نشریه پرستاری و مامایی ارومیه
سال پانزدهم شماره 3 (پیاپی 92، خرداد 1396)

Appropriateness and Nature of clinical decisions and medical interventions in trauma management is one of the most important concepts in prehospital trauma care systems. Therefore, this study aimed to determine the nature of prehospital medical interventions delivered to traumatic patients in Tabriz.
In this descriptive study, the records of all traumatic patients activated EMS and led to a prehospital mission, investigated in 2014. A six-part checklist consisted of patients’ characteristics, mechanism of injury, type of trauma, level of consciousness, medical interventions, physician consult and coordination with the hospital were used for collecting data. Descriptive and inferential statistics were applied to the data by SPSS v.13 software.
A total of 5614 out of 37002 registered missions during a year were related to trauma injuries. 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. Although 92/46%of traumas were related to head and neck trauma and multiple trauma, the cervical collar has been merely used for 11.5 percent of them. Also, 93% of the trauma missions led to the transfer of patients to the hospital while in 99.43% of them, no coordination was done between prehospital emergency medical services and hospitals’ A&E departments.
According to study results, despite the high percentage of trauma to the head and neck and multiple trauma, the cervical collar and long back board has been merely used for a few traumatic patients which is unacceptable and indicates the necessity of organizing prehospital trauma care courses and workshops for emergency medical technicians. Also, regarding the lack of coordination between prehospital and hospital facilities, it seems that a much more robust and organized structure is required in Iranian healthcare system.

Constipation is Common complication gastrointestinal that have a significant impact on the health and quality of life. Using heat therapy is one of the proposed non-pharmaceutical interventions. The present study was conducted to determine the effect of abdominal local heat therapy on the state of defecation in patients fed through nasogastric tubes.
This study is a double blind clinical trial performed in 2015 to 8 months in the inner part of Qaem Hospital of Mashhad - Iran. In this study, 64 patients on nutrition through a nasogastric tube were randomly studied into two groups: placebo and experimental group. The patients in experimental group of local heat therapy with standard hot pack with the temperature 50 ° C on the abdomen for 23 minutes. In the placebo group, hot pack temperature was equal to the ambient temperature. Data were collected using a demographic questionnaire and a form containing records of the patients’ digestive function. Data were analyzed in SPSS 20.
Defecation in the experimental group statistically had a significant difference before and after the intervention (p The findings of this study show the effect of local Hyperthermia in improves on the state defecation and reduce constipation in patients being fed through nasogastric tube and it is suggested further studies to use it at the same time.

Assessment and management of pain in patients undergoing mechanical ventilation can be a major challenge for intensive care nurses. Behavioral pain scale (BPS) is one of the instruments which by using the behavioral indicators, studied pain in these patients. The aim of this study is to translate and determine the psychometric properties of the BPS.
Pain by using BPS at 6 times of before, during, and after nociceptive and non-nociceptive procedures in 60 patients hospitalized in medical and surgical critical care units. In re-test 33 patients studied after 8-12 hours.
Alpha coefficient, 0/749 and the correlation coefficient between two evaluators in different times were (r = 0/78 – 0/94) was obtained. The correlation coefficient between test-retest was (r = 0/52 – 0/78). Significant differences in pain score between painful and non-painful procedures (p Iranian version of BPS has good and reliable psychometric properties, for pain assessment in patients hospitalized in medical and surgical of intensive care units which do not have able to communicate.

According to the development of chronic diseases, including chronic renal failure and the appearance of physical and mental problems that occurs to them during the period of disease and Treatment process, they require a person to take care of them. Caregiver that he/she is a family member of a patient in the care process may be faced with many problems that eventually led to the emergence of burnout in it gets. The aim of this study is to determine the effect of care centered group discussion on the caregiver burden of patients undergoing hemodialysis.
This study was a randomized clinical trial. Participant of this study contain 70 caregivers of patients undergoing hemodialysis in educational therapeutic centers in Urmia. Caregivers selected and allocated randomly in two groups of intervention (group discussion) and control. Demographic and caregiver burden questionnaire completed by caregiver before the intervention. This program consists of 6 sessions of group discussion during 6 weeks. Two weeks later of intervention the caregiver burden of questionnaire will be completed by caregiver in intervention and control groups. At next the data obtained from questionnaire analysis of descriptive and analytic statistics.
Results showed that there was no significant difference between the study and control groups before intervention in the mean scores of burnout and its dimensions (p>0.05.). But after the intervention there was significant difference in the mean scores of burnout and its dimensions between intervention and control groups (p The results of this study can be found that training classes such as group discussion had a significant reduction in the severity of caregiver burnout. Therefore it is recommended that in the Health system planning attend to the role of family members in the treatment of these patients also benefit from this training method.

