فهرست مطالب

Iranian Journal Of Nursing and Midwifery Research
Volume:17 Issue: 6, Sep-Oct2012

  • تاریخ انتشار: 1392/01/01
  • تعداد عناوین: 13
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  • Motives for entering nursing in Iran: A qualitative study
    Zahra Tayebi, Nahid Dehghan Nayeri, Reza Negarandeh, Shirin Shahbazi Page 13
    Context: Choosing a career is an important decision for each individual, which is affected by many different factors. The process of entering nursing, as one of the pivotal healthcare discipline, certainly affects quality of care, and retention of nurses in the profession.
    Aims
    Exploring factors affecting the students’ decision to enter nursing.Setting and Design: This qualitative content analysis was carried at the school of Nursing and Midwifery of Tehran University of medical sciences.
    Materials And Methods
    The semi structured interview method was used to conduct this qualitative study on 11 nursing freshmen in 2010. We transcribed the interviews verbatim and analyzed them using the conventional content analysis approach.
    Results
    Four main categories, reflecting the factors affecting the participants’ decision to enter nursing emerged in this study: Capabilities of the profession, coercion, having an interest in the medical and allied health fields, and receiving positive feedbacks. The participants had tried to gather information about nursing through different sources, including nurses and other health care professionals, counselors and Internet, which almost all the time, yielded to no useful information and sometimes with negative feedback.
    Conclusions
    Findings revealed that, unlike other countries, although few participants had entered nursing with a real interest in helping and caring for others, other factors such as having an interest in the medical and allied health fields, coercion, and good employment opportunities were the most important motives. Students’ lack of knowledge about the profession deserves special attention. Nursing managers’ should try to introduce the reality of nursing to the public and as a result, attract more competent students to the profession.
    Keywords: Career choice, Iran, Nursing, Qualitative research
  • Stressors in Clinical Nursing Education in Iran: A Systematic Review
    Tahereh Changiz, Alireza Malekpour, Ali Zargham, Boroujeni Page 399
    Background
    Clinical education is a critical and complex component of nursing education that is influenced by many variables. One of them is stress, which may disturb students’ learning, too. Stressors may differ according to the learning situation and environment, and recognizing them, seems to be essential for corrective interventions. The present work was performed to identify stressors in clinical nursing education in Iran, according to the published research reports.
    Methods
    In this systematic review, all published research reports available in Iranian and International web-based data bases and search engines were searched. Also the archives of peer reviewed Iranian nursing and medical education journals (published between 1989 and 2009) were hand searched. Out of 1104 retrieved records (by a more general terms of “clinical education” AND “Nursing”), after stepwise screening, 15 original research articles were selected for content analysis. Coded data were classified and their frequency was represented in tables.
    Results
    The following themes were obtained to classify main areas of importance for factors related to stress in clinical nursing education: a) clinical competence and ability to play one’s roles, b) care load, or stress due to care, c) main area of education, d) interpersonal relationships and interactions, e) clinical environment (facilities and equipments, space, learning opportunities, etc,…). Subthemes were also identified in each theme.
    Conclusion
    Published studies in Iran provide appropriate background evidences for planning and evaluating interventional programs to reduce stress among nursing students and instructors. Each identified theme in this study could be considered as a subject for planned interventions. Among them, it seems that “interpersonal relationships and interactions” is of the highest priority.
    Keywords: Clinical education, stress, Iran, stressor, systematic review
  • Masoud Bahrami, Somayeh Dehgani, Maryam Eghbali, Reza Daryabeigi Page 408
    Introduction
    One of the most frequent issues nurses encounter with after or during cancer-related surgeries is pain. For postoperative pain relief, different nonpharmacologic interventions, such as nurse–patient communication, mental support, preoperative education, and consultation can be used. Doing such interventions may decrease postoperative pain. However, the research results regarding the effect of such measurements on pain intensity is contradictory. So in this research study the effect of a pain management plan on pain intensity after cancer surgery was assessed.
