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Nursing and Midwifery Studies - Volume:4 Issue: 4, Oct-Dec 2015

Nursing and Midwifery Studies
Volume:4 Issue: 4, Oct-Dec 2015

  • تاریخ انتشار: 1394/09/20
  • تعداد عناوین: 10
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  • Saeideh Ghaffarifar, Fazlollah Ghofranipour*, Fazlollah Ahmadi, Manouchehr Khoshbaten Page 1
  • Bentolhoda Kolahkaj, Fatemeh Zargar* Page 2
    Background
    Studies suggest that mindfulness-based interventions can improve anxiety, depression and stress in patients with multiple sclerosis (MS). However, no study investigated the effectiveness of this method in patients with a combination of problems such as depression, anxiety and stress simultaneously. However, comorbidities of depression and anxiety in MS are prevalent.
    Objectives
    This study aimed to assess the effects of mindfulness-based stress reduction (MBRS) on anxiety, depression and stress in women with multiple sclerosis.Patients and
    Methods
    This randomized controlled clinical trial was performed in 2013 in Ahvaz MS Society. Forty eight patients were selected by convenient sampling and randomly assigned in experimental and control groups. The patients in the two groups filled out depression, anxiety and stress scale (DASS-21) at initiation of study, 8 weeks later and 1 month after the end of intervention. The experimental group received 8 sessions of MBRS, while the control group treated as usual. Finally, data of 40 patients analyzed using t-test, chi square and repeated measures analysis of variance.
    Results
    In the MBSR group, the mean depression, anxiety and stress were reduced significantly (P < 0.001). The mean depression score was 8.35 ± 1.78 before the intervention and reduced to 4.80 ± 0.83 and 4.45 ± 0.60 after the intervention and follow-up (P < 0.001). Also the mean anxiety score was 8.90 ± 1.97 before the intervention, which was significantly reduced to 4.70 ± 1.38 and 4.55 ± 0.99 after the intervention and follow-up (P < 0.001). The mean stress score was also 8.80 ± 2.35 before treatment and 4.80 ± 1.67 and 4.70 ± 1.34 after the intervention and follow-up (P < 0.001).
    Conclusions
    This study showed that MBSR training can reduce mean depression, anxiety and stress scores in patients with MS. These findings suggest that MBSR is useful for psychological problems such as depression, anxiety and stress in patients with MS.
    Keywords: Multiple Sclerosis, Mindfulness, Depression, Anxiety, Stress
  • Atye Babaii, Mohsen Adib, Hajbaghery*, Ali Hajibagheri Page 3
    Background
    Patients in coronary care unit are at risk of sleep deprivation. Sleep deprivation can be associated with increased blood pressure and heart rate, raising the risk of developing cardiovascular problems among patients hospitalized in coronary care unit.
    Objectives
    This study was carried out to examine the effect of eye mask on sleep quality in cardiac patients.Patients and
    Methods
    In this randomized controlled trial, 60 patients who met the inclusion criteria were selected using a convenient sampling method and randomly allocated into the experimental and control groups. Patients in the control group received routine care. However, in the experimental group, patients received routine care and eye mask for three subsequent nights. In the both groups, the sleep quality was assessed using the Pittsburgh sleep quality index. Data were analyzed by the chi-square test, independent samples t-test, Mann-Whitney U, and Wilcoxon signed-rank tests.
    Results
    After the study, the median scores of the subjective sleep quality, the sleep latency, the sleep duration, the habitual sleep efficiency, and the sleep disturbances domains, as well as the median score of overall Pittsburgh sleep quality index in the experimental group were significantly lower than those in the control group (P < 0.05). However, no significant differences were observed between the two groups in terms of the use of sleep medications and the daytime dysfunction domains (P > 0.05).
    Conclusions
    Using eye mask can significantly improve the sleep quality in cardiac patients. Therefore, nurses are recommended to use eye mask in combination with current treatments for improving patients’ sleep quality.
    Keywords: Sleep, Coronary Care Unit, Nursing
  • Sayyed Hossein Hashemi, Ali Hajbagheri, Mohammad Aghajani* Page 4
    Background
    Restless leg syndrome (RLS) is a common problem in patients with chronic renal failure. It can reduce the quality of life and sleep disturbances. This disorder is usually treated pharmacologically. Recently, complementary medicine methods have been suggested because of chemical drugs adverse effects. There is not enough evidence about the effect of aromatherapy on RLS.
