نشریه پرستاری و مامایی ارومیه
سال هجدهم شماره 2 (پیاپی 127، اردیبهشت 1399)

Increasing in the inter-recti abdominal muscle during pregnancy and postpartum, called diastasis recti abdominal.  Many musculoskeletal disorders occur in women with diastasis recti After pregnancy in the lumbopelvic region. This research article aims to compare the static, dynamic balance and curvature of the spine in women with and without diastasis recti abdominal in the postpartum period.

This study is a retrospective study of the type of case_control. Forty women participated in the study, 2 to 5 months after childbirth, and were divided into two groups, healthy(n=20) with a mean age of 26.4± 4.88 years and diastasis recti(n=20) with a mean age of 29.5 ± 5.88 years. To assessment the two groups in this study, a flexible ruler was used to assess the curvature of the spine and to measure static and dynamic balance using the Biodex balance system. The information was analyzed using SPSS software version 24 and an independent t-test.

The results of this study showed that between the two groups, the lumbar lordosis angle was significant (P≤0.05) and the kyphosis angle was non-significant (P≥0.05). Also, the results of static balance in the overall, anterior-posterior and lateral-medial stability, showed a significant difference between the two groups (p 050.05), but in dynamic balance except in anterior-posterior stability(P≤0.05), not observed a significant difference(P≥0.05).

This study showed that lumbar hyperlordosis and postural instability are associated with diastasis recti Abdominal, and women with this disorder have little improvement after childbirth without treatment modalities, because after childbirth due to shrinking uterine volume, Abdominal muscles become weakness and sag, and there is a lack of muscle support in this area, which can increase the postural instability of patient women compared to healthy women and slow the recovery process of hyperlordosis.

Considering the importance of nursing practice in increasing the quality of care and treatment of patients and the importance of paying attention to some effective factors this study aimed to investigate the relationship between job stress, fear of negative evaluation and accountability with job performance of nurses in hospitals in Behbahan city.

For this purpose 208 participants from all hospital nurses in Behbahan city (434), were selected through the multistage random sampling method. The instruments used in this study were the Gray-Toft and Anderson nursing stress scale(1981), Leary brief fear of negative evaluation scale(1983), Gough responsibility inventory (1987), and Paterson job performance questionnaire(1970). To analyze data, descriptive statistics (maximum and minimum, average and standard deviation), correlation simple, and multiple regression were used.

Results obtained in this study showed that there was a negative and meaningful relationship between job stress with job performance (p<0.01, r= - 0.354), and between fear of negative evaluation with job performance (p<0.01, r= - 0.285). Also, there was a positive and meaningful relationship between responsibility with job performance (p<0.01, r= 0.251). Results obtained from multiple regression showed that among the predictor variables, based on β coefficients, job stress (p<0.01,
β=-0.152) is considered to be the best predictor of job performance.

Hypertension is recognized as the leading risk factor for disability and death worldwide. The aim of this study was to determine the effect of applying continuous care model on the amount of dietary sodium intake and blood pressure in hypertensive patients referred to the heart clinic of Seyed al-Shohada educational and treatment center of Urmia in 2018-2019.

This randomized clinical trial was conducted on a total of 50 hypertensive patients in two groups (intervention and control) as pre-test and post-test. Continuous care model was conducted on intervention group over a period of 3 months. At the end of study, the mean of blood pressure and the amount of dietary sodium intake in both groups was measured again.

The mean of sodium intake, systolic and diastolic blood pressure of patients in the intervention group after the intervention decreased significantly (p<0.05). In other words, applying continuous care model had a significant effect on the reduction of dietary sodium intake and the mean of blood pressure in patients.

Applying continuous care model can reduce dietary sodium intake and blood pressure in hypertensive patients. Therefore, it is recommended to use this model along with drug therapy in the care and nursing of hypertensive patients in order to control problems and achieve better therapeutic results.

Assessment of nursing students' clinical competency is one of the concerns of nursing instructors. This descriptive study was conducted with the aim of designing, implementation and evaluation of Objective Structured Clinical Examination (OSCE) for assessing the clinical competence of nursing students in nursing faculty of Jiroft.

This cross sectional study was conducted in three stages: designing, implementation and evaluation. Firstly, according to the priority of the instructors, 10 skills were selected from nursing clinical skills and their checklists were developed. 27 nursing students participated in OSCE on one day. For assessment of OSCE Kirkpatrick model, Criterion validity and reliability was measured. For criterion validity, correlation between the last 4 clinical scores mean and total OSCE score was measured. A likert three points questionnaire with 16 items and one open question at the end of questionnaire was used to examine the students' reaction to OSCE according to the Kirkpatrick model.

In results 50% of all students were completely satisfied, 34.6% (N=10) were relatively satisfied from OSCE, and 57.7% (N=16) of the students believed that OSCE has shown their learning weaknesses. 76.9% (N=21) of students believed OSCE as an opportunity for learning. 96/2% (N=27) believed that OSCE was stressful. Qualitative analysis of the open question led two categories including the strengths of test and the weaknesses of test. The correlation between the total score of OSCE and the criterion validity was 0.43 and was significant. In the internal consistency of OSCE, the correlation between total score and each station score was significantly positive, except the basic resuscitation station, communication with the patient station and professional ethics station. The Cronbach's alpha calculated between stations' scores was 0.55.

