مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و هفتم شماره 1 (پیاپی 67، فروردین و اردیبهشت 1398)

Cardiovascular disease is considered to be one of the most common chronic diseases in Iran and the World. Studies show that death anxiety is common among cardiac patients. There are several studies related to the effect of pharmacological and non-pharmacological methods in reducing the psychological outcomes in cardiac patients. Spiritual care program can be mentioned as one of the non-pharmacological and less known methods in present era. The present study aimed to identify the effect of spiritual care program on death anxiety of cardiac patients. 
This study was a Randomized clinical Trial. 100 cardiac patients hospitalized in cardiac intensive care unit of Shahid Modarres Hospital in Tehran were chosen to attend this study using the available sampling method, from Dec 2015 to Apr 2016. The patients were randomly assigned to control group (receiving routine care) and intervention group (receiving spiritual care). The 15th item of Templer Death Anxiety Scale was completed for the patients by the researcher before and after the intervention. The spiritual care was done during 3 sequential days (from 17 till 21) for patients of intervention group according to the written program (supportive presence, ritual support and using supportive system) and patient’s desire and needs. Finally, the data was analyzed by descriptive and analytical statistics (independent t-test, chi square and ANOVA), using SPSS 23.
The results of present study showed that there was no significant difference between the distribution of variables in control and intervention group before the intervention. No significant change was observed in the rate of death anxiety of control group before (38.56±6.998) and after the intervention (38.96±5.838) (P=0.498) and either in intervention group before (39.96±5.715) and after the intervention (39.90±5.613) (P=0.898).
The results of this study indicated that although the death anxiety of cardiac patients was reduced after the implementation of spiritual care, this reduction was not statistically significant.

Different studies have demonstrated that maternal thyroid dysfunction during pregnancy is associated with adverse obstetrics and fetal outcomes. There is no international consensus regarding to use a guidelines for screening in high risk women. The aim of the present study was to determine prevalence of thyroid disorders in high and low risk pregnant women.
In a cross-sectional study during 2015-2016, from all pregnant women who had referred to Hamadan health center Lab for their first visit, a sample of 852 pregnant women were selected and assigned to low risk and high risk group. Thyroid tests and Anti TPO tests were carried out.
Of 852 pregnant women, 26.5% had Subclinical hypothyroidism, 1.2% had overt hypothyroidism, 0.5% had overt hyperthyroidism and 0.2% had subclinical hyperthyroidism. 25.6% were in the high risk group and 74.4% in the low risk group and 37.4% of high risk group and 25% of the low risk population had thyroid disorders (P<0/001). 89% were Anti TPO negative and 11% were Anti TPO positive.
Hypothyroidism is common in pregnant women, and if screening is performed only in high-risk groups, 25% of pregnant women with subclinical and overt hypothyroidism will not  be detected explicitly. In addition, to determine the exact frequency of thyroid disorders, we need to look for newer and more effective criteria.

Spirituality and spiritual intelligence can be effective in all spheres of human life such as the spheres of work and social activities of human beings. The present research was conducted to investigate the effect of spiritual intelligence on the quality of nursing care in Hamadan University of Medical Sciences hospitals.
This descriptive-correlational study was conducted on 174 nurses working in teaching hospitals in Hamadan city, using stratified random sampling method in 2018. The data gathering tool was a questionnaire of Spiritual Quran Inventory and Quality of Nursing Care Quality Questionnaire (QUALPAC). Data were analyzed using Cronbach’s alpha, Kolmogorov-Smirnov tests and Pearson correlation in SPSS21 software and structural equation modeling in PLS software.
The mean age of the majority of participants was 31-40. The mean and standard deviation of spiritual intelligence dimensions included: transcendental consciousness (25.49±6.066), personal meaning (18.28±4.516), and critical thinking (25.22±6.152) development of consciousness (18.01 ± 4.707) and in dimensions of nursing care quality, psychosocial dimension (83.11±15.7), communication dimension (40.03±7.41), physical dimension (75.67±14.5). Transcendental consciousness, creation of personal meaning, existential thinking and development of consciousness had no significant effect on the quality of nursing care (P >0.05). There was no significant relationship between spiritual intelligence and psychosocial dimension and communication quality of nursing care (P>0.05). But Spiritual intelligence had a direct and significant relationship with the physical dimension of nursing care (P<0.05).
The results of this study showed that the effect of the four components of spiritual intelligence (existential critical thinking, development of the position of consciousness, the creation of personal meaning, transcendental consciousness) on the quality of nursing care and its two dimensions, including psychosocial aspect was not significant. Only a weak relationship was found between the physical dimension of nursing care with spiritual intelligence. Finally, there is a weak correlation between spiritual intelligence and quality of nursing care.

Hemodialysis is one of the chronic diseases that has negative effects on all aspects of the patient’s life. The quality of life of patients with hemodialysis is impaired due to the many problems and chronic nature of the disease. Also, fatigue is one of the common problems of these patients. The aim of this study was to evaluate the effect of sleep health education on the severity of fatigue and quality of sleep in hemodialysis patients in Hamadan.
In this quasi-experimental study, 60 hemodialysis patients were selected by available sampling from Besat (Intervention) and Beheshti (Control) hospitals. All samples completed the demographic checklist, Piper Fatigue scale and Pittsburgh Sleep Quality Index (PSQI). The control group received routine care and the intervention group, received sleep hygiene education face to face and by providing educational booklet in 3 consecutive dialysis sessions. After two months of training, sleep quality and fatigue intensity of the samples were checked. To analyze the data, SPSS software, descriptive and inferential tests were used.
There were no significant differences between the intervention and control groups in terms of underlying variables. There was a significant difference between the control and intervention groups regarding quality of sleep and fatigue after sleep hygiene education (P<0.001).
The study results showed that Sleep Hygiene Education had an important and decisive impact on the Fatigue and Sleep Quality in Hemodialysis Patients and holding educational courses in this field for patients can be useful.

