نشریه پرستاری و مامایی ارومیه
سال سیزدهم شماره 8 (پیاپی 73، آبان 1394)

Anxiety is one of the most common problems of nursing students in the clinical settings that can cause adverse effects on their learning. Peer-mentoring can be one of the strategies to reduce the students anxiety in the clinical environment. The purpose of this study is to examine the effects that a peer mentoring program has on anxiety student in clinical environment. This research is a quasi-experimental study in which 44 second semester nursing students of the faculty of Nursing and Midwifery were included in 1391 through census، and they were randomly divided into two groups of control (21) and intervention (23). In intervention group، a 7th semester nursing student as peer mentor was assigned to accompany 4-5 second semester nursing students by taking the role of guiding and supporting. In the control group، clinical education was performed typically by clinical teachers. The instruments for data collection were Spiel Berger Anxiety Questionnaire which measures the student's anxiety in the first and at the end of the apprenticeship training for both groups. The data were analyzed by SPSS (16) software using، Chi²، Wilcoxon test، Mann Whitney. The results of this study showed that anxiety scores of students in the intervention group after the peer mentor program declined from of 34/34 to 29/69. Wilcoxon test also showed a significant statistical difference (P=0/001). Although student's anxiety score means were lower in both groups after the program، the average of anxiety student score in the experimental group was lower than that of the control group. The difference between the mean scores of the two groups was significant according to Mann Whitney test (p=0/001). Peer mentoring program -based education leads to reducing on the student's anxiety in clinical environment. So، it is suggested that clinical curriculum designers use this inexpensive method as a complementary educational method، even if not as an independent method.

Clinical nurses perform different roles in helping patients. Optimal performance of nurses in their clinical roles have always been encountered with several barriers. Awareness of nursing managers of these barriers has considerable impact on planning strategies to eliminate these barriers and thus improving the quality of nursing services. This study aims to investigate nursing manager’s opinions on barriers of clinical nurse’s role. In a descriptive – analytical study, 101 manager of educational hospitals of Kerman University of Medical Sciences were selected using consensus method. Data collection tool was a questionnaire consisted of demographic characteristics and barriers to nurse’s clinical role. Data analysis was done using SPSS V16, by applying descriptive and inferential statistics. In this study, 85.1% of study subjects were female, 75.2% were married, 93.1 % had bachelor degree, and 64.4% were head nurses. The study participants were aged between 28-51 years (mean 43.01±4.68). They have the work experience of 7-30 years, and their management work experience was between 1-25 years. The averages of manger’s opinion showed that the most important barriers were related to job security (68.9%), motivational factors at work environment (64%), factors related to management and leadership (63.4%), factors related to patient and caregiver’s believes (51.2%), nurse’s personal believes (49.75%) and the gap between theory and practice (47.5%). Weak association was found between gender and job security factors (r=0.3), as well as poor association between nurse’s personal believes and gender (r=0.3), age (r=0.16), and marital status (r=0.5), respectively. There was a weak correlation between marital status and the gap between theory and practice (r=0.23). Other demographic characteristics did not show any correlation with nurse’s role barriers. ANOVA test results showed that there were significant difference between the opinions of the three levels of managers (head nurse, supervisor, and metron) in term of job security, personal believes of patients and caregivers and nurse’s personal believes(p<0.05). The study found that the main barriers to nurse’s clinical role from nursing manager perspective were related to job security, workplace motivational factors and factors related to management and leadership. Therefore it is recommended that by planning actions such as timely payment of wages and benefits, improved working conditions and increased nursing facilities as well as modification or adjustment of their management styles, the managers could remove these barriers and thus improve the quality of nursing services.

The prevalence and mortality of heart failure is high and progressive. The incidence and prevalence of this disease is increasing in spite of medical advances. Because of the poor prognosis of the disease, limitations in physical activity, cessation of social interaction, psychological distress, increasing dependence and early retirement, it imposes a negative impact on the quality of life of the patients. The purpose of this study is assessing the effect of applying continuous care model on the quality of life in patients with heart failure. In the present clinical trial which was carried out in 2013, 60 patients with heart failure admited in Taleghani and Seyedolshohada Urmia hospitals were selected using accessible-sampling method, and they were randomly divided into two groups of 30 patients as the experimental and control groups. To evaluate the quality of life as a dependent variable, the Minnesota standard quality-of-life questionnaire was used for heart failure patients, including 21 questions on the three major dimensions of the quality of life (physical, mental and socioeconomic). The intervention was implemented during three months according to the continous care model in the experimental group. Data were analyzed by SPSS v.19 software using descriptive statistics (mean, standard deviation, frequency), chi-square, independent and paired t-tests analysis. At the end of third month, the mean of quality of life reached in the experimental, and control groups from 65.13±5.39 to 33.83±4.85, and from 65.86±3.7 to 67.43±7.03, respectively. There was a significant difference between the two groups in all aspects of quality of life including the physical, psychological, and socioeconomic dimension (p=0.00). Applying effective care model, training and follow-up with lifestyle changes in patients with heart failure can improve and enhance quality of life in them.

Iinvestigating the mental health determinants in hospital staffs specially nurses is very essential because of stressful conditions that they tolerate. So, the purpose of this study was to investigate the relationship among the meaning in life, religious well-being, existential well-being, and mental health in the nurses. In this cross-sectional study, 102 nurses from Talesh city were selected by available sampling method, and they were asked to answer Meaning in Life, Spiritual well-being and General Health Questionnaires. The data were analyzed by multivariate regression and standard multiple regression. The results showed that the relationship of religious well-being with meaning in life is positive and significant, but its relationship with anxiety, depression and social withdrawal is negatively significant. Moreover, the relationship of existential well-being with meaning in life is positive and significant. Its relationship with somatization, anxiety, depression and social withdrawal were negative and significant. Also, the relationship of meaning in life with anxiety and depression was negative and significant. Mental health of the nurses can be predicted by meaning in life, religious well-being and existential well-being.

