مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و دوم شماره 1 (پیاپی 44، بهار 1393)

Spirituality as interesting dimension of well-being is important in childbearing women. Holistic approach to care in pregnancy requires focusing on unborn child and his spirit. Considering the primary role of the mother in the prenatal care of the foetus، the maternal behaviors associated with the spiritual health of him/her was explored. This study used a qualitative research design to explore spiritual experiences of pregnancy in the lives of 18 women by 28 unstructured interviews. Sampling conducted purposefully in Tehran in 2013. Themes were identified using conventional content analysis. «Direct or indirect relationship with God” and” acceptable and blessed nutrition” is important experiences have emerged. Mothers tried to» promote the body and soul «of themselves to institutionalize the ideal spiritual and moral future of unborn child. These finding points to the importance of cultural and religious belief on spiritual care patterns of unborn child’s spirit in Iran that reflects the increasing need for more culturally competent perinatal care by midwives.

The comorbidity of personality disorders is a common phenomenon among bipolar patients. The purpose of this study was to present the frequencies of personality disorders in a sample of bipolar I patients after treatment of manic phase in patients consulted Farshchian Hospital in Hamadan. In this cross-sectional study of 101 adult patients with a diagnosis of bipolar disorder in the manic phase of hospitalization in Farshchian psychiatric hospital in Hamadan city assessed according DSM-IV after treatment of manic phase in 2012 by means of Millon clinical multiaxial inventory-3. Data analysis by frequency and chi square. the overall frequency of personality disorder was (44. 6%). The most common personality disorder cluster was cluster B (32. 7%)، followed by cluster C (6. 9%) and a cluster (1%). Frequency of personality disorder was significantly high in patients with having family history of psychiatric disorder. The prevalence of cluster B personality disorder was high in the younger patients and (A + B) personality disorder was high in the older patients. Overall، the presence of comorbidities in BPD has negative prognostic implications for psychological health and for medical well-being. Clinicians should consider the diagnosis and treatment of personality disorders in patients.

This study was designed to determine the effects of calcium-vitamin D supplementation on insulin resistance، inflammatory factor and biomarkers of oxidative stress among healthy pregnant women and pregnancy outcomes. This randomized double-blind controlled clinical trial was performed among 42 p regnant women، aged 18-40 year old who were carrying singleton pregnancy at 25 weeks of gestation. Pregnant women were randomly assigned to receive either 500 mg calcium-200 IU vitamin D supplements (n=21) or placebo (n=21) for 9 weeks. Fasting blood samples were taken at baseline and after 9-wk intervention to measure insulin resistance، high sensitivity C-reactive protein (hs-CRP) and biomarkers of oxidative stress including plasma total antioxidant capacity (TAC) and total glutathione (GSH). Newborn''s weight، length and head circumference were measured during the first 24 h after birth. Consumption of calcium-vitamin D supplements compared with the placebo resulted in a significant reduction of serum hs-CRP levels (-1856. 76 vs. 707. 13 µg/mL، P=0. 006)، a significant elevation of plasma TAC (89. 29 vs. -9. 37 mmol/L، P=0. 03)، serum vitamin D (2. 49 vs. -1. 72 ng/mL، P<0. 0001) and calcium levels (0. 6 vs. -0. 1 mg/dL، P<0. 0001). The supplementation led to a significant decrease in DBP (-1. 9 vs. 3. 1 mmHg، P=0. 02) compared to placebo. In conclusion، consumption of calcium-vitamin D supplements for 9 weeks among pregnant women had the beneficial effects on metabolic profiles.

Episiotomy is the most common incision in midwifery that facilitates expulsion of the fetus، which like any other wound need to care. So we compare the effect of saline normal healing with Povidon Iodine on episiotomy in nulliparous. Methods& This is a randomized control clinical trial. 120 nulliparus women were enrolled of Taleghany Maternity House at Arak، Iran. They were randomly assinghed to receive either normal saline 10cc (case group) or Povidon Iodine (control group) TDS for irrigation the episiotomy. They were visited for wound healing with REEDA cheklist in 5th and 10th days of post parum. The data were analyzed with T test، χ2 and Mann-whittney U. There was no significant difference between two groups in mean of redness، edema، infection at 5th and 10th، discharge، ecchymosis at 5th and approximation in 10th days of post partum. In 5th day mean of wound approximation was less in normal saline than Povidon Iodine group [0. 73 (±0. 71)، 0. 47 (±0. 57)] (Pv<0. 04) respectively. In 10th day in case group mean of ecchymosis and discharge [0. 36 (±0. 52)، 0. 36 (±0. 56)] was more than control group [0/16 (±37)، 0. 1 (±0/36)] (Pv<0. 02، 0. 007) respectively. It seems normal saline can be replaced with povidon iodine solution in episiotomy care. This is safe، cost benefit، accessible and easy to use.

