Journal of Multidisciplinary Care
Volume:5 Issue: 3, 2016

Most patients undergoing knee replacement surgery have pain and limited range of motion during recovery and rehabilitation and due to pain and lack of experience and knowledge are not able to run an effective rehabilitation program. So, this study was aimed to determine the effect of blended instruction on the intensity and the admission palliative of patients undergoing knee surgery.
64 patients scheduled for knee replacement surgery randomized block Foursome assigned to two experimental and control groups. The training program including film screenings and providing face to face training, manual and training video in the individual manner was implemented days before the surgery for the experimental group. The control group received routine care. Data by demographic and clinical form and pain assessment checklist were collected using a visual analogue scale. Numerical data about the pain from the second to fifth days and one month after surgery were collected and analyzed useing the SPSS software and Independent t-test, Chi-square and Repeated measure tests.
The results of this study showed that the experimental group reported significantly less pain than the control group at most times (P=0.012). According to independent t-test statistically significant difference between the 2 groups in terms of the amount of admission palliative at the time was found (P>0.054). However, based on analysis of variance with repeated measures between the admission palliative on study, there was a significant difference in both groups (P According to our results, the combined intervention before surgery can reduce the level of pain experienced after surgery and as a training method used to teach these patients after surgery.

Creativity and its impact on students’ performance is an important factor in the success and effectiveness of services in clinical settings. This study aimed to investigate the relationship between clinical efficacy and creativity of nursing students.
This cross-sectional study was carried out on 200 students who were interns and externs at the School of Kerman Nursing and Midwifery from October to May 2014, 2 semesters, who were selected by available sampling. The data were collected using three questionnaires: Demographic information, Torrance creativity and efficacy clinical practice based on the nursing process. Pearson correlation and Regression methods were used to analyze data with the use of SPSS software.
Average score of creativity and self-efficacy score were respectively 102.71±9.6 and 107.83±8.04. 97 percent of students had medium and strong clinical self-efficacy. Pearson correlation test showed a positive relationship between the total creativity and self-efficacy score (P The results of the study revealed a significant positive and strong correlation between creativity and clinical self- efficacy. Therefore, in addition to predicting student's curriculum units to foster creativity, emphasizing expansion into detail domain, it must be put special emphasis on nursing process in clinical environments. Because it can possibly be effective on their clinical self-efficacy as an important clinical skill in patient’s care.

The aim of treatment of hematologic malignancies is to relieve symptoms, increase survival and improve the ability of the patient and quality of life. In the recent years, it was taken consideration the use of complementary medicines for improving patients QoL. Massage therapy is one of these complementary medicine methods which usually will be accepted by patients. However, very few studies have been conducted on the effects of massage therapy on the leukemia patients. Therefore, this study was aimed to evaluate the effect of back massage on the quality of life in the patients with acute leukemia undergoing chemotherapy.
In this randomized controlled trial in Shafa hospital (2013-2014), 60 patients with acute leukemia chooses on the basis of inclusion criteria, and then were placed in the intervention and control groups with random assignment (30 patients in each group). Sampling performed during 6 months. After obtained informed consent, the intervention group received Slow Stroke Back Massage (SSBM) three times a week (every other day for ten minutes) for 4 weeks. The quality of life dimensions was measured using the SF-36 form. Statistical tests of independed t-test, and chi-square were used for data analysis.
Results showed that before intervention, it was not observed a significant difference between two groups in the means of quality of life dimensions (P=0.969), Whereas, after intervention, it was a significant increase in means of quality of life dimensions in the intervention group compared to the control group (P=0.001). After intervention in the intervention group, it was a significant increase in means of quality of life dimensions except social functioning and vitality dimensions.
Slow Stroke Back Massage, as a simple and safe approach can be useful to improve quality of life which main target of care of patient with hematological malignant. Therefore, it is recommended that the use of massages therapy in patients with leukemia should be included in training and caring programs of clinical nurses and students.

One of the nursing staff’s responsibilities is patient transferring. The disproportionate burden imposed on the person according to his ability is the most important causes of occupational accidents and injuries. This study was aimed to evaluate nurse's workload caused by patient transferring in khatam ol anbiya hospital (s) in Tehran.
This was a descriptive- analytic study. Its research community is all Khatam (s) nursing staff 260 of which were selected using convenience sampling and Morgan table. Using patient transfer assessment index (PTAI), the staff’s scores were calculated in terms of transfer and finally the data were analyzed using descriptive statistics (average and standard deviation), inferential statistics (Pearson correlation coefficient, Anova) and SPSS.
The people involved in the study had the average age (35.40±6.65yrs), work experience (11.36±5.71yrs), hight (1.73±5.79m) and weight (73.82±8.72kg), and body mass index (24.57±2.4). Statistical test results showed that none of the participants uses relocation equipment when transferring patients and based on PTAI, workload at danger level equaled to 0% at level 1, 8.07% at level 2, and 91.93% at level 3. Besides, nurse and nurse aid’s average PTAI score was equal to (32.83±17.14) and (42.25±12.46), respectively, which was significantly related to workload (P=0.001).
The results showed that the workload caused by patient transferring in nursing personnel is at a high risk. Thus, it is recommended to teach proper ergonomics principles and to use transfer equipment (non-mechanical and mechanical) in order to reduce the workload caused by patient transferring.

