فهرست مطالب

Iranian Journal Of Nursing and Midwifery Research
Volume:18 Issue: 1, Jan-Feb 2013

  • تاریخ انتشار: 1392/02/08
  • تعداد عناوین: 15
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  • Mohsen Shahriari, Eesa Mohammadi, Abbas Abbaszadeh, Masoud Bahrami Page 1
    Background
    Ethical values offer a framework for behavior assessment, and nursing values influence nurses’ goals, strategies,and actions. A literature review was adopted in order to determine and define ethical values for nurses.
    Materials And Methods
    This literature review was conducted based on the Centre for Reviews and Dissemination guidelines. The key words used to search relevant sources were nursing, ethics, ethical values, and nursing values. The search of articles in English was carried out in Medline, CINAHL, PubMed, Scopus, Ovid, and Proquest databases. The search of articles in Persian was conducted in databases of Magiran, SID, and Irandoc publications. After assessing and analyzing the obtained data, 17 articles which had a distinct definition of ethical values were chosen and subjected to a thorough study.
    Results
    The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency.
    Conclusions
    This study showed that common ethical values are generally shared within the global community. However, in several areas, influences of social, cultural, and economical status and religious beliefs on values result in a different definition of these values. This study revealed that based on humanistic nature of nursing, common values in nursing protect human dignity and respect to the patients. Recognizing and definition of ethical values can help to improve nursing practice and develop codes of ethics.
    Keywords: Ethics, literature review, nursing, social values, values
  • Ziba Farajzadegan, Pooya Koosha, Ghazaleh Jamalipoursufi, Mahrokh Keshvari Page 9
    Background
    Health measurement is one of the major challenges in today’s researches. Various indicators including well‑being are used to evaluate health. Many factors including culture, structures, and values can be effective on family health, quality of life, and well‑being of family members that these elements themselves are effective on the whole society’s health. One of other effective factors on these indicators is family function.
    Aims
    This research was aimed at investigating the relationship between family function and women’s well‑being in Isfahan, Iran.Settings and Design: This study is a cross‑sectional, descriptive, and analytical study carried out on 300 subjects in Isfahan in 2011. The inclusion criteria were the families residing in Isfahan for more than 1 year and the women who were willing to cooperate with the project. Sampling method was in the form of cluster. Isfahan has 13 clusters of which 50% (6 clusters) were randomly chosen. Fifty samples were chosen systematically on the basis of the sample volume (300 samples). The selection of the first sample was based on random numbers table and the next samples on the basis of K (the families lies numbers/K = 50).
    Materials And Methods
    The data collecting tools included Bloom’s Family Function questionnaire and well‑being questionnaire, whose validity and reliability have been already confirmed.Statistical Analysis Used: Data were analyzed by descriptive statistical tests, analysis of variance (ANOVA), and Pearson correlation test through SPSS software version 14.
    Results
    The sample’s mean age was 45 (4.3) years, well‑being dependent variable mean was 23.6, and family function variable mean was obtained as 183.6 by ANOVA. Well‑being was better in families with higher function, compared to the other groups, but no significant difference was observed.
    Conclusions
    Family function has direct and indirect effect on quality of life and well‑being. It should be considered as a social determinant of health to improve well‑being in family as a part of community.
    Keywords: Family nursing, Iran, questionnaire, well‑being
  • Zeinab Samadi, Farzaneh Taghian, Mahboubeh Valiani Page 14
    Background
    Premenstrual syndrome (PMS) is a combination of physical, psychological, or behavioral changes in the late secretary phase of menstrual cycle and interferes with interpersonal relationships or activities.The purpose was to assess the effects of 8 weeks of regular aerobic exercise on PMS in non-athlete girls.
    Materials And Methods
    This quasi-experimental study was conducted on 40 non-athlete girl students aged 18-25 years at Khorasgan Azad University, with a diagnosis of PMS. The instruments included personal information and a medical questionnaire, a form of premenstrual symptoms DSM-IV, the GHQ 28 questionnaire, and the Beck Depression and Anxiety questionnaire, and also, daily symptoms were recorded for 4 months (two courses before the training period and two during training). Individuals in the experimental group practiced aerobic exercise for 8 weeks, three sessions per week for 60 min. The subjects were evaluated during the first (the pre‑test), second (the mid‑test), and third menstrual period (the post‑test).Statistical analysis used in this study is t‑test and repeated measurement analysis of variance (ANOVA).
