نشریه پرستاری و مامایی ارومیه
سال چهاردهم شماره 8 (پیاپی 85، آبان 1395)

Cardiac surgery and its side effects can have a serious effect on the patient and his family. Mental health problems can increase anxiety in the patient's family, and so it can aggravate the effective care of the patients. The use of a need-based training program on educational needs and priorities based on beliefs and culture of the patient's family seems logical. Therefore, this study aimed to investigate the effect of need-based training program on the anxiety of the families of the patients undergoing coronary artery bypass graft surgery.
In this semi experimental study, 60 family members who had a patient having heart bypass were selected, and they were randomly assigned into the two groups of control (n = 30) and intervention (n= 30). In the intervention group, need-based training program was delivered to the caregivers of the patients who underwent an open-heart surgery. The program included face-to-face training in three half-hour sessions, and distributing booklets among them. The Spielberger anxiety questionnaire was used to collect the data. Independent and paired t-test was applied to compare the mean scores of the anxiety level.
Before the intervention, the anxiety score in the control group was 43/23 ± 12/473, while it was 46/03±11/ 275 in the intervention group, which was not significant statistically (p =0/365). After the intervention, the anxiety scores were 40/3±12/374 and 31/79± 6/16 in the control and intervention groups, respectively. The difference was significant statistically (p =0/002).
The results showed that needs-based training is effective in reducing anxiety in the families, therefore; identification and assessment of psychological, social and educational needs of the patient's families should absolutely be considered in planning family education.

Spirituality is a powerful force in the universe or beyond the material aspects of life, and it creates a profound sense of unity or link to the universe. Pregnancy period is important because health and a better life in the mother directly affect fetal life. Physical and mental health of women significantly can affect the fetus, natural childbirth and breastfeeding. This study aimed to explore the experiences of spirituality in pregnancy.
The study was conducted as a qualitative research with phenomenological approach. It was done in the health centers of the Karaj's city. 6 pregnant women were selected by purposive sampling. After sampling, deep and semi-structured interviews using an interview guide were designed to collect the authentication information. In analyzing the data, Heidegger's hermeneutics approach known as hermeneutics cycle was used.
The findings included a central theme by the name of spirituality in pregnancy, and 7 sub-themes including: 1. Religiosity in pregnancy, 2. Spirituality in pregnancy, 3. Sensitization during pregnancy, 4. Control behavior towards spirituality, 5. Pregnancy as a change, 6. Shadow spirituality on embryos, and 7. The effect of spirituality on people.
Spirituality is an important factor in improving the health of the mother and fetus. So health professionals should consider spiritual attitude during pregnancy caring. Using religious teachings is important as one of the most essential factors in the spiritual health of pregnant women and the fetus.

Invasive procedures Such as angiography, influence on physiological reactions and vital signs of patient and side effects such as dysrhythmia, spasms and vessels rupture caused, and him/her in danger. Aromatherapy and Relaxation leads to mental relaxation, feel comfortable and physiological responses can be changed. The aim of this study was comparison of Aroma inhalation and Benson Relaxation on the Vital Signs of patients experiencing coronary angiography.
This study was a quasi-experimental and conducted on three groups of patients undergoing catheterization. This study is a clinical trial with pretest and post test, This study performed on 100 patients hospitalized for coronary angiography in sari Fatemeh-Zahra hospital,Iran in 2014.They were selected based on purposive sampling and randomly divided to control(n=33), Benson Relaxation(n=34)and Aromatherapy(n=33 )groups. The collecting data tools consisted of, demographic questionnaire data, recording sheet of hemodynamic variables blood pressure gauge and chronometer. The collecting data tools consisted of, demographic questionnaire data, recording sheet of hemodynamic variables blood pressure gauge and chronometer. Questionnaires have been filled out for three group after and before aromatherapy.
After sampling, the collected data was analyzed by using SPSS-16 software, Chi-square and Mann-Whitney tests, cross Kalvalys were analyzed.
The findings show that there was a significant reduction in mean physiological parameters (systolic blood pressure, respiratory rate, pulse number) between relaxation and control groups and Aromatherapy and control groups. But the results showed no significant statistical difference between the relaxation and aromatherapy groups after the intervention.
Considering the results of this study can be suggested that using relaxation and aromatherapy before Invasive diagnostic technics could be keep stable vital signs.

Respect for the dignity and rights of individuals is an integral part of health services, and features of nationality, race, religion, age, gender, and even political or social characteristics of patients cannot be determinant factors regarding their superiority over each other. On the other hand, the number of factor that can affect promotion and health quality level of all members of society are the development and correct treatment according to patient's rights charter which is essential in their healthcare matters. The main aim of this study is to determine the level of respecting for the patients based on their exact rights by the nurses, as well as determining factors which facilitate their rights.
Compilation method (quantitative and qualitative) has been conducted in this study. First, exploratory interview was performed on 30 nurses, then, data were gathered using a questionnaire from a sample of 400 nurses in public hospitals of Urmia in 2014. At last, the results were analyzed using factor analysis.
The results obtained from factor analysis of present study showed that the existence of the facilities and expertise, increasing number of staffs, reducing in patients number (increasing the number of hospitals), patient's awareness of their rights when interacting with nurses, allocating sufficient time for patient care, empowering administrative systems, patient's familiarity with the treatment system, not using sub-forced in main treatment are the main factors facilitating patient's rights in Urmia city hospitals. These factors can explain 54/60 % of the variance of patient's rights. In addition, respecting the patient's right by nurses exactly equals to average (62.50 %).
Results of this study shows a need to pay more attention to governmental hospitals and facilitator factors for patient's rights.

