فصلنامه حیات
سال هجدهم شماره 4 (پیاپی 55، زمستان 1391)

Pain is an unpleasant experience related to potential or actual tissue damage. Distraction is an effective technique to control pain. This study aimed to examine the effect of pressing a small soft ball during intravenous catheter insertion on pain related behavioral responses of children. Methods & Materials: A randomized clinical trial study was conducted in surgical ward of the Qods hospital in Qazvin، Iran in 2010. Sixty children aged 4-6 were selected through a simple randomized sampling method. The children were allocated into two equal intervention and control groups. Data were collected using the FLACC scale. In the intervention group، children were asked to press a soft ball during IV catheter insertion. The researcher marked the FLACC during the procedure. In the control group، no distraction was made during the IV catheter placement. The data were analyzed using descriptive statistics، independent-sample t-test، Chi square at P<0. 05.

There was no significant difference between the two groups in terms of demographic variables including gender، birth order، race، age and type of disease. In the intervention group، none of the children experienced severe pain during IV catheter insertion; and 63. 3% of the children had moderate pain. In the control group، 50. 0% of children had moderate pain and 23. 3% of them experienced severe pain during IV catheter insertion. There was a significant difference in perceived pain between the children of two groups (P<0. 001).

Distraction is an effective، non-expensive، and easy-to-access technique to control and reduce pain in children during IV catheter placement. This study showed that distraction through pressing a soft ball was effective in reducing the behavioral responses of pain in children who underwent IV catheter placement.

Most of the psychological turmoil of marital conflicts is related to sexual dissatisfaction. Sexual satisfaction is influenced by physical and mental illnesses. Pelvic floor muscle relaxation is a major health problem in which prolapsed pelvic floor muscles causes paralysis، pelvic organs'' prolpases، pelvic organs'' dysfunction، dyspareunia، and back pain. The aim of this study was to assess the effect of pelvic floor muscle exercise on sexual satisfaction in primiparous women. Methods & Materials: This clinical trial was conducted among 100 primiparous women selected through cluster randomized sampling from five clinics of Tehran University of Medical Sciences. Samples were randomly divided into two equal groups. The intervention group received pelvic floor exercises (Kegel) for 16 weeks. The control group did not receive any intervention. Data were collected using the Linda Berg questionnaire before the intervention and 16 weeks after the intervention in both groups. Data were analyzed using descriptive statistics and chi-square، t-test in the SPSS v. 18. After 16 weeks، significant differences were reported in the levels of sexual satisfaction in the intervention and control groups (P<0. 001). The Kegel exercises are easy and non-expensive methods that should be offered by health professionals to increase sexual satisfaction in women after childbirth.

Asthma is one of the most prevalent chronic diseases worldwide. About 6. 5 million people suffer from asthma in Iran. The Effective strategy to control asthma is related to education. The self-management has a major role in the standard education program. This study aimed to assess the effect of education on using peak flow meter and follow up via SMS on asthma self management. Methods & Materials: This study was a quasi-experimental controlled clinical trial. The samples included 98 patients، suffering from asthma referred to the pulmonary clinic in Imam Khomeini and Shariati hospitals. Patients were selected using convenient sampling method and were randomly assigned into the experiment (n=47) and control (n=51) groups through blocking method. Two educational sessions were held in the experiment group about how-to-use peak flow meter. Accordingly، the patients in the experiment group sent their peak flow rates via SMS to the researcher within 12 weeks. The researchers provided feedback to the patients about their asthma control via phone، weekly. Patients in the control group did not receive any education. Data were collected using the Asthma Control Test before and three months after the intervention. Data were analyzed using the statistical tests of Chi-square، Mann-Whitney، Independent t-test and Kolmogorov-Smirnov.

There was a significant statistical difference between the two groups of experiment and control in terms of asthma control (P=0. 002).

The education using peak flow meter and following up via SMS promotes asthma self-management. With regard to the significant role of nurses in patient education، educating patients with asthma by nurses is recommended at the Iranian Society of Asthma and Allergies clinics and medical centers.

