Advances in Nursing & Midwifery
Volume:27 Issue: 4, Winter 2018

Diabetes is one of the most common chronic diseases that is also highlyprevalent among adolescents. The present study was conducted to determine therelationship between demographic characteristics and self-management in adolescentswith type 1 diabetes. This descriptive-analytical study was conducted on 426 adolescents withtype 1 diabetes aged 13 to 18, and diagnosed for at least one year. The research toolsincluded a demographic information form covering the patients’ personal, family,and health details, and the Self-Management of type 1 Diabetes in Adolescence(SMOD-A) with five subscales of collaboration with parents, diabetes care activities,diabetes problem-solving, diabetes communication, and diabetes goals. The contentvalidity of the measure was then evaluated by a group of experts and found to beacceptable (SCVI = 98%). In the assessment of the measure›s reliability, the intraclasscorrelation showed an overall Cronbach’s alpha of 0.88. The test-retest showed aconsistency of 0.73 for the measure. The results obtained showed that the presence of another diabetic memberin the family leads to higher levels of self-management in some dimensions, includingproblem-solving, communication, and goals, yet to lower levels in some others,including collaboration with parents and diabetes care activities. A direct relationshipwas observed between the duration of time since the diagnosis and the scores obtainedby the adolescents. An inverse relationship was observed between the type of physicianin charge and the scores obtained in the subscales of collaboration with parents,problem-solving, communication, and goals. The scores obtained were directly relatedto having a school health record and having access to diabetic care tools at school.Family income was found to be directly related to diabetes care activities and inverselyto problem-solving, communication and goals. P of ≤ 0.05 was considered significantfor all relationships. Self-management was found to be moderate to good among Iranianadolescents with type 1 diabetes; however, it could be further improved with thesupport of both families and medical teams involved.

Ostomy is a surgical procedure performed to divert feces and urineoutput in cases of anorectal anomalies. Although this procedure is a crucial interventionwith excellent treatment effect, it is associated with complications, such peristomal skinlesions. This study aimed at evaluating the effect of providing ostomy care education tomothers of infants with peristomal skin complications. Forty mothers of neonates with intestinal stomies were informed about theaim of this study and invited to participate. The sampling was conducted in accordancewith the quota sampling method. The participants were randomly and equallyallocated to the control and experimental groups. The mothers in the experimentalgroup attended a three-session educational program, whereas the mothers in thecontrol group received information about routine care methods used by the studysettings. The peristomal skin conditions of the infants in both groups were examinedbefore discharge and 30 days after discharge using the Telegram Software or in person,according to an established checklist. Data were analyzed with the SPSS 21 software toobtain descriptive and analytical statistics. Prior to discharge, the majority of the neonates in both groups had healthyperistomal skin. In the control group, five neonates had acute dermatitis and one hadchronic dermatitis. In the experimental group, four neonates had acute dermatitis andtwo had chronic dermatitis. The χ-square test showed that the two groups were notsignificantly different (p-value = 0.94). After discharge, most of the neonates in theexperimental group had intact peristomal skin and only four neonates had chronicdermatitis. In contrast, in the control group, only six neonates had intact peristomalskin. The results of Fisher’s exact test indicated that the two groups of study weresignificantly different (p-value = 0.013). In the experimental group, 16 and 14 neonateshad intact peristomal skin before and after discharge, respectively. In the control group,14 and 6 neonates had intact peristomal skin before and after discharge, respectively.The results of McNemar’s test revealed no significant differences in the experimentalgroup before and after discharge (p-value = 0.69), whereas the control group showedsignificant difference in this context (p-value = 0.021). Providing mothers with education on proper ostomy care significantlydecreased the occurrence of peristomal skin lesions in neonates with intestinal ostomies.

The decline in fertility and childbearing tendency in Iran is due tovarious demographic, economic, social, and cultural variables. The present research wasconducted to review studies carried out on factors affecting the decline in childbearing. This systematic review searched for articles published from 2011 to 2017in all the available Iranian and foreign databases, including SID, Magiran, Irandoc,Medlib, Pubmed, Google Scholar, Science Direct, and Proquest using the followingkeywords, “childbearing”, “fertility”, “fertility decline” and “population decline”. Thesearch ultimately led to the inclusion of 53 studies. The main factors affecting the decline in childbearing discussed in the 53reviewed articles were divided to three general categories: 1. Personal and familyfactors, including aging, older age at marriage, current number of children, theduration of marriage, the mean birth spacing, gender preferences, hopefulness, maritalsatisfaction, and quality of life, 2. Socioeconomic factors, including social support,education, occupation and social participation, especially of females, place of residenceand the effect of social networks, 3. Cultural factors, including modernity, urbanizationand industrialization, attitude change towards the value of children, changes in familyvalues and religion. To intervene in the decline in childbearing and to increase the successrate of the designed plans and strategies, policy-makers and planners should providestrategies to deal with all the three noted groups of factors affecting childbearing.

