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Nursing and Midwifery Sciences - Volume:3 Issue: 3, Jul-Sep 2016

Journal of Nursing and Midwifery Sciences
Volume:3 Issue: 3, Jul-Sep 2016

  • تاریخ انتشار: 1395/06/15
  • تعداد عناوین: 8
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  • Saba Karimi, Zohreh Vanaki, Homayoon Bashiri, Seyed Abdolmotalab Hassani Pages 1-10
    Background and
    Purpose
    Colorectal cancer (CRC) is one of the most highly prevalent and life-threatening digestive tract cancers. CRC and its treatment are associated with numerous complications in the patients. Orem’s self-care model is a theory on clinical improvement and reducing fatigue in patients with CRC. This study aimed to investigate the effects of Orem’s self-care theory on the nutrition status and fatigue of CRC patients.
    Methods
    This quasi-experimental study was conducted on 70 patients diagnosed with CRC in the teaching hospital of Imam Reza in Kermanshah, Iran in 2014. Samples were randomly divided into two groups of experimental and control. Data were collected using the food frequency questionnaire (FFQ) and Brief Fatigue Inventory (BFI). After data collection, a self-care training program was implemented based on Orem’s self-care theory.
    Results
    Self-care training intervention in the experimental group improved the consumption patterns of fruits (P=0.002), vegetables (P=0.001), and dairy products (P=0.001). Moreover, general fatigue of CRC patients in the experimental group decreased after the intervention (P=0.0001).
    Conclusion
    According to the results of this study, Orem’s self-care model could reduce the clinical symptoms and fatigue of patients with CRC. Therefore, it is recommended that this model be applied to enhance the self-care behaviors and clinical conditions of CRC patients.
    Keywords: Colorectal cancer, Fatigue, Nutrition, Orem's model, Self, care
  • Hamid Rabat Sarpooshi, Mojtaba Vaheb, Yasser Tabarayee, Ali Vahidi Sabzevar, Forough Mortazavi Pages 11-17
    Background and
    Purpose
    Vitamin C is administered orally or intravenously for the treatment of burn wounds. However, effects of the topical application of vitamin C remain unclear. This study aimed to evaluate the effects of topical vitamin C solution on the necrotic tissue volume of second-degree burn wounds.
    Methods
    This clinical trial was conducted on 30 patients with second-degree burns admitted to the burn unit of Vasee Hospital of Sabzevar, Iran. Burn wound areas were divided into two parts, receiving routine treatment with sulfadiazine ointment and vitamin C in addition to sulfadiazine. After cleaning the wounds, dressings were replaced daily. Depth of burn wounds in each area was observed to be similar. Burn wounds were examined on days one, three, seven and 14 after the burn incidents using Bates-Jensen Wound Assessment Tool. Data analysis was performed in SPSS version 20 using repeated measures ANOVA.
    Results
    In patients of the experimental area, mean volume of necrotic tissue was1.033±0.182 at baseline, while it reached 1.233±0.430 on day 14 after the incident. In the control group, mean volume of necrotic tissue was 1.000±0.000 at baseline, while it increased to 1.700±0.794 on day 14 after the incident. On day 14, a significant difference was observed between the experimental and control groups in this regard (P=0.018; f=5.982).
    Conclusion
    According to the results of this study, topical administration of vitamin C could be largely effective in the treatment of second-degree burn wounds.
    Keywords: Burn_Necrotic tissue volume_Topical vitamin C solution_Wound
  • Abolfazl Farhadi, Nasrin Elahi, Rostam Jalali Pages 18-26
    Background and
    Purpose
    Professionalism refers to the professional character and manners of an individual, which encompasses different attributes and a lifestyle reflecting responsibility and commitment. Effective communication between physicians and nurses enhances the quality of patient care, reduces medical errors. Over the years, there have been repeated admonitions to improve nurse-physician communication, which is influenced by several factors. This study aimed to evaluate the effect of professionalism on the professional communication between nurses and physicians.
    Methods
    This qualitative study was conducted using the phenomenological approach developed by Husserl. Semi-structured interviews (n=15) were performed on eight nurses and seven physicians engaged in the hospitals of different cities in Iran in 2014. Participants were asked to describe their experiences regarding the professional communication between nurses and physicians. All interviews were recorded and transcribed, and data analysis was performed using Colaizzi’s method.
    Results
    Four main themes emerged from data analysis, including professionalism, communication patterns, confounders, and communication usefulness, the most important of which was professionalism. In this study, we focused on professionalism and its subthemes, including autonomy, dignity and respect, responsibility and preparedness.
