Iranian Journal Of Nursing and Midwifery Research
Volume:17 Issue: 4, Ma-Jun 2012

At the beginning of the 21st century, the third millennium, the pandemic flu A (H1N1) occurred. Between mid March and mid April 2009, a pandemic influenza A virus emerged in Mexico.[1] The disease spread very quickly in different parts of the world. It has to be said that the disease infected millions of population in different continents and killed at least 18449 people,[2] but less than the previous pandemic flu in 1918 (Table 1). Perhaps it was due to quick medical and nursing care. The disease appeared more severe in Mexico than in other countries perhaps as a result of genetic susceptibility, low immunity of individual, and epidemiological and health care availability for preventing the disease.[3,4] Data were collected using an online survey of PubMed as the main database of medical literature only one year after that pandemic finished. Many articles have been published by researchers and were indexed. Based on my survey, only 3424 papers were published and indexed in PubMed on H1N1 by first of June 2011 compared to Spanish flu which occurred in 1918-1919 which showed only 149 papers indexed in PubMed.[5] The researchers from America, Europe, Asia, Australia, and Africa have published 605, 376, 374, 219, and 25 papers regarding H1N1, respectively. The other articles do not mention those areas. It should be added that only 213 out of 3424 papers were related to the source of pandemic flu in the Mexico City flu infection in the April 2009, as shown in table 1. The number of articles may also be correlated with the number of mortality rate. Africa with 0.91 mortality rate had the lowest published papers, instead the America region and the Euro region with 44.2 and 26.4 mortality rates had highest with 605 and 376 published papers. In Asia and EMRO region, with total 16.3% of death-related pandemic, there have been 374 published papers so far. This survey indicates that production of knowledge in EMRO has increased sharply with consideration of recent pandemic flu published papers. This survey also indicates that nursing articles related to pandemic flu are well published too.

Planning the educational programs and informing people regarding the prevention of widespread diseases like cancers is necessary. With regard to high mortality rate of gastric cancer, the present study was conducted to define the effect of education based on Health Belief Model on knowledge, attitude and nutritional practice of homemakers. In this interventional study, 84 housewives were randomly divided into two groups. The study group underwent seven sessions of education based on Health Belief Model. Control group did not receive the education. Both groups filled valid and reliable questionnaires before and 2 months after program. There was no significant difference between the two groups in demographic characteristics. While mean scores of knowledge, attitude and practice were not significantly different before education, the intervention group showed significantly higher scores after education (p < 0.001). Health education based on Health Belief Model increases the knowledge and improves the attitudes and practices of housewives regarding prevention of the gastric cancer. It seems essential to development this sort of educational programs.

This study was done to assess the use of traditional/complementary and alternative medicine (TM/CAM) during pregnancy and the reasons behind it from the mother’s perspective. In a cross-sectional study, 919 pregnant mothers attending at prenatal care units of governmental health centers recruited through a multistage sampling and completed a self-report questionnaire about the use of TM/CAM during pregnancy. TM/CAM was used by 83.7% of women during pregnancy. Diet/nutrition change was applied by 42.3%, herbal preparations by 49.2%, vitamin and mineral by 30.1%, body based practices by 24.7% and spiritual methods by 22.9% of mothers. Most frequently used herbal products were frankincense in 28.6% and date fruit in 26.4% of mothers. The most common indication of diet/nutrition changes and herbal products used related to mothers was gastro-intestinal disorders. Most of the TM/CAM methods used (64.32%) were happening or beginning from the first trimester of pregnancy. The use of TM/CAM methods in pregnancy is very common, mainly included the methods suggested by traditional Islamic Iranian medicine. Thus, clinicians should be informed to address CAM methods at each obstetric visit. Safety and efficacy of CAM must be explored and taught in every health education program. Future studies should focus on the safety and efficacy of TM/CAM in pregnancy and clinicians should be educated to address these methods at prenatal visits.