    Materials And Methods
    The present study is a pre- and posttest case and control clinical trial, which was conducted in Sayyed-Al-Shohada Hospital of Isfahan University of Medical Sciences in 2011. Care program consisted of pain education, communication with the patient, and pain measurement. Seventy patients were sampled based on the inclusion criteria and randomly assigned in 2 groups. Data were collected using American Pain Society-patient outcome questionnaire, which measured pain intensity.
    Results
    In the experimental group, the mean score of pain intensity before surgery and in the first 12–24 h after surgery was less than the control group. Also comparing pain intensity mean differences before and in the first 12 h, before and in the first 24 h indicated that the experimental group had lower scores than the control group, but these differences were not statistically significant. In both the groups, in the first 24 h following surgery the mean score of pain intensity decreased significantly.
    Discussion
    Results of the present research study suggested that a nursing pain management program consisting consultation, education, and pain assessment may have a clinical effect on cancer patient pain intensity following surgery. However, these results were not statistically significant. This might be due to the limited sample size as well as conducting the program in a short period of time. It is recommended that effects of such a program on the pain intensity will be examined further with a larger sample and in a longer period of time.
    Keywords: Cancer, communication, consultation, nursing, pain, patient education, surgery
  • Mohsen Adib, Hajbaghery, Fatemehsadat Izadi, Avanji, Hossain Akbari Page 414
    Context: sleep is an effective factor in the process recovery from diseases. Many variables affect the ‎sleep quality of hospitalized older patients.
    Aim
    this study was conducted to evaluate the quality of ‎sleep and its related risk factors in hospitalized older patients in Kashan’s hospitals, Iran 2009. ‎Settings and design: a cross-sectional study was carried out on a sample of 400 hospitalized older ‎adults in the hospital of Kashan, Iran.
    Materials And Methods
    the Farsi Pittsburgh Sleep Quality ‎Index (FPSQI) was used for gathering data. A global sum of 6 or greater indicates a poor quality of ‎sleep. Statistical analysis used: data were analyzed using the Chi-square test, t-test, ANOVA, and ‎binary logistic regression at the multivariate model.
    Results
    the overall quality of sleep of the ‎patients in this study was poor. In the final regression model, sex (OR = 0.342), level of education ‎‎(OR = 0.470), type of ward (OR = 0.592), previous hospitalization experience (OR = 2.336), and use ‎of hypnotics in hospital (OR = 3.633) were the most important predictors of sleep quality. The most ‎prevalent sleep disturbing factors were worries and anxiety, environmental noises and pain. ‎However, the most negative effects on the PSQI mean score were reported to be from dyspnea, ‎environmental lights, and changes in the sleep habits. Quality of sleep also had significant ‎relationship with sleep latency (P = 0.001) and having a respiratory disorder.
    Conclusions
    the ‎knowledge of sleep disturbing factors in hospitalized older adults might help in planning preventive ‎strategies to improve quality of sleep.‎
    Keywords: aged, hospitalization, insomnia, risk factors
  • Tayebeh Mehrabi, Fatemeh Azadi, Saeid Pahlavanzadeh, Niloofar Meghdadi Page 421
    Introduction
    Nowadays, it has been known that individuals handle coping strategies when faced with stressful events. These strategies play an important role in individuals. Nurses are exposed to high stress, which directly affects their job satisfaction and the quality of their services. Therefore, the present study tried to investigate the effect of Yoga on stress coping strategies among nurses working in intensive care units (ICUs).
    Materials And Methods
    In this quasi-- experimental study, 34 female nurses working in ICU who were qualified to enter the study were selected. Yoga exercises were administrated two sessions a week for eight 8 weeks in the study group. CS--R questionnaire was filled before and after intervention. The data were analyzed by descriptive and inferential (Tt-- test) statistical tests.
    Results
    The results of statistical tests showed that the highest application of stress coping strategies was for inconsistent stress coping strategy. There was a significant difference in the mean scores of coping strategies of stress focus, emotion focus, and ineffectiveness after Yoga exercises compared to with those before thatthe yoga sessions.
    Discussion
    With regard to the findings, eight 8 weeks exercises of Yoga can be considered as a complementary treatment to amend stress coping strategies. Further studies in this field are suggested.