OSCE as a valid, reliable and nursing student’s accepted assessment tool is recommended to assessing nursing skills

Competency is a core ability to perform nursing responsibilities and has a direct impact on patients' health and safety. In this regard, evaluating, maintaining, and developing nurse competency has become one of the main and important tasks of professional managers. The purpose of the study was to investigate the nurses' competency studies conducted in Iran through an integrated review and analysis of the related challenges.

This integrated review study consisted of five steps, including specifying the review purpose, searching the literature, evaluating data from primary sources, analyzing data, and presenting the results suggested by Knafl & Whittemore. Databases like SID, IranDOC, Scopus, CINAHL, PubMed, Google Scholar, and ScienceDirect were searched using the keywords of competency, competence, assessment or evaluation of competency. The initial comprehensive search result consisted of 488 articles. After applying inclusion criteria and assessing the articles using the Bowling's Quality Assessment Tool, finally 19 studies were included.

After a thorough evaluation of the articles, results were itemized as following categories: a) Study factors, including concept of competency, evaluation methods, research tools, type of research, type of sampling, study wards and places, b) population factors including the demographic characteristics of the participants, c) the type of intervention designed to promote the competency of nurses, head nurses, and managers, and d) the competency correlation with other concepts. Finally, the related challenges were identified.

Competency as a vital feature of nurses should be included in the periodic evaluation of nurses and the continuation of the job must be dependent on obtaining the necessary qualifications. The results show that competency as a concept needs to be examined in-depth and there are some problems and challenges in planning and implementing related studies. It is hoped that findings of this study will be effective in promoting quality of nursing competency studies in Iran.

One of the common problems in patients undergoing hemodialysis is Poor adherence. Several factors affect the adherence of patients, which should be investigated in the cultural and social context of patients. Thus this research was undertaken to study the adherence of such patients 

This qualitative research was conducted from June to November 2018 to investigate the view points of the patients, their families and health care providers about Adherence to the treatment in Patients Under hemodialysis. At first, the sampling was based on a purposeful sampling method. A total of 29 participants (patients, their families and health care providers) were interviewed. The interviews were analyzed via Graneheim & Lundman qualitative content analysis.

Data analyses led to the production of 600 primary codes, 64 subcategories and 13 secondary categories, and finally 4 main categories of patient-related factors, socioeconomic factors, treatment-related factors, and related factors with the members of the health team appeared.

Considering factors such as socio-economic support, promotion of adaptability and self-care and improving the psychological state of patients can affect their compliance with the hemodialysis regimen. In this regard, members of the health team can play a significant role in adherence to the regime by communicating with patients and gaining their trust.

Clinical education is considered as the primary source of learning and shapes the professional identity of medical students. The aim of this study was to determine the current and optimal condition and gap in quality of clinical education among midwifery students at Jieroft University of Medical Sciences

This descriptive study was conducted among undergraduate students of midwifery at Jieroft University of Medical Sciences in 2014-15. The data collection tool was a two-part questionnaire (4 questions about demographic information, 22 questions about the Current and Optimal Condition). Validity and reliability were confirmed (Using the test-retest and correlation coefficient 0/87). All statistics were computed using the SPSS17 software, using statistical descriptive tests and t-test. p<0.05 denoted statistical significance.

Findings showed that the mean age of participants was 21/4 ± 1/8 years. Most of the current status and expected average scores were related to the students' attention to what other employees say (3/42 ± 0/98) and help coach students in clinical practice (4/82 ± 1/02). The lowest mean score gap was related to attention coach to feelings of students (-1/01). Largest gap relates to providing new and innovative activities for students (-3/25). (p=0/00).

Based on the results, the quality gap in all aspects of clinical education between the current and the expected situation is significant. The basic planning is needed to improve the quality of clinical training .

 Despite many advances in health, health systems still do not meet all the needs of communities. Countries at the 2018 Astana Summit agreed to strengthen primary health care (PHC) in order to achieve universal coverage of health (UHC). This study aimed to identify the challenges of the PHC system in Iran and to provide practical solutions to overcome them.

 This qualitative study was conducted using interviews and document reviews. Interviews were made with decision makers, executive and academic experts, PHC executives and experts. National and international documents were examined in the field of health. The WHO building blocks framework was used to encode the data. The data were analyzed by deductive content analysis using MAXQDA 12 software.

 Due to changing health needs of people, PHC system in Iran today faces challenges why so the centralized structure does not have the flexibility to deal with changes. The private sector plays a minor role in providing services. There is no coordination between levels of service delivery and parallel systems have emerged. Despite the scarcity of resources, there are problems in the planning and equitable distribution of resources.  Information systems are not yet complete.  University curricula are not in harmony with PHC and as a result human resources are unable to respond to job requirements.

In order to improve the health of the country and in line with international commitments as well as the need to reach the UHC, it must prioritize existing challenges and strategies, implement practical and tailor-made reforms while using the experiences of other countries to enhance PHC.