نشریه پرستاری و مامایی ارومیه
سال دهم شماره 4 (پیاپی 39، مهر و آبان 1391)

This study was performed to determine the nutrition condition of intensive care units patients in Arak hospitals in 1388. In this sectional study 115 eligible patients (71male، 44 female) contributed، who had been hospitalized during 8 months in 1388 in intensive care units. Serum prealbumin was used as measurement scale of survey to determine the nutrition condition of patients as they were hospitalized and 10 days after discharge. The prevalence of malnutrition was 43. 5% at patient acceptance time and 54. 1% after 10 days. In spite of 10. 6% increase of malnutrition within ICU patients، statistically there was no significant difference (p=0. 203). The incidence of malnutrition in aged patients after 10 days was more than young patients (0. 001). According to the high prevalence of malnutrition at patient acceptance point and its effects، it is required to examine the malnutrition condition of patents at acceptance time، and appropriate nutrition programs should be applied to protect vulnerable patients. The increase of malnutrition، particularly old patients، can be an evidence for inappropriate nutrition during hospitalization. It requires elevated awareness of treatment team about malnutrition in hospitalized patients.

despite evidences on association between ventilator associated pneumonia and inadequate mouth care of mechanically ventilated patients، no studies are available on the performance of Iranian nurses in this area. This study was designed to compare the perceptions of nurses about ICU mechanically ventilated patients'' mouth care and their actual practices. this cross-sectional study was conducted on 90 ICU nurses in different hospitals in Kashan، Isfahan and Najaf-Abad. A questionnaire including demographic information، frequency of oral assessment and oral care، use of checklist، priority of oral care، routine materials and equipments for oral care، and barriers to oral care in ICU was used. Nursing reports of 45 patients، concerning care records were evaluated. Collected data were analyzed using SPSS software. oral Care obtained the seventh rank and a mean score of 5. 7 on a scale of 10. Only 29% of participants had been trained in this field. The oral cares were ignored by 20% of participants in their usual duties. Suctioning was the most common method used in 83. 3% of cases. High load of writing tasks and personnel shortages were the major barriers to oral care. Only 20% of the charts included a report on oral care of mechanically ventilated patients. the nursing personnel gave a low priority to the oral care of mechanically ventilated patients. Results showed the lack of nursing knowledge in this area therefore re-training programs in the field of oral care are recommended and the supervision should be strengthened.

Dysmenorrhea is the most common complaint of young girls and one of the main reasons behind disarrangement in their daily schedule. The main purpose of this study was to explore the health effects and side effects of fish oil & vitamin B1 on symptoms of dysmenorrhea. In the present study a double-blind clinical trial design was conducted. Data were collected from 240 high school students in Urmia city by using randomized method، the participants were divided into four groups، three experimental groups and one control group، each group containing 60 students. The first group received vitamin B1 tablets (100 mg)، the second group took fish oil capsules (500 mg) and a mix of both fish oil and vitamin B1 was used for third group and fourth group received placebo. The severity of pain was measured using VAS and the duration of pain was obtained applying Cox in three separate times; prior to the study، one month and two months after taking supplements. The data were analyzed by SPSS software. The reduction of pain intensity in experimental groups showed a significant difference between three experimental groups and control group (p=0. 000). All three experimental groups reported a reduction of pain duration in the comparison of control group (p<0. 000). considering the digestibility and the health effects of vitamin B1 and fish oil on dysmenorrhea، these supplements are suggested as an alternative for other drugs.

Anger is considered to be a major concern for society. In many cases it leads to some behaviors that damage the economy of many countries. Researches confirm that many health problems and mental disorders have emotional and social roots، to overcome these problems، the life skills of people should be promoted. This study was aimed to investigate the impact of anger management skills training on students'' mental health in Urmia nursing and midwifery faculty. In this quasi experimental study 70 nursing students were participated. Data were collected applying general mental health questionnaire (GHQ)، the obtained data were analyzed by SPSS17 software. Female students occupied 60% of participant and the other 40% was occupied by males. 28. 2% of participants were selected from families with low income and 68. 5% of them came from families with moderate income and 3. 3% were from high income families with the mean age of 20. the obtained scores before and after training were compared، it indicated a significance difference between two groups، in other words there is a meaningful and positive relationship between anger management training and students'' mental health (p=0. 01).

