Iranian Journal Of Nursing and Midwifery Research
Volume:18 Issue: 6, Nov-Dec 2013

Fatigue is considered as a major problem in hemodialysis patients and can impair their quality of life. The purpose of this study was to investigate the effectiveness of acupressure on fatigue in hemodialysis patients. This is a clinical trial study in which 96 hemodialysis patients participated. Patients were randomly assigned into acupressure, placebo, and control groups (32 subjects fulfilling the inclusion criteria assigned to each group). The measures included the form of demographic characteristics, visual analog scale of fatigue, and Piper Fatigue Scale. Patients in the acupressure and placebo groups received acupressure intervention during the early 2 h of dialysis on six acupoints with massage for 20 min/day, 3 days per week for 4 weeks. In the placebo group, acupressure intervention was performed as mentioned above with a distance of 1 cm away from the actual intervention site. Patients in the control group received routine unit care only. Chi- quare test, Kruskal-Wallis, paired t-test, one-way analysis of variance (ANOVA), and Duncan test were used for data analysis. One-way ANOVA tests showed significant differences in the total mean score of fatigue and fatigue mean scores in the behavioral, emotional, sensory, and cognitive dimensions in the acupressure, placebo, and control groups. The results of this study showed that acupressure may reduce fatigue in hemodialysis patients, and use of this non-pharmacologic technique for hemodialysis nurses is suggested.

The awareness regarding the contribution of sexual self-concept to healthy sexual well-being is on a rise. The Multidimensional Sexual Self-concept Questionnaire (MSSCQ) was developed to assess the 20 aspects related to sexual selfconcept and has been widely applied in Western societies. The adequacy of its application in Iran has not been determined in order to guaranty its reliability and validity. An attempt was made here to interpret this questionnaire in Farsi and adopt it in Iran with respect to psychometric properties of the native youth. A cross-sectional design was employed and 352 couples were recruited from a premarital consulting center in Isfahan, Iran on a random basis. The MSSCQ was translated into Farsi and back-translated by four bilingual scholars. Face and content validity of the questionnaire was determined. Internal consistency was evaluated by applying Cronbach’s alpha. Pearson correlation coefficient was employed. The adopted model was tested through confirmatory factor analysis using SPSS-AMOS software (version 16). The mean age of couples was 25.68 years (women 23.92 ± 2.92 years and men 27.44 ± 3.14 years). The obtained Cronbach’s alpha was 0.88. Twenty-two items with an impact score below 1.5 and content validity index <0.70 were omitted. Pearson correlation showed positive and negative correlations among the dimensions. Sexual anxiety, fear of sex, and sexual depression had negative correlation with the other dimensions (r = −0.36, r = −0.43, r = −0.32, respectively). The model exhibited adequate fitness: c2/df= 4.95, goodness-of-fit index = 0.95, adjusted goodness-of-fit index = 0.91, normed fit index = 0.94, comparative fit index = 0.95, and root mean square error of approximation = 0.07. The Farsi version of MSSCQ with 78 items is valuable and reliable to be applied on the youth in Isfahan. This questionnaire was verified under two main categories through confirmatory factor analysis: negative sexual self-concept and positive sexual self-concept.

Culturally specific care requires that nursing students know, understand, and identify cultural factors related to client care, and conduct their nursing practice accordingly. The aim of this study was to identify the cultural self-efficacy of baccalaureate nursing students in a Greek University. In this cross-sectional study, a Transcultural Self-Efficacy Tool was used as a framework, to examine transcultural practices of Greek nursing students. A questionnaire was administered to a sample of students at a Greek Nursing Faculty, and 136 questionnaires returned (Response Rate: 87%). Neither group, i.e., freshmen and senior (4th) year students of a Greek Nursing Faculty, expressed confidence in their ability to care for culturally-diverse patients. Mean scores for the three subscales were higher for senior students (cognitive m = 7.17, practical m = 6.76, affective m = 7.77) than for freshmen students (cognitive m = 6.96, practical m = 6.60, affective m = 7.43) making year of studies a characteristic that was found to be statistically important. A medium level of self-efficacy was found for the two subscales; cognitive (72%, n = 39; 78%, n = 62), practical (52%, n = 26; 48.8%, n = 4), and for the affective subscale the level of self-efficacy was found high (78%, n = 39; 82.6%, n = 71) in freshmen year and senior students. Results suggest that freshmen students exhibited a lack of confidence asking patients from different cultural backgrounds, questions about their own cultural heritage and beliefs while senior students appreciated cultural sensitivity and awareness and therefore confirmed the value of skilled nursing care.

