مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و هفتم شماره 6 (پیاپی 72، بهمن و اسفند 1398)

One of the common problems of patients after open heart surgery is sleep disturbance. The aim of this study was to investigate the effect of benson relaxation on sleep quality after coronary artery bypass graft.

In this randomized controlled trial, 80 patients allocated to the benson relaxation and control groups. For the intervention group, Benson's relaxation technique was done twice a day for a period of four weeks. The control group received routine care only. In both groups, sleep quality was measured before and after study using Pittsburgh sleep quality questionnaire. Data was analyzed using SPSS software.

Befor intervention, there were no significant differences between two groups of Benson relaxation and control group in any variables of sleep quality and total sleep quality (P>0.05). After intervention, in the Benson relaxation group, the patients' sleep quality was significantly better than the control group in terms of subjective sleep quality, sleep latency, sleep efficacy, sleep disturbances and total quality (P<0.05). However, there was no significant difference between Benson relaxation and control group in the variables of sleep duration, taking sleep drugs and daily dysfunction (P>0.05).

Using Benson's relaxation technique as supplementary and alternative therapies to improve the sleep quality of patients after open heart surgery is recommended.

Medical emergency technicians are more likely to be exposed to workplace violence because of exposure to emergency situations. This study seems to be necessary because of the physical and psychological effects of the violence. Therefore, the present study aimed to determine the frequency of type of workplace violence against medical emergency technicians of Hamadan province and its relation with individual variables.

This descriptive cross-sectional study was conducted in 2018 on 137 employees of Hamadan medical emergency centers. Sampling was performed using a stratified random sampling method. Data was gathered by a questionnaire on workplace violence (the International Labor Office, the World Health Organization and the International Nursing Council). Questionnaire completion method was self-explanatory. The collected data were analyzed by SPSS 16 and descriptive and analytic methods.

Psychological violence (72.2%), Physical violence (22.6%), racial and religious harassment (4.5%) and sexual harassment (0.7%) were the most prevalent type of violence, respectively. There was a significant relationship between job status and workplace violence (P<0.05). Marital status, educational level, employment status, type of job shift, employment, direct contact with patients / injured, specific drug use and disease, participation in a training course, experiencing a personal crisis during the last six months, was not related to workplace violence (P<0.05).

There was a high prevalence of psychological violence against the staff; therefore, planners must identify the related factors in order to plan for preventing these violations.

Health promoting behaviors are one of the key determinants of health. One of the most important situations in which health promoting behaviors are of particular importance, is about female marginalized households. Therefore, this study was conducted to determine the mean scores of health promoting behaviors and its six dimensions, and also its relation to self-efficacy, social support and demographic factors in the women-headed families of Urmia suburb in 2017.

This was a descriptive-analytic study and its statistical population was all the female heads of the suburban families of Urmia of which 384 were selected. Data were collected through demographic questionnaires, perceived social support, general self-efficacy and Walker Health Promoting Behavior Inventory. Descriptive statistics including mean and standard deviation were used to describe descriptive characteristics and, Pearson and Kendall's correlation tests were used to describe analytical features.

The mean of total health promoting behaviors was 111.62±20.45. Self-efficacy, perceived social support and demographic characteristics of marriage and education had a significant positive correlation with health promoting behaviors (P<0.001), but there was no significant positive correlation between occupation and age with health promoting behaviors.

According to the findings of this research, health authorities and health care providers can found self-efficacy increase for female heads of households by designing health promoting education programs. Also governmental organizations and families with supplying necessary emotional supports can provide an area of social support increase and consequently, a change in behavior, for suburbanized female heads of households.

Patients undergoing spinal column surgery, experience severe postoperative pain. One of the special methods of pain control is use of a patient-controlled analgesia (PCA) pump. Studies show that despite this pump, patients suffer from moderate to severe pain. Therefore, the teaching patients how to use the pump by nurses is essential. Therefore, the present study was conducted to determine the effect of patient education about patient-controlled analgesia pump preoperative on severity of pain, nausea and vomiting after spinal column surgery.

The present study was a randomized controlled trial during which 60 candidate patients of Spinal column surgery hospitalized in Shahid Fatemi hospital in Ardebil, were selected by accessible method and randomly assigned into two groups of 30 individuals, intervention and control group. Both groups received routine training in the use of the pump in the recovery department, but the intervention group received a 15-minute face-to-face intervention session using a sample of the PCA pump. Postoperative pain intensity, nausea, and vomiting in three times, 2, 4, 24 hours after surgery were assessed and compared. SPSS 16 was used to analyze the data.

The findings showed that there was a significant difference between the control and intervention groups regarding the severity of pain in times of 2, 4, and 24 hours postoperative (P<0.001). Pain severity in intervention group was decreased compared to control group. However, there was no significant difference in nausea and vomiting frequency between the two groups (P>0.05).

