Iranian Journal Of Nursing and Midwifery Research
Volume:14 Issue: 4, Autumn 2009

Internal barriers are an important group of barriers to blood glucose level control. Finding the viewpoints of patients, their families and medical team on these barriers is an important step towards correct planning and effective control of blood glucose. This study aimed to find and compare viewpoints of patients, their families and medical team about internal barriers to control glucose levels. This was a descriptive-comparative and cross-sectional study with three groups and one stage. A total of 938 subjects including 420 type 2 diabetic patients, 420 members of their families and 98 medical team staff participated in the study. Data were collected using a researcher-made questionnaire that was completed by subjects. Data were analyzed using descriptive and inferential statistics methods and SPSS software. Results showed significant differences between viewpoints of the 3 groups of patients, families and medical team about internal barriers of blood glucose control (p < 0.001). The medical team gave the highest importance to these barriers while patients gave the lowest value to these barriers. Regarding the significant difference between the viewpoints of three groups, it can be concluded that this difference may count for lack of success in controlling patients'' glucose levels, because medical teams focus on barriers that are not so important to patients and their families and the barriers which are important in the viewpoints of patients and their families are less considered by the medical team.

Prenatal care is performed in order to diagnose high risk cases. Researchers have shown the significant relationship between high serum ferritin levels and preterm delivery. Preterm labors are one of the major risk factors in prediction of preterm delivery. Hence we performed this study in order to determine the frequency distribution of serum ferritin level and the relationship between serum ferritin level and preterm labors too. A descriptive and analytic research was performed on 267 pregnant women who referred to health centers of Isfahan. Data was collected using a questionnaire with interview, results of serum ferritin levels and hospital documents. Data was analyzed with T-test and SPSS software. Serum ferritin levels according to 10, 25, 50, 75 and 90 percentiles are categorized in series of 8.6, 12.7, 20, 30.3 and 42.5 ng/ml; so samples were divided into six groups. A significant relationship between serum ferritin levels (after 28-30 weeks of pregnancy) and preterm labors was found (p = 0.029). Considering the significant relation between serum ferritin and uterine contractions that are not caused by other reasons like smoking, it can be used as an indicator to find women who may have early uterine contractions. Our findings suggest that further researches about ferritin and related factors and pregnancy outcome are needed.

Success in patient care and gain credit for the hospital depend on nurse staff competent and appetency, so they must be lead in suitable manners and it is nurse manager''s duty that must have suitable personality and competency for powerful leadership. The purpose of this study is to assess the effectiveness of leadership and its relationship with extrovert/introvert personality. This is a descriptive correlation study. Samples were all 128 nurse managers of hospitals related to Isfahan University of Medical Science that were selected through census method. Data collection tool was questionnaire and data were analyzed by SPSS software. Findings showed that majority of samples were extrovert between 50 to 75 percent, also most of the managers had powerful leadership effectiveness and there was a direct and meaningful correlation between leadership effectiveness and extroversion in supervisors (r = 0.42, p = 0.01) and head nurses (r = 0.46, p = 0.0001). The correlation between leadership effectiveness and extroversion in supervisor and head nurse groups may be related to their various communications with others and different units employees.

Using care models provide a common method between teachers, students and nurses, which brings together education, services and research. Orem''s model of self-care has been widely studied and is globally applied in the modern nursing. This study is aimed to determine efficiency of Orem''s model of self-care in the recovery of patients with heart failure. This is a semi-experimental study and a clinical trial. Study population included all patients with heart failure (class I and II) who referred to medical centers of hospitals administered by Tehran University of Medical Sciences. Patients were randomly divided into two groups and both groups were monitored for 6 months. Data were collected using self-care questionnaire and were analyzed using chi-square and t-test. The findings showed a significant difference between self-care abilities of patients in experiment group after the intervention compared with controls (p < 0.001). Also, the recovery of patients, what they were doing to remove symptoms and their compliance with treatment regimen and the fluids balance of intervention group was better than controls (p < 0.001). Treatment of patients with heart failure needs long term control and the patient is the only one who can gradually improve their heart condition. To achieve this situation, the results of this study showed that applying Orem''s model of self-care is very effective for patients with heart failure. It resulted in higher scores of self-care, less referral, less hospitalizations and better liquid and electrolyte balance.

Speed of giving services in medical centers, especially in emergency department, play an important role in reducing death and handicap. The action of emergency department can have a great effect on other wards actions. This triangulation study conducted in 2005 in three steps. In the first step, problems of the emergency department of Al-Zahra hospital were extracted using an open questionnaire filled by employed personnel. In the second step, 14 managers of the center attended a meeting discussing those problems. Based on the gathered data, a closed questionnaire was designed and in the third step it was given to 64 hospital employee. Data were analyzed using SPSS software. In the first group (managers), 5 problems were scored more: security problem (70%), not paying attention to educational hierarchy (70%), absence of on-watch resident in the emergency department (60%), absence of a standard clinical protocol (60%), and absence of team work (38%). The second group (employed personnel of emergency department), gave more scores to nonscheduled transfers from other centers (70.6%), absence of on-watch resident in the emergency department (61.8%), not determining the correspondence attending for a multiple-trauma patient (58.9%), absence of team work (52.9%). Emergency ward has increased the chance of living for patients receive urgent medical services, in the first hours after an accident or a disease attack, known as "golden time"; so absence of on-watch resident in the emergency department of educational hospital has a negative effect on making decisions and functioning and mostly.