    Conclusion
    According to the results of this study, professionalism plays a key role in establishing efficient professional communications. Therefore, it is recommended that structured communication interventions be implemented in clinical environments in order to improve the quality of nurse-physician communication.
    Keywords: Nurses, Phenomenology, Physicians, Professional communication, Professionalism
  • Zohreh Vares, Zahra Aliakbarzadeh Arani Pages 27-33
    Background and
    Purpose
    Diabetes in the elderly is mostly associated with increased risk of development and worsening of geriatric syndromes. In addition, it has a significant impact on various aspects of individuals with these syndromes. Therefore, this study aimed to evaluate the quality of life (QOL) in elderly diabetic patients.
    Methods
    This descriptive and analytical study was conducted on 88 elderly diabetic patients (selected from 1400 diabetic patients) with medical records at diabetes centers in Kashan, Iran in 2006. The study tools were demographic questionnaire and Older People’s Quality of Life Questionnaire (41-item version), applied to evaluate the general (13-52 scores), specific (27-108 scores) and total (40- 160 scores) aspects of QOL. Data analysis was performed in SPSS version 16 using univariate and multivariate logistic regression models.
    Results
    In total, 65.9% of the patients were female and 34.1% were male. In terms of the aspects of QOL (i.e., general, specific and total), 68.2%, 77.3% and 53.4% of the elderly patients had weak scores, respectively.
    Conclusion
    Given the low QOL in the majority of elderly diabetic patients, our results indicated that these type of patients need special healthcare. In other words, this study reaffirmed the role of caring for the health of elderly diabetic patients.
    Keywords: Diabetes, Elderly, Quality of life
  • Nader Aghakhani, Masoumeh Akbari, Mohammad Abbasi, Jaleh Naderi, Rozita Cheraghi, Mohammad Ayremloo, Zoleikha Asgarlou Pages 34-39
    Background and
    Purpose
    Cancer is associated with significant changes in the lifestyle of patients. Spiritual well-being has been shown to be an inherent element of health, quality of life, increased survival rate, and enhanced adaptability of cancer patients with the disease. This study aimed to evaluate the spiritual health of cancer patients and their nurses.
    Methods
    This descriptive, correlational, cross-sectional study was conducted on 60 hospitalized cancer patients and 60 nurses in the hospitals affiliated to Urmia University of Medical Sciences, Iran during March-October 2014. Participants were selected via accident sampling, and data were collected using the Spiritual Well-being Scale (SWBS). Data analysis was performed in SPSS version 16 using descriptive statistics, Chi-square and T-test.
    Results
    In cancer patients, mean scores of religious, existential and spiritual well-being were 52±2.32, 46±1.23 and 99±3.73, respectively. In the studied nurses, these scores were 29±4.43, 40±1.17 and 70±4.02, respectively. A significant difference was observed between the scores of spiritual well-being between cancer patients and nurses (P=0.001).
    Conclusion
    According to the results of this study, spiritual well-being largely contributes to the mental health of cancer patients. Therefore, higher spiritual well-being of nurses could enhance the spiritual health of cancer patients as well.
    Keywords: Cancer patients, Nurses, Spiritual health
  • Farhood Nikouee, Mitra Soltanian, Alireza Safari, Mohadeseh Motamed, Jahromi Pages 40-45
    Background and
    Purpose
    Hepatitis B is a major health problem around the globe the prevalence of which varies depending on the region and study. In this study, we aimed to determine the epidemiology and prevalence rates of hepatitis B in Fasa, Iran.
    Methods
    This descriptive, cross-sectional study was performed using medical records of all the hepatitis B patients referring to Fasa Health Center during 2002-2014. The demographic variables and other required data were obtained and recorded, and then descriptive statistics (frequency, mean, and percentage) were reported using SPSS, version 18.
    Results
    In this study, from the 208 patients, 83.2% were male, and 83.2% were aged between 21 and 30 years. The majority of the hepatitis B patients (97.1%) did not have history of vaccination against the disease. The number of addicts using intravenous injection and suffering from hepatitis B was higher (31.7%) than others. The prevalence rate of this disease was 0.01% in 2014.
    Conclusion
    The prevalence and incidence of hepatitis B in 2014 in Fasa indicate the necessity of prevention and vaccination for those at high risk of the disease. Health education programs in schools, universities, organizations, and even mosques can play a major role in preventing the prevalence of the disease.
