Iranian Journal Of Nursing and Midwifery Research
Volume:17 Issue: 5, Jul-Aug 2012

Context: Vomiting is one of the most prevalent side effects of chemotherapy in cancer patients. The aim of this study was to evaluate the effect of ginger plant on chemotherapy-induced vomiting, since the previous studies were somehow imperfect and have provided controversial results. This randomized double-blind placebo-controlled clinical trial was conducted on 80 women with breast cancer undergoing chemotherapy and suffering from vomiting in Imam Khomeini Hospital, Tehran, Iran, between July and December 2009. During a convenience sampling the participants were randomly allocated into treatment and placebo groups after taking a written informed consent. Two groups were matched based on the age and emetic risk of chemotherapy drugs. The treatment group received 250 mg ginger powder capsules (Zintoma) and placebo group 250 mg starch capsules 4 times a day (1 g/day) for 6 days since 3 days before chemotherapy session. A two-part self-made questionnaire was used to assess the effect of ginger. Patients completed the instrument every day.Statistical analysis used: Then by STATA software version 8, the gathered data were analyzed using Fisher’s exact, Kruskal– Wallis, and Chi-square tests. The 2 groups had no significant age differences and were matched (ginger: 41.8±8.4 vs placebo: 45.1±10, P = 0.1). Vomiting cases were significantly lower in ginger group at anticipatory (P = 0.04), acute (P = 0.04), and delayed (P = 0.003) phases. Also, heartburn was the only and venial reported side effect (P > 0.05). Taking ginger capsules (for 6 days since 3 days before chemotherapy) accompanied by the routine antiemetic treatment could relieve chemotherapy-induced vomiting in all phases.

Clinical learning is one of the important issues that helps the perception of nursing students’ practice in a clinical setting and its effect on their professional development. The aim of this study is to describe and state the manner of clinical learning in nursing students. This qualitative study was conducted as a grounded theory. The individual semi-structured interviews and participants’ observations were taken into account with a purposive and theoretical sample of 27 participants. The data were analyzed using the grounded theory approach and the constant comparison analysis method. The results showed that students use two approaches of Micro- and Macrolearning. The first includes learning conditions and situations that act like a foundation for the second one (Macrolearning). Macrolearning is a continuous process including all categories of “Facing unfavorable clinical facts,” “Clinical situation and appropriate decision making,” “Bridging the gap between practice and theory,” “Struggle for clinical independence,” and “Dynamism” in a continuum reflecting the struggle to obtain clinical competency (core variable). Through provision of such conditions as students’ gradual acquaintance with real situations, selection of more resistant students, use of mentorship and preceptor ship in clinical learning, enhancement of educational standards in hospitals, handling collaborative learning methods to make a cooperation spirit in internship environment, and so on, students can be helped to obtain clinical competency.

Cancer and its treatments have a significant effect on the Quality of Life (QoL) of people who suffer from cancer. Nursing consultation involving cancer survivors might be beneficial for other patients as they successfully managed and lived with cancer. But controversies still exist in the research findings as how nursing consultation involving cancer survivors might influence other cancer patients’ QoL. Therefore, a research study was done to determine the effect of nursing consultation with the presence of cancer survivors on cancer patients’ QoL. The study was a quasi-experimental research using a pre–post test design, which was conducted in Sayyed- AL-Shohada Hospital affiliated to Isfahan University of Medical Sciences, Iran, in 2010. Twenty-two adult patients who suffered from acute leukemia who were receiving chemotherapy were selected. They participated in a nursing consultation group in which cancer survivors were actively engaged. The patients’ QoL was assessed before, 1 week, and 1 month after the nursing consultation using the European Organization for Research and Treatment of Cancer Quality of Life Core-30 Version 3 (EORTC QLQ-C30-V3) questionnaire. Comparing QoL mean scores of patients in the symptom, performance, and the general health status scales showed that there was not any significant change in the QoL scores before, 1 week, and 1 month after the consultation. It seems that the nursing consultation with the presence of cancer survivors couldn’t enhance patients’ QoL, although it might prevent worsening the patients’ QoL. Cancer has deleterious impacts on patients’ QoL and nursing consultation may not improve QoL in a short period of time. It is recommended that the study be conducted with a larger sample, in a longer time and with a case–control design.

