فهرست مطالب

Iranian Journal Of Nursing and Midwifery Research
Volume:22 Issue: 1, Jan-Feb 2017

  • تاریخ انتشار: 1396/01/17
  • تعداد عناوین: 16
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  • Armin Zareiyan Pages 1-7
    Introduction
    Identifying what adolescents perceive as their lifestyle and exploring the factors persuading their decisions to engage in or avoid healthy or unhealthy lifestyle behaviors could improve the ability of healthcare professionals to develop innovative preventive strategies and modify negative health behaviors in adolescents. Hence, the literature on adolescent health‑related issues reported by adults showed a rarity of information from adolescents themselves.
    Materials And Methods
    A qualitative study using the thematic analysis approach was conducted. Data were collected by semi‑structured, digitally recorded interviews from 32 male adolescents. Interviews were transcribed verbatim, and after collecting the data, the thematic analysis process was started and conducted in six phases.
    Results
    After data collection, the interview texts were transcribed, and approximately 800 initial codes were extracted. The initial codes were reevaluated to yield 48 main themes. Hence, the final thematic map was created as having 5 overarching themes and 12 subthemes, showing that interviewees emphasized unhealthy lifestyle.
    Conclusions
    The components of unhealthy lifestyle seem important to them because they consider that they could lead a healthy lifestyle through elimination of negative behaviors.
    Keywords: Adolescent, Iran, lifestyle, qualitative research
  • Samaneh Nakhaee, Ahmad Nasiri Pages 8-13
    Introduction
    Nurse–physician inter‑professional relationship is an important issue in health care system that can affect job satisfaction and patient care quality. The present study explores the major issues of nurse–physician inter‑professional relationships in Iran.
    Materials And Methods
    In this in‑depth qualitative content analysis study conducted in 2014, 12 participants (5 physicians and 7 nurses) were recruited from two educational hospitals. The data were collected from deep, open, and unstructured interviews, and analyzed based on content analysis.
    Results
    The participants in this study included 12 individuals, 6 females and 6 males, with the age ranging 27–48 years and tenure ranging 4–17 years. Four themes were identified, namely, divergent attitudes, uneven distribution of power, mutual trust destructors, and prudence imposed on nurses.
    Conclusions
    The results revealed some major inter‑professional issues and challenges in nurse–physician relationships, some of which are context‑specific whereas others should be regarded as universal. It is through a deep knowledge of these issues that nurses and physicians can establish better collaborative inter‑professional relationships.
    Keywords: Inter-professional relations, Iran, nurses, physicians, qualitative research
  • Marzieh Yousefi, Zahra Abdeyazdan, Soheila Ehsanpour Pages 14-18
    Introduction
    Birth weight is one of the most important indicators of infant’s health and could predict their health condition in future. This study was conducted to determine and compare indicators of growth [weight, height, and body mass index (BMI)] and behavioral disorders in children with normal, low, and very low birth weight at pre‑school age.
    Materials And Methods
    In this descriptive analytical study, 236 children (126 with normal weight, 100 with low birth weight, and 10 with very low birth weight) at pre‑school age were investigated in three groups. Data collection tools were a two‑part questionnaire including the Rutter Children Behavior Questionnaire for parents, and parents’ and children’s demographic characteristics questionnaire, scale, and stadiometer. Data were analyzed using descriptive statistics, variance analysis, Chi square, and Kruskal–Wallis tests.
    Results
    The mean of weight, height, and BMI at pre‑school age in three groups had a significant difference (P = 0.009) and it was lower in the group with very low birth weight than the other two groups; however, the difference between the group with normal birth weight and the group with low birth weight was not significant (P = 0.10). The mean score of behavioral disorder had no significant difference between groups (P = 0.49).
    Conclusions
    Results showed that children with very low birth weight grew less than the other two groups. Therefore, this group needs special attention and long‑term follow‑up for taking care of them to ensure better growth. It is recommended to conduct
    more extended studies to evaluate behavioral disorders in these children.
    Keywords: Child behavioral disorder, growth, Iran, low birth weight, very low birth weight
  • Ahmadreza Yazdannik, Alireza Yousefy, Sepideh Mohammadi Pages 19-25
    Introduction
    Understanding how academic dominant discourse is implicated in the shaping of nursing identity, professional aspirations and socialization of nursing students is useful as it can lead to strategies that promote nursing profession.
