مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و هفتم شماره 2 (پیاپی 68، خرداد و تیر 1398)

The results of studies have shown that inadequate awareness and self-care of patients with chronic renal failure, leads to an incorrect illness perception in these patients. Considering the importance of this issue, this study aimed to investigate the effect of self-care education in patients undergoing hemodialysis.

This was a simple randomized clinical trial. The statistical society of the study consisted of 120 patients undergoing hemodialysis in dialysis department of Bu-Ali Sinai Hospital in Qazvin from December 2016 to February 2017. The samples were assigned randomly to two groups of control (routine care) and intervention (illness perception intervention). Both groups completed the demographic information questionnaire, illness perception questionnaire before the intervention. The intervention group received self-care education based on illness perception in the patient’s bedside and before initiation of dialysis in 3 sessions of 30 minutes. A training booklet was also given at the second session of the patient’s delivery, which was provided by the researcher and under the supervision of the professors. Four weeks later, the questionnaire of illness perception was completed by both groups. Data were analyzed using descriptive and analytic statistical tools in SPSS 20. The results of this study showed that there was not a significant difference between the two groups in terms of demographic information, except for the duration of dialysis (P<0.014). The ANOVA test results showed a significant difference in terms of patient’s illness perception between the intervention and control group (F(1, 112)=13.88, P<0.001). Self-care educational intervention based on illness perception increased the perception of the disease in hemodialysis patients.

Women need to be well prepared for a healthy pregnancy, childbirth, and childcare. However, confronting unplanned pregnancy and disagreement with pregnancy can cause fear, anxiety and worry during the pregnancy, and may lead to many problems for mother and baby. The aim of this study was to compare health condition between wanted and unwanted pregnancy of women under the guise of health centers in Hamadan city, Iran. This cross-sectional study is a case-control study. The statistical population of this study included all pregnant women referred to Hamadan health centers in 2016. The sample consisted of 140 people (70 cases of wanted pregnancies and 70 cases of unwanted pregnancies) referred to Hamadan health centers. After collecting data, a demographic questionnaire and a mental health questionnaire (SCL-90R) were used for data collection. The data were analyzed by descriptive statistics and t-student test and Chi-square. Two independent and single groups were analyzed. For this purpose SPSS 18 was used with a significance level of less than 0.05.  The results of this study showed that there is a significant difference between obsessive-compulsive scales, physical complaints, interpersonal sensitivity, anxiety, aggression, anxiety and psyllopathy in both wanted and unwanted pregnancy groups (P<0.01). However, there was no significant difference between the result for depression in two groups of wanted and unwanted pregnancies (P>0.05). According to the results, it is necessary to use screening tools to diagnose mental problems, counseling and support for these women, along with the usual care during and after delivery.

Medication adherence is essential to improve outcomes emanated from the disease. The increase in the complexity of the medical regimens causes poor adherence in patients with heart failure; also, the progressive nature of Heart Failure (HF) and its complicated drug regimens are mostly stressful. This study has been conducted on the HF patients at the heart hospital of Kermanshah city with the objective of finding the association between medication adherence and coping skills. The present research is a descriptive-correlative study. Research cases include 400 HF patients at Imam Ali hospital of Kermanshah in 2015 who were selected using available sampling method. The self-reported epidemiologic characteristics form of HF patients, Morisky medication adherence Questionnaire (1986) and short form of Carver Questionnaire (COPE, 1997) were utilized for data gathering. SPSS 22 software and statistical test of Pearson correlation and descriptive statistical were used to analyze the data. The result showed that the majority of the studied cases (%94) had poor medication adherence. Pearson correlation data analysis revealed direct and weak statistical correlation between medication adherence and coping Skills (religion P=0.036, acceptance P=0.019, use of emotional support P=0.02, use of instrumental support P=0.001, hummer P=0.025, positive reframing P˂0.001, self-distraction P=0.002).  Given the weakness of medication Adherence and relationship between medication adherence and coping Skills in HF patients, the application of educational and intervention programs appears to be substantial.

Social skills are considered to be one of the important factors in the success or failure of every individual in a society. The present study was designed to determine the social skills of primary school children with and without parents of mental disorders.  In this research 60 kids between 6-12 years were selected using available sampling method, who had parents with mental disorder in addition to 60 kids at the same age who didn’t have parents with mental disorder. Research setting was Farshchian hospital in Hamadan city in 2017. Data was collected with demographic questionnaire and Gresham and Eliot with category scale of social skills that was completed by parents. Data was analyzed using SPSS 21 and descriptive statistics and inferential statistics including T test, covariance analysis and Chi-square test. The score of social skill in kids who had parents with mental disorder was 56.43±10.8 and in kids who didn’t have parents with mental disorder was 58.46±8.70. Comparing social skills in two groups showed that they are not significant difference in mean Score in social skills and its dimensions (cooperation, decisiveness, self-control and responsibility). Although there aren’t significant difference between two groups, mean score in witness group was more than another group (P=0.259). The social skills of children in both groups were at the medium range and were not of a desirable level. This calls for a review of family-based education and educational approaches, as well as training programs to promote social skills.

