نشریه پرستاری و مامایی ارومیه
سال دوازدهم شماره 4 (پیاپی 57، تیر 1393)

Coronary Artery Bypass Graft (CABG) will ensure the survival and health of cardiovascular patients if medical therapy is not effective treatment. The study aims at the coping strategies used by patients after CABG. In this conventional qualitative content analysis، the samples were 17 post-CABG patients in two Cardiac Rehabilitation Centers of in Guilan. Data collection was performed through unstructured interviews and purposive sampling. Data analysis accomplished according to the Graneheim and Lundman (2004) proposed steps. Scientific accuracy and integrity of the data and research ethics were taken into consideration. The data analysis results were catogorized in three main themes and fifteen subthemes، as conceptual and abstract based on their nature: Optimal adaptation (forgetting illness، emotional control، application of defenses procedures، Surrender)، changes in daily routine life (dietary modification، avoiding isolation، daily walks، stop smoking، effective communication)، regaining hope (trust and hope، hope for further improvement، the hope of a better future، long life expectancy، hope to return to relatively normal conditions) and self- management was as the main common concept in all categories. Based on patient’s experiences that showed optimal adaptation by using the «self-management» as the most important strategy after CABG، the need for supportive intervention programs after surgery to promote the life quqlity of these patients were confirmed.

Living skills of schizophrenic patient will be changed because of cognitive، perceptual، sensory- motor، psychological and psychosocial problems. So، determining their needs seems to be necessary. In this study living skills of schizophrenic patients were assessed by Kohlman evaluation of living skills. In this cross- sectional analytical- descriptive research، living skills of 51 outpatient and 35 inpatient with schizophrenia and 35 nonpsychiatric participants which were evaluated by kohlman evaluation of living skills were compared to each other and the fields of needing assistance were identified. Comparing the means of total scale score which was estimated by Kruskal-wallis test، showed that the difference between nonpsychiatric participants and schizophrenic patients was statistically significant (P< 0. 001). There was no significant difference between the mean scores in the evaluation of subgroups of schizophrenic patients. Also schizophrenic patients needed more than 50% of assistance in appearance، awareness of dangerous situation، identification sickness، obtaining and maintaining source of income، budgeting of monthly income، and leisure time activity subscale scores. Living skills was influenced by occupation: the mean scores in living skills of employed patients (2. 409) were better than unemployed ones (7. 083). Living skills of schizophrenic patients would be damaged in different areas as a result of progressing in the signs of disorder. They showed maximum assistance need in the areas of self-care، health and safety، money management، and leisure time activities which were evaluated by Kohlman evaluation of living skills.

Quality control of medicinal products، especially considering the amount of active ingredient of toxic side effects، and their complications is important. The present study was performed to measure Ciprofloxacine which is commercially available in the drug market of Iran. In this study pharmaceutical dosage form of Ciprofloxacine with different brands and dosage forms was prepared from a local pharmacy. High Performance Liquid Chromatography (HPLC) was used as the preferred analytical tool. The method uses a C18column. The mobile phase consisted of acetonitrile/ phosphate buffer with (pH= 3) (20:80) and fluorescence detection at 338 and 425 nm. The results of these experiments showed a linear standard curve for Ciprofloxacine over the range of 0. 1-2. 5 µg/ml. The corresponding regression equation was H= 4. 8247 C + 0. 8094 with an r2 value of 0. 9925. Taking one of the bulk samples as 100% references، the determined content was 209-309 µg/ml for infusion solutions of 200 µg/ml، 0. 25-0. 027 µg/ml for eye drops of 0. 3 µg/ml، 280-701mg for tablets of 250 mg and 511-947 mg for tablets of 500 mg. These findings confirm the necessity of quality and accurate controls over the industrial pharmaceutical companies.

To have a supportive، calm، experienced birth partner is every mother-to-be’s wish. Anxiety and stress during labor could decrease the progress of labor. The aim of this study is the investigation of effects of presence of midwifery and relaxation therapy on the speed of active phase of delivery in primiparous women. This study is an experimental study that was conducted in the period of 3 months. In this study، 90 primiparous women in active phase of labor were randomly selected and divided into three groups (one control and two experimental groups) with 30 subjects in each group. The control group received routine nurse care. In one experimental group، the subjects were under midwifery extra care، and in another experimental group the subjects received relaxation therapy in addition the presence of a midwifery psychologist. Observation and record of active time length phase frequency was used. The mean lengths of active phase among experimental groups were lower than control group، and the differences were statistically significant (the first experimental group= 183/83، the second experimental group= 138/67 and the control group= 245/50، p< 0/01). The mean length of active phase in the 2nd experimental group was significantly lower than the 1st experimental group. Primiparous women who received routine nurse care (the control group) had increased length of active phase of delivery compared to the women who were under extra care by midwifery (first experimental group). Women، who had relaxation therapy in addition to presence of midwifery (the second experimental group)، had decreased length of active phase of delivery compared to the women who were just under extra care by midwifery. The presence of midwifery and relaxation therapy can cause the decreasing of labor active phase.

