Modern Care Journal
Volume:12 Issue: 1, Jan 2015

Foot problems are common among patients with diabetes mellitus. In most cases, these problems finally result in amputation. The aim of this study was to investigate the impact of teach-back education on foot self-care among patients with type II diabetes. This controlled quasi-experimental study was conducted on 70 patients with type II diabetes referring to Birjand Diabetes Clinic, Birjand, Iran. Patients were randomly and equally assigned to the teach-back and the control groups. The study data were collected via the Orem’s nursing assessment form and a researcher-made foot self-care behaviors questionnaire. Based on patients’ educational needs and self-care deficits, foot self-care educations were provided personally and face-to-face to patients in the teach-back group in two to three sessions. Each session lasted 25–30 minutes. Patients in the control group received only the educations which were routinely provided in the study setting. The study questionnaires were recompleted through interviewing participants seven days and also one and three months after the intervention. The analysis of the study data was performed via the SPSS software (v. 16.0). The study groups were compared regarding patients’ demographic characteristics and foot self-care behaviors scores by conducting the Chi-square, the Fisher’s exact, and the independent-samples t test. In addition, within-group comparisons were performed by doing within-group analysis of variance and the Bonferroni’s post hoc test at a significance level of 0.05. The results of within-group analysis of variance and the Bonferroni’s post hoc test showed that in the teach-back group, the mean score of foot self-care at seven days and one and three months after the intervention was significantly higher than pretest readings (P<0.001). Moreover, all of the three pretest-posttest mean differences of self-care scores in the teach-back group were significantly greater than the control group (P<0.001). One and three months after the study intervention, the mean score of foot self-care in the teach-back group was significantly higher than both the pretest readings in the same group and the control group. These findings imply that teach-back education is effective in enhancing information retention. Using this technique in larger-scale studies is recommended for improving patients’ self-care ability.

Venipuncture is among the commonest painful invasive procedures performed by nurses. Preventing and alleviating children’s pain is of paramount importance. This study was undertaken to evaluate the impacts of acupressure on venipuncture pain among 6–12 year-old hospitalized children. In this clinical trial, eighty 6–12 year-old children hospitalized in Ali Ibn Abitalib and Moradi Hospitals, Rafsanjan, Iran, were recruited and allocated to the acupressure and the control groups by using the block randomization technique. Pain intensity was assessed in both groups after performing venipuncture by using a self-report numerical analog scale. Study data were entered into SPSS v. 18.0 and analyzed by performing the Chi-square, the Fisher’s exact, and the Mann-Whitney tests as well as median regression analysis. The intensity of venipuncture pain in the acupressure and the control groups was 3.35.±1.8 and 8.65±1.5, respectively. The difference between the study groups regarding the intensity of venipuncture pain was statistically significant (P<0.0001). Study findings suggest that as a non-pharmacological therapy, acupressure is effective in reducing pain. Consequently, it can be used as an effective strategy for managing venipuncture pain.

Relationship is an essential aspect of human life. During the course of illnesses and hospitalization, student-patient relationship significantly contributes to patient satisfaction and nursing care quality. The objective of the present study was to identify the factors affecting student-patient relationship from the perspectives of patients. This descriptive-analytical study was conducted in 2013 on 100 patients hospitalized in Imam Reza (PBUH) and Valiasr (PBUH) teaching hospitals, Birjand, Iran. Data collection was done by using a researcher-made instrument on patients’ perspectives on factors affecting student-patient relationship which included the four subscales of personal, social, environmental, and clinical factors. Data analysis was performed by using the SPSS software (v. 16.0), the measures of descriptive statistics, and the inferential statistics tests such as the independent-samples t, the one-way analysis of variance, the Mann-Whitney U, and the Kruskal-Wallis. The level of significance was set at below 0.05. The most and the least significant factors affecting student-patient relationship were respectively environmental factors (with a mean of 3.74±0.98) and personal factors (with a mean of 3.22±0.71). There was a significant correlation between social factors and participants’ gender and history of hospitalization as well as between environmental factors and participants’ marital status (P<0.05). Study findings suggest that the main factors affecting student-patient relationship are environmental factors, particularly poor environmental condition. Therefore, the effects of these factors should be moderated in order to enhance patients’ satisfaction with nursing services.

