نشریه پرستاری ایران
پیاپی 50 (تابستان 1386)

Introduction and Caring is a multidimensional nursing concept that can be actualized within the baccalaureate nursing curriculum through the purposeful teaching and student-centered learning of core values. Teaching interpersonal issues is possible through various methods such as role-play. The current study was conducted with the aim of describing the caring behaviors of two groups of sophomore-level student nurses after implementing either role-play or traditional method as teaching method of choice. The researchers used quasi-experimental study design using an equivalent control group and post-test. Fifty one nursing students were randomly assigned in either experimental or control group. After that members of the experimental group performed their clinical experience using role play and members of control group did practice as routine, caring behaviors of two groups were observed using CBI. In general, findings indicated that caring behaviors related to subscales “respectful difference to other” and “professional knowledge and skill” were, respectively, the most and the least frequent caring behaviors in both groups. More frequent occurrence of interpersonal aspects of caring in two groups indicates that in the beginning of professional nursing care, the sophomore-level students give priority to altruistic values. So, using approaches to develop and maintain interpersonal aspects of caring in nursing curriculum, coupled with changing the teaching methods of practical aspects of nursing care and appropriate integration of theory and practice is recommended.

Introduction and Long time working shifts and its related tiredness threatens the health of staff nurses in various dimensions. If nurses don’t experience a good general health, they would not be able to deliver good patient care. The health status of nurses as caregivers influences the quality of care received by patients. Therefore, in order to reach the point of maximum performance, it is necessary for nurses to be healthy. This study aims to compare the general health among two groups of staff nurses with either fixed or rotating working shift in educational health care centers of Iran University of Medical Sciences in year 2006. This comparative study was conducted with a sample of 520 nurses. A GHQ-28 tool was used to survey the general health of staff nurses participated in this study. The findings showed that 72.3% of nurses with fixed working shift had good general health, 18.8% had nearly good general health and 8.8% had bad general health. Of nurses with rotating working shift, 62.3% had good general health, 26.2% had nearly good general health, and 11.5% had bad general health. The results of Chi-Square test showed a statistically significant difference in general health of nurses with fixed working shift compared with nurses with rotating working shift, indicating that the nurses with fixed working shift have better general health (P < 0.005). Because nurses are responsible for society and patient's health taking their general health into consideration is of great importance. Based on findings of the present study, the researchers recommend the nurse managers to plan staff schedules in the form of fixed working shifts, in order to minimize untoward influences of rotating working shifts.

Introduction and As the prevalence of overweight increases among adolescents, thus factors that may influence children’s participation in weight-related health behaviors need to be examied. This study examined barriers to and support for physical activity in overweight and obese adolescents compared with normal weight adolescents. In this cross-sectional study, sample included 279 male students studying in two secondary schools in Tehran. Of all students, 179 (64.2%) were within normal weight range, 49(17.6%) were obese and 51(18.3%) were overweight. A questionnaire comprising demographic characteristics, and barriers to and support for physical activity, and also, a checklist of physical activity within current week were distributed to be filled out by students. Data were analyzed using One-Way ANOVA and Tukey's test. According to finding, adolescents with normal weight had significantly higher moderate and vigorous physical activity than obese adolescents and the time of TV watching were significantly more among overweight and obese adolescents than adolescents with normal weight. Body-related, social and fitness barriers were the most predominant ones among obese adolescents. There was no statistically significant difference between mean score of convenience and resource barriers among different weight groups. Obese adolescents also reported significantly lower levels of adult and peer support for physical activity. Obese adolescents may be particularly vulnerable to body-related, social and fitness barriers to physical activity. Reducing these barriers may be helpful, as physical activity intervention is most relevant for overweight youth. Interventions should be implemented for reducing barriers to physical activity and also enhancing parents and peers support for physical activity among obese adolescents.

Introduction and Sexual health of mentally ill women is of great importance due to personal and common health issues (both physically and mentally) mentally ill women faced to. The main purpose of the present study was to describe sexual health status among mentally ill women admitted to Razi psychiatric hospital, Tehran, during the years 2001-2003. This was a descriptive study with a sample of 580 adult mentally ill women with positive history of admission in psychiatric hospital. The researchers reviewed hospital charts of the participants and completed data sheets. 28.7% of participants had multiple sexual partner, 3.4% had exchanged sex for money, goods or a place for living. Also, 6.7% had a history of rape and 5.3% of them had a positive history of homosexuality. 33% of the participants had at least one sexual risk factor for transmission of infectious diseases such as HIV. Considering high percentage of sexual risk factors associated with transmission of infections such as HIV among mentally ill women, health managers should pay particular attention for improvement of mentally ill women's sexual health care. The study of barriers to sexual health care in this population is suggested.

