نشریه مدیریت ارتقای سلامت
پیاپی 4 (پاییز 1391)

Incivility behavior and violence have long-term complication on individual performance. These behaviors cause complex issues at workplace in the nursing profession and lead to embarrassment and threats of nurses and patients health and endanger the climate. The aim of this study was to determine workplace behaviors and its correlation with demographic characteristics، perspective of nurses in teaching hospitals in Gorgan.

In this descriptive - correlational study، 232 nurses who employed at two hospitals in Gorgan were participated. Data collected by «Nursing Incivility Scale»، «(NIS)». Validity of this scale was approved with face validity and reliability through test–retest (Cronbach''s alpha=0. 86). Data were analyzed using ANOVA and linear regression models with SPSS/16.

The total score of incivility from the perspective of nurses was 3. 89 of 5. 00 likert. The most incivility behavior score was reported with physician interacting and the lowest was observed in the interaction of nurses with a supervisor. There was a significant correlation between age and type of employment with incivility behaviors ((P=0. 04) and (P=0. 02) respectively. Similarly، the correlation between working in type of hospital ward and incivility behaviors was significant (P=0. 02). The highest score of incivility behavior reported in the emergency ward was 4. 43 from 5 and the lowest in genecology ward was 2. 71 from 5.

Incivility behaviors among nurses can affect the quality of services provided by them. Therefore، considering factors that lead to incivility in nursing workplace is necessary.

Capability evaluation of medical emergency personnel، which is considered as one the priorities in confronting the diseases، may provide an appropriate reflection of the performance of pre-graduation training programs and continuous training. The aim of this study was evaluation of clinical skills of medical emergency personnel in Tehran Emergency Center confronting the trauma. This descriptive study has been applied on 536 medical emergency personnel of Tehran Emergency Center. 213 persons were selected via stratified random sampling method. Data were collected through demographic questionnaire and “Clinical Skill Checklist”. Content validity of the “Clinical Skill Checklist” has been evaluated and confirmed by 10 lectures and experts. Also reliability coefficient of all skills was equal to 0. 803. The researcher observed the medical emergency personnel skills and then completed the “Clinical Skill Checklist”. Data was analyzed with SPSS/17، statistical independent T tests، univariante variance analysis، Bonferroni post hoc test and correlation coefficient of Pearson. The results of the study indicated that 62. 4% of the medical emergency personnel had good grade in trauma skill but practicing two skills of seated patient’s spinal immobilization and traction splint had major skill deficiency. Between age، educational level، field of study، employment records and trauma clinical skill a significant statistical relationship existed (P<0. 05). Although in most skills، the medical emergency personnel had good grade skill، but it is required to provide necessary trainings in two skills that have not obtained sufficient point.

Total Quality Management in medical training is a multi-step management method which recognizes the teaching-learning processes. Preparation of faculty managers، who are responsible for planning and taking the corrective actions، is the most fundamental step in the process of its implementation. The aim of this study was to determine preparation of Mashhad University of Medical Sciences for implementation of Total Quality Management. In this descriptive study، sample size was selected among all the managers or faculty members at the university’s medical science school (300). 221 samples were selected by using Morgan’s table and convenience method. Data was collected by “Preparation for Implementation of TQM Questionnaire” with 21 items which was developed by review of literature. Validity of the questionnaire was confirmed by 10 experts and researchers in TQM. Reliability was measured by using Cronbach alpha (α=0. 86). The data was analyzed using the SPSS/17، statistical method of independent T-test، Friedman and chi square methods. The results showed that ability to implement TQM in both the overall and also in each of eight symptoms were above the average and relatively high at the Mashhad University of Medical Sciences. The TQM-factor use-measure of managers’ moralities and material/resource assignments were the highest and lowest respectively. The results also showed that TQM، managers’ speech، employees’ recognition awards، organized management’ team endeavors and efforts، specific allotted time to TQM fact/fundamentals issuance، distinct program development and employee involvement ranked from the second to seventh. Mashhad University of Medical Sciences seems to have well established basis for the implementation of TQM in medical education. As a result، this university has the potentials to enter the higher levels of TQM implementation.

Cardiovascular disease is the most common cause of disability and death in the world. The aim of this study was to determine the risk factors of cardiovascular disease in elderly resident in nursing homes in Tehran. This descriptive study was conducted with 310 elderly men and women above 65 years in elderly house in Tehran. A sample was chosen with random clustering. Data was collected by questionnaire which included demographic questions (5 questions) and “Risk Factors of Cardiovascular Disease Questionnaire” (7 questions). Later section included، history of heart disease and medications، family history of heart disease، smoking، physical activity and exercise. Validity was measured by content validity index and reliability was determined by Cronbach''s alpha coefficient (0. 88). In addition، other data such as height and weight، blood pressure، blood lipids (cholesterol، triglycerides) and fasting blood glucose were collected. All statistics were computed using the SPSS/15. Findings showed that mean age of sample was 75/25±7/98. Prevalence of risk factors for high cholesterol (P<0. 001)، high triglyceride (P<0. 05)، diabetes (P<0. 05)، inactivity (P<0. 001)، lack of exercise (P<0. 05)، obesity (P<0. 001)، systolic blood pressure and diastolic، was higher in women than in men، whereas smoking was higher in men than in women (P<0. 001). Prevalence of risk factors for cardiovascular disease in nursing homes in Tehran is high. According to findings of this study، it can be concluded that، elderly women were more exposed than elderly men to risk factors of cardiovascular disease. Appropriate training toward their lifestyle change to prevent this disease and its complications is necessary.