Life-threatening and stressful events, such as myocardial infarction (MI) can lead to an actual crisis, which affects the patients spiritually as well as physically, psychologically, and socially. However, the focus of health care providers is on physical needs. Furthermore, the spirituality of the patients experiencing heart attack in the light of our cultural context is not well addressed in the literature. This study is aimed at exploring the spiritual experiences of the survivors of the MI. In this qualitative research a grounded theory approach was used. Key informants were 9 MI patients hospitalized in the coronary care units of 3 hospitals in Shiraz. In addition, 7 nurses participated in the study. In-depth interviews and a focus group were used to generate data. Data analysis was done based on Strauss and Corbin method. Constant comparison analysis was performed until data saturation. Five main categories emerged from the data, including perceived threat, seeking spiritual support, referring to religious values, increasing faith, and realization. The latter with its 3 subcategories was recognized as core category and represents a deep understanding beyond knowing. At the time of encountering MI, spirituality provided hope, strength, and peace for the participants. Based on the results we can conclude that connecting to God, religious values, and interconnectedness to others are the essential components of the participants’ spiritual experience during the occurrence of MI. Spirituality helps patients to overcome this stressful life-threatening situation.

Studies have shown that nurses are under considerable job stress, which can lead to health disorders and failure in duties. Stressors of nursing have been studied in some of quantitative studies; however, a few investigators have studied the nurses’ life experiences in this regard. The current qualitative research aimed to understand the nurses’ experiences and perceptions of job-related stress. This qualitative study was conducted in 2010-2011 by using the content analysis technique. Data were collected through individual deep interviews with 19 nurses working in hospitals affiliated to Kashan University of Medical Sciences. The content of data was analyzed by the Krippendorff method. Three categories were emerged including “nurses’ perception from the job stress,” “professional interest,” and “prioritizing career over family life.” The first category included the following subcategories of “being in constantly alarm situation,” “lack of experience,” “dignity and social status,” “lack of proper logistics,” “shortage of nurses,” “Irregularities in the organization,” “directors of nursing performance,” “undesirable relations among colleagues,” and “the patients conditions” all have effects on the nurses’ level of professional stress. The study participants defined job stress as a condition in which a nurse is under pressure so that the quality of care and the nurses’ personal and family life is interrupted. Being under continuous pressure, low social dignity, and the manner of nurse managers were among the important sources of job stress. Providing appropriate logistics, improving the coordination within hospital subsystems, and improving the managers and nurses relationships may decrease the stressors in nursing profession.

Adherence to diet and fluids is the cornerstone of patients undergoing hemodialysis. By informing hemodialysis patients we can help them have a proper diet and reduce mortality and complications of toxins. Face to face education is one of the most common methods of training in health care system. But advantages of video- based education are being simple and cost-effective, although this method is virtual. Seventy-five hemodialysis patients were divided randomly into face to face and video-based education groups. A training manual was designed based on Orem’s self-care model. Content of training manual was same in both the groups. In the face to face group, 2 educational sessions were accomplished during dialysis with a 1-week time interval. In the video-based education group, a produced film, separated to 2 episodes was presented during dialysis with a 1-week time interval. An Attitude questionnaire was completed as a pretest and at the end of weeks 2 and 4. SPSS software version 11.5 was used for analysis. Attitudes about fluid and diet adherence at the end of weeks 2 and 4 are not significantly different in face to face or video-based education groups. The patients’ attitude had a significant difference in face to face group between the 3 study phases (pre-, 2, and 4 weeks postintervention). The same results were obtained in 3 phases of video-based education group. Our findings showed that video-based education could be as effective as face to face method. It is recommended that more investment be devoted to video-based education.

Agitation is an early symptom of the acute opioid withdrawal syndrome in addicts that may start by inappropriate use of naltrexone. The current drug interventions are not efficient or need critical care as well. This study compares the clinical role of midazolam and diazepam for the management of agitation due to inappropriate use of naltrexone. In this double-blind randomized controlled clinical trial, 44 agitated addicts, who did not use any type of benzodiazepine, not on systematic central nervous system depressant drugs, without any known hypersensitivity to diazepam, midazolam, or any other component of their formulation and had no evidence for the need of critical care, were enrolled. An i.v. stat dose of 0.1 mg/kg diazepam and 0.1 mg/kg stat dose of midazolam and a 0.1 mg/kg/h infusion of these drugs were administered for different groups of patients, respectively. Agitation scores were recorded at 30, 60, 120 min after the start of drug administration using Richmond Agitation Sedation Scale score. A significant difference between the mean onset of agitation control in midazolam group (at 67 min) and diazepam group (at 81 min) was recorded. The difference of mean agitation score in the midazolam and diazepam group was only significant at 120 min. There was a negative correlation between agitation score and time elapsed from naltrexone administration to admission. Midazolam and diazepam may not be considered suitable and perfect pharmacologic agents for the initial controlling of agitation induced by naltrexone.