    Materials And Methods
    This is a qualitative research conducted through discourse analysis approach. Semi‑structured interviews, focus group, and direct observation of undergraduate theoretical and clinical courses were used to collect the data. Participants were 71 nursing students, 20 nursing educators, and 5 nursing board staffs from five universities in Iran.
    Results
    Data analysis resulted in the development of four main themes that represent essential discourses of nursing education. The discourses explored are theoretical and scientific nursing, domination of biomedical paradigm, caring as an empty signifier, and more than expected role of research in nursing education discourse.
    Conclusions
    The results indicated that academics attempt to define itself based on “scientific knowledge” and faculties seek to socialize students by emphasizing the scientific/theoretical basis of nursing and research, with the dominance of biomedical discourse. It fails to conceptually grasp the reality of nursing practice, and the result is an untested and impoverished theoretical discourse. The analysis highlights the need for the formation of a strong and new discourse, which contains articulation of signifiers extracted from the nature of the profession.
    Keywords: Baccalaureate nursing, discourse analysis, nursing education, nursing student
  • Maryam Rezaeyan, Mehrnaz Geranmayeh, Ashraf Direkvand Moghadam Pages 26-30
    Introduction
    Transcutaneous electrical nerve stimulation (TENS) through the skin is a nonpharmacological method of pain relief. The present study aimed to compare TENS and lidocaine on episiotomy complication in primiparous women.
    Material and
    Methods
    In a randomized, controlled clinical trial, 80 participants were included from March to July 2011 at the antenatal clinic and postdelivery ward in the Social Security Organization Hospital, Khorramabad, Lorestan, Iran. Data were collected using a demographic questionnaire, visual analog scale and redness, edema, ecchymosis, discharge, and approximation scales. The participants were randomized into two groups with equal number of participants. All participants received 5 cc of local infiltration of 1% lidocaine before episiotomy, and TENS electrodes were placed on He Gu and Shenmen points during the crowning of fetal head. The TENS group received TENS with 100; 250 µs, the output range of 15–20 mm amplifier from crowning of first stage of labor to the end of the episiotomy repairing. The lidocaine group received 10 cc of local infiltration of 1% lidocaine before episiotomy repair while did not receive TENS electrodes. The pain intensity during and after episiotomy repair was recorded.
    Results
    TENS and lidocaine have similar effects on pain relief at the episiotomy cutting, the start of the episiotomy repair, and at end of the episiotomy repair; however, the pain relief of both the interventions was different during the episiotomy repair. The effect of TENS in reducing edema was statistically significant (P = 0.001).
    Conclusions
    TENS and lidocaine are effective for the episiotomy complications during and after episiotomy repair.
    Keywords: Analgesia, episiotomy pain relief, Iran, transcutaneous electrical nerve stimulation), visual analog scale
  • Saiede Masomeh Tabaeian, Ahmadreza Yazdannik, Saeed Abbasi Pages 31-36
    Introduction
    Ventilator‑associated pneumonia (VAP) is the most common infection in the intensive care unit, and has many side effects such as increased mortality, increased length of hospital stay, and increased health costs. This study aimed to evaluate the compliance with the standards for prevention of VAP by nurses in the intensive care units.
    Materials And Methods
    In this descriptive cross‑sectional study, 120 nurses in 11 intensive care units of hospitals affiliated to Isfahan university of Medical Sciences, Iran, were assessed for 4 months from July to October 2014. The implementation of all measures for the prevention of VAP was investigated through observation and using a checklist.
    Results
    The mean compliance with the standards for the prevention of VAP in the intensive care unit by the nurses was 56.32%; analysis of variance test showed significant difference between the hospitals (P
    Conclusions
    Compliance with the standards for the prevention of VAP in the intensive care units was relatively acceptable; however, it still requires serious attention by the officials with training and sensitization of nurses in implementing preventive measures, especially through the provision of clinical guidelines and related protocols.
    Keywords: Intensive care unit, Iran, ventilator, associated pneumonia
  • Forogh Okhovat, Zahra Abdeyazdan, Mahboobeh Namnabati Pages 37-40
    Introduction
    Child’s hospitalization for surgery is a source of anxiety for the child and the family that persists for a long time after discharge. Therefore, it is necessary to provide appropriate solutions in this regard. This study aimed to investigate the effect of implementation of continuous care model on anxiety in mothers of children discharged from pediatric units of educational hospitals of Isfahan University of Medical Sciences in 2016.
