Modern Care Journal
Volume:10 Issue: 1, Mar 2013

Fever is of the commonest problemsof intensive care unit patients. Fever management reduces metabolic activity and oxygen demand, and thereby mortality will be reduced. Physical methods of temperature reduction can decrease body temperature in a short time, but their effectiveness and side-effects are not the same in different patients especially the highly sick ones. This study compared the effectiveness of active cooling and sponge cooling in decreasing body temperature of febrile patients in intensive care units.

This randomized clinicaltrialwas done on 57 patientsadmitted to intensive care units of educational-care centers in Qazvin and Tehran. Patients were selected by stratified block randomization and divided into sponge and active cooling groups. Samples were subjected to three hours of intervention. The data were analyzed repeated measurement ANOVA and Kaplan-Meier survival analysis using SPSS software at 0.05.

There was no statistically significant difference between the two groups in terms of age, gender, body surface area, and body mass index. After three hours of intervention, the mean and standard deviation of temperature reduced from 38.7 ± 0.21 to 37.6 ± 0.55degrees centigrade in the active cooling group and from 38.8 ± 0.25 to 37.1 ± 0.18 in the sponge cooling group (P<0.01). A fter 120 minutes of intervention, mean temperature in the active cooling group was significantly lower than that of the sponge cooling group (P<0.01). A fter 180 minutes of intervention, 100% of patients in the active cooling group experienced 1 degree cooler body temperature while in the sponge cooling group, only 65% had the same experience (P<0.02). Both methods, irrespective of acetaminophen dose received,reduced body temperature in a significant way (P<0.02), and the acetaminophen dose had no confounding effect.

Sponge method is an effective way to control the temperature, but the rate of temperature reduction in this method is less than that of the active method. Active cooling method was considered a better way for the rapid fever control, because this method reduced the temperature with a less fluctuating but faster speed than sponging. Hence, a more accurate estimate for the time to achieve the desired therapeutic response is provided for health providers.

Cardiac arrhythmia is one of the most common cardio-vascular diseases. Pacemaker, as a curative method in treating patients with arrhythmia,diminishes a lot of their symptoms.Awareness of modern educational methods compared with traditional methods can help instructors to use more effective methods and train more competent nurses so they can provide more proper care for these patients.The aim of this study is to compare the effect of compact disc and group education on nurses’ knowledge and performance regarding pacemaker care. In this quasi-experimental study with two groups, all 40 nurses working in heart wards of educational hospitals of Arak University of Medical Scienceswere selected and allocated randomlyto two groups of Compact Disc and Group Education. Data collection tools included a questionnaire to assess their knowledgeand a checklist to evaluate their performance. Questionnaires and checklists were completed by nurses and the researcher before and one month after education. Data was analyzed using descriptive and interpretive statistical methods and SPSS version 17. Knowledge scores means in the two methods of CD and group education increased from 13.40 ± 4.7 and 15.10 ± 7.26 before education to 27.85 ± 2.43 and 25.85 ± 4.25 after education. That of performance increased from 7.40 ± 4.18 and 10.45 ± 7.16 before education to 27.30 ± 1.45 and 24.85 ± 3.22 after education.Mean scores of knowledge and performance in the two methods significantly increased after education (P≤0/0001). There was no significant difference between the two methods concerningknowledge scores means, but as for their performance, the difference was significant (P≤0/0001). Although compact disc and group education methods were both effective on nurses’ knowledge and performance, but teaching through compact disc was more effective in increasing performance. Thus, considering its numerous advantages such as its economical efficiency, the possibility to watch included films, etc., it is recommended to use it in educational programs.

In recent years, clinical mentorship experiences for nursing students have become popular in nursing education. Peer education can be a useful adjunctive method for clinical skills training The present research was conducted to study the effect of performing mentorship program on self- confidence of nursing students in Imam Reza Hospital of Birjand in 2011. The present study was a half-experience in Faculty of Nursing (Islamic Azad University of Birjand).60 students of 4th semester (trainees of department of orthopedics) were randomly divided into two groups (30 students in mentored group and 30 in the non-mentored group). In the mentored group for each 3 students a student of 8th semester was assigned as mentor and in the other group only an instructor was available without any mentor. The data was gathered through self-confidence of (Montalto,2001(questionnaire (10 questions with favorite validity and reliability of 0.85) in both groups, before and after their training. The data was analyzed using spss16 software with statistical procedures paired samples t-test, independent samples t-test and analysis of variance (one-way anova). Data Analysis: Although student, s self-confidence has been high in both models, but there is no significant difference in the non-mentor group. The average of self- confidence score in the mentor group (427/0± 76/3) was higher than the non-mentor group (347/0±33 /3) and it difference was significant)p<0/001). Results of the study indicate mentorship program provides opportunity for 4th semester nursing students to enhance self-confidence. So it is suggested that clinical curriculum designers use this method as a supplementary educational, not independent method since it only needs not any additional expense.

