مجله پژوهش پرستاری ایران
پیاپی 29 (تابستان 1392)

The objective of this study was to explain the perspectives of managers regarding change management in nursing and midwifery faculties. This study was conducted according to the qualitative approach; in fact، a descriptive exploratory method was applied with triangulation. Snow ball sampling method was used. Subjects composed of managers in nursing schools in Tehran and the inclusion criterion was at least 1-year experience. In qualitative phase، no variable was measured. Data were gathered by semi-structured interviews in which a guide and field notes were used. Data were saturated after observing the repetition of codes. Content analysis was used for data analysis. The trustworthiness was achieved by a prolonged field experience، member check، peer check and sharing the content with two experts in qualitative research. Ten participants (7 females and 3 males) between 38 and 54 were interviewed. 2 of them had Master degree and 8 with Ph. D of nursing; only 3 of them were in high-level management of their faculties. After interviews، 124 conceptual codes، 15 sub concepts and 3 core concepts were extracted. Accordingly، the concept of change management was postulated as the purpose of this study. Furthermore، its influencing factors were identified. The implication of the study is in the faculties of nursing and midwifery to use the model according to organizational culture.

Disaster management role in the acquisition of hospital preparedness for responding to disasters plays. Coordination is the most problem of disaster management in Iran. Therefore in this study، Coordination Based Disaster Response Model as a practical solution، was investigated. The aim of the present study was The Evaluation of application of Coordination Based Disaster Response Model in Rajaye Hospital Disaster Preparedness in 1388.

This study was a quasi-experimental study in Shiraz Shahid Rajaye، the study population consisted of all members of the Committee Against Crisis (15). The data were collected using Khankeh checklist that the validity and reliability was investigated (P=0. 86). Bigining perform earthquakes Table top maneuver in simulated condition and «disaster preparedness» questionnaire complete (baseline) than one-day disaster management workshop and the establishment of disaster management model based on coordination were preformed. A month after workshop، hospital preparedness measured by first questionnaire. Information obtained by using descriptive statistics were compared.

Research findings show that scores in all sections of the questionnaire (coordination، planning، organization، training، and…) have increased. The total score of 29. 56 in pre test was increased to 86. 84 in post test (P<0. 05).

Results of this study showed that the use of Coordination Based Disaster Response Model increase hospital preparedness، with regard to the important role of nurses in disaster management this model can be used by nursing managers.

Heart failure is one of the most common cardiovascular disorders. In this disease heart is disable to perfusion، insufficient perfusion lead to many symptoms in this patients. Each of these symptoms in some patients is deprived from the suitable sleep. Sleep is a vital and effective element in the health and quality of life in these patients. The purpose of this study is to assess of relationship between sleep quality and quality of life in patients with chronic heart failure. In this cross-correlation study، 200 patients with chronic heart failure in two teaching university hospital of Tehran university of medical sciences was selected using sampling with proportional allocation. Data were collected using from demographic questioner، Pittsburgh sleep quality index and Kansas City Cardiomyopathy Questionnaire and then were analyzed using the SPSS software and statistical tests. Sleep quality، with some aspects of health related quality of life including physical limitations (P<0. 000)، symptoms (P<0. 001)، social functioning (P<0. 000)، quality of life، (P<0. 011) as well as general health related quality of life (P<0. 000) has a significant relationship. Considering that sleep quality are associated with health-related quality of life. Community health care providers especially nurses had to more than before attention to sleep quality in these patients.

Nurses play various roles and have various responsibilities in helping patients or other members of the family. This study aimed at assessing Nursing staffs point of view of Roles and activities at hospitals affiliated to the Tehran university of Medical sciences، 2007. Using descriptive analytic study method، 102 male and female members of the Nursing staff، systematic randomly chosen. The data were collected using a questionnaire consisting demographic characteristics and related to the clinical roles all statistics were computed by the SPSS v. 16 descriptive and inferential statistics. The results showed that; Ability to clinical procedures 1% poor، 5. 9% Average، 46. 1% Good، 47. 1% excellent، and 22. 5% of nurses be lives the most important reason for not doing clinical role are fatigue and hard working. There were significant correlations between demographic characteristic (age، sex، unit home). and the other were not any significant correlations between demographic characteristic of participants. The findings suggested that competence of the Nurses in performing most of roles was sufficient In addition some factors such as frustration، lack of on the job training، insufficient number of personnel. Lack of proper facilities، and insufficient income…، have a great impact on nurses and the removal of obstacles in the performance of their duties.

