Journal of Caring Sciences
Volume:1 Issue: 4, Dec 2012

There is lack of information on couple’s sexual relation during pregnancy and also the lack of a national written training protocol in this regard in Iran. State authorities want to develop and implement such a protocol. Therefore, this study aimed to determine the effectiveness of a sex education package on the sexual function of pregnant women. 88 women in their 8 to 14 weeks of pregnancy were randomly allocated into two groups of intervention and control. In the intervention group a midwife carried out sex education in two 60 minutes lecture sessions and group discussions for the participants. Moreover, educational booklets were distributed at the end of the first session and couple’s questions were answered by telephone. In the control group women were taught nutritional education with the same procedure. Sexual function was evaluated using the female sexual function index (FSFI) before and four weeks after the education. Paired t-test, student''s t-test and chi square were used to analyze the data. There were no significant differences among the groups in terms of their baseline characteristics, including mean sexual function scores before the education. After the education the mean of the total score of sexual function was significantly higher in the intervention group compared with the control group [mean difference 7.0 (95% CI 4.1, 9.9)]. Such a significant difference also existed in all the six domains of sexual function, i.e. desire, arousal, lubrication, orgasm, satisfaction and pain (p < 0.001). Providing such sexual education during routine prenatal care may improve couples’ sexual health during pregnancy.

The importance of resolving the problem of premenstrual syndrome for patients has been emphasized due to its direct and indirect economical effects on the society. The aim of the current study was to evaluate the effects of magnesium and vitamin B6 on the severity of premenstrual syndrome in patients referring to health centers affiliated to Isfahan University of Medical Sciences, Iran, during 2009-10. This two-stage double-blind clinical trial was conducted on 126 women who were randomly allocated into 3 groups to receive magnesium, vitamin B6, or placebo. The study was performed in 10 selected health centers in Isfahan and lasted for 4 months. To confirm premenstrual syndrome, the participants were asked to complete a menstrual diary for 2 months at home. Drug interventions were continued for two cycles and the results of before and after the intervention were compared. The findings of this study showed that the mean scores of premenstrual syndrome significantly decreased after the intervention in all groups (p < 0.05). According to our findings, vitamin B6 and placebo had the most and least efficiency in improving the mean premenstrual syndrome score.

Nowadays particular emphasis is placed on the developmental aspects of premature infants care. Massage therapy is one of the best-known methods of caring. Due to the minimal touch policy in neonatal intensive care units (NICUs), massaging is not usually performed on premature infants. However, there is not sufficient evidence to support the claim that newborn infants with complex medical conditions should not be massaged. This study aimed to determine the effects of massage with coconut and sunflower oils on oxygen saturation of infants with respiratory distress syndrome (RDS) treated with nasal continuous positive airway pressure (NCPAP). This was a randomized controlled trial on 90 newborns who were admitted to Alzahra Hospital (Tabriz, Iran). The infants were divided into control and massage therapy groups (massage with coconut and sunflower oils). Data was collected using a hospital documentation form. A 15-minute daily massage was performed for 3 days. Respiratory rate (RR), fraction of inspired oxygen (FiO2) and oxygen saturation were measured 5 minutes before the massage, 3 times during the massage, and 5 minutes after the massage. The collected data was analyzed using a mixed model. In comparison to coconut oil and control groups, mean oxygen saturation of sunflower oil group was improved. In addition, the coconut massage group showed lower oxygen saturation than the control group but was all values were within the normal range. Although massage decreased oxygen saturation, there was no need to increase FiO2. Massage therapy can provide developmental care for infants treated with NCPAP.

