نشریه مراقبت امروز
پیاپی 6-7 (بهار و تابستان 1386)

Acute urinary retention (AUR) is identified by inability to void and lower abdominal pain. This problem generally occurs following surgery or cardiac catheterization and needs to be solved through urinary catheterization, the risk of urinary tract infections needs non invasive precautions. The aim this study was to determine the effect of external use wet gas on relieving acute urinary retention in male patients following cardiac catheterization. A descriptive-analytic design was used to conduct this study.The sample consisted of 31 male patients with AUR following cardiac catheterization. After applied a gas was immersed in tepid water on symphysis pubis area elimination or relieving of AUR and it,s duation was assessed. After applying the wet gas on symphysis pubis area AUR was eliminated in 22 patients (71%). The mean time of elimination of AUR in patients was 16.63 minutes. According to the findings, the researchers recommend nurses to use gas soaked in tepid water as a solution for AUR in male patients following cardiac catheterization.

Traumatic birthing experience can superpose the mother in dangerous of creation posttraumatic mental disorder such as depression. The present study's aim was determining the effect of midwifery counseling intervention on depression after traumatic childbirth of prim: parous women. In a randomized control trial, of 324 primiparous women in gestational 3 d trimester that had inclusion criteria 180 experienced traumatic childbirth on DSM-IV criteria. This samples were randomlydivided into an intervention (n = 90) and control (n= 90) group. All women in two groups were similar in demographic characteristics, pregnancy complications and social support level. Also There was no significant difference between two groups in maternity social support level depression, stress, and anxiety grades average before intervention (P>0/05. (The intervention group received midwifery counseling during two sessions and control group just received usual care after childbirth. Data collection devices included exclusion and inclusion criteria, demographic information details of their reproductive history, Edinburg postnatal scale,depression,anxiety and stress scale 21 and Maternal social support scale. Both of them were followed up with partial – blind technique and compared 4 to 6 weeks and 3 months post partum. The data were analyzed by using descriptive and inferential statistics by SPSS software. There was significant differences between two groups in depression grades average at 4 to 6 weeks (P= 0.001(and 3 months (P= 0.001(follow-up. Findings of this research shows that performing counseling program by midwife could have significant effect on decreasing of depression rate after traumatic childbirth.

Multiple Sclerosis is a demyelinating progressive disease which afflicts central nervous system. The cause remains uncertain but various factors such as history of infectious diseases, defective immune system, stress, tension and nvironmental factors may contribute to this disease. As a chronic disease with sudden and npredictable attack, MS results in various stresses in patients’ lives. This stud was done to determine the stress rate in Multiple Sclerosis patients admitted to MS association in Iran. This study was a descriptive explorative study. Through sequential sampling 600 patients suffering from MS were selected and were introduced to the research procedure employed in this research. Coudron stress test was used to gathering data, the patients filled out questionnaires. 61.2 percent of the patients were suffering from stresses at life health level. Also, 76.3 percent had stressful context in their private lives. Findings showed a significant relationship between the rate of stress at life health and private life levels and employment status (p=0.00). Since the findings of this research show high stress in patients’ lives, sources of stress should be identified and suitable instructions should be provided to control such sources of stress and/or to help patients adopt themselves with the stresses associated with MS in order to improve patients’ quality of life.

one of the success’ secrets for nursing leaders in health organizations is to empower nurses. Head nurses’ empowering behaviors consists: creating meaningfullness of work, Participation nurses in decision making, expressing confidence in high performance, facilitating goals and festering autonomy and freedom all of which behaviors induce to perception of empowerment by nurses. The perception of empowerment increases autonomy, promots quality of care, increases satisfaction and decrease professional tensions. The aim of this study was to determe the nurses’ perception of their head nurses’ empowering behaviors in teaching hospitals of Lorestan university of medical sciences in khoramabad. 132 registered nurses occupied in three teaching hospitals: Shohada, Shahid Madani and Asali entered the study by strafied random sampling. This was a cross-sectional descriptive survey in which nurses’ perception of their head nurses’ empowering behaviors and were respectively measured by Leader Empowering Behavior (L.E.B) scale with 27 items (=0.82), and self reported questionnaires were completed by nurses outside their work setting. The collected data were analyzed using descriptive statistical tests by spss soft ware. Nurses in this study obtained a high score in L.E.B scale (= 5.01 1.28) from all L.E.B subscales, confidence in the employee and meaning of work rated the most empowering leader behavior (= 5.16 1.26), (= 5.22 1.15) and autonomy from bureaucracy rated the lower L.E.B. (= 4.80 1.49). Findings point out that cooperational managing system has an important role in increasing work effectiveness through empowering leader behaviors. It will also be important for current nurse managers to learn new methods of leading that will empower staff nurse to participate in their work, and be motivated enough to provide the high-quality care their patients deserve.

