Iranian Journal Of Nursing and Midwifery Research
Volume:16 Issue: 1, Winter 2011

Pain is a global health problem which exists from the birth to the last stage of the life. It has been proven that infants are able to feel the painful stimulus. Infants routinely experience the pain in the hospitals especially during the vaccination procedure. Therefore, finding out a non pharmacological method is necessary for pain relieving. The aim of this study was to compare the effect of oral sucrose, breastfeeding and combination of them on pain relief vaccination of less than 3 months of age infants with the first time vaccination in Tabriz. In this quasi-experimental study, 120 under 3 months of age infants referred to Tabriz Health Centers in 2009. The eligible infants referred to the centers entered the study provided with entry criteria. They referred to the mentioned centers then entered the study and finally randomly have been put into four groups respectively; oral sucrose 25%, breastfeeding, combined method and control groups. In case groups, vaccination was implemented two minutes after the mentioned interventions. Therefore, NIPS (Neonatal Infant Pain Scale) was used in order to determine the pain score at 0, 5 and 10 minutes after the vaccination. The duration of the infants crying and pulse rate was also measured. The data were analyzed using the SPSS software and statistical chi-square, ANOVA and Kruskal-Wallis tests. The findings of the present study indicated that the mean of the pain scale was the lowest immediately after the vaccination in breastfeeding group, but this difference was significant only in breastfeeding and control groups (p = 0.007). The minimum crying time was 66.6 (32.62) seconds in breastfeeding group and the maximum time was 126.26 (46.15) seconds in control group. The ANOVA test results showed that all the conducted interventions made a significant reduction of crying time in comparison with the control group. The ANOVA also showed that none of the above interventions had any effect on preventing from the increase of the following tachycardia. According to the findings of the present study, pain score and crying time was the lowest in breastfed neonates. Considering to the fact that breastfeeding is a natural, useful and free intervention and does not need any special facilities, using this method in pain management and control during this painful procedures for infants is suggested.

urgery is one of the most stressful incidents which may occur in everybody's life.When human life is threatened, whether it a real or a pseudo threat, stress would occur.This stress is characterized in physical and mental functions of the individual

Infectious disease control is one of the important components of patient care which can assist in reducing morbidity and mortality. Source isolation is one of the strategies that have used in order to prevent from the spread of contagious infectious diseases. Since nursing student should be able to do the caring in source isolation patients after learning the principles, it's necessary to assess the student's perception of caring for this client group in order to prepare them for the role of caring. This is a qualitative phenomenological study; its participants were selected with maximum variation by purposed sampling from first to fourth year nursing and midwifery students of Isfahan School of Nursing and Midwifery. The students used to do the patient caring during the clinical internship. The sampling done until 10 interview data saturation was obtained. In order to collect data, researcher used depth interview method. Data analysis was performed by seven-stage Collaizzi method. The findings of this study included 6 main concept (themes) from participant's experiences as following: 1. Stressor agents of caring,2. Response to stress,3. Care requirments,4. Care provider performance, 5. Consequence of care, and 6. Improper caring. Providing educational programs in terms of isolated patients can reduce anxiety in students which this can lead to more control and prevent the spread of infectious diseases. In addition, studying about patients’ needs can be useful for improving practical interventions and clinical care.

Psychiatric team has an important in treating and taking care of psychiatric patients. Using this team's experience seems necessary for enhancing care services. The aim of this study was to assess psychiatric team's experience of working in different psychiatric groups. This is a study with qualitative method or phenomenology approach. Samples were chosen using purposive sampling method. Samples included 10 personnel from psychiatric wards of 4 hospitals in Isfahan city in 2007. Data was gathered using deep interviews which were recorded on tapes. Data was analyzed using Kleizi's 7 steps method. Results from participant's experiences were summarized in 3 main concepts: "communication", "ability" and "conflict"; and 5 sub concepts: "cooperation", "self acknowledgement", "hope", "qualification" and "multiple roles". Results of this study could be used in future programming to enhance care services for psychiatric patients in hospitals.

