فصلنامه حیات
سال هفدهم شماره 1 (پیاپی 48، بهار 1390)

Parental involvement in diabetes management has a significant impact on diabetes control. Understanding worries of the parents help to recognize their anxieties which should be addressed effectively. This study aimed to explore parent's worries about adolescent girls with diabetes.Methods & Materials: In this qualitative study, 26 parents (16 mothers, and 10 fathers) of adolescent girls with type 1 diabetes were recruited purposively from the Diabetes Society in west Azerbaijan. Data were collected using in-depth and semi-structured interviews. Analysis of the transcripts was guided using qualitative content analysis. Qualitative content analysis demonstrated three original categories from parent's worries: 1) worries about the future; 2) worries regarding to treatments; and 3) worries about society's interaction. Better understanding of parent's concerns may promote effective communication between health professionals and the parents. Modification of parent's personal control and perceived threats by providing appropriate information may help to empower the parents.

Healthcare classification systems help to gather information and process health data. Nursing management focus on developing computerized records to answer legal, managerial and clinical needs. The Classification systems help organizations to use nursing data. This study investigated informational and structural needs of nursing data classification.Methods & Materials: This descriptive-comparative study was carried out in 2009. Current classification systems for nursing were investigated and their specifications were gathered in a questionnaire. The items were prioritized by experts in four degrees. Using statistical analysis items with a priority over 80 percent (average 2.4) were selected. Findings about nursing diagnosis, intervention and outcomes showed that diagnosis item (average 2.93 out of 3), intervention item (average 2.52 out of 3), and outcome item (average 2.84 out of 3) should be presented in the system. Structure of nursing data classification was identified as a hierarchical and combinational classification. The computerized terminology (average 1.86 out of 3) had no priority. It is suggested to make decisions for standardizing nursing data to use in computerized systems. Since, nursing system in Iran is moving toward defining tariff for nursing services, coding nursing care components will help this plan to be developed.

Quality of health care services shows the degree of achievement of health outcomes. From ethical and legal perspectives, nurses should be responsible for quality of presented care. Retired nurses can help to elaborate real and valuable concepts related to effective factors on quality of nursing care due to their experiences. The aim of this study was to explore the perspectives of retired nurses on factors that affect quality of nursing care in Semnan.Methods & Materials: In this qualitative content analysis method, 20 retired nurses were invited to the study using purposeful sampling. Data were collected mainly using semi-structured interviews. The analysis was carried out using content analysis. Findings of the study yielded to three significant themes including: 1) necessity of humanistic relationships; 2) suitable selection and education (3) planning and organizing nursing cares related to quality of nursing cares. Findings of this study explored perspectives of retired nurses on the effective factors on quality of nursing care. The three themes emerged in the study should be mentioned in planning programs.

Patient satisfaction has been recognized as a key indicator of health care quality which is used by accreditation agencies to monitor quality of care in hospitals. A high proportion of health caregivers are nurses. The services provided by nurses are significantly influential in satisfaction of patients. The aim of this study was to assess patient's satisfaction from nursing care in hospitals of Iran University of Medical Sciences in 2010.Methods & Materials: In this cross-sectional study, we recruited 200 patients from different wards (except for special wards, Emergency department, Pediatric and Psychiatric wards) at the time of discharge from hospital through multistage sampling method. Data were collected using Patient Satisfaction Instrument (PSI). Data analysis was performed using descriptive statistics, chi-square and regression analysis. Majority of patients (72%) were moderately satisfied. Patient satisfaction had a significant relationship with the type of ward (P≤0.001), and type of hospital (P≤0.001). Of demographic variables, only patient's level of education was significantly associated with patient satisfaction (P≤0.019). In this study, patients were moderately satisfied from nursing care services. Educating hospital staff, especially nurses; and encouraging them to actively participate in activities to promote patient satisfaction should be a priority for hospital management. We should also consider that in a competitive market of health and treatment care giving, institutions that put patient satisfaction as their main goal are more successful.

Patients adherence to medical recommendations requires new and effective strategies. Promoting self-efficacy is considered as an important measurement to help patients to participate in their own treatment protocol. This study was conducted to determine the effect of a nursing intervention on improving self-efficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases in a public hospital in Urmia.Methods & Materials: In this single group before/after study, 81 patients with at least two cardiovascular adjustable risk factors were recruited. The self-efficacy intervention was presented to the patients and one of their family members. The self-efficacy was scored before, immediately and one month after the intervention. The Cardiovascular risk factors were measured before and one year after the intervention. Descriptive statistics, ANOVA with repeated measures, paired t-tests, and McNemar test were used to analyze data. Overall self-efficacy scores and its sub-groups were significantly improved after one month. There were significant differences in the mean BMI, HDL, LDL, systolic and diastolic blood pressures, and weight before and one year after the intervention. The number of smokers and patients with hyperlipidemia were significantly decreased one year after the intervention. However, there were not significant differences in the number of overweight patients and patients with hypertension before and after the intervention. Results showed that our intervention to improve self-efficacy had positive effect on the overall self-efficacy score and the scores of its subgroups. Our intervention was also effective in controlling cardiovascular risk factors and in reducing the frequency of smokers and patients with hyperlipidemia. It seems that combination of medical orders with self-efficacy improving interventions on patients and their families are influential in controlling cardiovascular risk factors.

