مجله دانش و تندرستی در علوم پایه پزشکی
سال ششم شماره 3 (پاییز 1390)

Maslach Burnout Inventory (MBI) (Maslach & Jackson, 1981) is the most commonly used measure of burnout among people from different backgrounds and professions. The educator survey of MBI is the version designed for studying burnout among those engaged in the teaching profession.

MBI has been translated into various languages and its factor structure has been examined in many studies. This study examined the factorial structure of the Persian version of MBI through exploratory and confirmatory factor analyses among 570 Iranian EFL teachers.

The findings of the study confirmed the appropriacy of the original three-factor model as proposed by Maslach and Jackson for the Persian version of the MBI.

The results of this study indicate that the Persian version of MBI can be used in burnout research with Persian speaking Iranian participants.

Psychological therapy can have significant effects on improving the general health in asthmatic patients. The purpose of this research is to study the effectiveness of cognitive behavioral stress management (CBSM) therapy in general health of asthmatic patients. In this experimental study, 24 female asthmatic patients were randomly assigned to experimental and control groups. The data was gathered using the Global Health Questionnaire (GHQ-28), completed in pretest, posttest and follow-up stages by the participants. While CBSM therapy was conducted in 8 sessions on the experimental group, the control group received common medical treatments and meanwhile was laid in waiting list for psychological therapy. The obtained data was analyzed with SPSS software, mainly through the analysis of covariance (ANCOVA). The findings showed that mean scores of general health were decreased significantly in post-test and follow-up phases in experiment group (pre-test: 37.83 post-test: 30.33 follow-up: 35.66) compared to control group (pre-test: 38.17 post-test: 39.91 follow-up: 41.66) (P=0.0001). The results of present study demonstrate the effectiveness of cognitive behavioral stress management therapy in the improvement of general health of female asthmatic patients. Due to the decrease of mental health in asthmatic patients and the effectiveness of mental intervention, special attention should be given to psychological treatment in this group of patients.

Nursing process is a systematic and dynamic method that will help to improve the quality of patient care. Reviewing the literature indicates that implementation of nursing process not only in Iran but also in many countries has encountered many challenges. Applying nursing process requires understanding the factors affecting its implementation from the perspective of nurses and understanding the way these factors influence the nursing process. The purpose of this study was to explore the factors that may influence the implementation of nursing process by nurses in Iran. A grounded theory was used to explore the nurses’ perspectives on implementation of nursing process. 18 clinical nurses, 12 nurse educators and 6 nurse managers participated in semi-structured interviews and data were simultaneously and constantly compared. Personal-managerial factor was found as a core variable in this study. It means that a set of personal and managerial factors should be provided to help nurses apply nursing process to improve quality of nursing care. This variable includes two levels of axial codes: personal level and managerial level. Three categories in personal level code (awareness, attitude and skill) and five categories in managerial level code (supervision, adequate human resources, reinforcement and punishment, appropriate tools and conditions, and cooperation) emerged. Factors which influence the implementation of nursing process by nurses are varied and complex and relate to personal and managerial factors. Therefore, nurse managers and nurse educators should try to remove barriers and provide facilities to promote implementation of nursing process and increase the quality of care based on nursing process.

IUD is a common contraceptive method in the world. According to statistics reported by the national research of Integrated Monitoring Evaluation System in Iran (IMES), IUD was used by 11.9% contraceptive users in Iran in 2005, but it was only 4% in Khomein, which is very low compared to the national statistics. This study aimed at exploring the viewpoints and beliefs of women in Khomein about barriers to the use of IUD. This study is a qualitative research based on focus group discussions. Data was collected from married women, eligible for contraceptive use with ages 15-49 years inhabiting villages of Khomein. In focus group discussions, one person moderated the discussion and one person recorded the interviews. Data was analyzed according to the Content Analysis method. Majority of participants did not intend to use IUD. The most important reasons for this were side effects and false beliefs. Other reasons included feelings (fears and anxiety about the fitting of an IUD) and lack of information about IUD and its advantages and disadvantages, influence of other people’s views (care providers, etc) and husband’s dissatisfaction. With regard to the effective role of health care personnel and husbands, and also the significant role of the obstetrician’s and physician’s skill in choosing the appropriate contraception method, and with regard to the poor information of women about IUD, further training on correct IUD insertion and promoting the family planning counseling skills of health care personnel and improving the involvement of men in the family planning process is obviously necessary.

