نشریه پرستاری مراقبت ویژه
سال پنجم شماره 4 (پیاپی 17، زمستان 1391)

Understanding the experiences of mothers could be as a strategy for the physicians, nurses who are working in NICU and administrators in the care centers in order to provide supports for parents, particularly mothers and an effective step to improve the quality of nursing care of premature infants and their parents.

In this study, one of the qualitative research methods as descriptive phenomenology was used with Colaizzi approach. Data were collected through semi-structured interviews with 20 mothers with experience of a preterm infant in intensive care unit of treatment- educational centers of children and Alzahra(s) of Tabriz to share these experiences in 2010.

Among all the results of this study 4 themes were emerged which indicated structure of mothers’ experiences of hospitalization of a preterm infant in NICU. Themes and subthemes of this study were as: Sense of Alienation, Lack of control, Caring and Depravation.

According to the findings mothers were encountered with some positive and negative experiences. In this regard nurse’s practice was so effective to mothers’ ability and their partnership in taking care of the infant in order to form positive experiences and reduce the negative ones. Thus promoting some methods to support mothers’ feelings and to share caring of their babies seems to be necessary.

Nowadays, myocardial infarction is one of the cardiovascular life threatening diseases. After myocardial infarction, many patients experience psychological reactions such as stress. These emotional reactions can lead to increased treatment costs, mortality; delay of recovery and cardiac ischemia progression. The present study was done with the aim of “studying the effect of tactile touch on stress level in patients with myocardial infarction”. This quasi-experimental study was performed on 80 patients with myocardial infarction that were hospitalized for the first time in Zahra Heart Center in Shiraz during 2011 and 2012. Patients were randomly in two groups of intervention and control. For patients in the intervention group tactile touch was performed five days, it was half an hour every day. Questionnaires DASS-21 was used for data collection. Data were analyzed through SPSS version 15 and by using descriptive statistics and analytic statistical tests. Stress in patients with myocardial infarction after tactile touch period had a significant decrease (p<0.001) compared with that before intervention. Also, after tactile touch, Significant difference between intervention and control group was observed (p<0.001). This result reflects the positive impact of this method in reducing stress in these patients. Using tactile touch can be effective in reducing stress in patient with myocardial infarction. Training nurses in using this method can be effective in reducing these patients’ stress.

H emodialysis Patients suffer from many problems and complications during disease and their treatment.One of the most important and common problems is hypotension and dialysis adequacy.This study has been designed and implemented to determine the effect of hypertonic glucose on dialysis adequacy and blood pressure in non-diabetic dialysis patients. The present study was a quasi-experimental and single group study that 45 none-diabetic hemodialysis patients from the chosen hospitals were selected and hypertonic glucose infused patients for two weeks and three times a week, after two weeks durability, patients were assessed without manipulation for two weeks. In addition blood pressureand dialysis adequacy of the patients were measured in manipulation phase before and after each infusion of hypertonic glucose. Data collection tools included demographic information and dialysis adequacy was calculated by Daugirdasformula at the end of every stage in two study environments.then the data were analyzed by using SPSS 17 software and descriptive statistical tests (abundance- mean),inferential tests (paired t test, mane Whitney, Friedman, Kruskal-wallis and wilcoxon) The results showed thatdialysis adequacyand also blood pressure of the patients had been increased significantly in manipulation phase (p=0.001). Andanalysis of data between the gender (p=0.001) and vascular access (p=0.001) showed significant differences (p=0.001),but inother cases, there was no significant difference. results of this study showed thatinjection of hypertonic glucose increased dialysis adequacy in hemodialysis patients significantly and prevented hypotension.

Observing ergonomic principles during taking care of the patients by the nurses of ICU units can prevent many musculoskeletal damages. Regarding this, diagnosis of special related factors of every area can make it possible to have preventive effective program. The aim of this study was determining related factors of nurses’ Body posture Ergonomic during position changing of patients in intensive care units. In this analytic cross-sectional study all the nurses with determined characteristics of the study (n=91) had been assessed in intensive units of educational -therapeutic centers of Rasht in 2010 by census method and a 3-part tool including questionnaire of demographic factors, Knowledge and environmental factors that effect on Ergonomics during position changing. Data were collected by self-report method and observation and have been analyzed by inferential tests under SPSS software. The findings showed that almost half of nurses had moderate knowledge about ergonomics science (49/4%) and did position changing under desirable environmental condition (45/1%). According to GEE model, single samples with normal BMI and less work experience in ICU (p<0, 0001) among demographic factors, lack of adjustability of beds “parts “and “height” in work environment and poor knowledge were related to undesirable ergonomic condition. The findings highlight necessitation of considering proper planning for controlling preventive related factors of ergonomic in ICU units during patients’ position changing such as knowledge deficit, using present technologies and maintaining appropriate BMI.

