Iranian Journal Of Medical - Surgical Nursing
Volume:1 Issue: 1, 2013

With recent increased survived infants, it is considered to have the discharge plan modified with the aim of increasing survival rate and decreasing morbidity and mortality. Accordingly, the purpose of this qualitative study was to describe the preparations for discharge of infants from neonatal intensive care unit. A qualitative study (Conventional content analysis approach) was used. Data collection was done through interviews with 18 nurses, physicians and mothers and participant observation in neonatal intensive care units of university hospitals in Isfahan and Tabriz, Iran. MAXQDA, a qualitative data analysis package, was used for coding. Two themes and six categories were identified including: Teaching mothers (motivation, educational needs, learning recourses and enabling teachings) and providing discharge criteria (maintaining neonate`s health and trust to mother`s ability). The result of the study revealed that not all, but some of the preparations elaborated during the process of discharge are incomplete and must be improved by developing a discharge plan to reach the ultimate goals of neonatal intensive care unit.

Nurse's participation in clinical affairs improves patient care and reduces costs. Also, the lack of correct and timely decisions can prolong the treatment and care for patients and create problems. The aim of study was to determine the effect of nurse's participation in patient weaning from mechanical ventilator and on its outcomes on patients hospitalized in intensive care units in Esfahan Al-Zahra Hospital. This is a clinical trial in which 50 patients connected to mechanical ventilators for more than 48 h were selected through convenient sampling and were randomly divided into two groups of 25 subjects. In the Intervention group patients were prepared for weaning by trained nurses three times in every 24 hours using Burn’s wean assessment program in three shifts. Control group weaning followed the conventional care unit procedures. Findings were analyzed using descriptive and inferential statistical methods (t-test, chi-square and Fisher's exact). The findings showed that length of MV (P=0.03), length of staying time in intensive care units (P=0.006) and the weaning failure from mechanical ventilator (P=0.01) were all significantly different in the two groups; however, the average arterial oxygen saturation 2 hours after removal from mechanical ventilation was not significantly different between intervention and control group. The results showed that nurse participation in the weaning process of the patients from mechanical ventilator is a safe method in day time and shortens the length of MVT and length of staying in ICU and, reduces the weaning failure compared to the conventional methods.

Regarding the increase in the elderly population, using nursing theories especially Orem self-care model can be effective in self- esteem improvement. This study aimed at evaluating the effect of implementing Orem self-care model on the self- esteem of the elderly resident in the nursing homes in Urmia In this quasi-experimental study, 50 elderly people who have inclusion criteria were selected through available sampling and were randomly divided into two groups of control (25) and intervention (25). Self- esteem was evaluated via Rosenberg self-esteem questionnaire before and one month after implementing the self-care program. Data were analyzed via SPSS software v. 16, using descriptive and inferential statistical testes. Results showed that in the control group, need level in 48% of the elderly was low, in 44% moderate and in 8% high. In the intervention group this level was reported low in 44%, moderate in 52% and high in4% of the subjects. Chi-square test did not show a significant difference between the two groups regarding level of needs (P=0.76). In the intervention group, the mean score of self-esteem before the intervention was 25.70 which increased to 27.96 after the intervention. The difference between the means scores of self-esteem in the two groups was significant (P=0/015). Implementing orem's self-care model had a positive influence on improving self- esteem of the elderly people. Therefore, nurses and other eldercare providers are suggested to reinforce self-care spirit in these patients, according to the nursing theories and health care programs, to improve self- esteem in the elderly resident in nursing homes.

Health Belief Model is a comprehensive model in helping prevent diseases. According to this method, individuals who get sensitive to breast cancer are more motivated for a regular self-breast examination. Considering the 24 % of breast cancer in Iran placing the third leading cause of death in women, the present study was carried out to investigate the impact of teaching two methods of self-examination, based on health belief model, on knowledge, attitude and performance of school teachers in Zahedan. In this quasi –experimental study, the impact of two education methods (lecture & simulation) was investigated on knowledge, attitude (HBM) and performance as pretest and posttest on 100 school teachers in a multi-stage random sampling with inclusion criteria of at least 25 years of age, without a family history of breast cancer, and majoring in fields unrelated to medicine on Zahedan school teachers in 2008-2009’. Data were collected via standardized Champion questionnaire designed based on Health Belief Model and, then, analyzed applying SPSS V.15 and T paired, T students, correlation Pearson and, linear regression tests. Changes of knowledge, attitude (HBM) and performance mean scores obtained by paired T- test was significant in the both groups. However, between the two groups, only the performance mean score of the two groups was significantly different. Perceived severity Structures and self-efficacy showed a direct association with performance, while perceived barriers were inversely associated with performance. The only predictive variable of effective learning based on linear regression was health motivation. The current study confirmed efficacy of health belief model on promotion behavior of self-breast examination. Therefore, this model can eliminate barriers which lower self-efficacy in breast cancer and self-breast examination. It also provides a motivation in learning self-breast examination.

