The use of intra-vein cutters is one of the most prevalent and painful procedures، and children especially young children usually call it the most stressful aspect of their disease، hospitalization، and even their outpatient visit. The present research investigates the influence of familiarization play on the pain severity in the case of injection procedures on pre school age children.

The present study is a clinical experiment. The research sample consists of 60 Thalassemic children of 3-7 years old، in Thalassemia sections in Gilan. The participants were randomly divided into two groups. In the experimental group، a familiarization play was carried out for 10-15 minutes prior to the injection procedure. The instruments used in the research include: demographic characteristics، the Questionnaire of child clinical fear and the self report instrument of Chip Pooker Pain، The analysis of the data was carried out by using SPSS.

The data indicated that after the treatment، there was a significant difference between the experimental group and the control group in terms of the average scores of pain. It showed a significant decline in the familiarization play group (P< 0. 05).

According to the research results، the treatments of familiarization play is influential on the pain decrease resulted from the injection procedures in children Therefore it is suggested that child nurses use the methods of familiarization play in order to comfort the children with acute and chronic diseases who are frequently under treatment measures.

RAM is used in ERSD patients. Nurses play important role in their adaptation. The goal of the study is to explain the adaptive and ineffective responses of Hemodialysis patients based on RAM in qualitative part، and to compare their adaptation scores in quantitative part. qualitative design of this mixed study method is descriptive phenomenology. Data were saturated by purposeful sampling (n=14). Data were drawn by Struebert and Fawcett methods and confirmed by Lincoln and Goba method. T-paired test was used to compare the means. 680 primary codes (236 adaptive and 444 ineffective responses) were identified at physiologic، self-concept، role play and interdependence modes in 9، 5، 3 and 2 subcategories respectively. Total adaptation score، and adaptation scores in physiologic and self-concept modes increased significantly but not in role play and interdependence modes. Hemodialysis increases total adaptation of ERSD patients and is affective in physiologic and self-concept modes but not in role play and interdependence modes. Nursing interventions are necessary for these modes.

Trauma is one of the most important health problems and a leading cause of death in 4th decade of life. Mortality due to accidents has a critical situation in Iran and the mortality rate is increasing10-15% annually. The purpose of this study was assessing the relation of Shock index and revised trauma score with trauma patient’s mortality after first 24 hours of admission at khatam-al Anbia hospital in Iranshahr. Prospective design was used on 240 traumatic patients to predict mortality of trauma patients after 24 hours of hospitalization at Khatam-Alanbia hospital in Iranshahr. Descriptive statistics χ2 test and logistic regression was used for data analysis. 86/6% of trauma was due to accidents and falling. 38/3% experienced multi trauma. 2/1% expired during 24 hours of admission. The minimum and maximum sores and mean of SI were 0/31، 1/59 and 0/71 respectively. Also the minimum and maximum sores and mean of RTS were 7. 12 and 11/66 respectively. There was a significant relationship between SI and RTS with mortality of trauma patients by both X2 and logistic regression (P=0/000). The SI and TRS is a useful instrument for mortality predicating. To reduce errors in mortality prediction، it’s better to use them along with other kinds of triage instruments.

Humanistic approaches in nursing care are very important. But there is a little knowledge about how these approaches grow in nurses. The aim of this study is understanding and identifying of effective factors. This is a qualitative study. The participants were 14 nurses working in two hospitals in Tehran. The data were collected through 26 unstructured interviews and analyzed using conventional content analysis. The rigor has been guaranteed with prolonged engagement، maximum variance sampling، member check and audit trail. The main theme was learning in confrontation with planning our on planning situation in personal and professional life. These situations provide rich experiences for learning of humanistic behavior. Participants’ experiences are “confrontation with committed role models”، “work and care as learning chance” and “confrontation with unpleasant life experiences”. Education of humanistic approaches begins with childhood in the family. This is influenced by culture of family، education by family، faculty and nursing management. Paying attention to all three elements are necessary to reinforce these approaches.