Pediatric Cardiopulmonary Bypass (CPB) circuit invariably requires priming with Packed Red Blood Cells (PRBCs). Metabolic composition of stored PRBCs is unphysiological. Commencement of PRBC primed CPB leads to rapid transfusion of massive metabolic load. This predisposes pediatric patients to the risk of complications such as electrolyte disturbances, citrate toxicity, acidosis and activation of the inflammatory response. The aim of this study is to evaluate the effect of ultrafiltration of priming blood on clinical outcomes infants undergo cardiopulmonary bypass.  This was a clinical trial, with two groups (intervention and control) and a sample of 60 infants referred to Shahid Rajaie Hospital in Tehran (30 patients in intervention and 30 patients in control group) that was carried out in 2017. Ultrafiltration was used on prime with Conventional Ultrafiltration (CUF) for patients in the intervention group during CPB, but in the control group only CUF was used. Arterial blood gas parameters, amount of bleeding, blood transfusion rate, the duration of mechanical ventilation, residence in the ICU and the level of electrolytes were measured. Data of this study was analyzed using the Chi-square test, T- test Independent-Sample, Repeated-measure, Mann Whitney U test by SPSS 25. In terms of electrolytes, the prime solution used in the intervention group was significantly closer to physiological comparing to the control group (P<0.05). The intervention group showed significant reductions in postoperative blood loss; postoperative blood transfusion; time to extubation; the length of stay in the ICU; (P<0.05). The level of electrolytes and other parameters of arterial blood gas were similar in both groups. It can be concluded that the combination of the ultrafiltration of priming blood and CUF method effectively reduces the side effects of cardiopulmonary bypass.

Hypertension is a chronic disease that leads to many complications in vital organs of the body and can reduce the quality of life of patients. The aim of this study was to investigate the correlation between demographic characteristics and quality of life of hypertensive patients referring to the Farshchian Cardiac Hospital in Hamadan. This is a descriptive-correlational study. The quality of life of 282 hypertensive patients was evaluated in Farshchian Cardiology Center of Hamadan University of Medical Sciences at 2018. The data was collected using a two-part questionnaire including demographic questionnaire and quality of life questionnaire for hypertensive patients. In this study, validity and reliability of the questionnaire were confirmed. Data analysis was done using SPSS 23. 142 (50.4%) of the patients studied had good quality of life status, 135 (47.9%) had moderate quality of life and 5 (1.8%) had poor quality of life. The difference in mean of quality of life in patients under study was determined by the duration (year) of hypertension (P=0.011), occupational status (P=0.036) gaining information through television (P=0.444) and the number of drug use (P=0.026). In this study, the relationship between patients’ quality of life and some characteristics was illustrated. Therefore, nurses and health planners should consider the demographic characteristics of patients as a health promotion factor in care and education.

Teaching metacognition is one of the methods for improving the psychological well-being and quality of life of pregnant women. The purpose of this study was to investigate the effectiveness of meta-cognitive education on the psychological well-being and quality of life of pregnant women. This was a semi experimental study with pre-test and post-test design and control group. The statistical population of this study included all pregnant women who referred to Namazi Hospital in Shiraz in 2016. Sample size included 60 people from this community, who were randomly divided into two groups of 30 subjects. A psychological well-being questionnaire and a quality of life questionnaire were used for data collection; data was analyzed using one-variable covariance analysis, and SPSS 22. The mean (standard deviation) of the students in the experimental group was 33.4±2.8 and the control group was 34.7±2.9. The results of this study showed that the pre-test of well-being in the experimental group was 85.6 which increased to 99.2 in the post-test (P <0.0001, F=44.20), but the pre-test of the control group was 84.8, which reached to 85.4 in the post-test (P<0.05). The pre-test of quality of life in the experimental group was 71.2 which increased to 89.7 in the post-test (P<0.0001, F=30.70), but the pre-test of the control group was 86.5, which was 87.1 in the post-test (P<0.05, F=30.70). It can be concluded that metacognitive education was effective in increasing the psychological well-being and the quality of life of pregnant women.

One of the most important problems in childhood is urinary tract infections, which can lead to permanent damage to the kidneys. The purpose of this study was to measure the constructs of the theory of planned behavior regarding the preventive behaviors of urinary tract infection in mothers with a dughter under two years of age. This is a cross-sectional and analytical study that was carried out on 280 mothers of girls under the age of two years who referred to health centers and were randomly selected. The data was collected by a researcher-made questionnaire validity and reliability of which were confirmed. The questionnaire included demographic characteristics of the mother, dimensions of the planned behavioral model and maternal duty checklist. Finally, the data were analyzed using SPSS 20, Pearson correlation and linear regression tests. Mean and standard deviation of attitude score (3.87±0.37), subjective norm (4.09±0.49), perceived behavior control (4.32±0.47), behavioral intention (4.59±0.47) performance (2.78±0.58) and knowledge (0.62±0.1) was observed. In regression analysis, variables of knowledge and intention to behave, predicted a total of 15% (R2=0.16, B=1.342, P=0.001) of behavioral change. According to the results of the study, in designing educational interventions, the awareness and structure of behavioral intention should be considered as the most important predictor of mothers’ behavior.