cupping as a branch of complementary medicine for treatment and prevention of disease is accounted as pillars of Islamic and traditional medicine. This study aimed to determine the status of cupping in the city of Qom and the community knowledge of its rules in 2011. It was a descriptive, cross-sectional study. The sample- individuals referred to the cupping centers of Qom city in 2011 (n=400) - was recruited by cluster - systematic sampling. Data was collected using a researcher - made questionnaire and analyzed by descriptive statistics using S PSS-PC (v. 18). Age at first visit for most part of the sample (31.5%) was 30-20 year old and 31% of them have been using herbal therapy along with cupping. The most common reason to perform cupping was for health (43.3%) and 61% of them suffered from chronic diseases. Among the sample, 38.5% had an annual visit for cupping and were very satisfied with the effects of cupping (49.75%). For 71.75% of the sample, easy access to cupping was the most important reason for its selection and for 58 % of participates others’ recommendations was the most common reason. The most common site of cupping was in scapular area (59.5%). Most of sample had no accurate information about the principles of cupping. Of the sample, 42.25% had correct information about bathing after cupping. No complications were seen after cupping for 97/5% of them. Regarding the corroborated religious recommendations about cupping, high satisfaction of people and its ease of access, educating people by professionals about the rules and mores of cupping and its advantages in the prevention and treatment of diseases is recommended. Future studies about the effect of cupping for various diseases, such as muscle pain, asthma and allergies are also recommended.

Health care organizations have growing recognition to patient safety for improving the quality of services. The main requirement to improve patient safety is patient safety culture. The aim of this study was to determine the current patient safety culture from the perspective of nurses working in university and private hospitals of Ahvaz city. In this analytic cross-sectional study, 142 nurses working in five academic and three private hospitals in Ahvaz city were randomly selected. Data was collected by Hospital Survey on Patient Safety Culture questionnaire (HSOPSC). The first part of the questionnaire included nurses’ and organizational characteristics; the second part consisted of 42 questions to evaluate 12 dimensions of patient safety culture. Data was analyzed by descriptive statistics and independent T test using SPSS-PC (v.16). The average percentage of positive responses to patient safety culture questionnaire was %55.8 %16 and %56.3 %15 in academic and private hospitals respectively. The strengths of patient safety culture in academic hospitals were related to three dimensions of organizational learning-continuous improvement (71.54%), teamwork across hospital units (76.03%), and non-punitive response to errors (81.1%); and the strengths in private hospitals were related to the dimensions of organizational learning-continuous improvement and non-punitive response to errors. The lowest score of patient safety culture was related to communications and giving feedback about errors in university hospitals (26.7%), and patient transportation in hospital and communication among units in private hospitals (33.87%). Most nurses (68.2% in private and 66.3% in academic hospitals) have not reported any events to supervisor in the past 12 months. There was no statistically significant difference between academic and private hospitals in patient safety scores. Managers actions to promote safety, giving feedback in response to errors, creating an appropriate context for reporting accidents and exchange of patient information in the studied hospitals seems to be crucial.

It is a long time that human science researchers, especially industrial and organizational experts have noticed the importance of work-family conflict as a substantive and essential foundation for proficiency of organizational processes and job satisfaction. The aim of this study was determining the relationship between work - family conflict with job burnout and intention to leave among female nurses working in university hospitals of Khorramabad. It was a descriptive correlational study. The study population consisted of all female nurses working in university hospitals of Khorramabad city. The sample (n=220) was recruited by stratified random sampling method. Data was collected by Netemeyer (1996) Work-Family Conflict questionnaire, Maslach & Jackson (1981) burnout questionnaire and Kamant et al., (1979) turnover questionnaire and analyzed by descriptive statistics, and correlation coefficient Pearson and regression analysis using SPSS-PC (v. 19). There was a significant positive relationship between work-family conflict and burnout (P<0/01). There was also a direct relationship between work-family conflict and burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment) (P<0/01). Work-family conflict could also predict intention to leave among these female nurses (P<0/01). Regarding the findings, more assessments and continuous interventions to prevent job burnout and turnover in nurses is necessary.

