Journal of Caring Sciences
Volume:2 Issue: 1, Mar 2013

Nurses have a considerable role in caring and health promotion. Depressed nurses are deficient in their coping skills that are important in mental health. This study evaluated the effectiveness of training problem-solving skills on coping skills of depressed nursing and midwifery students. The Beck Depression Scale and coping skills questionnaire were administered in Tabriz and Urmia nursing and midwifery schools. 92 students, who had achieved a score above 10 on the Beck Depression Scale, were selected. 46 students as study group and 46 students as control group were selected randomly. The intervention group received six sessions of problem-solving training within three weeks. Finally, after the end of sessions, coping skills and depression scales were administered and analyzed for both groups. Comparing the mean coping skills showed that before the intervention there were no significant differences between the control and study groups. However, after the intervention, a significant difference was observed between the control group and the study group. By comparing the mean coping skills before and after the intervention, a significant difference was observed in the study group. Training problem-solving skills increased the coping skills of depressed students. According to the role of coping skills in people's mental health, increasing coping skills can promote mental health, provide the basis for caring skills, and improve the quality of nurses’ caring skills.

Heart failure is one of the most common cardiovascular diseases which decrease the quality of life. Most of the factors influencing the quality of life can be modified with educational interventions. Therefore, this study examined the impact of a continuous training program on quality of life of patients with heart failure. This randomized clinical trial study was conducted during May to August 2011. Forty four participants with heart failure referred to Shahid Madani's polyclinics of Tabriz were selected through convenient sampling method and were randomly allocated to two groups. The intervention group (n = 22) received ongoing training including one-to-one teaching, counseling sessions and phone calls over 3 months. The control group (n = 22) received routine care program. Data on quality of life was collected using the Minnesota Living with Heart Failure Questionnaire at baseline as well as three months later. The statistical tests showed significant differences in the physical, emotional dimensions and total quality of life in intervention group. But in control group, no significant differences were obtained. There was not any significant association in demographic characteristics and quality of life. Ongoing training programs can be effective in improving quality of life of patients with heart failure. Hence applying ongoing educational program as a non-pharmacological intervention can help to improve the quality of life of these patients.

High levels of sound have several negative effects, such as noise-induced hearing loss and delayed growth and development, on premature infants in neonatal intensive care units (NICUs). In order to reduce sound levels, they should first be measured. This study was performed to assess sound levels and determine sources of noise in the NICU of Alzahra Teaching Hospital (Tabriz, Iran). In a descriptive study, 24 hours in 4 workdays were randomly selected. Equivalent continuous sound level (Leq), sound level that is exceeded only 10% of the time (L10), maximum sound level (Lmax), and peak instantaneous sound pressure level (Lzpeak) were measured by CEL-440 sound level meter (SLM) at 6 fixed locations in the NICU. Data was collected using a questionnaire. SPSS13 was then used for data analysis. Mean values of Leq, L10, and Lmax were determined as 63.46 dBA, 65.81 dBA, and 71.30 dBA, respectively. They were all higher than standard levels (Leq < 45 dB, L10 ≤50 dB, and Lmax ≤65 dB). The highest Leq was measured at the time of nurse rounds. Leq was directly correlated with the number of staff members present in the ward. Finally, sources of noise were ordered based on their intensity. Considering that sound levels were higher than standard levels in our studied NICU, it is necessary to adopt policies to reduce sound.

Having an effective relationship with the patient in the process of treatment is essential. Nurses must have communication skills in order to establish effective relationships with the patients. This study evaluated the impact of communication skills training on quality of care, self-efficacy, job satisfaction and communication skills of nurses. This is an experimental study with a control group that has been done in 2012. The study sample consisted of 73 nurses who work in hospitals of Tabriz; they were selected by proportional randomizing method. The intervention was only conducted on the experimental group. In order to measure the quality of care 160 patients, who had received care by nurses, participated in this study. The Data were analyzed by SPSS (ver.13). Comparing the mean scores of communication skills showed a statistically significant difference between control and experimental groups after intervention. The paired t-test showed a statistically significant difference in the experimental group before and after the intervention. Independent t-test showed a statistically significant difference between the rate of quality of care in patients of control and experimental groups after the intervention. The results showed that the training of communication skills can increase the nurse's rate of communication skills and cause elevation in quality of nursing care. Therefore, in order to improve the quality of nursing care it is recommended that communication skills be established and taught as a separate course in nursing education.

Discharge rate of surviving infants from neonatal intensive care unit (NICU) has recently increased dramatically. It is deemed to have a discharge plan with the aim of decreasing rehospitalization, morbidity, and mortality. The aim of this study was to explore and describe the professionals’ efforts toward discharging the infants and their mothers from NICU. This qualitative study used a content analysis approach to define and describe the efforts implemented for discharging the infants and their mothers. Data collection was done through the interviews with twenty nurses, physicians, and mothers in the NICUs of some Iranian University Hospitals. In the present study, two categories and five subcategories were identified namely the process of teaching/training the mothers of high risk infants (mothers’ intrinsic motivation, considering mothers’ learning needs, and enabling trainings) and providing infant discharge criteria (maintaining infant’s health and believed abilities). The results of the study revealed that mothers’ intrinsic motivation and considering their learning needs are essential points in the learning process. Some of the efforts such as enabling trainings are insufficient and must be improved to yield desirable discharge plan.

