فهرست مطالب
Iranian Journal Of Nursing and Midwifery Research
Volume:16 Issue: 3, Summer 2011
- تاریخ انتشار: 1390/10/11
- تعداد عناوین: 12
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Page 191•BackgroundDelivering IUD services is one of the important competencies that midwifery students must obtain during academic period. As Objective Structured Clinical Examination (OSCE) can be reasonably reliable, valid and objective method for clinical skills assessment, this study was conducted to assess midwifery students` skill in delivering intrauterine device (IUD) services using a clinical examination and their satisfaction from the OSCE.•MethodsAll of the 62 eligible Bachelor of Science midwifery students of Mashhad University of Medical Sciences participated in a ten-station OSCE about delivering IUD services for 50 minutes in 2006. Students performed technical skills or interacted with standard patients in 6 stations and in 4 stations they answered to the related questions. Students’ performance in 6 stations was rated by observer or standard patients using validated checklists. Students’ level of satisfaction and also their experience of participating in OSCE examination were gathered.•ResultsPerformance of 98.2% of students was poor. On average, the students gained 49% of total score in counseling and screening, 35.7% in inserting the IUD, 40% in IUD removal and 24.4% in management of IUD side effect. Eighty percent of students rated their satisfaction from the OSCE high and very high. Students reported the OSCE as an enjoying examination experience.•Conclusionsstudents’ skill in delivering IUD services was lower than expected level that shows the need to change the current teaching methods. OSCE is a valid evaluation method which provides valuable information which cannot be obtained by more traditional assessment modalities. Based on the finding of this study a workshop program on providing IUD services for midwifery students and family planning providers should be prepared.
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Page 197•BackgroundEpisiotomy is the incision of perineum made to facilitate childbirth. Here are the two types of episiotomy: median and mediolateral. Considering the important role of incision characteristics such as length, angle and distance of initiation point from midperineum line in prevention of perineal rupture and reduction of further complications, this study investigated the comparison episiotomy in midwives and midwifery and medical students in maternity ward of hospitals of Mashhad University of Medical Sciences.•MethodsIn this descriptive cross-sectional study, 127 midwives and midwifery and medical students completed the novel validated pictorial questionnaire. The length of episiotomy drawn, the distance from the sagittal plane at which the episiotomy was begun, and the angle of the episiotomy from the sagittal plane were evaluated.•ResultsMedian length of the episiotomy from the midline was 2.89 ± 0.95 cm. Episiotomies drawn by midwives more angled than those drawn by students (P = 0.04) and median distance of the episiotomy from the midline in episiotomies drawn by students were significantly more than those drawn by midwives (P = 0.0001).•ConclusionsThis study demonstrated some differences in the episiotomy practice by midwives and midwifery and medical students. The differences demonstrated could predispose mothers to a greater risk of anal sphincter injuries and subsequence complications in child birth.
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Page 202•BackgroundSpiritual well-being is one of the fundamental concepts in chronic diseases which create meaning and purpose in life and is an important approach in promoting general health and quality of life. This study performed to determine the level of spiritual health and its dimensions in patients with multiple sclerosis (MS).•Methods236 members of Iranian MS Society were volunteered to participate in a descriptive co-relational study. Spiritual well-being was evaluated by The Spiritual Well-Being Scale (SWBS) questionnaires in two religious and Existential dimensions. Descriptive statistics, ANOVA, t-test and Pearson correlation coefficient were used to analyse the data.•ResultsThe majority of patients (% 97.9) showed moderate spiritual well-being (mean score = 74.3, SD= 8.90). Although Existential well-being (mean score = 40.3, SD= 5.51) was higher than religious well- being (mean score = 33.9, SD= 4.88). A significant relationship was seen between economic status and the spiritual well-being.•ConclusionsThe results emphasize on the necessity of spiritual well-being as an effective factor on different aspects of these patient's life. This key point is useful and even necessary to be considered to design programs of care and cure for these patients in a country (like Iran) with cultural and religious beliefs. On the other hand, patient's economic status should be considered.