Multiple sclerosis (MS) is considered to beone of the most common chronic diseases of the central nervous system. Its chronic nature, no cure being available and its onset at a young age can have a devastating effect on quality of life and fatigue. This research aims to study the effect of group mindfulness-based stress reduction program and conscious yoga on the quality of life and fatigue in patients with Multiple Sclerosis.
This was a quasi-experimental study with pretest-posttest design and control group. The sampling method was initially a public call amogst members of the MS Society in Tehran. 24 patients with MS and having the criteria needed for inclusion of the applicants were randomly assigned to the experimental group (n=12) and control group (n=12).The participants completed MS patients’ quality of life questionnaires (MSQOL-54) and the Fatigue Severity Scale (FSS), before and after treatment. The experimental group was treated in 8 sessions of group mindfulness-based stress reduction program (for 2 hours each session). Data was analyzed using covariance single variable and SPSS 21.
The results showed that there was a significant difference amogst the mean scores of some subscales of the quality of life including physical functioning, role in relation to physical and mental energy, mental well-being, health threats, perceived health, satisfaction with sexual function, quality of life and fatigue test and control groups (P<0/05). 
The results showed that the program of reduction of consciousness-based stress is effective in reducing fatigue and increasing some of the subscales of quality of life in MS patients. Therefore, it can be concluded that if such interventions are applied to patients with chronic illnesses such as MS in addition to medical therapies, their illness can be reduced by changing perceptions of patients from their long-term illness.

Adolescents on hemodialysis are faced with problems of mental health and academic failure; therefore, this study aimed to determine the effectiveness of life skills training on mental health and academic achievement of adolescents under hemodialysis.
A quasi-experimental study was conducted on 80 adolescents under hemodialysis in dialysis centers of Imam Khomeini and Imam Reza hospitals of Kermanshah by convenience sampling method; then the samples were randomly divided into intervention (n=40) and control (n=40) groups. Data collection tool was the standard questionnaire of mental health and in relation to academic achievement, students’ Grade Point Average (GPA) was used. Data were analyzed using SPSS 16 and Chi-square, the independent  t test and the paired sample t tests.
In the intervention group, the mean scores of anxiety (10.37±5.44), depression (15.43±7.34), physical complaints (8.99 ± 6.18), significantly decreased into (6.71±2.82), (11.23±2.87) and (4.82±2.24) respectively (P<0.05), and social activities score increased from (12.29±5.41) to (16.27±6.67) scores (P>0.05). The students’ GPA, before intervention (15.02 ± 2.09) compared with the results after intervention (16.72±1.13) significantly increased (P<0.05).
This study indicated that life skills training can promote the different dimensions of mental health and academic achievement of adolescents under hemodialysis. In this regard, it is suggested that the plan of lifestyle training should be considered during the treatment of adolescent under dialysis.

Parents of children with cerebral palsy are exposed to the complications of the child’s care; they need kinds of support to reduce problems of care for the child. Therefore, the current study was done in order to discover the factors that influence role of caring parents while taking care of the cerebral palsy child. This study is part of a qualitative study that was done in 2011-2013. Sampling was done based on goal-oriented and continued to saturate data. Thus، 33 participants including parents and family members of children with cerebral palsy that had been referred to Rehabilitation Centers in Tehran city and rehabilitation experts participated in this study. Data was collected through semi-structured interviews with each participant and analyzed through content analysis and continuous comparison of data. The results of data analysis showed the concept of parental capital with two categories: parents’ personal ability (subcategories: mental and physical ability in care, the ability to communicate with others, belief in the spiritual value of the child) and parental situational resources (subcategories: the socio-economic status of the family, the availability of helping relatives, cooperation and partnership in the family). Parental capital as a supporting factor has an effectiveness on the sense of parents’ dominance on the situation of taking care of child; so، it is important to pay attention to the parents’ capital (internal and external) for educating and home care planning of affected child and family.

Nurses are considered as the major part of the human resources of the health system. The aim of this study was to determine the relationship between quality of working life and job satisfaction of nurses in teaching hospitals of Hamadan University of Medical Sciences.  The study is descriptive-analytic. A total of 269 nurses from Hamadan hospitals were randomly selected. The collection tools were two job satisfaction questionnaires and quality of working life with a Cronbach’s alpha coefficient of 94.9 and 81 respectively. Data were analyzed by SPSS21 using t-test, ANOVA and Chi-square test. Findings showed that there is a significant relationship between quality of working life and job satisfaction (P<0.05). The results also showed that there is a meaningful relationship between the job satisfaction from the perspective of salaries and benefits (P<0.05), job promotion. But there are no significant relationships with other dimensions such as, the nature of the work, supervisor, and relationships with colleague and job promotion. There was a significant relationship between working life and job satisfaction (P=0.001). The results indicated that there is a significant and stable relationship between job satisfaction and quality of working life of nurses in the studied population. Therefore, the attention of policymakers, health system planners and hospital managers to the key needs of nurses, such as increasing salaries and benefits, job security, job promotion and fair evaluation can play an important role in increasing job satisfaction and improving the quality of working life of nurses.