فصلنامه سلامت و مراقبت
سال بیست و چهارم شماره 4 (زمستان 1401)

Nurses of Intensive Care Units (ICUs) require significant clinical competence due to the critical condition of patients and the optimal use of modern medical equipment. Due to the lack of experienced nurses, it is sometimes necessary to recruit new nurses in these departments, which requires the implementation of interventions to empower them quickly. This study aimed to investigate the impact of the multi-faceted familiarization program on the clinical competence of beginner nurses working in Intensive Care Units of public hospitals in Yazd.

In this quasi-experimental study, the respondents were selected by census sampling method. A number of 32 Beginner nurses working in special departments of teaching hospitals in Yazd city were randomly assigned to two control and test groups (19 people in the control group and 13 people in the test group) with moderate and poor clinical qualifications to enter the study. They received the test of the Multidimensional Orientation program including 20 hours of training, support and counseling during 6 months. Educational subjects for the control group were provided to them in the form of educational booklets without holding face-to-face classes. The tool for data collection was the nurses' clinical competence questionnaire, which was completed and compared in the form of self-assessment before the intervention, immediately after the intervention and after three months. The data was entered into SPSS software version 22 and descriptive statistical tests (mean, standard deviation and absolute and relative frequency) and inferential (independent t-test, paired t-test and repeated measures test) were became used.

The clinical competency scores of nurses working in ICUs based on self-assessment before the intervention was (156.75±7.7), immediately after the program was (176.55±24.75), and three months later was (191.4±23.65) for the experimental group. These scores for the control group before the intervention was (144.65±24.2), immediately after the program was (140.8±26.85), and three months later was (132±16.5). So, there was a significant difference between the two groups.

The current study showed that the Multidimensional Orientation program consisting of counseling, supervision and support training using theoretical and practical training methods in different fields can increase the clinical competence of novice nurses. Therefore, it is recommended to continue using this program in pre-service training and retraining and in other nursing departments

Nursing is viewed as a profession with a high prevalence of occupational, physical, and psychological problems. This study aimed to determine and compare subjective rumination and impulsivity among nurses working in psychiatric and non-psychiatric wards in Zare and Imam Hospitals, Sari.

This is a descriptive-analytic study done on 279 nurses of Sari, Zare and Imam Hospitals’ psychiatric (186) and non-psychiatric (93) wards, selected by simple random sampling. Research tools included demographic-occupational questionnaires, the short version of Ruminative Response Scale (RRS), and Barratt Impulsiveness Scale and Minnesota job satisfaction questionnaire (MSQ). Data were analyzed by SPSS-24 software through Chi-square, t-test, and Pearson’s correlation coefficient with significance.

The mean score of cognitive, motor, non-planning impulsivity of nurses working in psychiatric wards’ nurses were 13.98±2.15, 11.61±2.67 and 15.50±1.88; and at non-psychiatric wards’ those variables were 14.75±2.50, 12.84±3.14, 16.21±2.49 (p=0.01). Moreover, the mean score of rumination of psychiatric and non-psychiatric wards’ nurses were (24.81±4.47) and (25.85±4.68), respectively, being statistically significant (p=0.05).

According to the obtained results, rumination and all dimensions of impulsivity were higher than average among nursing staff in non-psychiatric departments and lower than average in psychiatric department. According to the results, based on the presence of rumination and impulsivity among the nursing staff of different departments of the hospital, interventions can be designed to control rumination and impulsivity and provide safe and quality services to patients.

One of the basic tools in changing the lifestyle and the patients’ perception of the disease is the existence of an educational program using innovative teaching methods. The present study was conducted to determine the effect of multimedia education with the Leventhal’s Model approach on the lifestyle and understanding of the disease in patients with atrial fibrillation.

In this quasi-experimental study, 60 patients with atrial fibrillation were randomly assigned into two intervention (n=30) and control (n=30) groups at Kashani Shahrekord hospital during the year of 2022. In the intervention group, two virtual training sessions were held through multimedia software (voice, video, image and animation) under the title of 4-hour training workshop for patients on the date and time coordinated with the help of Adobe Connect program. There was no intervention in the control group. After the workshop, lifestyle and disease perception were measured using Walker’s lifestyle and disease perception questionnaire. Data analysis was done using independent t and paired t-tests.

There was no statistically significant difference in the average score of lifestyle and disease perception between the two intervention and control groups before the study, and the two groups were homogeneous (p=0.041). However, the average score of lifestyle and disease perception in the intervention group has increased significantly after the implementation of the intervention compared to the control group (p≤0.001).