    Results
    Results showed that the mean scores of PMS and symptoms declined after 8 weeks of training in the experimental group. The comparison of the two groups showed that the mean scores of PMS, for symptoms during and after exercise, were significantly different (P ≤ 0.001) and the percentages of scores PMS changes, physical, and psychological symptoms of experimental and control groups had a significant difference (P ≤ 0.001) after 8 weeks of training.
    Conclusions
    Overall, the findings showed that 8 weeks of aerobic exercise is effective in reducing the symptoms of PMS and can be used as a treatment.
    Keywords: Aerobic exercise, Iran, non, athlete girls, premenstrual syndrome
  • Mitra Zolfaghari, Reza Negarandeh, Sana Eybpoosh Page 20
    Background
    We aimed to develop and evaluate outcomes of a blended learning (BL) program for nursing and midwifery education in Iran.
    Materials And Methods
    This was a participatory action research project. After designing BL website, providing technological infrastructures, and holding preparatory workshops, 22 blended courses were designed. BL method was implemented for one semester. Students’ grade point average, participation with courses, and opinion about educational methods, and instructors’ attitude and opinion about educational methods were assessed.
    Results
    Most students (n = 181; 72.1%) and 17 instructors (28.3%) consented to participate in the study. Students’ grade point average and participation was significantly higher in BL rather than in face‑to‑face method (P < 0.0001). Most instructors (n = 11, 65%) had positive attitude toward BL method. Textual analysis of participants’ opinion showed that most students preferred BL method and felt more independent in this method. However, they complained about lack of easy access to Internet and weakness in computer skills. Instructors admired the flexibility and incentives that had been provided in the program. However, some of them complained about the time-consuming nature of BL course design.
    Conclusion
    The program showed positive effect on students’ learning outcomes and participation. The strengths and weaknesses of the program should be considered for development of next phase of the project. Lessons learned in this phase might be helpful for decision makers who tend to develop similar programs in Iran. Motivational and communicational issues and users’ IT skills should be addressed in every BL program.
    Keywords: Action research, distance, education, Iran, midwifery, nursing
  • Nafisehsadat Nekuei, Ashraf Kazemi, Soheila Ehsanpur, Nastaran Mohammad Ali Beigi Page 27
    Background
    With regard to the importance of preconception conditions in maternal health and fertility, preconception risk assessment makes treatment trends and pregnancy outcome more successful among infertile couples. This study has tried to investigate preconception risk assessment in infertile couples.
    Materials And Methods
    This is a descriptive analytical survey conducted on 268 subjects, selected by convenient sampling, referring to Isfahan infertility centers (Iran). The data were collected by questionnaires through interview and clients’ medical records. Pre‑pregnancy risk assessment including history taking (personal, familial, medical, medications, menstruation, and pregnancy), exams (physical, genital, and vital signs), and routine test requests (routine, cervix, infections, and biochemical tests) was performed in the present study.
    Results
    The results showed that the lowest percentage of taking a complete history was for personal history (0.4%) and the highest was for history of menstruation (100%). The lowest percentage of complete exam was for physical exam (3.4%) and the highest for genital exam (100%). With regard to laboratory assessment, the highest percentage was for routine tests (36.6%) and the lowest was for infection tests (0.4%).
    Conclusion
    Based o the results of the present study, most of the risk assessment components are poorly assessed in infertile couples. With regard to the importance of infertility treatment, spending high costs and time on that, and existence of high-risk individuals as well as treatment failures, health providers should essentially pay special attention to preconception risk assessment in infertile couples in order to enhance the chance of success and promote treatment outcome.
    Keywords: Infertility, preconception care, risk assessment, Iran
  • Khadijeh Boroumandfar, Fatemeh Khodaei, Zahra Abdeyazdan, Maryam Maroufi Page 33
    Background
    Vaccination is one of the most common painful procedures in infants. Despite the irreparable consequences and complications of acute pain in infants, and existence of pharmacological and non‑pharmacological methods for pain control, pain control in infants has received less attention. Therefore, this research aimed to compare the vaccination‑related pain in infants younger than 6 months who receive vapocoolant spray and breastfeeding during injection, in order to suggest a strategy to provide emotional, mental, and physical health for infants.