Sleep quality is an important and determining factor in the quality of life in dialysis patients. Although many chronic dialysis patients complain of poor sleep, we know little about its related factors. Therefore, this study was designed to study sleep quality and its predictors among dialysis patients. This was a cross-sectional study carried out during August-December 2009 in Shariati Dialysis Center, Fasa University of Medical Sciences. Data were gathered on 61 patients receiving a hemodialysis treatment. Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) in dialysis patients in association with the main clinical and biochemical variables. Logistic and multiple linear regressions were used to assess predictors of sleep quality. Forty-five subjects (73.8%) reported poor sleep quality defined as a global PSQI score > 5. As the age (p = 0.036) and duration of dialyses (p = 0.022) increased, sleep quality decreased. Significant differences were found between sex and sleep quality (p = 0.044). Sleep quality problems had a significant association with MCV (p = 0.025). Poor sleep quality is a very common problem in dialysis patients. Assessment and management of sleep quality should be an important component of care giving to these patients. Large prospective longitudinal studies are needed to confirm the high prevalence of impaired quality of sleep and its related factors while controlling confounding variables.

There are situations in every woman’s life that impressively affect her whole life. Pregnancy is one of those situations. Pregnancy period is usually accompanied with positive emotions for the women and their families. Sometimes depression during pregnancy disturbs daily activities, acceptance of new roles, pregnant woman´s life responsibilities and pregnancy consequences. The goal of this study was to investigate the association between depression during pregnancy and preterm labor consequences and some personal characteristics. This was a cohort study in which the data were collected through cross-sectional method. Primarily, 10 health care centers in Isfahan were randomly selected. The subjects included 378 pregnant women selected based on the number of the pregnant women under the coverage of each health center. The data collection tool was a questionnaire which was filled in two phases. The first phase was during pregnancy and included both personal characteristics and Beck Depression Inventory II and the second phase was after delivery and included the subjects’ pregnancy age at the time of delivery. Content validity and Cranach’s alpha were employed for validity and reliability of the questionnaires, respectively. Prevalence of depression in the population studied was 26.7%. The results showed that there were significant association between depression during pregnancy and preterm labor (p < 0.001), the education of pregnant women (p < 0.001) and their spouses’ education (p = 0.001), the pregnant women’s occupation (p = 0.04) and their spouses’ occupation (p = 0.009). There was no significant association between depression during pregnancy and the women’ age of pregnancy. The findings of the study showed a relationship between depression during pregnancy and preterm labor. Therefore, mental health counselors and programmers are suggested to have some educational programs about psychiatric health for midwives and the personnel who provide health care services for pregnant women.

Cancer diagnosis is an important event in an individual’s life which has considerable outcomes and implications for patient and his/her family. Meanwhile, receiving assistance and support from family and friends has a significant impact on patients to help them to cope with disease-related stress and its treatment. This study aimed to assess the received social support and its correlation with demographic and medical variables. This was a cross-sectional descriptive study on two hundred cancer patients referred to Sayed Al-Shohada Medical Center in Isfahan, Iran. The study subjects were selected through convenient sampling method and required information collected by questionnaire containing demographic and medical data and Multidimensional Scale of Perceived Social Support (MSPSS). Some of the inclusion criteria included age over 18 with no history of mental disorders and not being at final stages of the disease. Content validity of MSPSS was confirmed by experts and its reliability was evaluated by test-retest (r > 0.85). The majority of cancer patients (94.5%) perceived a high rate of social support from their families, friends and relatives. Furthermore, the findings indicated a statistical significant correlation between the numbers of children with social support; however, no significant correlation was found between other demographic and medical variables with social support. The findings of this study indicated receiving the maximum acceptable social support from family, especially children, in patients with cancer. However, conducting further extensive studies is recommended to find effective factors on social support of patients with cancer.