A Nurse Practitioner (NP) is has completed graduate-level education (either a Master of nursing or Doctor of Nursing Practice degree). The core philosophy of the field is individualized care that focuses on patients'' conditions as well as the effects of illness on the lives of the patients and their families. NPs make prevention، wellness، and patient education priorities. In addition to health care services، NPs conduct research and are often active in patient advocacy activities. In Iran، formal and academic education of NP has recently added to nursing education curriculum of some nursing colleges. The aim of this study is exploration about understanding of NICU NP students about situation of this new discipline in Iran in comparison with what they know about their profession in the world. A qualitative study was conducted using a content analysis approach. Convenience sampling was employed to select 8 nursing master degree students of NICU studying in nursing schools of Tehran public universities، Tehran، Iran. Data were collected through semi-structured interviews، which were tape recorded and transcribed verbatim. Data were analyzed using descriptive content analysis approach according to Graneheim and Lundman method. Eight subthemes and 2 themes emerged from data analyses. Subthemes include «necessity of profession»، «positive attitude»، «conditional success for future»، «professional empowerment»، «no proportional current curriculum»، «frustration after enterance»، «unprepared of clinical fields for profession» and «the power of clinical experience». Two themes were ''role ambiguity'' and «conditioned success». It seems that in the opinion of participants for successful assurance of this newly profession field in Iran there is necessary to structural modifications in education and clinical management fields and without professional empowerment theris no any clear vision for their future professional career. Also the findings of this study can provide a base for further researches on this subject.

During of caring of comatose patients، caregivers involve in a lot of factors which effect on caring. This caring is a holistic care undergoing caregiver’s preferences. Our purpose was to examine the effective factors on comatose patient’s caring. Van Manen’s conception of hermeneutic phenomenology with purposeful sampling of caregivers of comatose patients was used in Tehran in 2012. The data were collected through 10 semi-structured interviews and were analyzed using Van Manen’s phenomenology. The participants were 5 males and 5 females، 8 nurses and 2 family members and working in critical care units between 6 and 23 years and working as a teacher. 7 essential sub themes were elicited: effective communication، mutual satisfaction، Depression and disappointment of caregiver، Hopefulness of caregiver، Guilty feeling of caregiver، Belief of death in caregiver and Compassion and sympathy then were classified into 1 theme: caregiver’s preferences. This caring means that the caregivers have to realize، percept، understand and evaluate of the caring because the comatose patients are unable to do them. The trustworthiness of sub themes and themes were achieved in our study. The caring in coma is a holistic care and the caregiver is instead of comatose patient. To enhance caring process and to achieve our goals، we created an assessment tool based on the findings of our study; it seems that the results can be used in this regard.

Coronary Artery Disease as a common health problem in the world that being affected to myocardial infarction is larger than health population. Increased knowledge and attitudes in this patients has significant role in reduse prehospital delay and nursing education has a significant role to reach in goal. This study assess the effect of nursing education on knowledge، attitude and beliefs in coronary artery disease to response to symptoms of myocardial infarction. This study is a Randomized Clinical trial. Research samples are 170 patients with one of the coronary artery disease that selected by convenience sampling and allocated to equal group (experiment and control) with block randomization. Results from study analized with descriptive statistics and chi-square، dependent and paired t test. Results from study show that increased mean score of knowledge، attitude and beliefs in experimental group after nursing intervention. Also there is significant differences between knowledge، attitude and belief score before and after intervention (P=0. 00). Nursing education programs have a significant role to improve knowledge، attitude and beliefs in cardiac patients. Thus attention to nursing education is nessessery to reduce prehospital delay.

Heart failure، one of the most common chronic diseases and major causes of mortality in the world with high prevalence of progressive with hospital admissions are unpredictable. Self care one important aspect of treatment in patients with heart failure. Self-care education، is necessary part of the comprehensive plan of care for patients during hospitalization to be exposed. This study aimed to determine the effect of educational interventions on knowledge، performance and readmission in heart failure patients was conducted in Ardabil. This randomized clinical trial، a total of 44 samples from patients with heart failure hospitalization Sabalan and Emam Khomeini (RA) Ardabil gradual sampling were selected randomly in two groups case (n=22) and control (n=22) were studied. Patient groups، for four 20-minute sessions were trained by the researcher. Data from the questionnaires and during interviews with patients before and after the intervention were collected. Data using SPSS version 16 software and using descriptive statistics and chi-square، independent t-test and the paired t-test were analyzed. Results indicate that after training، mean knowledge score in case group 89. 60±5. 95 in control group 62. 47±8. 84، mean performance score in case group 80. 75±3. 7 in control group 54. 78±6. 24، readmission rates in case group 15. 8 with a mean and standard deviation of 1±0. 15 and in control group 42. 1 percent with a mean and standard deviation of 1. 37±0. 37 based on independent t-test mean knowledge and performance with P=0. 0001 in the two groups had significant differences، but the amount Readmission Based on independent t-test with P>0. 05 is not significant. The findings of this study indicate that educational programs implemented to promote awareness، self-care behaviors and decrease readmission of patients is effective. Therefore، planning authorities and health team members and provide educational services to patients with a purpose Improve self care behaviors can be largely prevented the readmission of patients and obviously it helped the family economy and society will and obviously it helped the family economy and society will And recommended the education of the patient privacy and the privacy will be respected.