Traffic accidents are one social risk factors for women,s health in the fertility and pregnancy period. The trauma during pregnancy can lead to plocenta abruption, preterm labor, bleeding, mother and fetus mortality. Hyper prolactinemia after spinal cord, chest and breast injuries can due to amenorrhea and infertility. The aim of this study was determine the traffic accident injuries in women in the fertility ages rferring to the forensic medicine center of Khorramabad. The present study is a cross – sectional survey in which all the women (280 cases) that were in the fertility period (15-49 year) and suffered from traffic accident trauma and referred to the forensic medicine center of Khorramabad from April 2006 to October 2007(one year) were studied. The data was collected using a questionnaire and an observation chart that were completed by physicians who visiting the trauma cases in the forensic medicine center. 95.8% of the cases were injured after traffic accident. The most vulnerable part of the body (48.3%) were the limbs (feet and hands).69.8% of cases had ecchymosed and 48.8% suffered from fracture. 5.7% of the cases sufferd from pelvic fractures and the region with the most fractures in the pelvis (71.7%) was the symphysis pubic.1.78% of the cases were pregnant. 8.9%0f subjects died and head trauma was the most cause (58.6%) for mortality. statistical test showed significant relation between the region of injury with the need to a surgical operation (p=0.004). These results indicate a high prevalence of severe injury in the pelvis and the genital system that had negative effect on fertility and pregnancy in women at fertility ages. Traffic accidents should be prevented and attended to and analytical studies are recommended in order to understand the underlying cause of accidents.

Community based participatory research in population research center is an important plan of undersecretary for research and technology of ministry of health and medical education in Iran. Need assessment by participation of khoramabad population is the important aim of this project. Focus group discussion (FGD) was the method in this project. sixty nine sessions were organized and various groups of khoramabad citizens were participated in these sessions. view points of participants were collected with taking notes by facilitators. Finally the three bassis as mentioned problems and difficulties in each session were divided into, socio-economic health and proplems, etc and using spss software were an analysied. During the sessions 15 socio- economic problems were propounde. The first of which with the most perecentage (49.6%) was having gravel roads instead of tarmac. The second problem (40%) was the lack of recreation grounds. Then addiction (35.7%) and 35.6% complained about hooligans. Also 7 health problems were propound, the most of these problems were environmental health problems (33.3%), lack of geneal health in one of educatinal hospitals (18.3%), Insufficient number of bins in the streets (17%), and crowded and noisy streets (13.5%).Socio-economic and health problems are the most complains of people in Khoramabad and should be attended by city's recponsibels. Focus group discussion can be used for need assessment as an effective method in community based participatory researches. Also participation of people in executive interventions must be considered.

Today, due to social and domestic problems, a large number of children lose their families or guardians. Foster care is the last resort for many of these children. Conditional and emotional crises and maladaptations are problems that many of these children face in orphanage foster care units. Foster care workers and social workers play important roles in the growth and development of these children. Having the knowledge of childrens growth and developmental stages helps these workers in better dealing with these children and makes these environments more pleasant for both workers and children. The goal of this study is to investigate the effects of teaching growth and developmental stages of children to on foster care worker's knowledge. This study was conducted as a semi empirical study, 30 foster care workers and social workers participated in this educational program. A questionnaire, developed by researchers based on content of teaching program, was used. The questionnaire contained 40 questions about psycho-social needs of children at infancy, toddler and school age stages. Teaching program was 2 sessions (16 hours) and it be held with lecture, question and answer and role playing methods. The participants were asked to fill out the questionnaire before and two weeks after the program. Findings show the mean scores in Knowledge of samples was 31.35 at pre-test and 38.22 at post-test. There was a significant statistical difference with paired t test in samples's knowledge before and after course of education (P=0.001). For receive better and more advantage of foster care units. It,s need to more education for training parent foster care and more support are essential for successfully changing training and evaluating its impact.