    Keywords: Coping skills, intensive care units, nurses, yoga, coping skills, intensive care units, nurses
  • F. Sharif, Kh Nourian, H. Ashkani, M. Zoladl Page 425
    Background
    Depression is the world’s fourth most prevalent health problem which is ‎associated with substantial mortality, direct medical cost, diminished life quality, and ‎significant physical and psychosocial impairment. This study aimed to investigate the ‎effect of psycho-educational intervention on the life quality of major depressive patients.‎
    Materials And Methods
    Sixty patients who were willing and had met the required ‎criteria for participation were selected from hospitals in Shiraz city, Iran. So 30 of the ‎patients were assigned to the experimental group and 30 others to the control group. For ‎data collection, a two part questionnaire was developed, the first part consists of 13 items ‎related to general characteristics and the second part with 36 items on life quality were ‎used. The experimental group was divided into five subgroups of 6 patients. For each ‎group, six intervention sessions were scheduled. The control group did not receive the ‎intervention. The questionnaires were completed for all subjects in the experimental and ‎control groups before and 1 month after the end of psycho-educational intervention. ‎Tabulated data were analyzed using chi-square, independent and pair T-test.‎
    Results
    The results of the study indicated that psycho-educational intervention in ‎comparison with other available treatments proved to be more effective on eight domains ‎of life quality in the experimental group. A significant difference was observed for all the ‎domains (P < 0.001).
    Conclusion
    Psycho-educational intervention can be used as an ‎auxiliary treatment in improving life quality and decreasing depression in patients ‎suffering from major depressive disorder.‎
    Keywords: Depressive disorder, Iran, life quality, major
  • Narges Sadeghi, Zahra Abdeyazdan, Marzieh Ziaei, Rad, Behnaz Torkan, Minoo Motaghi Page 430
    Background
    Adolescents admitted to hospital are either surrounded by children or adults. However, age-appropriate facilities are often not provided to meet the needs of adolescents, which should be incorporated in the wards. This study compares the satisfaction level about physical environment of the wards among adolescents who have been admitted to pediatric and adult wards.
    Materials And Methods
    In a cross-sectional study, 200 adolescents aged 10–19 were selected from adult and pediatric wards and studied for their level of satisfaction about physical environments of selected wards in Isfahan city.
    Results
    Among the adolescents surveyed in adult and pediatric wards, 44% and 54% reported high satisfaction levels with physical aspects of the ward environment and its facilities, respectively. The average satisfaction level among adolescents in pediatric wards was higher than among adolescents in adult wards (P = 0.04). However, no significant difference was found between age, number, and length of hospital admissions, insurance, and satisfaction levels with physical aspects of the ward environment and facilities.
    Conclusions
    Adolescents reported better satisfaction with the pediatric wards’ environment compared to adults’ ward. They require specialized wards to meet their needs according to their developmental period. If not available, facilities should be provided in pediatric wards where adolescents have reported better satisfaction with the wards’ environment.
    Keywords: Adolescents, environment, hospital, hospitalization, patient satisfaction
  • Sedigheh Talakoub, Sakineh Ghorbani, Marzieh Hasanpour, Vahid Zolaktaf, Masoud Amini Page 434
    Adolescent is a time of profound biologic, intellectual, psychological, ‎and socioeconomic change that he will face a crisis. So compatibility may be ‎exposed to many hazards, such as depression, anxiety and other emotional ‎problems. But a planned regular exercise enhances physical and mental health ‎of adolescent female with diabetes. The aim of this study was to determine the effect of exercise on emotional ‎reactions of female adolescents with Type I diabetes.‎ This study was a quasi-experimental research conducted in Endocrine and ‎Metabolism Research center. A total of 72 patients who were randomly allocated ‎in two groups. The intervention group did aerobic exercise for 45 minutes. ‎Whereas control group did not aerobic exercise. Data were collected using a ‎SCL-90 questionnaire.‎ Data were analyzed and using descriptive and inferential statistics methods and ‎SPSS software. The result showed the mean score for physical symptoms, depression, ‎obsession-compulsion, interpersonal sensitivity, aggression, phobia, paranoid ‎ideation, psychosis and anxiety in the experimental group after intervention than ‎before intervention significantly reduced. The average score in the control group ‎did not differ. The average total score of emotional reactions in the test group ‎after the intervention than before intervention significantly decreased (p = 0 / ‎‎001). But in control groups, the mean scores did not differ (p = 0 / 97).‎ The findings showed that having regular exercise is effective on emotional ‎reactions of adolescent females with type 1 diabetes.‎
