نشریه پرستاری و مامایی ارومیه
سال شانزدهم شماره 4 (پیاپی 105، تیر 1397)

Clerkship education is a serious problem in education; therefore, recognition of existing issues in public health student’s education and corrective actions will fulfill the goals of learning and improve the quality of health services. The purpose of this study was to determine the viewpoints of students at Health School of Urmia Medical Sciences University about the status of clerkship education in 2017. In this descriptive-analytic study, the viewpoint of 45 students about the process of clerkship education in the dimensions of goals and curriculum, instructor's performance, dealing with the student, educational environment, and monitoring and evaluation were investigated by a researcher-made questionnaire. Data were analyzed using SPSS software and statistical methods. The status of clerkship education were assessed with the average of 122 out of 150 by public health students. The lowest score was assigned to the instructor performance scope (88) in the moderate level and highest to the scope of monitoring and evaluation (148) at a good level. The results of the study showed that the ratio of instructor to student is a major problem in student's education, therefore, the authorities of Health School should consider the above ratio in order to improve the quality of clerkship.Keywords: Clerkship, Public Health, Student, Instructor.

Spiritual health is a basic dimension of well-being and overall health that coordinates other aspects of health. The present study was conducted to determine the spiritual health and some related factors during pregnancy. The present descriptive cross-sectional study was conducted on 200 pregnant women presenting to health centers in Qazvin, Iran in 2015. A multi-stage sampling was carried out and data were collected in a self-report manner using the Spiritual Well-Being Scale developed by Paloutzian and Ellison and a demographic and midwifery questionnaire. Data were analyzed in IBM-SPSS-20 and using analysis of variance and Tukey's test. High spiritual health was observed in 69.5% of the participants, while 30.5% had moderate spiritual health. The overall mean score of spiritual health was 104.15±10.59, while that for religious health was 51.92±5.65 and for existential health was 57.3±6.36. A significant relationship was observed between spiritual health (Total score and subscales) and education, number of childbirths and family income, also a significant relationship was observed between subscales of spiritual health and grade of pregnancy (P0.05). According to this research, majority of mothers participating in this study had high spiritual health and some personal and prenatal characteristics were related to spiritual health, therefore, it is recommended to pay more attention to the spiritual and psychological dimensions of pregnant women along with other dimensions of health.

Research and knowledge production empowers nursing profession in anticipating and facing with challenges. Using the research results, knowledge is applied in the clinical settings and improves the quality of the services. Undoubtedly, the efficiency and effectiveness of the research depends on meeting the needs and expectations of the community. The aim of this study is to identify Nursing Research Direction and challenges and suggested solutions to address them. The present study is an integrative review and conducted based on the Broome method. Articles that related to the purpose of this study, being written in English or Persian and the full text of them were accessible, entered into research. Different data bases such as ProQuest, Ovid, PubMed, Science Direct, Google Scholar, Magiran and SID were applied for collecting articles by using a wide range of keywords such as nursing, research, research priorities, research direction and challenges. Search without time limit was made until 2017. After carefully assessing the title, summary and full text, a large number of articles have been dropped due to different titles and objectives, inappropriate summary or content. Ultimately, 34 articles were included. Data were analyzed based on Broom's method. The results of these studies indicated several challenges regarding the nursing research consisted of five main themes including illogical orientation of researches, low quality of research evidences, poor knowledge translation, weakness of team work and interdisciplinary research activities and challenges of community - based nursing care. It is expected that by drawing the nursing research challenges and providing a general guide to nursing planners and policymakers, we can take small steps forward strengthening and developing strategies for effective nursing research management and Optimal exploitation of knowledge gained from researches. In order to better understand the challenges of nursing researches and to formulate strategic solutions, further studies are recommended with qualitative approaches.

Nurses, with the onset of work in the hospital, have different experiences from the time of education and apprenticeship, and each of them tries to adapt and adapt themselves to the conditions of the work environment. This research explains the adaptation of newly arrived nurses in the hospital environment. This is a qualitative study in which the required data were collected through semi-structured interviews with 11 nurses entering the hospital from May 2014 to July 2014. Nurses were selected through targeted sampling from hospitals affiliated to Isfahan University of Medical Sciences. Recorded interviews were analyzed using content analysis methodology. According to the interviewees, the five main concepts, including exposure to work environment conditions, professional imaging, underlying predictions, gap between the status quo, the role of the patient and colleagues, were extracted from the data. The results from research data suggest that newly arrived nurses face different challenges for adaptation in the workplace, and if they, as well as their associated managers, are better aware of these challenges. The transition from hospitalization to professionalization will be easier and less stressful and anxiety, which will provide better service and more effective communication that will increase the satisfaction of the service. Also, given the time and money spent on training nurses and their professionalization, they will ensure their survival in nursing care and their commitment to their service.