Multimedia virtual education has led to the improvement of patients’ lifestyles and disease perception. It is recommended to carry out educational interventions to improve lifestyle and disease perception in patients with atrial fibrillation.

Postpartum pain or painful uterine contractions are one of the most common postpartum problems. This pain is affected by various factors and has maternal and neonatal adverse consequences. Nowadays, herbal and traditional remedies have been considered for management of this pain. The aim of this study was to evaluate the effect of hydroalcoholic extract of priest sachet Capsella bursa-pastoris on postpartum pain and volume of bleeding in women referring to Damghan Hospital affiliated to Semnan University of Medical Science.

In this clinical trial, 110 mothers with vaginal delivery were enrolled. Inclusion criteria were postpartum pain criteria of four and more. Patients were randomly assigned into two groups, the first group received hydroalcoholic extract of Capsella bursa-pastoris and the other received placebo. Visual scale of pain was used to assess postpartum pain. Data were analyzed by SPSS-20 software using independent t-test, Mann-Whitney, Chi-square and analysis of variance with repeated measures and linear regression at significance level less than 0.05.

The mean age was 29.13±6.6 years. The two groups were matched in terms of age and other factors including cultural and economic status, parity, delivery, and abortion, history of stillbirth and curettage, anthropometric indices, administration of oxytocin during labor, labor conditions and neonatal factors. There was no significant difference between the two groups in receiving of analgesics. Analysis of variance showed that time had a significant effect on pain severity, however, pain intensity at different times in the intervention group was significantly lower than control group (p=0.026).

Despite the effect of time on decreasing of postpartum pain, the severity of pain at different times in the intervention group was significantly lower than control group and recommended for postpartum pain.

Obsessive-compulsive disorder is one of the serious psychological disorders that can hinder the normal functioning of the affected person, so it should be treated. The purpose of this study was to compare the effectiveness of behavioral activation therapy and cognitive-behavioral therapy based on mindfulness on cognitive regulation of emotion and executive functions in people with obsessive-compulsive disorder.

This semi-experimental study was a pretest-posttest design with a control group. The statistical population included 42 patients suffering from obsessive-compulsive disorder in Karaj city in 2022. The sample randomly assigned to three groups: behavioral activation therapy, cognitive-behavioral therapy based on mindfulness, and a control group. Garnevsky et al.'s (2006) and Najati's (2013) executive function questionnaires were used to measure the effectiveness of treatments. Descriptive statistics and multivariate covariance analysis were used for data analysis using SPSS-18 software.

There is a statistically significant difference between the effectiveness of behavioral activation therapy and cognitive-behavioral therapy based on mindfulness on cognitive regulation strategies adapted to emotions (F=57.71, p=0.001), but these two treatment methods improve the executive functions of patients. It has not been effective.

It can be claimed that the treatment based on behavioral and cognitive-behavioral activation based on mindfulness has been able to increase adapted cognitive strategies in people suffering from obsessive-compulsive disorder, but it has not been effective on the executive functions of patients with obsessive-compulsive disorder. Therefore, through these two treatments, it is possible to increase cognitive regulation in patients with obsessive-compulsive disorder

Sexual problems and disorders are more common than previously thought. Therefore, it requires study and treatment attention. Therefore, the present study was conducted with the aim of investigating the effectiveness of sexual cognitive reconstruction training on sexual self-efficacy and sexual assertiveness of women with sexual problems.

The research method was semi-experimental which was carried out with a pre-test and post-test design with a control group. The statistical population of the research included all women in the range of 25 to 40 years with sexual problems who were referred to the psychiatric centers of Ardebil in 2022. 30 women were selected with the available sampling method. They were randomly replaced in the experimental and control groups. To collect data, the questionnaire of women's sexual disorders (Izodori et al., 2010), sexual Self-efficacy of vaziri-latfi kashani (2009) and Hulbert's sexual assertiveness index (1992) were used. Then experimental group received 8 sessions of 90 minutes of cognitive restructuring therapy (Rao and Kakar, 2019). Data analysis was done with MANCOVA multivariate analysis of covariance test with SPSS20 software.