One of the reasons for the increase of Caesarean section is women’s tend to choose this type of delivery. This tendency is due to unawareness and negative attitude of them toward normal vaginal delivery. The aim of this study was to determine the effect of attending women in childbirth preparation classes during pregnancy on their attitude toward mode of delivery.
In this quasi-experimental study, 59 women in case and 58 in control groups were enrolled in health centers in Isfahan. Women were randomly divided into two groups and the case group participated in 8 sessions of 90-minute classes and the control group just received routine care. Data were gathered by a researcher- made questionnaire in the beginning of the study, after classes and two weeks after delivery in the two groups. Data were analyzed using SPSS software and ANOVA with repeated measures and independent t-test.
In case group there was a significant difference in the scores of women attitude before and after the intervention also between the scores before of the intervention and post-delivery (P Due to the positive effect of childbirth preparation classes on women's attitude toward normal vaginal delivery, it is proposed to create conditions in which all women and their companions have an easy access to these classes.

Primary dysmenorrhea has an important effect on women's quality of life. The aim of this study was to investigate the effects of aerobic training and pelvic floor muscle exercise on primary dysmenorrhea in adolescent girls.
In this study that was conducted in semi empirical, 45 adolescent girls suffering from average and severe primary dysmenorrhea were selected voluntarily and were divided in a simple random method into three groups of 15 as aerobic training, kegel training and control groups. The exercise protocol were conducted three sessions a week with intensity of 65% of maximum heart rate during 45 minutes; and in pelvic floor muscle group it was done daily three sessions for 15 minutes. 2 groups had performed the exercises for 8 weeks. The control group had no exercise activity during this period. Primary dysmenorrhea measurement questionnaires were used to collect the data and in order to homogenize the aerobic fitness of the subjects, a test includes running a mile was used.
In terms of intensity and duration of pain between pre-test and post-test, a significant difference has been observed (P=0.001). Comparing the experimental data in these 3 groups, significant differences in terms of pain duration among aerobic training and kegel exercise groups with control group were revealed that implies the reduction of pain during in the exercise groups (P=0.026). No significant differences among 2 exercise group in terms of pain duration were found (P>0.05). There were no significant differences in terms of pain intensity between the groups (P=0.200).
The results showed that aerobic exercise and Kegel could be caused to improve primary dysmenorrhea. Therefore, such exercises can probably be used in the treatment of primary dismenorrhea.

Increasing the number of elective caesarean section in Iran caused by several factors including fear of normal delivery that is psychological factor. This study was conducted to investigate the relationship between triple dimensions (Subjective, psychological and spiritual) of well-being in prediction of fear of normal delivery in pregnant women.
This research method was descriptive and correlational. The research sample included178 pregnant women that referred to the clinic of two hospitals in Tehran with two tendencies of normal delivery and caesarean for childbirth, and were selected by convenient sampling. Participants completed the spiritual well-being scale, subjective well-being scale, psychological well-being index and researcher made questionnaire of fear of childbirth. Data were analyzed using Pearson correlation and stepwise regression analysis.
The results showed negative significant correlation between spiritual well-being, religious and existential well-being, life satisfaction, positive affect and psychological well-being with fear of normal delivery in pregnant women and positive significant correlation between negative affect and fear of childbirth (P≤0.01). Results also showed that existential well-being has negative significant role in predicting the fear of normal delivery. The final research model explains significantly 9% of variance of fear of normal delivery.
From correlation between fear of normal delivery with the subjective, psychological and spiritual well-being in pregnant women, it can be concluded the increasing of satisfaction with life, positive affect and enriching the existential and religious beliefs in pregnant women can reduce their tendency for caesarean section and increase their readiness for selecting normal delivery.

Violence against women is a public health crisis, because it affects the mother and fetus simultaneously and causes undesirable consequences. This study was performed to determine the prevalence of physical and psychological violence during pregnancy in the world and Iran in systematic review and meta-analysis.
This study was a systematic review and meta-analysis that was conducted on the English and Persian articles published from 1990 up to 2015. In this aim by searching the information at SID, Medlib, Irandoc, Google scholar, Pubmed, ISI, Iranmedex, Scopus and Magiran, using key words the prevalence of physical and psychological violence during pregnancy in the world and Iran were extracted all related articles independently by 2 trained researchers. The results of studies combined using the STATA and Spss20 software.
In the initial searching of 276 articles, 46 articles related to Iran with a sample size 40457, 83 articles related to other regions of the world and totally 124 with a sample size 417832 Person relevant articles met inclusion criteria for study. The prevalence of physical violence during pregnancy was estimated in the world 18% (CI95%: 16%-19%) and in Iran 23% (CI95%: 20%-27%) and prevalence of psychological violence during pregnancy were estimated in the world 38% (CI95%:35%-41%) and in Iran 44% (CI95%: 38%-50%).
According to the present meta-analysis results, the prevalence of physical and psychological violence during pregnancy in Iran is more than the world. Thus, it is recommended that the relevant authorities by implementation the intervention programs such as the establishment of Prevention Center for Social Damages, implementation the family education programs before marriage and pregnancy prevent of violence during pregnancy.