    Materials And Methods
    In this quasi‑experimental study, 64 mothers of children hospitalized in surgical units were categorized in two groups (experimental and control). The intervention was a continuous care model including orientation, sensitization, follow up, and evaluation stages. We used Spielberg’s Anxiety Questionnaire to assess mothers’ anxiety before, 1 week, and 1 month after the intervention. Data were analyzed using descriptive statistics, (t‑test and analysis of variance) using the Statistical Package for the Social Sciences version 16.
    Results
    The results of the study showed that the mean anxiety scores of the experimental group were 58.9, 36, and 31.4, respectively, before, 1 week, and 1 month after the intervention (P
    Conclusions
    Based on the results, use of the continuous care model led to a decrease in mothers’ anxiety during their children’s discharge from the pediatric surgery units. Therefore, we suggest the implementation of this model in pediatric units.
    Keywords: Anxiety, continuous care, Iran, mothers, patient discharge, pediatric, surgical
  • Fariba Taleghani, Elaheh Ashouri, Morteza Saburi Pages 41-45
    Introduction
    Development of nurse–patient empathic communication in the oncology ward is of great importance for the patients to relieve their psychological stress, however, nursing care of cancer patients is accompanied with high stress and burnout. The present study aimed to define the level of empathy and its association with burnout and some demographic characteristics of oncology nurses.
    Materials And Methods
    This descriptive/correlation study was conducted in a professional cancer treatment center in Isfahan. Through census sampling, 67 oncology nurses were selected. The data collection tools were Jefferson Scale of Nursing Empathy, Maslach Burnout Inventory, and demographic characteristics questionnaire.
    Results
    Mean nurses’ empathy and overall burnout scores were 62.28 out of 100 and 38.8 out of 100, respectively. Score of empathy showed an inverse correlation with overall burnout score (r = −0.189, P = 0.04), depersonalization (r = −0.218, P = 0.02), and personal accomplishment (r = −0.265, P = 0.01). Multiple regression test was used to detect which dimension of burnout was a better predictor for the reduction of empathy score. Results showed that the best predictors were lack of personal accomplishment (P = 0.02), depersonalization (P = 0.04), and emotional exhaustion (P = 0.14), respectively. The most influential demographic factor on empathy was work experience (r = 0.304, P = 0.004). One‑way analysis of variance showed that official staff had a higher empathy score (f = 2.39, P = 0.045) and their burnout was lower (f = 2.56, P = 0.04).
    Conclusions
    Results showed a negative relationship between empathy and burnout in oncology nurses. Therefore, nursing support from managers to reduce burnout increases empathic behavior of nurses.
    Keywords: Burnout, cancer, empathy, Iran, nurses, oncology nursing, patient-nurse relationship
  • Hajar Dadkhah, Ashraf Kazemi, Mohammad Hossien Nasr Isfahani, Soheila Ehsanpour Pages 46-50
    Introduction
    Infertility in men is one of the current problems of human society. Some studies suggest that the metabolic status of a man, including cholesterol intake, closely correlates with sperm function. The aim of this study was to evaluate the correlation between saturated fat intake and semen quality among men referring to the Isfahan Fertility and Infertility Center, Iran.
    Materials And Methods
    This cross‑sectional study was conducted on all men who referred to the Isfahan Fertility and Infertility Center. The study population consisted of 120 men selected through simple random sampling. The data collection tool consisted of a two‑part questionnaire including a demographic and anthropometric characteristics form and the Food Frequency Questionnaire (FFQ). The FFQ consists of 168 items that assess food and nutrient intake for 3 months. The reliability and validity of the instruments were confirmed in previous studies. Semen analysis was performed using computer‑aided semen analysis (CASA) method. Descriptive statistics and logistic regression test were used to analyze the data.
    Results
    Results showed that the chances of having semen volume of higher than 1.5 ml (normal volume) increased by 27.5% for every 1 g increase in total fat (CI: 1.11–1.46) (P = 0.001) and reduced 38% for every 1 g increase in saturated fat (CI: 0.42–0.90, P = 0.010). No association was found between semen quality and intake of dietary fats.