Gastrointestinal diseases are common disorders for which endoscopy is one of the most important diagnostic procedures. Patient satisfaction out of such an invasive procedure is an important criterion for measuring the quality of health care, and it gives important information regarding the fulfillment of the needs, values and clients expectations. The purpose of this study was to determine the effect of anxiety- reducing nursing interventions on satisfaction in patients undergoing endoscopy referred to Ayatollah Taleghani Hospital of Urmia in 2014. This quasi-experimental study was conducted on 80 patients undergoing endoscopy referred to Ayatollah Taleghani hospital of Urmia in 2014. The samples selected by simple random sampling, and they were randomly allocated to intervention and control groups. Nursing interventions were performed for the intervention group before endoscopy as well as the endoscopy day. The satisfaction rate was measured before and after intervention in both groups. The satisfaction measurement tool was the modified GHAA-9 questionnaire. Data analysis was done by SPSS software version 16, and descriptive and inferential statistics. Paired t-test before and after intervention showed that patient satisfaction in the control group was not significant (p=0.934). But results showed that patient satisfaction in case group increased significantly before and after intervention (p<0.0001). Also, independent t-test showed significant differences between two groups after the intervention (p<0.0001). Of course before intervention there was not significant difference between the two groups (p=0.270). As the implementation of nursing interventions increased patient satisfaction significantly, therefore it is recommended to the nurses to include this program in their plans for improving the quality of nursing cares and satisfaction in hospitals.

The related studies has shown that students learning is under the direct influence of assessment and evaluation methods. Many researchers believe that essay tests can assess the quality of the student's learning, however essay tests scoring a big challenge which causes their unreliability in many cases. Unlike objective tests that measure the examinee's ability independent of the individual judgment, in essay tests, the examinee's ability is directly related to the examiner's judgment. Therefore, the accuracy of test scoring is greatly related to the methods of paper correction, and the examiners accuracy. This study tries to explain various methods of essay tests scoring in different published papers. In this study, first the different papers and articles published in national and international journals were selected by using keywords of essay test, scoring, and student assessment. Later, they were studied and analyzed. 240 articles without time limit were found by searching in the Web. 163 articles were excluded because of lack of relevant to the topic, and 23 articles were excluded because of lacking abstract. Finally, 54 articles were selected to be included in the study. Based on the search results of study, the search topic was grouped in four categories:1.defining different grading methods in essay questions 2.selecting appropriate methods for essay questions scoring 3.the challenges of essay questions scoring. 4. new methods of essay questions scoring. Improving assessment and essay questions scoring requires using of various methods, and the combination of multiple high level tests. In applying these kinds of tests, we should pay attention to the reliability and validity of the essay tests and scores.Address: Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran

Serum leptin is a circulating hormone that is expressed abundantly in adipose tissue. Defects in the leptin gene and its receptor causes numerous pathological problems such as over eating and obesity, improper functioning of the reproductive and hormonal imbalances. The purpose of this review is summarizing and analyzing articles about the effects of leptin on pregnancy and neonatal outcome. The Pubmed, Medline, Irandoc, SID, Science direct, Magiran database were surveyed for original studies describing the association between leptin effects on pregnancy and neonatal outcome. Totally, 120 articles were reviewed and 70 articles of association with leptin effects on pregnancy and neonatal outcome were selected and investigated secondarily (review essay). A significant relationship was found between maternal weight and maternal serum leptin. Studies have indicated that leptin levels are increased in pregnancy complications such as preeclampsia and diabetes. Cord leptin level was significantly associated with birth weight, length and head circumference of infant. In addition concentrations of the polypeptide in umbilical cord blood were correlated with placental weights. This hormone is also found in breast milk that can prevent obesity in the infant. Many physiological roles have been suggested for leptin in human pregnancy. Leptin also plays a role in the pathophysiology of pregnancy, and it may be predictive in the complication of pregnancy. Studies have suggested that recombinant human leptin can be used in the treatment of pregnancies with fetal growth restriction. In general, to identify the effects of this hormone, further studies are needed.

About 3% of neonates have large physical disorders that need surgeries. Upon increase in birth of premature neonates, the disorders that need surgeries have increased.esophagial atresia, bowel obstruction and imperforated anus are among the common disorders of neonates that can be dealt more effectively and safer with nursing cares according to the existing standards and the duration of stay of neonates at hospitals shall be decreased. This study aims to evaluate the compatibility of pre and Postoperative nursing cares with the existing standards. The present research is a descriptive auditing study in which 150 cases of nursing cares before and after the neonatal surgical operations have been studies and compared with the existing standards. The data collecting tool was checklist containing the data related to the manner of standard cares before and after neonatal surgical operations, being designed based on the review of existing contexts and standards and its validity and reliability was evaluated by contextual validity study and calculation of ICC (Intraclass Correlation Coefficient), respectively, equivalent to 0.88. The method of information collecting was done by observation and recording the choices of the checklist at NICU (Neonatal Intensive Care Unit) of Mofid and Mahdieh Hospitals, affiliated with Shahid Beheshti University of Medical Sciences. The data were then analyzed with descriptive statistics. The compatibility of pre and Postoperative nursing cares at the neonates’ wards and NICUs was evaluated as medium (66.9%), where 60.7% of the cares were done properly and 12.5% of them were not done properly and 26.8% of the cares were not done. The pre and Postoperative neonatal nursing cares are far away from the standards and it can be attributed to the carelessness of the caretakers, insufficiency at education, and shortage of facilities and equipment.