H ealth communicators are in fact the link between people and health workers. They are volunteers to participate in social health programs. By given the importance of their presence and increase process of communication cut of health communicators، this research was done to explore health coaches and communicators'' point of view regarding the process of communication cut of health communicators. This is a qualitative study of content analysis type. Focus group discussions and depth individual interviews (semi- structural interview) were the used tools to data collection. Three groups took parts in this study، including: 1; working health communicators 2; cut health communicators 3; health coaches، discussion saturation was the final point of sessions. In general، 14 FGD sessions and 5 IID sessions took place to accumulate participants'' point of view. Content analysis method was used to records analysis. In conclusion 328 primary codes were obtained، considering overlap and combination of codes، 81 codes came out، as a result 3 concepts (theme) were confronted. The measurement of position was the one، which was put in consideration in this study. The concept consisted of three main categories: reactions، personal beliefs، and familial-personal position. The main category of reactions was divided into two sub-groups، medical-health team and family-community with two sub classes for each of them، the holder and the supportive. The main category of personal beliefs included two sub-groups، psychiatry and religious beliefs with one supportive sub class for each of them. Finally the main category of familial –personal position divided into two sub-groups، familial factors and personal factors with holder and supportive sub classes. The main reasons for communication cut were summarized as، migration، marriage، childbirth، employment، education، disease، distant from health centers، inappropriate behavior of employees and public، and the lack of official attention to their problems. It can be concluded that، the expectations of communicators should be stated as they are selected، in order to their stability at work. There is a need for meetings، hold between officials and communicators to present their problems and uncover their solution، holding ceremonies and providing appropriate programs to absorb financial resources، acknowledgment is the most efficient way in maintaining presence and maximizing health communicator program efficacy.

Parents of mental retarded children have many problems in maintenance، training and education of their children. These problems have negative impact on parent’s mental health and marital satisfaction. Considering the fact that these families need help to overcome their problems، this study was conducted to investigate the impact of marital counseling on marital satisfaction of parents with mental retarded children. the present research is an experimental study (pre-test and post test) with a control group، 30 couples with mental retarded children in two experimental and control groups were studied in two stages (before and 45 days after marital counseling program) using ENRICH marital satisfaction questionnaire. SPSS software and T-test statistical test were employed to data analysis. based on marital satisfaction scale and its four dimensions (idealistic distortion، marital satisfaction، communication and conflict resolution)، trained parents had a more favorable situation، compared with untrained parents. consequently، it is necessary to design and implement special training courses for parents with mental retarded children، in order to cope with psychological and marital conflict by the relevant organizations.

eye complications are common in Intensive care units’ patients. Different methods are recommended to prevent these complications. In this research the preventive effects of eye lubricant ointment and adhesive tape on eye-dryness and corneal abrasion were compared. The study carried on 87 ICU patients at Shariati hospital in Tehran and Shahid Beheshti Hospital in Kashan.

the patients randomly recruited in 3 groups of adhesive tape، eye lubricant ointment and control group. The eye care implemented، afterward the eye dryness and corneal abrasion were examined on the first and fifth days. The data analyzed using SPSS software and qhi-square، kruskal wallis and wilcoxon statistical tests.

although the difference in eye-dryness and corneal abrasion was not statistically significant، the incidence of corneal abrasion was twice in adhesive tape group. On the fifth day، 38 patients (43. 7%) had eye dryness and 12 patients (13. 8%) had corneal abrasion. The odds-ratio of eye-dryness on occurrence of corneal abrasion was 19. 5.

the eye lubricant ointment is a preferred method on prevention of eye dryness and corneal abrasion in ICU patients.

Bachground & Patients with end stage renal disease require long term treatment and care، therefore their caregivers encounter treatment related problems and caring difficulties along with responsibility adaptation. The aim of this survey was to examine the relationship between caring burden and coping strategies in hemodialysis patients caregivers. in this descriptive and analytical study، 120 caregivers of hemodialysis patients who referred to fifth Azar educative and therapeutic center in Gorgan، were selected through Census sampling method. Data were gathered via caregiver burden and coping strategies questionnaire. Data analysis was performed by SPSS software by means of Pearson correlation coefficient، liner regression and independent t-test. mean and standard deviation of caregivers'' age was 42. 22±13. 09 and men formed 59% of subjects. Regression analysis showed that one score increase in problem based coping strategies decreases total caregiver burden as 0. 295 (P<0. 05) and also one score increase in emotion based coping strategies could increase care burden as 0. 655 (P<0. 05). according to the findings، coping educational programs for hemodialysis patients caregivers should be develop. Improvement of effective coping strategies could decline care burden and then promote physical and psychosocial health.

Hemodialysis is the most common treatment for end stage renal disease (ESRD). Inadequate dialysis is a risk factor for morbidity and mortality of this group، so it is necessary to determine the adequacy of dialysis. This study was performed to determine the adequacy of dialysis with High Flux membrane in hemodialysis at Shahid Beheshti hospital in Hamedan.

in this cross sectional descriptive study، 40 hemodialysis patients in Shahid Beheshti Hospital of Hamadan city participated. In second dialysis session with High Flux membrane (FR60) before and 30 seconds after decreasing blood flow rate to 80mg/min at the end of dialysis، blood samples were taken in order to assess BUN. KT/V and URR indexes used to determine hemodialysis adequacy. Data analyzed by SPSS 16 software.

in the present study 67. 5% of participants were male and 32. 5% were female. The mean of their age were 47. 56 ± 10. 79 years. The mean of kt/v was 1. 27± 0. 28 with the minimum of 0. 71 and the maximum of 2. 12. The mean of URR was 0. 65±0. 09 with the minimum of 0. 45 and the maximum of 0. 92.

