Modern Care Journal
Volume:10 Issue: 4, 2014

Today, journals are trying to improve their rankings both at local and international scales. Achievement of the journal relies heavily on our ability to publish articles in scientific journals with the highest quality. In this regard, high quality manuscript review plays an important role in supporting editors-in-chief an d executive s to choose the most relevant papers and also helping authors to improve their manuscript quality to the highest possible level. Peer review process is considered an integral part of scholarly communication helping to ensure validity, increase accuracy, and enhance content prior to publica­tion. A good peer review includes an assessment of many dimensions of manuscript, but the most important dimensions include the overall quality, scientific quality, novelty, and relevance to the journal. We discuss these topics in this letter to emphasize on the importance of a good review.

Heart failure is a chronic disease that affects the physical and psychological aspects of life. Psychological adaptation of patients needs follow-up and training. The purpose of this study was to determine the effectiveness of an educational program based on Roy adaptation model on the psychological adaptation in patients with heart failure.

This clinical randomized trial was performed on 60 patients with heart failure admitted in Vali-e-Asr Hospital and Heart Research Center in Birjand in 2013. The patients were selected through the convenience sampling and randomly allocated to an intervention group and a control group (30 individuals in each group). The data was collected using Roy assessment form and Mental Health Inventory (MHI-38) whose reliability are confirmed in previous studies. The content validity of the Mental Health Inventory was first confirmed. Later, in order to check for its reliability, it was given to 20 individuals for which Chronbach's alpha was 0.91. The intervention group received an educational program based on maladaptive behavior and stimuli which was followed by a follow-up period of one month. The control group received the regular service. The data were analyzed in SPSS (version 15) using independent t test, paired t test, Mann Whitney, Wilcoxon, Fisher Exact Test, and Chi square.

Mean scores for maladaptive behaviors and the number of maladaptive behaviors showed no significant differences before the intervention, while the difference was significant after the intervention in the two groups (p<0.001). In the intervention group, the dimensions that had significant decrease included physiological (p<0.001), self-concept (p<0.001), interdependence (p<0.004), and role function (p<0.001). The psychological adaptation scores mean significantly increased in the intervention group (p<0.001). However, there was no significant difference in the control group in the different dimensions (p>0.05).

Using an educational program based on Roy adaptation model can be effective on the psychological ad aptation and reduc tion of maladaptive behaviors in patients with heart failure. In this regard, nurses can play a more effective role in improving the psychological adaptation of patients using the educational program.

Urinary tract infections (UTIs) are the most common bacterial infections in all age ranges, and indwelling catheter in the bladder is a predisposing factor for them. Any action to reduce or prevent the occurrence of bacteriuria is very important; taking care of the catheter is among such actions which is no doubt of nurses’ duties. This study aims to examine the effect of washing meatus urinary region with Chlorhexidine and Betadine solutions on the appearance of bacteriuria in patients hospitalized in Neuro-Internal Ward with fixed urinary catheter suffering from brain stroke (CVA). This study was a clinical one. Seventy-five patients with CVA were admitted in the Neuro-Internal Ward after 24 hours of catheterization. In order to synchronize, random blocking method was used. The samples were divided into three groups of 25 persons. The Meatus region of the two case groups were washed by chlorhexidine and Betadine and that of the control group by normal saline for as long as 5 minutes a day and at most 10 days. Culture tests and urine analysis were performed on days 1-5 and 10. Demographic information questionnaire and NIHSS scale were used to study the characteristics of patients. Its validity was confirmed, and its reliability was found to be 0.9. For data analysis, descriptive and inferential statistics such as chi-square and ANOVA were used by SPSS (version 16). The comparison of the three indicators of infection (number of positive cultures, the rate of bacteriuria, and Pyuria) in the chlorhexidine, Betadine, and normal saline groups showed no significant difference between the groups on the fifth day. Yet, their comparison on the fifth through the tenth day indicated significant difference between chlorhexidine and normal saline in indicators of positive cultures numbers (chlorhexidine with 16% and normal saline with 56% (p=0.02) although it was not significant for the other two indicators. The comparison of Betadine and normal saline also showed the significant difference of these three indicators only in terms of positive cultures numbers (28% for the Betadine group and 56% for the normal saline group (p=0.02). It was not significant for the two other indicators. The comparison of Chlorhexidine and Betadine revealed no statistically significant difference between the three indicators of infection. Chlorhexidine and Poidon Iodine can better than Normal Salin reduce the level of urinary infections in meatus of patients who are hospitalized in Neuro-ward and expected to have catheter for more than five days.

