فصلنامه پرستاری، مامایی و پیراپزشکی
سال سوم شماره 4 (بهار 1397)

Quality is the most important index in healthcare services, especially nursing care. Since absolute quality cannot be achieved, it is crucial to assess this index on a regular basis. The present study aimed to evaluate the quality of nursing care services in nursing staff. This descriptive-analytical study was conducted on 210 nurses at Shahid Beheshti University in Tehran, Iran. The participants were selected via convenience sampling. Data were collected using a two-part demographic questionnaire and standard questionnaire of the quality of care by Koval and Peck with 72 items in the psychosocial, physical, and interactive dimensions. Data analysis was performed in SPSS version 16 using descriptive and inferential statistics. Mean age of the nurses was 33.53 years. Among the participants, 20% were male, and 76.1% were female. Quality of nursing care was considered favorable in the psychosocial (84%), physical (79%), and interactive dimensions (68.5%). Moreover, the results of Mann-Whitney U test indicated a significant association between the quality of nursing care and gender, so that female nurses provided better care compared to male nurses (P=0.01). In the viewpoint of the nurses, the quality of nursing care was favorable. Nevertheless, the expectations of patients are not met in some cases. Therefore, it is recommended that the standards of the quality of care be re-evaluated in terms of the structure, processes, and outcomes from the perspective of nurses and patients in order to adopt effective strategies to enhance proper healthcare interactions between nurses and patients and meet the psychosocial needs of patients as far as possible.

Anxiety is a common psychological disorder among the elderly, which could deteriorate social and cognitive functions and lead to disabilities and low quality of life in this population. Physical exercise is an important, inexpensive therapeutic approach to improving geriatric psychological disorders. The present study aimed to investigate the effects of tai chi chuan on the level of anxiety in elderly women. This clinical trial was conducted with a pretest-posttest design on 60 elderly women in the intervention and control groups in 2014. The subjects were the retired members of Tehran Petroleum Industry. The subjects were selected via stratified random sampling and allocated to two groups of intervention (n=29) and control (n=31). The intervention involved 24 sessions of tai chi chuan exercises for eight weeks (three times per week). Data were collected using demographic questionnaires and Spielberger’ state-trait anxiety inventory (STAI). Mean score of anxiety before the intervention was 41.79 in the intervention group and 39.54 in the control group, which indicated no significant difference (P=0.368). After the intervention, the mean score of anxiety in the intervention and control groups was 29.41 and 39.38, respectively. According to the results of ANCOVA, the intervention could significantly reduce anxiety in elderly women (P=0.001). According to the results, tai chi chuan exercises could decrease the level of anxiety in elderly women. Therefore, the implementation of this safe and economical method seems essential to enhancing the psychological health of the elderly.

Multiple sclerosis (MS) is a progressive disease of the central nervous system, which has debilitative effects on the quality of life of the patients due to its various physical complications. The present study aimed to assess the effects of using Orem’s self-care model on the physical dimensions of quality of life in MS patients. This quasi-experimental study was conducted on 74 patients with MS referring to the MS Association in Hamedan, Iran in 2014. The patients were selected via convenience sampling and randomly allocated to two groups of intervention and control. Data were collected using MSPHQOL-54 in the study groups. In addition, a training program was implemented for 2-4 sessions based on the extracted needs of the patients in the intervention group. After two months of the self-care program in the intervention group, MSPHQOL-54 was completed again by the two groups. Data analysis was performed using Chi-square, paired t-test, and independent t-test. Mean quality of life in all the physical dimensions was 57.2±20.5 in the intervention group before the training program, which significantly increased to 67.5±15.3 (P=0.001). However, no such difference was observed in the control group. According to the results, Orem’s self-care model could improve the physical dimensions of quality of life in MS patients. Therefore, it is recommended that this model be applied to enhance the physical dimensions of quality of life in these patients.

Information literacy is a concept emerged through the rapid transformation of information technologies, which is essential to survival in an information community. The present study aimed to determine information literacy and its contributing factors in the students of Kurdistan University of Medical Sciences and Kurdistan University in 2015. This descriptive-analytical study was conducted on 500 students at Kurdistan University of Medical Sciences and Kurdistan University in Kurdistan, Iran in 2015. The subjects were selected via single-stage cluster sampling. Data were collected using the standardized questionnaire by Davarpanah and Siamak. Data analysis was performed in SPSS version 20 using t-test and one-way analysis of variance. Mean score of information literacy was 25.12±8.40 (total score: 87) among the subjects. The mean score of information literacy was higher in the students of Kurdistan University of Medical Sciences (25.99±8.43) compared to the students of Kurdistan University (22.68±7.91) (P=0.02). In addition, the score of information literacy was higher in the medical students compared to non-medical students (P=0.03). Considering the low level of information literacy in university students and given the importance of information skills in the scientific progress and professional efficiency of individuals, training should be provided on such skills through research methodology workshops and computer work in order to increase the information literacy of these students.

