International Journal of Community Based Nursing and Midwifery
Volume:3 Issue: 4, Oct 2015

Chiropractic is a complementary medicine that has been growing increasingly in different countries over recent decades. It addresses the prevention، diagnosis and treatment of the neuromusculoskeletal system disorders and their effects on the whole body health. This study aims to evaluate the effectiveness of chiropractic in the treatment of different diseases. To gather data، scientific electronic databases، such as Cochrane، Medline، Google Scholar، and Scirus were searched and all systematic reviews in the field of chiropractic were obtained. Reviews were included if they were specifically concerned with the effectiveness of chiropractic treatment، included evidence from at least one clinical trial، included randomized studies and focused on a specific disease. The research data including the article’s first author’s name، type of disease، intervention type، number and types of research used، meta-analysis، number of participants، and overall results of the study، were extracted، studied and analyzed. Totally، 23 chiropractic systematic reviews were found، and 11 articles met the defined criteria. The results showed the influence of chiropractic on improvement of neck pain، shoulder and neck trigger points، and sport injuries. In the cases of asthma، infant colic، autism spectrum disorder، gastrointestinal problems، fibromyalgia، back pain and carpal tunnel syndrome، there was no conclusive scientific evidence. There is heterogeneity in some of the studies and also limited number of clinical trials in the assessed systematic reviews. Thus، conducting comprehensive studies based on more reliable study designs are highly recommended.

Cardiovascular diseases are the most prevalent disorders in developed countries and heart failure is the major one among them. This disease is caused by numerous factors and one of the most considerable risk factors is unhealthy lifestyle. So the aim of this research was to study the effect of family-center empowerment model on the lifestyle of heart failure patients. This is a randomized controlled clinical trial on 70 heart failure patients referring to Hazrate Fatemeh heart clinic in Shiraz. After convenience sampling the patients were divided into two control and intervention groups using block randomization Method. The intervention based on family-center empowerment model was performed during 5 sessions. Research tools are lifestyle and demographic information questionnaires. Both intervention and control groups were similar regarding their demographic information (P>0.001).Before the intervention on lifestyle, all measures of the two groups were equal (P>0.001) but after the intervention; statistically significant differences were reported in all dimensions of lifestyle, the total lifestyle score in the intervention group was 70.09±16.38 and in the control group -6.03±16.36 (P<0.001). Performing the family-center empowerment model for heart failure patients is practically possible, leading to improvement or refinement of their and their families’ lifestyle.

After many years of teaching, both the efficiency and efficacy of communication skills programs are under question because patients’ dissatisfaction with doctors’ communication behavior is at the top of the complaint lists. It is assumed that finding the specific role of different determinants of doctors’ communication behavior, instructional designers can plan more effective training programs. This study aims to explore the predictive value of interns’ knowledge and self-efficacy in building effective relationship with patients and determine the causal relationship between interns’ knowledge and self-efficacy about effective doctor-patient relationship. In this cross-sectional study, PRECEDE model was applied and the analyzed content from semi-structured interviews with 7 interns and 14 faculty members was combined with the items from literature review. All the emerged items were categorized under eight constructs of social cognitive theory. The validity and reliability of the items of the research questionnaire were examined by 40 interns and an expert panel of 14 faculty members. The questionnaires were completed by 203 medical interns and confirmatory factor analysis (CFA) was done on the items. The data were analyzed by SPSS.21 and LISREL 8.80. CFA indicated a good fit to the data. Knowledge and self-efficacy, together, explained 23 percent of the variance in interns’ communicative behavior. 53 percent of the changes in interns’ self-efficacy were attributed to the changes in interns’ knowledge. Improving the interns’ shared vision can increase the quality of their knowledge and instructional designs based on learning facts, and gaining insights about effective doctor-patient relationship can increase the interns’ self-efficacy and consequently improve the interns’ communication skills.

Iran is one of the countries with considerable road traffic injuries. Pre-hospital interventions have an important role in preventing mortalities and disabilities caused by traffic accidents.The present study aimed to explore the barriers of pre-hospital care in traffic injuries in Tehran, Iran. A qualitative content analysis approach was conducted based on 21 semi-structured interviews with 18 participants. A purposeful sampling method was applied until reaching data saturation. Interviews were transcribed verbatim, and then data condensing, labeling, coding and defining categories were performed by qualitative content analysis. Four main barriers including 4 main categories and 13 subcategories emerged; they included Barriers related to people, Barriers related to metropolitan infrastructure,Barriers related to the profession and Barriers related to managerial issues. Based on the findings of this study, pre-hospital service barriers in traffic accidents have many dimensions including cultural, structural and managerial domains. Policy makers in health system can use these findings to promote the quality of pre-hospital services, especially in the field of traffic injuries.