    Conclusions
    Based on the findings of this study and the prevalence of infertility in recent decades, changes in diet and saturated fatty acids intake may improve semen quality.
    Keywords: Diet, food frequency questionnaire, Iran, semen quality
  • Zahra Zandiyeh, Elaheh Zare, Tayebeh Mehrabi, Mansour Shiri Pages 51-56
    Introduction
    Improving the health of the elderly must be based on their special needs that can be achieved through self‑needs assessments through education, which is one of the most important tools in the field of health improvement. The aim of the present study was to evaluate the effect of need‑oriented educational interventions on the general health of the elderly living in nursing homes.
    Materials And Methods
    The present study is a clinical trial conducted among the elderly living at the Sadeghieh nursing home of Isfahan, Iran. Seventy elderly people who satisfied the inclusion criteria were selected and divided into two groups of case and control. The case group went through 8 sessions of group therapy for educating participants who were previously investigated through needs assessment. The control group received the usual health care. The general health level of the participants was evaluated before and 1 week and 1 month after the intervention using Goldberg’s general health questionnaire. Data were analyzed using Chi‑square test, independent t‑test, paired t‑test, Mann–Whitney test, and variance analysis.
    Results
    The score of general health had no significant difference between both the groups before the intervention, however, the difference in the score between both the groups 1 week and 1 month after the intervention was significant (1 week after the intervention, the scores were 15.6 and 30.3, and 1 month after the intervention, the scores were 16 and 32.2, respectively) (P
    Conclusions
    Need‑oriented educational intervention is an effective, safe, and inexpensive method for improving the general health of the elderly living in nursing homes.
    Keywords: Education, elderly, general health, needs assessment
  • Ahmadali Eslami, Seyde Sharbanoo Daniali, Karim Mohammadi, Negar Reisi Dehkordi, Firoozeh Mostafavi Darani Pages 57-61
    Introduction
    Self‑efficacy is an essential factor for effective self‑management in chronic‑disease patients. Therefore, the measurement of self‑efficacy with a valid and reliable instrument is required. In this study, cultural adaptation and psychometric properties of the Persian version of “Self‑Efficacy for Managing Chronic Disease” (SES6G) are illustrated in a sample of Iranian chronic‑disease patients.
    Materials And Methods
    This was a cross‑sectional study in which translation and backward translation was performed by bilingual translators. The final version of the Persian scale was assessed to determine the content validity index (CVI) and the content validity ratio (CVR). A panel of experts reviewed items of the scale. Factor analysis was performed for the final version of the Persian scale to assess internal consistency and construct validity among chronic‑disease patients attending government health care centers from March 2015 to June 2015 in Isfahan, Iran (n = 483).
    Results
    CVI and CVR scores were 0.87 and 0.89, respectively. There were no eliminated items in the cross‑cultural adaptation process. Internal consistency met the criterion for a reliable measure (Cronbach’s alpha = 0.89). An initial factor analysis produced a one‑dimensional scale (6 items) with Eigenvalues more than 1 that explained 69.49% of the extracted variance.
    Conclusions
    The SES6G is a reliable and valid instrument to assess patients’ self‑efficacy for managing chronic diseases in Persian language. Because the self‑efficacy score determines the educational strategies to have effective educational programs, the use of this simple and brief scale could be considered among Persian patients.
    Keywords: Iran, nurses, psychological adaptation, psychometric, self-efficacy
  • Zohre Ahmadi, Shahnaz Torkzahrani, Firouze Roosta, Nezhat Shakeri, Zohre Mhmoodi Pages 62-66
    Introduction
    One of the important tasks in managing labor is the protection of perineum. An important variable affecting this outcome is maternal pushing during the second stage of labor. This study was done to investigate the effect of breathing technique on perineal damage extention in laboring Iranian women.
    Materials And Methods
    This randomized clinical trial was performed on 166 nulliparous pregnant women who had reached full‑term pregnancy, had low risk pregnancy, and were candidates for vaginal delivery in two following groups: using breathing techniques (case group) and valsalva maneuver (control group). In the control group, pushing was done with holding the breath. In the case group, the women were asked to take 2 deep abdominal breaths at the onset of pain, then take another deep breath, and push 4–5 seconds with the open mouth while controlling exhalation. From the crowning stage onward, the women were directed to control their pushing, and do the blowing technique.