Patients’ hospitalization is associated with family members’ anxiety. Fulfilling family members’ needs such as providing them with information and helping them have physical contacts with their patients can alleviate their anxiety. This study was conducted to investigate the impacts of family members’ supportive presence in a neurological intensive care unit on their anxiety In this clinical trial, sixty family members of patients who had been hospitalized in a neurological intensive care unit were recruited and randomly allocated to the experimental and the control groups—30 persons in each group. Family members’ anxiety was evaluated by using the Hospital Anxiety and Depression Scale. The study intervention was the provision of basic care services to patients by their family members twice a day for six days during the first week of hospitalization in intensive care unit. Study data were analyzed by using the SPSS software (11.5) and by conducting the paired and the independent-samples t, the Chi-square, and the Fisher’s exact tests. At the beginning of the study, respectively 90% and 86.7% of patients’ family members in the experimental and the control groups suffered from anxiety. Before the study, the difference between the groups regarding the mean score of anxiety was not statistically significant (P=0.767). Compared with pretest readings, the posttest mean scores of anxiety in the experimental and the control groups decreased by 7.87 and 2.74 units, respectively. The pretest-posttest mean difference of anxiety score in the experimental group was significantly greater than the control group (P<0.001). Family members’ supportive presence in neurological intensive care unit significantly reduces their anxiety. Critical care nurses can alleviate family members’ anxiety through facilitating their supportive presence at their patients’ bedside

Nurses are among the main contributors to patient care and are in direct contact with patients. Nurses’ professional commitment can affect their job satisfaction and retention in nursing and enhance patient safety and care quality. Therefore, identifying factors behind their professional commitment is crucial. One of the factors which may affect professional commitment is organizational justice. This study was made in 2014 to evaluate the correlation of organizational justice and professional commitment among nurses working in teaching hospitals located in Birjand, Iran. In this descriptive-analytical study, 215 nurses working in Valiasr (PBUH) and Imam Reza (PBUH) Teaching Hospitals, Birjand, Iran, were recruited through stratified random sampling.A demographic questionnaire, the Nurses’ Professional Commitment Scale, and the Organizational Justice Questionnaire were used for data collection. Professional commitment was evaluated in the five subscales of understanding of nursing, nursing compliance, involvement of nursing professionals, devotion to nursing, and retention of nursing professionals while the three assessed dimensions of organizational justice were distributive, procedural, and interactional justice. The SPSS software (v. 16.0) was used for conducting one-way analysis of variance, multiple regression analysis, and the statistical tests of independent-samples t, Tukey’s post-hoc, and Pearson correlation at a significance level of less than 0.05. The mean scores of nurses’ professional commitment and perceived organizational justice were respectively 3.85±0.56 and 4.44±1.7, indicating high professional commitment and moderate organizational justice among the participating nurses. There was a significant correlation between organizational justice and professional commitment (r=0.54 and P<0.001). Moreover, the mean scores of professional commitment and organizational justice and all their subscales among nurses working in Imam Reza Hospital were significantly greater than the nurses working in Valiasr Hospital (P<0.001). Healthcare managers can adopt strategies and make wise decisions for enhancing nurses’ professional commitment through improving their perceived organizational justice.

