فصلنامه حیات
سال شانزدهم شماره 2 (پیاپی 45، تابستان 1389)

Poor physical and psychological health status in chemical warfare victims could result in decreasing quality of sleep. This study was conducted in order to evaluate the effect of using Continuous Care Model on sleep quality in chemical warfare victims with bronchiolitis obliterans.Methods & Materials: A total of 62 chemical warfare victims with bronchiolitis obliterans were recruited to the study. The participants were randomly allocated to experimental and control groups. The Continuous Care Model was used to experimental group for a period of two months. The quality of sleep was measured using Pittsburgh Sleep Quality Index (PSQI) before and after the intervention in both study groups. Data were analyzed using independent sample t-test, and paired t-test in the SPSS-version 15. There were significant differences between experimental and control groups in the means of Subjective Sleep Quality, Sleep Disturbances, Use of Medications, and global scores after the intervention (P<0.05). Using Continuous Care Model had positive effect on sleep quality in chemical warfare victims suffering from bronchiolitis obliterans.

Professional socialization is defined as the process of acquiring knowledge and skills; and internalizing values, attitudes, and norms to develop professional identity. This process occurs primarily during formal education programs and continues during orientation to hospital settings. The aim of this study was to clarify professional socialization concept; and to identify its attributes, antecedents and consequences in nursing context.Methods & Materials: Rodger's evolutionary method of concept analysis was used to facilitate clarification of professional socialization concept in nursing. The search, performed on scientific databases using the keywords: 'socialization', 'professional socialization' and 'nursing', resulted in findings of a sample of 446 papers covering the period 1995 to 2009 represented the disciplines of nursing and related sciences. After applying inclusion and exclusion criteria, a total of 47 articles and four books were included in the final analysis. The process was audited by two independent experts to ensure neutrality and credibility of the study and to reduce the potentials for bias. The result of the analysis showed that professional socialization is a complex process consisting of four critical attributes: learning, being interactive, developing, and being adaptive. Comprehensive educational programs, competent role models, and provision of adequate field experiences were antecedents for these attributes. The widespread and diverse consequences of professional socialization depend on personal, situational, and organizational factors. Thus, while occurrence of socialization process generates benefits, its nonoccurrence entails severe consequences. Professional socialization process is a complex, diverse, dynamic, ongoing, inevitable, and unpredictable process. This process can have both positive and negative consequences on professional development. However, negative consequences are more prominently documented in the literature. Thus, successful socialization requires establishing facilities in education and practice. The purpose of this revolutionary concept analysis was to focus on significance and how-to-apply ways of the concept in nursing. These findings not only are added to the body of knowledge, but also serve as an important impetus for further theory development and research in nursing.

The mortality rate of pneumonia caused by mechanical ventilation is about %25-30. Pneumonia prolongs length of stay in hospital to more than 13 days. There are various approaches to decrease rate of pneumonia in medical wards. The aim of this study was to assess the effect of planned passive respiratory exercise on prevention of pneumonia in coma patients undergo ventilation.Methods & Materials: In this quasi-experimental study, 76 patients were assigned into two experimental and control groups. The control group (n=38) received usual care in the ICU. The experiment group (n=38) received planned respiratory care within six days. The procedure was done in five minutes/six hours for a three day period; and then in 10 minutes/six hours for the next three days. Laboratory tests were done before the intervention and in the third and sixth days of the intervention. The respiratory care planning included respiratory passive exercises along with the common respiratory care. The results indicated that there were significant differences in the results of lab tests between two groups after the intervention (P<0.0001). The results of this study showed that planned respiratory care had positive effect on prevention of respiratory infection in coma patients.

Osteoporosis is a serious public health concern known to have several etiologic factors. This study compared lifestyles among postmenopausal women with normal and abnormal bone marrow densitometries (BMD).Methods & Materials: In this case-control study, 81 postmenopausal women (33 cases with abnormal BMD and 48 control individuals with normal BMD) were selected using simple random sampling from Osteodensitometry center of Shariati hospital in Tehran. The BMD at lumbar spine and femoral neck had been measured with DXA. The Lifestyle was assessed using a questionnaire containing items about taking calcium, vitamin D, hormones, and Alendronat, doing physical activity, consuming tea and cola, and smoking. Reproductive characteristics were also collected via a questionnaire. Data were analyzed using χ2 test and independent sample t-test. Crude and adjusted odds ratios and relevant 95% confidence intervals were calculated through logistic regression, using SPSS v.13.

The results showed significant differences between two groups in weight (P>0.001), BMI (P=0.022), number of pregnancies (P=0.002), number of children (P=0.004), duration of lactation (P=0.0002), dietary calcium intake (P≤0.001), and period of calcium supplement intake (P=0.002). The average of acquired scores of lifestyle factors in the case group was significantly lower than the control group (P=0.037). Inappropriate lifestyle had increased risk of the disease (OR=3.36, 95%, CI: 1.10-10.26). Meanwhile in the multivariate analysis, only insufficient intake of calcium was found to be a risk factor (P=0.002) for osteoporosis.

In conclusion, the results of this study showed positive effect of calcium intake on bone mineral density.