There have been limited studies on quality of life and its predictors among postmenopausal women. Due to the importance of this subject in health promotion, this study was performed to assess quality of life and its predictive factors in postmenopausal women living in Ilam, Iran. In this descriptive correlational study, 400 postmenopausal married women who aged 50-59 years old and lived in Ilam were recruited from 80 randomly selected clusters. The participants were interviewed by a female interviewer using the standard questionnaire of quality of life (SF-36). Data was analyzed by analysis of variance (ANOVA), student''s t-test, and linear regression analysis in SPSS. Mean scores (standard deviation) of quality of life in 4 dimensions of physical functioning, general health, mental health, and vitality were 76.8 (19.2), 71.1 (29.2), 74.3 (18.8), and 73.1 (19.6), respectively (with possible range of 0-100). According to linear regression analysis, women with chronic diseases, vasomotor symptoms, or insufficient family income and divorced and widowed subjects had significantly lower scores in all the 4 dimensions of quality of life. Aging was associated with reduced quality of life only in physical functioning dimension (p < 0.001). Although in univariate analysis, quality of life was significantly lower among illiterate participants and those with more children and longer duration of menopause at least in one dimension, the differences were not found to be significant in linear regression analysis. Chronic diseases, vasomotor symptoms and insufficient income were strong predictors of all the 4 dimensions of quality of life of postmenopausal women. Therefore, interventions are necessary to improve quality of life and health among this group of individuals.

Recovery from heart failure and dealing with its effects is significantly influenced by patient’s self-care. In order to maximize the effects of behavioral interventions and for educational planning, it is essential to know how much experience and information do patients with heart failure have about their disease and self-care behaviors. The present study aimed to identify self-care behaviors in patients with heart failure. Eighty heart failure patients hospitalized in Shahid Madani Training Center in Tabriz, Iran, participated in this study. Data collection was done through Self-Care of Heart Failure Index (SCHFI) that contained 22 questions in three sections including self-care behaviors, self-care management and confidence in performing self-care behaviors. The patient’s self-care behaviors in three behavioral sub categories of maintaining, managing and confidence were low. The most repeated self-care behavior in the participating patients was taking medication and visiting the doctor. The results of the study showed low levels of self-care behaviors in patients with heart failure, which notes the need for patient empowerment. It is necessary to develop appropriate strategies in this regard by the authorities.

Safety culture is considered as an important factor in improving patient safety. Therefore, identifying individual and organizational factors affecting safety culture is crucial. This study was carried out to determine individual and organizational factors associated with nurses'' perception of patient safety culture. The present descriptive study included 940 nurses working in four training hospitals affiliated with Urmia University of Medical Sciences (Iran). Data was collected through the self-report questionnaire of patient safety culture. Descriptive (number, percent, mean, and standard deviation) and inferential (t-test and analysis of variance) statistics were used to analyze the data in SPSS. Nurses'' perception of patient safety culture was significantly correlated with marital status, workplace, and overtime hours. The results of this study revealed that some individual and organizational factors can impact on nurses'' perception of patient safety culture. Nursing authorities should thus pay more attention to factors which promote patient safety culture and ultimately the safety of provided services.

Pain has been pointed out as one of the concerns of cardiac surgery patients. Acute pain management has been a challenge for health professionals and several regiments have been described. We designed this study to evaluate the effectiveness of pain control with patient-controlled analgesia (PCA) versus conventional nurse-controlled analgesia (NCA) during the postoperative period in the intensive care unit (ICU) after coronary artery bypass graft (CABG) surgery. In this randomized clinical trial, 80 elective CABG candidates were selected by convenience sampling. They were randomly allocated to two groups to receive either PCA or NCA. PCA plus continuous infusion of morphine started immediately after transferring the patients to the ICU. NCA was based on intravenous injections of morphine on demand. Pain was assessed using a verbal rating scale (VRS). Sedation level and morphine consumption were also evaluated from extubation until 48 hours after surgery. Data was analyzed using SPSS13. VRS scores were higher in the NCA group compared to the PCA group [3.27 (1.17) vs. 0.75 (0.66); p < 0.001]. Morphine consumption was significantly higher in the PCA group compared to the NCA group [28.43 (7.15) mg vs. 8.37 (5.36) mg; p < 0.001]. PCA was safe and respiratory depression was not observed in any of the subjects. Mean sedation scores did not differ between the two groups. PCA with background infusion of morphine increases morphine consumption and improves pain relief. It appears to be superior to NCA and can be recommended for patients after CABG surgery.