One of the main effective factors of development of hypertension in people is lifestyle. The aim of this study was to compare military and civilian life style of people with hypertension. This descriptive-comparative study on 200 patients with hypertension was conducted in Tehran. Convenience sampling method was used to select hypertensive patients referred to the military hospitals and civilian hospitals. Data was collected by «Hypertension Lifestyle Inventory» in four main dimensions (nutritional status 36 items، stress 13 items، smoking 9 items and physical activity 10 items). Validity of the inventory was measured by content validity and reliability by test re-test (r=0. 83). The blood pressure device calibration was measured based on company manual. For collecting data، blood pressure was measured two times and data was analyzed by SPSS/17. Findings showed that lifestyle in the field of nutrition، physical activity، stress and smoking in the sample is not appropriate. In this study، factors such as marital status، education، nutrition and physical activity were significant with hypertension (P<0. 05). The results on the importance and urgency of intervention measures for change in lifestyle are emphasized. Therefore، educational programs in order to make lifestyle changes such as quitting smoking، regular exercise programs، diet modification is necessary.

After delivery، family’s attention changes from mother to child، while mothers tend to get very busy and do not pay attention to their health. The aim of this study was to determine prevalence and persistence of health problems after child birth and maternal correlations with parity In this descriptive-longitudinal، study 308 mothers who visited Mahabad community health centers for parental care (36-38 weeks) were selected. Instrument in this study was Postpartum Morbidity Scale، which developed by researcher. Content validity، internal consistency (0. 94) and test-retest reliability (0. 98) was measured. Data gathered by interview at 7 days، 8 weeks and 12 months after delivery and analyzed by SPSS/18. To determine difference and causing problems among multiparous women primiparous، Chi2was used and 95% confidence interval was used to determine the relative risk. The result showed that common reported problems at first and second stage were backache 64% and 60% and fatigue 63% and 60% respectively. However، after 12 months of the delivery fatigue was 43%. During 7 days of delivery، we found significant relationship between backache (P=0. 005)، headache (P=0. 013)، tiredness (P=0. 008)، side effect of anesthesia (P=0. 041) and sleep problems (P=0. 001) with multiparous mothers. These values after 8 weeks of delivery were backache (P=0. 047)، stitches infection (P=0. 023)، urinary tract infection (P=0. 000)، sex problems (P=0. 003)، postpartum blue (P=0. 002)، sleep problems (P=0. 001) reported more between multiparous. 12 months after delivery، there were a significant relation between postpartum blue (P=0. 024)، sex problem (P=0. 001)، sleep problems (P=0. 036) and multiparous of mothers. Due to high prevalence of postpartum morbidities and lack of attention to solving these problems، changing the postpartum regular care and offering educational courses to mothers are necessary and highly recommended.

Use of tobacco products is a most common problem among adolescents. Few researches have been conducted on correlation of family functioning and self-concept among adolescent smokers. The aim of this study was to determine the correlation of family functioning dimensions and self-concept of adolescent smokers in Zanjan. In this descriptive-correlational study، 100 male adolescent smokers were selected by purposive sampling method. A questionnaire was used for data collection that included 3 parts: 1- demographic characteristics 2- Mc Master Family Assessment Device 3- Beck Self-Concept Test. Face and content and validity index of instruments were measured. Reliability of the instrument was determined by internal consistency for Mc Master Family Assessment Device (α=0. 81)، Beck Self-Concept Test (α=0. 91) and test- retest method (г=0. 84) and (г=0. 91) respectively. Data was analyzed by SPSS/16. Results showed that the highest and lowest dimensions of family functioning were problem solving function and roles function respectively. Most subjects (88%) had average family functioning and only 4% of them had high family functioning. In addition، results illustrated that، 61% of subjects had neutral self-concept. There was a significant correlation between family functioning and self-concept and affective response had the highest score than other dimensions of family functioning (r=0. 34، P=0. 000). The results of the study showed that adolescents’ self-concepts were correlated with family functioning. Therefore، creating a supportive family environment and parenting education، should be incorporated in nursing interventions of smoking prevention.

Retirement is a new phase in the life cycle and away to improve health and self-care and living conditions. The aim of this study was to explore the experiences of retired nurses in retirement time. This study was performed by qualitative design and content analysis method. Sampling was based on purposive and participants were 20 retired nurses that live in Semnan. In addition، participants had a BSc in nursing and 1 to 5 years of retirement time. However، they had different positions in various wards and hospitals with 23-30 years’ of full-time experience. Data was collected through semi- structured interviews and the sampling ended when the data reached saturation. The main theme extracted from the data analysis was to identity the threat. Classes include «shock and disbelief»، «hard separation of the work» and «frustration” that contained several sub-classes. The experience of retired nurses during the retirement was identity threat. Suitable retirement planning and effective interventions to improve existing conditions by authorities and managers of nursing، can prevent incidence of identity threat in retired nurses and provide health promotion and efficiency for nurses. Furthermore، findings of this study can provide and facilitate more future studies in this field. Retirement، Retired nurse، Qualitative study، Content analysis.