Nurses are informed from patients needs using effective mutual communications. This study aimed to explore the communication strategies between nurses and patient. Methods & Materials: This study had a qualitative approach with the content analysis method. Participants included 23 nurses، patients and their families in medical and surgical wards of Imam Khomeini hospital of Tehran University of Medical Sciences. Data were collected using interviews and observations. The first and second interviews were conducted unstructured. The semi-structured interviews were then conducted according to the derived concepts from the first and second interviews. We used observation in order to gain a deeper understanding and verifying data from interviews. The observations focused on the interactions between nurses and patients during mutual communications. A final theme was emerged through the data analysis: adaptation of nurses'' attitudes and performances. This theme derived from three main categories: caring according to acute needs of patients، creating a professional realm، and participation. The caring according to acute needs of patients included subcategories such as identifying patients'' acute needs and nurses'' communication behavior. Creating the professional realm implicated on the clarifying roles and maintaining of privacy communication. Participation was defined as the audience and content. The findings showed that nurses، in response to the underlying conditions of nursing care، assimilate their attitudes and performances to be able to meet their professional needs and their patients'' needs. In fact، the main character of nurse-patient communication is nurses'' active role and patients'' passive role.

Implementation of the motivational program by nurse managers can improve nurses'' performance and behaviour، provide better care for patients، and promote patients'' satisfaction. This study aimed to determine the effect of implementation of the motivational program designed using «Expectancy Theory» by head nurses on patients'' satisfaction. Methods & Materials: This was a quasi-experimental study conducted in medical and surgical units of two hospitals in Zanajn in 2011. Data were gathered using a patient satisfaction questionnaire. The reliability of the questionnaire was confirmed (α=0. 72). Fourty participants were selected and allocated in two study groups. The groups were matched for some variables before the intervention. The motivational program was implemented in the intervention group for five months. The program had two designing and implementation phases including: 1) determining nurse managers'' expectancies from nurses، assessing nurses'' attitudes about valuable rewards، founding reward management committee and management improvement committee، and providing evaluation checklists for nurses'' performance; 2) implementing standards of nursing care and patient education by nurses، monthly evaluation of nurses by head nurses and collaborative members of the reward management committee، determining level of rewards based on the results of nurses'' performance evaluation، and giving reward to nurses at the end of each month in a reward ceremony. Data were analyzed using the Paired t-test، Independent t-test، Mann-Whitney، and Chi-squared in the SPSS v. 16. There were no significant differences between the two groups at baseline dealing with the demographic variables. The results showed that patients satisfaction was significantly higher in the intervention group after the intervention (P<0. 05). This motivational program designed based on the «expectancy theory» has clear steps to be implemented among nurses and can be used as a practical guide by nurse managers to improve patients'' satisfaction.

Poor sleep quality is a common problem among patients hospitalized in the CCUs. This study aimed to determine the effect of environmental factors modification strategies on quality of sleep among patients admitted to CCU. Methods & Materials: This was a quasi-experimental study with a single-blinded design. Sixty patients admitted to the CCU of Shariati hospital were divided into two experiment and control groups. Sleep quality was measured in the first day of admission and three days later using the Pittsburgh sleep quality index in both groups. In the intervention group، we implemented a modified work environment between the two measurements. Data were analyzed using the Chi-squared and t-test in the SPSS v. 18. Findings showed a significant decrease in sleep quality in the control group after hospitalization، compared with the intervention group (P<0. 001). There were no statistically significant changes in the sleep quality before and after hospitalization in the intervention group (P=0. 053). Using environmental factors mitigation strategies can improve sleep quality of patients admitted to CCUs.