Diabetes has a high prevalence in Iran and it is estimated to rise from 3.5 million adults in 2005 to 5.1 million by 2025. Given the high prevalence of diabetes in Iranians, it is surprising how little is known about understanding of diabetes in public population. This study aimed to explore and describe people without diabetes explanation for the disease. This is a qualitative study, content analysis one, using unstructured, in-depth interviews, with the participation of 21 individuals without diabetes (13 = women and 8 = men), 18–61 years old, who were selected for this purpose in the cities of Isfahan and Tehran for the period of October 2010 to May 2011. The data was analyzed using latent content analysis method. The participants had different beliefs and ideas about diabetes and most of them suggested a negative and black image of diabetes. Although a small number of individuals considered diabetes better than AIDS and cancer, they often took diabetes as a black mass, end of romances, and a gradual death. However, it was a small study; the findings showed that the participants’ perspective on diabetes is negative and destructive. It seems shaping a new identity in the path of empowerment could be difficult within the social and cultural context. These findings can give an insight to health care providers to realize how important it is to find out about the public perception about diabetes. They are responsible to change or modify the public view on diabetes through introducing the disease via prominent people and educating individuals in the society on all aspects of living with diabetes, not simply the symptoms and disabilities it brings along.

To develop nursing education and promote nursing strategies, there is a need for a staff with positive attitude. The present study was conducted to compare the attitudes among clinical nurses and nursing students toward the nursing profession. In this descriptive study, 313 clinical nurses and 81 nursing students (total n = 394) of Tehran, Iran, were selected through a systematic sampling method and their viewpoints were investigated using a nursing professional attitude questionnaire. The findings of this study showed that 72.6% of nurses and 65.4% of students had positive attitude toward their profession, and despite the high percentage of the clinical nurses’ positive outlook, the difference was not statistically significant (P > 0.05). The results showed that approximately one-third of the students and nursing practitioners had neutral or negative attitude toward their occupation. Due to the serious effect of one’s professional attitude and commitment of service, it is necessary to have further studies about the current situation to eliminate such negative factors.

Obesity is common in patients with cardiovascular disease (CVD) and the vast majority of patients entering into cardiac rehabilitation program (CRP) are obese. Regarding the gender differences, the risk of developing coronary heart disease (CHD) is recognized to be different between obese men and women. So, the purpose of this study was to explore the effect of CRP in functional capacity (FC) and risk factors, such as obesity indexes, lipid profiles, and fasting blood sugar (FBS) in obese men and women with CHD.Marterials and In an observational study between 2000 and 2011, we evaluated a total of 156 obese men and women patients with CHD who were referred to cardiac rehabilitation of Isfahan Cardiovascular Research Institute. Before and after CRP, FC and risk factors were assessed and all the participants completed this period. Data were analyzed with SPSS software version 15. For comparing the mean of outcomes, independent t tests and paired sample t tests were used. Data revealed, after CRP, obese women had significant improvement in most evaluated risk factors except total cholesterol (P = 0.05) and FBS (P = 0.09); and obese men had favorable changes in weight (P = 0.00) and body mass index (P = 0.00), FC (P = 0.00) and total cholesterol (P = 0.02); in spite of no significant differences in other lipid profiles. Comparing the 2 groups did not show any significant differences unless high-density lipoprotein cholesterol (P = 0.01) and low-density lipoprotein cholesterol/ high-density lipoprotein cholesterol ratio (P = 0.02) had greater improvement in obese women. We concluded that CRP is an important step initiating the process of risk reduction and restoration of FC in obese men and obese women with CHD under attendance and supervision of physician, nurse, and exercise physiologist.

Breast feeding is universally and traditionally practicised in India. Experts advocate breast feeding as the best method of feeding young infants. To assess the role of various factors in determining colostrum feeding in block R. S. Pura of district Jammu. A stratified two-stage design with villages as the primary sampling unit and lactating mothers as secondary sampling unit. Villages were divided into different clusters on the basis of population and sampling units were selected by a simple random technique.Results and Breastfeeding is almost universal in R. S. Pura. Differentials in discarding the first milk were not found to be important among various socioeconomic groups and the phenomenon appeared more general than specific.

A healthy lifestyle is one of the basic health promotion strategies. Several factors are involved in shaping health promotion behaviors. The internal barriers are the opinion and feelings that surround the individual and are the reasons that complicate the change of behavior. The aim of this study was to identify internal motivations and barriers effective on the healthy lifestyle in middle-aged Iranian women. This is a qualitative study based on content analysis of indepth semi-structured interviews with 21 middle-aged women in the city of Yazd, selected using purposeful sampling approach. The interviews continued until data saturation was reached; and the interviews were audio-recorded and transcribed exactly. The transcripts were analyzed. Five main themes emerged from the analysis of the interviews. Women’s knowledge of health-promoting behaviors; importance of health and healthy behavior of women; Affliction or fear of affliction to chronic disease and its consequences; and responsibilities of women in the family and society: skills of life management in women.Discussion and The findings suggest that empowering individual participants in health promotion is the most important factor determining their health. Thus the design of appropriate programs, for to education and empowerment of people, is essential to promoting health. Health policy makers, with knowing of these factors, can design comprehensive, socialization programs to promote women’s health.