Considering the importance and high prevalence of hepatitis C among substance abusers, especially injection drug users, this study aimed to determine the prevalence and risk factors of Hepatitis C in self-introduced substance abusers in Farabi Addiction Hospital in Kermanshah in 2007.Methods & Materials: A total of 263 drug addict's medical files were assessed during the study. Data (individual characteristics and results of serological tests) were gathered through the files. Data were analyzed by measuring frequency of correlation between the variables (Chi square test and logistic regression). The mean age was 31.82±9.18 years; mean duration of drug abuse was 121.7±29.1 months for prisoners. From 263 individuals in the study, 22.1% were infected with HCV. The most common ways of substance use were injection (33.1%), and fumigation (32.3%). There was no history of imprisonment in 74.9% of individuals; and 52.9% had no history of drug injection. There was a history of physical or mental disorder in 25.5% of individuals. The Chi square statistical test showed significant relationship between HCV infection and substance abuse, and the way of consumption; and the t-test showed significant relationship with average daily consumption frequency. The highest relative risk ratio was for positive history of physical or mental illness (OR=8.33), and positive history of imprisonment (OR=5.94). Having multiple sexual partners increased the risk of being infected with the HCV (OR=2.92). The risk of HCV infection was independently increased with having a history of imprisonment, having multiple sexual partners, presence of physical or mental illnesses, and consumption methods in substance abusers.

Early diagnosis of breast lumps through breast self-examination (BSE) is important for early detection of breast cancer. The aim of this study was to evaluate factors predict the BSE behavior using Health Belief Model constructs in women referred to health centers in Bandar abbas، Iran. Methods & Materials: In this cross-sectional study، 240 eligible women were randomly selected from eight health centers. Data were collected using a self-administered questionnaire including demographic characteristics and Champion''s Health Belief Model Scale (CHBMS). The CHBMS measures the HBM concepts of susceptibility (3 items)، seriousness (6 items)، benefits (4 items)، barriers (8 items) and self-efficacy (10 items). All items were ranged in a Likert scale ranging from ‘‘strongly disagree (score: one) '' to ‘‘strongly agree (score: five) ''. A total of 240 women took part in the study. The mean age of participants was 37. 2 (SD=6. 1). Of all، 32. 5% had high school education; and 95. 8% were married. The results showed that 31. 7% of the women had performed the BSE; however، only 7. 1% had performed it regularly. Perceived BSE benefits، perceived BSE barriers and perceived BSE self-efficacy of the participants who performed the BSE were significantly higher than those who did not (P<0. 03). The results from regression analysis indicated that the perceived BSE self-efficacy and perceived BSE barriers predicted breast self-examination behavior (P<0. 001). The findings of this study indicated that perceived BSE barriers and perceived BSE self-efficacy were influencing factors in predicting the BSE behavior. Therefore، in order to improve self-efficacy and decrease the barriers، BSE training programs are strongly recommended.

Primary dysmenorrhea is a common medical disorder in young women that affects their quality of life. According to the research studies، overweight and obesity increase biosynthesis of the prostaglandin; and consequently increase the severity of dysmenorrhea. The aim of this study was to examine the prevalence and severity of primary dismenorrhea and its relation to anthropometric parameters. Methods & Materials: In this descriptive-analytical study، 388 students from Ahwaz University of Medical Sciences were selected using random cluster sampling. Demographic data were collected using a questionnaire. The height and weight، BMI، fat mass، waist and hip circumferences، waist to hip ratio (WHR) and waist to height ratio (WHtR) were measured. Visual Analogue Scale (VAS) was used to evaluate the severity of dysmenorrhea. Data were analyzed using Pearson correlation test. The p<0. 05 was considered to be significant. Mean age of the participants was 20. 7±1. 8 years. The mean age at menarche was 13. 4±1. 2 years. Moderate or severe dysmenorrheal were experienced by 71. 65% of the participants. The severity of dysmenorrhea was significantly related to body fat mass، waist circumference، hip circumference and WHtR (P<0. 05). However، there was no significant relationship between the severity of dysmenorrhea with weight or BMI. Anthropometric parameters that are associated with central obesity such as waist circumference and WHtR are more related to the severity of dysmenorrhea. Increased visceral fat mass is a more effective predictor for dysmenorrhea. More studies are needed to clarify these relationships.