    Results
    According to the results, intact perineum was more observed in the case group (P = 0.002). Posterior tears (Grade 1, 2, and 3) was considerably higher in the control group (P = 0.003). Anterior tears (labias) and episiotomy were not significantly different in the two groups.
    Conclusions
    It was concluded that breathing technique of blowing can be a good alternative to Valsalva maneuver in order to reduce perineal damage in laboring women.
    Keywords: Breathing technique of blowing, delivery, laboring women, perineal lacerations, pelvic floor muscle
  • Fatemah Nahidi, Nafiseh Gazerani, Parsa Yousefi, Ali Reza Abadi Pages 67-71
    Introduction
    Infantile colic is a painful condition in the first months of infancy. This study was carried out with the aim of testing the hypothesis that massage treatment has a clinically relevant effect on this condition.
    Materials And Methods
    This randomized clinical trial was conducted among 100 infants of
    Results
    Significant differences were not observed in infant and mother demographic information. Before intervention, the mean of total number, length, and severity of crying were 6.12 (1.76) time/day, 4.97 (1.37) hour/day, and 6.60 (1.54) in the massage group and 6.96 (2.9) time/day, 3 (1.31) hour/day, and 5.98 (2.22) in the rocking group, respectively. After 1 week of intervention, the mean difference of total number, length, and severity of crying were 4.08 (1.83) time/day, 2.81 (1.77) hour/day, and 2.9 (2.37) in the massage group and 0.56 (2.28) time/day, 0.27 (1.09) hour/day, and 0.02 (1.64) in the rocking group, respectively.
    Conclusions
    This trial of massage treatment for infantile colic showed statistically significant or clinically relevant effect in comparison with the rocking group.
    Keywords: Colic, infant, massage, rocking
  • Razie Rasti Emad Abadi, Abbas Naboureh, Morteza Nasiri, Nilofar Motamed, Faezeh Jahanpour Pages 72-77
    Introduction
    Parental presence during induction of anesthesia (PPIA) has been a controversial issue, with some studies showing its effects on reducing anxiety. Hence, this study aimed to investigate the effects of PPIA on preoperative anxiety of children as well as their parents.
    Materials And Methods
    This clinical trial was conducted among 60 children aged 2–10 years and their parents. Children were randomly assigned to intervention (n = 30) and control (n = 30) groups. Children in the control group were taken to the operating room (OR) alone, while those in the intervention group were taken to the OR with one of their parents. When the anesthetic mask was placed on the children’s face (induction), the children’s preoperative anxiety in both groups was assessed using Modified‑Yale Preoperative Anxiety Scale (M‑YPAS), and after that the parents in the intervention group were escorted to the waiting area. Parents’ anxiety in both the groups was measured by the Spielberg State‑Trait Anxiety Inventory (STAI) in the waiting area. Data were analyzed using descriptive and inferential (independent t‑test and Chi‑square test) statistic methods through the Statistical Package for the Social Sciences version 18 software.
    Results
    Results showed no significant difference between children’s anxiety in the intervention (70.83) and control (70.39) groups in the preanesthetic period. In addition, no significant difference was seen between the intervention (79.23) and control (85.86) groups regarding total parents’ anxiety.
    Conclusions
    PPIA was not successful in reducing the children’s preoperative anxiety as well as parents’ anxiety. Future studies in this area are needed to clarify the effects of this intervention in pediatric populations.
    Keywords: Anesthesia, anxiety, children, parental presence, preoperative care
  • Prasuna Jelly, Rakesh Sharma Pages 78-80
    Introduction
    Nurses are trained with specific clinical skills, and objective structured clinical examination (OSCE) could be a better approach to assess clinical skills of nursing students.
    Materials And Methods
    A comparative study was conducted by observational checklist regarding antenatal care and opinionnaire on the usefulness of OSCE and tradition evaluation method (TEM) was used to assess the clinical skills and to get opinion.
    Results
    The mean score of OSCE was more than TEM and the difference was statistically significant (P
    Conclusions
    The study concluded that implementing OSCE will overweigh the advantages of the TEM.
    Keywords: Clinical skills, India, nursing students, OSCE, traditional examination method
  • Saurabh R. Shrivastava, Prateek S. Shrivastava, Jegadeesh Ramasamy Pages 81-82