    Objectives
    The aim of this study was to determine the effects of massage with lavender oil on RLS symptoms in hemodialysis patients.Patients and
    Methods
    This randomized clinical trial study included 70 hemodialysis patients with RLS that were randomly assigned into two groups in 2014. The experimental group received effleurage massage using lavender oil and control group received routine care for three weeks. Data was collected with RLS questionnaire and analyzed using independent and paired t-test and Chi-square test.
    Results
    The mean RLS scores were not significantly different in the two groups at the start of study (22.41 ± 7.67 vs. 22.90 ± 4.38, P = 0.76). At the end of study, the mean RLS score significantly decreased in the intervention group, while this score remained relatively un-changed in the control group (12.41 ± 5.49 vs. 23.23 ± 4.52, P < 0.0001).
    Conclusions
    Lavender oil massage was effective to improve RLS in hemodialysis patients. It has no adverse effects, is practical and cost-effective. It is suggested to be used along with routine treatment of RLS in hemodialysis patients.
    Keywords: Massage, Lavender Oil, Restless Leg Syndrome, Hemodialysis
  • Firoozeh Mirzaee Rabor, Ali Taghipour, Moghaddameh Mirzaee, Khadigeh Mirzaii Najmabadi*, Masoud Fazilat Pour, Seyed Hosein Fattahi Masoum Page 5
    Background
    Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear.
    Objectives
    The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery.Patients and
    Methods
    This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth.
    Results
    In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95).
    Conclusions
    The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management.
    Keywords: Medical Ethics, Natural Childbirth, Validation Studies, Attitude, Women
  • Steve Parker, Lidia Mayner*, David Michael Gillham Page 6
    Background
    Undergraduate nursing students are often confused by multiple understandings of critical thinking. In response to this situation, the Critiique for critical thinking (CCT) project was implemented to provide consistent structured guidance about critical thinking.
    Objectives
    This paper introduces Critiique software, describes initial validation of the content of this critical thinking tool and explores wider applications of the Critiique software.
    Materials And Methods
    Critiique is flexible, authorable software that guides students step-by-step through critical appraisal of research papers. The spelling of Critiique was deliberate, so as to acquire a unique web domain name and associated logo. The CCT project involved implementation of a modified nominal focus group process with academic staff working together to establish common understandings of critical thinking. Previous work established a consensus about critical thinking in nursing and provided a starting point for the focus groups. The study was conducted at an Australian university campus with the focus group guided by open ended questions.
    Results
    Focus group data established categories of content that academic staff identified as important for teaching critical thinking. This emerging focus group data was then used to inform modification of Critiique software so that students had access to consistent and structured guidance in relation to critical thinking and critical appraisal.
    Conclusions
    The project succeeded in using focus group data from academics to inform software development while at the same time retaining the benefits of broader philosophical dimensions of critical thinking.
    Keywords: Nursing, Professional Competence, Education, Distance, Mainstreaming (Education), Peer Review, Research, Problem Solving, Group Thinking, Critiique
  • Alireza Rahati *, Hossein Sotudeh, Arani, Mohsen Adib, Hajbaghery, Majid Rostami Page 7
    Background
    Several studies are available on organizational commitment of employees in different organizations. However, the organizational commitment and job involvement of the employees in the prehospital emergency medical system (PEMS) of Iran have largely been ignored.
    Objectives
    This study aimed to investigate the organizational commitment and job involvement of the employees of PEMS and the relationship between these two issues.
    Materials And Methods
    This cross-sectional study was conducted on 160 employees of Kashan PEMS who were selected through a census method in 2014. A 3-part instrument was used in this study, including a demographic questionnaire, the Allen and Miller’s organizational commitment inventory, and the Lodahl and Kejner’s job involvement inventory. We used descriptive statistics, Spearman correlation coefficient, Kruskal-Wallis, Friedman, analysis of variance, and Tukey post hoc tests to analyze the data.
    Results
    The mean job involvement and organizational commitment scores were 61.78 ± 10.69 and 73.89 ± 13.58, respectively. The mean scores of job involvement and organizational commitment were significantly different in subjects with different work experiences (P = 0.043 and P = 0.012, respectively). However, no significant differences were observed between the mean scores of organizational commitment and job involvement in subjects with different fields of study, different levels of interest in the profession, and various educational levels. A direct significant correlation was found between the total scores of organizational commitment and job involvement of workers in Kashan PEMS (r = 0.910, P < 0.001).