The performance of the community health nurse depends on a combination of scientific and practical competencies acquired by educational experiences during the nursing course. Curriculum planners of nursing education need to understand nursing education to train professional and community-oriented nurses. The aim of this article is to explore the experiences of nursing students during their community health nursing clinical clerkship courses. A grounded theory approach was used to conduct this study. Twelve nursing students, 13 health-care staff members, and 10 nursing instructors were interviewed individually in 2011-2012. The interviews were tape-recorded and later transcribed verbatim. The transcriptions were analyzed using the method of Strauss and Corbin. Ambivalence of motivation was the main category and included five subcategories: Professional identity, educational atmosphere, educational management, motivation-based approaches, and inadequate productivity. This paper presents the aspects of the community health nursing clerkship course from the viewpoint of students in areas such as the role of the community health nurse, attitude toward the course, medical orientation, prerequisite skills/knowledge, poor administrative planning, rotation of students, insufficient activity for students, passiveness, providing service to clients, responsibility, and inproductivity. These categories could explain the nature of the community health nursing clerkship of the Mashhad Faculty of Nursing and probably others in Iran. The findings revealed inadequate productivity of the community health nursing education; so, it is suggested to define a position for nurses in this setting and remove barriers and provide conditions for them to play more important roles in the promotion of community health.

Pre-eclampsia (PE) is a pregnancy associated disorder characterized by hyper-tension and proteinuria. The first 2 stages of PE cause dysfunction in uteroplacental perfusion and oxidative stress while the third stage of PE is due to the release of inflammatory and angiogenic factors, which could lead to maternal endothelial damage and systemic inflammatory response. In this study, we compared the serum levels of tumor necrosis factor-α (TNF-α), interleukin-15 (IL-15), and interleukin-10 (IL-10)in PE and normotensive women. Serum samples of 84 pregnant women (44 PE and 40 normotensive) were evaluated for TNF-α, IL-15 and IL-10 by sandwich ELISA assay. The women with PE showed significantly higher serum levels of TNF-α and IL-15 (P = 0.001 and 0.01 respectively) in comparison with normotensive pregnant women. Conversely, the serum levels of IL-10 in normotensive women were significantly higher compared to PE patients (P = 0.01). The results of this study demonstrated that inflammatory T helper 1-type responses are increased in PE women compared to normotensive pregnant women.

Student-teacher relationship is a salient issue in nursing education and has long-lasting implication in professional development of nursing students. Nowadays, this relationship in clinical settings is different from the past due to changing in nursing education paradigm. The purpose of this qualitative study was to explore the experiences of students and teachers about student-teacher relationship in the context of clinical nursing education in Iran. In this qualitative study that has been carried out adopting conventional qualitative content analysis approach, six bachelor nursing students and six clinical teachers in school of Nursing and Midwifery, were selected through purposive sampling. Semi-structured interview and participant observation were used for data collection. Interviews transcribed verbatim and analyzed using conventional content analysis through the process of data reduction and condensation, coding and also generating the categories and themes. Results of the study showed the existence of a type of relationship in clinical education in which supportive actions of clinical teachers were prominent. These supportive actions appeared as three major categories including educational support, emotional support and social support which emerged from data. The results of this study explicit the ways that support could be provided for students in their relationship with clinical teachers. It also determines the teachers’ need to know more about the influence of their supportive relationship on students’ learning and the best possible outcomes of their education in clinical settings.