    Materials And Methods
    This is a randomized clinical trial study on 144 infants less than 6 months of age, referred to Ibn Sina Health Care Center in 2009, who were selected by convenience sampling. Forty‑eight infants were allocated through systematic random sampling to each study group (i.e., breastfeeding, vapocoolant spray, and control group). Inclusion criteria were: Fully conscious infants, lack of any disease (sensory, motor abnormalities, cold, etc.), taking no medication, exclusive breastfeeding, vaccination for hepatitis B and DTP, regular visits to health care center, infants with Iranian nationality, and quiet infants who did not cry. The infant was excluded if he/she was crying and it was impossible to make him/her quiet before injection. Data were gathered by a questionnaire (six questions) and checklist [neonatal infant pain scale (NIPS)]. Data were analyzed by descriptive and inferential statistical methods through SPSS.
    Results
    The findings suggest that breastfeeding during vaccination has a more analgesic effect on vaccination pain, compared to application of vapocoolant spray before vaccination. In 64.6% of the infants, breastfeeding during vaccination caused analgesia, while 25% of the infants who received vapocoolant spray experienced analgesic effect. There was a significant difference in pain between the infants who received vapocoolant spray and those on breastfeeding during injection (P < 0.001).
    Conclusion
    It seems that breastfeeding during vaccination in infants under 6 months of age is an effective, natural, safe, accessible, and inexpensive method without side effects to reduce vaccination‑related pain.
    Keywords: Breastfeeding, pain, vaccination, vapocoolant spray
  • Mohammad Sahebalzamani, Hojjatollah Farahani, Reza Abasi, Mehdi Talebi Page 38
    Background
    Spiritual intelligence is defined as the human capacity to ask questions about the ultimate meaning of life and the integrated relationship between us and the world in which we live. It results in an increase in psychological welt-being of individuals as well as having a goal in their life. This study was conducted to investigate the relationship between spiritual intelligence with purpose in life and psychological well-being among the nurses.
    Materials And Methods
    The study was a descriptive correlation study. In this study, 270 nurses were selected from some hospitals of Tehran University through convenient sampling. Data were collected through a four-section questionnaire including demographic characteristics, a 24-item questionnaire of spiritual intelligence and its four components, psychological well-being questionnaire with six subscales and 84 questions, and the questionnaire of purpose in life with 20 questions. The data obtained from the questionnaires were analyzed through SPSS software.
    Results
    The results showed that there was a significant relationship between spiritual intelligence with psychological well-being and having a purpose in life. Furthermore, there was a significant association between the components of spiritual intelligence including conscious state expansion, personal meaning production, transcendental awareness, and critical existential thinking with psychological well-being.
    Conclusion
    High level of spiritual intelligence in nurses helps them to improve their psychological well-being and have a purpose in life, which can lead to the health provision of them and their patients.
    Keywords: Intelligence, Iran, nurses, psychological adaptation, quality of life, spirituality
  • Leila Mardanian Dehkordi, Nahid Shahgholian Page 42
    Background
    Hemodialysis patients are exposed to different stressful factors and have to use coping strategies as supportive processes. The goal of the present study is to investigate coping styles of hemodialysis patients.
    Materials And Methods
    This is a descriptive analytical study conducted on 96 patients referring to hemodialysis centers affiliated to Isfahan University of Medical Sciences in 2011. The data, collected by a questionnaire including two sections of demographic characteristics and patients’ coping with the disease, were analyzed by parametric and non‑ parametric statistical tests.
    Results
    Patients used emotion focused coping strategies more (mean = 20.07, SD = 4.39) to adapt with the disease compared to problem focused coping strategies (mean = 14.65, SD = 5.08). There was a significant association in coping (P = 0.027) and emotion focused dimension (P = 0.008) in various ages, but there was no significant association in problem focused dimension (P = 0.134).
    Conclusion
    Since most of the hemodialysis patients use emotion focused coping styles, it is suggested to consider educational programs on application of problem focused coping styles for these patients in order to decrease the pressures of the disease and treatment, and to promote their mental health, quality of life and efficiency.
