فصلنامه سلامت و مراقبت
سال بیستم شماره 4 (زمستان 1397)

Marital satisfaction is one of the most important factors influencing health in life. Nurses are the most important members of the health and care systems and hence examining the factors affecting their health would be in priority. The aim of this research was to determine the relationship between attachment to God, moral intelligence and differentiation of self with marital satisfaction in nurses. This study was a descriptive-correlational study. The samples of study included 162 participant nurses in hospitals of Ahvaz city selected by simple random sampling method. Data acquisition tools were questionnaires to measure the variables; attachment to God, moral intelligence, differentiation of self, inventory and marital satisfaction. Pearson Correlation coefficient and multivariable regression (p<0.05) were employed to analyze data using SPSS-21. The result showed that there were significant and positive correlations between attachment to god (r= 0.235), moral intelligence (r=0.38), and differentiation of self (r=0.322) with marital satisfaction. In addition, multiple regression analysis showed that the attachment to God, moral intelligence, and differentiation of self can be used to predict the marital satisfaction of nurses. Based on the results of this study, holding workshops on education for promoting attachment to God, moral intelligence and differentiation of self, are necessary for improved of marital satisfaction of nurses.

Fatigue is a common complaint in patients with type 2 diabetes, which can affect self-care behaviors and people's efforts to control diabetes. This study was conducted to determine the severity of fatigue and its related factors in patients with type 2 diabetes.

In this descriptive-correlational study, 218 patients with type 2 diabetes mellitus who were referred to diabetes clinic of Imam Khomeini Hospital in Ardabil in 2017 were selected by available sampling. Data were collected by five questionnaires including: socio-demographic form, Fatigue Questionnaire, Pittsburgh Sleep Quality, Beck Depression, and Visual Analogue Scale. Data analysis was done by using descriptive (mean, standard deviation and frequency) and Inferential statistics (Pearson correlation coefficient, simple and multiple regression model) in SPSS software v22.

The mean fatigue score of the participants was 57.07±17.16, which indicated moderate fatigue. Pearson correlation test revealed a significant correlation between fatigue and pain (r=0.440 p<0.01), depression (r =0.590, p<0.01), Number of complications of the disease (r=38.0, p<0.01), Duration of diabetes (r=0.21, p<0.01), duration of exercise (r=-0.305, p<0.01), and sleep quality (r=0.390, p<0.01). However, no significant correlation was found between fatigue and glycosylated hemoglobin and BMI. Data analysis using multivariate linear regression showed that four factors of pain, depression, duration of disease, and duration of exercise were predictors of fatigue in patients with type II diabetes.

The present study showed that fatigue was a relatively common problem in patients with type 2 diabetes and factors such as pain, depression, duration of disease and duration of exercise were factors that affect fatigue. Health care providers need to pay special attention to fatigue assessment in patients with diabetes and proper interventions be taken to reduce pain and diagnosis and control depression in these patients.

Stress during pregnancy can be associated with serious and long-term adverse outcomes for mothers, fetuses, newborns, children, and even adolescents. One of the coping mechanisms with stress during pregnancy is paying attention to women's spiritual beliefs and values. The aim of the current study was to determine the role of spiritual well-being in the prediction of pregnancy-specific stress in women referred to health centers in Hafshjan. The current study was a descriptive- correlational study. The study population consisted of all pregnant women referred to health centers in Hafshejan, 2015. Two hundred pregnant women were selected using convenience sampling method. Spiritual well-being (Paloutzian and Ellison) and pregnancy-specific stress questionnaires (Sallary) were used for data collection. Data analyses were performed by Pearson correlation and multivariate linear regression tests using SPSS version 20. The mean age of the study sample was 27.68±4.75. The results showed a significant negative correlation between spirituality and pregnancy stress (r= -0.29, p<0.001). Multiple regression analysis indicated that spiritual well-being is capable to predict the stress during pregnancy (β = -0.444, R2=0.139, p<0.001). Taking into consideration the predictive role of spiritual well-being in pregnancy stress, women's health care professionals should pay particular attention to implement effective strategies for promoting of spiritual well-being level during pregnancy.

Considering the prevalence of psychological problems in patients with multiple sclerosis (MS), some reports have recognized the effectiveness of emotional self-regulation model prior to conventional therapies in these patients. The aim of this study was to investigate the effectiveness of emotional self-regulation model to improve the components of life quality in MS patients.

This study was a semi-experimental with pre- and post-test, and control group. The quality of life test was performed on 220 MS patients in Tabriz, 2018.40 patients who had unsatisfactory scores were selected and divided randomly into experiment and control groups. The intervention was conducted in the form of emotional self-regulation training in twelve 90 min sessions per week. Quality of life test was performed again in each group 10 days and three months after the end of the intervention. Data were analyzed using covariance analysis.

