فهرست مطالب

Nursing and Midwifery Sciences - Volume:4 Issue: 1, Jan-Mar 2017

Journal of Nursing and Midwifery Sciences
Volume:4 Issue: 1, Jan-Mar 2017

  • تاریخ انتشار: 1395/12/24
  • تعداد عناوین: 10
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  • Fereshteh Araghian Mojarad, Leila Jouybari, Akram Sanagoo Pages 1-2
    Drug dependence is a prominent issue in individuals of different professions, education levels, and socioeconomic classes. Authors of this paper, including the first author (as a qualified clinical nurse and nursing supervisor), aimed to address the challenges associated with substance abuse and the subsequent failure in interactions between healthcare personnel and patients referring to clinical centers. Clinical reports have denoted various forms of addiction as a common problem among clinicians. In this regard, a nursing shift supervisor remarks: "In one of my shifts, I noticed that a fellow paramedic member had a long list of prescription drugs, which seemed unreasonable. After checking the prescription, I reported the matter to the matron, who mentioned that the majority of paramedic staff members suffered from substance abuse during their shifts.”
    The quotation above suggests that in addition to nurses, drug addiction affects different healthcare team members. Unfortunately, reported cases of drug dependence in the clinical environment are frequently neglected by hospital authorities, leading to the failure of rehabilitation attempts. Furthermore, substance abuse among healthcare personnel may cause disabilities, failure in clinical performance, expulsion, early retirement, and even death. The concept of “addiction potential" suggests that in case of availability, some individuals are more prone to substance abuse than others (1). This issue has prevailed among nurses for at least 150 years. According to historical evidence, reports of drug addiction among nurses emerged in the mid-19th century during the era of Florence Nightingale.
    Moreover, the American Nurses Association reported substance-related disorders among nurses in 1980 for the first time (2). In a cross-sectiona study performed in a medical school in India, 229 male physicians, 1,130 medical male students, and 73 female nursing students were reported to be drug abusers (3). Furthermore, approximately 10-15% of all healthcare professionals experience substance abuse at a certain point in their professional life. Identification of healthcare professionals with drug abuse is more complicated compared to the general population (2). Findings of a study indicated that the prevalence of substance abuse among nurses and general population is about 10% (4). Drug dependence is a grave concern, likely to disintegrate the standards of nursing practice and delivery of safe, high-quality care (5). Therefore, nurses with substance abuse problems must receive special attention and support since they might risk the health of patients. However, such consequences may be undermined due to the refusal to report substance abuse issues in treatment centers. In healthcare team members with drug dependence, fear of punishment could be an obstacle for requesting assistance or cooperation in rehabilitation (2).
    Based on the systematic observation and clinicalexperience of the authors of this article, since drug addiction is a social stigma, almost all healthcare personnel refuse to report such cases to the related authorities. Other challenges in this regard are lack of appropriate instructions to prevent substance abuse in treatment centers and insufficiency of comprehensive studies on drug addiction among medical staff, especially nurses. Therefore, national research is required regarding the prevalence and influential factors in substance abuse among healthcare providers. In addition, basic strategies must be adopted as to tackle this issue in clinical environments.
    With their remarkable professional reputation in the community, medical personnel are responsible for the safety and welfare of patients. As such, healthcare providers with drug abuse should be supported through non-punitive approaches, early intervention, and referral to specialists in order to receive effective treatment. To overcome this silent epidemic and prevent the devastation of organizational capital, a few strategies could be adopted, including a National Awareness Day (Drug addiction is an illness, not a crime), in-service education of healthcare staff, periodic training of nursing directors and hospital managers, identification of staff with drug abuse and providing support facilities, and proper management of drug storage and usage in hospitals.
  • Farshad Heidari Beni, Seyyedeh Roghayeh Ehsani, Amir Tabatabaee, Esmaeil Mohammadnejad Pages 3-7
    Background and
    Purpose
    Heart failure (HF) is a chronic, debilitating disease, and physical limitations and progressive symptoms of which associated with this condition can reduce quality of life (QOL). Patient education regarding heart HF is one of the main components of self-care. In this respect, peer education is significant in improving health and creating a learning environment. This study was performed to determine the effect of peer education on QOL in HF patients.
