مجله پرستاری گروه های آسیب پذیر
سال دوم شماره 4 (پیاپی 5، زمستان 1394)

Osteoarthritis (OA) is oneof the leading causes of disability among older adults that causes joint stiffness, muscle weakness and decreased knee function.Acupressure is a non-invasive nursing intervention that causes energy balance in the body through massaging specific pressure points and improving comfort and health.
This study aimed to investigate the effectiveness of acupressure on physical function of the knee among older adults with osteoarthritis.
The present study is a single blind randomized clinical trial conducted onall older adults with osteoarthritis of the knee living in nursing homes in west of Tehran. The sample size comprised 51 men and women over 60 years old from three nursing homes. All residents of each nursing home were randomly assigned to one of the three groups of real acupressurepoints , unreal acupressure points, and control groups.Both intervention groups received massage in form of 10 sessions of 15 minutes three days a week on 8 real and unreal points. WOMAC was usedto assess the knee function in patients before and after the intervention. Data were analyzed in SPSS19 statistical software using chi-square test, independent t-test, paired t-test and analysis of variance.
The three groups matched in terms of knee function before the intervention. However, the intervention led to significant differences in mean function of the knee (P Given the effectiveness of acupressure on improving knee function among older adults with osteoarthritis in the present study, it is recommended that this inexpensive, safe and simple procedure be used forolder adults with osteoarthritis of the knee.

Moral distress in nursing is to act against a nurse’s moral beliefs, which can lead to job burnout in the nurse, in addition to impacting them and patient’s treatment process negatively and finally to inefficacy of healthcare systems.
This study aimed to investigate the relationship between moral distress and burnout among nurses of ShahidGanji Hospital, Borazjan in 2015.
The present cross-sectional, descriptive and analytical study recruited all the nurses from different medical wardsof ShahidGanji Hospital, Borazjan.Ninety-one nurses completed Corley moral distress questionnaire and Maslach Burnout questionnaire (in three dimensions including emotional exhaustion, depersonalization and personal accomplishment). The collected data were analyzed in SPSS 19 software(p = 0.05).
The results revealed a positive significant correlation between the mean severity and frequency of moral distress and burnout(p = 0.001 and r = 0.404). Meanbaseline intensity of moral distress was59.53in the participantsand its repeat was59.47, while burnout was93.77. We also found the significant relationship of individual success rate (p = 0.007 and r = - 0.284) and depersonalization (p = 0.002 and r = 0.327) inburnout with monthly work hours.
Because moral distressaffects patients’ treatment, leads to nurses’ burnout and disruptshealthcare functioning, this problem should seriously be examined by managers to reduce its effects on patients, nurses and healthcare system.

Since, patient receives care services in hospitals; its opinion is an appropriate indicator to measure the degree of satisfaction for hospital performance.
The aim of this research was to evaluate patients and patient’ companion satisfaction for health reform plan in the Shahid Mostafa Khomeini hospital of Ilam city in 2015.
This cross-sectional study included the information for a sample of patients and patient’ companion during May, 2015. The tool consisted of demographic data and a 21- item questionnaire that the score of each question ranged from 1 to 5 (the total scores ranged from 21 to 105) using Likert type question. The overall score categorized into four levels; the poor level (scoring from 21-42), the low-moderate level (scoring from 43 to 63), the up-moderate level (scoring from 64 to84) and the good category (scoring from 85 to 105) while the SPSS V.19 was used for data analysis.
The sample consisted of 171 patients (48.9 %) and 179 patient’ companion (51.1 %) in which 113 persons (32.3%) were male and 237 persons (67.7 %) were female with the age average of 30.5 years old. The highest level of hospital satisfaction was attributed to the good level (48 %), then the up-moderate level (44.6 %), the low-moderate level (7.4 %) and the poor level (0.0 %). A significant relationship was found between age and hospital satisfaction (P= 0.0) in which females were more satisfied with hospital services.
Since, most of the sample under study was satisfied with the health reform plan, it is recommended to conduct a survey to compare hospital satisfaction for other groups (e.g., nurses and doctors) before and after the health reform plan, for future studies.

Normal functioning of life disrupts in cancer patients and this disruption has a negative impact on mental health.
Having a purpose in life, spiritual beliefs, tolerance and spiritual approach to health can help these patients to improve the quality of life.
This study was design to determine the effectiveness of spiritual therapy in mental health of cancer patients. Seventy patients was randomly selected in Bushehr Cancer Center and categorized to case and control groups. Patients of case group have participated in eight sessions of spiritual approach class. The control group did not participate in any educational sessions. After one month, mental health questionnaires (GHQ-28) were completed by both case and control groups.Spss20 and t-test were used for data analysis.
The results showed that mean score of mental health experimental group (t=4.97, p Spiritual therapy can modify patient's attitudes toward the disease and suggested to use in cancer patients by health giver.

Lack of vitamins and mineralscancreateirreversible complicationsforpregnant womenandtheir fetuses. Tow of important cause of nutritional anemia inpregnant women and NTDS are related with iron and folic acid deficiency.
Thisstudy was done tomeasureknowledge, attitude and operation ofpregnant women abouttaking supplements inKermanin 1393.
the current study was conducted in across-sectional method. 122pregnant womenin Kermanparticipated in a cluster samplingmethod in the study. Health centers of four region of kerman city was choicedrandomely and also tow busy womensclinic. womens was choisedaccessly and questionnaire was complemented by them. The instrument of data collection was a questionnaire consisting of 4 parts of demographicquestions (9 items), knowledge (10 questions), attitude (8 questions) andperformance (10 items). The Face and content validityof the questionnairehad been confirmed by thethree doctors, onemidwifeandalsoanutritionexpert. Cronbach’s alpha index for Knowledge, attitude and performance section’s was respectively 0/76, 0/84 and0/82. Data were analyzedusingSPSS 16 softwareanddescriptive statistics (mean, standard deviation, frequency, and percentage of frequency) andMann-Whitneytest, Kruskal-Wallis andSpearman correlation coefficientwas used.
The mean score of knowledge among pregnant women in Kerman6/35±2/03, attitude 28/90± 3/36 and the performance 7/29±1/99. The majority of pregnant women have the average knowledge and attitudeof 51/6, 62/3% but their performance was good 58 2%. Knowledge, attitude and performance ofpregnant womenhada significant relationshipwith their education (0. 05) so that thehighereducation was, the three dimensions of questionnairewas even higher. The attitudewas significantly associated withnumber of childrenandbirth order (0. 05). The performancewas also significantly associated with planned or unplannedpregnancy (0. 05). The variable of age was not associatedwithknowledge ofpregnant women, butwith theattitude of them showedan inverse correlation and withtheir performance had a direct correlation as well. Thevariable of knowledge with attitude and performance ofwomenhadpositive and significant correlation (0. 05).
the results showed that the knowledge and attitude of pregnant women in taking supplements was average and used this knowledge in practice but more effort is needed to improve it.