Neonatal morbidity is known as an important problem in neonatal medicine. Since there has been a noticeable increase in rates of cesarean sections compared to normal vaginal delivery, determining the best time of delivery is of paramount importance. The aim of this study was to determine the neonatal morbidity associated with gestational age in non-emergent cesarean sections. This cross-sectional study was performed in Asali Hospital-Khorramabad from July 2011 to October 2011. In this study, 250 pregnant women who underwent non-emergent cesarean section were studied. Data was collected through direct interviews with patients and observing the infants` condition in the operation room or neonatal unit at the hospital. Data analysis was carried out using ANOVA, Kruskal–Wallis and Chi-squared test s in SPSS-PC (v.10). In this study, 14 % of caesarean sections were performed at the 37th week of gestation, 3.2% at the 38th week and 54.8% at the 39th week. 34.3% of neonatal morbidity including transient tachypnea of newborn, Respiratory Distress Syndrome (RDS), sepsis, hypoglycemia, seizure and hyperbilirubinemia was observed at the 37th week of gestation, 9% at the 38th week, and 0.7% at the 39th week. Respiratory morbidity was estimated 31.5 % at the 37th week, 5.1% at the 38th week, and 0.7 % at the 39th week. The findings showed that elective cesarean sections at the37th week of pregnancy led to higher rates of neonatal morbidity such as respiratory morbidity compared to cesarean sections at the 38th or 39th week. However, further research with a larger sample size is recommended in order to achieve more definitive results in this respect and other research about approaches to reduce these cesarean sections is also recommended.

Fear of unknowns before a surgery makes children to experience more pain after these procedures. This study was performed to examine the effect of preoperative psycho- educational interventions on postoperative pain and return to normal life in children undergoing tonsillectomy in Shiraz city. It was a quasi- experimental study. Convenience- systematic sampling was used to recruit 199, 9 - 12 years old children admitted for tonsillectomy to Dastgheib hospital in Shiraz city. They were randomly assigned to either experimental (n=100) or control group (n=99). The experimental group received psycho- educational interventions including a 45- minute session. Postoperative pain was assessed by Visual Analogue Scale (VAS) and return to normal activity was evaluated by a brief questionnaire. Data was analyzed by t-test, Chi-square test and repeated measurements design using SPSS-PC (v. 11). The results revealed that psycho-educational interventions results in rapid return to normal activity in experimental group (p < 0.05) but it has no statistically significant effect on post -operative pain (p= 0.316). The study provided no empirical evidence in support of effectiveness of using psycho- educational interventions for reducing postoperative pain in children but it could be an effective method for rehabilitation of children after tonsillectomy.

Providing protection strategies against depression or anxiety after coronary artery bypass surgery has been recommend by different studies. Accordingly this study was conducted to investigate the relationship between perceived social support and depression and anxiety before and after surgery in patients undergoing coronary artery bypass graft in 2012. This cross-sectional study was performed through convenience sampling with 105 patients undergoing coronary artery bypass graft admitted to the Dr. Lavasani hospital in 2012. After completing the perceived social support, anxiety and depression questionnaires, patients were assigned to three groups (low, medium and high social support); then One week after surgery, patients were again asked to complete questionnaires for depression and anxiety. Data were analyzed by descriptive and inferential statistical (chi-square, t-test and ANOVA) using SPSS-PC (v. 16). The majority of patients were male (55.2%) and married (83%). The mean score of perceived social support was 57.49, the mean score of pre and post- operative depression was 13.62± 6, 16.97± 7.88 respectively and the mean score of pre and post-operative anxiety was 21.8 ± 8.95, 17.79 ± 7.49 respectively. There was a statistically significant difference between the three groups of patients (low, medium and high perceived social support) in terms of depression and anxiety (P< 0.000). In other words, the mean depression and anxiety in patients with low perceived social support was higher than the other two groups. There was a statistically significant relationship between perceived social support and depression and anxiety in patient undergoing coronary artery bypass grafts. Accordingly it seems crucial to recognize and improve these patients’ social support resources.

Considering the role of personality factors in the etiology of migraine headache as the most common neurological symptoms and medical complaints, this study aimed to determine the association between migraine symptoms and personality factors in nurses. Martial & It was a descriptive correlational study. The study population consisted of all female nurses working in educational hospitals of Khorramabad, among them 180 were recruited through Cochran formula using stratified random sampling method. Data was collected by Inventory of Personality factors NEO and Najarian Migraine symptom questionnaires. The criterion validity and reliability of the NEO Personality Inventory was 0/66 and 0/78 respectively, and reliability of migraine questionnaire was 0/80. Data was analyzed by descriptive statistics including mean and standard deviation and also inferential statistics including correlation coefficient and regression analysis using SPSS-PC (v.16). A significant correlation was found between Personality factors and symptoms of migraine headaches. Multiple regression showed that personality factors explain 42 percent of the variance of migraine headaches in nurses (P< %5). Considering the predictability of migraine headache by personality factors, the findings could be used as a basis for further research and preventive interventions for nurses with migraine.