Diabetes is a chronic disease that can affect the physical, psychosocial, and social adaptation of patients. This study aimed to assess the psychosocial adaptation of patients with type 2 diabetes who referred to the Diabetes Research Center of Birjand.

In this descriptive‒analytical study, 120 diabetic patients who referred to the Diabetes Research Center of Birjand in the spring of 2013 were selected through convenience sampling. Data collection tools included Demographic Information Form and Psychosocial Adaptation to Illness Survey (PAIS), whose content validity was confirmed by 10 members of the faculty; its reliability for 20 patients was calculated as 0.94 using the Cronbach's alpha. The obtained data was analyzed in SPSS (version 15) using independent t-test and ANOVA at the significant level of P<0.05.

The overall mean score for psychosocial adaptation in the study was 1.28±0.43 which was at a moderate level. As education level increased in participants, the overall mean score for psychosocial adaptation and the components of family environment, social environment, and psychological disorders also increased in a significant way. However, mean scores of psychosocial adaptation in vocational environment, sexual relationship, and social environment decreased along with increase in the duration of diabetes.

The results of this study showed that psychosocial adaptation of type 2 diabetic patients was moderate and that demographic factors were effective on psychosocial adaptation of these patients. Therefore, it seems necessary to plan for educational and caring interventions by health centers to enhance psychosocial adaptation, and hence, more effective medical treatment.

Patients who are hospitalized for heart surgery have some degree of anxiety which may cause adverse physical and psychological effects. Familiarizing patients with heart surgery can increase their participation in self-care programs and may probably be a method for controlling anxiety. This study aimed to determine the effects of orientation about cardiac surgery on anxiety in patients undergoing coronary artery bypass grafting. In this experimental study, 100 candidates for coronary artery bypass surgery hospitalized in the heart ward of Afshar Hospital in Yazd were selected and randomly assigned to two groups of 50 subjects. Data were collected both before and after surgery and after education in the case group by standard Spielberger Trait Anxiety Inventory whose validity and reliably were confirmed in previous studies. Data were analyzed in SPSS (version 16) using paired t test and independent t test. Preoperative anxiety score mean was 47.90±6.49 in the case group and 47.04 ±8.25 in the control group. The mean anxiety score in the case group reduced to 37.54 ±6.20 after the education which was significant (P=0.0001). Based on the findings, familiarization of patients with heart surgery reduces their anxiety of coronary artery bypass graft surgery. It is, therefore, necessary that nurse managers develop and implement clear policy for reducing anxiety especially as regarding high-risk patients.

Staff of any organization are the main index for the superiority of the organization. Organizational commitment is an important predictor of organizational behavior whose analysis can help leaders and supervisors to identify the potential problems. This study was conducted to investigate the relationships between nurse's burnout and organizational commitment at Valiasr Hospital of Birjand in 2011. In this descriptive-correlational study, 146 nurses were selected through the convenience sampling. Data were collected by Maslach's Job Burnout as well as Meyer and Allen’s Organizational Commitment Questionnaires whose reliability and validity were confirmed in previous studies. Data were analyzed in SPSS (version 15) using independent t test, ANOVA, Pearson correlation and linear regression at the significant level of 0.05. Burnout and organizational commitment mean scores were 72.87±20.02 and 95.01±14.25 respectively.There was a negative significant correlation between nurse's burnout and dimensions of organizational commitment (p<0.05) including affective (p<0.001) and normative (p<0.01) dimensions. a lso, there was a significant correlation between organizational commitment and sex; however, there was no significant correlation with other demographic variables. According to the results of this study, which indicates a significant correlation between burnout and organizational commitment, it seems that organizational factors are more influential than personal ones on organizational commitment. Managers can reduce burnout and enhance commitment by controlling factors influential on job burnout.