    Methods
    In this quasi-experimental study performed during 2016, 60 HF patients affiliated to Tehran University of Medical Sciences were randomly divided into intervention and control groups (n=30). After preparing the peer group, four peer-to-peer training sessions were conducted during one month. The Persian version of Ferrans and Powers’ Quality Of Life Questionnaire was used for data collection, which was completed by both groups before, just, and one month after the intervention. SPSS version 21 was employed for data analysis.
    Results
    No significant difference was observed between the two groups in overall QOL score and its domains before the intervention (P=0.31). The mean scores of QOL immediately after the intervention were 126.2±6.7 and 163.1±1.6 in the case and control groups, respectively. The mean scores of QOL one month after the intervention were 134.5±0.7 and 169.9±2.3 in the case and control groups, respectively. After the intervention, paired t-test showed that peer education had a significant relationship with QOL of the HF patients (P
    Conclusion
    Based on this study, peer education intervention can be a beneficial educative-supportive approach, which might enhance QOL in HF patients.
    Keywords: Heart failure patients, Peer education, Quality of life
  • Hamideh Manchri, Akram Sanagoo, Leila Jouybari, Zahra Sabzi, Seyyed Yaghob Jafari Pages 8-13
    Background and
    Purpose
    The students studying at the universities of medical sciences deal with numerous stressors during their educational experiences in the healthcare settings, which lead to poor mental health status and low performance. These stressors include the psychological pressures of the environment, the hospital settings, diseases, patients, heavy course load and training, economic and family problems, and no hope for the future career. Regarding this, the present study aimed to investigate the relationship between mental health and academic performance among the students of Golestan University of Medical Sciences, Iran, in 2015.
    Methods
    This descriptive-analytical cross-sectional study was conducted on the undergraduate students of Golestan University of Medical Sciences using quota sampling method. For the purpose of the study, a total of 270 students were entered into the study from the medicine, nursing and midwifery, health, and paramedical schools. The data collection was performed using a demographic form and the 28-itemed General Health Questionnaire. Additionally, the academic performance was determined using the grade point average (GPA). The data were analyzed using the Spearman correlation coefficient and Chi-square test through the SPSS version 16.
    Results
    According to the results of the study, the GPA was found to be 15.9±1.54. The means of the somatic symptoms, anxiety/ insomnia, social dysfunction, severe depression domains, and total mental health were 3.52±6.57, 6.99±3.97, 8.61±2.95, 4.24 ±4.12, and 27.47±10.55, respectively. The Spearman correlation test demonstrated a positive correlation between the mental health and age (P
    Conclusion
    Considering the importance of the mental health issue in the students of medical sciences, the authorities should pay more attention to solving the students’ mental health problems and provide them with more student counseling center
    Keywords: Academic performance, GHQ, Mental health, University student
  • Parand Pourghane Pages 14-20
    Background and
    Purpose
    Floating on water provides the opportunity for the elderly to exercise and take positions that may not be possible for them on the ground. The aim of this study was to explore the experiences of elderly women regarding barriers to hydrotherapy and how they can be ruled out.
    Methods
    This qualitative study was performed using content analysis method in Guilan, north of Iran. A total of 23 elderly women undergoing hydrotherapy based on physician’s order were chosen through purposive sampling. Semi-structured interviews were conducted for data collection, which were analyzed using the method suggested by Graneheim and Lundman (2004). The study’s rigor was ensured and ethical considerations were considered during data collection and analysis.
    Results
    Three main categories and nine subcategories, including internal barriers (lack of interest, insufficient knowledge, and doubt about its effectiveness), high expenses (expensive entrance fee, as well as expensive equipment and transportation), and environmental drawbacks (challenges of access, limited number of pools, and no companions), were developed during data analysis.
    Conclusion
    Various factors were reported as barriers to hydrotherapy. The assessment of these barriers and resolving them can help improve quality of life in elderly women.
    Keywords: Cutaneous leishmaniasis, Endemic, Epidemiology
  • Abdolmotaleb Hassani, Roghieh Nazari, Seyed Hamid Sharif Nia, Peiman Fereidouni Pages 21-25
    Background and
    Purpose
    Nosocomial infection is a threat to patient safety. In this study, we aimed to investigate the effect of alcohol-based handrub solutions recommended by the World Health Organization on skin integrity of health care providers.