Today, as many as 1.5 million Americans use ventilators once in a year.. Response to mechanical ventilation alarms remains to be one of the most challenging tasks facing physicians, nurses or other medical personnel in the ICU. In the present study we aimed to compare the response times to “vocal alarms” and “visual or audible ones”. In the present study we developed a system to evaluate the “Vocal Alarm” and improve the medical ventilator “Benet 7200 Alarms” with it. Ventilator generates the alarms when patient has any problem. The time of Activation & Deactivation is recorded. The survey was done in central ICU for six days, 3 days with vocal alarm, and 3days with “Beep” alarms and detected Alarm events then recorded seventy-two hours of data for each type of alarms. All of events information saved in the memory and SPSS was used to determine difference between two types of alarms. On the average, the duration of the ventilator alarms activation were 33 ± 21 seconds for vocal alarms and 60 ± 46 for audible “Beep” alarms. The response times for vocal alarms were significantly lower (P = 0.001). The response times for normal “Beep” alarms were longer than vocal alarms.

Hypertension is one of the most crucial health problems and most common chronic disease in developed and underdeveloped countries, which is called silent killer. Usually diagnosis happens suddenly. Despite this fact that is a preventable and treatable condition but without treatment it leads to serious and life threatening complications (such as heart, kidney and brain destruction), and in most cases these complications result in disability. It can be prevented by, increas knowledge and awareness, chang attitude and practice. Prevention, plays significant role in controlling this disease. A cross-sectional, correlation-descriptive study was conducted in one stage, by one group. Two hundred thirty four (234) patients were recruited by random sampling among hypertensive patients referring to public health care centers in Khoor & Biabanak(an area in Isfahan Iran). Data gathering was carried out with a questionnaire. Data analysis was carried out SPSS software with descriptive and inferential statistics. Findings indicate that there is significant relationship between awareness and knowledge; awareness and attitude; awareness and practice. There is no significant relationship between knowledge and attitude; or knowledge and practice. In addition, there is significant relationship between attitude and practice. Although patients relatively had high awareness, knowledge, attitude and practice about their disease but still their hypertension was not under control. Several barriers are associated with uncontrolled hypertension particularly treatment-related barriers. Findings suggest further studies to determine new effective strategies to solve this problem.

Occupational stress is a recognized problem in health care workers. Nursing has been identified as an occupation that has high levels of stress. This study aimed to investigate the sources of job stress and the adopted coping strategies of nurses who were working in Accident and emergency department. In this descriptive survey ninety emergency ward nurses from three large teaching hospitals in Shiraz City, Iran, were involved in the study. The data was collected through a self-administered questionnaire to identify the sources of job stress and nurse’s profile and Lazarous standard questionnaires to determine the types of coping strategies. The greatest proportion of respondents was women (86.7%), range 23-50 years, had less than 5 years of experience (56.7%). The following stressors were identified: problem related to physical environment, work load, dealing with patients or their relatives and handling their anger, being exposed to health and safety hazards, lack of support by nursing administrators, a physician not being present in a medical emergency and lack of equipment. The most common strategy used by nurses was self-controlling and Positive Reappraisal and the strategy least used were accepting responsibility. In this study large proportion of nurses used an emotion-focused strategy but Problem-focused approaches were generally less used. It was concluded that the coping scales, positive reappraisal and self-controlling are extremely important in emergency department nurses.

Around 5% of the world populations are the carriers of the hepatitis B virus. Prevalence of carriers in many different areas of the world is various. Iran, including the rate of 2 to 3%, is among countries, which has the average prevalence. The aim of this study was to determine the prevalence of antigen HBs positive and associated factors in pregnant women who had referred to urban health centers of Isfahan Province in 2009. A descriptive study conducted on 1078 pregnant women who had referred to the urban health centers of Isfahan, Barkhovar, Meymeh, Khomeini Shahr, Lenjan and Najaf Abad in 2009 in order to register their physical condition and conducting pregnancy care. Random sampling method by quota was systematic. First, a questionnaire completed including demographic characteristics and records of high-risk behaviors in mothers and wives. Then, 4 cc of their blood drawn and evaluated the antigen surface in serum. Finally, the data were analyzed using SPSS15 software, Chi-square, Fisher and Logistic Regression tests. According to the findings, serum of 0.5% of pregnant women under the study was HBsAg-positive. The average age of subjects was 26.1 (4.9) years old and the average pregnancy number was 1.79 (1.0). Using Fisher's test as well as logistic regression test and based on the previous records of high-risk sexual behaviors and tattooing, a significant difference was observed in positive-HBsAg group in comparison with negative-HBsAg group (p ≤ 0.05). Instructing target groups and giving awareness in large-scale, close monitoring in high-risk centers such as beauty shops, tattooing centers and etc, and also staff training in how to use disposable and sterilized equipments have to be accomplished at the right time.