Clinical practice guidelines (CPGs) are brief principles in health care providing and Implementation of CPGs which can improve patient safety and patient outcomes. According to effective role of nurses in caring patients, this study aims to design and validate the evidence based on the nursing care guideline among the patients with diabetic foot ulcer (DFU) based on Stetler model in 2015.
This study was a methodological study based on Stetler Evidence based Model. Studies for 5years with related keywords in Pub Med, Scopus, Web of Science and Google Scholar, SID, Magiran were selected. According to nursing diagnosis and evidence levels were designed as a guideline, related evidences about nursing care in DFU were extracted as well. Quality appraisal of guideline was done by AGREEII instrument in 6 domains of Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability and Editorial Independence by an expert panel. Furthermore, applicability of the guideline in clinical state was assessed with a checklist by nursing group.
From 114 studies in this field, 19 studies were chosen. In the AGREEII domains, Scope and Purpose (92%) and Applicability (76%) were the highest and the lowest scores respectively. 92.9% of nurses reported that implementation of guideline recommended on caring of DFU were effective and lack of needed equipment for its implementation was a barrier.
According to nurse’s opinion, implementation of recommended guideline has effective role in prevention and reduction of complication in DFU.

Gestational diabetes is a disease that affects pregnant women throughout the pregnancy period. In addition to difficulties of pregnancy, it would be creating more problems for pregnant women, and make a high-risk pregnancy for mother and fetus as well. Pregnant women's awareness about the disease and know how to control it can reduce the risks of complications. The main purpose of this study was to develop a personal health record application for gestational diabetes.
this was an applied developmental study. Based on the present study, a questionnaire was prepared to determine the data elements and their fields. For this aim, the questionnaire was filled by all faculty members of the department of obstetrics and gynecology in Kashan university of medical sciences (5 persons), and faculty members of the department of midwifery, school of nursing and midwifery in Iran university of medical sciences (7 persons) as a requirement assessment. Prototype was developed using basic4 android integrated development environment, and android programming language based on results obtained from the requirement assessment. Then the prototype of application was installed on smart phone of 25 pregnant women with gestational diabetes who were referred to gynecology hospital affiliated with social security organization in Kashan during one-month. Finally, usability and user satisfaction assessment questionnaire was distributed among participants to express their opinions about the available application.
Usability evaluation showed that patients evaluated the application with a mean score of 7.99 (out of 9 points) and it was evaluated in a good level.
The mobile applications can be used to help patients with gestational diabetes to control blood sugar level, reduce complications of the disease, and health promotion.

One of the most important concepts in pre-hospital trauma patients is a rapid response and transfer in order to provide high quality care and reduce injuries and deaths in the emergency situation. Several time indicators affect the process of dispatching ambulances. This study aims to investigate the pre-hospital dispatching time intervals in Tabriz.
In this descriptive study¡ the records of all trauma patients¡ which activated Emergency Medical Services (EMS) and led to an emergency dispatch¡ studied in 2014 in Tabriz. A four-part checklist consisted of patient characteristics¡ patient condition¡ scene status and dispatching time intervals used for collecting data. Descriptive and inferential statistics were applied to the data by SPSS v.16 software.
A total of 5614 out of 37002 registered missions during a year were related to trauma injuries. The majority of patients (75.88%) were male. Their mean age was 35.54 ± 17.71. 94.5% of patients had stable level of consciousness and no patient had died during their transfer in the ambulance. The average time of activation¡ response¡ spent at the scene and transfer to hospital were 2.38¡ 10.07¡ 8.11 and 9.13 minutes¡ respectively. Traffic accidents (72.9%) were the most common cause of trauma and blunt trauma (85.6%) were the most common type of trauma among injured patients. The mean of total dispatching time (from call to delivery of patients to the hospital) was 30.16 minutes. There is a significant relationship between the activation time in the various levels of consciousness and mechanism of injury. Also¡ there is a significant relationship between the mean of total dispatching time¡ level of consciousness¡ type of trauma¡ and the mechanism of injury.
The results indicated that traffic accidents were the leading cause of trauma in Tabriz. Overall dispatching time indicators were better in comparison to other studies and emergency personnel were quick in patients with low GCS and penetrating trauma. Ambulances activation time seems to be higher that requires more planning and modifications to take proper actions in this area.

Marital satisfaction is a very important and complicated aspect of a marital relationship. Due to midwives awareness of issues related to marital relationship and constant contact of them with the society that can act as professional family advisers, this study done to determine the effect of counseling based on cognitive-behavioral approach on marital satisfaction.
This is apre-post semiexperimental study by control group. After completion the ENRICH marital satisfaction questionnaire, 60 couples by the inclusion criteria and score of 30-60 simply selected from 3 randomly selected healthy centers (20 couples from each center). Then the couples devided to two intervention and control groups randomly. The intervention done for 5 counseling sessions of 2 hours with one week intervals. No intervention done in the control group.After one month passed the last counseling session, the questionnaire completed by the couples again. Collected datas analyzed by use SPSS-22.
After intervention, the ANCOVA analaysis of scores by deletion of pre-influence showed significant difference in total matital satisfaction in men and women of both of control and intervention groups (p Marital counseling based on cognitive-behavioral approach has a great influence on marital satisfaction of couples, especially on couples communication, conflict-solving skills and sexual relationship. So it should be done in the healthy centers by trained personels such as masters of ejucated of midwifery counseling.