Nursing work in emergency departments is tangled with unbearable hardship and high working pressure as well as an increased risk of occupational injuries. Needle stick injury is among such risks. Incidence of these injuries differs in different hospital wards. This study aimed to determine needle stick injury risks in emergency ward in comparison with other wards of Qazvin hospitals in 2010.

This historical cohort study was done on nursing staff working in Qazvin hospitals. Statistical population included nursing staffs at Qazvin hospitals who were responsible for direct patient care. From among nurses working in the emergency wards, 52 were selected. Control group consisted of 258 nurses who had worked in other wards of the same hospitals. The research instrument was a self-administered questionnaire. To determine validity and reliability of the Instrument, content validity and test-retest were performed. The collected data was analyzed using Independent t test, Mann-Whitney, Chi-Square, Fisher Exact Test, and Logistic Regression through SPSS (version 16) at 0.05.

Risk of injury in emergency ward was three times more than other wards (p<0.01). The average numbers of beds in emergency wards and in other wards were 24.2 ±. 6.7 and 18.1 ± 10.7 respectively. Nonetheless, number of nurses on different shifts in emergency wards, especially in the evening shift, was significantly lower (p<0.05). However, according to logistic regression analysis, the work in emergency ward was an independent risk factor for needle stick injuries (p<0.05).

The risk of needle stick injuries among nurses in emergency wards is dramatically higher than other wards. It seems that more beds per nurse affects this increased risk. It is proposed that the number of nurses in emergency departments be increased, especially in the evening shift so that the risk of this serious injury may be reduced.

Inappropriate use of mobile phones may lead to pathological stress in some people. Identification of people at risk, the underlying conditions, and prevention are necessary. Uncontrolled emotions can lead to addictive and compulsive behaviors. Thus, this study aimed to determine the relationship between mobile phone dependency and student's emotional intelligence in Azad University of Birjand in 2012. This descriptive-analytical study was conducted on 312 students who were chosen with systemic random sampling method. Tools to collect data included Bar-On’s 90-item five-scale Emotional Intelligence Scale and 20-item mobile dependency questionnaire in three areas. In the mobile questionnaire, scores greater or equal to 70 indicated addiction, between 63-70 suggested intensive uses, and scores less than 63 implied moderate use. Reliability coefficient was 0.93. Students were selected by systematic random sampling. The data were analyzed in SPSS (version 14) using Chi-square, Fisher exact test, independent t test, and ANOVA as well as Pearson correlation and regression. From among the 312 students with the mean age of 22.16±3.39 years, 90% (283) were moderate users, 7.4%(23) intensive users, and 1.9%(6) were addicted. M obile dependency had a significant difference with time of mobile use but not with the mean score of emotional intelligence. Mobile dependency was more in married and master students. Mean score of students’ mobile dependency was 45.59±11.61, and the highest score was related to insisting field (18.91±4.70). There was a positive significant relationship between emotional intelligence and mobile dependency; the correlation coefficient between mobile dependency and emotional intelligence was 0.29. Regression suggested that emotional intelligence can predict dependency on mobile use. Mobile dependency can be predicted on the basis of emotional intelligence. Mobile dependency can be prevented by identification of individuals at risk and underlying conditions and controlling emotional stresses.

Upon skin-to-skin contact with the mother, newborns immediately seek their mother's breast and start sucking without help. The aim of this study was to determine the effect of skin-to-skin contact on breast feeding status in full term cesarean section newborns.

In this randomized clinical trial conducted by convenience sampling, 90 pairs of mothers and cesarean section infants were selected and randomly assigned to skin-to-skin (case group; n=46) and routine care (control group; n=44). In the case group, the mother and newborn were transferred to the ward after cesarean section, and the naked infants in diapers were positioned between their mother’s breasts in a prone position for 1 hour. In the control group, the infant was dressed and put in the cot and later embraced by their mothers to be breastfed according to hospital routine care. During one hour of skin-to-skin contact, the mothers in the two groups were educated in breastfeeding. After one hour, the status of breastfeeding was assessed by the Infant Breastfeeding Assessment Tool (IBAT). The data were analyzed in SPSS (version 17) using descriptive statistics including frequencies, means, standard deviations, independent t tests, and Chi-square.

