Iranian Journal Of Nursing and Midwifery Research
Volume:19 Issue: 2, Mar-Apr 2014

Continuous high-intensity noise in the Neonatal Intensive Care Unit (NICU) is stressful for premature infants and its reduction is considered as a nursing care. This study aimed to evaluate the effects of earmuffs’ use on the physiologic and motor responses of premature infants. This is a clinical trial conducted on 64 premature infants admitted to the NICU, who met the inclusion criteria, and were randomly assigned to study and control groups. Earmuffs were used for premature infants for 2 h in the morning and 2 h in the afternoon for two consecutive days to reduce the noise intensity in the busiest time of the NICU. The group with earmuff (study group) was compared with the control group receiving only routine care. Infants’ physiologic and motor responses were observed before, during, immediately, and 1 h after the intervention. Analysis of covariance and repeated measure analysis of variance (ANOVA) were used to analyze the data. When infants wore the earmuffs, they had significantly higher mean arterial oxygen saturation, the less frequent motor response, and a decrease in their pulse and respiratory rate. Paying attention to environmental noise can help the patients, especially the neonates in the NICU, and can be considered as a nursing care. Wearing earmuffs can protect premature infants against noise in the NICU and improve their physiological and motor state.

Annually, about 6000 new cases are diagnosed with breast cancer in Iran. In Iran, more women are affected with breast cancer than a decade earlier in comparison with other countries, and 70% of them are diagnosed at an advanced phase. Insomnia is the most common disorder following breast cancer, and interference in sleep quality and rest causes changes in physiological functions and reduces the body’s daily performance. The objective of this study was to determine the effect of massage therapy on the quality of sleep in patients with breast cancer. This clinical trial was conducted for about 1 month in a referral chemotherapy clinic of a teaching hospital in Isfahan, Iran. The participants consisted of 57 women with breast cancer who were selected by simple random sampling. They were randomly assigned to two groups of control and experimental. The control group was treated only by usual medical therapy, whereas the case group was treated by combined medicalmassage therapy. Data collection tools were the validated Pittsburgh Sleep Quality Index and a demographic questionnaire. Data were analyzed by SPSS using descriptive statistics, Chi-square test, paired t-test, and Students t-test. The results showed significant differences in the mean scores of quality of sleep before and after the intervention in the case group, while no significant differences were observed in the mean scores of quality of sleep before and after the intervention in the control group. In addition, no significant differences were observed in the mean scores of quality of sleep before the intervention between case and control groups. However, significant differences were observed in the mean scores of quality of sleep after the intervention between case and control groups. According to the results of this study, learning and applying massage techniques by medical staff causes health promotion and improves the quality of sleep in cancer patients. Furthermore, massage therapy is suggested as a non-pharmacologic method to improve sleep quality in these patients.

The family caregivers of the people with cancer such as breast cancer experience a decrease in their quality of life and an increase of their caring burden. In most of the cases, the researchers consider the quality of life and physical and psychological problems in patients with cancer and pay less attention to the family caregivers. To reduce the caring burden imposed to the caregivers and improve their quality of life, supportive strategies such as problem solving can be used. These interventions may have benefits for the caregivers although the research results are contradictory. The aim of this research was to determine the effect of a supportive educational program, based on COPE model, which focuses on creativity, optimism, planning, and expert information on individuals, on the caring burden and quality of life in the family caregivers of women with breast cancer. The present study is a clinical trial, which was conducted in Seyed-Al-Shohada Hospital of Isfahan University of Medical Sciences and a private center of chemotherapy in 2012. In this study, researchers investigated the effect of a supportive educational program based on COPE model on the caring burden and quality of life in the family caregivers of women with breast cancer. This supportive educational program included two hospital visits and two telephone sessions based on COPE model for 9 days. A total of 64 patients were selected based on the inclusion criteria and randomly assigned into two groups. Data were collected by use of Caregiver Quality of Life Index-Cancer (CQOL-C), World Health Organization Quality of Life — Bref(WHOQOL-Bref)_, and Zarit caring burden at the beginning of the intervention and a month after the intervention. The results showed that in the experimental group, the mean score of physical, mental, spiritual, environmental domains and overall quality of life in the family caregivers was significantly increased compared to the control group, but there was no change in the social domain of quality of life in the two groups. In the experimental group, the mean score of caring burden among the caregivers was significantly decreased compared to the control group.

