فصلنامه حیات
سال سیزدهم شماره 1 (پیاپی 32، بهار 1386)

Item analysis is a process in which both test items (questions) and student's answers are examined in order to assess the quality and quantity of the items and test as a whole. The purpose of this study was to investigate the effect of analysis of multiple choice test items of summative exams on quality of the test design by faculty members of Tehran Nursing and Midwifery School. Methods & Materials: A quasi experimental method (pre-test and post-test) without control group was used in this study. After a pilot study, 33 nursing faculty members of school of nursing and midwifery at Tehran University of Medical Sciences were chosen through census sampling. Then one of their exams designed in the second semester (83-84) were chosen to be analyzed. The analysis results were reported to the faculty members. Then their designed tests for the next semester were analyzed again. The analysis was carried out using a checklist which included item structure, whole structure of exam, content validity, and levels of thinking skills reflected in questions and criteria for holding an exam. Moreover, for the quantitative analysis of questions, item difficulty and discrimination index were calculated. Item distracter analysis was examined by calculating the percentage of examinees who selected incorrect alternatives. Integrated t-test, Pearson and Spearman correlation coefficients, and Fisher's exact test were used for the statistical analysis.

1056 questions before presenting the feedback and 803 questions at the end were analyzed and then the results were compared. According to the results, there was a significant difference between before and after intervention in variables item structure (P<0.001), levels of thinking skills (P<0.05), and item distracter analysis (P<0.001).While there was not significant difference between item difficulty, discrimination index, whole structure of exam, content validity, and criteria that should be considered on holding of an exam. Although, Pearson correlation coefficient showed that variables such as age (r=-0.535, P=0.004), and years of services (r=-0.546, P=0.003) with difficulty index were statistically significant.

The results emphasized that item analysis, providing feedback to the faculty members and offering educational booklets to assist them were effective means on improving some qualitative and quantitative items analysis measures.

Diabetes is the most common disease due to metabolism disorder with long term complications. Self-care is a basic factor in control of the disease. If diabetic patients perceive the benefits of self-care behaviors, then the perceived barriers will decrease(net benefit) and the likelihood of engaging in self-care behaviors will increase. This study was carried out with the aim of determining perceived benefits/barriers to self-care behaviors and it's relation with practicing self-care behaviors among diabetic patients referred to Yazd diabetes research center.Methods & Materials: This is a cross-sectional study. Study subjects (n=120) were selected among patients referred to Yazd diabetes research center. Data were collected using a two-section questionnaire. The first section was to assess demographic characteristics of the subjects and the second section was to assess perceived benefits and barriers and self care behaviors constructs.

Perceived benefits score among the patients was 88 per cent and perceived barriers score was 27.75 per cent. Self-care behavior was done by 62.79 per cent of the patients. There was a significant relationship between perceived benefits and diabetes duration. Perceived benefits was also positively correlated with self care behaviors (P=0.01). There was also a negative correlation between perceived barriers and self-care behaviors (P=0.01). Net benefit also had a direct correlation with self-care behavior with P=0.01. Perceived benefits and perceived barriers also had a negative correlation with each other with P=0.01. Perceived benefits and barriers accounted for 28.2 percent variance of self-care behaviors.

Perceiving benefits of self-care behaviors by diabetic patients will cause an increase on practicing self-care behaviors and this will be more possible if the barriers to self-care behaviors be minimized. Therefore, for promotion of diabetic patient's quality of life, attention to these important factors is recommended.

Asthma, as a chronic respiratory disease, is a major health problem worldwide. The quality of life of asthmatic patients is affected by long-term treatment and continuous episodes of asthmatic attacks. The aim of this study is to assess the quality of life in asthmatic patients.Methods & Materials: This descriptive study carried out among randomly selected asthmatic patients (n=386) referred to lung clinic in Imam Khomeini hospital, Tehran. Data were collected using a two-section questionnaire. The first section was to assess demographic characteristics of the subjects and the second section was to assess the quality of life. Validity of the questionnaire was evaluated using content validity and reliability was determined using a-kronbach.

The results showed that the majority of subjects were female, married, illiterate, and in the 41-50 age group. 45.1 per cent of study subjects had relatively appropriate quality of life. Quality of life in 45.3 per cent of the patients was inappropriate. There were significant statistical relationship between sex, age, education, economic status and quality of life (P<0.05).

According to the findings, in general, quality of life was inappropriate and relatively appropriate. So comprehensive programs for treatment and care of these patients should be planned.

Women with high risk pregnancy experience changes in their personal, family, and social life that affect their quality of life and mental status. The aim of this study was to determine the effect of type of pregnancy (normal or high risk) on quality of life and depression levels in pregnant women.Methods & Materials: In this case-control study, a total of 100 women (50 women with normal pregnancies and 50 women with high risk pregnancies) who referred to the prenatal clinics of Kashan Medical University were studied. Subjects were randomly selected and then allocated in the normal (control) or high risk (case) groups. Data were gathered using a three-part questionnaire that included demographic characteristics, the Short Form 36 Health Survey (SF-36) to assess the quality of life, and the Beck Depression Inventory (BDI) to assess the levels of depressive symptoms.