Based on the findings, the average pre-test score of sexual self-efficacy for the cognitive reconstruction group is 11.40 and post-test is 18.53. Also, for the control group, the average pre-test score is 12.06 and post-test is 12.33.
For sexual assertiveness, the average score of pre-test for the cognitive reconstruction group is 55.13 and post-test is 70.06. Also, for the control group, the average score of pre-test is 55.53 and post-test is 55.93. The experimental conditions were effective on increasing sexual self-efficacy (F=534.452, p<0.001) and sexual assertiveness (F=405.73, p<0.01) of the experimental group. Due to the results, sexual cognitive reconstruction training can increase the rate of sexual self-efficacy and sexual assertiveness of women with sexual problems.

Therefore, counselors and therapists can use that treatment method to increase sexual Self-efficacy and sexual assertiveness

Nursing is known to be a stressful job, and the psychological pressure caused by existing stressors has an adverse effect on both the individual and the organization.The purpose of this study was to examine the effectiveness of mindfulness based stress reduction (MBSR) on mental fatigue, perceived stress, and emotion regulation in nurses of Shafa hospital in Urmia.

The current research method was semi-experimental, with a pre-test-post-test design and a control group. The statistical population of the research was all the nurses of Shafai Hospital in Urmia city (200 people), among whom 30 people were selected in a targeted way and were replaced by random method in two experimental and control groups. Data collection tools included psychological fatigue scale, emotion questionnaire and perceived stress scale. The implementation method was in the order that first the subjects were selected by the screening method and divided into two separate experimental groups. And before the implementation of the intervention in each group, three questionnaires were administered as a pre-test on the participants of all groups. After that, each experimental intervention was implemented on separate experimental groups, and finally, the same questionnaires were again implemented as a post-test on the participants of both experimental groups. Data analysis was done using multivariate covariance test in SPSS22 software.

The average scores of nurses' mental fatigue before and after the intervention in the experimental group were 7.13±1.68 and 10.6±1.68 respectively and in the control group 10.8±3.61 and 2.99 respectively. It was ± 27.11. The average scores of perceived stress in the stages before and after the intervention in the experimental group were 35.6±6.42 and 29.73±3.99, respectively, and in the control group, 37.8±5.82 and 6.97±6, respectively. 36.36 and the average emotion regulation scores before and after the intervention in the experimental group were 60.53±4.36 and 65.6±7.49 respectively and in the control group 61.33±5.54 and 87.53±53 respectively. It was 60/ The results showed that the average scores of mental fatigue, perceived stress, and mindfulness in the experimental group, after the intervention of stress reduction based on mindfulness, have decreased significantly compared to the control group (p<0.01).

The results showed that stress reduction training based on mindfulness leads to improvement of perceived stress level and improvement of mental fatigue and level of emotion regulation in the group of nurses. Therefore, it is suggested to use this intervention for psychological empowerment and emotion regulation of nurses

Nurses always suffer many job tensions and challenges that can affect their career resilience. Sharing knowledge and new experiences can play an effective role in strengthening their resilience. The present study was conducted with the aim of investigating the relationship between career resilience and knowledge sharing in nurses of medical education centers in Tabriz.

A descriptive design was used to conduct this study. The statistical population of the study included nurses from medical education centers affiliated to Tabriz University of Medical Sciences, 351 of whom were selected for the study using stratified sampling based on share. The data were collected with the consent of the nurses using career resilience questionnaire, knowledge sharing questionnaire and demographic questionnaire. SPSS-22 software and t-test, Pearson correlation and linear regression tests were used for data analysis.

The results showed that the level of career resilience of nurses in a scale of 0-100 is equal to 56.4 (SD=0.03) and the level of knowledge sharing is equal to 67.7 (SD=0.032). According to the results of bivariate relationships, the relationship between nurses' career resilience and knowledge sharing variables (r=0.402, p<0.001) and its three dimensions include; Sharing the best way of working (r=0.353, p<0.001), sharing errors and mistakes (r=0.204, p<0.001) and promoting ideas (r=0.435, p<0.001), age (r=0.311, p<0.001) and the hospital of service (low career resilience of nurses in corona-susceptible hospitals compared to other hospitals) was significant (p<0.001). The results of the regression model also showed that the three dimensions of knowledge sharing, age, and gender (despite the non-significance of this variable in bivariate relationships) remained in the model (R=0.26) and the explanatory power of idea promotion was more than other variables (Beta=0.292).

Knowledge sharing and its dimensions had a positive effect on nurses' resilience. Therefore, hospitals should support nurses who provide new ideas and experiences by rewarding and encouraging them. The level of resilience of female nurses was lower than that of males, which requires more attention to female nurses