Caring for a patient with heart failure can be a challenging and stressful situation. However, researchers have paid less attention to caregiving outcomes in heart failure caregivers. This study was conducted to investigate the relationship between perceived life changes and mental health of family caregivers of heart failure patients. Through a correlational design, a convenience sample of 90 Iranian family caregivers of patients with heart failure was selected. Data were collected using demographic-clinical characteristics form, Bakas Caregiving Outcomes Scale and General Health Questionnaire-28. Data were analyzed in SPSS using independent t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression analysis. Half of the caregivers reported that their lives had changed for the worse and nearly three fourths were suspected cases of mental disorders. There was a strong negative correlation between perceived life changes and mental health (r=-0.607, P<0.001). This finding remained consistent (B=-0.522, P<0.001) even when potential confounding factors including caregiver’s age (B=-0.222, P=0.016), caregiver’s marital status (B=-6.085, P=0.025), and patient’s age (B=-0.153, P=0.030) were controlled. Being younger, unmarried caregiver and caring of younger patients were identified as other correlated factors of poor caregivers ’mental health. The strong negative correlation between perceived life changes and mental health in caregivers of patients with heart failure suggests that the heart failure caregivers with poor mental health may benefit from nursing interventions that improve appropriate coping with life changes related to caregiving.

Despite the success of developed countries in preventing the spread of HIV/AIDS, the disease is expanding in developing countries where an unfavorable attitude exists among people, health professionals and employees. This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV (PLWHA). The study is a cross-sectional survey. The data were gathered using a structured questionnaire. The study sample included 575 health care providers of public and private hospitals in Shiraz. The data were gathered using a structured questionnaire in spring 2014. Data analysis was carried out using the Statistical Package for Social Sciences, version 21. The most dominant attitude of the health care providers toward HIV/AIDS patients was related to fear (42.42%). According to the results of this study, there was a significant relationship between stigmatized attitude of the health care providers and their religious beliefs, society stigmatized attitude, and knowledge of transmission routes. The relationship between social stigmatized attitude of health care providers and their knowledge of transmission routes, with their willingness to provide services to patients is significant, as well (P<0.05). 39.6% and 46.2% of the respondents preferred not to provide services to the prostitutes and homosexual patients. Fear of contamination and social stigmatized attitude are the main impediments to dealing with patients and providing services to them. Hence, it seems that creating an effective knowledge about transmission and correcting the socio-cultural beliefs of health providers are two key strategies to tackle this problem.

Social desirability may affect different aspects of people’s quality of life. One of the impressive dimensions of quality of life is mental health. The prevalence of Minor Psychiatric Disorders (MPD) among health care workers is higher than other health workers. This article aims at evaluating the relationship between social desirability and MPD among nurses in southern Iran. A cross-sectional study was carried out on 765 nurses who had been employed in hospitals in the southern provinces of Iran. The 12-item General Health Questionnaire (GHQ-12) and Marlowe-Crowne Social Desirability Scale (MC-SDS) were used for evaluating the MPD and social desirability in nurses, respectively. The Robust Regression was used to determine any quantified relationship between social desirability and the level of MPD with adjusted age, gender, work experience, marital status, and level of education. The mean scores of GHQ-12 and MC-SDS were 13.02±5.64 (out of 36) and 20.17±4.76 (out of 33), respectively. The result of Robust Regression indicated that gender and social desirability were statistically significant in affecting MPD. The prevalence of MPD in female nurses was higher than males. Nurses with higher social desirability scores had the tendency to report lower levels of MPD.

Families with disabled children need more psycho-social considerations. Motherhood care of the children with multiple disabilities is difficult. Due to its importance, the aim of this study was to investigate the causal factors affecting loving care of mothers of children with multiple disabilities. The study used a cross-sectional method in which 75 mothers of exceptional children with multiple disabilities (physical and mental) in elementary schools in Shiraz, Iran. The data were collected through questionnaires which, besides demographical factors, evaluated the relationship between mothers’ loving care of children with multiple disabilities and four other variables including purpose in life, life satisfaction, religious attitude, and sense of coherence. Mann-Whitney U was used for comparison between mothers’ loving care and other variables. Results revealed that demographic variables did not have a significant relationship with loving care. In the case of social variables, there was a significant relationship between mothers’ loving care and purpose in life (P<0.001), religious attitude (P<0.001), and life satisfaction (P=0.01). Motherhood care of disabled children is a unique phenomenon which is due to attachment of mother-child situation. Nevertheless, these mothers are vulnerable and marginalized people who need more attention and social supports provided by related governmental institutions and also NGOs actors.

Due to the high clinical challenges, differences in coping strategies, and high workload in nurses, there is a need to develop strategies to keep them in the profession. The aim of the present study was to explore the Iranian nurses’ coping strategies to deal with intention to leave. A qualitative content analysis was used to obtain rich data. We performed 13 in-depth face-to-face semi-structured interviews with nurses working in hospitals affiliated to Tabriz and Urmia Universities of Medical Sciences in Iran, selected through purposive sampling. Constant comparative method was used for data analysis. Three categories and eleven subcategories emerged during data analysis. The extracted categories and sub-categories consisted of (I) Self-empowerment (practical knowledge increase, responsibility, finding identification of the nurse, balancing work and life, seek support and humanitarian interests), (II) Self-controlling (tolerance, avoidance, the routine-based performance), and (III) Pursuing opportunities for advancement and promotion (community development, planning for higher education). Nurses make attempts to individually manage problems and stressors perceived from bedside that have led them to leave the bedside; these efforts have been effective in some cases but sometimes they are ineffective due to discontinuous training and relative competence in terms of how to manage and deal with problems. It is suggested that nurses should learn strategies scientifically to meet the challenges of bedside. Through enabling and supporting behaviors and creating opportunities for growth and professional development, nursery managers can help nurses to stay and achieve improvement of the quality of cares.