It is essential to conduct studies on factors related to obesity in both reproductive ages and menopausal period. The aim of this study was to describe the prevalence of general and android obesity and to assess determinants of overweight in pre- and post-menopausal women.Methods & Materials: In this cross-sectional, random survey of households, about 610 women 20-65 years were recruited. Data were collected via interviews with the participants. Weight, height, waist and hip circumferences were measured as well. The Body Mass Index (BMI) and the waist to hip ratio (WHR) were calculated. Overweight and general obesity were defined as 25≤BMI<30 and BMI≥30, respectively. Android obesity was defined as WHR≥0.85. The prevalence of overweight and general obesity was 90.6% in the premenopausal women; and 72.6% in the post-menopausal women. About 75% and 41.9% of pre- and post-menopausal women had android obesity, respectively. Low literate post-menopausal women had significantly more general and android obesities. In addition, postmenopausal women with more parity had more android obesity. Pre-menopausal women with low literacy and housewives had significantly more general and android obesities. In addition, pre-menopausal women with more parity had less general obesity and more android obesity. In these women, android obesity was increased with age and decreased with physical activity. The prevalence of general and android obesities was high in Islamshahr women, especially in the post-menopausal women. This result indicates that the women have potential risks for various diseases.

Conflict occurs more frequently in health care organizations than the other settings due to complexity, frequent interaction between personnel, variations in specialties, roles, and hierarchy. Although conflict is not harmful and destructive in its nature; and some degrees of conflict can help to improve health care services, high levels of conflict or its continuity may be harmful. Therefore, it is necessary to manage and control conflict. This study was carried out to assess the relationship between components of the conflict control model. Methods & Materials: In this cross-sectional study, we developed a questionnaire that probed the relationships between components of conflict control model. A total of 290 nurses were recruited to the study using multi-stage sampling procedure from general educational hospitals in Tehran. Data were gathered using a questionnaire. Content validity of the questionnaire was examined by the expert panel. The internal consistency of the questionnaire was 0.81. Data were analyzed in the SPSS using descriptive statistics and spearman statistical test. The range of age was 22-53 (34.5±8.2). The majority of the respondents (88.6%) were female, 57.6% were married; and 84.8% were staff nurses. From the majority of nurse's perspective, the meaning of conflict was discoordination, disagreement and disparity. However, some of the nurses meant it as violence, and difficult issues. About 41.4% of the respondents used negotiation, when they faced up to conflict. Other strategies were aggression, disagreement, avoidance, forgiveness, ignorance, and imposing own ideas to the others. From the respondent's point of view, factors that might cause or control the conflict were "mutual understanding and interaction" (32.4%), personality of nurses and their individual characteristics (26.6%), and conditions of the job (21.7%). Interaction was recognized to be the core strategy in conflict control model. Interaction had also significant associations with the five main variables in this study. Lack of appropriate and efficient communication was an important factor in occurrence of conflict from the nurse's point of view. It is essential to improve nurse's and manager's communication channels by helping personnel to use effective communication skills. This measurement can be helpful for staff in understanding each other and reducing misconceptions. In addition, recognizing additional factors and variables that increases the occurrence of conflict can help to modify effective approaches.

Anxiety is a common experience; which is felt as uneasiness, non-specific threat, and activation of autonomic nervous system. The aim of this study was to assess the effect of muscular relaxation on anxiety level of patients underwent cardiac catheterization.Methods & Materials: In this clinical trial, 118 patients who were expected to have a cardiac catheterization were recruited from an educational hospital at Tehran University of Medical Science. The participants were allocated to two groups, including muscular relaxation group (50 patients), and control group (68 patients). Data were collected using a questionnaire, and a self-report paper for recording anxiety level. Anxiety level was recorded one hour before cardiac catheterization in two groups. Then, the intervention group was asked to listen to the Benson muscle relaxation guide direction tape for 20 minutes through headphone. After using muscle relaxation in the intervention group and immediately before cardiac catheterization, the anxiety level of the respondents was recorded once more. Control group received standard nursing cares. Data were analyzed using χ2, Fisher's exact test, Kruscalwallis, Man-Whitney and Wilcoxon statistical tests in the SPSS. There were no significant difference between two groups in demographic characteristics and anxiety level before the intervention; and one hour before cardiac catheterization. After the intervention, the anxiety level was significantly reduced in the intervention group (P<0.001); while it increased in the control group. Based on the results of this study, Benson muscle relaxation significantly decreased anxiety level in patients who were expected to go for cardiac catheterization.

Nurse's perspective on organizational climate can affect job satisfaction and quality of care. Organizational climate influences staff's attitudes and behaviors in either positive directions, such as productivity, satisfaction, and motivation, or negative directions, such as absenteeism, staff turnover, and work accidents. The purpose of this study was to determine factors that influence the nurse's perspectives about organizational climate.Methods & Materials: This descriptive study was carried out in four educational hospitals in Tehran during fall 2009. A total of 140 nurses were selected for the study using simple sampling method. Data were gathered using organizational climate questionnaire including 25 items about in-service education, work communication, group participation, leader supervision, job promotion, and work policies and standards. Data were analyzed in the SPSS v.13. The most important dimensions of organizational climate from the respondent's point of view were: leader supervision (31.4%), coworker communication and support (19.26%), and skills in practice (17%). The most important negative factors that influenced the nurse's perspectives were: lack of reward system (49.3%), high work pressure (47.1%), and lack of participation in important decision-makings (39.3%). The most important positive factors influenced nurse's perspectives were: adequate job information (63.6%), having good communication with coworkers and having supportive coworker (47.9%), and having good communications with the leaders (40.7%). Using effective communication skills and making supportive systems in hospitals can help to create optimal organizational climate; and may reduce rate of job dissatisfaction, absenteeism, and staff turnover.