فصلنامه سلامت و مراقبت
سال پانزدهم شماره 4 (زمستان 1392)

Breastfeeding is the healthiest and the most natural kind of nutrition for infants. Since most of the mothers have little information about exclusive breastfeeding, appropriate support could play a significant role in promotion of mother's knowledge and thus increase the rate of exclusive breastfeeding. So, present study aimed to determine the effect of supportive program on exclusive breast-feeding over. This quasi-experimental study was performed by emotional support, education and follow-up over 63 nulliparous women in two groups of control (n=33) and case (n=30) which had been selected by conensus method. Data gathered using demographic information questionnaire and check list of neonates exclusive breast feeding, which filled by mothers in the period of one month after delivery. Data were analyzed by descriptive-analytical statistical tests in SPSS v.16. Based on the results, exclusive breastfeeding’s rate were 56.7% in treatment group and 27.3% in control group which was statistically significant (p=0.018). Also, there were statistically significant difference in the consumption of solution of sugar and water and herbal medicines in the two groups by chi-square (p=0.007). But there was no significant difference about consumption of milk powder (p=0.455). The results indicated that a protective program can be effective in the enhancement of exclusive breastfeeding, so it should be more emphasis on present protective programs in healthcare and medical services centers.

Pain control is a major challenge for nurses. Nurses need to be skilled in pain assessment and its relief and be able to perceive patient`s expectations or misinterpretations. With regard to importance of congruence between patient and nurses perception on pain control, this study was conducted with the aim of comparison of nurses and patient's perception on quality of pain control in patient under coronary artery bypass graft. This comparative cross-sectional study was conducted on 108 patients undergoing coronary artery bypass graft, and nurses that were responsible of care of them in Dr. Heshmat Hospital of Rasht in 2011. Data was gathered by a 3-part tool consisted of demographic data questionnaire, standard questionnaire of pain control and numeric rating scale for patient satisfaction. Sampling was done by sequential method Data were gathered by observing the patient's medical record information and interviewing with patients and their nurses. Gathered data was analyzed by descriptive and inferential (Anova, Spearman, T-test and Wilcoxon) statistical tests in SPSS v.16. Findings revealed that, mean of perception on total pain related care and all of its subsets, exception of environment subset, in nurses was significantly higher than patients (p<0.001). Also, the mean of nurse's perception on patient's satisfaction of pain control was significantly higher than patient's perception. (p<0.028). The significant differences between patients’ and nurses’ perceptions of pain control in this research highlights the need for special planning in the aim of standardization of pain control and improving protocols for effective nurse-patient relationship and proper perception of patient`s needs by nurses.

Needle stick injuries are one of the most important ways of transmitting pathogens to health care workers. Such injuries may impose some mental distress and costs on the injured persons and heath care organizations. The first step for providing the preventive strategies in these injuries is to identify the prevalence and factors associated with them. The aim of the current study therefore was to determine the prevalence and some factors related to these injuries among nursing students in Birjand city, 2012. 214 nursing students participated in this descriptive- analytical study. Participants were studying nursing at Birjand University of Medical Sciences and Islamic Azad University, Birjand Branch and selected by Concensus Method. Data were collected using a researcher-made questionnaire, consisting three parts. The gathered data were analyzed by Duncan's multiple range test statistic and Kruskal-Wallis in SPSS v.16. Of the 214 nursing students with a mean age of 21±4.8, 121 (56.3%) had suffered a needle stick. The majority of these exposures occurred after injection and before discarding of the needle (40.5%) (p=0.00013). Also, about of actions after injury, the most important steps were washing with soap and water (34%), reporting to the instructor (27%) and pressing of injury location (23%) (p=0.00012). The highest rate of needle stick injuries was observed among female students (57.7%) who were single and studying at fourth semesters (33.2%) (p=0.00032). Due to the high prevalence of needle stick injuries in the current study, appropriate strategies are needed to be developed to prevent these events. The focus of these strategies particularly should be after injection and before throwing needles. The results also remind the necessity of providing the useful education about the appropriate measures and recommended protocols to needle stick injuries among the nursing students.

Nowadays, using of internet for academic and non-academic activities is an integral part of student's life. Studies show that overuse of electronic media has negative impacts on physical and mental health. This study was conducted to determine the relationship between internet addictions and sleep problems in students of Islamic Azad University of Karaj. This descriptive-analytical study was done over 500 students, which were selected by convenience sampling from Karaj Islamic Azad University in 2010. Data were collected by self-report method. Data collection instruments used for this study were: Internet Addiction Questionnaire, Epworth Sleepiness Scale, Sleep Disorder Index and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by SPSS v.18 and using descriptive statistics, t- test, ANOVA, and linear regression. The mean PSQI score was 5.04 ±2.93. 132 people (26.4%) had worse sleep quality. Mean sleep disturbances score was 5.50 ±3.96 and insomnia was the most common sleep disturbance. Mean daytime sleepiness score was 6.19 ±3.35 and 219 people (43.8 %) had mild daytime sleepiness. Mean score of internet addiction was 31.95 ±9.10 and 26 people (5.2 %) were at risk for internet addiction. There were significant relation between internet addiction with sleep quality (p=0.005) and daytime sleepiness (p=0.005). Excessive use of the internet was related to high daytime sleepiness and low quality of sleep. Choosing correct pattern in use of the internet helps to reduce sleep problems in students.

