نشریه پرستاری و مامایی ارومیه
سال سیزدهم شماره 9 (پیاپی 74، آذر 1394)

To make a development in nursing education, it’s necessary to evaluate the processes of the clinical education and become informed about modern executive models. In this regard, Competency Based Education Model (CBEM) is a new educational model that aims to reach desired clinical role. This study aims to determine the effect of implementing competency-based education model on nursing students’ clinical performance in Coronary Care Unit (CCU). In this quasi-experimental study with post-test design 34 senior nursing students, who met the inclusion criteria, were selected through census and divided into two groups as control and experimental. The control group received conventional education and the experiment group received competency based education for their CCU course. The students’ clinical performance score was measured through 3 researcher-made data collecting instrument (clinical performance assessment checklist, self-report questionnaire and multiple choice test). The collected data was analyzed by SPSS (16) software using descriptive and inferential statistics (Chi-square, independent t-test and Mann-Whitney U test). The results indicated that clinical performance of students in the experimental group was significantly higher than students in the control group both in terms of specific clinical performance (P<0.001) and generic clinical performance (P=0.001). Competency-based education model more than the conventional model improved the students’ generic and specific clinical performance. Therefore, it is recommended that nursing educational officials improve the efficiency and the effectiveness of clinical courses by taking advantages of this educational model and modifying the nursing curriculum based on modern educational strategies.

Cancer as a chronic and life-threatening diseases needs a strong resilience capacity. Evaluating the effectiveness of interventions on promoting resilience in adolescents with cancer requires appropriate tools to measure this concept. This study is conducted to evaluate psychometric properties of the Persian version of "Conner-Davidson Resilience Scale" in adolescents with cancer. This study is a methodological research to evaluate the psychometric properties of the Persian version of "Conner-Davidson Resilience Scale" (CD-RISC) in adolescents with cancer who attended in clinics and oncology wards in Children's Medical Center of Tehran, clinics and oncology wards in hospitals of Urmia, Children's Medical Center of Tabriz and the Cancer Research Center of Isfahan. Content validity index based on the opinions of 10 experts, was calculated. Construct validity (confirmatory factor analysis), was composed in sample of 200 adolescents with cancer and Cronbach's alpha and correlation coefficients were calculated between the two tests within 3 weeks. Data were analyzed by SPSS version 20 and AMOS version 21. Assessment of Content validity about the scale with no changes in the number and content of the statement was not performed. The confirmatory factor analysis by removing items 2 "is at least one of my close associations with him in times of stress (stress) to help me," five-factor model of the scale was confirmed. Internal consistency for "Conner-Davidson Resilience Scale" &alpha=0/82 and for each of the subscales including Personal competence and self-sufficiency (&alpha =0/75), tolerance of negative effect and strengthening effects to stress (&alpha =0/72), positive acceptance of change (&alpha =0/74), Self -control (&alpha =0/73) and Spiritual influences (&alpha =0/75) were calculated. The Pearson correlation coefficient between the two test results r =0/404 (p<0/05) was calculated The Persian version of "Connor - Davidson Resilience Scale" with 24 items and 5 subscales in adolescents with cancer, was confirmed in the study of resilience in adolescents with cancer and can be used to evaluate Resilience in Iranian adolescents with cancer.

How can nurses improve the airway suctioning expedite recovery? This study is performed to assess the effect of clinical audit process on the tracheostomy suctioning skill of nurses working in the critical care units in AJA hospitals in Tehran. In this randomized clinical trial study, 135 critical care nurses in AJA hospitals in 2013-2014 were selected by simple randomized method, and they were randomly allocated to the intervention and control groups. By applying the five-steps clinical audit, the intervention was carried out in the experimental group.To determine tracheotomy suctioning skill, before and after nurse’s intervention, the researcher made a checklist. Face and content validity and reliability of the checklist has been confirmed (&alpha=0.78). The data were analyzed by SPSS software version 21. Before intervention, T-student test didn’t show significant difference in the mean of total score in the tracheostomy suctioning skill between two groups (P=0.73). But after the intervention, the same test showed significant difference in mean of total score of the program (P=0.0001)