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Page 207•BackgroundExclusive nutrition with breastfeeding is the health provider of the infant and mothers and its continuing would provide more advantages. Exclusive nutrition on different communities is affected by different factors. This study aimed to determine continuous exclusive breastfeeding and some of the related factors.•MethodsThis was a descriptive-analysis prospective study. The study population included all the breastfed mothers admitted in the obstetrics wards of the selected hospitals. Selecting the hospitals also was done randomly. Data collection tools included a questionnaire completed by 291 mothers. To obtain the data about breastfeeding duration, mothers were phone called at the first and sixth postpartum months. The collected data were analyzed using descriptive and analytical statistics and software SPSS.•ResultsEstimation of mean and standard deviation of exclusive breastfeeding duration at the first and sixth months after the delivery, respectively, were 3.86 (0.55) and 23.67 (6.63) weeks. One month after the delivery, 93.1%, 6.2% and 0.7% of the mothers, respectively, had exclusive breastfeeding, breastfeeding with formula milk or other ingredients and discontinuation of breastfeeding; 6 months after the delivery, these values changed to 86.3, 12 and 1.7%, respectively. The most frequent period of breastfeeding discontinuation (6.9%) was related to 1-4 weeks. The results indicated that statistically there was a significant correlation between breastfeeding duration and age and the birth hospital. While the results of the study showed no association between breastfeeding duration and number of the children, duration of marriage, educational level and mothers’ occupation.•ConclusionsThe findings of the present study represented a high continuous exclusive breastfeeding which perhaps was due to applied baby-friendly hospitals strategies. Furthermore, to prevent from discontinuation of exclusive breastfeeding, knowing the discontinuation time and its related factors, particularly the first four postpartum weeks, can increase the knowledge of the health staff about counseling and education.
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Page 212•BackgroundOne of the most prevalent side effects of hemodialysis is intradialytic hypotension and its symptoms. Using sodium profiles 3 and ultra filtration profile 3 and cold dialysate are the ways to overcome this problem. Since none of these methods could control this complication lonely, this study was done to investigate the effect of combination of two methods on intradialytic hypotension.•MethodsThis study was a cross over clinical trial in which 24 patients experienced intradialytic hypotension frequently, underwent three different methods of treatments during 9 successive hemodialysis sessions, group 1 used sodium profile 3 and ultra filtration profile 3, group 2 underwent hemodialysis with cold dialysate, and group 3received combination of both methods. Blood pressure was controlled before, during (3 times) and after hemodialysis. Data were analyzed via SPSS version 15, using x2 and ANOVA test.•ResultsFindings showed that although there was no significant difference considering intradialytic hypotension and its symptoms in two groups of sodium profile 3 and ultra filtration profile 3 and cold dialysate and the combination group (p > 0.05), but there was a significant difference considering the mean of blood pressure in three groups (p < 0.05). In combination group, drop of systolic and diastolic blood pressure was less than groups using each of methods.•ConclusionsConcerning the decreased rate of hypotension using combination method, nurses can use this method to decrease intradialytic hypotension and help the patients undergo hemodialysis for enough time and improve their quality of life.
