Journal of Multidisciplinary Care
Volume:3 Issue: 2, 2014

Hospital readmission is considered as one of worrying issues for patients, healthcare providers, and hospitals due to influencing costs and quality of hospital cares as well as imposing extra burden on patients and their families. This study was conducted to predict patient readmission based on LACE index in internal ward of Hajar Hospital, Shahrekord. In this descriptive, analytical study which was conducted cross-sectionally from January, 2013 to June, 2013, the probability of readmission of patients hospitalized in internal ward of Hajar Hospital was estimated within one month after discharge, based on the data extracted from the medical file of each patient and asking patients to answer questions about each one of the components existing in LACE index checklist at discharge. Of 120 individuals participating in the research, 67 patients were female. The mean hospitalization duration of patients was three days. 62.4% of the patients had a history of cardiovascular, diabetes, and renal diseases of moderate level. Based on statistical results of chi-square, readmission of the patients was significant only for different age groups and with different education (P<0.01), but exhibited no significant difference for gender, marital status, occupation, and insurance (P>0.05). In regression analysis, the difference in LACE index score had a confidence interval of 0.611, standard deviation of 0.053, and significance of 0.040 in the individuals with and without history of readmission for readmission diagnosis. The groups at high risk need more healthcare training in view of lower education; therefore, it is recommended that the patients who obtain the score of higher than eight based on LACE index be particularly included in training programs.

Child Cancer has several effects on all family members. Caring of children facing chronic diseases like cancer, can imposes large burden on the parents. This article reviews and compares care giving burden of parents who have a child with cancer. In this descriptive study, a total of 150 families, all eligible participated in this research. Samples were taken using convenience sampling method from patients who admitted at Tabriz children medical and training centre and their families. Child and parents completed Care of My Child with Cancer questionnaires. Total care giving burden of parents was higher than average. Mothers’ care giving burden in physical and caring domains was more than fathers, and father’s care giving burden was more than mothers in emotional aspect. Parents travelling domain of care giving burden was not significantly different (P>0.05). The findings emphasized on the impact of child cancer on families. Mother can be informed about the disease, treatment, when nurses care of the patient. So, it can reduce the amount of care burden. Father’s emotionally supportive interventions can also reduce the burden of care on them.

Women’s pregnancy- and childbirth-associated mortality is one of the most important indices of a country’s development status. Therefore, It was examined the mortalities of pregnant women in Chaharmahal va Bakhtiari province within a 10-year period. This descriptive, cross-sectional, retrospective study was conducted in 2013-2014 in Chaharmahal va Bakhtiari province. All files of the pregnant women from 2002 to 2012 were examined. Within this 10-year period, 28 (17.2% of 100000 live births) pregnant women died. The mean age of women was 31.1±5.9 years old and the mean gestational age was 35.17±6.61 years old. The majority of the women were illiterate and rural (71.4%). A high proportion (46.4%) of the women experienced ≥4th pregnancy and most (46.4% of the) deliveries were cesarean. 19 (67.9% of the) deaths were directly pregnancy-related and nine were indirectly pregnancy-related. The most prevalent reasons for direct and indirect deaths were bleeding and heart disease, respectively. 4 (14.28% of the) died women whose death was due to direct reasons did not receive complete pregnancy healthcare. Regarding the results, promotion of literacy and knowledge of mothers, prevention from repeated pregnancies in older ages, appropriate pregnancy healthcare, and prevention from unnecessary cesareans help to decrease mortalities among pregnant women.

Delay in diagnosis of breast cancer is still a main cause of death among disease women. However, preventive procedures to solve this problem are less than expectation. The success rate in the treatment of breast can be directly related to early diagnose and breast self –examination is one of the ways to detect the disease early. This study was aimed to examine the effect of education on knowledge, attitude and performance of employed women about breast self-examination. In this quasi-experimental study, 50 employee women randomly selected of Shahrekord University randomly. Participants during 2 weeks, in 2 sections and each session 2 hours performed self –examination. The rate of knowledge, attitude, and performance of participants before and after education using a questionnaires and check list were evaluated and compared. Based on the results, the mean scores of subjects from 33.5±18.4 to 68.9± 9/2 increased (p<0.001). The mean scores for attitude increased from 74.5± 14.7 to 82.2±10.2 and the mean score for function from 41.5±30.8 before training to 84.8± 7.8 after training (p<0.001). Before training, %30 and after training, %84 of the wards under research breast self-examination performed. BSE McNamar test showed a significant difference before and after training breast self-examination (p<0.001). According to the present study, educational programs designed to enhance the knowledge, attitude and function and representation it through social media and health care centers is commend to provide opportunities for the use of screening methods.

Breastfeeding is a God's gift that combines with maternal emotions and gets suitable with needs of the child and his/her age. Self-efficacy in breastfeeding is self-adjustable frame that can be promoted with training programs to increase the rate and duration of breastfeeding. Therefore, this study aimed to investigate the effect of relaxation training on breastfeeding self-efficacy of mothers with preterm infants.

In this clinical trial study, 60 mothers with premature infants hospitalized randomly was assigned within two blocks of two months in both intervention and control groups. Mothers in the intervention group within 24-72 hours after childbirth individually and practically were included by the investigator for 30 to 45 minutes of progressive muscle relaxation training in Jacobson method. The Dennis Breastfeeding and demography information questionnaires were completed at baseline, the end of the fourth and eighth weeks by the mothers.