In this study, the results revealed that the mean score of the quality of life was lower in the women with high risk pregnancy (53/20±16/83) in comparison with the women with normal pregnancy (62/18 12/48). The mean of the BDI scores in high risk pregnancies (15/34±9/15) were significantly higher than in normal pregnancies (9/8±5/44). Depression has strong negative correlation with quality of life in both women with high risk and normal pregnancies (P<0.001).

To sum up, it is very important to identify women that are at risk and help them to promote their quality of life.

Due to increasing urbanization, diet changes, and sedentary lifestyle in today's world, the incidence of certain chronic diseases is dramatically increased. This study is designed to investigate the lifestyle of nurses as individuals that play an important role in educating healthy lifestyle in different groups of people.Methods & Materials: This cross-sectional study was carried out on 300 nurses working in Shiraz University Hospitals as study group. Subjects were selected through stratified random sampling by means of a questionnaire including different questions about lifestyle. The statistical tests of the 11.5 version of SPSS software were used for data analysis; these tests included t-test, One-Way ANOVA test, Kruskal Wallis H-test and Spearman correlation. P-Value was considered statistically significant at >0.05.

Research analysis showed that 54% of the study group had average conditions in their diet, 60.3% had moderate physical activity and 76% had intermediate and poor conditions in mental health. 44.6% of individuals had got poor grades in personal health care and 62% had got poor grades in disease prevention activities. 96.3 per cent of nurses did not smoke and 95.7 per cent of individuals did not ever consume alcohol.

According to the results of this study, nurses, in spite of being educated and having important role in patient's education, do not have desirable lifestyle

It is important to identify modifiable causes of preterm delivery and low birth weight; which are strong predictors of infant's later health status and survival. Research findings show that there are less low birth weight and preterm labors in the communities that have high intake of sea food. Consumption of Sea foods rich in w3 fatty acid can increase birth weight by prolonging gestation and reduce the risk of occurrence of preterm delivery.Methods & Materials: In this prospective cohort study, samples (n=1200) were selected among pregnant women with different pattern of seafood intake at 16th week of pregnancy receiving routine antenatal care in Gilan prenatal clinics. Subjects were selected by random sampling method. Women who had risk factors for preterm delivery or fish allergy were excluded. During 2004-2005 the pregnant women were visited monthly to determine their dietary habits (seafood intake). Infant's weight and mother's gestational age were determined at the time of delivery. Data were collected by means of a validated self-determined questionnaire and a check- list. Statistical analysis was carried out using SPSS statistical software package.

Results showed that the per cent of term delivery (more than 37 gestational weeks) in women with more than 3 times, 1-3 times, and less than once sea food intake in a day is respectively 94.5%, 91%, and 91.5%. Moreover, birth weights more than 3000 gram in the neonates of these women were respectively 75.7%, 74.7%, and 71.2%. There was significant relationship between more than 3 times consumption of sea food in a month with gestational age (P<0.001) and birth weight (P<0.05).

Sea food consumption is effective in decreasing preterm delivery and low birth weight. Related nutritional educational programs for pregnant women are

Hemodialysis centers are highly susceptible to nasocomial infections due to application of hemodialysis machines, medical equipment, and invasive techniques and devices. This research was carried out in order to evaluate methods of infection control using by staff of hemodialysis centers.Methods & Materials: In this descriptive study, all hemodialysis units in hospitals of Tehran University of Medical Sciences (n=4) were studied. Data were gathered using a 3-section questionnaire as well as five series of check-lists that were designed to evaluate physical characteristics of the units, methods of disinfection processes of the units, hemodialysis machines, and common equipment, and finally precaution measurements using by the staff. Data were described using SPSS statistical software.

Research findings showed that just one of the study units was appropriate regarding physical characteristics of the units. Method of disinfection of hemodialysis centers was appropriate in 50 per cent of the study units and it was relatively appropriate in the rest. Disinfection of hemodialysis machines was appropriate in all units. Regarding disinfection of the shared equipment, all units were relatively appropriate. In 25 per cent of the units, staff had relatively appropriate precaution measurements and the rest (75 per cent) had inappropriate measurements.

Results showed that the methods of infection control using by the staff of hemodialysis centers in hospitals of Tehran University of Medical Sciences were not appropriate.

Working conditions in some professions particularly among health care providers result in exposure to various stressors in daily work life that can affect mental health status. Regarding specific conditions that midwives encountered in their workplace, this study investigates mental health status among midwives working in Tehran's public hospitals and its related factors.Methods & Materials: In this cross-sectional study all midwives working in Tehran's public hospitals who had inclusion criteria (n=370) were studied. Data were gathered using GHQ-12 questionnaire and then were analyzed using chi-square statistical test.

The results showed that 35.1% of subjects had not good mental health. Midwive's mental health was significantly related to their educational level (P<0.001), economic statue (P=0.04), marriage status (P<0.001) and shift work (P=0.02).

Regarding high prevalence of poor mental health status among midwives, it is recommended to investigate related occupational factors in order to improve working conditions of midwives working in hospitals