Iranian Journal Of Nursing and Midwifery Research
Volume:17 Issue: 7, Nov-Dec 2012

Islam clearly exempts fasting in Ramadan during sickness, pregnancy, and breastfeeding. Yet, some women prefer to fast despite realizing their increase in nutritional demand during pregnancy. Nurses and other healthcare providers face a difficult task of providing appropriate medical advice to Muslim women regarding the safety and impact of their fasting. The present study was conducted to examine the concepts and practices of maternal fasting during pregnancy in Pakistani Muslim women. A cross-sectional study was done in 2008 on 353 females from gynecology departments of hospitals in major cities of two provinces of Pakistan. Non-probability convenient sampling technique was used and a questionnaire was used to collect data from females who had experienced pregnancy during Ramadan at least once in life. Questions related to perceptions and practices of fasting in pregnancy along with demographic data were asked. Analysis was done on SPSS version 16. Chi-square test was used to assess associations and P < 0.05 was considered statistically significant. All ethical considerations were taken into account for the respondents. Out of the total, 309 (87.5%) fasted during their pregnancies while 43 (12.5%) did not fast at all. Among those who fasted, 42.5% (n = 150) fasted for the whole month, 23.8% (n = 84) fasted on alternate days, 10.5% (n = 37) fasted only on weekends/holidays, and 10.8% (n = 38) fasted on particular special days. The majority perceived no harm and risk caused by fasting to them or to fetus during pregnancy. Although adverse effects during fasting were frequently reported, only 24% break their fast. A significant association was found between gravida and education with fasting (P < 0.05). A total of 88% of women believed that fasting during pregnancy (in good health) is “obligatory” while 12% thought otherwise. Pakistani Muslim women showed a strong compassion for fasting in pregnancy despite overall decrease in maternal health indicators. There is a need for nurses and other healthcare providers in all Muslim countries and especially in non-Muslim countries with cultural diversity to be fully aware of the effects of fasting in pregnancy so that they can act promptly ensuring safe and healthy delivery.

Professional commitment has been widely discussed during the last decade. There is no comprehensive definition about “professional commitment in Iranian nurses.” Hence, this study was conducted with the aim of analyzing the concept of professional commitment in Iranian nurses. Hybrid model was used in three phases. Firstly, in the theoretical phase, data were retrieved from the CINHAl, MEDLINE, PubMed, OVID, Google scholar, and SID databases. The literature search used the keywords “professional commitment” and “nursing.” The final sample included 27 papers published in English between 2001 and 2011.Secondly, in the fieldwork phase, deep interviews with five clinical nurses were carried out, and thirdly, in the final analytical phase, the obtained data from theoretical and fieldwork phases were combined and a comprehensive analysis was conducted. Loyalty and tendency to remain in the profession and responsibility to the professional issues were extracted in theoretical phase. Commitment to promote caring abilities, satisfying of being a nurse, and belonging to the nursing profession were obtained in fieldwork phase. Finally, two main themes including “commitment to offering the best nursing care” and “commitment to promotion of the nursing profession” were extracted. Nursing is a humanistic profession; it has some particular characteristics due to the profession’s nature. In this paper, a definition composed of two main dimensions of professional commitment in nursing has been introduced.

There are several structured self-management education programs which are available nationally for patients with diabetes in the UK. This study was aimed to determine the factors influencing participation of patients with diabetes in the programs.Patients and A cross-sectional survey through semi-structured questionnaire distributed to 550 patients attending primary or secondary care diabetes services, as well to those in community venues, was conducted. The inclusion criteria were people ≥18 years with diabetes diagnosed for 1 year or longer. There was a lack of awareness of the programs among the respondents. There were statistically significant differences between tendency to attend the programs with demographic variables, qualification, and self-efficacy. The results also indicated that an individual will be more likely to participate in the structured self-management education programs if she/he feels at risk of complications, that diabetes complications are serious, and believes that the programs may help to avoid these risks. This study indicated the nature of multidimensionality of the factors influencing participation in the programs.