This study aimed to assess relationship between perceived benefits/barriers and decisional balance with stages of change for physical activity among high school students in Bandar Abbas، Iran. Methods & Materials: This cross-sectional study was conducted in high schools of Bandar Abbas، in the south of Iran. A total of 422 high school students were selected. Twenty two participants did not fill out questionnaires completely. A total of 400 questionnaires were analyzed (response rate=94. 8%). The perceived benefits/ barriers to exercise and decisional balance were assessed using the Exercise Benefits/Barriers Scale; and stages of change were assessed using the Physical Activity staging. Data were analyzed in the SPSS v. 16.

The mean age of the participants was 15. 9 (SD=1. 1) ranging from 14 to 18 years. More than half of the participants (51. 8%) were male and 48. 2% were female. About half of the participants (49. 2%) were engaged in regular physical activities. Fifteen per cent of the participants in the precontemplation stage، 15. 8% in the contemplation stage، 20% in preparation stage، 15. 8% in action stage، and 33. 4% in maintenance stage for physical activity. From precontemplation stage to maintenance stage، the perceived benefits and decisional balance were increased and the perceived barriers was decreased.

The results of this study are in line with the Transtheoretical model. This model can be used as a framework to design interventions for improving physical activity in population.

Stress is a main problem among nurses which affects their professional performance and personal life resulting in conflict between work and life. The aim of this study was to determine the effect of stress management on work-family conflicts. Methods & Materials: In a quasi-experimental two-group study، 64 medical nurses were selected randomly to the study from Shahid lavasani hospital in Tehran. Data were gathered using a questionnaire including demographic characteristics، work-family conflict items، and nursing stress scale. Then، the experimental group participated in a 2-day stress management course. The questionnaire was completed by the participants one month later. Data were analyzed in the SPSS v. 18.

The mean work-family conflict score was 3. 97 in the experimental group at baseline. It declined after the intervention to 3. 357 (P<0. 001). There was statistically significant difference between the two groups on work-family conflict after the intervention (P=0. 007). There was a significant decrease in the job stress from baseline (46. 52) to the post-intervention measurement (35. 61) in the experimental group (P<0. 001). There was a statistically significant difference between the two groups in the mean of job stress after the intervention (P=0. 014).

Stress management education declined work-family conflict and job stress among nurses. This education should be used in nursing clinical and educational training programs.

Production of knowledge in nursing and midwifery is essential to develop body of knowledge and improve quality of health care. In recent years، growth rate of scientific publication in Iran was significant as it could be considered as a scientific jihad. Although everyone is proud of this accomplishment، an important question remaining in nursing and midwifery is that how the pace of scientific publication in these fields is consistent with the pace of scientific publication in other scientific fields. This editorial tries to answer this question. Through searching the Scopus for Iranian papers during 2008-2012 articles، I found 1063 articles in nursing and midwifery indexed in the Scopus. The number of articles was almost doubled per year within the last five years، excluding 2012. It implies coordination of scientific publication in nursing and midwifery with rapid growth of total scientific activities in other scientific fields in the country. On the other hand، findings showed that only 29 articles (2. 7%) published by Iranian nursing and midwifery researchers were review articles. While، in the UK، 13. 5% of articles in nursing and midwifery was review articles. This finding along with the importance of review articles as credible scientific evidence for clinical decision-making and improving management procedures shows the necessity of writing review articles by senior researchers in Iran. Comparing nationality of authors between Iranian articles with the UK articles showed that only 154 Iranian articles (about 10%) had a non-native author; while، in the UK articles، about half of the articles had non-English collaborating authors. This finding reveals the necessity for further efforts to international studies. Through searching the Pubmed and Web of Science for Iranian articles during 2008-2012، we found 390 and 174 Iranian articles، respectively. The lower rate of articles indexed in these two databases، comparing to the Scopus، indicates the necessity of designing and conducting high quality studies and submitting articles in journals indexed in these two databases. Writing articles which observe principles of scientific writing in proper English language can increase the probability of acceptance of articles in more valid journals. Indexing Iranian nursing and midwifery journals in authoritative indexes can increase the rate of scientific publication. It requires more attention of administrators and editors of Iranian scientific journals to this critical issue.