E-learning can increase knowledge in patients and provide an efficient way to enhance the personnel–patient interaction as well as patient-specific education materials. So, the aim of this study was to compare the effects of two methods, multimedia and illustrated booklet educational method, on primigravida women’s knowledge of prenatal care. This was a quasi-experimental study based on pre-and post-tests carried out on 100 primigravida women (50 in electronic and 50 in illustrated booklet groups) referring to Navabsafavi Health Center of Isfahan University of Medical Sciences in 2012. Subjects were randomly divided into two groups of learning interventions, including multimedia and illustrated booklet. Subjects’ knowledge scores were collected using a researcher-made questionnaire with 50 questions. Before training, the mean scores (out of 50) of knowledge in e-learning and illustrated booklet education groups were 29.21 ± 7.4 and 30.01 ± 6.4, respectively. The difference between the mean scores was not significant 4-6 weeks after education. The score was 44.74 ± 3.4 in the e-learning group and 40.74 ± 6.4 in the illustrated booklet group, which showed a statistically significant difference (P < 0.01). Also, the level of knowledge increased in e-learning and illustrated booklet groups as 61% and 37%, respectively. This study showed that the courses of e-learning training improved the knowledge of pregnant women to a higher extent compared to illustrated booklet education. Therefore, different aspects of e-learning, including computer literacy and infrastructure of telecommunications, should be revised.

Clinical education is the heart of the nursing education program. Effective nursing clinical instructors are needed for graduating the future qualified nurses. There is a well-developed body of knowledge about the effectiveness of clinical teaching and the instructors. However, translating this knowledge into a context-based evaluation tool for measuring the effectiveness of Iranian clinical nursing instructors remains a deficiency. The purpose of this study is to describe the development and psychometric testing process of an instrument to ealuate the characteristics of Iranian effective clinical nurse instructor. Following a precise review of Iranian literatures and expert consultation, 83 statements about the characteristics that make clinical nurse instructors effective were extracted. In the next phase, the psychometric properties of the instrument were established by looking at the content validity, face validity, and internal consistency. Content validity of the instrument was assessed based on the comments of an expert panel including 10 nursing faculty members. During this phase, 30 items of the instrument were omitted or merged. Face validity of the instrument was assured based on the advices of 10 nursing students and 10 nursing faculty members. Finally, in the pilot test, the data of 168 filled questionnaires were gathered and analyzed by an exploratory factor analysis to reduce the items and identify the factor structure of the instrument. Through subsequent analyses, of the 83 items, 31 items were merged or omitted. At last, 52 retained items were divided into four subscales including student-centric behaviors, clinical performances, planning ability, and personality traits. The Cronbach’s alpha level of the inventory was 0.96, with the value for each domain ranging from 0.87 to 0.94. Iranian Effective Clinical Nurse Instructor evaluation tool has acceptable psychometric properties and can be used in evaluating the effectiveness of clinical nursing instructors.

Although today parents’ participation in taking care of hospitalized children is considered as an indispensable principle, it is still among the concepts with no consensus about. The main objective of this study is to define parents’ participation in taking care of hospitalized children. The concept of “parents’ participation in taking care of hospitalized children” was analyzed using a hybrid model in three phases: Literature review (theoretical phase), fieldwork, and combination of literature review and fieldwork (analytical phase). Based on the results of theoretical (literature review), fieldwork, and analytical phases, the best definitions for the concept The findings of this study showed that the dimensions of parents’ participation can be applied in pediatric wards, and nurses can improve the quality of care through application of the obtained findings.

Divorce is one ofthe most controversial and damaging social issues. Since the divorce rates are increasing rapidly, the current study evaluated the effects of factors leading to divorce application. This qualitative content analysis used purposive sampling to select 10 female divorce applicants at Isfahan Department of Justice (Isfahan, Iran). In-depth interviews were used for data collection. The contents of the interviews were transcribed verbatim and analyzed using a phenomenological method. The reliability and validity, i.e. real values, applicability, stability, and fact-based results, were ensured through relevant measures. Overall, 110 codes were extracted from the interviews. The codes were organized in 18 subthemes and seven main themes. The main themes included experiences of violence, cultural factors, family factors, financial factors, safety factors, experiences of promiscuity, and social factors. Different individual, social, and cultural factors may lead to divorce. The first step in reducing divorce rates is to identify the most important and influential risk factors for divorce. Community health nurses will then be able to help the families solve their problems. In general, eliminating the causes of divorce can prevent its severe consequences at individual, family, and social levels.