    Methods
    This experimental study was carried out on 40 healthcare personnel of 17 Shahrivar Hospital, Amol, Iran, in 2016. The subjects were selected through convenience sampling method. The participants used the recommended solution for one month. The participants’ skin condition was evaluated by using two questionnaires filled out by the observer and participants in the first week and after one month. To analyze the data, the phi coefficient and Cochran’s Q test were used in SPSS, version 19.
    Results
    The results of the objective skin evaluation showed that there was no significant difference between the evaluations regarding skin redness (P=0.846), scaliness (P=0.276), and visual scoring of the skin (P=0.5). However, a significant difference was observed in terms of skin tears (P=0.05). The visual skin evaluation (P=0.001), skin disorders (P=0.006), moisture content (P=0.001), sensation (P=0.004), and overall skin integrity (P=0.023) showed a significant change after the use of the solution.
    Conclusion
    The results indicated that the recommended solution was compatible with the hand skin of the participants. We highly recommend the authorities to provide the necessary education for health personnel to improve compliance.
    Keywords: Alcohol-based solution, Hand hygiene, Tolerability
  • Samaneh Emami, Masoumeh Bagheri Nesami, Sina Sabourian Jouybari, Seyede Zeynab Mazloumi Baghloui Pages 26-31
    Background and
    Purpose
    Spiritual well-being plays an important role in the mental and physical health, and is considered as a common strategy to cope with problems. Given the importance of promoting spiritual well-being in the nursing and midwifery students, we must first determine the level of this state in this population. Regarding this, the present study aimed to examine the spiritual wellbeing and its related factors in the nursing and midwifery students of Mazandaran University of Medical Sciences, Sari, Iran.
    Methods
    This descriptive analytical study was conducted on 183 nursing and midwifery students studying at the Mazandaran University of Medical Sciences in 2015. The sampling was performed using the systematic random sampling technique. The research instruments included a demographic form and the Spiritual Well-Being Scale developed by Palotzian and Ellison. The data were analyzed through the SPSS version 16 using the descriptive and analytical tests, including frequency, percentage, t-test, and Pearson correlation coefficient.
    Results
    According to the results of the present study, the mean spiritual well-being was 69.70±11.62. In addition, the means of religious and existential well-being were 35.77±6.80 and 34.04±6.19, respectively. The results demonstrated no significant correlation between the demographic variables and spiritual well-being in the participants (P>0.05). However, spiritual well-being had a significant relationship with the religious and existential well-being (P
    Conclusion
    As the findings of the present study indicated, the majority of the nursing and midwifery students had a moderate level of spiritual well-being. Furthermore, religious well-being was found to be slightly higher than the existential well-being, which could be due to the cultural issues.
    Keywords: Nursing, Midwifery, Spiritual well-being, Students, University of medical sciences
  • Reyhaneh Gholamzadeh, Mohsen Jadidi, Reza Donyavi Pages 32-39
    Background and
    Purpose
    Responsibility among adolescents is of great significance, and families can influence sense of responsibility by creating purpose in life and developing social competence. Herein, we aimed to investigate the structural model of the relationship of family functioning and social competence with sense of responsibility and mediating role of purpose in life in this relationship among female junior high school students.
    Methods
    This correlational study has practical objectives. The participants were 384 female junior high school students of District 2 of Sari, Mazandaran province, Iran. Cluster random sampling was used for sample selection. The instruments included four questionnaires: 1) responsibility scale of the California Psychological Inventory (CPI), 2) family functioning of MacMaser, 3) social competence of Felner, and 4) purpose in life of Crumbaugh and Maholick. Pearson correlation coefficient and path analysis were used to analyze the data.
    Results
    The results indicated that family functioning, social competence, and purpose in life have a positive significant relationship with responsibility, and in the relationship of family functioning and social competence with responsibility, purpose in life plays a mediating role (P
    Conclusion
    Adolescents spend a considerable amount of time in family and school; therefore, students’ family functioning and social competence can be by providing appropriate training courses for their families and teachers. Furthermore, sense of responsibility can be reinforced among adelescents by creating purpose in life.
