فصلنامه سلامت و مراقبت
سال بیست و دوم شماره 1 (بهار 1399)

The ability of treatment staff to interact with each other as a single group improves effectiveness, reduces error and dissatisfaction, and provides optimal care. Therefore, it seems necessary to pay more attention to issue of nurses' interaction with managers in therapeutic settings. The purpose of this study was to determine the interaction between nurses and managers and its influencing factors in Ardabil educational centers.

This was a descriptive- correlational study with 407 participants of employed nurses in Ardabil's medical- educational centers. The sampling method was stratified random sampling method. Leiden & Maslin's Leader and Employees’ Interaction Questionnaire, and demographic characteristics were used for data collection. Data were analyzed by SPSS v. 22 using descriptive statistics (mean, standard deviation, frequency) and inferential statistics (Chi-square test).

The results showed that most nurses had positive interaction with head nurses (82.1%), supervisors (59.2%) and nursing services managers (54.5%). There was a significant correlation between nurse-head nurse interaction and nurse- supervisor interaction with workplace hospital of nurses (p=0.024) (p=0.009). The results also showed that there was significant relationships between nurses-nursing services managers interaction with gender (p=0.02), workplace hospital (p=0.027) and work ward (p=0.048).

The finding showed that nurses had good interaction with nursing managers especially with head nurses. Male nurses working in dialysis wards and Imam Reza Hospital had the highest percentage of interaction with nursing managers. Therefore, it is recommended to pay attention to gender boundaries and to provide a suitable work environment for nurses to interact with managers as much as possible.

Earthquake is one of the natural disasters that, in addition to cause injuries to survivors, can have some positive consequences. One of these consequences is post-traumatic growth, which is the positive psychological consequence of indirect exposure to a traumatic event. The aim of this study was to predict the vicarious post traumatic growth based on cognitive flexibility and cognitive reappraisal in nurses providing services to Kermanshah earthquake victims.

This study was a descriptive-correlational research. The statistical population consisted of all nurses providing medical services to earthquake victims in Kermanshah in 2018, among them 181 nurses were selected by available sampling method. Data were collected by Tedeschi & Calhoun Post-Traumatic Growth Scale (CIS), Dennis & Vander wal Cognitive Flexibility (2010) and Cognitive Emotion Regulation of Garnefski et al. (2001). Data were analyzed using Pearson correlation coefficient and Simultaneous regression tests in SPSS 25 software.

The results showed a significant positive correlation between cognitive flexibility and cognitive reappraisal with post-traumatic growth. The results of regression analysis also showed that cognitive reappraisal and cognitive flexibility can predict post-traumatic growth (p<0.05).

The results revealed the importance role of cognitive flexibility and cognitive reappraisal in predicting post-traumatic growth in nurses. Therefore, increasing the cognitive flexibility and cognitive reappraisal training, may help the mental development of nurses.

Tooth caries is the most prevalent chronic childhood disease, and its prevention is very important. Furthermore, early and successful training of mothers regarding oral health and early childhood caries can have a great effect on raising their awareness, attitude and performance and stabilize the healthy behaviors of their children in the future. The aim of the present study was to determinee the effect of training of preventing methods of early childhood caries on awareness, attitude and performance of pregnant mothers.

This was a quasi-experimental study with before-after design. The statistical population included pregnant mothers with gestational age of 12-27 weeks who referred to Yazd health centers in 2017. Among them, 116 pregnant mothers were selected by cluster and random sampling. At the beginning of the study, a form of demographic characteristics and questionnaires of awareness, attitude and performance were completed by all subjects. Then, two one-hour training sessions about prevention of early childhood caries were held. One month after intervention, the subjects were re-evaluated by the same questionnaires. Data analysis was carried out using ANOVA analysis of variance and paired t-test and independent t-test.

The mean scores of awareness, attitude and performance of mothers before training were 0.99 (out of 9), 20.71 (out of 28) and 6.29 (out of 24), respectively. After training, all three parameters increased significantly (p<0.05).

The findings of this study indicated the positive effects of training program on enhancing awareness, attitude and short-term performance of pregnant mothers in preventing early childhood caries. Therefore, it is recommended that coherent training programs to be developed for pregnant mothers regarding oral and dental health of children.

Women undergoing cesarean section may have some difficulty in self-care and also the care of their baby due to post-operative pain. Therefore, the present study was conducted to determine the effect of non-pharmacological self-care training methods on pain management in women undergoing cesarean section.

This quasi-experimental study was performed on 72 women candidates for cesarean section at Shohaday-e Sarpol-e Zahab hospital. Samples were selected by available sampling method and randomly assigned to two experimental and control groups. In the 37th week of pregnancy, the test group was presented with a self-care pain control training booklet and its content was also taught by researcher in a 45-60-minute face-to-face session until full learning. The control group received the usual methods. The severity of pain in first 24 hours after surgery was assessed using a visual acuity scale (VAS) in both groups. The test group was then asked to perform self-care exercises. On the ninth day after surgery, the severity of the pain was re-evaluated in both groups. Data analysis was performed using independent t-test, paired t-test, chi-square and statistical indicators in SPSS software version 20.

The results showed that the mean pain severity scores were 5.19±1.69 in experimental group and 4.19±1.20 in control group (p=0.005). Also, the mean pain severity scores, nine days after cesarean section, were 0.92±0.97 in the experimental group and 2.59±1.34 in control group which showed a statistically significant difference between two groups (p<0.001). Pain severity was lower in the experimental group than in control group.

