فهرست مطالب

Iranian Journal Of Nursing and Midwifery Research
Volume:13 Issue: 2, Spring 2008

  • تاریخ انتشار: 1387/05/07
  • تعداد عناوین: 9
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  • Maryam Allahdadian, Shayesteh Salehi, Roshanak Hassanzahraie, Hassan Farahmand Page 41
    Background
    The first stage of the accreditation, process as the most important way of assurance and improvement of thequality of high education process is collection of standards. To describe present and desirable quality of nursing and midwiferypostgraduate education via accreditation process in Iran, we decided to compile applicable standards in this field,using available international standards as well as suggestion made by nursing and midwifery education experts in Iran.
    Methods
    This was a multiple triangulation study carried out in the years 2005-2006. First, international standards wereextracted from the World Wide Web; then, these standards were used as well as the viewpoints of supervisors to set appropriatenational standards. In the third stage, Delphi method was used to take votes. 50 experts in nursing and midwiferypostgraduate education of the country were selected by purposive sampling and their suggestions, regarding desirabilityand applicability of these standards in Iran were used. Results of this stage were analyzed via descriptive statistics usingSPSS software.
    Results
    90% of international standards had appropriate level in Iran. Final comments suggested 28 standards and 224 criteriain master level and 21 standards and 81 criteria in 6 distinct domains in doctorate level of nursing and midwifery.
    Conclusion
    The necessary changes were made in standards based on the experts'' viewpoints and the proposed Iranian nationalstandards in nursing and midwifery postgraduate education system was conducted.
  • Sima Babaei, Mahin Moeini, Fakhri Sabouhi, Nahid Mohammadi Page 43
    Background
    Hypertension is one of the major chronic disorders. Hypertensive patients have various disease-relatedexperiences, based on personal and social characteristics, life style and other effective factors. Nurses face differentsituations during their activities process and presentation of these experiences obtained during working with patientscan help them to improve the clinical activities. The purpose of this study was to determine the experiences of hypertensivepatients.
    Methods
    This was a qualitative phenomenological survey. The study population was hypertensive patients referred tohospitals of Isfahan University of Medical Sciences. The sampling method was purposeful. The data collected by indepthinterviews and data analysis was done by Collaizi''s seven-staged method.
    Results
    The findings of the interviews classified in 133 codes and the thematic analysis revealed three major clustersas: 1. clinical experiences about the disease; 2. social experiences of the disease; and 3. mental-psychological experiences.
    Conclusion
    Hypertensive patients had mostly experienced chronic situations and treatment process as well as their surroundingproblems such as diet and life style. Life style is an important criterion for our physical health and it should bechanged so that hypertensive patients feet relatively healthy, fine and peaceful in the rest of their life. Patient indicatedbeliefs about their disease and experienced its psychological signs.
  • Mahin Moeini, Zahra Zare, Maryam Hazrati, Mahmood Saghaei Page 47
    Background
    Coronary artery bypass graft (CABG) surgery is very traumatic and makes patients very nervous. Since it is amain task of nurses to improve patients'' comfort and safety, this study investigated the effect of therapeutic touch in cardiovascularpatients'' anxiety before CABG surgery.
    Methods
    In a controlled clinical trail study the simple random sampling was used to select 44 patients from two separatedlists of random numbers of women and men among the patients waiting to undergo CABG surgery at Shiraz Namazi Hospitalin 2006. Data was collected using the Spielberger''s Anxiety Inventory. In the case group, therapeutic touch was performedby the researcher for 20 minutes and the state anxiety test was taken before and after the therapeutic touch sessionby the research assistant. In the control group the anxiety was measured twice with 20 minutes gap in between, without anyintervention. Data were analyzed using student t-test, paired t-test, and descriptive tests via SPSS software.
    Results
    Results showed a significant difference between the mean of anxiety before and after therapeutic touch in the casegroup (p < 0.001); but there was no significant difference in anxiety mean in the control group. It was a significant differencebetween the mean of anxiety of the two groups of case and control (p < 0.001).
    Conclusion
    Therapeutic touch is a safe and effective intervention to reduce the anxiety of patients. This technique is verysimple, inexpensive, feasible, and applicable in all health centers and hospitals and even in patients'' residences.
