نشریه پرستاری و مامایی ارومیه
سال شانزدهم شماره 12 (پیاپی 113، اسفند1397)

Poisoning as an important dilemma of public health. In this study, we investigated the effects of Silymarin on decreasing elevated levels of liver enzymes and early outcome in patients with drug poisoning admitted to the intensive care unit. In this cross-sectional study, 65 patients with poisoning were evaluated during 1394. The patients’ demographic information (age - sex), the initial level of liver enzymes was checked at the time of admission and after taking the drug and also the outcome of the patients was evaluated. Patients with history of alcohol consumption, another co-morbidity such as viral hepatitis and pregnancy were excluded. In the group receiving the drug, ALT was decreased in 24 patients (58. 5%) and was not decreased in 17 patients (41. 5%), compared with the control group, the difference was statistically significant (P = 0. 04). In the intervention group, 21 patients (51. 2%) had recovery in the AST levels, but in 20 (48. 8%) cases, there was no reduction in AST. This difference is significant in comparison with the control group (P = 0. 03). In the control group, AST was decreased in 6 patients (20%), but in 18 (75%) patients no decrease was observed, this difference was significant between the two groups (P=0. 03). There was no significant difference in serum alkaline phosphates between interventio and control groups (P = 0. 26). According to Kaplan-Meier analysis, the patients in the intervention group had a faster recovery in the level of enzymes and have been transmitted to ward or discharged earlier. The present study shows that Silymarin reduces liver enzymes and causes the patients be discharged or transmitted earlier than usual to the ward and can be used in other cases in addition to the current treatment of poisoning.

Breast cancer is one of the common cancers in many countries and in Iran that reduces self-efficacy. The aim of this study was to determine the effectiveness of spiritual care on self-efficacy of women with breast cancer. This experimental study was carried out on 40 women with breast cancer in 2017 in selected centers of Qom. They were randomly divided into two groups of intervention (n=20) and control (n = 20). For the intervention group, six sessions of spiritual care (one session in a week and each session for 90 minutes) were performed. Demographic information and general self-efficacy questionnaire of Sherer et al. were utilized for data collection. The subjects completed the questionnaires before the intervention, immediately after the intervention and two months after the intervention. Data were analyzed using the SPSS software version 21. According to the results of the study, the groups had the same demographic and underlying characteristics. There was a significant difference between the intervention group and control group in the mean score of self-efficacy immediately and after the intervention. The effect level was 40.1%. Therefore, spiritual care education affected the self-efficacy in women with cancer. The design and the implementation of this program based on the educational and supportive care needs of patients.

Educational programs are the main part of any educational system and the Community Health Nursing Period is a period of training for the most important and influential health professionals. To identify the strengths and weaknesses of the existing curriculum, this study was conducted to compare Community health Nursing Master's Education Program in Iran and John Hopkins School of Nursing. This descriptive-comparative study was carried out in 2018, data were collected by searching the internet with the keywords of nursing, community health nursing, curriculum, Iran, America, and with a review of the history and details of the community health nursing master's education program in Iran and the Johns Hopkins nursing school. Comparison was made using Bereday’s four-stage model: description, interpretation, Juxtaposition and comparison. The Public health nursing master's education program in the United States was presented in three separate branches and only Learning Strategies were common between Iranian universities and Johns Hopkins School of Nursing. However the definition of the field, the conditions and the manner of admission in the course, the job status of the graduates, philosophy, vision, mission, general purpose, roles of graduates and the subjects of the master's degree in nursing education were different. The Public health nursing education program in the United States is comprehensive and it is tailored to the needs of the community. It is recommended to revise the main components of this course in Iran according to the existing needs of the community.

Anxiety involves feelings of helplessness, uncertainty and arousal. Control of anxiety in patients is based on pharmaceutical and non-pharmaceutical methods. Among these, Benson's muscle relaxation and mental imagery are more widely considered. But the difference the two methods are still unknown. Therefore, the present stu study aimed to determine the difference between Benson's muscle relaxation and mental imagery on the anxiety of hemodialysis patients. For the purpose of this study, 96 patients under hemodialysis referring to hospitals in Maheshahr city (Imam Hospital, Imam Musa Kazem (AS) were selected by available sampling method. They were randomly assigned to three groups a relaxation group, an illustration group, a control group). Before the intervention, patients completed two demographic questionnaires and Beck Anxiety Inventory. Both intervention groups performed these techniques twice a month and twice a day. The control group did not receive any interventions. After one month of intervention, Beck anxiety inventory was completed by patients. Data were analyzed using paired t-test, t-test and Bonferroni post hoc test. The mean of anxiety score before intervention was not statistically significant in the three groups. In the two groups of imaging and Benson intervention, the reduction in the anxiety score after the intervention was significantly higher than the control group before the intervention. However, there was no significant difference in the reduction of anxiety score after intervention in comparison with the previous intervention in the two groups of imagery and Benson (p = 0.263). The results of this study showed that Benson's muscle relaxation and mental imagery reduced the anxiety of patients, and there was no difference in the effect of these two methods. Therefore, it is suggested that these methods be used to control anxiety in patients undergoing hemodialysis and other patients.