Training the use of patient-controlled analgesia pump before operation, without changing the severity of nausea and vomiting, reduces pain after spinal column surgery. Therefore, it is recommended that the way of using the pump, be taught before operation.

Pain in the lower back and pelvic pain are one of the most common problems in pregnancy. Appropriate and low-cost diagnostic and validated measurements are required. Therefore, there is a need for a reliable, valid and responsive measurement tool.

This descriptive study was performed on 135 pregnant women with pelvic pain referring to Shahid Beheshti University of Medical Sciences in Tehran in 2017. The data collection tool was a participant's personal information form, pelvic pain questionnaire, and brief pain inventory. The results were analyzed by descriptive, correlation and regression tests using SPSS 22. The P-value>0.05 was considered significant.

The mean and standard deviation of age in women were 29.43±5.7 years. The mean pain based on the pelvic belt tool was 37.00±18.00 and the mean pain was 4.25 ± 1.87, respectively. There was a significant positive correlation between the two tools in the sensory evaluation of pregnant women (r=0.818, P=0.001). The pelvic girdle questionnaire, according to R2 = [0.669, BPI=1.109+ 0.085(PGQ)], predicts the amount of pain in the pain relief tool.

Considering the importance of pelvic girdle and a significant correlation between these two questionnaires, it seems useful to use a questionnaire and a tool with a high degree of accuracy which requires shorter time to complete. Therefore, it can be concluded that a brief pain instrument is a useful tool for measuring pain and its effects in the life of patients with pelvic girdle.

Mothers of cesarean section need more support for breastfeeding. The purpose of this study was to use Bristol's tool for lactation counseling on the breastfeeding status in mothers undergone Cesarean section.

In this quasi-experimental study,80 primiparous women after cesarean section In Fatemieh Hospital of Hamedan in year 2018 were selected by available sampling method and assigned to two groups of test (pairs) and control (individual days) (40 persons per group). In two groups, the researcher reviewed the Bristol Breastfeeding checklist, assessed the breastfeeding status, nuchal infant, milk swallowing and infant suction and, based on the need, a breastfeeding counselor was provided in the test group. The counseling was given to the mother during the first 2 hours, 2 days, 10 days and one month after delivery. During this time, the control group received routine care only. The lactation continuity questionnaire was completed for both groups during the four months after delivery.

Two groups had no significant differences in demographic variables (P > 0.05). There was a significant difference between the mean duration of lactation during the four months postpartum (P <0.001). The mean of Bristol instrument scores in the first session did not have a significant difference between the two groups, but in the second, third and fourth sessions after delivery, there was a significant difference between the two groups (P <0.001).

The Bristol tool is a good tool for evaluating mothers breastfeeding.

Patients with coronary artery bypass (CAB) surgery are at risk of atelectasis. Use of respiratory exercises as an effective approach has had controversy finding in CAB patients. This study aimed to determine the effect of breathing exercises on the prevention of atelectasis in patients undergoing coronary artery bypass surgery.

In this randomized clinical trial, 80 patients with CAB surgery who referred to Ekbatan Hospital, Hamadan, Iran from July 2013 to May 2015 were randomly divided into two groups. In experimental group (n=40), respiratory exercises (30 deep respiratory per hour for 3 days postoperatively) were performed by patients, after full education and extubation along with routine care. In control group (n=40), patients only received routine care. Chest x ray was used to diagnose atelectasis. Data analysis was done by SPSS 17.

The two groups did not differ significantly in terms of personal characteristics such as age, sex, education, bmi and etc. (P<0/05). The result of the Mann-Whitney test in order to compare the two groups of test and control for the occurrence of atelectasis, respiration and respiratory type showed a significant difference between the two groups at all hours after surgery (P<0/001). These findings confirmed the effectiveness of respiratory exercises.

This study showed that breathing exercises can reduce the incidence of atelectasis. Therefore, applying this method as a routine care is recommended in patients with CAB surgery.

In medical ethics, privacy is one of the main aspects of patient rights. Since the outcomes of respecting privacy as one of the dimensions of patient's rights are not clear, this study was performed to explore outcomes of observance for patient privacy in hospital.

This study was conducted with qualitative research approach and contractual content analysis method. Participants included 20 patients hospitalized in the internal and surgical wards of Tehran's hospitals who were selected based on purposeful sampling. Data was collected using semi-structured interviews. Then data was analyzed based on conventional content analysis method and using the MAXQDA 10 software.

Analyzing the interviews with patients, 56 primary codes, 13 subcategories and 4 themes were extracted, which indicated the perception of participants for consequences of observance for privacy. These themes included: preservation and promotion of the dignity of the patient, compromise with the existing situation, health development and satisfaction.

The results of this study showed outcomes of observance for patient’s privacy. With the treatment team's awareness of these consequences, the patients' expectations are respected, which leads to the provision of favorable health care and patient satisfaction.