Today, despite remarkable advances in the care of hemodialysis patients, the quality of life (QOL) for these patients is still unsatisfactory. Although previous reports confirmed the effect of exercise on the well-being of renal patients, less than 50% of end-stage kidney patients participate in a regular sports program. Tai chi is a slow and gentle exercise that is suitable for people with chronic illnesses and those with severe intolerance of exercise. Therefore, this study aimed to determine the effect of tai chi exercise on the QOL of hemodialysis patients. This was a quasi-experimental study conducted in a single group and in two steps. Twenty-five hemodialysis patients, admitted to hospitals in Isfahan, Iran, were selected, and their QOL was compared before and after intervention in two domains of satisfaction and importance. Convenience sampling was used. The sampling was convenience. The subjects were trained in the intervention through a single session of tai chi exercise class for one hour weekly, for 12 weeks, with a training compact disc (CD) that helped the patients to exercise at least twice a week at home. Data were collected by the completion of a demographic characteristics form and a researcher-made QOL questionnaire adopted from Ferrans and Powers Quality of Life Index Dialysis Version and the Kidney Disease Quality of Life-Short Form (KDQOL-SF) questionnaire by the researchers. The data were analyzed by a paired t-test through SPSS software version 18. Data analysis showed that there was a statistically significant difference in health and functioning (P < 0.001), socioeconomic (P < 0.001), and psychospiritual (P < 0.001) dimensions, and the family dimension had P = 0.002 in the satisfaction domain and P = 0.008 in the importance domain; the total score of quality of life in both domains was P < 0.001. According to the research findings, tai chi exercise improves the QOL score significantly in all dimensions, and adding tai chi classes to the rehabilitation program of hemodialysis patients can have a positive effect including an improved QOL for them. Therefore, this study supports the results of other research studies that showed positive effects of tai chi on QOL.

Patients’ compliance to treatment is an important indicator for evaluating the successful management in chronic illnesses. Despite the fact an applicable definition of compliance is required to suitable intervention and research, this concept is not clear and there is no consensus concerning its meaning, definition, and measurement. The aim of this study was to explore the concept of compliance and to formulate a working definition. Theoretical phase of Schwartz-Barcott and Kim’s Hybrid Model of concept analysis was used to analyze the concept of compliance. Data were collected by using literature reviews. Medline, CINAHL, Ovid, Elsevier, Pro Quest and Blackwell databases were searched from 1975 to 2010 using the keywords “Compliance,” “Non-compliance,” “Adherence,” and “Concordance.” Articles published in English were selected if they included adult patients with chronic illnesses and reported attributes of compliance; 23 such relevant articles were chosen. The attributes of compliance included patient obedience, ability to implement medical advice, flexibility, responsibility, collaboration, participation, and persistence in implementing the advices. Antecedents are organized into two interacting categories: Internal factors refer to the patient, disease, and treatment characteristics and external factors refer to the healthcare professionals, healthcare system, and socioeconomic factors. Compliance may lead to desirable and undesirable consequences. A working definition of compliance was formulated by comparing and contrasting the existing definitions with regard to its attributes which are useful in clinical practice and research. This finding will be useful in clinical practice and research. But this working definition has to be tested in a clinical context and a broad view of its applicability has to be obtained.

All health professionals are responsible for facilitating mpowerment among people with diabetes. However, research suggests that health professionals do not have the knowledge and skills to help people with diabetes become empowered. As a result, many Iranian people with diabetes do not become empowered. The aim of the study was to explore and understand how impowerment occurs in Iranian people with diabetes. Grounded theory using individual open in-depth interviews, field notes, and memos was used to collect data from 25 people with diabetes, their families, and health professionals Strauss and Corbin’s constant comparative analysis was used to analyze the data. Empowerment is a transitional, perceptual, and continuous process. The process for people with diabetes includes threatened identity when diabetes is diagnosed, reconstructing identity, and integrating diabetes into identity to become an empowered person with diabetes. The empowerment process was influenced by a combination of knowledge, social support, values and beliefs, psychosocial issues, and the nature of diabetes. Health professionals can help people with diabetes integrate diabetes into their identity and become empowered; however, becoming empowered is complicated and occurs over time.