Since the success of organ donation process is closely related to the knowledge, attitude and practice of nurses toward organ donation process, the nurses who are dealing with this phenomenon should be aware of their roles in this process. This study was conducted to compare the effect of two teaching methods (context based learning and lecture) on nurse's knowledge, attitude and practice about nurse's role in organ donation process. In this experimental study, Ghaem and Imam Reza hospitals of Mashhad city were by random sampling assigned to CBL (Ghaem) and lecture (Imam Reza) groups. Then, through stratified random sampling allocation method, 60 ICU nurse's (each group, n=30(were selected. The CBL training was performed in 3sessions, every session lasted 2 hours, and the time interval between sessions was1 week. In the lecture group, the intervention group consisted of 1session of 6 hours. Both groups, before and 1 month after intervention, completed the questionnaire of assessing nurse's knowledge, attitude and practice toward nursing role in organ donation process. Data analysis was done by spss11.5 software, and by using t-test, paired test and chi-square. Both educational methods were useful in enhancing nurse's knowledge, attitude and practice but the mean difference score of Knowledge (p=0/0001),Attitude (p=0/0001) and Practice (p=0/0001) in the CBL group were significantly more than the lecture group. The result showed that the Context Based Learning was more effective in increasing average level of Knowledge, Attitude and Practice than lecture.

Higher education system is a great asset and Playsdifferent rolesinsocieties. Ensuring from the acquisition of knowledge, skills and competencies required by the graduates and the need for evaluation as a management practice are prerequisite for this system. The present study aimed to assess the common methods of educational evaluation from the view of faculty members was conducted. In this cross-sectional study in 2013, 167 members of the Faculty of Urmia Medical Sciences were selected. Data collected by a Researcher made questionnaire. Friedman test, t-test and ANOVA were used for data analysis. Of 165 respondents, 27 PhD were and 108 were PhD degrees. From the view of faculty members, participatory and goal-free models were more favorable. Analysis of the results revealed preference models on the basis of teaching experience gender and having a managerial position were not significant. ANOVA and LSD tests showed that in the goal-oriented model, difference of mean scores between the ranks of associate professor and assistant professor (P=0.003) and in the management-oriented model difference of mean scores between the ranks of lecturer and assistant professor (P=0.04) were significant. Preferences of faculty members indicated that considering only the defined goals objectives and neglecting unforeseen and actual results on the one hand and participation of stakeholders, particularly students, were important criteria in the selection. Considering all results, and interaction with all stakeholders in evaluation, will strengthen its credibility and effectiveness.

Improving mother’s health can lead to socio-economic development of any society. In this regard, social support and social capital are important determinants of health. The present study tends to examine the path analysis of these social determinants on Physical and Psych-social dimensions of mothers’ health in Sirjan city. In this descriptive-correlation study, 150 mothers (who were referred to health centers in Sirjan) were selected using random sampling. Three questionnaires measuring social capital, social support and Health (SF-36) were employed to collect data. The data were analyzed by SPSS and AMOS Softwares. The findings of the current study revealed the higher score of physical component summary of health than psychosocial component. Social capital and social health had significant and direct relation with both dimensions of mother’s health (p<.05).Social capital due to social support affected mother’s health, in addition of having direct effect. The final model showed that 73% of physical health, and 59% psychosocial health variance were attributed to social support and social capital. This study revealed mediator effect of social support in relation to maternal health. In this regard developing plans to promote mothers psycho-social health, and paying more attention to the role of social relationships and protective factors is recommended.

Disasters are seen in any society and have been considered as a factor that are beyond the control of human beings and usually lead to many deaths and injuries.And those critical situations are faces hospitals with different problems.The aim of this study is the use of the experiences of UrmiaSeyyedolshohada Hospital’s nurses during plane crash as the closest medical center to the site of the accident,that must be prevented problems and similar confusion, possible events in the future by taking advantage of experiences and learned lessons in conjunction with mentioned crisis and take appropriate measures.This study is a qualitative research, that was conducted using qualitative content analysis, to determine the meaning and themes derived from in-depth interviews, with the participation of nurses, that were present in the crisis of Sydalshhda Hospital of Urmia during the plane crash in Persian date Dey 19 1389.The final finding of the study is composed of two main themes each consisting of two subdirectories emotional - mental reactions and lack of scientific knowledge related to nurseand the second main theme is included inefficient management that is divided into two sub-branches, weak management and a lack of emergency resources.The main themes extracted from this study is included lack of activity of crisis committee, lack of incident command system to practice, and lack of training courses and simulation exercises, as well as the lack of preparedness of nurses, to perform triage and some basic clinical skills in response to the crisis.