The women''s ultimate satisfaction of birth is influenced by their expectations and real experience. A birth experience is a reason for increasing cesarean rate based on mother''s demand. This study aimed to clarify the role of previous birth experience on women''s decision-making about the type of next delivery. This study is a qualitative research with descriptive-exploratory design. A purposive sampling was done in all women with at least once natural delivery or c-section or both who referred to health centers of Sari until six months postpartum. Sampling was continued until data saturation. After interviewing with 16 participants consisting of 10 mothers with normal vaginal delivery، and 6 cesarean sections، data saturation was achieved. Face to face semi-structured interview was used to explore the experiences. Coding and data analyses were done during sampling by using Graham and Landman content analysis method. Initial codes were 166 with two main themes; effective factors on selection of natural delivery، and cesarean. Four sub-themes that formed effective factors in the natural birth were pain management، stress management، experiencing natural childbirth outcomes، and low costs. Lack of awareness during cesarean، faster process of cesarean، the consequences of cesarean، having knowledge and staff’s behavior were 5 sub-themes in effective factors on selection of cesarean delivery category. Positive experiences lead to positive attitude of the mother about vaginal birth. Based on the results، women often chose cesarean as an approach to deal with negative experiences of natural childbirth. It seems that many factors that lead to negative birth experiences could be corrected. So، attention to the encouraging or inhibiting factors in both of natural and cesarean delivery can reduce the demand for cesarean.

Preeclampsia has remained as one of the most important obstetrical problems for which different factors have been suggested. Recently، psychopathologies identified many risk factors for preeclampsia، but few studies have focused on the relation between maternal mental health status and preeclampsia risk. The aim of this study was to determine the association between depression and incidence of preeclampsia in pregnant women admitted to Mahdieh Hospital، 2012. In this case-control study، Beck Depression Inventory was used as data gathering tool. 190 pregnant women، 95 as case group (preeclampsia) and 95 as control group (healthy)، who had inclusion criteria، were included in the study. All participants were selected based on target sampling method. The results of this study showed that 81. 1% of healthy and 76. 8% of preeclamptic women had some levels of depression. 35. 8% of healthy، and 34. 7% of preeclamptic women had mild depression، 31. 6% and 17. 9% had moderate depression and 13. 7% and 24. 8% had severe depression respectively. Among cofounders، numbers of prenatal cares was controlled by entering in logistic regression. After adjusting for cofounders the effect of depression remained ineffective. Regarding the high prevalence of depression in pregnant women، midwives and health care worker''s should pay attention to the psychological health of pregnant women during prenatal period، and depression screening and appropriate treatment should be emphasized.

Due to the increasing of cesarean operations in Iran as a health problem، and its effects on maternal mortality، this study aims to determine the prediction of the type of delivery according to the Theory of Planed Behaviors (TPB). This study was conducted by using descriptive-analytic method in the second half of 2012 and the first half of 2013 on 392 pregnant women admitted to the women’s clinics of Baqiyatallah and Najmieh hospitals in Tehran. The data were collected through a questionnaire based on the theory of planned behavior variables such as knowledge، attitudes، perceived behavioral control، subjective norm and behavioral intention. Data were analyzed using SPSS software version 16 and also logistic regression. The mean age of the mothers under study was 27. 6 + 4. 5. Out of 392 pregnant women، 218 (58. 1%)، and 157 (41. 9%) had chosen a vaginal delivery and cesarean delivery respectively. Among the factors of the theory of planned behavior، mostly the subjective norm predicts the pregnant women’s making an informed choice (Wald=49. 74). Other effective variables are knowledge، attitudes and perceived behavioral control، respectively. The subjective norm (social factor) was identified as the most effective factor in predicting the informed delivery choice type. Therefore، along with educational programs to promote awareness and correcting the attitude of young women about natural delivery، it is recommended that the specialists including obstetric and gynecologists be encouraged to promote natural childbirth.

The nature of nursing necessitates attention to be devoted to caring concerns more than remedial concerns. Inadvertency to care-related issues can bring about negative outcomes and in turn lead to contradictory conflicts. The present study is an attempt to provide an explanation and prediction of the observed conflicts in the Professional Ethics of nurses in public hospitals of Tabriz city. The statistical community includes all nurses of all government hospitals in the city of Tabriz which includes 1800 people، 297 people were selected by stratified sampling method and the Cochrane formula. The validity of the instruments was examined through the face validity component and the Cronbach’s Alpha reliability which was turned out to be 0. 95 for the Professional Ethics variable، and 0. 82 for the organizational conflict variable. The results of correlation analysis show that there is a significant negative relationship between the Professional Ethics in general along with its specific components of trust، equity، enhancement of knowledge and ability، loyalty، respect to colleagues، care quality and commitment to the reserve of nursing reverence in particular with the amount of conflict in general. Moreover، the results of multiple regression analysis indicate that the components of Professional Ethics of nurses in general predict 7 percent of the conflict degrees in general hospitals of Tabriz. Professional nursing practice is based on honesty، cooperation and collaboration with colleagues and patients. Therefore، to reduce organizational conflict، the professional ethics as a predictive variable can be utilized.

Patients on hemodialysis need effective self-care education. Computer-based patient education is an effective educational method. The aim of this study was to compare the effects of multimedia based education، and traditional method on patients’ hemodialysis knowledge and treatment adherence.

In this quasi- experimental study، all of the patients referred to four hemodialysis centers in Tabriz City were divided randomly into intervention and control groups. A knowledge (Cronbach’s alpha = 0/78) and treatment adherence questionnaire (Cronbach’s alpha = 0/84) were completed as a pretest and repeated three months after the educational program. The intervention group interfaced and navigated their way through the Hemodialysis and Essentials Care application with a laptop during their hemodialysis time. The control group received the same content in the traditional way (face to face and pamphlet).

Findings showed that post-education knowledge mean scores had changed substantially (p< 0/05) in both the intervention (n= 32) and control groups (n= 30)، however، treatment adherence mean scores were statistically significant only in the intervention group (p< 0/05). There were no statistically significant differences between the two groups in pre- and post-education knowledge and treatment adherence mean scores (p>0/05).

The Hemodialysis and Essentials Care application based education improved patients’ knowledge and treatment adherence compared to the traditional method. This application could be used to facilitate the patient education process and to improve its quality.