The purpose of this study was to examine the psychometric properties (validity and reliability) of Persian version of the 25-item Caring Dimension Inventory (CDI-25). A psychometric instrument validation study was designed. Content validity, internal consistency, and stability were confirmed. A total of 288 participants (143 nurses and 145 nursing students) were selected based on quota sampling approach. The PCDI-23 showed good test–retest (Spearman correlation coefficient of 0.89 for nursing students and 0.91 for nurses), internal consistency reliability (0.86), and acceptable face and construct validity. However, considering the results of analyses, excluding items 4 and 16 from the Persian version of the CDI is suggested. This instrument can be used to determine caring behaviors and nurses’ perceptions of the importance of caring behaviors among Persian language nurses.

Organizational and structural obstacles are a group of major obstacles in achievement of appropriate family planning counseling. Detection of these obstacles from the viewpoint of managers, staffs and clients who are key members in health services providing system is a major step toward appropriate planning to modify or delete this group of obstacles. The present study was conducted with the goal of comparing managers’, staffs’ and clients’ viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012. This is a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 staffs and 126 clients in medical health-care centers in Isfahan in 2012. Managers and the staffs were selected by census sampling and the clients were recruited through convenient random sampling. The date collection tool was a researcher made questionnaire, which was designed in two sections of fertility and personal characteristics and viewpoint measurement. Descriptive and inferential statistical test were used to analyze the data. The obtained results showed no significant difference between mean scores of viewpoints in three groups of managers, staffs and clients concerning organizational and structural obstacles in family planning counseling (P = 0.677). In addition, most of the managers, staffs and clients reported organizational and structural obstacles as the obstacles in the process of family planning in moderate level. The results showed the necessity of health services managers’ planning to modify or delete organizational and structural obstacles especially the agreed obstacles from the viewpoint of managers, staffs and clients

Family burden is defined as the problems, concerns, and unpleasant events affecting the patients undergoing coronary arteries’ surgery, and is associated with these patients physical and psychological improvement. Nurses are in a good position to provide appropriate intervention. This study aimed to investigate the effect of family-focused nursing interventions on the burden of the family members of the patients undergoing coronary bypass surgery. This is a clinical trial conducted on 50 family members of the patients undergoing coronary bypass surgery in Isfahan Shahid Chamran hospital. Caregivers were selected by convenient sampling and were randomly assigned to two groups of study and control. Caregivers in the study group attended a three-interventional session program during their hospitalization time, while the subjects in control group did not. Data collection tool was Novak and Guest caring burden inventory (CBI). Data were analyzed by SPSS. Means and SDs of caring burden before and after the intervention were 30.08 (14.03) and 19.2 (10) in the study group, respectively, and 30.16 (12.62) and 35.44 (10.42) in the control group, respectively. Changes of total scores of caring burden showed a significant difference after the intervention in the study and control groups (P < 0.001). Score changes of subscales of time dependence (P < 0.001), developmental (P < 0.001), physical (P < 0.001), and emotional caring burden (P = 0.007) were also significant. Results showed that family-focused nursing interventions were effective in reducing the family burden of the patients undergoing coronary bypass surgery. Nurses can administrate family-focused nursing interventions to reduce the caregiver burden.

Effective time management is considered important for managers for achieving the goals in an organization. Head nurses can improve their efficiency and performance with effective use of time. There has always been a lot of disagreement in understanding time management behaviors of head nurses; therefore, the present study was conducted with an aim to compare the understanding of head nurses and staff nurses of the time management behaviors of head nurses employed in Social Security Hospitals in Tehran, Iran in 2011. This was a comparative descriptive study in which 85 head nurses were selected through census and 170 staff nurses were also selected through simple random sampling method from hospitals covered by the Social Security. Data collection was done through a standard inventory with high validity and reliability, which consisted of two parts: Socio-demographic characteristics and time management inventory. The obtained data were analyzed by descriptive and inferential statistics through SPSS software version 13. Mean score of time management in head nurses’ viewpoint was 143.22 (±18.66) and in staff nurses’ viewpoint was 136.04 (±21.45). There was a significant correlation between the mean scores of head nurses’ time management and some of their socio-demographic characteristics such as gender, clinical experience, passing a time management course, and book reading (P < 0.05). There was a significant correlation between the mean scores of staff nurses’ time management and their clinical working experience, education, using time management approach, and type of hospital (P < 0.05). The majority of head nurses (52.9%) believed that their time management was in a high level; besides, most of the staff nurses also (40%) believed that time management of their head nurses was high. However, there was a significant difference between the perceptions of both groups on using Mann–Whitney test (P < 0.05). With regard to the importance of time management and its vital role in the quality of nursing care for clients, and also the fact that head nurses believed more in their time management behaviors, they are expected to improve organization’s goals and developments in order to modify the weaknesses and shortages and promote the skills and capabilities of their staffs and also resolve the disagreement on the understanding of time management. Moreover, effective time management training programs can be an important step for staff nurses and their head nurses.

