نشریه پرستاری و مامایی ارومیه
سال یازدهم شماره 11 (پیاپی 52، بهمن 1392)

Respiratory complications are the most complicated problems after the surgery، especially thoracic surgery that changes the lung performance. Therefore، the present study has been done with the aim of survying the effects of cough-assist on the respiratory complications in patients under thoracic surgery in Imam Khomeini educational-therapeutic center، Urmia. This study was an experimental research. The subjects under the study were 60 patients hospitalized in Imam Khomeini Hospital in Urmia with the age range of 35-64 years old. The subjects have been chosen by sequential sampling، and they were allocated randomly into two groups of intervention (30) and control (30). In the intervention group، the cough-assist was used، while the control group recived routine care. The data collection tools were demographic form plus a form to write the results of physical examination، and respiratory complications observation. For data analysis، SPSS version 16، descriptive and inferential statistics such as chi-square، and T-test were used. The study showed that in control group 66. 50 percent of respiratory complication were observed، while in intervention group this figure was 16. 70 percent. Respiratory complications between two groups had significant difference (p>0/05)، so the patients in intervention group had relatively low percentage of respiratory complications. Based on the results of this study، it can be concluded that using Cough-Assist could decrease the incidence of respiratory complications in patients under thoracic surgery.

University is one of the most important institution in every human society, and the students were experienced their socialization process through faculties formal and informal educational classes. It is why, in many cases, society's expectations of higher education systems are to develop moral intelligence than the professional development. Therefore the purpose of this research is to explore the relationship between Moral Intelligence and Teaching styles of Urmia University faculties members. This is a correlational descriptive survey. The research participants were all 412 faculty members of Urmia University from which 156 samples were selected by stratified random sampling method. Research instruments were Lennick & Kiel's (2011) moral intelligence questionnaire and Grasha (1996) teaching styles questionnaires. Their reliability has been calculated by using cronbach coefficient, and the results respectively were 0/94 and 0/855.; Descriptive statistics method, Pearson correlation coefficient and, two independent sample T-test and analysis of variance and regression tests have been applied to analyze the data by using SPSS 16 software. According to the findings, there is a positive and significance correlation between moral intelligence and teaching styles. There was no significant relationship between teaching styles and, moral intelligence between the faculty members’ point of view considering their gender. By adopting appropriate teaching styles in classroom, the students Moral Intelligence level could be raised.

Due to the increasing proliferation, high costs and numerous physical and psychological disabilities of multiple sclerosis (MS), efficient rehabilitation care is important. Studies show that high quality rehabilitation care to MS patients currently is not provided. This study aimed to explore the barriers of rehabilitation care in MS patients. A qualitative content analysis method was used to analyze the gathered data. The study participants were 35 (15 patients, 5 nurses, 6 family members, 2 physiotherapists, 2 doctors, 2 occupational therapists, 2 psychologist and the director of MS Society) that were chosen by purposeful sampling from MS associations of Isfahan and Tehran (Iran). Data was gathered through non structured interviews. The analysis led to five themes as the barriers of rehabilitation care in MS patients.The five themes introduced under the headings: lack of information, lack of achieve to adaptation, poor context for utilization, poor performance and poor patient characteristics. These are explained in the text.These themes can lead to increased information of the government, community, families, and health care authorities about barriers to appropriate rehabilitation care to MS patients. This will help to develop better plan and support for MS patients, and it will reduce the possibility of adverse mental and physical disabilities in MS patient.

N ursing is associated with a high degree of stress d ue to its nature. Job stress is a challenge for the nursing profession, and its adverse effects on physical and mental health nurses, create serious problems for the health care system. This study aimed to determine the job stressors in nurses working in critical care units. In this descriptive – analytical study, 60 nurses working in critical care units of Urmia therapeutic –educational centers (Emam Khomeini and Shahid Motahhari) were participated in the study in May 2013. Expanded Nursing Stress Scale (ENSS) is used as data gathering tool. ENSS is an expanded and updated version of the classic Nursing Stress Scale (NSS) developed by Toft-Gray &Anderson. Data were analyzed by using SPSS version 16 software. T he highest mean score on job stressor factors related to death and dying (135/70±26/55), and the lowest mean score (100/65±29/57) related to the problems with colleagues. Mann-Whitney test showed significant differences on stress factors of death and dying, and problems with supervisor between two therapeutic-educational centers of Emam Khomeini and Shahid Motahari (p<0/05). 58/35 of the nurses in this study reported high level stress es. Because of high level stress in nursing, determining its factors and resources is important.