    Keywords: Family functioning, Purpose in life, Responsibility, Social competence
  • Razieh Rezaeekalantari, Ramazan Hassanzadeh Pages 40-47
    Background and
    Purpose
    Childbirth is a normal physiological process and a family event. Women in various societies with different cultural backgrounds have diverse reasons for childbearing. Understanding the reasons behind childbearing might help overcome some issues associated with early/late reproduction, or lack of desire to give birth. This study was an attempt to develop, validate, and standardize a scale for measuring the childbearing orientations.
    Methods
    To this purpose, 30 items related to the childbearing orientations were collected based on the related theories and literature. The reliability of the developed scale was confirmed, showing Cronbach’s alpha reliability index of 0.95. In addition, the validity was approved by three correlated components. The content and face validities of the scale were confirmed for all the 30 items using the opinions of five experts in the fields of psychology, nursing, and midwifery. The developed questionnaire was distributed among 215 participants to be filled out. The participants were selected out of the students studying five different majors, including human sciences (n=123), engineering (n=48), medical sciences (n=18), agriculture (n=8), and basic sciences (n=18) using the quota sampling technique. The participants were categorized based on their age, educational level, and marital status.
    Results
    Based on results of the factor analysis, four items with loading below 0.5 were discarded and the rest 26 items formed three components, including intrinsic motivation (14 items), developmental motivation (7 items), and extrinsic motivation (5 items). The developed instrument proved to be both valid and reliable (r=0.95).
    Conclusion
    Researchers in the fields of nursery, midwifery, and psychology may find the developed instrument and the related discussion useful.
    Keywords: Childbearing orientations, Properties, Psychometric
  • Robabe Khalili, Masoud Sirati Nir, Masoud Fallahi Khoshknab, Hosein Mahmoudi, Abbas Ebadi Pages 48-57
    Background and
    Purpose
    Post-traumatic stress disorder (PTSD) is identified as the risk factor for functional difficulties in most of the survivors. The aim of this study was to investigate the current evidence-based literature on the area of self-care and ADL status in the veterans with combat-related PTSD.
    Methods
    This review was conducted on the studies published within 2005-2015. The search was performed using such databases as SID, Iran Medex, Magiran, Science Direct, ProQuest, and PubMed. The searches were initially carried out using single keywords, and then continued with using OR/AND for combining words such as “self-care activity, instrumental activities of daily living, physical functioning, post- traumatic stress disorder in war veterans, etc”. Finally, a total of 783 papers were retrieved, out of which only 15 publications were considered relevant to the subject under discussion and investigated in-depth.
    Results
    According to the findings of the reviewed articles, there is a relationship between the self-care status and PTSD severity; as a result, greater PTSD symptoms are accompanied by poorer self-care practices and ADLs. Furthermore, in all the studies, the physical functioning (self-care or ADLs) was lower in the PTSD population in comparison to the non-PTSD population.
    Conclusion
    As the findings of the retrieved articles indicated, it can be conclude that the self-care practices and ADLs were poor among the veterans suffering from PTSD. Therefore, it is necessary that nurses develop a comprehensive care planning for this population to facilitate their achievement of independence in ADLs.
    Keywords: Activity of daily living, Combat, Post- traumatic stress disorder, Self-care, Veteran
  • Farhood Nikouee, Mitra Soltanian, Farzin Babaee, Mohadeseh Motamed Jahromi Pages 58-62
    Background and
    Purpose
    Cutaneous leishmaniasis is an endemic disease in different parts of Iran. The aim of this study was to investigate the epidemiology of cutaneous leishmaniasis in Zarrin Dasht, Fars, Iran, during 2013-2015.
    Methods
    This descriptive, cross-sectional study was performed on 266 patients selected through census sampling method. Data such as gender, age, occupation, disease season, location of scar on the patient’s body, and place of residence were gathered using a checklist and analyzed through descriptive statistics and nonparametric methods.
    Results
    In this study, the majority of the patients were female (58.3%) within the age group of 0-5 years (66.2%), living in rural areas (53%). The highest incidence rate was observed in autumn (49.2%). The majority of lesions (49%) were observed in face.
    Conclusion
    The results of this study showed that cutaneous leishmaniasis is an endemic disease in Zarrin Dasht, and it annually infects numerous people. Although the disease process has been declining during 2013-2015 in this region, this disease is still a health hazard and needs to be managed.
    Keywords: Cutaneous leishmaniasis, Endemic, Epidemiology