Healthy diet is one of the most important matters in Diabetes and the patients themselves have the main role in this area. In interventional trainings in Iran، the patients with diabetes are less entered into training programs. Therefore، the aim of this study is to investigate the effect of teaching based collaborative care model on diet of patients with Diabetes type II. This study is a single-blinded randomized clinical trial which was done in Educational Center of Diabetes of Tabriz. The sample consisted of 40 patients with diabetes who were randomly divided into two groups of experimental (20 patients) and control (20 patients). At first، the patients took the pre-test and then collaborative testing was held for seven one-hour sessions for the experimental group including the stages of motivation، preparation، engagement and evaluation. Also، three months after the collaborative program، patients of both groups took a post-test. Life Style Questionnaire (LSQ) was used for collecting data. The data were entered into SPSS13 and analyzed by descriptive and inferential statistics. The results of the study showed that after performing the intervention، the patients of the experimental group reported better performance in compare with control group in items related to using snacks between main meals (p= 0. 05)، liquid fats (0. 01)، animal fat and butter (p=0. 04)، fruit (p=0. 001)، vegetables (p=0. 03)، fish (0. 02). According to the results، it is recommended to use collaborative care model for training Diabetes type II.

The presence of a child’s parents during the induction of anesthesia has always been a controversial issue. While early studies found that parental presence could reduce parents'' anxiety and increase cooperation of them. This study aimed to evaluate parental presence during children induction of anesthesia on a parent''s anxiety. This is randomized controlled trial research. 60 parent of Children 2 to 11 years undergoing surgery were randomly divided into experimental and control groups. Parents were present in the intervention group. Anxiety Inventory for parents Spilberger in two stages were examined، and finally SPSS/18 software and the chi- Square test، Fisher exact test، t test and t pair we were used for data analysis. The preoperative parental anxiety average scores between the two groups were not statistically significant difference. Parental postoperative anxiety average scores between the two groups had significant differences (p = 0. 035). As well there were no significant difference between parental anxiety levels and sample demographic characteristics of the two groups before and after surgery. Result showed that parental presence during induction of anesthesia to the child had no additive effects for reducing the parent''s anxiety; however، effective interventions to preparing and reducing of anxiety of childrens'' parents undergoing surgery should be done.

Regarding high prevalence of sleep disorders among coronary care unit patients and the impact of proper sleep on health and improvement of patients, the aim of this study is to define the effect of nursing interventions on quality of sleep among patients in coronary care unit.

This clinical trial study was accomplished by participation of 196 patients in CCUs of Ekbatan Hospital of Hamadan city via convenience sampling methods and then they were divided in Control and Intervention group randomly. At first, the quality of sleep in control group which received routine nursing cares was measured in the morning of the third day by SMHSQ questionnaires. After preparation of environment and defined nursing intervention for in-patients sleep were taught to the nurses. In morning of the third day of hospitalization, the patients’ quality of sleep of intervention group was measured by SMHSQ questionnaires. Then, the patients’ quality of sleep of control and intervention groups was compared.

Results showed the mean score (standard deviation) of sleep quality in control group and intervention groups was 26.58 (6.64) and 17.87 (5.36) respectively. univariate analysis of variance test indicated a statistically significant improvement in sleep quality in intervention group than that of control group (p=0.031).

Using appropriate nursing interventions for sleep and adequate rest and preparing appropriate physical conditions could have a major role in improving quality of sleep of patients in coronary care units.

The standards describe an optimal level of performance. Do not applying medication care standard, results in different problems. This study was done in order to determine applying structure & process standards of medication care at pediatric wards. In this descriptive cross - sectional study, a sample was selected via systematic random sampling; consist of 610 medication care procedures, applied by nurses of pediatric wards at one of the Hamadan University of Medical Sciences Educational and Treatment Center. The research instrument was a medication care check list. Using descriptive statistics (Mean and Standard Deviation) and inferential statistics (Spearman Correlation Coefficient, One Way ANOVA and Tukey post-hoc) data were analyzed by SPSS 16 software. The utilization of oral medication care structure standards as well as intra-venous injection structure standards were good, but application of their process standards were weak and moderate respectively. There was a significant indirect correlation (p=0.006) between using intra-venous structure and process standards. In terms of utilizing oral medication structure standard, the nurses with age group of 29 years and less were applied mentioned standard more than others (p<0/001); moreover, regarding intra-venous injection process standard, the nurses with age group 36 years and over were utilized the standard more than others. In order to ensure that children benefit appropriate and quality medication care, continuous evaluation of applying medication care standards are necessary.