    Keywords: Epidemic, Epidemiology, Hepatitis B, Intravenous drug abuse
  • Ali Vahidi Sabzevar, Hamid Robat Sarpoosh, Farzaneh Esmaeili, Amir Khojeh Pages 46-53
    Background and
    Purpose
    Nurses are frequently exposed to anxiety-related problems. In fact, anxiety and stress can negatively affect nurses’ mental health and performance. Therefore, in the present study, we aimed to investigate the effect of emotional intelligence training on employed nurses in Sabzevar, Iran in 2014.
    Methods
    In this experimental trial, 135 nurses working in Sabzevar hospitals were enrolled and randomly assigned to intervention and control groups. The subjects were evaluated, using a demographic questionnaire, Bar–On's emotional quotient inventory, and Spielberger’s State-Trait Anxiety Inventory (STAI). The intervention group was trained in six sessions by an expert. In the final session, the questionnaires were completed by the participants and analyzed. For statistical analysis, t-test and non-parametrical tests were performed. P-value less than 0.05 were considered statistically significant.
    Results
    Based on the findings, 80% of the samples were female. The mean age of the participants was 32.11±6.68 years. Before the intervention, the difference between the two groups was insignificant (P>0.05), while after the intervention, a negative relationship was found between the STAI score and emotional intelligence in the two groups. Also, the difference between the groups regarding STAI scores was significant (P
    Conclusion
    The present results showed that emotional intelligence scores could improve as a result of training, while the STAI scores significantly decreased.
    Keywords: Emotional intelligence, Nurses, State anxiety, Trait anxiety, Training
  • Soheyla Kalantari, Ghorban Mohammad Koochaki, Leila Jouybari, Akram Sanagoo, Aliakbar Aghaie Nejad Pages 54-55
    We are writing this letter to draw the attention of the faculty members of medical universities to the formation of professional ethics and professionalism in the clinical and theoretical education of nursing and operating room students using the hidden
    curriculum. Professional values are standards for clinical practice, which are based on the agreement of professional groups and experts. These values are adopted in providing a framework to evaluate the ideas and perspectives that influence behavior (1). Clinical competence, adequate skills for medical practice, keeping updated, honesty, confidentiality and appropriate communication with patients are among the most imperative professional values (2). To develop professionalism, medical education in Iran has undergone several integrative reforms by the Ministry of Health and Medical Education, as part of the health system reform (stage four). The comprehensive program of higher education in the Iranian health system is a strategic plan developed based on key documents, such as Iran’s Vision 2025, Comprehensive Scientific Map of Iran, Iran’s Comprehensive Health Sector Road Map, and Health System Reform. One of the macropolicies of this evolutionary reform plan is the institutionalization of professional ethics in universities (3). Hidden curriculum refers to the process of
    cultural conduction and transmission of moral norms in relation to the feelings and behaviors of medical students in clinical settings as an ethical environment. In other words, a hidden curriculum consists of the implicit norms, values and beliefs
    that are transferred through rules and regulations, structures, routines, and social interactions in educational institutions. While only a part of this culture is transmitted via formal education, values, beliefs and accepted behaviors are passed on to
    students through the hidden curriculum (4). In general, learning experiences that are resulted from the hidden curriculum encompass a set of expectations and values without theoretical knowledge. Therefore, hidden curriculum could remarkably influence profess i onal practice in the clinical environment. In theoretical education, medical, nursing and paramedical students only receive tutoring on disease management and formal communication with patients and clients. However, in clinical settings, they are faced with actual cases, complicated demands, chronic patients with different socioeconomic status, and interactions with other healthcare providers and educators, which might be extremely challenging or confusing (5). Hidden curriculum plays a pivotal role in conveying the required knowledge and clinical skills to deal with actual patients, physicians, diseases and
    reality of the society (6). Evidence suggests that the hidden curriculum might occasionally be contrary to the learned clinical knowledge of students. Meanwhile, the ethical aspect of hidden curriculum could appear as a barrier against proper decisionmaking under different circumstances (6). Current data in this regard indicates that through the proper management of hidden curriculum, it is possible to predict and improve qualified behaviors and professionalism in the clinical environment (1, 7-10). Domestic studies on the impact of the hidden curriculum on professionalism have mainly adopted qualitative approaches in order to assess the experiences of students (11). Authors of this letter have worthy experiences regarding the application of narrative writing and reflective journaling about clinical errors and ethical events by nursing students during internship in the hospital (12, 13), in addition to individual and group reflective journaling by operating room students and their educators in clinical practice with the propose of developing professionalism. In conclusion, a beneficial approach to teach ethics through the hidden curriculum involves opportunities for students to have open dialogue, critical discussions, and brainstorming with clinical educators. Moreover, they must attempt to practice reflective journaling and narrative writing about ethical values, professional malpractice, and professional behaviors in clinical environments.