Fatigue is a common sign in health care providers، including oncology nurses which affects quality of care. There is a lack of valid and reliable tool to measure fatigue in oncology nurses. The present study aimed to develop a reliable and valid scale to measure fatigue in oncology nurses. In this methodological research، samples were oncology nurses who work at selected hospitals in Tehran that were selected according to inclusion and exclusion criteria. After reviewing literatures about fatigue and gathering developed scales for measuring any aspects of fatigue، a 45-items fatigue scale was developed. Content Validity Index were assessed by 10 nurse faculties and 9 oncology nurses who were expert in this area. After this stage، construct validity، concurrent validity، internal consistency and stability was assessed via SPSS 16. A fatigue scale for oncology nurses with 21 items was developed. The factor analysis revealed 3 factors. Correlation of the scale scores with scores of criterion scale was 0. 793 (P<0. 001). Internal consistency of the scale including alpha coefficient and test-retest reliability with a 3-week time interval were 0. 821 and 0. 877 respectively. “Oncology Nurses Fatigue Scale” is a valid and reliable scale which can measure various dimensions of fatigue in oncology nurses.

Quality in health care has varied aspects، definitions and interpretations. According to many differences in definition of nursing care quality in various cultures، this study was done to explore the meaning of nursing care quality from the stakeholders’ point of view. A hermeneutic phenomenology approach was used to conduct this study in order to depict the lived experiences of nurses، doctors، patients and their relatives about nursing care quality. Data were collected through individual deep interviews، focus group and observasions، and analysis using Dikelmann’s method. In this study، six doctors، ten nurses، twenty-two patients were interviewed individually، and 20 patients’ relatives were interviewed by focus group. 2312 initial codes were extracted at first stage of analyzing data. Then in ongoing process of analyzing، comparing and reductions، finally، 22 subthemes were extracted and five themes emerged. The concept of quality nursing care from the perspective of doctors، nurses، patients and their relatives'' was difined as “meet the needs of patients with intentioality، emotional - psychological relationships، support، respect، responsibility and accountability”. Nursing managers must identify strategies to support and provide better nursing care، which reflect purposeful care، nursing responsibility، promotive psychological-affective relationships، patient respect and support for all clients. Findings may also be used by nurse educators to modify the nursing education curricula based on caring models within these meanings of quality of nursing care.

Applying “Roy adaptation model«for diabetes patients need carefully assessment and care planning based on principles of this model. But no study has done by that، up to now in our nursing. So، this study was done in order to assess the effect of nursing care plan designed based on “Roy adaptation model” on psychological adaptation in type II diabetics'' patients. The study was a quasi experimental one carried out on two groups; before and after intervention which was done in Parsian Diabetes Foundation in Mashhad in 2009. Samples were 60 diabetics’ patients selected non- randomly and allocated in two groups randomly. For data gathering “Roy assessment form”، adaptation strategies questionnaire، and HgA1C test were used. In “Roy assessment form”، maladaptive behaviors and their stimulators in psychological domains were determined. Then، nursing care plan was designed based on the results of it، and it was implemented for 2. 5 months and one month follow up. After this، data repeatedly gathered and analyzed by “chi-square test، t- test and Wilcocxon test” in SPSS17. Analyzing demographic data in two groups with chi-square test (x2) showed that they were matched (p >0. 05). Average of age was 48 ±7/3. Comparison of HgA1c before and after intervention in case group by paired t-test was significant (p >0. 05). Also، Wilcoxon test showed (p >0. 05) the decreasing of maladaptive behaviors in self concept and interdependence mode in case group. But role function mode did not show significant decreasing (p >0. 05). Applying the»care plan designed«based on “Roy adaptation model” for increasing psychological adaptation in type two diabetics'' patients is highly recommend.