Care of brain dead donors is complex, critical, and sensitive and has a direct and positive impact on the end result of organ and tissue transplantation process. This study describes the nurses’ experiences of care of brain dead donors in intensive care units (ICU). This research was performed by phenomenological method that is a qualitative approach. Purposive sampling was used to gather the data. The researcher reached to data saturation by deep interviews conducted with eight participants from ICU nurses in Isfahan hospitals who cooperated in care of brain dead donors. Data analysis was performed according to Colaizzi analysis method. Interviews were analyzed and the results of analysis led to “Excruciating tasks” as the main theme formed by psychological effects of facing the situation, heavy and stressful care, defect of scientific knowledge, conflict between feeling and duty, outcome of attitude change in behavior, emotional responses to perceived psychological afflictions, doubt to medical diagnosis, spiritual perceptions, and biological responses when faced with the situation. Caring of brain dead organ donors is difficult and stressful for intensive care nurses and can be a threat for nurses’ health and quality of nursing care. So, providing suitable physical, mental, and working conditions is necessary to make suitable background to maintain and increase nurses’ health and quality of care and effective cooperation of this group of health professionals in organ procurement process.

Several studies have established that all nurses need continuing education, especially those who are working in oncology wards. In the current programs, there are just two general patterns for teaching: Teacher-centered and student-centered patterns. In this study, the effect of teacher-centered (lecture) and student-centered (module) teaching methods in relation to safety standards with cytotoxic drugs on the knowledge and practice of oncology nurses was compared. This research was a quasi-experimental study with two intervention groups (module and lecture) and a control group. In this study, 86 nurses in Shiraz, Fars province in 2011, who participated in the prescription of cytotoxic drugs to patients were selected and randomly divided into three groups. The module group used a self-directed module, the lecture group was taught by an experienced lecturer in the classroom and the control group did not receive any intervention. Data in relation toknowledge and practice of oncology nurses in the three groups were collected before and 8 weeks after the intervention by using a questionnaire and checklist. To analyze the data paired-samples t-test and one way ANOVA analysis were used. Knowledge and practice scores increased significantly from baseline in both intervention groups, but there was no significant difference between the scores of the two groups. No considerable changes were observed in the control group. Both module and lecture methods have similar effects on improving the knowledge and practice of nurses in oncology wards. Therefore, considering the advantages of student-centered educational methods, the work load of nurses and the sensitivity of their jobs, we suggest using module.

Underutilization of mental health care services has been a challenge for the health care providers for many years. This challenge could be met in part by improving the clients’ readiness to use such services. This study aimed to introduce the important aspects of the clients’ readiness to use mental health services in the Iranian context. A thematic analysis of in-depth interviews was undertaken using a constant comparative approach. Participants (11 health professionals consisting of 3 physicians, 7 nurses, 1 psychologist, and 5 patients/their family members) were recruited from educational hospitals affiliated with Isfahan University of Medical Sciences, Iran. The credibility and trustworthiness was grounded on four aspects: factual value, applicability, consistency, and neutrality. The study findings uncovered two important aspects of the clients’ readiness for utilizing mental health care services. These are described through two themes and related sub-themes: “The clients’ awareness” implies the cognitive aspect of readiness and “the clients’ attitudes” implies the psychological aspect of readiness, both of which have perceived to cultivate a fertile context through which the clients could access and use the mental health services more easily. For the health care system in Isfahan, Iran to be successful in delivering mental health services, training programs directed to prepare service users should be considered. Improving the clients’ favorable attitudes and awareness should be considered.