Burn is one of the most painful injuries that can be experienced by the human being. Despite the fact that spiritual well-being plays an important role in the reduction of pain, the relationship is not well studied in burn patients. This cross-sectional study is conducted to evaluate the relationships between spiritual well-being and pain in hospitalized burn patients. A total of 84 patients, who were hospitalized at the Imam Khomeini Hospital of Urmia selected as the sample for the study. To assess study variables, patients completed self- report measures: The Spiritual Well-Being Scale and Visual Analogue Scale (VAS). Additionally, demographic data gathered by a self-constructed questionnaire. At the morning of next day, intensity and quality of procedural pain assessed at bathing and dressing change time. the results showed a significant and inverse relationship between the spiritual health and pain intensity (r =- 0.522 p < 0.0001).Regarding the demographic variables associated with spiritual health, data showed a statistically significant relationship between spiritual health and living environment with marital condition (p < 0.001) and education level of participants (p = 0.004). There was a significant correlation between education level, depth and level of pain intensity (p< 0.001(. according to the study, improve dimension of spiritual health as the influential factor in reducing the pain of burn patients and provide care based on culture are necessary.

Randomized clinical trials, unlike observational studies, have less potential for bias; therefore, they are considered as a golden standard to compare the effects of different types of interventions in the health siences. The purpose of this study was to investigate the concept of bias in randomized clinical trials, the causes and types of bias and ultimately provide effective strategies for managing and reducing the effects of various bias. This study is a narrative review using existing resources. Search for articles and related books were done in international databases including Medline, SOUPUS, Google Books, Google Scholar, Web of Science, and national databases including Magiran and SID without any time limitation, in both Farsi and English languages. At the end, 36 article and 10 books related to the topic were found that results were presented at different levels of a clinical practice. In this review article we discussed different types of bias in the various phases of a clinical trial, including planning, implementation, outcome measurement, data analysis and interpretation, reporting of results, publication and uptake phases. There are various types of bias in the scientific research, which had different impact on the study results. Bias may occur in the planning to post- publication of a study phases. They can damage to the study results seriously and leading to inaccurate conclusions and undermining the internal validity of the study; therefore, the results of these studies should be interpreted with caution.

Effective communication with elderly patient is essential in nursing process that is important in satisfying the patient, achieving satisfactory therapeutic outcomes, and motivating the patients comply with the recommended regimen. The aim of this study was to determine and compare the viewpoints of nurses and elderly patients regarding communication barriers in Urmia Imam Khomeini Hospital. The Sample of this descriptive cross-sectional study was consisted of 100 nurses and 100 elderly patients admitted to the internal and surgical wards of Imam Khomeini Hospital in Urmia from April to July 2017. The data gathering tool was a three-part questionnaire that evaluated communication barriers in three domains of nurse related barriers, elderly patient related barriers and environmental related barriers. Data were analyzed by SPSS software using descriptive statistics and independent sample t-test. The average age of nurses and the elderly were 28.36 ± 4.63 and 68.12 ± 2.23 years, respectively. The most important nurse related barriers were nurse’s fatigue and inattention of nurse from the view point of nurses and elderly, respectively. The most important elderly related barrier were impatience of patient and not trusting the nurse from the view point of nurses and elderly, respectively. Finally the most important environment related barrier from nurses and patients points of views was heavy workload. There was a significant differences between ten nurse related barriers, five elderly patient related barriers and three environment related barriers. The comparison of the average of communication barriers was significant from the viewpoints of nurses and patients, and nurses had given higher points than patients. According to the results of this study, most of the identified barriers related to nursing and elderly patients which prevented effective communication were due to the weakness of communication skills of nurses and the lack of knowledge of physiological problems of the elderly, which can be solved by conducting training courses. Environment and working conditions barriers should be considered by the hospital authorities and appropriate measures should be taken to solve them.

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Cardiac catheterization is one of the most frequently methods that used for diagnosis and treatment of coronary artery disease. This invasive procedure often leads to anxiety and fear in patients. Anxiety by increasing hemodynamic parameters has negative consequences in cardiovascular disease. The aim of the study was evaluation the effects of video information on the level of anxiety and hemodynamic parameters in patients undergoing coronary angiography. In this study a quasi-experimental design was used. 104 patients waiting for coronary angiography were randomly allocated to experimental group (n=54) and control group (n=54). The control group received routine verbal information by nurses. Experimental group watched an informative video about angiography. The level of state and hidden anxiety, blood pressure, heart rate and respiratory rate were measured at baseline and after educational intervention. Data were collected from July of 2015 to August 2016 through a hemodynamic variable sheet and Spiel Berger anxiety inventory (SAI). Paired t-test, Independent sample t-test and Chi square were used to analyze the data in SPSS19 software. P-value<0.05 was considered statistically significant. The experimental group showed a statistically significant decrease in the blood pressure (SBP (p=0.007), DBP (p=0.000)), respiratory rate (p=0.000) and heart rate (p=0.003) after the educational intervention compared to the control group. There were significant differences between the two groups after intervention concerning level of state anxiety (p=0.000) and hidden anxiety (p=0.000). Video education decreases the vital signs and anxiety in coronary angiography patients. Therefore the video education is recommended for improving quality of nursing care and patient education before invasive procedures such as coronary artery angiography.