The estimated prevalence of functional bowel disorders and its subtypes varies enormously depending on the diagnostic criteria employed. This study aimed at estimating the prevalence and risk factors of functional bowel disorders in an Iranian community. This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, including 18,180 participants who were randomly selected and interviewed face-to-face using a validated questionnaire based on Rome III. In general, 1.1% of the participants met the Rome III criteria for Irritable bowel syndrome (IBS), 1.5% for functional bloating (FB), 2.4% for functional constipation (FC),5.5% for unspecified functional bowel disorder (U-FBD), 0.4% for functional diarrhea (FD) and 10.9% of the participants had at least one type of Functional bowel disorders (FBD). Interestingly, among participants with Functional Dyspepsia, Diarrhea, Bloating, Constipation and Abdominal pain; 83.8%, 78.6%, 77.2%, 74.55%, 72.9% respectively had FBD. This study revealed low rate of Functional Bowel Disorders among urban population of Tehran province. The Rome III criteria itself, and the problems with interpretation of the data collection tool might have taken part in underestimating the prevalence of FBD. In addition the reliability of recall over 6 months in ROME III is questionable for our population.

Two of the most critical co-infection associated in patients with HIV is hepatitis C and hepatitis B. Thus considering the adverse effects of these co-infections and the paucity of research in this area, this study was conducted to describe the frequency of co-infection hepatitis B and hepatitis C in patients with HIV and the related factors. Three hundred and sixty five infected patients from the voluntary counselling and testing center of Imam Khomeini Hospital in Tehran, Iran participated in this cross sectional study. The individuals who co-infected with hepatitis B, C and also HIV were selected. Then the information like demographic factors, routes of transmission, history of vaccination, stage of disease and HBs Ab were extracted from their records. Our results showed that 26.3% of patients were co-infected with HIV / HBV/ HCV. One hundred and eighty eight infected patients (51.5%) were between 21 to 40 years. Out of all co-infected patients 34.9% were infected through drug injection. Moreover 30.1% of them were in incubation stage of disease. Furthermore, 22.3% of patients with co-infection had the positive history of Hepatitis B vaccination and 30.7% of all co-infected participants revealed HBs Ab positive. We recommend that HIV positive patients should inject hepatitis B vaccine. Also, it is emphasized to take Highly Active Antiretroviral Therapy (HAART) in patients suffering from co-infection with HIV, HBV and HCV.

Hospitals are major health service places which deal with disasters and whose preparedness and offering on time services play vital role in reduction of injuries and death. This research was conducted to determine preparedness of hospitals in Semnan province to deal with disasters (2010). In this practical, cross-sectional study, all head managers of hospitals in Semnan Province were selected through the census method, and a questionnaire comprising 40 questions and a checklist include of 133 questions were completed through observation and interview. The collected data were analyzed using ANOVA. Out of the 10 studied hospitals, 50% were teaching hospitals and the rest were therapeutic. Average preparedness of programming support for vital services was 80%, for natural disasters management programs in hospital was 65%, for programming for environmental health activities against disasters was 56.2%, for security of equipments and hazardous material was 64.2%, for programming for reduction in structural dangers was 43.8%, for evacuation and field treatment was 49.5%, and average score for hospital educational planning to deal with disasters was 42.2%. ANOVA test has shown significant relationship between manager’s awareness and hospital preparedness, (P=0.010). Hence province hospitals with 58.5±15.7% average, attain medium level against disasters. Results indicate that managers require to be trained in confronting disasters and it is essential to retrain managers in all the fields including environmental health activities against disasters reduction in structural dangers and programming for evacuation and field treatment for confronting disasters.

Pain is a hurting and destructive experience which remains in the mind of the child suffering from it. The spectrum of studies done on the relationships between these reactions and painful stimuli is very wide, therefore, knowing and studying these in addition to helping neonates can bring about some change in painful medical and nursing procedures on neonates. Hence the aim of this study was to determine the behavioral and physiological pain signs in neonates admitted to the pediatric ward of Imam Hossein Hospital in Shahroud in 2006. This is a descriptive study which included all legible neonates hospitalized in the pediatric ward in first half of the year 2006. The data were recorded in a standard check list based on ALS theory of development Neonate-Infant pain scale (NIPS), Lawrence et al. (1993). From 141 participants, 44.7% (n=63) were female and 55.3% (n=78) were male. Mean age was 7.2 ± 6.5 days (with the range of 1-17 days) and mean weight was 3015.2 ± 258.6g (with the range of 2250-3950g). Icter with 55.3% (n =78) was the highest diagnosis leading to admission. 71.6% of the neonates were breastfed and 78% were born through C-section. Taking blood samples, as a medical procedure, had been applied to all participants. Among the behavioral signs, facial expression with 96.8% and change in respiratory patterns with 94.8% were the most frequent signs. The Mean score obtained by neonates was 6.21 ± 1.85 (range = 2-7). Heart beat and respiratory rate change showed significant relationships with the applied procedures. As the findings of this study indicate, we can rely on the behavioral and physiological pain signs in neonates to investigate the pain they suffer, and with preparing more appropriate behavioral and physiological pain sign scales, the effectiveness of these instruments can be improved.