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Page 217•BackgroundOne of the important requirements for cultural, social and even economic development is having a book-loving nation. In order to achieve this, there is a need for purposeful and continuous programming. The purpose of this research was to determine the relationship between student's study habits, happiness and depression in Isfahan University of Medical Science.•MethodsThis research was a kind of descriptive and correlation survey. Statistical population included all MSc and PhD students in the second semester of the Isfahan University of Medical Science (263 students). In this research, stratified and random sampling was used in which a sample of 100 students was selected. Data collection instruments were Beck Depression Inventory (BDI), Oxford Happiness Inventory and a researcher-made questionnaire to determine the amount of student's study. Validity of this questionnaires was determined by structure and content related validity and its reliability was calculated by Cronbach's alpha coefficient for the first (r = 0.94), second (r = 0.91) and third (r = 0.85) questionnaire. Analysis of research findings was done through descriptive and inferential statistics.•ResultsFindings showed that 68.8 percent of students study less than 5 hours and only 2.5 percent of students study more than 10 hours. 65 percent of students had high amount of happiness and 35 percent had medium amount of happiness. In 60 percent of students there was no symptom of depression and 7.5 had depression symptoms. Also, there was no significant relationship between happiness and studying but there was a significant and negative relationship between studying and depression and happiness and depression.•ConclusionsThe amount of study and tendency for reading are among the most important indices of human growth in terms of potential abilities for achieving a perfect human life and to prevent one-dimensional thinking. Thus, finding ways to encourage students to study is considered essential to achieve a healthy and developed society.
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Page 222•BackgroundOne of the important health indicators in every society is maternal and neonatal health status. Provision of the best prenatal care can reduce mortality rate in these two susceptible groups. This study focused on the effect of maternal care log book on pregnancy outcome.•MethodsThis was a clinical trial and 180 samples were randomly selected from the mothers referred to private offices of gynecologists and midwives and were divided into two groups of case and control. The outcome of pregnancy was determined by prenatal care log books in the case group and with pregnancy card in the control group. The data were collected using quality of life questionnaire and a pregnancy complications questionnaire. Descriptive and analytical statistical methods (Fisher’s exact test, independent t-test and chi-square test) were used to analyze the data.•ResultsThe results demonstrated a significant difference between case and control groups concerning normal vaginal delivery (p = 0.01), preterm labor (p = 0.015) and postpartum infection (p = 0.012). The result of quality of life in physical and mental domains and especially in mental domains was better in the case group than in the control group (p = 0.026 in physical and mental dimensions and (p = 0.02 in mental dimensions). This difference was lower in physical dimensions alone (p = 0.049). However, there was no significant difference between the case and control groups in terms of preeclampsia, intrauterine growth retardation and intrauterine fetal death.•ConclusionsAs found out by the results, using maternal log book of mothers cares due to its comprehensive care items was more effective than simple maternal cards used by gynecologists and midwives. This can bring about better prenatal care and detected pregnancy complications.
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Page 227•BackgroundNurses play a crucial role in patient-care. Therefore, assessing nurses’ clinical competence is essential to achieve qualified and safe care. The aim of this study was to determine and compare the competence assessments made by head nurses and practicing nurses in a university hospital in Iran in 2009.•MethodsA cross-sectional survey was conducted to make comparisons of both self-assessment of nurse competence as well as assessment made by their respective head nurses working in a university hospital setting in Iran. The instrument employed for data collection was Nurse Competence Scale (NCS), whose reliability and validity have been previously confirmed. The clinical competence of the nurses in 73 skills under 7 categories was determined based on a Visual Analogue Scale (VAS) (0 to 100). They were also asked to indicate the extent to which their competence was actually used in clinical practice on a four-point scale of Likert. The data was analyzed through descriptive and inferential statistics.•ResultsComparison of self-assessment (87.03 ± 10.03) and the assessment done by head nurses (80.15 ± 15.54) showed a significant difference but no precise differences were found between the assessment methods for the frequency of using these competencies.•ConclusionsThe results of this study indicated no consensus between the nurses owns assessment and their head nurse assessment. Therefore, it is necessary to use a combination of nurses’ competence assessment methods in order to reach a more valid and precise conclusion.