Angina pectoris influences on work abilities، social interactions and daily activities of patients. This study examined the physical summary score of quality of life in patients with angina who underwent enhanced external counterpulsation. This was a quasi-experimental study. We studied 64 patients with angina who underwent enhanced external counterpulsation. Data were collected using demographic and clinical data questionnaires as well as health related quality of life Short Form 36 (SF-36) questionnaire (Iranian version) in three stages. The results were analyzed using descriptive and analytical statistics by applying spss. The mean age of patients was 65 (SD= 10/54) years old and male/female ratio was 38/26. The mean coronary artery disease duration was 8 years (SD=5/72) and about 70/3% had history of myocardial infarction. The results of study showed that the mean of all the subscales of physical summary scores showed significant improvement at the end of treatment and at 3 months after treatment compared to before enhanced external counterpulsation. Significant improvement is achieved in physical summary score of quality of life of patients after enhanced external counterpulsation. It appears that beyond 3 months this improvement continues to be significant in all the subscales of physical summary score. Therefore enhanced external counter pulsation can be used as noninvasive and effective treatment to increase quality of life in patients with angina

Low birth weight (LBW) infants need complementary interventions like massage because they are very fragile. Tactile Kinesthetic Stimulation is a kind of massage with passive joint motion that has very benefits for infants. LBW prevalence in our country has been reported 10% and these infants would have many developmental problems and dysfunction in future. The present study was done to determine the effect of Tactile-Kinesthetic Stimulation (TKS) in the reflex state of LBW neonates. This research was a clinical trial study in which 40 LBW neonates were randomly allocated into test (20) and control (20) groups. TKS was provided for three 15 minute periods per day for 10 consecutive days to the test group، with the massages consisting of moderate pressure strokes in supine and prone position، and kinesthetic exercises consisting of flexion and extension of limbs. All measurements were taken before and after completion of the study with the same equipment and by the same person. Results indicated that reflex state in the intervention group was not significantly higher than that in the control group after the 10 days TKS. TKS is not an effective intervention in reflex state of LBW neonates during the first days of life. Comparing this result with those of other researches، more studies need to be done in this field.

Fetal movement counting is a method that used by the mother to quantify her baby''s movements. Since 1970s a variety of counting techniques with different alarm limits have been developed few of which have been evaluated for predictive values and hence the clinical value of the absolute number of fetal movements has not been established. This cross-sectional study was carried out in 2011 in Educational and Medical Center of Alzahra in Tabriz. Three hundred singleton pregnant women at 32-40 weeks’ gestation having inclusion criteria were selected randomly from among women with complaint of decreased fetal movement. To perform the counting of three fetal movements in one hour and their recording in related chart was instructed by the researcher in a face to face manner. After the counting، pregnant woman was referred to ultrasound unit in order to perform the test of biophysical profile، then the two test results were compared with each other. According to the test of fetal movement counting، 99. 7% of fetuses were active and 0. 3% of them were inactive. On the basis of the test of biophysical profile، 96. 3% of fetuses had score of 10 and 3. 7% had score less than 10. In this study، a significant relationship was found to exist between the result of maternal fetal movement counting and biophysical profile (p< 0. 001). The sensitivity، specificity، positive and negative predictive value of the test of fetal movement counting were 100%، 96%، 9% and 100% respectively. The result of this study suggests the usefulness of maternal fetal movement counting as an early simple screening and noninvasive method in assessment of fetal well-being.

Fear of labor pain is one of the problems that raises the rate of caesarean section in our country. Midwifes can use one of the non-pharmacological pain relief methods such as reflexology، and they can encourage mothers to normal vaginal delivery. The aim of this study was to determine the effect of reflexology on the outcomes of labor in primiparous. This clinical trial study was carried out on 80 nuliparous women with low risk pregnancies that refer to Karaj hospitals. They were randomized into two groups، intervention group received reflexology for 40 minutes، and control group. The duration of labor، type of delivery and Apgar at 1&5 minutes were determined for both two groups. Duration of labor in the intervention group significantly was lower than the control group (p<0. 001). the difference between type of delivery، the 1st and 5th minutes Apgar score between two groups were different significantly (p<0. 001). Reflexology can lead to decrease duration of labor، increase rate of normal delivery and Apgar score. Therefore، we can use this non-invasive technique to decrease the labor pain and encourage mothers to normal vaginal delivery that is one of the aims of midwifery.