The importance of instructing patients and their families in cardiac rehabilitation is obvious for every one, but this doesn’t happen in nursing system correctly, this leads to decreasing quality of nursing care. In fact, nurses who work in critical care units have good scientific knowledge and nurses’ Job satisfaction and empowerment skills, but in regard to studies, their job satisfaction is very little. This study conducted for determining the impact of primary nursing care that is patient-centered completely and emphasis on patient education on patients knowledge about self care and also nurses’ Job satisfaction. This is a quazi-experimental study in which 60 patients by random allocation in two groups of 30 (primary and current nursing care groups) and 25 nurses contributed through census. The tools included nurses’ job satisfaction and their patient's information of self care. Data were measured before and after performing the primary and current care methods. Based on demographic characteristics there wasn’t any significant different between two groups. The mean of patients’ knowledge of self care in current group at admission time was (37.6±0.7) and while discharge time was (38.93± 3.1), the diference wasn’t statistically significant. In primary group in admission time was (39.13±7.3) and in discharge time was (52.2± 7.7), that difference was significant(P<0.001). The mean of nurses’ satisfaction in current group was (80.44 ±7) and in the primary group was (106.3 ±3.8), that difference was significant(P<0.001). There wasn’t any significant relationship between individual characteristics and job satisfaction. Considering the results of this study the patients’ self care knowledge at the discharge time in comparison to admission time increased in primary care. which indicates education’s role. Also nurses’ job satisfaction in primary method wasmore than the current method. So it was suggested to use primary care method in critical care units for increasing patient’s and nurses’ satisfaction.

Mobility is one of the physiologic needs of human and is the most basic of human needs classification, and immobility has bad impacts on all of the body systems.One of the main duties of the nurses, is to teach the patient to contribute in self-care programs.The aim of this study was to determine the effect of the patient's attendant Participation in teaching programs on the patient's self care function for preventing immobility's complications in the patients who had been hospitaized in orthopedic wards of Shohada Hospital of Khoramabd in 2004. This research is a semi-experimental pre and post study. The sample consisted of 60 patients who had the orthopedic problems which leaded to immobility and were chosen gradually by sampling and were studied in two groups of 30 patients. The teaching programs for prevention of immobility complications were given in the control group only to the patients and in the exprimental group,to patient and his /her main attendant.the data collecting tools were damographic questionaire and self care function check list for preventing immobility complications, which were filled out before teaching and after the educational program. Teaching in both groups caused the improvement of self –care function and attributed to preventing the immobility complications (P=0.000).but this improvement in the group of teaching the patient and his/her attendant was better and more than the group of teaching only to the patient (p=0.000). Considering the results and new nursing theories, including the family center caring is purposed that the patients’ attendants should be taken part in teaching and caring programs for the patients.

Evaluation of functional disability in ADL in elderly people, especially in nursing home residents is important for determination of their health needs. this study was carried out in order to assess functional in ADL and its related factors in Kashan's Golabchi ederly people nursing home. In this cross-sectional study all of the people aged ≥50 years old who resided in Golabchi center and had including criteria (n=100) were selected. Barthel Index-100 was used for data collection. 0-90 and ≥91 scores were spotted as disable and able groups, respectively. The data analyzed using t-test, Chi-square, Fisher exact test, Yate's chi-square, Mann- Whitney U, OR and Difference Percent. The most problems related to bathing, grooming and stairs, respectively. The best status related to feeding. Disability prevalence at least in one of the functional aspects was 86% and 29% were able in actwitas of daily living. Number of disease was more in disable group (0.003). There was significant relation between religious beliefs and disability (p=0.005, OR=6.89).Age, residing duration and number of children had no significant effect. Disability prevalence in ADL in nursing home is numerous. It is necessary to attend to this problem and it's related factors to improve the old peple's quality of life in the nursing homes.