Breast cancer and adverse effects of chemotherapy disorder physical, psychosocial, social and spiritual proceeds and reduce the quality of life in patients. So, Self-care education should be improved to sense of well-being in patients. The aim of this study was to determine the effects of self-care education on quality of life (QOL) in women with breast cancer, undergoing chemotherapy.
A quasi-experimental study was conducted on 64 women with breast cancer, undergoing recently mastectomy and were in the first session chemotherapy program. The patients were randomly divided in two groups of case and control. The questionnaire has two parts: 1) demographic characteristics, 2) the quality of life, standard questionnaire of National Medical Center and Beckman Research Institute related to breast cancer. In the first session of chemotherapy program the questionnaires were completed for two groups and the self –care was educated to study group for 60 minutes and booklets were given them to study. Again, after four months the questionnaires were completed and compared for two groups. Chi –square test, t-test and fisher test was used for analysis of data.
There was no significant difference between quality of life mean scores of study group, before and after intervention (P>0/05).
This research shows that aforementioned education in the first session of chemotherapy program did not improve quality of life of women with breast cancer.

Self-care management is one of the most important determinants in the prognosis of heart failure, which can improve the symptoms of disease, function and reduce mortality in these patients. The aim of this study was to determine the effect of applying follow-up care model on self-care management in heart failure patients admitted to Abbasi Hospital in Miandoab.
In this clinical trial study, 80 patients with heart failure hospitalized in cardiac units were randomly divided into two groups of 40 patients (follow-up care model) and control (routine care). In the intervention group, a follow-up care model was implemented for three months from the beginning of April to the end of June 2016 and self-care management rate in heart failure patients in the two groups before and after the appalling of follow-up care model were analyzed. Data collection tools included two parts: Demographic characteristics and specific questionnaire of self-care heart failure index. The data were analyzed by SPSS v. 20, chi-square, independent t, and paired t-test.
The mean score of self-care management before appalling of follow-up care model in intervention group was 35.52 ± 14.69 and in control group 33.00 ± 14.75 that there was no statistically significant difference between the two groups (P-value= 0.451). But after appalling of follow-up care model, the mean of self-care management score in the intervention group (55/38 ± 15/6) was significantly higher than the control group (34/50 ± 24/10), (P According to the findings of this study, it follows that the appalling of follow-up care model can lead to effective self-care management in patients with chronic heart failure.

to prevent and control diabetes as a complex chronic disease, monitoring of blood glucose and professional nursing care are necessary. Due to side effects and heavy expense of chemical drugs, using of no pharmaceutical methods such as exercise, has become advocated. The aim of this study was to comparison the effect regular tai chi and walking exercise on fasting blood glucose levels in patients with type2diabetes.
It was a semi-experimental three group trial that was done in Tehran in1395, 100 patients with type 2 diabetes were randomly assigned into three groups (Taichi, walking, control). Taichi and Walking groups practiced for30minutes, 3days a week for8consecutive weeks.Fasting blood glucose was measured one day before and one day after the study.Data was analyzed by descriptive statistics, paired T, ANOVA, Sheaffe and Chi-square tests using SPSS (v.16). Level of significance was considered as less than0.05.
according to paired t test,there was a significant difference between the mean of before and after fasting blood glucose of Tai chi exercise group and also walking exercise group(p According to the findings, 8weeks of exercise (taichi or walking) reduces fasting blood glucose levels; therefore, both of these exercises are recommended to patients with type2diabetes.However, walking exercise is more effective on the reduction of blood glucose.