Continuous evaluation is required in order to ensure the university system’s efficiency. One of the important aspects of evaluating the educational system’s effectiveness is judging the system’s ability in meeting environmental needs. The present research’s goal has been to investigate nursing education’s efficiency through investigating the graduate’s condition and their views on education and studying in Isfahan University’s School of Nursing and Midwifery in 2008. This is a descriptive research which has investigated the nursing graduate’s view on the nursing education efficiency. The sample of the present research contains one hundred graduates between the years 2001 and 2005 which have been chosen randomly to complete the questionnaire. The questionnaire is divided into five sections including; growth, demographic information, and satisfaction with professional development and the acquired scientific experiences during the education. The criteria of achieving educational goals, and acquiring individual and social development were used to determine the content of the questionnaire. Through further examination the validity of the questionnaire was calculated to be 0.85. The final analysis was done using the SPSS statistics software. The majority of the participants were female and with an age range of 24 to 30. Among these, 55% were unemployed and 67% of them had no education higher than a bachelor degree. The mean scores of each of the efficiency fields were as following (the total score was 4): Professional growth 2.13 ± 0.36, Satisfaction with the obtained scientific achievement during studies 2.80 ± 0.48, achievement of the educational objectives1.95 ± 0.51 and individual and social improvement 2.70 ± 0.36, neither of which are desirable. There was no significant difference between the demographic information and education efficiency index. Considering the results of the present research, the nursing education system’s efficiency level in Isfahan University is medium. Acquiring the educational goals is not satisfactory for the students. According to the results of this research, some changes have been suggested to change the lesson plans.

The worldwide nursing shortage is threatening the quality of healthcare. The two most common causes in maintaining nurses are job satisfaction, a positive working environment, and good relationships among staff. This study aimed to determine the effect of interpersonal communication skills training on job satisfaction among the nurses working in Al-Zahra Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, in 2011. This study was a quasi-experimental research with two groups and two phases, and was carried out on 70 nurses from Al-Zahra University Hospital. Only nurses who had been employed for more than one year were accepted into the study. There were 35 nurses in the test group and 35 nurses in the control group. The study questionnaire included personal details and job satisfaction scale by Smith and Kendall. Sampling was done randomly and nurses were divided into test and control groups. In the test group, the communication skills training program was done in 6 sessions, twice a week and each session was held for 2 hours. The questionnaire was completed in two stages; before, and two months after the study. Data were analyzed by descriptive and inferential statistics through SPSS Software version 18. Findings showed that pre-intervention mean score of job satisfaction of nurses in both groups had no significant difference (p = 0.92). After the communication skills training program in the experimental group, mean score of job satisfaction increased and it was significant compared to the control group (p < 0.01). The data analysis showed that the interpersonal communication skills training program increased the mean score of job satisfaction in the test group. Therefore, it seems necessary that nursing managers design training programs for them.

Since the family is a social system, the impairment in each of its component members may disrupt the entire family system. One of the stress sources for families is accidents leading to hospitalization particularly in the intensive care unit (ICU). In many cases, the families’ needs in patient care are not met that cause dissatisfaction. Since the nurses spend a lot of time with patients and their families, they are in a good position to assess their needs and perform appropriate interventions. Therefore, this study was conducted to determine the effectiveness of nursing interventions based on family needs on family satisfaction level of hospitalized patients in the neurosurgery ICU. This clinical trial was conducted in the neurosurgery ICU of Al-Zahra Hospital, Isfahan, Iran in 2010. Sixty four families were selected by simple sampling method and were randomly placed in two groups (test and control) using envelopes. In the test group, some interventions were performed to meet their needs. In the control group, the routine actions were only carried out. The satisfaction questionnaire was completed by both groups two days after admission and again on the fourth day. Both of the intervention and control groups were compared in terms of the mean satisfaction scores before and after intervention. There was no significant difference in mean satisfaction scores between test and control groups before the intervention. The mean satisfaction score significantly increased after the intervention compared to the control group. Nursing interventions based on family needs of hospitalized patients in the ICU increase their satisfaction. Attention to family nursing should be planned especially in the ICUs.