Taking into account the wide variety of problems of patients with heart valve replacement, it stands to reason to educate them to solve their problems. Further, the information needs analysis can increase the effectiveness of educational programs. The present study was performed to determine the impact of a planned educational program on patient's informational needs after heart valve replacement. In this quasi-experimental single-group study done with a pre-test and post-test, 31 patients who had undergone valve replacement since 3 years ago participated through the availability manner. Demographic and informational needs analysis questionnaires were completed before the educational program was held. A planned educational program was devised on the basis of patient's informational needs and instructed through 5 successive sessions. One month after the intervention, informational needs were studied, and the difference between levels of informational needs before and after the intervention was analyzed statistically using SPSS software and descriptive statistical tests including mean and standard deviation as well as t-paired parametric and Wilcoxon, Mann Whitney, and Krushall-Wallis non-parametric tests. The results of the study showed that before the intervention 80.6% of patients had "high informational needs" in terms of awareness of the nature of the disease which decreased significantly to 35.5% after the intervention (P = 0.000). Also, 51.6% of patients had high informational needs regarding awareness of drugs, 74.2% regarding nutritional diet, 100% regarding activity, and 96.8% concerning complications which decreased to 25.8%, 58.1%, 93.5%, and 67.7% respectively. Wilcoxon test showed a significant difference in all domains except for the diet. Intervention's effects on both genders and different ages were compared in terms of different domains of informational needs, and the comparison indicated statistical significance in some domains. The results indicate that performing an educational program on the basis of needs analysis decreases such patients’ levels of informational needs and, subsequently, the probability of their problems. Thus, nurses should perform needs analysis before starting an educational program and then design and carry out the program in an organized way.

Anxiety and depression are among serious problems in human's lives which are almost observable among all ages and genders. Optimism is considered as a proper solution to decreasing them both. This paper studied the effects of teaching optimism on university student's anxiety and depression. This study was a semi-empirical one with a pre-test, post-test, and a control group. All bachelor and master students of psychology at Birjand Azad University were voluntarily given Beck Anxiety Inventory (BAI) and Beck’s Depression Test. 46 students who had both an anxiety score of above 15 and a depression score of above 18 simultaneously were selected and randomly allocated to 2 experiment and control groups with 23 students in each. Both groups were given positive-negative psychology test. The experiment group received seven 80-minute-long sessions of positive-psychology-training program by the researcher twice a week. The control group received no training. Both groups were later given the post-test. The instrument included Beck’s Anxiety and Depression as well as Seligman’s Optimism-Pessimism. The data were analyzed using SPSS 17, independent t-test, and paired t at α=0.05. After teaching optimism, results indicate, the experiment groups’ anxiety scores average decreased from 23/74±10/70 to 11/48±6/51 and that of their depression, from 26/70±12/33 to 8/78±6/61 which is statistically significant (p<0.001). Besides, the study increased people’s optimism from 13.13±2.72 to 15.04±2.96 but had no significant effect on their pessimism. According to the results, it seems that teaching optimism helps decrease university students’ anxiety and depression; however, the pessimism scores average has not been statistically significant in the experiment group after the intervention. Thus, this educational program can be used in university counseling centers in order to decrease anxiety and depression.

Birth of a mentally retarded child could have a negative impact on the structure and function of the family and can subject parents, especially mothers, to physical, psychological, social, and economic tensions. This study investigated the effectiveness of training self-awareness and assertiveness skills based on group therapy on compatibility and self-esteem of mothers of mentally retarded children in Shahrekord in 2009.

This applied and quasi-experimental study with a pre-test and post-test was conducted in 2009. The population comprised of all mothers of mentally retarded children of Shahrekord. From among them, 30 were selected randomly on whom the intervention was performed. The tools used in this study included Bell adjustment inventory and Rosenberg self-esteem scale. Parents were taught self-awareness and assertiveness skills twice a week and for 12 sessions in all. Data were analyzed by SPSS version 15 and paired t test at the significant level of P <0.05.

Results of this study showed that training self-awareness and assertiveness skills had a significantly positive impact on the overall compatibility and its components (i.e., social adjustment, home adjustment, and emotional adjustment) as well as the self-esteem of mothers of mentally retarded children (P=0.001).

Training self-awareness and assertiveness skills is an effective method to improve compatibility and self-esteem of mothers of mentally retarded children.