mouthwash helps prevent and treat mucositis. The aim of this study was to investigate the effect of honey mouthwash in the prevention mucositis due to head and neck radiotherapy In this clinical trial, single blind study, 80 patients with head and neck radiotherapy who attended in radiotherapy ward in Shafa Hospital, Kerman, 1389, was investigated. Applying simple sampling technique, the cases were selected and randomly divided into two groups of control and experiment. The experiment group (N=40) would gurgle 5 spoons of honey mouthwash after tooth brushing, and control group (40) used water as mouthwash. In this 14-day study, subject's mouths were examined regarding mucositis, based on WHO grading scale on the 1st, 7th, and 14th days. Data were then analyzed applying SPSS, v.16 and employing Fisher exact test, and Mann-Whitney test. In the experiment group, in the units under study the severity of mucositis was mild in the first day (42.9%) and lacking mucositis in both the 7th (62.8%) and 14th (68.6%) days. In the control group, the severity was mild in the 1st day (29.5%) in the most units under study, and was mild and moderate in the 7th (29.4%) and 14th (32.4%) days, respectively. There was a significant difference between 2 groups regarding mucositis intensity in the first, seventh & fourteenth days (P<0.000). Since mucositis can be easily prevented by using mouthwash, honey mouthwash can be applied to prevent mucositis and reduce its intensity in head and neck-radiotherapy units.

Myocardial infarction is the leading cause of death in Iran and the world. Differences in signs and symptoms sometimes delay the diagnosis. This study aims at comparing clinical signs and symptoms of acute myocardial infarction in men and women. This analytic - descriptive research was carried out on 110 patients (36 women and 74 men) with MI experience who referring in emergency wards of Imam Reza (PBUH) and Ghaem hospitals. The subjects were selected randomly sampling. Data were collected from sample forms, individual information forms; the pain characteristics record forms, electrocardiogram and laboratory forms, pain numerical rating scale, Mc-Melzac pain questioner and electrocardiogram machine. The results showed that Chest pain was the most common initial symptom in both men and women so that 77% of women and 89% of men complained of chest pain. Intensity of infarction angina in women was more rigorous than men (P=0.04). Quality of pain described as sharp pain by most women and burning pain by men (P=0.01). Concerning accompanying signs, 63% of women and 75%, 55%of men reported sweat and nausea respectively which was not significant difference (P= 0.1).For other symptom (shortness of breath) chi square showed significant difference (P=0.03). Pain was reported to spread to back and left shoulder in most women and to left shoulder in most men. findings showed that women who have MI are different on comparing by men from view of intensity, quality and location of pain.

Introduction & Acute coronary syndrome is health threatening and a major cause of mortality in elderly. Recognizing factors associated with symptoms of acute coronary syndrome are important in reduction of consequences of delayed diagnosis of symptoms. This study proposes to examine factors associated with early symptoms among elder with ACS. This is a cross sectional study. The early symptoms of 446 patients with diagnosis of ACS were assessed eight hospitals at Tehran-Iran (2006). Symptoms categorized as typical and atypical symptoms. Correlation between demographic and risk factors with age group and early symptoms were assessed using the chi-square test. Multivariate logistic regression analyses were conducted to determine factors related to early symptoms acute coronary syndrome. Elder (≥65yr) and younger (≤65) have a statistically significant difference in chest symptoms, arm pain, jaw or neck pain and dyspnea (P<0.001). Palpitation was the most common reported symptom in patients over 65 years (38.19%) and less than 65 years (37.08%). Multivariate logistic regression showed that elder patients with a history of hypertension (P=0.002, OR=0.43), smoking (P= 0.019, OR=0.51), and obesity (P=0.011, OR=0.69) have less chance to experience the early symptoms compared to younger patients, respectively. Obesity, hypertension and smoking are risk factors which lower the initial symptoms of acute coronary syndrome in the elderly.Nurses and physicians should be careful attention in history taking of elderly suspected to acute coronary syndrome.

Primary dysmenorrhea is a common gynecologic problem in teenage girls and women of reproductive age that has an adverse impact on women's quality of life. The aim of the present study was to determine the effects of oral Aloe vera gel on the intensity of primary dysmenorrhea in students of Zahedan University of Medical Sciences. This double – blind clinical trial was conducted over 80 students who suffered from primary dysmenorrhea. The subjects were matched in terms of dysmenorrhea severity. Then they were randomly divided into 2 groups of 40 subjects each. They were similar in age, menarche, body mass index, and length, and duration of bleeding. The subjects in the intervention group were given a bottle containing 120 cc Aloe vera gels for every cycle, and control group were given a bottle containing 120 cc placebos for every cycle, each. Subjects took one tablespoon of the given medicine every day, starting two days before menstruation until the first 3 days after the onset menstrual cycle for two successive cycles. Drug effects on dysmenorrhea severity were evaluated via verbal multidimensional scoring system. Data were analyzed using SPSS software and descriptive and inferential statistical testes. Findings showed that there was a significant difference between aloe vera and placebo groups concerning the intensity of pain, number of Analgesics and amount of bleeding (P<0/05), but no significant difference was observed regarding the side effects (P>0/05). Aloe vera seems to reduce the severity of dysmenorrhea so it can be a replacement to non-steroid anti-inflammatory tablets.