There was no significant difference in baseline characteristics of the two groups (P0.05). At the beginning of the study, t-test showed that the breastfeeding self-efficacy mean scores of the two groups did not significantly different (P=0.45). After the intervention in the fourth weeks, the average score of breastfeeding self-efficacy in the intervention group was (50.51± 6.79), and in the eighth weeks was (57.62± 6.22) compared to the control group (47.10± 8.85) and this difference was significant (P=0.001). The mean score of breastfeeding self-efficacy in the intervention group were significantly different at these times of study (P<0.001).

Regarding the effect of relaxation training on breastfeeding self-efficacy of mothers with preterm infants, education and training of it as a low cost and effective way to improve the health of mothers of premature infants is recommended.

Nurses are an important part of the care team that in the care of the elderly plays a major role that their attitudes towards working with older people have an impact on the quality of care. This study was aimed to determine the attitude of teachers and nursing students towards the nursing care of the elderly.

In this descriptive analytical study, all of 116 nursing students of third and fourth year and 22 clinical instructors in Arak University of Medical Sciences participated in this study in 2012. Samples were selected with census method. Data collection instrument was an investigator- made questionnaire that its validity and reliability was established. Scores of attitudes were arranged to three levels of weak, average and good after recoded in terms of accepted scores.

In terms of attitudes toward care of older people, findings showed that teachers (3.69±0.42) have more positive attitude toward caring for the elderly compared to students with an average of 3.45±0.32. This difference was significant (P=0.01). The majority of nursing students (83.6%) and teachers (72.7%) had moderate attitude towards the care of elderly patients.

Although obvious weakness of this approach was less visible; teachers can be a suitable model by knowledge and a change in their attitude for their students and try for induction understanding of health value for all members of society, and create better living conditions for them.

Among the complications of diabetes, foot problems such as ulcers, infections of the feet and lower limb amputation is increasing due to nonconformity of safety and preventive issues. Therefore, this study has been conducted with the aim to evaluate the foot care status based on the theory of Planned Behavior in diabetic patients. In this cross-sectional study, 69 type II diabetic patients referred to the Golestan Hospital Diabetes Clinic of Ahvaz during a three months period from June to September 2013 were selected randomly. Data were collected by means of a three-parts researcher made questionnaire(59 items) including medical and demographic data, knowledge, planned theory’s structures (attitude, subjective norm, perceived behavioral control and intention) and foot care performance were evaluated. The findings showed that 53.6% of participants had poor knowledge in foot care practices, whereas 79.71% had high attitudes toward these practices. 52.17% reported pressures and social support in high level and 52.1% stated an average level of the control on foot care practices. 79.7% had a high intention toward these practices, while 43.4% had poor performance. Also, the results showed that there is a direct and significant correlation between the mean of knowledge and performance and all theory's structures (P<0.05). The results of this study emphasis on necessity attention to a series of effective factors in diabetic patient's behavior change and could be the basis for developing theory-based educational interventions with the aim of improving the foot care.

Pain is the most common complication follows the surgery. The aim of this study was to evaluate the effectiveness of inhalation aromatherapy with Pelargonium graveolens on the postoperative pain in children. In a double blind placebo-controlled clinical trial study, 64 children with 3-6 years old in eases way selected and divided randomly into two groups and in each group 32 children. Patients in group A were given inhalation aromatherapy with pelargonium graveolens and in group B were given almond oil as a placebo. Inhalation aromatherapy used at the first time of child enter to ward as the 0 time and then at 3, 6, 9 and 12 hours afterward and common treatment to palliative pain were used in two groups. 30 minutes after per time aromatherapy, the postoperative pain in children were evaluated with the checklist, Toddler Preschooler Postoperative Pain Scale. It was found that the pain score at the first time of child enter toward (before received any aromatherapy or palliative care) have no significant difference between two groups (P>0.05). After each time of aromatherapy and at the end of treatment, the reduction of pain score was significantly higher in the aromatherapy group with pelargonium graveolens than in the placebo group (P<0.05). According to this study, aromatherapy with pelargonium graveolens can use in postoperative pain in children with other common treatment without any significant side effects.

Focus on patient safety in intensive care units is a major issue, and one of the most important factors related to patient safety is communication skills of the nurse – patient. This study aimed to determine the relationship between the communication skill of nurse - patient with patient safety in the critical care units of Urmia based on nurses point of view. In correlational descriptive study, 167 nurses working in intensive care unit educational and non-educational hospitals of Urmia, participated with census sampling method. Data were gathered using valid and reliable questionnaires including communication skills of the nurse-patient and patient safety and was evaluated communication skills of the nurse-patient and patient safety. The majority nurses working in educational and non-educational hospitals, respectively (97.5, 97.8) evaluated their communication skills in good level. The majority nurses working in educational and non-educational hospitals, respectively (87.6, 84.8) evaluated patient safety in good level. The study results showed that there is statistically a significant relationship between communication skills of the nurse-patient and patient safety (P>0.001). Regarding to the result of this study, nurses can use suitable communication skills with patients that hospitalized in intensive care unit to maintain and promote patient safety.