In recent years, the importance of families’ active participation in care delivery has increased dramatically. Nurses’ attitude is a key factor in the implementation and the success of programs which actively involve families in critical care delivery. The purpose of this study was to analyze the effects of relatives’ participation in critical care delivery on nurses’ attitude to collaborative care. This pretest-posttest quasi-experimental study was conducted in 2013 on 44 critical care nurses of ShahidRahnemoun Hospital, Yazd, Iran, who were recruited through census method. The intervention was the involvement of patients’ relatives in providing basic care services to their own critical care patients for three consecutive months. A demographic questionnaire and the Families’ Importance in Nursing Care-Nurses’ Attitude scale were used for data collection. The items of this questionnaire are scored on a four-point Likert scale. Scores of 52 and less are considered as nurses’ negative attitude to families’ participation in care delivery. The face and content validity as well as the reliability of the questionnaire were confirmed by respectively ten experts and the test-retest method. Study data were analyzed by using the SPSS software (v. 16.0) and via conducting the paired- and the independent-samples t tests and the one-way analysis of variance. The level of confidence was set at greater than 0.95. The mean of nurses’ pretest and posttest attitude scores were 64.11±9.64 and 65.93±7.08. The difference between these two scores was not statistically significant (P=0.18). The pretest-posttest mean difference of the FINC-NA score of nurses whose first-degree relatives had the history of hospitalization in ICU significantly differed from nurses who had not such history (P<0.03). Study findings revealed that in overall, nurses had a positive attitude to relatives’ participation in care delivery. Although the study intervention had no significant effect on nurses’ attitude, their positive attitude to such an intervention can be taken into account by healthcare managers for developing more family-centered care programs.

Breast cancer is the most common cancer among women. Early diagnosis of breast cancer is extremely effective in its treatment. The aim of this study was to investigate the impacts of education on breast self-examination knowledge, attitude, and practice among female employees of Birjand University, Birjand, Iran. This one-group pretest-posttest quasi-experimental study was conducted in 2012 on 89 female employees of Birjand University who agreed to participate in the study. A three-part researcher-made questionnaire was used for data collection. The first part was a demographic questionnaire containing items such as age, marital status, and education, history of common breast problems, history of breast self-examination, and history of breast cancer among first-degree relatives. The second and the third parts were related to breast self-examination knowledge (20 items) and attitude (ten items). An educational program was implemented for the participants by a pathologist. Educations were provided in a 90-minute session through presenting a lecture, distributing pamphlets, showing a video clip, and using the question-and-answer method. The knowledge and the attitude questionnaires were completed by the participants both before and two months after the study intervention. The data were analyzed by using the SPSS software (v. 15.0) and through performing the Wilcoxon, the Kruskal-Wallis, the Man-Whitney U, and the McNemar’s tests. P values of less than 0.05 were considered as significant. Among 89 participating women, 81 (91%) were married. Participants’ average age was 39.2±7.3 years. Compared with the pretest readings, the means of women’s breast self-examination knowledge and attitude significantly increased after the intervention (P<0.001). Moreover, after the study, there was a significant difference among women with different educational status regarding the mean scores of knowledge and attitude. However, the differences among different age and gender groups were not significant. The pretest-posttest mean differences of knowledge and attitude were also not significantly related with women’s other demographic characteristics. Based on the findings of the present study, education can be effective in improving women’s knowledge and attitude about breast cancer screening methods. Consequently, running educational programs is recommended for effective prevention and prompt treatment of breast cancer.

Considerable increase in the rate of cesarean section is currently a major health challenge in our country, Iran. Cesareans are performed mostly without having a medical indication and due to pregnant women’s negative attitude to normal vaginal delivery. This study was conducted to measure the effectiveness of group cognitive behavioral training in changing nulliparous women’s attitudes and choiceof delivery route.

Forty nulliparous women referring to Imam Khomeini Hospital, Mahallat, Iran, were recruited conveniently to this quasi-experimental study. The women were assigned to either the control or the experimental groups—20 women in each group. In the control group, the women solely received routine prenatal care while the women in the experimental group, received group cognitive behavioral training in addition to routine prenatal care. The data collection tool was the Attitude to Delivery Questionnaire. The SPSS software (v. 18.0) as well as the paired- and the independent-samples t, the McNemar’s, the Chi-square, and ANCOVA tests were used for data analysis. The level of significance was set at below 0.01.

Results show that in the experimental group, the mean of ADQ score significantly increased after the study (P=0.001), while in the control group, it did not change significantly. Moreover, the results of ANCOVA also revealed a significant difference between the study groups regarding the mean score of attitude (P=0.001). The results of the McNemar test were also significant. In other words, the number of women in the control and the experimental groups who chose normal vaginal delivery after the study intervention was equal to one and eight respectively (P=0.008).

Group cognitive behavioral training positively affects nulliparous women’s attitudes and their choice of normal vaginal delivery.