  • Ashraf Kazemi, Roshanak Hassanzahraei, Azam Khoshbin Page 53
    Background
    Polycystic ovaries syndrome (PCOS) is the most common disorder in infertile women with ovulation sterility.There are some instances of abnormal endocrine in the women stricken by this syndrome and so the clinical results of ovulatinginduction in them, because of severe response of ovary against ovulating induction, are very discussing and may leadto different results from those with normal ovary. In this research the effect of ovulating induction among this group ofwomen was compared with the women with normal ovary and tubal sterility.
    Methods
    This prospective cohort study performed on 260 infertile pairs with PCOS and tubal factors under treatment usingfertility assistance techniques in IFIC. The numbers of oocyte, concentration of testosterone and andrestandion, fertilityrate and embryo quality were compared.
    Results
    The mean of oocyte retrieved, concentration of andrestandion in follicular and LH0 phases, and testosterone inLH0 phase were higher in PCOS patients (p < 0.05), but the fertilization rate indicated no difference between two groups.According to the results there was a significant association between the concentration of andrestandion and testosteronephase LH0 and the embryo quality.
    Conclusion
    The ovulation induction in PCOS by increasing the serum androgen concentration would lead to undesirableinfluence on oocyte, so that the achieved embryo has a lower quality and the ratio of good-quality embryo decrease, butbecause of the high number of oocyte and the number of achieved embryo in the women with PCOS the chance of growingmore good-quality embryo is high
  • Akram Aarabi, Effat Kordi, Hassan Farahmand, Farzaneh Gholami, Soheila Bakhtiari Page 59
    Background
    Personal protection equipments (PPEs) should be easily accessible to decrease contact with infecting factorsand also should be used purposefully to effectively keep the health care personnel in a safe distance from the patient bloodand body fluid which can easily infect the operating rooms personnel. This study aimed to find the operating rooms'' personnelcompliance with standards of two PPE items, mask and eye/face protection and the effective factors on their compliance.
    Methods
    This was a descriptive correlative study. Sampling method was simple and 250 operating room personnel wereselected. Data were collected by a questionnaire consisting of three parts; demographic characteristics and standards usageof mask and eye/face protection. Participants were divided into four groups of perfect, favorable, relatively acceptable anddeficient based on their scores of their compliance with standards in the second and third parts of the questionnaire.
    Results
    The favorable compliance with standard usage of mask and eye/face protection was 33.9% and 46.4%, respectively.Participants said that lack of mask and eye/face protection was the main effective factor for their compliance. There wasno significant relationship between work place and educational degree, and the personnel''s compliance with standard usageof eye/face protection and mask.
    Conclusion
    Compliance with standard usage of mask is not acceptable and is almost in agreement with other studies. Theimportant point is that there is no significant difference between personnel''s compliance with standard usage of mask andeye/face protection in high risk and low risk environments.
  • Minoo Packguhar, Nafisehsadat Nekui, Zohreh Khakbazan, Mahmud Mahmudi Page 65
    Background
    Midwives are responsible for providing preconception care for couples, they should have adequate knowledgeand decision making skill in this regards. This study aimed to determine the knowledge and decision making skillregarding preconception care in midwifery students and also the relationship between the mentioned items.
    Methods
    In a cross sectional study, all undergraduate midwifery students in their last year of study at ";Tehran";, ";Iran"; and";Shahid Beheshti"; medical universities were included through headcount sampling (N = 40). A questionnaire with 26 multiplechoice questions used to evaluate the level of knowledge; a computerized patient management problem (CPMP) questionnairewith 9 questions, required short answers, was also used in form of a computer software to assess clinical decisionmaking. The results were analyzed using descriptive statistics, Pearson and Spearman''s correlation coefficients, and χ2tests via SPSS software Regression used to determine the share of each field of knowledge and decision making in the aggregatelevel.
    Results
    In a scale of 100, the mean score for knowledge of preconception care was 54.23 (± 9.04) and for clinical decisionmaking 35.62 (± 7.01). All units remained at average in both cases. A significant relationship was seen between the levelof knowledge and the decision making skill (p = 0.017, r = 0.36).
    Conclusion
    The knowledge and decision making skills of midwives were in an average level. Much attention should bepaid to their education and new methods such PMP should be used in training and evaluating them.