Nursing profession is based on the caring of patient. The complexity of the concept causes the care receiver to have different meanings, which needs to be accurately identified. This study examines the concept of care from the perspective of patients with stroke. This descriptive phenomenological study aims to achieve experiences of stroke patients, included 6 men and 7 women, of the phenomenon of treatment, hospitalized in Al-Zahra and Shariati hospitals affiliated to Isfahan University of Medical Sciences, Iran. In this study, unstructured interviews were used to collect the data. Interviews, with the consent of the participants, were recorded on cassettes. Data analysis was performed using the Colaizzi method. From 13 interviews, 118 open codes, 34 primary concept, 11 subthemes, and four themes were extracted, including: "meeting the educational needs", "full and timely care," "emotional needs" and "continuity of care for patients”. Patients always need some knowledge about the disease process and treatment. It is expected that professional nurses do a holistic, on time, and continuously care. In patients with sensory motor deficits following a stroke, this need is much more noticeable.

Lack of training and preparation is the main cause of the increasing of medical interventions in mothers with maternal and fetal complications. Women's satisfaction from childbirth experience, service providers, policy makers, health care systems are among the the most important indicators of quality of care systems. The aim of this study was to survey the effect of mother's Group Edication on maternal satisfaction and pain intensity in mothers referred to health centers in Zanjan, in 2013. In this interventional and quasi-experimental study, 280 primipara pregnant women, who were referred to the medical centers of Zanjan in 2013-2014, were selected through stratified cluster sampling method, and they were randomly assigned in two groups of experimental and control. Eight sessions of 90-minute pregnancy readiness classes were held for the experimental group, while mothers in the control group were received the usual education. A questionnaire was used to collect the data in two phases of pre-test and post-test, then they were analyzed using SPSS through chi square, Fischer, and t-test. According to the results, there was no significant difference between the two groups in terms of age, Body Mass Index (BMI), education level, gestational age, and employment status. The pre-intervention pain intensity was not significantly different however, the pain intensity at 3-4 cm dilation and 7-8 cm dilation in the physiologic labor group was significantly less than in the control group (p = 0.001). The results showed significant differences between birth mother's satisfaction in both trained and untrained mothers (p <0.000). The findings show the effect of mothers education on pain intensity and mother's satisfaction. The widespread use of physiologic labor could improve qualitative indicators for maternal health.

Despite the recommendations for exercise-based cardiac rehabilitation as an integral component of comprehensive cardiac care of patients with CHD, most patients do not receive it. Home-based cardiac rehabilitation with a nurse manual-support is a popular method of rehabilitation. It can be effective in reducing disorders in patients, and increasing their participation. The aim of this investigation was to compare some of the behavioral characteristics and quality of life in both groups of cardiac rehabilitation. In a semi-experimental study, 40 patients (mean age 59 ± 6.28 year) voluntarily were divided into 3 groups: 1- home-based exercise rehabilitation (N=12), 2- centre –based CR (N=15) and 3- control (N=10). Subjects of both home and centre based of cardiac rehabilitation started their activity for 8 weeks. The type A behavior, anger, pessimism, anxiety, depression and quality of life variables of patients were measured by standard questionnaires in the beginning and at the end of eight week exercise rehabilitation. Data were analyzed using analysis of covariance (ANCOVA) in P< 0.05 level. After CR, scores of limit physical health, emotional wellbeing, body pain (Questionnaire SF36), and anger (Questionnaire TAB) were significantly improved. No significant differences were observed between the home –based exercise and centre-based cardiac rehabilitation programs based on all indices apart from the limit physical health index. Home-based exercise rehabilitation such as centre-based CR improved some of the psychological factors. Meanwhile the home –based exercise rehabilitation had a greater impact on the limit physical health index.