Preterm premature rupture of membranes (PPROM) can result in fetal complications such as oligohydramnios. This study aimed to determine the effects of intravenous (IV) fluid bolus on amniotic fluid index (AFI) in pregnant women with PPROM. 24 women with PPROM during singleton live pregnancy of 28 to 34 weeks whose baseline AFI was ≤ 5cm were randomized into two groups. The study group received one liter intravenous fluid bolus of isotonic Ringer serum during 30-minute period. Reevaluations of amniotic fluid index in both groups were made 90 minutes and 48 hours after baseline measurement. Independent t-test and paired t-test were used to compare the two groups and mean amniotic fluid index before and after treatment, respectively. Results The results of this study demonstrate that AFI decreased statistically significant in both the control and study groups. AFI decreased in both groups at 48 hours later. This decrease was not statistically significant in any group. The mean change in AFI (90 minutes and baseline) and (48 hours and baseline) between the two groups were not significant. The time between mean baseline measurements and delivery were 196.41 and 140.58 hours in the study and control groups, respectively. This difference was not statistically significant. This study did not find significant impact of hydration On AFI as a prophylactic method on oligohydramnios in pregnant women with PPROM.

Hip fracture is common in the elderly. However, the quality of life of the elderly after hip fracture surgery has been largely ignored. Therefore, this study was conducted to compare the quality of life of the elderly with and without history of hip fracture surgery. In a case-control study, 70 individuals with a history of hip fracture surgery at least three months before the study (case group) were compared with 70 elderly with the same specifications except the history of hip fracture (control group). The five-dimensional instrument of Euro Qol (EQ5D) was used to collect data. Chi-square test, t-test, analysis of variance (ANOVA) and calculating the odds ratio were used for data analysis. Compared to the control group, mobility, pain/discomfort, anxiety/depression, health status, self-care, and level of activity were lower in patients with the history of hip fracture. The mean scores of quality of life were also significantly lower in the case group regardless of all demographic variables such as age, sex, living arrangements, income, marriage, level of education, and job. The chance of undesirable quality of life in patients with a history of hip fracture surgery was 9.17 times greater than the elderly without a similar history. Therefore, developing supportive systems and rehabilitation facilities may improve patients’ quality of life.

Many studies support the positive short and long-term developmental care for premature infants. This study aimed to determine the congruence of nurses’ activity in four areas of developmental care in order to obtain basic information for authorities to provide a program to achieve related standards in the future. The study was performed on 70 nurses working in neonatal intensive care units in Tabriz, Iran. Nurses answered to a questionnaire retrieved from Robison’s developmental program. Content validity and reliability (Cronbach’s alpha) of translated version were evaluated. Data were analysed using SPSS. The mean (standard deviation) of total score was 3.06 (0.44). It was 3.02 (0.50) for individualized care, 3.01 (0.63) for appropriate development environment for the child and family, 3 (0.46) in supporting family relationship and approving the relationship between infant and family and 3.22 (0.56) for collaboration among all care factors. Score 4 was considered as completely meet standards. Therefore, a mean of 3.20 and above was considered as observance higher than 80% and was favorable. The Friedman test showed statistically significant difference among the activities related to the four areas (p = 0.001). The collaboration field had the highest mean score and providing services in this field had more congruence with the related standard of developmental care. The study showed that the congruence of nurses’ performance with standards of developmental care still requires more efforts. Therefore, it is necessary to train the staff in this regard and prepare them for structural and functional facilities.

Controlling over allergens and environmental irritants is one of the essential elements of controlling asthma. Asthma control in adolescents is a challenge. The current study was performed with the goal of investigating the effect of an educational and modifying intervention about asthma triggers on asthma control among adolescents. The current study was a randomized clinical trial. 60 adolescents of 12-18 years of age participated in this study. The participants were randomly divided into the two control and experimental groups. The Juniper’s Asthma Control Questionnaire was completed by the adolescents before and 5 weeks after the intervention. Training sessions, planning for modification of asthma triggers and telephone follow-up were performed in the experimental group. There was a significant difference between the asthma control score before and after the intervention in the control and experimental groups. The asthma control status improved in the experimental group. In other words, the educational interventions to modify asthma triggers were effective in improving asthma control. Since this intervention method can improve the asthma control in adolescents, it is recommended that adolescents directly participate in such programs about asthma triggers and the education become less parent-centred. Moreover, the necessity of such an intervention in clinics and outpatient clinics is emphasized.

Entering the state of fatherhood combined with the birth of a preterm neonate puts father's mental health at risk. Paying attention to fathers as a major supporter for mothers is essential. Therefore, the present study was conducted to evaluate anticipatory grief reactions among fathers with premature infants hospitalized in neonatal intensive care unit. The current descriptive, cross-sectional study was conducted on 120 fathers with premature infants hospitalized in neonatal intensive care unit in hospitals of Tabriz (Iran) during 2011. Fathers were selected using convenience sampling method. Data was collected using a valid and reliable anticipatory grief scale which rated items as 0-3. All fathers reported anticipatory grief reactions. The mean score of items was 1.47. The most common reactions were unremitting mental engagement with the infant and feeling of sadness. Irritability and feeling of anger were reported to be less severe. The least important reactions were related physical reactions such as disorders of sleep and appetite and feeling of guilt. Fathers experience anticipatory grief after the birth of premature infants and their hospitalization in neonatal intensive care unit. Therefore, it is essential for the health care providers to pay more attention to cognitive and emotional reactions of fathers.