Sleep disturbances are common among older adults. Recently there is much interest in complementary and alternative medicine (CAM) from the population in general, and the elderly are no exception. Tai Chi exercise as a CAM can be performed by older adults. The purpose of this study was to evaluate the effects of Tai Chi Exercise on sleep quality of elderly residents in Sadeghiyeh elderly care home. In this Clinical Trial, 62 older subjects aged older than 65 years residents of elderly home in Isfahan were studied. They randomized in two experimental and control groups. The intervention was the Tai Chi Exercise sessions wereheld three times per week for 12 weeks. Duration of exercise was 5 minutes at first session which gradually increased to 20 to 25 minutes by the midpoint of intervention. The Pittsburgh Sleep Quality Index (PSQI) was used for pre and post evaluation of older adult sleep quality. Data analyzed using the SPSS14 software. There were no differences in demographic characteristics or psychological variables between two groups. Mean age of studied subjects in experimental and control groups was 68.74(5.48) and 69.42(5.34), respectively. In the Tai Chi group sleep quality was improved significantly with decrease in PSQI global score. In control group sleep quality was not changed significantly. At the end of study, mean differences of PSQI global score between two groups different significantly. Our finding is coherent with other studies in this field indicated that the Tai Chi Exercise can have a significant effect on sleep quality in older adults.

Prehypertension is considered as a cardiovascular disease predicator. Management of prehypertension is an appropriate objective for clinicians in a wide range of medical centers. Treatment of prehypertension is primarily nonpharmacological, one of which is massage therapy that is used to control the blood pressure. This study aimed to evaluate the effect of Swedish massage (face, neck, shoulders and chest) on blood pressure (BP) of the women with prehypertension. This was a single-blind clinical trial study. Fifty prehypertensive women selected by simple random sampling which divided into control and test groups. The test group (25 patients) received Swedish massage 10-15 min, three times aweek for 10 sessions and the control groups (25 patients) also were relaxed at the same environment with receiving no massage. Their BP was measured before and after each session. Analyzing the data was done using descriptive and inferential statistical methods (chi square, Mann-Whitney, paired t-test and student t-test) through SPSS software. The results indicated that mean systolic and diastolic blood pressure in the massage group was significantly lower in comparison with the control group (p < 0.001). Findings of the study indicated that massage therapy was a safe, effective, applicable and cost-effective intervention in controlling BP of the prehypertension women and it can be used in the health care centers and even athome.

Acute lymphocytic leukemia is one of the common cancers of childhood and currently, 80 percent of these children survive more than 5 years by getting the right treatment. Since long-term treatment is painful and invasive, preventingthe side effects and their influence on life quality is an important issue which introduces consideration for self-care. Consequently, the present study was conducted in 2007-2008 about the effects of self-care on the lives of children suffering from acute lymphocytic leukemia, referring to treatment centers in Isfahan City. The present study was a two-staged, two-group clinical trial. 48 children aging 5-18 and suffering from acute lymphocytic leukemia were selected through convenient sampling method and the training program was administered beforethem and afterwards, they were divided randomly into two groups of experiment (n=24) and control (n=24). The General Scale and Cancer Scale Life Quality Identification Questionnaires were used to define the life quality of the children.The validity and reliability of the questionnaire were in turn defined by content validity method and Cronbach’s alpha test. The experiment group received the self-care checklist after training and was controlled and examined for 3 months. The pre-and-post self care Life Quality Questionnaire were both filled out in both groups and accordingly, the SPSS software, independent t test, chi-square and paired t tests were used to analyze the data. The findings of the study showed that both groups were homogeneous by virtue of influential factors on life quality, like age, gender, type, stage and duration of treatment (p > 0.05). There was no significant difference between theexperiment and control groups'' life quality average scores before administering the self-care training program. The results of paired-t test in the experiment group after administering the self-care program showed a significant difference in General and Cancer Scale Questionnaires with that before administering the program, while no significant difference was observed in the control group. Also, the independent t-test showed a significant difference in the average of life quality score shift after administering the self care between the experiment and control groups. Life quality improved after administering self-care training program in the experiment group while it did not improve in the control group and even the increase in average score of life quality in Cancer Scale in this group was an indicator of an increase in problems related to disease, treatment and care. The results of this study showed the positive effects of administering self-care on the life quality of children suffering from acute lymphocytic leukemia.