Starting sexual relations in early ages, diminution of family size and couple''s delay for having babies in recent years have increased the length of using contraception methods and women need contraceptives for an average of more than 30 years. On the other hand, the tendency to use a contraceptive method like other tendencies depends on the general attitude to apply it and this means satisfaction. Therefore, satisfaction of using a contraceptive method is very important for women. This study aims to compare the satisfaction of women with the contraceptive methods. This is a descriptive comparative study with cross-sectional data collection method. The study sample included 706 women using LD pills, condoms, intrauterine devices (IUDs), Depo Provera injections, female sterilization and withdrawal method. The sample was selected using systematic random sampling. Data were collected using a researcher made questionnaire included 8 questions for three methods of using IUD, sterilization and withdrawal methods and 9 questions for pill, condom and DMPE injections. Questions were multiple choices (5- choices) and each question ranked from 1 to 5. Content reliability and re-test were used to evaluate the reliability and validity of the questionnaire. ANOVA and Kruskal-Wallis tests using SPSS software were used for data analysis. Findings showed that the maximum and minimum mean scores of satisfaction belonged to female sterilization (4.36) and condom (4.08), respectively. Also, there were significant differences in mean score of satisfaction between users of IUD and condom, sterilization and condom as well as sterilization and withdrawal. Women were more satisfied with reliable methods. It means that efficiency and reliability have an effective role in women''s satisfaction with contraceptives and this should be considered in birth control counseling.

People''s personality and psychological factors usually affects job satisfaction or job dissatisfaction and so level of burnout. In this study the role of personality characteristics in nurses'' burnout is examined. It is a correlation study. The statistic population is consisted of all nurses in a state hospital of Shahr-e Kord who''ve been working there during 2007. One hundred of them were selected by simple random method and then Maslach Burnout Inventory (MBI) (emotional exhaustion, depersonalization, reduced personal accomplishment) and NEO personality characteristic (neuroticism, extraversion, conscientiousness, agreeableness and openness to experience) questionnaires were distributed among them. Out of 100, 75 questionnaires were completed and returned. Also multiple regression method was used to statistically examine the relation between personality characteristics and burnout. The study findings showed that neuroticism has positive relation with emotional exhaustion and extraversion has negative relation with emotional exhaustion (p < 0.05). Neuroticism has a positive relation with depersonalization and agreeableness has a negative relation with depersonalization (p < 0.05). Extraversion, agreeableness and conscientiousness have negative relation with reduced personal accomplishment (p < 0.05). All of these relationships were meaningful. Since nurses'' health plays as an important role in effectiveness of their health care for patients, it is important to consider their personality characteristics, because incongruity between personality and work place increases their burnout.

Discharging from hospital is one of the most complicated issues in health system. This process should follow standard clinical criteria and needs mutual cooperation of the hospital and society. Psychiatric patients, nowadays, are hospitalized only for the severe period of their sickness and after that they are returned to the society. This study compares the current discharge process with the standard process. This was a cross-sectional, descriptive-comparative study on 52 schizophrenic patients discharging from hospitals. Samples were selected with convenient method from psychiatric centers during a period of 4 months. Data were collected using a standard checklist and the items considered at the time of discharge. Data were analyzed using SPSS software, by descriptive and inferential statistical methods. The findings showed that in 93.4% of patients hospitalized in the psychiatric wards, the indexes of discharge process were followed to some extent and in 3.6% of cases, the indexes were followed thoroughly. Also, comparison between the mean scores of indexes that followed during discharging schizophrenic patients from psychiatric wards with the standard process showed a significant difference (p < 0.005).Considering that the standard indexes of discharging process were followed just in a small percentage of patients, it is important to include educational plan in the discharging process on the importance of medications, control of hallucinations and delusions and suicidal thoughts for patients'' families and in general acquainting the patients and their families with health center.

Hospital infections are a main cause of infant death among hospitalized infants in the neonatal wards. This research was conducted aiming to assess the medical staff''s knowledge of hospital infections. This is a cross-sectional study, conducted in all neonatal in Isfahan hospitals wards. 65 nurses answerd to a questionnaire. Results showed that 66.7% considered septicemia as the commonest kind of hospital infections and 82.5% called it the most dangerous kind. In general, findings showed that averagely 63.9% of nurses correctly answered questions related to hospital infections. These results support the need for more interventions to prevent hospital infections.