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Page 235•BackgroundAccurate recording of the nursing care indicates the care performance and its quality, so that, any failure in documentation can be a reason for inadequate patient care. Therefore, improving nurses’ skills in this field using effective educational methods is of high importance. Since traditional teaching methods are not suitable for communities with rapid knowledge expansion and constant changes, e-learning methods can be a viable alternative. To show the importance of e-learning methods on nurses’ care reporting skills, this study was performed to compare the e-learning methods with the traditional instructor-led methods.•MethodsThis was a quasi-experimental study aimed to compare the effect of two teaching methods (e-learning and lecture) on nursing documentation and examine the differences in acquiring competency on documentation between nurses who participated in the e-learning (n = 30) and nurses in a lecture group (n = 31).•ResultsThe results of the present study indicated that statistically there was no significant difference between the two groups. The findings also revealed that statistically there was no significant correlation between the two groups toward demographic variables. However, we believe that due to benefits of e-learning against traditional instructor-led method, and according to their equal effect on nurses’ documentation competency, it can be a qualified substitute for traditional instructor-led method.•ConclusionsE-learning as a student-centered method as well as lecture method equally promote competency of the nurses on documentation. Therefore, e-learning can be used to facilitate the implementation of nursing educational programs.
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Page 244•BackgroundMajor depressive disorder is one of the most widespread psychological problems in the world. The feelings of a person who is affected by this condition is boring. This article aimed to shed light on the experiences of women with major depressive disorder.•MethodsA qualitative approach with thematic analysis design has been used to describe the studied phenomenon as experienced by the participants.•ResultsAnalysis of 92 codes from 12 interviewed participants brought about 4 main themes including loss, inappropriate marital life, cognitive errors, and economic condition.•ConclusionsThis study revealed main concerns of the participants through their life and suggested that psychotherapists should be more sensitive to these aspects of their depress patient's experiences.
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Page 253•BackgroundClinical learning environment (CLE) is an important factor in clinical education of nursing students. The CLE of nursing students has been less studied in Iran. Therefore, the aim of present study was to investigate the viewpoints of nursing students in Tabriz nursing faculty regarding CLE.•MethodsIn this descriptive study, 133 nursing students participated. For data collection the CLE inventory was used that assesses six aspects including personalization, cooperation, task orientation, innovation, satisfaction with clinical education, and satisfaction with clinical instructors. The score ranged from 46 to 184 and scores below 115 were considered as a negative.•ResultsThe average score of viewpoint regarding CLE was 108.4 (12.7) and 93.2% of students had a negative viewpoint about CLE.•ConclusionsEducational authorities should have special attention to the quality of CLE of nursing students.
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Page 257•BackgroundHealth professionals face the adverse health effects of climate change and air pollution in their practices. This review underscores the effects of these environmental factors on maternal and children’s health, as the most vulnerable groups to climate change and air pollution.•MethodsWe reviewed electronic databases for a search of the literature to find relevant studies published in English from 1990 to 2011.•ResultsEnvironmental factors, notably climate change and air pollution influence children’s health before conception and continue during pregnancy, childhood, and adolescence. Experts have suggested that such health hazards may represent the greatest public health challenge that humanity has faced. The accumulation of greenhouse gases such as carbon dioxide, primarily from burning fossil fuels, results in warming which has an impact on air pollution particularly on levels of ozone and particulates. Heat-related health effects include increased rates of pregnancy complications, pre-eclampsia, eclampsia, low birth weight, renal effects, vector-borne diseases as malaria and dengue, increased diarrheal and respiratory disease, food insecurity, decreased quality of foods (notably grains), malnutrition, water scarcity, exposures to toxic chemicals, worsened poverty, natural disasters and population displacement. Air pollution has many adverse health effects for mothers and children. In addition to short-term effects like premature labour, intrauterine growth retardation, neonatal and infant mortality rate, malignancies (notably leukaemia and Hodgkin lymphoma), respiratory diseases, allergic disorders and anaemia, exposure to criteria air pollutants from early life might be associated with increase in stress oxidative, inflammation and endothelial dysfunction which in turn might have long-term effects on chronic non-communicable diseases.•ConclusionsHealth professionals have an exclusive capability to help prevent and reduce the harmful effects of environmental factors for high-risk groups, and should consider this capacity in their usual practice.