Cholecystitis is one of the most common diseases in gastrointestinal tract which can be presented as acute or chronic cholecystitis. S everal factors cause this diseases. The outbreak and epidemiologic features of cholecystitis has changed due to revolutionized style of living. The purpose of this study was to evaluate the acute and chronic diseases at different ages, gender and location. The p atients who were operated of laparoscopic cholecystectomy in 2010 with diagnosis of cholecystitis were selected and assess ed. The patients were divided into acute and chronic groups based on their surgical and pathological findings. The data was analyzed by using SPSS. In this research, the total 448 of patients were assess ed, 313 patients were chronic cholecystitis, and 135 patients were acute cholecystitis. M ost of the patients were at their 40 s, and 50 s. 353 patients were women, and 95 were men. And also, 180 patients were living in the village s while 268 patients were liv ing in the city. According to this study, the outbreak of disease in the female patients was at their 40 to 60 years old. This could be due to physiological and hormonal changes. T he higher incidence of cholecystitis in urban life could be related to the type of nutrition and personal activity.

80 percent of works in healthcare system conducted by nurses. Nursing is one of the high workload occupations. Assessments of work load in nurses who are concerned with human life are important, in order to provide effective service. The object of the current study was to determine mental work load among nurses and its effective factors. This study was a descriptive - analytic and cross-sectional one that was conducted among 120 nurses of Urmia University of Medical Sciences hospitals in 2013. In this study, we used NASA - Task load indexes (TLX) for assessment of mental workload of nurses. Data were analyzed by descriptive statistics and Pierson correlation analysis. The Results showed that mental needs were maximum (86/16 ± 21/24) and physical needs were minimum (55/83 ± 22/16) compared to other workload aspects. Mean mental work load score in Intensive Care Unit (ICU) was maximum (82/33 ± 20/49). Between the hours of work per week, department, shift work and the number of patients per nurse with mean mental workload score, there were significant correlations. Mean mental workload score was higher among nurses, which can negatively impact the quality of care provided by nurses, therefore, implementation of effective programs to mitigate and reduce the mental load in order to enhance nurse's performance are suggested.

The ethical decision making process to identify the problems through analysis, and to decide about them in accordance with ethical standards is an important factor in medical science. Nurses are the largest group of health service providers, and they have a great impact on quality of health care services. In a descriptive study, 200 nurses working in Ayatollah Taleghani Hospital were selected. To collect the information, a demographic and ethical sensitivity questionnaire was used to evaluate decision making. The validity and reliability of the questionnaire was determined by using Cronbach's alpha (0/77). The collected data were analyzed by SPSS version 19 software. Descriptive and inferential statistical techniques such as analysis of variance were used. The average score achieved for the ethical sensitivity in Ayatollah Taleghani Hospital was 61/1, which was in the middle range. The average moral sensitivity in decision making for nurses in different departments was as the following: the emergency department 60/2, men's internal ward 59/4 (Medium), infectious department 61/7 (Medium), women's internal ward 64/7 (Medium), Heart unit 60 (medium), CCU 60/4 (medium), poisoning 4/50 (average), ICU 9/62 (medium), angiography 2/64 (medium), echo and clinical governance office 52/1 (average), and dialysis 66/2 (average). The highest and lowest points dedicated to the nurses of the dialysis, and poisoning wards respectively. According to the findings, it was found that the mean ethical sensitivity in decision making for the nurses who were working in Ayatollah Taleghani Hospital was 61/1that is in the average range. With proper planning, it is required to increase nurse's ethical sensitivity in the mentioned hospital.