Almost two thirds of Iranians eligible for using contraceptive methods use these methods. Their dissatisfaction with the methods would directly and indirectly affect the quality of family planning services and would bring about detrimental results for the service recipients and consequently for other family members. Therefore, identification and evaluation of the factors leading to dissatisfaction with contraceptive methods can help the authorities responsible for family planning services to provide some solutions to increase satisfaction with these methods. This research was a qualitative phenomenological study. The study population consisted of the women using intrauterine device (IUD) or contraceptive pills only as contraception, referred to 14-Masoum, Amir Hamzeh, Ebn-e Sina, Shahid Motamed, and Navab Safavi clinical centers. Sampling was goal-based, and 14 individuals participated in the study. Data collection was carried out in four months using deep interview. Data analysis was performed using seven-step Colaizzi’s method. The findings of the interviews were assigned 104 codes categorized into three groups; 1- physical and psychological harms experienced by the method, 2- the shortcomings of the methods, and 3- continuation in spite of dissatisfaction with the method. According to the results, the users of contraceptive methods would have some experiences, which lead to their dissatisfaction with the methods. Since dissatisfaction with the methods will result in a decrease in continuation of use of the methods or discontinuation of the method, providing some policies to increase the satisfaction with contraceptive methods can cause more effective use of the methods and continuation of their use.

With regard to the high commonality of vaginal infections among pregnancy-age women, especially gardnerella, candidiasis vaginitis, trichomonal vaginitis and chlamydia and by attending to this fact that these infections have ahigh cost, including the medical expenses and other services like missing working hours and bear a negative effect on the life quality of women as influential individuals in family and society, we decided to examine the commonality of some of these infections and their related factors among women referring to selected health centers in Isfahan City. This research was of an analytical-descriptive type conducted on 266 samples referred to the midwifery unit of selected health centers in Isfahan City due to one of the common vaginal infections (gardnerella, candidiasis vaginitis, trichomonalvaginitis and chlamydia). The collection of data was carried out via conducting interview with women and filling out the researcher-made questionnaire with close-ended answers (38 questions) and open-ended answers (25 questions). Data analysis was done by descriptive and analytical statistics (variance analysis and chi-square test). The findings of the study showed a significant relationship (p = 0.04) between suffering from different kinds of vaginal infection and fertility factors (the treatment record of the spouse). But, there was no significant statistical relationshipbetween suffering from these infections and delivery type, period regulation, seeing stains and the pregnancy prevention type. Meanwhile, a significant relationship was found between suffering from vaginitis and demographic and individual factors like women''s job (p=0.001), their educational level (p = 0.006), body mass index (p = 0.01) and their weight (p = 0.02). However, no significant relationship was found between suffering from common vaginal infections and individual health factors. With regard to the research findings, knowledge of the factors related to vaginal infection, including the fertility factors, can be instrumental in preventing and reducing the suffering from these infections. Therefore, training relatedto mothers'' educational level and consulting with women for knowing the susceptibility factors like the effect of weight, attending to mothers'' professional issues and prevention methods by following individual and sexual health-related issues by men and women can reduce the rate of suffering from these infections and promote the health level of mothers and hence, the society''s health status.

Infants'' palliative care becomes an important aspect of nursing when providing welfare and promoting children''s life quality become the objectives of caring. The number of children with life threatening disease has increased alongside the developments in technology and medical treatment in medicine. Accordingly, it is a pure fact that our attitudes are related to our behaviors and performances. This research was conducted with the aim of assessing the effect of intensive course of children''s palliative care on the attitudes of children and infants'' nurses at Isfahan University of MedicalSciences. This study was a semi-experimental, two-group, two-staged study in which 56 nurses working at Infants and Children sections, who met entrance inclusion conditions, were divided into the two groups of experiment and control. In this study, the balanced, reliable and already validated questionnaire of Infants and Children Sections Nurses'' Attitudes Regarding the Dying Children was used. Then, the experiment group participated in the Infants'' palliative care training course which lasted for 3 weeks. The results were analyzed by the statistical SPSS software. There was no significant difference between the two groups by virtue of demographic features, except for the marital status which was not that much distorting to the study. It was found at the end that there is a significant differencebetween the average of test and re-test in the experiment group and also between the average of scores after training in both control and experiment groups; but, there was no significant difference between the average of scores before and after training in the control group. End-of-life children care is one of the issues in modern medicine which has not gained a definite status in our country. It is hoped that nurses would be the forerunners of this modern science in Iran.