Low back pain is a complaint in communities. Low back pain has negative effects on different aspects of the patient، s lives. Different methods used for reduction effects. Foot reflexology causes pain and disability reduction. This study conducted to examines effects of foot reflexology on disability in patients with low back pain. This study was clinical trial study and 3 groups. This study conducted 150 men with low back pain returnee to Baghiatallah hospital in Tehran. First men patients were selected by purposive sampling and then they with random allocation method had been divided into three groups: Experimental (foot reflexology was applied in real points once a week for three week)، placebo (sham foot reflexology was applied low pressure in all points once a week for three weeks) and control (without any intervention). Dates were collected by demographic questionnaire and Roland-Morris Disability Questionnaire. For analyze of data used SPSS v. 18 and variance q squre. The results indicated that disability before intervention in 3 groups not differences significant (P>0. 05) but after intervention Variance showed mean of disability reduced in three groups (P<0. 05). In conclusion، the study showed foot reflexology effects of reduction of disability. So proposes for nurses to use foot reflexology for reduction of disability in patients with low back pain.

Cognitive disorders are one of geriatrics outcomes that can cause a vast spectrum of disorders in older people. This change in cognitive function may see as an early sign before behavioral manifestations. Thus early diagnosis in high risk older people can be an important step in prevention in cognitive disorders and disabilities in this population. The purpose of this study is assessment of older people cognitive status based on demographic characteristics. This study is a cross-sectional، descriptive study that was conducted in 1389-1388 in Rasht. 194 older people that retired form governmental organization participate in that and were selected in regular randomized sampling. The instrument for gathering data was Mini Mental State Examination (MMSE) that has 5 parts in orientation، data recording، concentration and calculation، remembering and verbal skills. Data were assessed after gathering and were analyzed by SPSS v. 16 and Kruskal Valise، Man Whitney U and Spear man statistical test. The findings showed that among 194 older people 70. 6 percent were man and 29. 4 percent were women. 91 percent of illiteracy older people had normal cognitive status، 7. 5 percent of them had mild cognitive disorder and 1. 5 percent of them had moderate cognitive disorder. Among graduate persons، 82 percent had normal cognitive status، 17. 3 percent had mild cognitive disorder and 0. 8 percent had moderate cognitive disorder. Among demographic character (age، sex، marries، education and morbidity) cognitive status has a significant correlation with age (P<0. 03)، marriage status (P<0. 002) and education (P<0. 0001). The study showed that cognitive status assessment by health care professionals can help in detecting the high risk patients and promote their caring. Moreover it can help to potential senilement health care and help to delay in starting and progressing cognitive disorders among older people.

Morbidity and mortality of Thalassemia significantly reduced and nowadays there are more attention to the quality of life and related factors. Considering that thalassemia and its complications impact on quality of life of children، it is still unknown. The aim of this study was investigation of quality of life of Thalassemic children in four domains of physical، social، emotional and school، that compared with the control group. Thalassemic children (n=40) referred to the special diseases center of Besat hospital selected. Also، healthy children (n=40) that was matched based on age، sex and education selected from their classmate as control group. The standard quality of life questionnaire consisted of two sections used for data collection، the first section included demographic questions (n=9)، second section included 23 questions about the quality of life in four dimensions: physical، social، emotional and school. Data analyzed by SPSS v. 14 software. Kolmogorov-Smirnov test used for testing normality of the distribution. The mean age of subjects with mean and standard deviation were respectively 13. 2±4. 26، level of education of the majority of children (45 percent) were elementary school and 50 percent of their fathers were illiterate and 34. 5 percent of mothers in elementary level. The majority (67. 5 percent) of residents were without private homes (40 percent) and personal vehicles (70 percent). Results related to the quality of life showed that children the quality of life in four domains of physical، emotional، social، and school children with specific thalassemia was lower than control group (P<0. 05). Total quality of life in were 1. 4±0. 69 in children with thalassemia and 9. 6±0. 14 in healthy children، t-test showed a significant statically relationship (P=0. 000). The results showed that children with thalassemia have problems with the quality of life in four domains of physical، social، emotional and school. Therefore planning to promote mental health، participation in social activities، providing the necessary consultations and adaptive solutions along with clinical and therapeutic services in this patients center patients can increase their quality of life.