Vaccination is one of the most common painful procedures in infants. The irreversible consequences due to pain experiences in infants are enormous. Breast feeding and massage therapy methods are the non-drug methods of pain relief. Therefore, this research aimed to compare the vaccination-related pain in infants who underwent massage therapy or breast feeding during injection. This study is a randomized clinical trial. Ninety-six infants were allocated randomly and systematically to three groups (breast feeding, massage, and control groups). The study population comprised all infants, accompanied by their mothers, referring to one of the health centers in Isfahan for vaccination of hepatitis B and DPT at 6 months of age and for MMR at 12 months of age. Data gathering was done using questionnaire and checklist [neonatal infant pain scale (NIPS)]. Dataanalysis was done using descriptive and inferential statistical methods with SPSS software. Findings of the study showed that the three groups had no statistically significant difference in terms of demographic characteristics (P > 0/05). The mean pain scores in the breast feeding group, massage therapy, and control group were 3.4, 3.9, and 4.8, respectively (P < 0.05). Then the least significant difference (LSD) post hoc test was performed. Differences between the groups, i.e. massage therapy and breast feeding (P = 0.041), breast feeding group and control (P < 0.001), and massage therapy and control groups (P = 0.002) were statistically significant. Considering the results of the study, it seems that breast feeding during vaccination has more analgesic effect than massage therapy. Therefore, it is suggested as a noninvasive, safe, and accessible method without any side effects for reducing vaccination-related pain.

The postpartum period is a critical life event for women leading physical, emotional, and social changes. Postpartum quality-of-life may be affected by delivery mode. The purpose of this study was to determine the association between postpartum health related quality-of-life (HRQoL) and mode of delivery. In a prospective study, 300 women consisting of 150 vaginal deliveries (VD) and 150 cesarean sections (CS) were recruited between August 2007 and October 2008 from health centers. Stratified random sampling was performed to select 10 Health Centers in Kashan City, Iran. Physical and mental HRQoL was measured using the SF-36 questionnaire and compared between VD and CS groups 2 and 4 months after delivery. Data were analyzed by using the Student’s t-test, Mann– Whitney U-test, and Chi-square test. Results showed physical HRQoL at 2 months after VD was better than CS significantly; there were significant differences in the physical functioning and role physical subscales. Furthermore mental HRQoL at 4 months after VD was better than CS significantly; there were significant difference in the social function and emotional health subscales. The findings demonstrated that VD leads to a better physical health at 2 months after delivery and mental health at 4 months after delivery. Efforts should be made to reduce CS.

Collaborative methods of learning in the university have been a successful and the main aspects of the students’ engagement. The purpose of this study was to determine university engagement and collaborative learning in nursing students of Kerman University of Medical Sciences. This research was a descriptive correlation study on a total of 238 nursing students with different levels of education were asked to fill four subscales of the modified National Survey of Student Engagement (NSSE) tool with a total of 40 items. NSSE reliability was confirmed by Cronbach’s alpha (r = 0. 78). The NSSE instrument relies on a students’ self-reports tool. Data were analyzed with descriptive and analytical statistics by SPSS version 16. Means scores of university engagement in nursing students was 96. 6 ± 19. 07. There was a significant positive correlation in components including active and collaborative learning (ACL) level، students’ level of academic challenge (LAC) as well as student faculty interaction (SFI)، supportive campuses environment and enriching educational experiences (EEE) with total score of university engagement (P < 0. 05). Findings in this study showed that university engagement level in nursing students is moderate and there is a significant association between the model of teaching and ACL، and LAC and EEE.

Hemodialysis, as the main remedy of chronic renal failure, can cause mental problems among patients receiving this treatment. These clients face depression because of being treated long-term and invasive therapeutically methods. This is a descriptive-analytical study in which 171 patients receiving hemodialysis. They were divided in to those ones suffering from syndrome and the second group without syndrome. The results showed that the depression average grade was 47.31 ± 11.60 and 43.15 ± 10.3, in the first and the second group. This was a significant relation. Being high level of depression among these patients who suffering from restless leg syndrome, its suggested monitoring depression level intermittently.vital signs and decrease serum cortisol level in patients undergoing gynecological elective surgeries.