Asthma is the most common chronic disease of childhood، since adolescence is one of the most important periods، in development and asthma could interrupt the process. The present study is aimed to examine the effect of school students'' health promotion on the knowledge and practice on fellow students with asthma، «took place.

This quasi-experimental study of student peer education، forty individuals with asthma using a questionnaire and checklist before and after training compared. As well as the control group were forty students didn’t receive the educational intervention and knowledge and، practice of them were assessed and compared with the intervention group، And statistical data using independent t test، paired t، Mann Whitney analysis used.

The knowledge of peers of asthmatic student in intervention group was1. 3±0. 03 before the intervention and 80. 5±21. 5 six month after the intervention and difference was significant (p<0. 001). in control group with was 2. 2±1. 25 at beginning of study and 6. 9±5. 5 six months after and the difference was not significant. Also the practice of peers in intervention group was 2. 2±0. 8 before and 80. 9±18. 4 six month after the intervention and there was a significant difference between them (p<0. 001). in control group it was 0±0 at the beginning of study and 2. 4±1. 3 six month after study and the difference was not significant.

Educational intervention in peers of asthmatic student increased the knowledge and improved their، practice about the asthma disease. Such educational interventions were suggested in other chronic disease.

Quality of life is now recognized as an important outcome for adolescents with diabetes. Diabetes may affect men and women equally، but the suffering associated with the disease when it appears in adolescent girls will have disastrous effects on their life. This study aimed to evaluate the health-related quality of life of adolescent girls with diabetes. This descriptive-analytical study was carried out on 145 type 1 diabetic adolescent girls'' referral to the Urmia and Iran Diabetes Association. Data were gathered using quality of life valid and reliable questionnaire for Iranian adolescent girls with diabetes. Data were analyzed using descriptive statistical testes and independent T test. The total mean score of the quality of life of adolescent girls with diabetes was 67. 70. The lowest mean score in the adolescent girls'' quality of life was related to psycho-emotional subscale (61. 12) and highest mean score was related to spiritual subscale (76. 72). Results of the study showed significant difference between total mean score of the quality of life with duration of suffering from diabetes and HbA1c (p<0. 05). Diabetes related HRQOL information is clearly of supreme importance to care givers and health policy makers to identify and implement appropriate interventions for achieving better management of diabetes and ultimately improving the quality of life of adolescent girls with diabetes.

Medication errors are one of the important challenges of health care systems worldwide. It is also one of the threatening factors of patient safety. For this reason، medication error rate is used as one of the patient safety indicators. The aim of this study was to determine the frequency of medication error and its reporting، according to self- report by nurses in hospitals of Khoy in 2011. This study was a descriptive research. The study population included all nursing staffs of Khoy hospitals (n= 350). A questionnaire was used to gather the data about the perspectives of nurses on the frequency of medication errors and its reporting. Descriptive and analytical statistical analyses were performed with SPSS 16 software. The frequency of medication errors and its reporting were 28. 9% and 14. 4%، respectively. The most common types of medication error that reported were concomitant administration of oral drugs with potential interaction (57. 7%)، wrong rate error (46. 34%)، and giving pain medications without a physician''s prescription (44. 39%). There were a statistically significant relationship between medication error rate and age group (p= 0. 035). Medication errors occurred most frequently among nurses with 20-30-years age. There were also a significant relationship among medication errors and working hours (p=0. 023) and participation in retraining courses (p= 0. 033). There was a significant relationship between medication errors and its reporting rate (p= 0. 000). According to our findings، reduction in medication errors can be achieved by reducing the nurses’ work hours and holding retraining courses. In this study، a low report of medication errors has been revealed. Establishing an efficient recording and reporting system of medication errors along with minimization of barriers to reporting them may reduce the risk of medication errors.