فصلنامه سلامت و مراقبت
سال سیزدهم شماره 1 (بهار 1390)

Bacterial vaginosis (BV) is a condition characterized by an imbalance in the vaginal flora which can lead to preterm delivery, abortions and maternal infections. The main goal of this study was to study the prevalence of bacterial vaginosis in Ardabil.In these cross-sectional study 507 pregnant women, 16-45 year-olds were screened from rural health centers of Ardabil. Data were collected via Questionnaire, general physical and obstetric examination and vaginal specimen. Three from four Amsel’s clinical criteria were used for diagnosis of bacterial vaginosis. Data were analyzed using SPSS software version 13, and descriptive statistics.Prevalence of Bacterial vaginosis in this study was 12.4%. The majority of women (66%) were in range 20–30 years, housewife (62%) and low literate (58%). None of them were smoker and most of them used contraceptive pills (61%). The most common complaint of patients with bacterial vaginosis was a smelly discharge. The most common Amsel criteria in patients with bacterial vaginosis were 69.2% homogenous discharge, 67.3% Whiff test, and 32% clue cells.According to results of this study bacterial vaginisis was higher in 20-30 year-olds, and most common sign was fish odor discharge. Therefore educating women can prevent pregnancy problems.

Life without mobility can be destructive and lack of regular physical activity adds to the severity of disability in the retired. Low levels of physical activity leads to increased cardiovascular diseases, glandular diseases, and psychological illnesses in all ages, especially in the elderly. Exercise and physical activities have psychological and social goals not only as a recreational activity but also as an educational tool. So the present study was performed to determine the physical activities in the retirees of education department in Bojnourd.This is a descriptive cross- sectional study and the sample society includes 259 people of retired teacher in Bojnourd who were selected using survey and convenient sampling method in 2009. The data was collected using a two-part, researcher –made questionnaire which included questions about personal details and physical activities and was completed through interviews by trained personnel. Validity and reliability of the tools were measured using Content and Test-re- test methods respectively. Data analysis was performed through descriptive statistics, chi-square and the software SPSS V. 13.from 259 people, 68.3% were males and 31.7% were females and their mean age was 60±2/2. Walking for Exercise was 66/8% and Other Sports in total was 13.5%. Men had different physical activities such as weightlifting; climbing and women had activities such as yoga and fitness. 86.5 % of the samples did not have appropriate physical activity. From different physical activities, going to the park and walking for exercise were significantly associated with marital status (P=0/003).The majority of the participants lacked adequate physical activity. Therefore, the need to work out and physical activities as a physical need for retirement is a priority. In addition, the organization for planning and regular media advertising to encourage seniors to exercise and do age-appropriate exercise seems necessary.

Beta thalassemia major is one of those diseases in which the natural growth of individuals can be disrupted due to complications of the disease. Despite the recent advances in treating these patients, growth retardation in a significant percentage of them is observed. This study was conducted to determine the growth criteria in thalassemia major patients and compare them with NCHS standards.This study is a Cross-sectional study. The study population included all patients with thalassemia major (n=37) is in the city of Ardabil. Data collection tools included a demographic questionnaire, a meter and a scale. Data from questionnaires were analyzed by SPSS software. Of the 37 patients studied, 19 were male and 18 female. Average age of subjects was 15. 43 ± 5.97 years and 54.05 %. 15 people were under 15 years of age. Average height of patients was 142.43 ± 18.03 centimeter and their mean weight was 38.41 ± 12.32 kg. 64/9 %. 24 people of the patients’ height were below 5% percentile and 54 % (20 people) had weight below 5 % percentile. In total, Weight and height of patients were below NCHS, and with age, this difference was greater.growth retardation of patients with thalassemia major starts from the first decade of their life and it worsens by age. To prevent growth failure, it is necessary to regularly check the growth rate of the patients, identify the factors involved in growth disorders and take appropriate preventive measures.

Clinical training is fundamental part of nursing education program and causes the student to apply the theoretical knowledge in caring for patients. The nature and duties of nursing in community is such a special issue that doubles the sensitivity of coordination between theoretical courses and clinical services. About half of nursing and midwifery training time is spent on clinical training but there are many factors that affect the process of clinical education. Therefore the aim of this study is assessing the problems of clinical training in nursing students in clinical environments in Nursing and Midwifery faculty of Isfahan.This descriptive analytical study was performed on 75 nursing students in their last term. A two-part questionnaire included questions on demographic information and factors to assess clinical training problems in six major areas of problems: problems related to learner, clinical instructor, clinical environment, patient, educational program and clinical evaluation. Data analysis was performed in SPSS software.After analyzing the data the following results were obtained: most of the problems were related to the clinical instructor 78%, learners 73%, clinical environment 71%, clinical training program 66%, clinical evaluation 60% and patient-related problems 43%.Results of this article showed that there are problems in clinical training in nursing, especially in fields that are related to learner and clinical instructor. Due to the fact that Clinical Education is the fundamental part of clinical training and in this type of training, students in interaction with instructors and the environment, apply the learned concepts in the clinical field, by understanding nursing and midwifery clinical education problems, the planners will be able to design good educational programs to increase the quality of health services to all people. Therefore, to reach this goal there is a need to more assessment and continuous clinical evaluation processes.