    Keywords: Aerobic exercise_affective symptoms_female adolescents_ýtype 1 diabetes mellitus
  • Esmat Noohi, Maryam Karimi, Noghondar, Aliakbar Haghdoost Page 440
    Context: The ability to think critically is an essential element in nursing education and ‎more specifically in nurses’ clinical decision making (CDM).‎
    Aims
    Critical thinking (CT) and CDM ability as well as their relationship were ‎examined among nursing students of Kerman University.‎ Settings and Design: Study was designed in four towns: Kerman, Bam, Jiroft, and Zarand, ‎settled in Kerman province.‎
    Materials And Methods
    This research was a cross-sectional descriptive correlation study. ‎‎300 nursing students with different level of education were asked to fill two questionnaires ‎including: (1) California Critical Thinking Skills Test (CCTST) and (2) Lauri and Salantera ‎‎(2002) CDM instrument. Statistical Analysis Used: Data were analyzed with SPSS12 and ‎descriptive and inferential statistics.
    Results
    Nursing students yielded a low score (mean = ‎‎5/40 from 20) of CT and a mild score (mean = 12.8 from 20) of CDM. We found positively ‎correlation between male and CT and CDM score with mean score of the nursing student. ‎Also CDM score in male was more than female but not significant, and Jirofts CDM ‎nursing student was significantly better than other city.‎
    Conclusions
    Although students that answers evaluation question in CCTST better can ‎gave better CDM score but there isnt relationship between CT and CDM of nursing ‎student. The finding showed that mean score of nursing student CT was low. Reason can be ‎either due to the defects of nursing education program, teaching, and learning strategies.‎
    Keywords: Clinical research, decision making, nursing education, nursing students, ýthinking
  • Marzieh Javadi, Maryam Yaghoubi, Saied Karimi, Maryam Maroufi Page 445
    Context: Medical waste(MW) is all waste materials generated at health care facilities. Mw MW naturally is Hazardous for environment and subsequently for human.Waste minimization (WM) is the latest Alternative for risk reduction. All Hospital Staff generally and Nurses specially can play an active role through education and the implementation of measures to reduce medical wastage and their environmental effects.
    Aims
    This study is aimed to compare nurses and other staff functions in selected hospitals in Isfahan about Waste minimization Strategies Settings and Design: this is a descriptive analytical study. The study tool was a researcher –designed questionnaire in 5 area of waste minimization based on WHO recommendation Methods and Material: There were 90 nurses and other staff From Randomized Selected public and private hospitals of Isfahan as the sample of this research. This study was done in 2009. Statistical analysis used: Data were analyzed by t-test using SPSS16.
    Results
    nurses mean score of WM performance was 58.16(12), and others was 58.56(12.18)(of max 100).There was no significant difference between nurses and others mean score of WM performance according to t-test There was not significant difference between WM performances of two studied groups in public and private hospitals based on t-test.Comparing between two studied groups mean scores by waste minimization Areas, indicated that Nurses have done significantly better in Source reduction Area and other staffs have Acted better in Waste segregation(p<0.05).
    Conclusions
    All of hospital staff specially, nurses has an important role in qualified waste management practice of hospitals. Totally mean score of WM performance in hospitals (nurses and other) was average. With regard to other countries Activities, this result is disappointing. So it is necessary to plan educational programs for hospital staff, especially nurses.
    Keywords: waste minimization, nurses, hospital staff, waste management
  • Susan Bahrami, Marzieh Hasanpour, Saeed Rajaeepour, Taghi Aghahosseni, Nilofar Hodhodineghad Page 451
    Context: Management of health care organizations based on employee's mutual trust will increase the improvement in functions and tasks.