Oxytocin is the most consumed medication in modern midwifery. The consumption of oxytocin in inducing and strengthening delivery in delivery wards requires an efficient method for making use of this medication with maximumeffect and minimum side effects. In this regard, this study has been conducted aiming at comparing the effect of tow methods of prescribing oxytocin in inducing delivery on the duration of stages. The present study is of a clinical trial kind with three-blinded parties which was conducted in 2010 on 120 research volunteers who had the inclusion criteria. The samples were randomly assigned into two groups of control and experiment.The data collection means consisted of a questionnaire and a checklist. In order to analyze the data, the SPSS software, version 17, Student T-test and Chi-square test were used. There was no statistically significant difference between two groups regarding the duration of the first and the first stages and the active phase. The duration of the third stage of delivery was shorter than the group which had stoppedusing oxytocin at the active phase. There has been no significant difference between the mean of oxytocin dioxin from the initiation of the delivery induction till the active phase. The mean of oxytocin dioxin has been significantly different between two groups during all stages of delivery so much so that this rate has been lower in the experiment group The results of the data analysis show that the continuation of oxytocin after the active phase not only does not have any advantage regarding the shortening of duration of stages and its cutting but also it leads to a decrease in theconsumption dosage of oxytocin in the active phase and the second stage of delivery and on the other hand leads to a decrease in the side effects of the medication on mother and infant.

Disease is an abnormal process that affects all aspects of the human life. The hospital environment and particularly the intensive care unit (ICU) causes stress in the patient and hi/her family. Delirium, due to its sudden onset and startle, unconsciousness, memory impairment, illusion and dynamic or sedentary behaviors, is known as one of the stressor agents. Despite its high prevalence and the high cost complications such as long term mechanical ventilation, hospital pneumonia, pressure ulcer, prolongation of hospitalization in the hospital or the intensive care units, performance reduction and increase in mortality, this disorder remains unknown in most cases. In line with the other treatment team members, nurses should also participate in controlling the discountable factors, helping patients to cope with uncontrollablefactors and using pharmacological methods to manage the delirium and feature their own unique capacity more through quick recognition, reviewing the causes and providing scientific care in improving the quality of patient care and improving the patients’ health status. Hence, this study aimed to review the effect of nursing interventions on delirium of the patients admitted to ICU of the neurosurgery ward in Al-Zahra hospital in Isfahan. A two-group multi-stage clinical trial study was carried out on 40 patients with hyperactive delirium admitted to ICU. The questionnaire included demographic data, Richmond Agitation Sedation Scale to assess the irritability rate andstudy method and also cognitive confusion in intensive care unit to determine delirium status of the study population. Simple sampling method was conducted and the study samples were randomly divided into two intervention and control groups. The following nursing interventions performed on the intervention group: assuring, emotional support, clear information and effective communication with the patients and their families and also allowing family visits twice a day. In the control group, the sample received the normal and routine ICU cares. The irritability and delirium severity status of the samples were analyzed on the day of admission and the fifth day using descriptive and inferential statistical methods and also SPSS software. Statistical analysis showed that although there was no significant difference between the groups on the first day of admission in terms of the irritability and delirium severity status, this was significant on the fifth day of the study. Wilcoxontest in the intervention and control groups indicated a significant difference between the study subjects in terms of the irritability and delirium severity status on the first day of admission and the fifth day which indicated the reduction in the irritability severity. But, this reduction was higher in the intervention group than in the control group. Furthermore, McNemar test showed that the number of the subjects with delirium in both groups reduced on the fifth day compared to the first day of admission and there was a significant difference between these two days, the number of samples withoutdelirium in the intervention group was almost two times higher than that in the control group on the fifth day. Nursing interventions are considered as one of the non-pharmacological methods in treating delirium and by using these methods appropriately in ICUs, the patients’ hypoactive delirium can be reduced.

