نشریه پژوهش توانبخشی در پرستاری
پیاپی 2 (زمستان 1393)

According to increase of CABGs in society, importance of post-operative complications and quality of life is considered more than past. The aim of the current study was to investigate the effect of continuous care model on the quality of life and prevention of post-operative complications in CABG's patients.
in a quasi-experimental study, seventy patients that were undergone the CABGs selected based on purposive sampling and were randomly assigned to intervention and control groups. in the intervention group patients received continuous care model for two months but the control group received routine care only. data gathering was conducted using mac new health related quality of life questionnaire in three times (before, one and two months after surgery) and checklist of post-operative complication one and two months after surgery in both groups. Statistical methods of independent t-test, repeated measurement ANOVA and post hoc tukey tests were used.
The results showed that implementation of continuous care model in intervention group resulted a significant difference between two groups on mean scores of quality of life and the complications (p 0/001). in addition the percentage of postoperative complications in the intervention and control groups after one month were %40 and %85 respectively and this difference also interpreted as statistically significant (P Results of this study revealed that the continuous care model from aspects of quality of life and post-operative complications has positive effects on CABG's patients. Therefore, it is recommended that this model should be used more extensively on these patients.

Complications of brain damage are one of very important issue and a potential barrier to the optimal recovery of these patients. Hospital based training of family caregivers have not been able to solve the various problems of the patients and their families. The goal of this research is to determine the effect of empowering family caregivers of brain damaged patients base on problem solving by telephone follow-ups on knowledge, attitude and skills of caregiving.
This study is a randomized clinical trial with a control group. Sixty caregivers of brain damaged patients were selected by convenience sampling and were randomly allocated to experimental (30 people) and control group (30 people). In the control group routine care was provided to patients until their discharge from hospital. In the experimental group a training program for family caregivers based on problem solving at the patient's bedside was initiated and after discharge from hospital they were followed up by telephone for 8 weeks. Data collecting tools in this study was a researcher-made questionnaire including information on demographic factors, awareness, understanding and skills of caregiver. The validity of the questionnaire was checked and confirmed by experts and the reliability of it was examined and confirmed by Cronbach's alpha. This questionnaire was filled out by caregivers before and after the research. Then the data were analysed with SPSS V.16 by independent Mann-Whitney T test and Wilcoxon's matched pairs T test by repeating measurement.
Based on independent T-test there wasnt a significant difference among means of scores of awareness, understanding and skills of control group and experimental group before introducing interference (P>0.05). But the numbers resulted from two months interference was significant (P0.05).
Training in releasing period based on problem solving by telephoning follow-ups leads to increasing awareness, understanding and skills of brain damaged caregivers and will help them in different caregiving jobs. It will lead to improving the role of caregivers and health condition of the patient. We can recommend it as a substituting method when there is no social nursing present in Iran.

In recent years, road accidents have had incremental trend which resulted in physical, financial and psychological outcomes. One of the major psychological problems of road accidents is the emergence of post-traumatic stress disorder in people. Therefore the present study was carried out to investigate the effectiveness of acceptance and commitment therapy in treating adolescents suffering from post-traumatic stress disorder in road accident survivors in the province of Isfahan.
The method of the current study was semi-experimental, with pretest-posttest one-group design due to the manner of available sampling. The statistical population of the study included individuals who had road accidents and the signs of post-traumatic stress disorder in 2012-13. In order to conduct the study 10 adolescents with post-traumatic stress disorder were selected through available sampling. So the entering criterion to the study was having post-traumatic stress disorder resulting from road accidents and the age of adolescence and exiting criterion was having post-traumatic stress disorder and not being adolescent. The applied instruments were the scale of traumatic event and the scale of post-traumatic stress syndrome. The achieved data were analyzed via ANOVA with repeated measurements by SPSS 20 software.
The results showed that there is a significant difference between groups in the research variables (p0/05).
Acceptance and commitment therapy helps the adolescents with post-traumatic stress disorder to be able to contact with the present moment and now and here-and-now experience more and avoid living in the past which is concomitant with mental rumination of traumatic memories.

Incisional chest and sternal pain is one of prevalent in patients after open heart surgery. If pain is not properly managed it may prevent patients from performing activities such as deep breathing and effective coughing which are important factors for preventing postoperative respiratory complications.
This is a quasi-experimental study on patients who were undergone open heart surgery and were spending 2ed day post operation in ICUOH. It is done on 30 patients who were randomly selected and divided into two equal experimental and control groups. The study tools were a questionnaire including demographic information and Numeric Rating scale for measuring patient’s pain. Participants underwent three sessions of deep breathing & coughing on second postoperative day and then their pain were scored by NRS. In experiment group 3 other sessions of deep breathing and coughing were preceded by cold application on patient's sternum for 20 minutes and in control group these maneuvers were performed without applying gel pack. Data were analyzed using SPSS software.
Results of this study showed that cold therapy was effective for managing patient's pain associated with deep breathing and coughing following open heart surgery and the mean pain scores post intervention in experimental and control groups were 3/9±1/8 and 5/5±1/9 respectively (p>0.01).
This study demonstrates that cold therapy is useful for managing patient's pain associated with deep breathing & coughing following CABG surgery. Cold therapy is low risk, low cost and can be easily integrated into nursing practice since cold packs are easily accessible in most hospitals. With nurse's close supervision, cold therapy is a safe and effective pain management modality that gives patients an active role in their pain management.