Motivation is a key element in treatment and recovery of substance use disorders by influencing patients to seek, complete, and acceptance of treatment and making successful long-term changes; so the current study was conducted to investigate the role of cognitive self-control and self-compassion on prediction of treatment motivation in people with substance dependency. The method of this research was descriptive-correlational. The whole people with substance dependency were referring to Shiraz centers of addiction treatment in the second half of 2013, comprised statistical society of this research. One hundred and fifty people of this society were selected by multi-stage random cluster sampling method for this study. Having conducting clinical interview, they were being asked to respond to questionnaires of cognitive self-control, self- compassion and treatment motivation. Collected data were analyzed by tests of Pearson correlation and multivariate regression using SPSS16. The results showed that treatment motivation negatively related to low self-control, and positively related to self-kindness, self-judgment, common humanity isolation, mindfulness, and over-identification. The results of multiple regression showed that 30% of variance of motivation, 30% variance of problem recognition, 28% variance of ambivalence and 24% variance taking steps explained by self- compassion and cognitive self-control. The results of this study demonstrated that cognitive self-control and self- compassion play role in predicting treatment motivation and readiness to change in drug-dependent peoples.

One of the most important motivating factors of nurses is improvement of their job engagement. Since the job engagement can be affected by various factors including the leadership style of nurse managers and organizational learning, this study intended to investigate the relationship between servant leadership style and organizational learning with job engagement of nurses in Ardabil University of Medical Sciences. This descriptive and correlational study was performed during autumn and winter of 2012 among 914 nurses working in hospitals affiliated to Ardabil University of Medical Sciences; of them 273 nurses were sampled regarding the Krejcie and Morgan table. Three questionnaires were used to gather data: servant leadership style questionnaire, organizational learning and job engagement questionnaire. The data were analyzed using descriptive and inferential statistics with SPSS-18. The results showed that there was a positive and significant relationship between servant leadership method, organizational learning, and job engagement (p≤0.01), and that, servant leadership method and organizational learning can predict job engagement. Improving of organizational learning and servant leadership method components can improve and increase job engagement of nurses.

Multiple sclerosis (MS) is the most common demyelinating disease of central nervous system. Genetic and environmental factors are involved in etiology of disease. One of the environmental risk factors is smoking. This study aimed to assess the relationship between smoking and multiple sclerosis in patients admitted to Alavi hospital in Ardabil province. This case-control study was conducted in the Alavi educational hospital of Ardabil, 2012. Through randomized sampling method 80 MS patients as the case group and 80 healthy people as the control group were involved in the study. A self-administered questionnaire used for data gathering in two parts: demographics and smoking behaviors. Data was analyzed by SPSS v.16, using descriptive and inferential statistics. The results showed that the first symptoms that appeared in patients of multiple sclerosis was diplopia (%57.5) and limps paresthesia (%36.3). Twenty percent of patients versus %5 of control group had history of smoking that was statisticaly significant. Also %62 of patients and %18/8 of control group reported smoking history by their relatives (p=0.0001). This study showed that smoking is one of the risk factors for multiple sclerosis. Likewise, the risk of multiple sclerosis in people who were exposed to cigarette smoke was more than other people. Cigarette cessation and withdrawing from smoking can help the people to decrease the probability of multiple sclerosis.

Cerebral palsy is a non-progressive static movement and position disorder that occurs following neurological injury. It's a general term for a group of chronic disorders that disrupts person movement control. Movement disorders appear in early years of life and usually do not gets worsen over time.The cerebral palsy occurs due to the defect in brain development or damage to motor areas of the brain, so these areas are not able to control movement and posture of Person. Cerebral palsy is diagnosed throughout motor skills and reflex examination, medical history and various special tests. In this article, cerebral palsy, etiology, early diagnosis and intervention are discussed. In this review article, the information related to keywords of cerebral palsy, prevalence, etiology, early diagnosis and intervention has been searched in SID, PUBMED, GOOGLE SCHOLAR, MAGIRAN and IRANMEDX. All articles from 1992 until 2014 were evaluated. According to children with cerebral palsy’s conditions, early detection and intervention are necessary.