An explanation of factors improving the quality of clinical services requires as a prerequisite the identification of factors associated with the elevation of clinical service provision quality. In this line, university student's interest in special patients, as a major factor in clinical service provision, plays an important role. Thus, this study was designed with a qualitative approachto describe experiences of students as well as their interest in special patients. This study is a qualitative purposive-sampling study conducted on a selected group of students from all majors available at Jahrom University of Medical Sciences. Data concerning student's experience and the extent of their interest in special patients was collected through 20 deep structured interviews with5 focus groups and were analyzed through content analysis. From among the 95 codes derived, the data could be categorized into 2 themes oftendency towards special patients including“unpredictable cases”, “adventure in the unknown cases”, “patient's experience” and “positive mood” or they could be considered as lack of tendency to special patients including“suffering”, “patients protest”, and “patients’ hate”. Many factors contribute to students’ increasing interest in special patients. Thus, medical students must be given proper justifications regarding the unique features of medical fields of study. Also, justice in treating patients must be emphasized so we can be of a role in establishing clinical governance in society upon the institutionalization of professional ethics criteria.

Neck and shoulders pain are the most prevalent disorders among computer workers that lead to disabilities, sickness absence and financial sequences for individuals and socials. The aim of this study is the survey of relationship between work-related physical and psychosocial factors and persistent neck and shoulders pain among computer office workers. We conducted a longitudinal study with 12 months follow-up among all eligible computer office workers at Shahroud universities (182 cases). Data were collected using the CUPID questionnaire includes demographic characteristics, physical, and psychosocial factors at work. At baseline questions were asked about pain in the neck and shoulders (lasting ≥1day in the prior 12 months).At follows up one year later we asked about neck and shoulders pain in the last month. Associations were explored using chi-square and logistic regression. At the base-line of the study 39.6% of participants reported neck and shoulders pain equally. Among them at follow up 59.7% and 51.3% reported persistent neck and shoulders pain respectively. Age, gender and decision latitude at work associated significantly with persistent of both neck and shoulders pain separately. After one year follow up persistent neck pain was upper than shoulder pain. Age, gender and decision latitude at work were identified as related risk factors for both pains.

Method of withdrawal applied along with another method has a big role in unwanted pregnancies of women visiting County Health Center No. 1 in Mashha d. This paper studies the experiences of using withdrawal by women who visit health and care centers under County Health Center No. 1 of Mashhad in order to contribute to policy-making and have more comprehensive family plans.

This descriptive phenomenological study was conducted on 31 women visiting Health Center No. 1 in Mashhad aged 18-50 who used withdrawal. The study applied purposive sampling, and the data were analyzed by the 7-step methods developed by Colaizzi.

Classes derived from this study included psychological burdon (fear of contraceptive methods because of implification, friend's misconceptions, and pregnancy), efficiency (reach orgasm, relaxation after intercourse), accessibility (convenience and direct interface of the withdrawal method), traditional religious attitudes (God's will, tradition,and narrations from past generations), supportive changes of the spouse (interest in spouse, more satisfaction of the spouse, tendency to continue using withdrawal), expressing emotions (reduction of marital conflict, more excitement), and prevention of unwanted pregnancy(success of withdrawal).

Family planning programs cannot and should not eliminate withdrawal method, but they should focus onissues such as educating the correct use of this technique, informing of reproductive cycles in women most likely of pregnancy,emergency contraception methods,and increased participation of men in family planning in order to reduce unwanted pregnancies resulting from withdrawal method.

Work life quality is an outcome of work place variables which plays an effective role in elevating job satisfaction, maintaining nurses, and improving quality of work force services. This study tried to evaluate the quality of work life of nurses working in educational hospitals affiliated to Birjand University of Medical Sciences. This was a cross-sectional study, and the sample included all the 300 nurses working in Valiasr and Imam Reza educational hospitals. The two-part questionnaire included demographic and work life quality information and was based on Richard Walton's QWL model (7 options) with 30 questions. It was approved of by test-retest method, Pearson coefficient correlation of 0.72, and Cronbach's alpha of 0.65. Data were analyzed using SPSS (version 15.5) and the results were presented by descriptive statistics as well as ANOVA, Pearson correlation and independent t tests. The mean score of nurse's quality of work life was 40.79±10.77 which is at the intermediate level. Work life quality frequency was high for 7%, moderate for 83.8%, and low for 10.3%. Quality of work life increased with age and work experience but decreased with overtime through the month (P < 0.05). Quality of work life was found to be at the intermediate level. To elevate it, group sessions in hospital wards can be recommended so that younger nurses can enjoy the experiences of more experienced nurses. Increase in nurse's salaries and benefits are also suggested.