Considering the increasing prevalence of breast cancer, today, the main problem in the field of women's health is the control and prevention of breast cancer. One of the main areas in preventing this disease is controlling the risk factors associated with lifestyle. Wearing of brassiere is also a lifestyle-related habit that has sparked many debates today as a risk factor for breast cancer in women. This study was conducted to determine the behavioral Habits of wearing brassiere in women with and without breast cancer. This case-control study was conducted on women with and without breast cancer.A total of 360(120 in the case group -240 in the control group) individuals were selected based on available sampling method. The study tools were Demographic and behavioral habits of wearing brassiere questionnaires. Data were analyzed by Descriptive (mean and standard deviation, Frequency) and analytical tests (Independent t test and Chi-square) by using SPSS version 18 software. Based on the results, the average hours of wearing brassiere in women with and without breast cancer was 19.2 ± 3. 21 and 17.9 ± 3.19 respectively. The mean frequency of wearing brassiere during sleep in women with and without breast cancer was 5.78 ± 1.16 and 4.18 ± 0.83 times per week. There was a significant difference between the two groups regarding the average hours of wearing brassiere, the mean frequency of wearing brassiere during sleep and the habit of wearing a tight brassiere (p<0/05). The findings of this study revealed differences in some behavioral habits of wearing brassieres in women with and without breast cancer. So, in preventive interventions for breast cancer, women's education should be considered in order to be aware of the proper behavioral habits in wearing brassieres.

In recent years the issues surrounding competency-based education (CBE) increased attention and debate among health professionals and the international conferences and pilot projects proposed by a growing number of many of the issues of education magazines Medical critically examined. Because it had not been provided in nursing competency-based framework, providing a comprehensive framework, based on merit, competence in the development and standardization of the nursing department is a necessity. The review included all articles published from 1990 to 2015 related to defined competency framework for competency-based education in nursing, to languages, English and Farsi were analyzed. Ask first study defined search strategy was determined. Search for studies of databases with international and domestic sources, such as CINAHL, Web of Sciences, Science direct, ERIC, Google Scholar PubMed, SCOPUS, Wiley, Springer, Cochrane, EMBASE, SID, Irandoc, Iranmedex, MagirIran and related journals use key words appropriate Competency, competency framework, competency-based education, nursing, critical review and synthesis were used. Articles met the inclusion criteria of quality were assessed by using the checklist. 2,700 articles were found and 217 of them were review articles entered the study. With regard to the relevance of related or unrelated divided into two categories and, ultimately, 84 Article of the final selection was then analyzed. The main purpose of the use of competency-based education in nursing competencies increase the likelihood of transmission is performance-based learning experiences in organizational outcomes. To achieve this, educational institutions a wide range of studies to identify competency to employ that will help students to prepare for the world of work.

Breast milk is the best food for all neonates. Self-efficacy includes the belief and confidence of the individual in his ability to perform health behaviors, including exclusive successful breastfeeding. Self-efficacy in breastfeeding is vital for breastfeeding continuation. In addition, self-efficacy is an important variable in predicting the duration of breastfeeding, as well as the identification of mothers who terminate their breastfeeding promptly. The aim of this study was to compare Breast-feeding Self-Efficacy in mothers with infants admitted in the neonatal ward and mothers with healthy infants in the first week, the first month and third month after delivery. This present descriptive study has been performed in Isabn-E-Maryam Hospital. The number of individuals in each group of mothers with infants admitted in the neonatal ward and mothers with healthy infants was 49 who met the criteria for entering the study. Convenience sampling was used for the selection of the participants. The data were collected by a two-part questionnaire. Demographic data were collected in the first part of the questionnaire and the Dennis Breastfeeding Self-Efficacy Scale-Short form was the second part of the questionnaire. To analyze the data, independent t-test, co-variance and variance with repeated observations were used and data were analyzed using SPSS-18 software. In the hospitalized group, most neonates were admitted because of pathological jaundice.   The two groups of mothers with infants admitted in the neonatal ward and mothers with healthy infants were homogeneous. In both groups, mother’s Breast-feeding Self-Efficacy average was more than 52.22 which indicated a good attitude of mothers and showed that mothers were in favorable condition. In the hospitalized neonates’ group, most neonates were admitted because of pathological jaundice. The mean of Breast-feeding Self-Efficacy scores of mothers and Breast-feeding Self-Efficacy was not significantly different between the two groups at any time and in any of the three times between two groups (P> 0.05). In this study, although Breast-feeding Self-Efficacy in two groups of mothers was not significantly varied at different postpartum intervals, Breast-feeding Self-Efficacy of mothers with infants who were admitted to the newborns was lower than those mothers whose babies was healthy, which may be due to the mental and environmental conditions of the mothers following the admission of the newborn babies. The Breast-feeding Self-Efficacy in the group of mothers with a healthy baby also declined during the three months after delivery, which calls for continued education and support for mothers in the promotion of breastfeeding.