Violence against women is a phenomenon in which women are violated because of their sex، and it causes many expenses and sociosomatic complications to them. Violence against women is hidden in the rites، cultural traditions، social norms and beliefs. Addiction is one of the problems that not only endanger the lives of millions of persons، but also their families have to face a lot of problems. In this research، the role of addiction in the amount of domestic violence experienced by women married to addicted and non-addicted husbands in Urmia City was studied. 296 women who referred to the forensic medical center in Urmia city were studied by a questionnaire that its content validity validated by experts and the members of the scientific board and was tested by some of the women who referred to forensic medicine center. 89. 3% women (268) were violated. 13% (39) of them had an addicted husband. Physical، sexual، economic violence in women with addicted husband were 92. 3 percent (36women)، 79. 5 percent (31 women) and 76. 9 percent (30 women)، and in women with non addicted husband were 88. 9 (232 women)، 71. 6 percent (187 women) and 88. 9 (232 women)، respectively. It was found that the difference in mean scores against wives of addicted men and violent experience is significant. The study also showed a significant relationship between physical violence (p=0. 42). and economic violence (p=0. 36) in women with addicted husband. However، there was no significant association between sexual abuse and addiction in husband (p=0. 35). With regard to significant relationship between addiction and domestic violence، legal and health managers must screen these cases before marriage and establish supportive centers for women and help them against poverty and unemployment. Research must be done to study the causes of domestic violence and to solve them for better conditions. More s upport and intervention to reduce drugs is recommended.

Albumin and globulin are the largest components of the body proteins. Albumin is a protein made in the liver and 50-60% of the total protein. In this prospective study، 225 patients who admitted to intensive care unit were enrolled. Serum albumin level on admission to the ICU were recorded and patients were followed. Data analyzed with SPSS. Mean albumin levels were 3. 52±0. 87، in 49 trauma patients 3. 74±1، in 36 patients with cancerous 3. 41± 0. 77، in 38 patients with lung disease 3. 63±0. 7، in 30 patients with CNS disorders 3. 61 ±0. 77 and in 72 patients with other underlying diseases 3. 26±0. 92 gr / dl، respectively. According to Chi-square test there were no significant correlation between albumin level and the need for mechanical ventilation in all patients (P = 0. 47)، trauma (P =0. 44)، patients with cancerous (P=0. 70)، lung disease (P =0. 42) patients) CNS0 (P=0. 24) and patients with other underlying conditions (P =0. 24). Also according to Chi-square test there were no significant correlation between albumin level and mortality in all patients (P =0. 36)، trauma (P =0. 96)، cancerous patients (P =0. 16)، lung disease (P= 0. 78)، patients with CNS disorders (P =0. 52) and patients with other underlying diseases (P =0. 13). Our results showed there is no correlation between albumin levels in patients (trauma، pulmonary، CNS، cancer، and other underlying diseases) and the total patients admitted to the intensive care unit. Although in several studies albumin has known as an indicator of the metabolic status of patients requiring mechanical ventilation، mortality and length of stay، In our study، there is no significant correlation between albumin level and those items. Needed for further studies.

This study investigated the effects of methamphetamine (MA) on the patients admitted to addiction treatment centers in Tehran. The study tries to determine the situation of MA use on the patients، and its effects on their family and community. The population of the study was the patients who were being treated for substance abuse in Tehran. Multi-stage cluster sampling was conducted to collect the data. 100 questionnaires were equally distributed between the two drug treatment centers، and then the collected data from the questionnaires were analyzed. Majority of MA consumers (including women) were very young. The educational status of most patients admitted to addiction treatment centers was low. Concerning their education، sixty four percent of them were under high school، and 24% were high school graduates. All of the participants had a concomitant use of at least an opiate substance. The results showed an increase of drug abuse among the married subjects، so that 54 % of MA abusers were married. The divorce rate was increasing among the subjects، and most of them has severe family dispute. The age of starting to substance abuse was decreasing، while the amount and type of MA abuse was increasing among the subjects. Incidence of violence، family disputes، and divorce has interactive effects on MA abuse، and /or it can be the result of MA abuse. The effects of available activities concerning MA abuse are very weak.

Knowledge management is one of the most important factors for any given organization''s success in data competition age. Therefore، the present study was done aiming to assess the status of k nowledge management processes at Urmia University from the faculty members viewpoint. This descriptive survey was conducted on the 412 faculty members of Urmia University in 2012 and 2013. 187 people were selected to be included in the study using stratified random sampling. For data collection، a two-section questionnaire including demographic questions and Jashpara (2004) Knowledge Management questionnaire with 32 items in four subsections were used. Descriptive statistics method، single-sample T-test، two sample T-test and analysis of variance tests have been applied to analyze the data by using SPSS 16 software. A ccording to the faculty members، the condition of knowledge management in Urmia University was under the average level. There was no significant difference between the faculty members’ point of view considering the ir scientific position and gender. Nowadays، considering the right usage of organizational knowledge and its application with modern management''s implement such as knowledge management makes the organization to be in a competitive situation which in turn is a preliminary factor for success.