Although several studies have confirmed the validity and the strength of the student-centered approach and most training centeres have put it as the heading of their agenda, there are still problems in the method of implementation, increasing the need for further research to review the mode of implementation. In this regard, the present study has been conducted to investigate students’ and educators’ perception in terms of interaction manner in clinical education process.Settings and Design: This study was performed in a qualitative approach and by the conventional content analysis method. Data were collected until saturation through use of individual semi-structured interviews. Twenty-one subjects including undergraduate nursing students (8 cases), faculty member educators (9 cases), head nurses (3 cases), and educational supervisor (1 case) participated in the study, and the data were analyzed using MAXQDA3 software. “Student democracy” was extracted through data analysis as the main theme of the study. Participants’ experience in terms of the five sub-themes included instructor’s loss of dignity, negligence in the evaluation of the students, poor discipline, lack of compliance with the educator, and lack of motivation. Instructor’s weaknesses in planning, guiding, and evaluating the students led to student''s interference in these affairs and a challenge in effective student-centered approach. Although excessive emphasis on students’ opinion for educational evaluation is apparently a sign of tribute to the students, it ultimately contributes to ignoring the process of learning to attract students'' interest, occupational devaluation, ​​and a decrease in students’ motivation.

Nursing education is both formal and informal. Formal education represents only a small part of all the learning involved; and many students learn more effectively through informal processes. There is little information about nursing student informal education and how it affects their character and practice. This qualitative study explores undergraduate nursing student perceptions of informal learning during nursing studies. Data were gathered through semi-structured interviews with a sample of undergraduate nursing students (n = 14). Strauss and Corbin’s constant comparison analysis approach was used for data analysis. The categories that emerged included personal maturity and emotional development, social development, closeness to God, alterations in value systems, and ethical and professional commitment. Findings reveal that nursing education could take advantage of informal learning opportunities to develop students'' nontechnical skills and produce more competent students. Implications for nursing education are discussed.

Background and Goal: Burn is an irreparable event, which results in numerous physical, psychological, social, and economic complications. The burned patients should be merely treated in a professional burn center due to vast clinical range of these patients.Since, a percentage of mortality in burned patients is for the patients’ transportation from other centers; this study has aimed to investigate the manner of their transportation to Imam Mosa Kazem Hospital. This is a descriptive cross-sectional study on 98 subjects selected through sequential sampling from thermally burned patients being referred to Isfahan burn emergency center by ambulance from August 2011 to November 2011. The data including demographic information and event details, burned surface, burning grade and the province of origin were collected by a questionnaire, as well as a checklist related to caring team standards, transportation team, transportation equipment, and outcomes. The data were analyzed by descriptive statistical tests. Based on the findings, the longest transportation time was 6.35 (4.30) hours. There was no significant association between patients’ O2 intake and hypoxemia. There was no association between patients’ hypothermia and cooling the burn in the patients at the event location. There was a significant association between intake of fluid within transportation and urine output and hypovolemia (P = 0.00). Most of the defects of treatment were related to the equipments and infection control devices. The findings showed that burned patients’ transportation is so far from standards in Iran, and the authorities’ should pay specific attention to that in form of vast national investigations.

Evidence-based practice (EBP) is one of the main professional competencies for health care professionals and a priority for medicine and nursing curriculum as well. EBP leads to improve effective and efficient care and patient outcomes. Nurse educators have responsibility to teach the future nurses, and an opportunity to promote patient outcomes. Therefore, the aim of this study was to describe nurse educators'' knowledge and attitude on EBP. This was a descriptive study conducted in nursing faculties of two major universities of medical sciences affiliated to Ministry of Health and Medical Sciences in Tehran, Iran. Data were gathered using a three-section questionnaire. Content and face validity was further enhanced by submitting it to nursing research and education experts. Statistical analysis was carried out using SPSS 11 software. According the results, nursing faculties’ knowledge of EBP was mainly moderate (47.1%). Significant statistical relationship was found between the level of knowledge with education and teaching experience in different nursing programs. Nurses generally held positive attitudes toward EBP (88.6%) and there was no statistical significant relationship with demographic variables. Nursing educators are in a position to influence nursing research in clinical practice in the future. Therefore, it is critical to achieve implementation of EBP and be a change agent for a paradigm shift toward EBP.