    Keywords: Coping, hemodialysis, Iran, renal disease
  • Habibollah Hosseini, Sara Torkani, Khosrow Tavakol Page 47
    Background
    Perceived self‑efficacy is a strong predictor for behavior. Considering the importance of health‑promoting self‑care behaviors in increasing quality of life in the elderly, this study was aimed at defining the effect of nurse home visits on self‑care self‑efficacy of the elderly in rural areas.
    Materials And Methods
    This is a pre and post quasi‑experimental study conducted on 33 older adults randomly selected from five villages in Falavarjan province in Iran. Intervention program was in the direction of self‑care self‑efficacy in four domains including nutrition, health practice, physical activity, and well‑being in the form of five home visit programs and one group session by a nurse during 6 weeks, and included two different sections of education and nursing interventions administered based on needs assessment and determination of the tasks for the clients and their families. Theoretical framework of this study was supported by Bandura’s self‑efficacy, Orem’s self‑care theory, and Pender’s revised health promotion model. The data were collected by self‑care self‑efficacy and demographic information questionnaire before and after the intervention. Data were analyzed by descriptive statistics and paired t‑test.
    Results
    The mean elderly score in the four aforementioned domains increased after the home visit program. A significant difference was seen in the mean total scores of self‑care self‑efficacy and its subscales by paired t‑test before and after intervention (P < 0.001).
    Conclusions
    It was observed that home visit program, integrated with the theories, had a positive influence on improving self‑care self‑efficacy of the elderly, and was supported by Bandura’s theory of self‑efficacy suggesting four sources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. With regard to the importance of self‑care behavior in health promotion of the elderly, multifaceted low‑cost interventions with the highest effect seem essential.
    Keywords: Community health nursing, elderly, home visit, Iran, self‑care, self‑efficacy
  • Narges Majidipour, Zahra Abdeyazdan, Ali Zarghamboroujeni Page 54
    Background
    Infection control should be an integrated part of patient care, especially to ensure safety and survival in hospitalized neonates. Although povidone‑iodine (PVP‑I) solution has been used as the most common antiseptic in hospitals of Iran, chlorhexidine is currently used in some wards for skin disinfection. However, there is no evidence about the superiority of either antiseptic solution over the other one. This clinical trial carried out in two university hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, aimed to compare the effects of chlorhexidine and PVP‑I solutions on skin bacterial colonization in hospitalized neonates.
    Materials And Methods
    The participants were 98 hospitalized infants. In each infant, one area on the skin was disinfected by chlorhexidine while the contralateral site was disinfected by PVP‑I. Skin cultures were taken before and after disinfection. Microorganisms were determined and colony count was performed based on a standard method. The collected data were analyzed using descriptive and inferential statistical methods in SPSS v. 14.
    Results
    The mean of microorganism colony count before and after disinfection by either solution was statistically different (P < 0.001). There was no significant difference between the two groups in terms of mean microorganism colony count before disinfection. However, a significant difference was observed after disinfection.
    Conclusions
    PVP‑I is more efficacious than chlorhexidine for skin disinfection. Consequently, it seems better to use PVP‑I for skin preparation before invasive procedures.
    Keywords: Bacterial infection, chlorhexidine, disinfection, Iran, neonate, newborns, povidone‑, iodine
  • Zahra Tayebi, Nahid Dehghan‑Nayeri, Reza Negarandeh, Shirin Shahbazi Page 59
  • Samereh Abdoli, Parvaneh Abazari, Leila Mardanian Page 65
    Background
    Empowerment of people with diabetes means integrating diabetes with identity. However, others’ stigmatization can influence it. Although diabetes is so prevalent among Iranians, there is little knowledge about diabetes‑related stigma in Iran. The present study explored diabetes‑related stigma in people living with type 1 diabetes in Isfahan.
    Materials And Methods
    A conventional content analysis was used with in‑depth interview with 26 people with and without diabetes from November 2011 to July 2012.
    Results
    A person with type 1 diabetes was stigmatized as a miserable human (always sick and unable, death reminder, and intolerable burden), rejected marriage candidate (busy spouse, high‑risk pregnant), and deprived of a normal life [prisoner of (to must), deprived of pleasure]. Although, young adults with diabetes undergo all aspects of the social diabetes‑related stigma; in their opinion they were just deprived of a normal life
    Conclusion
    It seems that in Isfahan, diabetes‑related stigma is of great importance. In this way, conducting an appropriate intervention is necessary to improve the empowerment process in people with type 1 diabetes in order to reduce the stigma in the context.