According to the findings, non-pharmacological self-care methods for pain management have been effective in reducing pain after cesarean section. Therefore, it is recommended that nurses consider these safe, non-invasive, cost-effective self-care techniques along with medication.

Natural childbirth is a painful experience that can be treated with non-pharmacological methods to reduce the pain and stress. The aim of this study was to compare the effect of massage, hot compress and normal perineal care methods on perceived stress and the severity of labor pain in first-born mothers.

The present study was a quasi-experimental study. The research population consisted of first-born pregnant women in Gonbad-e Kavous. A total of 150 samples were included in the study, which were randomly assigned to one of three groups of massage therapy, hot perineal compression, and routine perineal care. Perceived stress and McGill pain questionnaires were used to collect data. Data analysis was performed using descriptive and inferential statistical methods including independent t-test, chi-square and repeated meassure, using SPSS software version 16.

The mean stress scores were 23.78±3.4 in massage therapy group, 23.66±1.7 in hot compress group and 25.3±2.04 in normal care group. Statistically, there was a significant difference between the perceived stress scores of massage therapy (p=0.009) and hot compression groups (p=0.001) at different times, but in normal care group (p=0.162) this difference was not significant. In terms of pain intensity, the mean scores after 20 minutes intervention was 5.29 in massage group, 5.45 in hot compression group and 7.15 in normal care group (from a totall score of 10). Statistically, the mean scores of pain intensity before and after the intervention in the massage therapy (p=0.001) and warm compression (p=0.013) groups were significantly different.

Based on the results, hot compress method was more effective in reducing stress and massage therapy was more effective in relieving pain than other two methods. Therefore, these methods can be used as safe and secure ways to control the pain and stress of first-born mothers.

150 years consensus on clinical diagnostic criteria of pain, contraction and spasms has been questioned to explain vaginismus. The aim of this study was to understand the process of vaginismus diagnosis in women.

The present study was conducted with a qualitative approach based on the content analysis between 2014-2015. A total of 33 participants including 20 in patients group and 13 in clinical diagnostic group (gynecologist, midwife and clinical psychologist) were selected through purposeful and theoretical sampling in the clinics and family health centers of Tehran and Karaj and they were interviewed based on semi-structured method.

From data analysis, two topics of "perceived disorder in marital relations" with sub-themes of physical suffering and inability to have sexual intercourse and annoyance and psychological-emotional damage and also "applied diagnostic skills and knowledge" with sub-themes of behavioral interaction, were obtained from the diagnostic conditions and diagnostic criteria of the therapist.

The results showed that the therapist should be able to skillfully observe and discover the clinical diagnostic criteria of vaginismus, such as spasm, contraction, and pain, based on what he or she has learned as knowledge of vaginismus. The vaginismus is subsequently confirmed by a skillful analysis of the patient's marital status and the discovery of the dimensions of the patient's physical suffering and inability to have sex and the resulting psychological and psychological damage. For a definitive diagnosis of vaginismus, it is recommended that, at the first, a gynecological examination be performed to detect the clinical features, and second, a skilled analysis of the quality of the couple's marital relationship is recommended.

Misconceptions and misinformation about childbirth can lead to cause mood symptoms such as anxiety and depression during pregnancy, which have irreversible effects on the developmental characteristics of birth, such as birth weight or Preterm delivery. The aim of this study was to determine the effect of preparation classes about physiological childbirth in the last month of pregnancy on depression, anxiety and social support.

This study was semi-experimental. The statistical population included all primary pregnant women with moderate depression in Qom city (n=186), of which 50 women were selected by simple random sampling method and randomly divided into two groups of experiment and control, with 25 women in each group. The women in experimental group participated in physiological childbirth preparation classes with their husbands, and the control group received free counseling services for six months after the study, in accordance with the ethics of research. Anxiety, depression, and social support for both groups were measured using Questionnaires of Beck's Depression Inventory, Vandenberg Pregnancy Anxiety Inventory and Mary Prosidano Social Support, after 20-weeks as Pre-test and 36-weeks as post-test . Data analysis was performed using mean, standard deviation, Levin test and independent t-test with SPSS software version 20.

The findings showed that depression (t=22.819) and anxiety (t=10.976) were lower in the experimental group than in the control group. Also, the level of social support (t=-3233) in the experimental group was significantly higher than the control group.

Based on the results, the training provided in physiological childbirth preparation classes was effective in reducing depression and anxiety and increasing social support during pregnancy. Therefore, using these classes can help reduce depression and anxiety of pregnant mothers and increase their social support.

 The issue of ethics is considered as an essential element in all health professions, especially in the nursing profession. Due to the importance of ethics in nursing practice, the present study was conducted to determine the level of professional ethics from nurses’ perspective and its related factors in educational and medical centers in Hamadan.

 This research was a descriptive-analytical study on 287 nurses working in educational and medical centers of Hamadan in 1398, which was conducted by proportionate-stratified sampling. The data collection tool was a standard questionnaire for nurses' performance in observing professional ethics. Data were analyzed using SPSS-16 software and descriptive and inferential statistics.

 The performance of 78.8% of nurses in the study was evaluated in moderate level. In this study, the highest rate of observance of professional ethics codes was related to nurses in the field of nursing and service provision (6.65±1.08) and the lowest rate was related to nurses in the field of nursing and education and research (1.20±0.97). There was no positive and significant relationship between the demographic characteristics of nurses and the principles of professional ethics, except in the "work section" (p=0.14).

 Considering the average observance of ethical principles by nurses, it seems that improving the current situation and identifying the causes of some shortcomings in observing some areas of professional codes ethics, including in the field of education and research, should be considered by relevant officials.