Hands have important role in nosocomial infection transmission and is the most effective, cheapest and easiest method for prevention of these infections, but we do not have enough information about this behavior. This article was done with the aim of hand washing behaviors assessment in health care workers.Inthis descriptive study 153 health care workers (doctors, nurses and other therapists) of Mazandaran were randomly selected in 2008. Educated observers observed their hand washing behaviors in 612 situations. Data was documented in a checklist. This checklist was prepared based on state guidelines of principles of safety and protection against diseases, and contained demographic characteristics and hand washing instruction methods. Data was analyzed using spss13, descriptive statistics, t-tests and chi-square test.Sample was 153 cases, (n=125) 81.7% were female, mostly nurses (n=134) with average 29.28 ±8.28 years old and 4.94±5.7 years of work experience. 612 hand washing situation were observed; hand washing was done in 194 situations (31.7%). Most materials used for hygiene were water and soap (n=113, 58.3%) or alcohol-based liquids (n=48, 24.7%). HCWs in 79.2% of situations (n=154) washed their hands just after contact with patients. The preferred method for hand drying in most cases was paper towel (n=105, 54.2%).In 78 situations (40.2%) didn’t dry their hands.This study showed that health care workers’ performance in hand washing behavior is poor, therefore more research is advisable for both finding the reasons and planning for more serious education in order to change the hand washing behavior of health care workers.

Patient education is one of the pillars of basic nursing duties. Education improves the ability for self-care in patient and, as a result, it decreases the use of the prescribed drug by 5%; it also reduces the re-admission of the patient to the hospital by 42%. The purpose of this survey is to study the impact of educating nurses on patients’ satisfaction of teaching patients and also the effect of education on knowledge, attitude and performance of nurses. This is a quasi-experimental study, 140 patients were divided into two groups, before and after training, satisfaction questionnaires were completed, the questionnaire included demographic information and 15 questions on patient satisfaction. 60 nurses were selected and were trained for a month about the importance of patient education. Nurses completed the questionnaires on patient education of knowledge, attitude and performancebefore and after the training. The questionnaire also contained questions about demographic information, Knowledge, attitude and performance about teaching to the patients. Data were analyzed using SPSS software.There was a significant difference between the average score of patients’ satisfaction of training before and after theintervention.There was also a statistically significant difference in average score between nurses’ knowledge and performance before and after the intervention. this study showed that training nurses about patient education can increase patient’s satisfaction. It also increases the knowledge and improves the nurses’ performance. Considering the importance of patient education and its role in improving the disease, training programs for nurses is recommended.

Tools such as MPM (Mortality Probability Map) are used extensively for mortality in patients who, with different diagnosis, are admitted to the intensive care units. These indexes are also considered as a standard tool for studying the duration of hospitalization,, quality evaluation of care provided and classification of illness severity. The purpose of this study was to determine predicted mortality rate in patients admitted to intensive care unit with MPM technique.In this cross sectional study all of ICU patients in two health care facilities of Shahid Rajaee and Bo-Ali in Qazvin were studied by census method during six months of 2010. After applying exclusion criteria, data from 240 patients was gathered by questionnaire and MPM. Statistical analysis was performed using SPSS13, descriptive and analytical statistics (mean ±SD), t-test and regression logistic. All levels of testing means were considered less or equal to 0.05.71.3 % of patients were male and 28.7% of them were female. Predicted mortality mean using the MPM tools was 39.62 ± 39.37 percent (minimum 1.37 and maximum 99.73) and death was 33.7 percent. MPM score in survived patients was 34.91 ± 36.91 and in dead patients was 48.85 ± 42.55 (p = 0/013). Modified results of regression logistic model showed that by increasing MPM score death chance increased by 11%.The result of the present research showed that the MPM can be very accurate in prediction of hospitalized patient's mortality in the intensive care unit. Hence, using these indicators and other disease severity classification instruments will be useful in predicting the ICU patients’ course of treatment; nevertheless, further studies in this field should be done.

Since the phenomenon of aging lead to changes in physiological, psychological and social being of the elderly, their performance may weaken and predispose them to disorders such as depression and loneliness.This study aimed to assess the impact of reminiscence groups on the loneliness and the need for belonging in elders in Sari.This study is an experimental study, from elderly people referred to the Elderly Daily Centre in Sari 32 were chosen with available method and were randomly divided into control (16 persons) and intervention group (16 persons). Data was collected using loneliness questionnaire, the need to belonging scale and a brief mental state examination and was analyzed using descriptive statistics and paired and independent t-tests.After intervention, reminiscence group paired t-test showed that the mean recovery of loneliness (p= 0.01) and the need for sense of belonging is statistically significant. While in the control group there was not a significant difference between the means before and after intervention. In addition, after intervention, comparison of the scores of feeling lonely and the need for sense of belonging in the two test groups showed statistical significant (p=0.01). Before the reminiscence group significant difference between intervention and control groups did not exist.Considering the positive effects of reminiscence on the decrease of feeling of loneliness and the increase of sense of belonging in the elderly, this easy and effective technique, which has been neglected, can be applied in all elderly care centers or homes.