Nausea and vomiing are the common symptoms of early pregnancy. Without treatment, vomiting can complicate the pregnancy, so it must be reduced. Wide varieties of treatment have been used for nausea and vomiting in pregnancy. This study compared the effectiveness of vitamin B6 and dimenhydrinate for gestational nausea and vomiting. One hundred and forty pregnant women with a gestational age of <16 weeks who had symptoms of nausea and vomiting were selected. They were randomly allocated into group A (n = 70) and group B (n = 70). The patients in group A received a vitamin B6 tablet, while the patients in group B received a dimenhydrinate tablet daily; the tablets were identical in appearance. The degree of nausea and vomiting was assessed by physical symptoms of Rhodes score. One hundred and thirty-five women returned to follow-up. Dimenhydrinate and vitamin B6 significantly reduced nausea and vomiting scores from 8.3 (7.4) to 2.8 (2.0) and from 8.6 (2.9) to 3.8 (2.3), respectively. The mean score change after treatment with dimenhydrinate was greater than with vitamin B6. Both dimenhydrinate and vitamin B6 were effective in the treatment of nausea and vomiting in early pregnancy. Dimenhydrinate was more effective than vitamin B6.

Emotional intelligence has evolved lot of interest in a variety of fields. The aim of this study was to determine the emotional intelligence and its related factors among junior medical sciences students. The research design was a descriptive — analytic analysis. Based on a census sampling method, the emotional intelligence of 322 junior medical sciences students was evaluated using the Bar-On Emotional Quotient Inventory. This study was done from 2008 to 2009 in the Mazandaran University of Medical Sciences. The findings showed that 48.1% and 22.4% of students had effective functioning and enhanced skills in emotional intelligence, respectively, while 29.5% of them needed some interventions in order to enhance the emotional intelligence. The study revealed that the students required intervention in every composite of emotional intelligence. In addition, emotional intelligence was correlated with gender, psychiatric history of the student and his/her family, experience of stressful life events, interest in the field of study, grade of study, and marital status. The results of the present study have shown that the students need some interventions to improve their emotional intelligence.

Vascular access complications are a major cause of excessive morbidity and mortality in the dialysis population. Moreover, there is not sufficient research regarding the factors correlated with vascular access complications among hemodialysis patients. This study aimed to evaluate the vascular access complications and their related factors such as nursing techniques and self-care in hemodialysis patients. A cross-sectional study was performed on 110 patients undergoing hemodialysis in Isfahan Aliasghar hospital during 9 months from July 2010 to March 2011. The data collection tools were a demographic questionnaire and three checklists designed to assess the complications of vascular access and care techniques. Data were collected by observations and interviews with the patients. Fisher’s exact test, chi-square test, Pearson correlation coefficient, and descriptive statistics were used to analyze the data through SPSS 16. Among 110 subjects, there were 63 male and 47 female subjects. Subjects’ mean age was 55.88 (15.51) years. There were 72 patients undergoing hemodialysis through arteriovenous fistula and 38 through permanent intra-jugular catheters. Insufficient blood flow in the catheter was the most common complication in patients with jugular catheters. Also, aneurysm was the most prevalent complication in patients with arteriovenous fistula. Low self-care of patients and needling into the aneurysm were correlated with aneurysm size. Presence of underlying diseases was related to ischemia. Nursing techniques and self-care of patients were correlated with the occurrence of complications. Therefore, it draws the attention of the nurses toward continuing professional education and patients’ education, which can increase the longevity of vascular access.

Sir, September 29 is observed as “World Heart Day” and the theme of the present year (2013) is “take the road to a healthy heart.” In continuation of the 2012 theme, the focus on prevention of cardiovascular diseases (CVDs) among women and children will be reinforced in 2013, emphasizing the fact that from childhood through adulthood, we have the opportunity to prevent the burden of heart disease and. ...