Labor pain relief has been considered since many years ago. Heat as a non pharmacological method of pain relief helps reducing the pain intensity and increases the pain consistency. The aim of the study was to determine the effect of the heat therapy on the labor pain in primigravida women. In this clinical trial study, 64 low risk nulliparous women were randomly divided into two heat therapy and routine care groups. In addition to the routine cares, warm bag were used for the heat therapy group for the low back, fromcervix dilatation of 3-4 cm to the end of the labor’s first stage and for perinea at the second stage. The pain intensity was determined by McGill pain questionnaire in dilatation of 3-4, 6-7 and 9-10 cm and at the end of the labor‘s second stage.Data was analyzed using t-test and chi square test by using SPSS 11. Results of research showed a significant decrease in the pain intensity in the heat therapy group at the first stage and the second stage of labor and comparing two groups showed significant difference(p<0.001). According to the results of this study, it seems that heat therapy in addition to its beneficial effects, causes the mother to sense the labor pain in a lower pain severity.

Based on the literature review that was conducted, no research study has been found in Australia to provide a detailed understanding of why nurses differ in their perceptions about cancer patients’ Quality of Life (QoL) when they communicate with patients in oncology wards. This descriptive exploratory qualitative study was completed in 2007 in two major public hospitals in Adelaide, South Australia. 10 nurses from different inpatient and outpatient oncology services and a palliative setting took part in semi-structured interviews. After the data collection and analysis six main themes were identified. Differences in nurses’ perceptions about cancer patients’ QoL were discussed in the light of the sub theme “relationship and rapport”. In general, participants commented that differences existing between patients’ and nurses’ perceptions about cancer patients’ QoL were due to a poor relationship and rapport between cancer patients and their nurses. Therefore,nurses need to have a genuine interest to make an open relationship with patients in a non-judgmental way. This rapportneeds to go beyond the patient and include other health care professionals as well as the patient’s family.

Spiritual needs are among an individual’s essential needs in all places and times. With his physical and spiritual dimensions and the mutual effect of these two dimensions, human has spiritual needs as well. These needs are an intrinsic need throughout the life; therefore, they will remain as a major element of holistic nursing care. One of the greatest challenges for nurses is to satisfy the patients’ spiritual needs. This is a qualitative study with hermeneutic phenomenological approach. Data were collected from 16 patients hospitalized in internal medicine-surgery wards and 6 nurses in the respective wards. Data were generated by open-endedinterview and analyzed using Diekelmann’s seven-stage method. Rigorousness of findings was confirmed by use of this method as well as team interpretation, and referring to the text and participants. In final interpretation of the findings, totally 10 sub-themes, three themes including formation of mutual relation with patient, encouraging the patient, and providing the necessary conditions for patient’s connection with God, and one constitutive pattern, namely spiritual need of hospitalized patients. Spiritual needs are those needs whose satisfaction causes the person’s spiritual growth and make the person a social, hopeful individual who always thanks God. They include the need for communication with others, communicationwith God, and being hopeful. In this study, the three obtained themes are the spiritual needs whose satisfaction is possible in nursing system. Considering these spiritual aspects accelerates patient’s treatment.

Dental fear leads to lack of child cooperation. In general, without the patient''s cooperation, success in remedy is impossible. This study aimed to evaluate parental view about the origins of the dental fear in children as well astheir view about factors contributing to the prevention of child dental fear. This was a cross sectional descriptive and analytical study which was carried out on 200 parents of children aged 6-12 years referred to dentistry center of Isfahan University of Medical Sciences. The level of dental fear in these children was screened using Children''s Fear Survey Schedule - Dental Subscale (CFSS-DS). This questionnaire consisted of 15 questions and each question had a 5-point Likert-type Scale. Total scores ranged from 15 to 75. Based on the scores children were divided into two groups: Group with low fear (score of 25 or less) and group with high fear (score of 37 or more). The parents were asked about the causes of their child''s dental fear. There was an inverse significant correlation between the average score of fear and the age of the children. In the group with high fear, most of the parents (31%) had chosen previous dental experiences as the cause of their child''sfear. There was no significant relationship between parental belief and their gender, the level of education, the level of their own dental fear and the child''s age and fear score. According to the parent''s standpoint, previous dental experience was a major factor in the development of childhood dental fear. Temperamental factors also played a major role in some of the fearful children. Most of the parents in group with high fear attributed their child''s fear to the external factors and seemed they were unable to control and prevent it. Therefore, more attention should be given to the behavior and attitude of the parents as well as dentists in thefuture researches.