The Objective Structured Clinical/Practical Examination (OSCE/OSPE)is one of the best assessment methods for measuring the students’ realization of theireducational goals in cognitive, emotional, and psychomotor domains. Given that gendermay influence the evaluation of medical sciences examinations, the present study wasconducted to compare the female and male nursing students of Shahid Beheshti Universityof Medical Sciences during years 2011 to 2015 in terms of their OSCE/OSPE scores for thebiochemistry laboratory. This study had a comparative descriptive design. All of the students participatedin this study from 2011 to 2015 (census). Over these four years, 649 students tookthis examination and their scores were recorded. The data collection tools included ademographic information questionnaire and a researcher-made checklist. Pearson’sCorrelation Coefficient was calculated for determining both the criterion validity and theinternal consistency (r = 0.732). The Pearson correlation coefficient confirmed the testretestreliability of the test (r = 0.88). The data were analyzed using the SPSS-22 softwarewith descriptive statistics, the independent t-test, the one- way Analysis of Variance(ANOVA), and Scheffe’s post-hoc test. The scores of 361 female students and 288 male students were assessed in thisstudy. The mean score was 11.6 ± 1.83 in female students and 11.2 ± 1.75 in male students(out of 14). The difference between the female and male students’ OSCE/OSPE scores inbiochemistry laboratory skills was significant (P = 0.02). Comparing the mean scores ofthe female and male students in biochemistry laboratory skills according to OSCE/OSPEby year of admission showed a significant difference between the genders in the studentsadmitted to the school during year 2012 (P = 0.01). There were also significant differencesbetween the age groups of < 20 and 25-29 and the other age groups in terms of the meanOSCE/OSPE scores (P < 0.05). There was a significant difference between the two genders in the meancrude scores obtained and the female students had slightly higher scores. Future studies arerecommended to investigate the students of other disciplines, academic levels, and schoolsto improve the generalizability of these findings.

Mothers’ participation in the Neonatal Intensive Care Unit is importantin promoting neonatal care and good outcomes for neonates and their mothers. Thepresent study was conducted with the aim of assessing the effect of empoweringmothers of hospitalized neonates on the level of their participation in neonatal care. This quasi-experimental single-group study with before-after designrecruited 59 mothers of neonates hospitalized at the NICU, selected according to thestudy inclusion criteria. Data were collected using educational needs questionnaireand the maternal participation checklist. The questionnaire was completed bymothers and the participation checklist by the researcher before the intervention. Theempowerment program was then implemented over 2 to 4 days. Comparison of participants› checklist scores before and after theimplementation of the empowerment program in 3 domains of care needs, informationneeds, and bonding, and attachment needs, showed significant increases in the level ofmothers› participation. The comparison of checklist participation scores showed thatthe Mean (M) and Standard Deviation (SD) of scores before and after performing themothers› empowerment were respectively 7.61 ± 3.66 and 12.38 ± 1.31 in the carearea, 1.47 ± 0.99 and 3.13 ± 0.66 in the information area, and 4.77 ± 1.42 and 5.70 ±0.59 in the area of attachment and dependency. Implementation of the empowerment program for mothers based ontheir educational needs significantly increased mothers› participation in neonatalcare. This empowerment program could be applied for a broad range of population ofmothers at the intensive care units of neonates.