    Conclusions
    This study showed that the employees in the Kashan PEMS obtained half of the score of organizational commitment and about two-thirds of the job involvement score. Therefore, the higher level managers of the emergency medical system are advised to implement some strategies to increase the employees’ job involvement and organizational commitment.
    Keywords: Commitment, Emergency Medical Services, Emergency Care, Involvement, Job Satisfaction, Organizations, Prehospital
  • Saeide Heidari, Atye Babaii*, Mohammad Abbasinia, Mahdi Shamali, Mohammad Abbasi, Mahboobe Rezaei Page 8
    Background
    The instability of cardiovascular indices and anxiety disorders are common among patients undergoing coronary artery bypass graft (CABG) and could interfere with their recovery. Therefore, improving the cardiovascular indices and anxiety is essential.
    Objectives
    This study aimed to investigate the effect of music therapy on anxiety and cardiovascular indices in patients undergoing CABG.Patients and
    Methods
    In this randomized controlled trial, 60 patients hospitalized in the cardiovascular surgical intensive care unit of Shahid Beheshti Hospital in Qom city, Iran, in 2013 were selected using a consecutive sampling method and randomly allocated into the experimental and control groups. In the experimental group, patients received 30 minutes of light music, whereas in the control group, patients had 30 minutes of rest in bed. The cardiovascular indices and anxiety were measured immediately before, immediately after and half an hour after the study. Data were analyzed using the chi-square test and repeated measures analysis of variance.
    Results
    Compared to the immediately before intervention, the mean anxiety scores immediately after and 30 minutes after the intervention were significantly lower in the experimental group (P < 0.037) while it did not significantly change in the control group. However, there were no significant differences regarding the cardiovascular indices in the three consecutive measurements (P > 0.05).
    Conclusions
    Music therapy is effective in decreasing anxiety among patients undergoing CABG. However, the intervention was not effective on cardiovascular indices. Music can effectively be used as a non-pharmacological method to manage anxiety after CABG.
    Keywords: Music Therapy, Cardiovascular System, Anxiety, Coronary Artery Bypass Graft
  • Tahereh Ashktorab, Shahzad Pashaeypoor*, Maryam Rassouli, Hamid Alavi, Majd Page 9
    Background
    Evidence-Based Practice (EBP) is one of the nursing professional roles that can lead them to provide the best and more effective care. However, no studies are available on nursing students’ competencies in EBP.
    Objectives
    This study aimed to investigate the nursing students’ knowledge, attitude and intention to implement EBP and its related factors in two nursing and midwifery faculties in Tehran, Iran.
    Materials And Methods
    In this cross-sectional study, 170 undergraduate nursing students were selected from two faculties of nursing and midwifery in Tehran, Iran. A census sampling method was applied and they were all before graduation in 2013. The Rubin and Parrish questionnaire was used to assess the students’ knowledge, attitude and intention to implement EBP as well as factors affecting the implementation of EBP. Students completed the instrument through self-report. Descriptive statistics, Independent sample t-test and Pearson correlation coefficient were used to analyze the data.
    Results
    The students mean scores of knowledge, attitude and intention to implement EBP was 31.08 ± 5.77, 50.40 ± 9.58, 36.01 ± 4.64, respectively. The students’ age was inversely correlated with their scores of knowledge, attitude and intention to use EBP (P < 0.05). However, the students’ GPA was in direct association with their knowledge, attitude and intention to implement EBP (P < 0.05). No significant differences were observed between the males and females mean scores in the three subscales. However, significant differences were found between the students mean scores in the two subscales of knowledge and attitudes toward EBP in terms of familiarity with statistics and research methods (P < 0.05). Neither familiarity with research methods nor familiarity with EBP could significantly affect the students’ intention to implement EBP.
    Conclusions
    The present study showed that nursing students have not a high mean score in the three subscales of knowledge, attitude and intention to implement EBP. It is essential for faculties and nurse managers not only to focus on education of EBP, but also to support nurses and nursing students to implement it in the process patient care.
    Keywords: Evidence, Based Practice, Nursing Students, Knowledge, Attitude, Intention
  • Mohammad Sharafkhani, Mohammad Reza Armat, Amir Emami Zeydi* Page 10