The birth of a Handicapped child cause many problems and stress for their families especially mothers. The current research is aimed to determine the any differences in quality of life and psychological capital of mothers of healthy and handicaped children.
this study was a descriptive- correlational research. The statistical population of this study comprized of mothers of handicaped childern subsidiary to Ahar city rehabilition center. The ststistical sample of the study were 60 mothers of handicaped children who were selected using convenient sampling method and 60 other mothers with normal healthy children who selected with random sampling method and matching with their conterparts in aspects of age educational level and socio-economic status. The data gathering were conducted using self administered well knowen and psychometrically robust generic quality of life (SF-36) and Psychological Capital (PCQ-24) Questionnaires. Descriptive and inferential data analysis were conducted using SPSS ver 19 (Mean SD) and multivariate- analysis of variance.
The results indicated that there is a statistically significant difference between quality of life and psycholigical capital scores of two group of mothers. Mothers with handicped children had relatively lower scores in these regards. So that mean and standard deviation of psychological capital and quality of life were 46/30±6/1, 1519/16 ±385/37 in mothers of handicapped children and 53/13±12/7, 2029/25±572/25 in mothers of healthy children.
It seems that quality of life and psychological capital of mothers with handicaped children are lower than mothers of normal children and thus it is imperative that these important rehabilitative constructs be fortified in these mothers .

Regarding technological developments in recent years the phenomenon of addiction to internet has been negatively influenced the people's various psychosocial wellbeing of people. The present study has been carried out to compare the psychological wellbeing, social acceptance and adaptation among internet addicted and non-addicted student girls in Isfahan high schools.
the method of the present study was causal-comparative. The statistical population of the study included all girls having internet addiction and normal girls at Isfahan high schools in 2012-13. In order to do the study, 30 high school student girls addicted to internet and 30 normal students were selected through multi-stage clustered random sampling method. The criterion of entering into the study was the permanent presence at high school and Internet Addiction Test score of 40 and above and the criteria of exit were having major physical or psychological problems. The applied instruments were questionnaire of psychological wellbeing, the questionnaire of social adaptation, social acceptance and the questionnaire of addiction to internet. The data were analyzed through MANOVA statistical method.
the results showed that there was a significant difference between groups (p0.001).
considering the significant difference of the components of psychological wellbeing and social adaptation among internet addicted and non-addicted girls it seems necessary for the cultural and educational experts to organize courses in order to increase the student's and parent's awareness of adverse effects of excessive use of internet.

Addiction is one of the most important problems of the present century, which could be the basis for many of the social and family problems. Physical and mental health in addicts people is severely affected by Addiction. The purpose of this study was to compare mental and physical dimensions of health-related quality of life in addicts and healthy people.
This was a comparative – correlational study. A sample of 50 addicted and 50 healthy counterparts in the city of Tabriz were selected based on convenience sampling method. Demographic and health-related quality of life data were collected using pertaining questionnaires. These data were analyzed using SPSS 20 software. Descriptive and multivariate analysis (MANOVA) was conducted on collected data.
The results showed that the physical and mental aspects of health-related quality of life between addicts and their healthy peers (components of general health perceptions, physical functioning, role limitations due to physical problems, role limitations due to emotional problems, bodily pain, vitality and general mental health) differed significantly. However, no significant differences were found between two groups in social functioning. In general health related quality of life of addicts estimated as more lower than healthy counter parts.
Physical and mental of health-related quality of life between addicts and healthy people differed significantly. The findings could have important implications in the care and rehabilitation of addicts. Substance abuse rehabilitation centers should consider promotion of health related quality of life of their clients as a high priority therapeutic objective.

Information behavior focuses on how people find and use information for their work or personal needs. components of information behavior of cardiac rehabilitation (CR) patients throughout the program are under investigation. The purposes of the present study were to identify the information behaviors of cardiac patients over the third phase of CR programs.
In this mixed method research 44 Patients with cardiovascular disease were participated in martyr Rajai Hospital by convenience sampling method. An interview guide was prepared to conduct the interview. The questionnaire ‘reasons for seeking health information’ were developed based on a list proposed by warner and procaccino. Descriptive statistics and qualitative content analysis were used for data analysis.
findings showed that cardiac patients in third phase of cardiac rehabilitation were most interested in information regarding learning for safety, healthy life style, risk factors, alternative therapies, Islamic and traditional medicine, state of the art and high tech medicine and also playing active roles in their daily lives, stress/psychological factors and trajectory of disease in the future. More than 95% of the participants reported that their health information seeking was driven by the desire for information about health-promoting behavior, or for information needed to make decisions about medication/treatment plans. majority of them reported that they use these information for sharing ideas with cardiac rehabilitation professionals and their peers, prevention of health risks and maintaining and promoting their health.
patients information behaviors varied over the course of their CR programs and the disease states. The future studies should be focused on any interventions that could boost information seeking and information behavior of these patients and improvement of information sharing between patients, families and CR health workers and to ensure these programs are meeting patient' information needs across all stages of recovery.