International Journal of Community Based Nursing and Midwifery
Volume:2 Issue: 4, Oct 2014

This review focuses on the impact of liaison nurse in nursing care of patient after ICU discharge on patient’s outcomes, compared with patients that are not taken care of by liaison nurses. The role of the ICU liaison nurse has transpired to solve the gap between intensive care unit and wards. Therefore, we aimed to review the outcomes of all studies in this field. A systematic review of intervention studies between 2004 and 2013 was undertaken using standard and sensitive keywords such as liaison nurse, intensive care unit, and patient outcomes in the following databases: Science direct, PubMed, Scopus, Ovid, Oxford, Wiley, Scholar, and Mosby. Then, the articles which had the inclusion criteria after quality control were selected for a systematic review. From 662 retrieved articles, six articles were analyzed in a case study and four articles showed a statistically significant effect of the liaison nurse on the patient’s outcomes such as reducing delays in patient discharge, effective discharge planning, improvement in survival for patients at the risk for readmission. Liaison nurses have a positive role on the outcomes of patients who are discharged from the ICU and more research should be done to examine the exact function of liaison nurses and other factors that influence outcomes in patients discharged from ICU.

The most common treatment for asthma is transferring the drug into the lungs by inhaler devices. Besides, correct use of inhaled medication is required for effectiveness of pharmacotherapy. Thus, it is necessary to train the patients how to use Metered Dose Inhaler (MDI). This study aimed to determine the effect of training about MDI usage with or without spacer on maximum expiratory flow rate and inhaler usage skills in asthmatic patients. This randomized clinical trial was conducted on 90 asthmatic patients who were randomly divided into inhalation technique group with spacer, inhalation technique group without spacer, and a control group. Then, the Peak Expiratory Flow Rate (PEFR) was measured using a peak flow meter, as a basic test. In addition, the patients’ functional skills of inhalation technique were assessed using two checklists. Afterwards, 3 sessions of training were arranged for both groups. PEFR and the ability to use the MDI were evaluated immediately and 1 month after the intervention. Finally, the data were entered into the SPSS statistical software (v. 18) and analyzed using independent t-test and repeated measures ANOVA. After the intervention, MDI usage skills improved in the two intervention groups compared to the control group (P<0.001). In addition, a significant difference was found between the intervention groups and the control group regarding the mean of PEFR after the intervention (P<0.001). However, no significant difference was observed between the two intervention groups (P=0.556). According to the results, providing appropriate training for asthmatic patients increased MDI usage skills, and both methods of inhalation (with or without spacer) could improve the PEFR among the patients.

Smoking is the cause for many preventable deaths worldwide. The rate of smoking has not increased in Iran in the past two decades, but its increase among adolescents and young adults is a concern. This study investigates the risk factors of initiation and continuation of smoking in Iran using a qualitative approach. This is a qualitative content analysis study conducted on 12 smokers and 6 non-smokers in 4 selected cities in Iran. Data were collected with deep and semi-structured interviews, verbatim transcription and simultaneously coding. Then, they were analyzed through content analysis. Three themes and 16 subcategories emerged. The themes were personal inefficacy with 6 subgroups included inadequate information, low age, curiosity, consideration of smoking not as a major problem, wrong beliefs, and making reasons. Family inefficacy with 4 subgroups included poor authority, lack of reaction, existence of stressors, and history of smoking. Vulnerable social environment with 6 subgroups included poverty, social stressors, magnification of smoking, network of cigarette smoking, smoking as a norm and convenience of access. Recognition of smoking among children, modification of wrong beliefs about smoking, empowerment of the individuals against smoking from the very childhood, consideration of familial stress and crisis, and ultimately, paying attention to the role of social variables will play a major role in prevention of smoking and encouraging individuals to quit smoking.