Medication errors are the most common type of medical errors that cancause serious problems for public health and are considered a threat to patient safety.This study was conducted to determine the effectiveness of patient safety trainingon nurses’ medication errors at the emergency department of a hospital of GolestanProvince in Iran. The present quasi-experimental study was conducted from March toSeptember 2016. The study population consisted of nurses working at a hospitalaffiliated to Golestan University of Medical Sciences and a sample of 40 nurses atthe emergency department of this hospital were selected through a census. Thedata collection tools used included a demographic questionnaire and Wakefield’sMedication Error questionnaire for nurses (consisting of 21 domains), which wereused once their reliability was confirmed. A patient safety training program wasdesigned and implemented for the selected emergency nurses in the form of a twodayworkshop. The obtained data were analyzed using the SPSS-18 software with theWilcoxon test. Results showed that the rate of medication errors (80.62%) of nurses wereat a low level. The majority of nurses (80.62%) scored low in terms of the frequencyof medication errors; after the training, a significantly greater number of nurses scoredlow in terms of this index (90.31%; P < 0.001). The analyses showed the effectivenessof the patient safety training program for nurses in the two domains of wrong timeerror and missed dose error (P < 0.001); however, the training had no significant effects in the other domains. As patient safety training can be effective on nurses’ medication errors,retraining courses on safe medication administration are necessary regarding nurses’significant role in the prevention of medication errors.

Adaptation to the maternal role is an important factor for health ofmothers and infants. With regards to numerous stresses after childbirth and effect ofsocial support in modifying stresses, the present study was conducted for detecting thecorrelation between adaptation to the maternal role and social support in primiparousfemales. This cross-sectional study was performed on 260 primiparous females, whohad referred to public health centers of Shahid Beheshti University of Medical Sciencesin Tehran, during year 2016. Data gathering tools included the «DemographicQuestionnaire», «Adaptation to the Maternal Role in Iranian Primiparous WomenQuestionnaire», «Multidimensional Scale of Perceived Social Support», andEdinburgh Postnatal Depression Scale. Data analysis was done using the SPSS software(version 22) and it was based on descriptive statistics and statistical independent t-test,Analysis of Variance (ANOVA), Spearman correlation, and linear regression. P value <0.05 was considered significant. The score of adaptation to a maternal role had a significant correlation witha total score of social support and its subscales (P = 0.001). Also, the adaptation toa maternal role had a reverse significant correlation with the mother and father’seducation and the rate of family income, yet the results of the linear regressiondemonstrated that only two variables, “social support” and “mother’s education”, weresignificant in predicting the adaptation to a maternal role (P = 0.001), and they couldpredict 15% of variance for adapting to a maternal role. Social support is an effective factor for adaptation to the maternal role inprimiparous females. Therefore, providing an appropriate situation for these supportsis recommended. Also, it is required for health care providers to make sure about anadaptation to a maternal role, especially in mothers with higher education.

The aim of this study was to explain how the spiritual leadership modelcould be used as a paradigm for nursing leadership. Nursing leaders play a critical rolein the management of the health care system. Spiritual leadership is a new area that hasrecently been considered in nursing management. In this review article, electronic databases (PubMed, Scopus, GoogleScholar and Science Direct) were searched from September 2014 to July 2016 to findrelevant articles using keywords, such as spirituality, leadership, management, nursesand motivation. In this regard, the articles that fulfilled the goals of the study that werewritten in English or Persian, had their full texts accessible, and were published in theintended time interval were entered in the study. The articles without authors’ namesand dates and non-scientific papers were excluded from the study. On the whole, a totalof 120 articles were obtained, of which 48 were selected and analyzed. A review of the literature focusing on spiritual leadership demonstrated thatthe spiritual leadership model has been examined in different countries, various fieldsof the industry, trade training, and the health system with positive individual andorganizational consequences. It seems that the characteristics of this style of leadershipfits the nursing profession as well. Of course, more large-scale future studies for testingthis model of leadership in the field of nursing will bring about more promising results. Spiritual leadership could improve the organizational productivity andemployees’ satisfaction. Nursing leaders should have paid greater attention to this typeof leadership to achieve positive organizational outcomes; therefore, they need moretraining in this issue..

Psychological disorders are the leading cause of disabilities, socialharms, and reduced quality of life in patients with Multiple Sclerosis (MS). Thisqualitative study was conducted to describe the concerns of females with MS. In this qualitative study, 16 females with MS at the reproductive agewith medical records at the MS Society of Tabriz were selected using the purposivesampling technique and underwent semi-structured in-depth individual interviews.All interviews were recorded, transcribed, and analyzed using conventional contentanalysis. In this study, 23 codes were identified from transcribed interviews andcategorized to two sub-categories, fears and feelings. These two sub-categories formedthe main category, named concerns. Regarding concerns of these patients, their regular health monitoring byphysicians and healthcare providers is recommended in an attempt to alleviate theseconcerns.