According to the results of our study، we suggest the use of High Flux membrane dialysis and increase of blood flow rate doing hemodialysis to increase dialysis efficiency and to achieve international standards.

pain is a multidimensional phenomenon that is defined as «an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Infants and children are vaccinated before two years on several occasions. DPT injection begins from 2 months- old and continued to 4-6-years-old for 4 times in Iran. The aim of this study was to evaluate the pain reducing effect of topical Tetracaine in inter muscular DPT injection compared to placebo. in this study 40 infants by the age of 18 months were divided in two groups using random allocation، and two injections were performed for each group، using Tetracaine gel 4% and a placebo injection. The severity of injection was recorded using the FLACC pain scale by a pediatric registered nurse. Results showed that Tetracaine could not significantly decreased the pain severity of DPT vaccine IM injection in case group as compared with placebo group (p>0. 05). although findings of this study indicated that topical Tetracaine could not play an important role in decreasing of pain during DPT vaccine IM injection but it did lead to faster recovery time. The average pain intensity in the case group was less than placebo group (8. 5 vs. 9. 2). The time to pain relief and return to baseline in case group was much lower than the placebo group. However، more studies are needed to determine the effect of pain reduction strategies.

Due to the uncertain etiology and adverse consequent of cardiac syndrome X، patients with this syndrome have high levels of anxiety and depression. The aim of this study was to determine the effects of cardiac rehabilitation (CR) and relaxation therapy (RT) on anxiety and depression in patients with cardiac syndrome x. This research is a Randomized Clinical Trial study. 40 patients were chosen according to none randomized method، and then randomly divided into four groups as control، RT، CR، CR+RT groups. Data were collected through the demographic information questionnaire and Hospital Anxiety and Depression Scale. Group CR performed phase III CR exercise، group RT performed progressive muscle relaxation and group CR+RT performed combination of exercise and relaxation for eight weeks. Data were analyzed with Chi-square، Kruskall-wallis and Rank Sum Difference tests. Results showed that there was a significant difference in anxiety and depression between the four groups after intervention (P<0. 001) and Multiple comparison test shows that differences in anxiety and depression scores among all group، except the group RT with group CR is significant (P< 0. 05). Combination of exercise and relaxation reduce anxiety and depression in patients with cardiac syndrome x.

all over the world، healthcare systems are under intense pressure to improve their performance. The cost of healthcare is a critical issue for employers and patients، and they also constitute the nation’s central financial challenge. Hospitals as part of health system command the majority of any countries’ health care budget. Decreasing hospitalization time with an increased beds capacity، will lead to improved efficiency and productivity. The aim of this study was to measure inappropriateness of inpatient stays in the west azerbaijan selected hospitals. in this retrospective study، medical records of 435 hospitalized patients (1536 patient days) were carefully scrutinized based on appropriateness evaluation protocol in selected hospitals. Inclusion and exclusion criteria were determined. Data using descriptive and inferential statistics such as x2 test were analyzed. the study was carried on in medical-surgical and gynecological wards of different selected hospitals in the west azerbaijan، 435 medical records of hospitalized patients (1536 patient days). The study showed that 6% (92 days) of stay days was medically unnecessary a nd there was a significant relationship between unnecessary hospitalization days and type، affiliation and ownership of hospitals (p<0. 05). The most inappropriate hospitalization days were found in teaching and state-owned hospitals. reducing inappropriate hospital stay increases hospital productivity and decrease waiting list، and at the same time decreases the costs for both hospital and patients. Managerial and system factors had a meaningful relationship with unnecessary stay days، showing the importance of management in the health system and its sub-systems such as hospital.

training internship period has a fundamental role in forming basic skills and professional abilities of nursing students. Training in emergency unit is more important than other units. The goal of this study was to explore the nursing students'' training experiences in emergency wards. this is a qualitative-research study in which 12 nursing students involved in. students’ experiences which had been collected using in-depth face to face interviews and written narratives methods، were analyzed using conventional content analysis. since a huge number of primary themes were obtained by analyzing the narratives، they were summarized into five main themes including، an opportunity for gaining more clinical skills، confidence as a way of staff- students relationship، promoting practical self-efficacy along with continuous stress، training experience in a turbulent situation، and paradoxical experiences in educational reality. although there are clear strengths in emergency unit training، there are some weaknesses as well، that can be eliminated by more clarification، employing proficient instructors and further educational supervision.

Patient training has an important role in diabetes control. Tele-education is effective، due to the elimination of­­ both space and time limitation and establishing an effective relationship with client care. This study was carried out to determine the impact of tele-education by telephone and short message service on glycemic control in patient with type 2 diabetes. this experimental study carried out on 66 members of Urmia Diabetes Association with type 2 diabetes. They were selected and allocated in two intervention and control groups randomly. Data gathered with demographic questionnaire and information form. Intervention group received education، followed by telephone and short message control، for 12 weeks. Data were analyzed using descriptive and inferential statistical testes. findings of the study showed a decrease o f blood sugar and glycosylated hemoglobin in intervention group after intervention. There was a significant difference in blood sugar and glycosylated hemoglobin between intervention and control group (P= 0. 000). telephone follow-up and tele - education by nurse has important effects on patients'' metabolic control in diabetic patients.