Sleep is an essential part of life. Lack of sleep has been linked with increased morbidity and mortality. The objective of this study was to determine the sleep quality of older adults residing in a private elderly care institution in Malaysia. This cross sectional study was conducted among consenting residents of a 200-bed non-governmental charity old folks home in Penang, Malaysia. The sleep quality of the respondents was measured using the Pittsburgh Sleep Quality Index (PSQI). Quality of life (WHOQOL-BREF), their attitude to ageing (AAQ), Barthel index (Activities of Daily Living) and body mass index were also measured. Data was analysed using PASW. The PSQI score ranged from 0 to 16 with a mean score of 7.1 (SD 3.4) and 76.8% (116) had scores ³ 5. The differences in the mean score for chronic illness (t = 0.14 / P = 0.04), the people that could be counted on for help (t = 4.09 / P = 0.02) and the feasibility of getting practical help from fellow residents (t = 4.41 / P = 0.01) were statistically significant. There was a negative correlation between the PSQI score and the WHOQOL-BREF score (-0.318 / 0.00) and AAQ score (-0.332 / 0.00). Staff working in an elderly care institution should understand the important relationship of illnesses, social support and sleep hygiene in the wellbeing of the residents.

BACKGROUND AND GOAL: Weaning decision for the patients on a mechanical ventilation (MV) device is often made based on personal judgments and experiences, which results in longer MV length of stay and higher costs. Therefore, the present study aimed to the effect of application of Burn’s wean assessment program on MV length of stay among the patients hospitalized in ICUs. 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. Burn’s wean assessment program was employed in study group, while weaning was assessed by a physician in control group. The findings were analyzed by descriptive (frequency distribution, mean and SD) and inferential (independent t-test, chi-square, Fisher’s exact test, and Mann Whitney) statistical tests. The findings showed that length of MV was 134.2 (20.5) h which was significantly less than the control (P = 0.03). The results showed that application of Burn’s wean assessment by the nurses to assess patients’ readiness for weaning from the ventilator is a safe method in day time and shortens the length of MV in ICUs compared to the routine methods.

Burnout is a syndrome containing three dimensions of emotional exhaustion, depersonalization, and reduction of personal accomplishment. Nurses are exposed to professional burnout (PB) due to their exposure to physical, mental, and emotional stressors, which can lead to numerous complications in their personal, social, and organizational life. This study aimed to define the prevalence of PB amongst nurses working in hospitals in Tabriz and to detect its related effective factors in 2010. This is a cross-sectional analytical study conducted on all selected nurses working in hospitals in Tabriz. The questionnaires were filled and returned by 712 subjects after taking their consent. The data were collected by a questionnaire including questions on demographic characteristics and Maslach Burnout Inventory (MBI). Independent t-test was employed to compare mean quantitative variables in two groups of individuals with and without PB. Chi-square test was also adopted to compare the prevalence of PB in levels of qualitative variables. Logistic regression test was employed for multiple analyses of PB related factors. In this analysis, variables in level of 0.2 which had an association with PB as a single variable were entered to the model. Among the nurses taking part in the study, 156 (21.9%, CI 95%: 19.0–25.1) suffered from PB based on its definition. The risk of burnout is increased by 1.12-folds for each overwork night shift. Higher education increases professional burnout by 3.17-folds. The prevalence of burnout among nurses in Tabriz was revealed. Night shift and education level were shown to have an association with professional burnout.

Fractures of femur are among the most important causes of mortality in musculoskeletal injuries. Owning to lack of adequate research to compare various techniques of fracture stabilization, there has not yet been an agreement over a protocol to utilize a specific type of splint for femoral fracture immobilization. This study was thus conducted to compare the effects of simple and traction splints on pain intensityimmediately after and at the 1st, 6th, and 12thh after splinting among patients with femur fracture in the centers affiliated to Isfahan University of Medical Sciences (Isfahan, Iran). This quasi-experimental study was performed on 32 patients with femur fractures. Prehospital emergency ambulances were divided into two groups of simple and traction splints using a table of random numbers. Continuous convenient sampling was employed in each group to use either a simple or a traction splint for the patients with femur fractures. Pain intensity of the patients was then measured by a visual analogue scale (VAS) immediately, 1 h, 6 h, and 12 h after splinting. The effects of the two techniques were finally compared. After splinting, pain intensity decreased significantly in both groups (p=0.0001 in both groups). The reductions were significantly more in the traction splint group at the 1st, 6th (p=0.0001), and 12thh after splinting (p=0.02) compared with the simple splint group. There was no significant difference in pain intensity immediately after splintingbetween the two groups (p=0.441). The significant difference in pain reduction between the simple and traction splint groups at the 1st, 6th, and 12thh after splinting emphasizes the superiority of traction splints.