    Aims
    The present study was performed to investigate the relationship between organizational trust and the nurse administrator's productivity in educational health centers of in the Health-Education Centers of Isfahan University of Medical Sciences. Settings and Design: This research was a descriptive and correlational study. Methods and Material: The population included all nurse administrators'. In this research, 165 nurses were selected through random sampling method. Data collection instruments were organizational trust questionnaire based on Robbin's model and productivity questionnaire based on Hersy and Blanchard's model. Validity of these questionnaires was determined through content validity and theirs reliability was calculated through Cronbach's alpha. Statistical analysis used: The data analysis was done using the SPSS (18) statistical software.
    Results
    The indicators of organizational trust such as loyalty, competence, honesty, stability were more than average level but explicitness indicator was at average level. The components of productivity such as ability, job knowledge, environmental compatibility, performance feedback and validity were more than average level but motivation factor was at average level and organizational support was less than average level. There was a Significant multiple correlations between organizational trust and productivity. Beta coefficients among organizational trust and productivity were significant and no autocorrelation existed and regression model was significant.
    Conclusions
    Committed employees, timely performing of tasks and developing sense of responsibility among employees can enhance production and productivity in the health care organizations.
    Keywords: Trust, Nurse Administrators, Hospitals
  • Maryam Yaghoubi, Mina Afshar, Marzieh Javadi Page 456
    Numerous researches have beencarried outto indicate that organizational justice(OJ) is a variable that anticipatesmany other variables in organizations especially in hospitals. OrganizationalCitizenshipBehavior(OCB)is one of the most important variables.This paperaimed to study the relationshipbetween OJand OCBof nursesin selectedhospitals in Esfahan.
    Methods
    This was a descriptive co-relational study.The researchwas conducted amongnurses of selected hospitals in Esfahan. Data weregathered through two questionnairesofOJ, andOCB. T– test, chi-square and Pearson correlation test were employed to analysis the data throughSPSS ver13.
    Results
    In general, the mean score(SD) of OJamong nurses was 41.2(16.2)and the mean score of OCB was57.7(18).Finally, there was nosignificant relationship between OJ, civil virture and sportsmanship. Therewas asignificant relationship between OJ, OCB, courtesy and conscientiousness
    Conclusion
    Since the score of OCB and OJ among nurses were averagein selected hospitals,the managers of the hospitals should improve the perception of justice among nurses.Today, organizations need efficient and expert workers to achieve their goals, to grow and improve in all aspects. In fact the efficiency and effectiveness of organizations depend on the staffs especially in hospitals.
    Keywords: Organizational Justice, Organizational Citizenship Behavior, nurses
  • Hanieh Salehi Pour Mehr, Sakineh Mohammad, Alizadeh, Jamileh Malakouti, Azizeh Farshbaf Khalili Page 461
    Background And Objectives
    Preeclampsia is one of the main causes of maternal and fetal mortality. Despite numerous studies, its etiology is unknown. Recently there has been attention towards Folic acid. This study examined the association of Folic acid consumption and its serum levels with Preeclampsia.
    Materials And Methods
    A case-control study conducted in Tabriz- Alzahra hospital. 52 preeclamptic women in 34-42 weeks and 52 normotensive pregnant women were studied from Jun to Nov 2009. Data was gathered through interview with the women and review of their medical records. Folic acid serum levels were measured by electrochemiluminescence method on Elecsys-2010 system using the Roche brand kit. Data were analyzed by t-test, chi-square, exact fisher and logistic regression.
    Results
    46% of women in the case group and 71% in the control group regularly consumed Folic acid supplements before and during the first trimester of pregnancy. Frequency of correct pattern of Folic acid consumption in the case group were significantly lower than control group (P = 0.02). Findings about frequency of main food group's consumption containing folic acid indicated that the only mean difference between two groups was in relation to fruits (P = 0.002). The mean of Folic Acid serum levels in preeclamptic group was significantly lower than non- preeclamptic group [10.9 (3.9) vs. 13.6 (4.0) ng/ml, P = 0.001].
    Conclusion
    it is recommended all health care providers educate clients especially high risk women about regular and timely consumption of supplements as well as food groups containing Folic acid specially fruits and its possible role in prevention of preeclampsia.
    Keywords: Diet, Folic acid, Iran, preeclampsia, prenatal care