Introduction and MS is one of the progressive and chronic demyelinative disorders involving active members of society. The study of quality of life in these patients could decrease relieve some disabilities and promotes residual abilities to maximal levels. Regarding relatively high prevalence of MS in Mazandaran province, this study was designed to measure the quality of life in Multiple sclerosis patients living in Mazandaran Province. In this discriptive study, the community of research included members of Mazandaran Multiple Sclerosis Association (MMSA). The census sampling method was used. The volunteers (101 patients) were assessed from october 2005 to March 2006. Assessment tool for data collection was standard questionnaire SF-36. This questionnaire consists of 36 questions and its validity has already been determined in many countries including Iran and it has high reliability (alpha chronbach 0.77-0.90). Clinical manifestations and the severity of the disease were evaluated with history and physical examination taken by Neurologist and using EDSS criteria. The results showed that 76% of the patients were females and 26% were males. The age range was 18-60 years (mean age 33.27 ± 8.31). The emergence of disease was at age 12-54 years (mean age 27.12 ± 8.03). About %7 of the patients had positive family history of multiple sclerosis. The mean score (based on 100) of general health, physical health, mental health, vivacity, social health, and physical pain were, respectively, 41.34 ± 10.22, 54.75 ± 30.25, 53.25 ± 22.03, 54.75 ± 24.44, 56.62 ± 20.96, and 35.75 ± 31.68.. In this study, the quality of life was relatively good in all aspects. This may be due to mildness of disease in majority of the patients, low age at time of disease emergence and shorter duration of disease.

Introduction and All societies in the world are experiencing burgeoning numbers of "elders", defined as persons aged 65 year and older. It is expected that at least 40% of the population over 75 years need extensive health care services in the last years of their lives. Countries with an ageing society have developed long term care policies for older people. In Iran, as the rate of transferring the elderly to the nursing homes is increasing, it would be important to investigate the experience of self-determination, respect and value among elderly people living in these settings. The powerlessness results in loss of hope. In addition, older adults who feel powerless may also lose their independence. In this situation, family members or health professionals take over and make decisions for them. Elder's empowerment can promote their quality of life and well-being. This study aimed at description of the experience of powerlessness in elderly who are living in nursing homes. The research question was "how is the experience of powerlessness in elderly who are living in nursing homes? The qualitative phenomenological approach with purposive sampling was used in this study. Participants in this study were elderly residents of private and governmental nursing homes in Esfahan city. Sampling continued till data saturation occured with 10 participants. The data were collected through in-depth interviews. Researcher used field notes for completing data collection process. Colaizzi's method was applied for data analysis. The rigor criteria of the present study were based on transferability and credibility. Three themes were extracted from the data (structural components of the experience), including: 1) compulsory tolerance, 2) Waiting for exiting permit, and 3) Constrained autonomy. In this study, some participants experienced lack of ability in changing conditions and also compulsory tolerance of the situation, two main findings from which the concept of powerlessness was perceived. Transferring to nursing home is a source of fear and anxiety in the end years of life. For the institutionalized elders, empowerment can come through participating in making decisions regarding patient care and other aspects of life in this setting. In addition, mental, spiritual and physical needs of elders should be met through whole care, because simply focusing on physical needs deprive hopeful, meaningful and purposive life in nursing homes.

Introduction and Healthcare is considered as one of the most important indicators for determining the level of development in all societies. To this end, hospitals play an important role and the role of the charity hospitals which provide healthcare for poor patients is of great importance. Therefore, understanding and analyzing the administrative manner of these hospitals is crucial. The main goal of this study is to design an administrative model for charity hospitals in Iran. Information from Library documents including books, scientific magazine, and domestic foreign texts documents as e-mail, electronic database and also contact with several charity hospital executive in several countries and visiting charity hospitals in other countries were used. Further information gathered about weaknesses and strengths of charity hospitals in Iran, and several foreign countries charity hospital models. The primary model was designated and after analyzing various view points, reviews and criticism by scholars and experts, the final model was presented using the Delphi method. This study showed that charity hospitals in Iran are managed in different ways without any specific model and do not supported financially by the government. A number of these hospitals are not autonomous. In charity hospitals outside Iran, different management styles were being used, but they were not managed like Iranian charity hospitals and most of them were foundations or companies. Furthermore, a number of them were not managed as charity hospital since the nationalization of healthcare had taken place. Whereas the cost of healthcare in private sector is very expensive and most of them do not have contracts with insurance companies, charity hospitals can have an important role in providing healthcare for the society. Using model described in this paper could be helpful in responding to the needs of poor clients.

Introduction and Uncontrolled incremental trend of population growth is the basic problem in developing countries. Establishing family planning programs at an extensive level in these countries increases economical, social, and cultural advantages and decreases maternal and fetal mortality. One of the methods of implementing these programs is community-based distribution. CBD can effectively deliver family planning services at home. CBD facilitates family access to family planning methods that culminate in appropriate choices and continuity of using contraception methods. The aim of this study is to examine the effect of community based distribution on appropriate choices and continuity of using contraception methods among Hamedan households. This study is part of a larger study conducted by controlled field trial design. Using a multi-staged method, the researchers chose 297 subjects and divided them into two groups, control (n= 100) and experimental (n=197). The setting of the study was Hamedan households covered by field workers. Data collection tools were two questionnaires, three checklists, and one referral card. To determine the scientific validity of the tools, the researchers used the content validity method. The scientific reliability of the tools was determined through conducting the retrial method in a random sample of ten subjects. The findings revealed that through delivering family planning services at home, appropriate choices and continuity of using contraception methods were increased (p=0/001). According to the findings of the present study, CBD led to appropriate choices and continuity of using contraception methods. Therefore, application of this kind of services is recommended. Also, the study of the effect of delivering this kind of services at villages, deserted places, different tribes, and its economic aspects are recommended.