    Keywords: Diabetes, disease‑related stigma, Iran, people with diabetes, qualitative research, social stigma
  • Leila Valizadeh, Mahboobeh Namnabati, Vahid Zamanzadeh, Zohreh Badiee Page 71
    Background
    The infants, hospitalized in the neonatal intensive care unit (NICU), engage with problems from admission to discharge, exploring of which ensures their safe transition. The purpose of this study was to identify the factors that influence infant’s transition from the NICU to home.
    Materials And Methods
    A qualitative study was used for identifying the factors that affect infant’s transition. Data were gathered by interviewing 16 nurses and physicians in NICUs of university hospitals in Iran; and were analyzed by qualitative content analysis method. MAXQDA, MAX Qualitative Data Analysis, is a software which has been developed in Berlin, Germany. software, the qualitative data analysis package, was used for coding and categorizing.
    Results
    There are 10 categories that affect infant’s transition, as revealed in data analysis. These categories were delineated into three themes: Cognition of infant’s needs, effectiveness of trainings, and organizational context.
    Conclusion
    The results of this study further disclosed the factors that facilitate or hinder infant’s transition from the NICU to home. The aspects of correct cognition along with more effective trainings must be fully introduced to the staff to meet infant’s needs. Also, authorities are better to make policies to decrease organizational barriers. Therefore, it is suggested that applying developmental care can ease infant’s transition.
    Keywords: Content analysis, infant's need, neonatal intensive care unit
  • Hamid, Reza Khankeh, Davoud Khorasani, Zavareh, Farah Azizi, Naghdloo, Mohammad, Ali Hoseini, Mahdi Rahgozar Page 79
    Background
    Long wait time interval in emergency department (ED) of hospitals, from the patients’ point of view in ED is a major problem causing patients’ dissatisfaction and may result increasing in patient morbidity and indirectly nurses dissatisfaction. Evaluation of wait time intervals in ED and giving nursing feedback may improve the quality of services, as well as patient satisfaction. The present study was designed to investigate the effect of nursing triage on receiving treatment of wait time interval and satisfaction of the patients referring to ED in Shahid Rajaee hospital.
    Materials And Methods
    This study was conducted on patients those referring to Shahid Rajaee hospital in Karaj, Iran employing quasi experimental design d ividing in two experiment and control groups during 2009. This is a quasi‑experimental study of which the data were collected by standard questionnaire covering patient satisfaction and measuring wait time. t‑test, Mann‑Whitney and frequency analysis were used to evaluate the effect of triage on wait time from receiving treatment services and patients’ satisfaction.
    Results
    The findings showed that there was a significant difference between experiment and control groups regarding wait time from receiving treatment services and patients’ satisfaction.
    Conclusions
    Triage could significantly reduce the wait time interval between patients’ entrance to ED to receive treatment services and enhance patients’ satisfaction. It may help nursing in emergency ward to have better performance and indirectly their satisfaction.
    Keywords: Nursing, patient satisfaction, triage, wait time
  • Zahra Royani, Masoud Rayyani, Naser Behnampour, Mansour Arab, Javad Goleij Page 84
    Background
    Patients with end‑stage renal disease (ESRD) who receive dialysis confront the burdens of long‑term illness and numerous physical problems.
    Materials And Methods
    This was a quasi-experimental study. The selected patients from Gorgan Dialysis Centre were randomly assigned into an empowerment group (n = 40) and a control group (n = 40). Instruments comprised scales of Empowerment and the Strategies Used by People to Promote Health (SUPPH). Data were collected at baseline and at 6 weeks following the intervention. The data were analyzed by descriptive and inferential statistics through SPSS (version 17).
    Results
    The results indicate that scores of the empowerment (P ≤ 0.001) and self‑care self‑efficacy (P = 0.003) in the empowerment group showed a significantly greater improvement than the control group.
    Conclusions
    The study supports the effectiveness of the empowerment program to promote empowerment level and self-care self‑efficacy of hemodialysis patients.
    Keywords: Empowerment, end‑stage renal disease, hemodialysis, Iran, nursing, self‑care self‑efficacy