The chi-square test showed significant difference between full term infants’ breastfeeding status in skin-to-skin group and the control group in terms of readiness to breastfeed (p=0.021) and sucking (p=0.03) Concerning latching Concerning latching. Furthermore, the means of breastfeeding assessment total score showed a significant difference in the skin-to-skin group (8.76±3.63) and in the routine care group (7.25±3.5) (p=0.048).

Skin-to-skin contact of the mother and the newborn for one hour after cesarean delivery can enhance infant’s breastfeeding success.

Nurses plays an important role in the development of health care and treatment. Thus, a main task of a nursing director is to pay attention to the motivational energies of nurses. This study aimed to determine the job motivation of nurses working in Valiasr Hospital of Birjand in 2013.

This descriptive cross-sectional study was conducted on 117 nurses in Valiasr Hospital of Birjand who were selected by census. Data were collected using the Herzberg's Motivation- Hygiene Questionnaire which consisted of 30 items and 11 components with 5 Likert scale. Its reliability and validity were confirmed in previous studies. Data were analyzed in SPSS (version 16) using independent t test and ANOVA at the significant level of p<0.05.

In this study, nurse's overall score for job motivation was moderate with a mean score of 2.9±0.5. Intrinsic motivation al factors were more important than health factors (extrinsic) in creating job motivation. The most and least important motivational factor from among the components of motivational factors were the nature of work (3.8±0.8) and identification (2.3±0.9) and from among the components of health factors, related cooperation (3.8±0.7) and job security (1.8±0.8). There was no statistically significant difference in the overall motivation mean score in terms of demographic characteristics.

In light of nurse's job motivation and intrinsic motivational factors, it is recommended that nurse managers pay more attention to factors such as staff appreciation, economic problems, security, and working conditions.

Blended learning is a combination of two or more educational methods that takes advantage of other training methods such as multimedia courses, seminars, and e-learning in addition to attending classes. This study aimed to assess nursing students’ experiences of blended learning and to evaluate the effectiveness of this method. This study used content analysis methodology and had a qualitative approach. For this reason, 30 third-semester nursing students from Urmia Islamic Azad University were selected through purposive sampling. Medical-Surgical II was prepared and implemented for the purposes of this study. At the end of the semester, students’ experiences were derived using focus group interview during four sessions. The content analysis method was used for data analysis. Three main themes and n ine sub-themes were extracted from the results. The main themes included "benefits of blended learning", "offers for increasing efficiency of blended learning", and "disadvantages of blended learning". Participants expressed that blended learning is more useful than traditional education, and leads to ease of understanding learning, increases motivation to continue to higher education, and reduces test anxiety. In comparison with traditional learning, blended approach improves learning, has positive impact on exam results, and improves working skills with computers. Therefore, using blended education in medical training is strongly recommended.

Prematurity is the main reason for NICU hospitalization. ‍Care of neonates in NICU must be qualified to decrease their stress. The present study aimed to determine and compare the mean of physiologic responses of preterm infants before and during a designed program to decrease stressful stimuli in the NICU.

In this single-group quasi-experimental study, 31 preterm infants hospitalized in the NICU of Al-Zahra Hospital in Isfahan, who had inclusion criteria, were selected by randomization method and enrolled after parents’ consent. The interventions included decreasing noise and light in the environment and neonatal handling for two consecutive days, each day for 2 hours. Their respiratory rate, SPO2, and frequency of body movements were measured before and during the intervention. Data were analyzed using paired t test in SPSS (version 16).

The mean percentage of SPO2 increased but the mean number of body movements decreased significantly compared with the time before the intervention and during the intervention (p<0.05). However, there was no significant change in respiratory rate (p=0.44).

The findings showed that creating periods of low light and noise stimulation in the NICU can greatly help to improve SPO2 and decrease body movements in preterm infants.