Cognitive impairments, which are common problems among the elderly people, account for a wide range of aging disorders. Group reminiscence can be used as a profitable therapeutic method for preventing cognitive-behavioral disorders in older adults. Therefore, we aimed to investigate the effect of group reminiscence on the cognitive status of elderly people. This study was a non-blinded randomized controlled trial. We enrolled 100 elderly people who were under the support of Ilam Welfare Organization, western Iran in 2013. Balanced block randomization method was used to randomize the participants into intervention and control groups.Elderly people in the intervention group participated in a group reminiscence program consisted of two one-hour sessions per week for 8 consecutive weeks. Data were collected using Mini Mental State Examination (MMSE). The questionnaire was completed four times by the participants; before, immediately after, two and three months after the intervention. The mean±SD of cognitive status scores in the intervention group was 24.66±3.8 which increased to 25.02±3.67, 25.04±3.72 and 24.72±3.66 immediately after, two and three months after the intervention respectively. The results showed that the changes in the mean scores were statistically significant in the intervention group immediately after the intervention (P=0.001) and at second month (P=0.003) follow-ups. However, we found no statistically significant difference in the intervention group at the mentioned time intervals in this regards (P=1.000). We concluded that continuous programs of group reminiscence could improve cognitive status of elderly population.

Hospitalization in neonatal intensive care unit (NICU) leads to a lot of stress and shock to the parents. Nurses, as the primary sources of information, could play an important role in reducing their stress. The aim of this study was to determine the effect of educational program on the premature infants’ parental stress in NICU. This double-blind randomized controlled trial study with a pre-and post-test and follow up design was conducted from February 2013 to March 2014. Sixty parents in Hazrat Zainab hospital affiliated to Shiraz University of Medical Sciences were randomly allocated into the intervention (received educational program) and control groups (received routine care). The valid and reliable”Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU)“was used to measure the parental stress. In the intervention group, information about general condition of the baby, the equipment and unit’s environment, spouse support, and problem solving strategies were given. The data were collected the second day after admission, fifth day after admission, and a week after the intervention. The data were analyzed in SPSS (Version 14), using t-test and repeated measures analysis of variance. In the second day after admission, the mean score of stress in premature infants’ mothers and fathers in the intervention group were 94.79±14.28 and 76.77±16.39, respectively. In the control group, it was 94.48±20.03 and 92.30±21.95 for mothers and fathers. After the intervention in the fifth day of admission, a significant difference was observed between the two groups concerning the premature infants’ maternal (t=-5. 23, P<0.0001) and paternal (t=-6.17, P<0.0001) stress. Moreover, a week after the intervention, the stress mean scores were (in the intervention group: for mothers=59.72±13.55 and for fathers=61.22±18.00), and (in the control group: for mothers=86.75±12.12 and fathers=84.70±18.46). Moreover, a significant difference was shown between the two groups concerning the premature infants’ maternal (F=23.05, P<0.0001) and paternal (F=17.35, P<0.0001) stress mean scores during the three study periods. The results of this study showed that parents’ educational program can reduce their stress and they can spend their energy to support and care for their baby instead of coping with stress.

Tension and stress are among the factors that lead to hypertension. In most individuals, behavioral strategies, such as relaxation and massage, are effective in controlling the individuals’ response to stress, thus reducing hypertension. This non-blind clinical trial was conducted on 90 patients with primary hypertension. The patients were randomly divided into a control and an intervention group. In both groups, blood pressure was measured and recorded twice a week before and after a 10-min Swedish back massage and rest for 6 weeks. The study data were collected using a questionnaire including demographic information, a check list of blood pressure record, and a fixed manometer. In the intervention group, systolic and diastolic blood pressure decreased to 6.44 and 4.77 mmHg, respectively after back massage (P<0.001). The obtained results were indicative of the effectiveness of back massage in reducing blood pressure in the study participants. Using stress control methods, such as massage, is a simple, acceptable, and teachable method for families to control blood pressure. After conducting more studies on this issue, back massage can be recommended as a non-pharmacological method to control blood pressure.