  • Zahra Tayebi, Heidar Ali Abedi Page 73
    Background
    Today, liver transplantation is a routine procedure in the treatment of patients with end stage liver diseaseand its survival rate is high. In order to promote health, nurses and other health care professionals need to discover themeanings of lived experiences after liver transplantation. It is important for nurses to know what patients really experience;appropriate nursing intervention can be extracted from such understanding. This study aimed to describe themeaning of lived experiences of liver transplant patients after discharging from hospital.
    Methods
    A Phenomenological approach was chosen for the study. Unstructured and open-ended interviews were conductedwith 9 liver transplant patients. The method of analysis described by Colaizzi (1978) was utilized.
    Results
    According to Colaizzi, seven categories emerged: support, gradual adaptation, transplant outcomes, concerns,fallow up, gratitude and waiting for transplant. The patient''s physical and mental problems prevented them to fulfillpersonal goals before transplant. Although they had some concerns such as fear of graft rejection, they were at the peacewith the world after transplantation. Lifelong medications were identified insignificant for the participants. Social supportwas essential for recovery and meeting other recipients in the same situation as well as sharing health and life experiencesis an important aspect among liver transplant patients. Health professionals were universally praised in the studyhowever the fallow up care they received from them was not desirable.
    Conclusion
    Health professional especially nurses should take a more active role in continuing care for such clients. Also,the support patients give each other should be encouraged and aided by health care team
  • Azad Rahmani, Alireza Mohajjel Aghdam, Eskandar Fathi Azar, Fariborz Roshangar Page 81
    Background
    An important question of nursing trainers regarding clinical education is ";why some students, in spite of goodclinical education, are not able to perform nursing skills in suitable level?"; An educational method to solve this problem ismastery learning. The aim of present study was to compare the effect of mastery learning and composed clinical teachingmethod on performance of nursing students in intensive care unit.
    Methods
    In a quasi-experimental study with pretest-posttest design, fifty-one last-year nursing students participated anddivided into experimental and control groups. After pretest, control groups educated with composed clinical teaching methodand the experimental groups educated with mastery learning method for 9 clinical days. For assessment the performanceof nursing students in selected clinical procedures four checklists was prepared. For statistic analysis Mann-Whitney and Wilcoxon tests was used via SPSS software.
    Results
    In comparison the pretest-posttest differences of two groups, the average score of experimental groups in all procedureswas further than control groups (p = 0.001). Also, in the end of clinical education many of experimental studentsreached to mastery level, but, few students in control groups reached to mastery level.
    Conclusion
    Due to significant effect of mastery learning method on clinical performance of nursing students, we suggestthat nursing trainers use this method as a basic clinical teaching method especially to educate fundamental nursing skills.
  • Zahra Javanmardi, Marjan Beigi, Effat Nouhpisheh, Mehrdad Memarzadeh, Mohammad Reza Radan Page 87
    Background
    Improving the neonatal health and reducing the neonatal mortality rate is valuable for not only health reasons,but social, psychological and economic reasons. It has advantages not just for the neonatal period of life but for the wholelife. Unfortunately in Iran, in spite of efforts, there has been little success in decreasing the neonatal mortality rate. Sinceinvestigating the causes of neonatal mortality is important for planning interventions, this study aimed to find the reportedcauses of neonatal death in the hospitals of Isfahan province.
    Methods
    This was a cross-sectional descriptive study in which all the neonates who died in the hospitals of Isfahan provincewere selected by headcount method and data were extracted from their files by using a questionnaire.
    Results
    The most neonate death was in the hospitals with NICU wards (43.4%) and most frequent reasons for neonataldeath were problems of prematurity (44.6%, 42.6%) and congenital malformations (23.5%, 21.3%) in hospitals with andwithout NICU departments in Isfahan city, respectively; in hospitals of other cities in the province, most frequent reasonsfor neonatal death were problems of prematurity (47.5%) and Respiratory Distress Syndrome (18.1%).
    Conclusion
    To achieve the important goal, reducing the neonatal mortality rate, there should be more efforts to improvethe number and quality of NICU departments and prevent preterm birth. Also, there should be emphasis on necessity ofhealth care before and during pregnancy and genetic consultations.