Medication errors are among the most prevalent medical errors leading to morbidity and mortality. Effective prevention of this type of errors depends on the presence of a well-organized reporting system. The purpose of this study was to explore medication error reporting rate and its barriers and facilitators among nurses in teaching hospitals of Urmia University of Medical Sciences (Iran). In a descriptive study in 2011, 733 nurses working in Urmia teaching hospitals were included. Data was collected using a questionnaire based on Haddon matrix. The questionnaire consisted of three items about medication error reporting rate, eight items on barriers of reporting, and seven items on facilitators of reporting. The collected data was analyzed by descriptive statistics in SPSS14.The rate of reporting medication errors among nurses was far less than medication errors they had made. Nurses perceived that the most important barriers of reporting medication errors were blaming individuals instead of the system, consequences of reporting errors, and fear of reprimand and punishment. Some facilitating factors were also determined. Overall, the rate of medication errors was found to be much more than what had been reported by nurses. Therefore, it is suggested to train nurses and hospital administrators on facilitators and barriers of error reporting in order to enhance patient safety.

Cardiac surgery has many physiological, psychological, emotional, growth and spiritual potential consequences due to stress. Identifying and understanding the nature of stress can help nurses in controlling and reducing it. However, few studies have been conducted to identify the stressors. Therefore, the objective of this study was to determine nurses'' perceptions of patients'' stressors associated with coronary artery bypass surgery. During a two month investigation, qualified nurses (n = 68) of patients undergoing coronary artery bypass were selected on the third to fifth day after surgery. With the use of Revised Cardiac Surgery Stressors Scale (RCSSS), interpersonal, intrapersonal and extrapersonal stressors were determined. The findings showed that the most interpersonal, intrapersonal and extrapersonal stressors were; “the need to have cardiac surgery”, “death due to illness or surgery”, “needing assistance with various activities”, “doctors and nurses discussing about other patients”, “having chest tube” and “Payment of hospital and medical bills”. Identification of stressors in patients with coronary artery bypass graft helps nurses in taking better care of them. It would make a better ground for the officials and practitioners towards managing the stressors, especially interpersonal and extrapersonal stressors. Thereby patients are helped to cope with stressors.

Stress is one of the main factors affecting one''s efficiency as well as staff health and quality of nursing services. Neonatal intensive care units (NICUs) can be stressful environments for nurses, infants and families as well. Since there is no evidence in this regard in Iran, the present study aimed to determine stress levels related to care delivering in NICU from the viewpoint of nurses in NICUs of East Azerbaijan Province, Iran during 2011. This was a descriptive study including a purposive sample of 110 nurses working in NICUs of hospitals in East Azerbaijan Province. The data collection tool was a self-report questionnaire. The validity and reliability of the questionnaire were assessed by content validity and Cronbach''s alpha coefficient (α = 0.84). According to factor analysis, the stressors included environmental and nurse and human factors. Stress sources in total and separately in each category were reported as moderate. The mean and 95% confidence interval of the factors in the categories were 2.75 (0.84); 2.59-2.91 and 3.21 (0.72); 3.07-3.35, respectively. Therefore, human factors caused significantly higher levels of stress compared to environmental factors (p < 0.05). Stressors involved in NICU nursing include environmental and human factors. Planning to remove or reduce their impact can improve the quality of nursing services in intensive care units and, thus, decrease the adverse effects of stress on workers.

Intrauterine device (IUD) is the most common reliable, effective and reversible contraceptive method used worldwide and in areas with high growth rate is of particular importance. IUD insertion is associated with high anxiety in most people that causes pain and discomfort. The aim of this study was to determine the effects of aromatherapy on anxiety and pain caused by IUD insertion. This study was conducted on 106 women in a health care center located in Ardebil, Iran. Participants were divided into two groups by randomized blocks of 4 and 6. In the experimental group lavender scent was inhaled and in the control group the placebo was inhaled 30 minutes before IUD insertion. The anxiety of the participants was measured by Spielberger questionnaire, and the pain of IUD insertion was measured immediately after the insertion using visual analog scale (range 0-10). The mean score (standard deviation) of anxiety before intervention was 43.2 (9.2) in the experimental group that decreased after intervention to 39.0 (10.5) (p < 0.001), while this score was 42.2 (9.0) and 41.5 (8.4) before and after the intervention in the control group (p = 0.21). Mean differences of anxiety in both groups was statistically significant (p < 0.001). The pain score after intervention did not show significant difference between two groups (p = 0.51). Aromatherapy with lavender inhalation was effective in decreasing anxiety in IUD procedure, and this method can be used in health care centers as complementary treatments.