Promotion of patient satisfaction is one of the foremost goals for healthcare managers. Patient satisfaction is defined as the interactions between healthcare professionals and recipients of care, which is correlated with the connection of nurses with their profession. The present study aimed to evaluate the association between psychological wellbeing in nurses and patient satisfaction considering the intermediary role of job burnout. This descriptive-correlational study was conducted on all the nurses employed in the governmental hospitals in Lorestan province, Iran (n=2,602) in 2018. Samples size was determined at 335 based on the Cochrane’s formula, and the subjects were selected via convenience sampling. Data were collected using the questionnaire of psychological wellbeing by Sam Aram and Mahboobi (2014), patient satisfaction inventory (PSI), and Maslach burnout inventory (MBI). Data analysis was performed using descriptive statistics and structural equations. Psychological wellbeing had a direct (β=0.40) and an indirect association (β=0.44) with the intermediary role of job burnout, which affected patient satisfaction (β=0.84). Moreover, psychological wellbeing influenced job burnout (β=0.72) and patient satisfaction (β=0.62). Considering the intermediary role of job burnout, psychological wellbeing had a positive impact on patient satisfaction. Therefore, it is recommended that healthcare managers enhance patient satisfaction through increasing psychological wellbeing and eliminating the influential factors in job burnout.

Professional ethics is defined as ethical commitment and conscience in regards to every profession, duty or responsibility in order to prevent patient harm, which in turn accelerates recovery. The present study aimed to determine the level of knowledge regarding professional ethics and its influential factors among midwives in Sanandaj, Iran in 2017. This cross-sectional study was conducted on 150 midwives employed in the hospitals and health centers in Sanandaj city. The subjects were selected via simple random sampling. Data were collected using a two-part questionnaire. The first section consisted of demographic characteristics, and the second section contained data on the knowledge of various aspects of professional ethics. Data analysis was performed in SPSS version 18 using descriptive and inferential statistics at the P-value of less than 0.05. The general knowledge of the majority of the midwives (92%) regarding professional ethics was favorable. In addition, significant associations were observed between marital status (P=0.046), workplace (P=0.010), and interest and motivation (P=0.013) with the general knowledge of professional ethics. According to the results, the midwives employed in the hospitals and health centers in Sanandaj had proper knowledge of professional ethics.

Job burnout is defined as the response to the chronic psychological distress caused by one’s occupation, leading to poor efficiency and loss of human resources. The present study aimed to evaluate the rate of job burnout and its influential factors in the midwives employed at the hospitals and health centers in Sanandaj, Iran in 2016. This descriptive-analytical study was conducted on 200 midwives employed at the hospitals and health centers in Sanandaj city. The subjects were selected via simple random sampling using a random number table. Data were collected using Maslach burnout inventory. Data analysis was performed in SPSS version 18 using descriptive and inferential statistics at the significance level of 0.05. In terms of job burnout dimensions, low cynicism was observed in 62 subjects (31%), moderate cynicism was observed in 72 subjects (36%), and severe cynicism was observed in 66 subjects (33%). Low emotional exhaustion was detected in 70 subjects (35%), moderate emotional exhaustion was observed in 74 subjects (37%), and severe exhaustion was reported in 56 subjects (28%). With regard to personal efficiency, high self-effectiveness was denoted in 71 subjects (35.5%), while the level was moderate and low in 78 (39%) and 51 subjects (25.5%). According to the results, the rate of job burnout was moderate among the studied midwives. Given the importance of midwifery in health care, preventive programs are recommended in order to promote the quality of care services and satisfaction of healthcare professionals, as well as reducing the rate of job burnout.

Toxic epidermal necrolysis (TEN) is among the most severe forms of dermatological reactions, which often occurs in response to non-steroidal anti-inflammatory drugs (NSAIDs) and leads to death in 20-50% of the cases. A 41-year-old male patient was referred with a history of NSAID use, presenting with maculopapular rashes, at Kowsar Hospital in Sanandaj, Iran. The patient was hospitalized and received various therapies. He was discharged after 14 days in a good overall condition. Determining the basic etiology and disruption of pharmaceutical factors are essential to the treatment of TEN. The therapeutic interventions are similar to those used for burn patients.