Fathers’ cooperation has been less taken into account in the process of pregnancy. The present study aimed to investigate the effect of training the fathers regarding attachment skills on maternal-fetal attachment in primigravida women in 2013. This randomized controlled trial was performed on 150 qualified pregnant women’s husbands. The intervention group took part in four 90-minute sessions of maternal-fetal attachment training held once a week. On the other hand, the control group received the routine pregnancy care. Both groups completed Spielberger’s anxiety scale and Cranley’s questionnaire before and after the intervention. Then, the data were analyzed using paired and independent t-test. Besides, P<0.05 was considered as statistically significant. The intervention group’s mean score of attachment was 55.98±6.99 and 61.90±5.41 before and after the intervention, respectively. The results of paired t-test revealed a significant difference between the intervention and the control group regarding their mean scores of attachment before and one month after the intervention (P<0.001). Additionally, the results of independent t-test showed a significant difference between the two groups regarding the five dimensions of the questionnaire, namely interaction with the baby (P<0.001), acceptance of maternal role (P<0.001), differentiation between oneself and the baby (P<0.001), attribution of some features to the baby (P=0.01), and self-devotion (P=0.01). Training the fathers regarding the attachment behaviors and skills led to an increase in the maternal-fetal attachment scores. Thus, paternal training should be considered in pregnancy care programs.

The concept of family- centered care in neonatal intensive care unit has changed drastically in protracted years and has been used in various contexts differently. Since we require clarity in our understanding, we aimed to analyze this concept. This study was done on the basis of developmental approach of Rodgers’s concept analysis. We reviewed the existing literature in Science direct, PubMed, Google Scholar, Scopus, and Iran Medex databases from 1980 to 2012. The keywords were family-centered care, family-oriented care, and neonatal intensive care unit. After all, 59 out of 244 English and Persian articles and books (more than 20%) were selected. The attributes of family-centered care in neonatal intensive care unit were recognized as care taking of family (assessment of family and its needs, providing family needs), equal family participation (participation in care planning, decision making, and providing care from routine to special ones), collaboration (inter-professional collaboration with family, family involvement in regulating and implementing care plans), regarding family’s respect and dignity (importance of families’ differences, recognizing families’ tendencies), and knowledge transformation (information sharing between healthcare workers and family, complete information sharing according to family learning style). Besides, the recognized antecedents were professional and management-organizational factors. Finally, the consequences included benefits related to neonate, family, and organization. The findings revealed that family centered-care was a comprehensive and holistic caring approach in neonatal intensive care. Therefore, it is highly recommended to change the current care approach and philosophy and provide facilities for conducting family-centered care in neonatal intensive care unit.

Prostate cancer has been reported as the second leading cause of cancer death and the most common cancer diagnosed in men. Since Health Belief Model (HBM) has been intensively used for assessing health beliefs associated with cancer screening behaviors, we aimed to investigate the level of knowledge and health beliefs about prostate cancer screening among retired men. In this descriptive study carried out in 2013, we enrolled 180 men aged 50-70 years who were retired from Shiraz Education Department. Data were collected using three questionnaires including demographic questionnaire, HBM and the Knowledge about Prostate Cancer Screening questionnaires by interviewing the participants. Our findings showed that 95.6% and 85.6% of the interviewees had no experience of digital rectal examination (DRE) and prostatic-specific-antigen (PSA) testing for prostate cancer screening, respectively. 86.1% of men had no knowledge about such screening. 12.7% of the respondents reported good knowledge scores. 74.4% and 90.5% of them had good health motivation and perceived benefits scores, respectively. 81.6% of them revealed intermediate scores for perceived barriers. Moreover, 32.7% and 7.2% of the subjects reported good severity and susceptibility scores, respectively. Developing an assessment based on HBM could be effective in designing and implementing educational programs by helping to identify the needs and priorities of the target population.