Stigma is one of the obstacles in the treatment and regaining the mental health of people with mental illness. The aim was determination of mental illness stigma among nurses in psychiatric wards. This study was conducted in psychiatric wards of teaching hospitals in Tabriz, Urmia, and Ardabil in the north-west of Iran. This research is a descriptive analysis study in which 80 nurses participated. A researcher-made questionnaire was used, which measured demographic characteristics and mental illness stigma in the three components of cognitive, emotional, and behavioral. All data were analyzed using SPSS13 software and descriptive and analytical statistics. Majority of nurses (72.5%) had medium level of stigma toward people with mental illness. About half of them (48.8%) had great inclination toward the social isolation of patients. The majority of them (62.5%) had positive emotional responses and 27.5% had stereotypical views. There was a significant correlation between experience of living with and kinship of nurses to person with mental illness, with prejudice toward and discrimination of patients. There was also a significant correlation between interest in the continuation of work in the psychiatric ward and prejudice, and also between educational degree and stereotypical views. The data suggest there is a close correlation between the personal experience of nurses and existence of mental illness stigma among them. Therefore, the implementation of constant educational programs on mental illness for nurses and opportunities for them to have direct contact with treated patients is suggested.

Despite so many unmet sexual health education (SHE) needs of adolescents, socio-cultural challenges have caused this issue to be ignored in different scoieties. This study investigated Iranian female adolescents’ experiences and perceptions with respect to SHE that they received at schools, and what they really needed, expected, and preferred. In this qualitative study, seven focus group discussions (44 adolescents) and 13 individual in-depth interviews were conducted among female adolescents aged 14–18 in Mashhad and Ahvaz, Iran, to explore adolescents’ experiences and perceptions towards SHE in Iranian schools. Data were analyzed using qualitative content analysis. Analyzing adolescents’ perspectives and experiences revealed their great dissatisfaction with SHE in schools. Emerged categories included: lack of obligation and priority for SHE, sexual reticence and evading, making adolescents frightened of sexual issues, inconsistency of SHE with adolescents’ needs, unqualified educators, and lack of appropriate educational materials. This study found some similarities between expectations of Iranian adolescents and those of adolescents from other cultures about an SHE program. Adolescents showed great abilities to appraise health services delivered for them, and so any program for sexual health promotion in adolescents ought to address adolescents’ needs, demands, and aspirations. Their contribution can provide insights for tailoring SHE programs for adolescents.

Cardiac syndrome X is a relatively common disorder, and still not much is known about the causative factors or its pathophysiology, which makes it difficult to cure. Due to its chronic nature and debilitating symptoms, many patients have significantly reduced quality of life (QOL).The purpose of this study was to assess the impact of phase III cardiac rehabilitation (CR) and relaxation on the QOL of patients. This research is a randomized clinical trial study. Forty eligible and consenting women (age 30–65 years) were randomly assigned to four groups. In the first group (n = 11), progressive muscle relaxation (PMR); in the second group (n = 11), phase III CR; and in the third group (n = 11), PMR along with phase III CR were performed for 8 weeks at home. The fourth group (n = 7) was used as the control group. Short form of QOL questionnaire (SF-36) was used for data gathering.Data analysis was performed using c2, Kruskal–Wallis, and rank sum difference tests. After phase III CR, relaxation, and combination of CR and relaxation, patients demonstrated improved QOL (P < 0.001). The results of post-test multiple comparisons showed that there were statistically significant differences between control and all intervention groups (P < 0.05). There was also statistically significant difference between relaxation and combination of phase III CR and relaxation groups (P < 0.5). An 8-week phase III CR program together with relaxation improved QOL of patients with cardiac syndrome X. We suggest phase III CR program together with relaxation as an effective treatment in these patients.

With regard to the importance of life skills, the present study deals with the effect of life skills training on general health of the students. This was a one-group, pre-test, post-test, quasi-experimental research. Forty students were selected through purposive sampling method. The data collection tool was Goldberg General Health Questionnaire. Paired t-test showed a 22 score significant decrease in general health after education compared to before education (P < 0.01). This study showed that life skills education increases general health level of the students.