Analyzed data showed that there was a significant difference between the mean scores of post-test in the experiment and control groups (p<0.01), indicating that emotional self-regulation training improves the components of quality of life in the experimental group. Also, the emotional self-regulation model had a lasting effect on the quality of life of MS patients after a three-month follow-up.

Taking into consideration the positive psychiatric effects of emotional self-regulation it is recommended to conduct such training programs for MS patients to improve their mental health.

Nurses are in face with physical and psychological problems associated with the shift-work. Therefore, the maintenance of their health seems to be necessary in order to protect workforces and adverse effects on the health and safety of patients. The purpose of this study was determining the prevalence of physical and psychological health problems among nurses and their relation with the shift-working.

This cross-sectional study was performed on 465 shift-work nurses in three hospitals in Mazandaran province in 2017 using the SOS (survey of shift work) questionnaire. Data analysis was performed using descriptive statistics and logistic regression model using SPSS version 24 software.

The results of the current study showed that complaints of physical problems including cardiovascular, musculoskeletal and gastrointestinal disorders were 12.3%, 45.8%, 28.6%, respectively, and the complaints of psychological problems were 30.8%. Chi-square analysis results showed that cardiovascular disorders have significant relation with marital status, the number of children, work experience in the shift-working system, and the type of shift-work system (p<0.05). Also, logistic regression results indicated that work experience in the shift-work system and the average sleep time affect the incidence of cardiovascular and skeletal-muscular problems.

Based on the results, there was a significant relationship between shift-work and the physical and psychological problems among nurses. The reduction of shift-working times and preparing the favorite places to rest during the shift-time can protect nurses against abovementioned problems.

A desirable quality of educational services and training of responsible human resources are two tasks of the educational system. The current study aimed to determine the relationship between the quality of educational services and responsibility in students of Ardabil nursing and midwifery faculty. A correlative study was conducted on 329 students of Ardabil nursing and midwifery faculty, 2017. Data were collected using the SERVQUAL and standard questionnaires for educational services quality and responsibility, respectively. Data were analyzed statistically using independent t-test and one-way ANOVA by SPSS-15 software. The mean age of students was 21±3.06 years. The majority of students were female (54.7%), mostly studying nursing (32.5%) and in the second year of education (35.8%). The mean and standard deviation of educational services quality and responsibility scores were 3.07±0.25 and 3.97±0.05, respectively. Pearson correlation coefficient showed a significant statistical relation between educational services quality score and responsibility (p<0.0001, r=0.013). Considering the direct and significant relationship between the quality of educational services and responsibility, paying attention to these items through improving the educational services quality and training of responsible studentscan increase the efficacy of students in clinical environments.

Aerobic exercise is recommended to autistic children suffering from sensory and motor disorders. The present study was aimed to determine the effect of aerobic exercise on motor skills and body composition of autistic children in Tabriz city. In this study, 40 out of 83 autistic patients diagnosed by a psychiatrist were randomly selected and assigned to experiment and control groups. The evaluation tools included the Brininx-Oresetsky Expedition Test and the Physical Fitness Machine and Intervention Tool for Aerobic Exercise. The experiment group received 12 sessions of 90 minutes of aerobic exercise, while no exercise was provided for the control group. The collected data were analyzed using SPSS software version 21 by descriptive statistics including mean, standard deviation, and inferential test for multivariate covariance analysis. The results of the analyzed data showed a significant difference in the post-test scores between the experiment and control groups (p<0.01). Aerobic exercise improved the level of fine and elegant motor skills, and body composition as well as their components in children with autism. Based on the obtained results, aerobic exercise can be used as a useful and non-pharmacological action to improve the motor skills and the physical composition of children with autism.

Background & Skin problems and incidence of infection in the vascular access sites are two common problems in hemodialysis patients. Increasing the self-efficacy of patients can improve self-care behaviors. Considering the importance of patients training about skin and fistula care, the current study was performed with aiming of determining the effect of education based on the self-efficacy theory on the skin and fistula care in hemodialysis patients.
This interventional study was performed on 70 hemodialysis patients, in two groups of 35 persons, in Qom city, 2016. Data collection tools consisted of demographic characteristics form, researcher-made questionnaires of skin and fistula care, and self-efficacy standard questionnaire (SUPPH). Questionnaires were completed before and 3 months after the intervention in the sort of education based on the self-efficacy theory in 4 sessions of 15-20 minutes. Data were analyzed by Chi-square, independent T-test, Paired T-test, and Mann-Whitney test using SPSS 16. 
The difference between the two groups in terms of mean scores of self-efficacy and skin and fistula care was no significant before the intervention but it was significant after the intervention (p<0.001). Mean scores of self-efficacy and skin and fistula care of patients showed significant difference before and after the intervention (p<0.001).
According to the results of this research, implementation of proper education program using the self-efficacy theory can promote the self-efficacy of hemodialysis patients in the field of skin and fistula care.