One of the important aspects of life quality is sexual function. Chronic renal failure and its treatments have effect on sexual function. The aim of this study was to investigate sexual function of women with chronic renal failure undergoing hemodialysis and factors related to it. In this cross sectional study, one hundred women with chronic renal failure undergoing hemodialysis at four dialysis units in Karaj were interviewed in 2011 and also their medical records were investigated. Sampling method was census sampling. The instruments used included: demographic data form, the (CES-D) center of epidemiologic studies of depression scale and Female Sexual Function Index (FSFI) and World Health Organization life quality (WHOQOL- BREF) questionnaire. Data was analyzed by SPSS software and using descriptive statistics, t-test, ANOVA and coefficient Pearson correlation. The findings indicated that mean score of female sexual function index was 13.22 ± 8.58 (1.2-36 range) and 100% of women had score of female sexual function index lower than 28. Sexual desire decrease, 62% sexual arousal decrease, 52% vaginal lubrication decrease, 60% failure to orgasm, 33% sexual dissatisfaction and 54% dyspareunia were experienced. There were significant inverse correlation between score of female sexual function index undergoing hemodialysis with creatinine level (p=0.016), depression (p=0.016) and positive correlation with hemoglobin level (p=0.001) and total score of life quality (p=0.006). The presence of diabetes showed significant relationship with score of female sexual function (p=0.049). with regard to sexual dysfunction prevalence among women with chronic renal failure undergoing hemodialysis and negative impact on life quality, it seems that in order to provide holistic nursing care, assessment and planning for treating it, is necessary.

Professional nursing is recognised for having high working anxiety levels due to continuous interaction with patients, their family and colleagues in a high stress working environment. As a compilation of non cognitive skills and abilities, emotional intelligent could be helpful in controlling stress and increasing the individual’s productivity at work. Intensive Care Units’ employees experience higher stress levels as compared to General Units’. This study was conducted with the aim of comparing the emotional intelligence in general and Intensive Care Units. This descriptive sectional analytic study was conducted on 212 participants of who were randomly selected from the individuals employed in the specialized and General Units of selected military hospitals of the city of Tehran, in 2011. In order to assess the emotional intelligence, Bradberi and Greaves (2005) Emotional Intelligence Questionnaire including 28 questions and 5 levels was used. The data obtained from this study was analysed using SPSS 17. software application’s descriptive analysis and statistical test. The average emotional intelligence score for nurses 79.4 (±7.3) was calculated. The average relative frequency of emotional intelligence scores were categorized in five levels; Excellent (10.4%), Good (38.2%), Required Assistance (42.5%), Requires Work (8.5%) and Warning (0.5%). The highest frequency of emotional intelligence among the nurses employed in General Units was observed in Good level (46.1%). The highest frequency of the level of emotional intelligence among the nurses employed in Intensive Care Units was observed in Requires Assistance level (47.2%). This difference between general and Intensive Care Units was statistically significant (p = 0.02).

Aims a: Intensive care units are one of the most sensitive parts of each hospital; codification of appropriate structural standards and its measurement improve the quality of services in those units. So this study had been done with the aim of “determining structural conditions of intensive care units” : This cross-sectional study had been designed for measuring structural standards of intensive care units in three areas of human force physical conditions and medical equipment in educational hospitals of Hamadan and comparing it with the last existing standards according to international guidelines and principles and accreditation standards of Iranian hospitals and it had been performed from April to September of 2011. Data were collected via completing assessing forms with direct observance of the researcher and they had been analyzed by using statistical tests, ANOVAs (variance analysis) and Spearman in SPSS (17) software. All the three units of the study achieved less than 50% score of structural standards among the total 843 score that Besat intensive care unit 48% (the mean score 406)، Ghaem intensive care unit 45% (the mean score 376) and Milad intensive care unit had 41% (the mean score 346) of the standards. The most percent of the standard score was related to human force with (%58) and the least one was related to physical conditions and facilities with (%38). In intensive care units of the study, achieved scores in structural domination was less than appropriate standard level. Therefore it had been suggested that the executives consider achieving global standards specially promotion of structural standards that is guarantor of quality promotion and optimization performance of intensive care units.

Nowadays nosocomial Infection control is one of the important management issues in neonatal intensive care unit that in this context, the NICU’s physical structure can improve infection control processes or interfere it. The aim of the present study is assessing physical environment of neonatal intensive care unit from the perspective of nosocomial infection control indicators. This study is a descriptive cross sectional study in 2011with statistical population of 11 neonatal intensive care units and research environment of all includes 10 public hospitals of Tehran Medical Sciences University. The study tools had been taken from the 7thand latest report of the “Recommended standards for the NICU design” proposed by consensus committee. The researchers completed check list by observation method and analyzed data by using descriptive statistic and spss software of version 14. The findings of this study suggested that there have been observed lack of compliance with all the recommended standards in all the studied sections about air conditioning, features of NICU section levels, sink, neonates care space, isolated room and the features of contaminated instruments storage space, which are indicators of infection control. According to the existence conditions of the physical environment of NICU, it has been suggested to observe recommended standards of designing NICU in constructions that are building or are being renovated for providing suitable implementation in order to activate infection control programs.