Nursing is naturally a stressful job. Stress in nurses can cause depression, isolation from patients, absence and decrease in their qualification. This study aimed to determine the causes of job stress in nurses of Kashan, Iran. In this cross-sectional study, 189 nurses from Kashan hospitals of different wards were studied. The information collection tool was Occupational Stress Inventory-Revised™ (OSI-R™). The most important job stress aspects in female nurses were range of roles (48.4%), role duality (40.9%) and job environment (39.6%). In men, range of roles (57.5%), job environment (50%) and responsibility (45%) were the most significant aspects. In addition, lack of balance between skill and education and job environment requirements in both genders was the least important aspect of job stress. The results showed that the level of stress in most of the nurses was in medium level. Job factors were more involved in job stress than demographic and other factors.

Reproductive health is an important health topic. There are many challenges in reproductive health and it is necessary to train experts to manage them. The aim of this study was to define the tasks of Master of Science (MSc) graduates in reproductive health through comprehensive needs assessment to establish the course. The study comprised of three steps. In the first step, through literature review, the draft and basic fields of main tasks were defined. In the second step, by establishing a focus group of 10 experts, the tasks were extracted on the basis of the country’s needs. In the third step, a Delphi study was carried out among 51 experts who were selected to finalize the list of tasks and their priorities using three criteria of “importance”, “feasibility” and “availability”. 57 tasks were extracted with regard to the four main functions of management and planning, education, consultation, and screening in reproduction age of men and women. According to Delphi’s results and their priorities, 45 tasks were important and feasible but not available, and they were higher-priority tasks. The tasks extracted are consistent with the framework of reproductive health provided by the World Health Organization (WHO) and the American Guideline of Educational Planning. However, considering the differences of problems in Iran comparing with other countries, the list is not exactly similar to any list prepared for other countries. Therefore, it is necessary to consider the results of this research in university curriculums.

Bed sore is one of the main problems for people confined to bed for long time and cannot move. According to the fact that prevention is easier and cheaper than therapy, in this study the effect of fish oil ointment on the improvement of first stage bed sore was assessed. This study was carried out on two groups with 30 patients that had bed sore on shoulders, sacrum or heel. In the intervention group patients’ position was changed every 2-3 hours and the bed sore was washed with water and cotton-wool and fish oil with thickness of 2-3 mm was applied on the place of sore. This method was used for seven days. If they improved, the method was stopped in the first days of procedure. At the end of seven days, again the first day checklist was completed, and it was compared to the questionnaire of the two groups, and analyzed separately according to the daily changes of intervention and control group. There was statistically significant difference between the average of changes in the size of sore of the study group and control group (p < 0.002). The time average of improvement in the intervention group was less than control group. Local use of fish oil could increase the improvement of first stage bed sore and increase in vessels, blood and oxygen supply of the place of sore.

Main suggested theories about patients’ adherence to treatment regimens recognize the importance of motivation in positive changes in behaviors. Since cardiac diseases are chronic and common, cardiac rehabilitation as an effective prevention program is crucial in management of these diseases. There is always concern about the patients’ adherence to cardiac rehabilitation. The aim of this study was to describe the motivational factors affecting the patients’ participation and compliance to cardiac rehabilitation by recognizing and understanding the nature of patients’ experiences. The participants were selected among the patients with cardiac diseases who were referred to cardiac rehabilitation in Isfahan Cardiovascular Research Center, Iran. The purposive sampling method was used and data saturation achieved after 8 semi-structured interviews. The three main concepts obtained from this study are “beliefs”, “supporters” and “group cohesion”. In cardiac rehabilitation programs, emphasis on motivational factors affects the patient’s adherence. It is suggested that in cardiac rehabilitation programs more attention should be paid to patients’ beliefs, the role of patients’ supporters and the role of group-based rehabilitation.