نشریه پرستاری و مامایی ارومیه
سال دوازدهم شماره 9 (پیاپی 62، آذر 1393)

Continuous light exposure and lack of the natural day-night rhythm in the ICU، can modify the circadian rhythms due to melatonin secretion suppresses which in turn leads to the sleep disruption in the patients. Therefore، the purpose of this study was to determine the impact of eye masks on nocturnal sleep in patients in cardiac care units. In this experimental study، 40 eligible patients were randomly assigned into 2 groups: control and eye mask. Demographic questionnaire، Pittsburgh Sleep Quality Index (PSQI)، rating pain scale، and Leeds Sleep Evaluation Questionnaire (LSEQ) were used for data gathering. The data were analyzed by using SPSS 16، Independent T، and Chi-square tests. The results showed that after intervention، the average total sleep score in control group was 4. 8±0. 5، while in the eye mask group it was 6. 7±1. 1. The difference between the two groups was statistically significant (P <0. 001). Based upon the findings of research، using of eye mask improves sleep in patients hospitalized in intensive cardiac care units.

Many patients with chronic renal failure undergo dialysis to survive their illness. Since this is a chronic and debilitating disease, patients are prone to multiple psychiatric consequences. Depression and anxiety are the most common disorders. Physical, psychological, social problems are brought to light in regards to the patient's ability to perform activities and self-efficacy in achieving a good quality of life.The purpose of this study is to examine relationships among self-care self-efficacy, anxiety and depression in 160 patients receiving hemodialysis. This is an analytical-descriptive study that was done on 160 patients under hemodialysis treatment, and they were selected randomly in educational - therapeutic centers of Rasht city, Iran, in 2011. The data were collected by using four questionnaires of demographic information, Hospital Anxiety Depression Scale (HADS‏), and General Self Efficacy Scale (GSES). The data were analyzed by SPSS 17 soft ware by applying Pearson correlation test, t-test, and analysis variance linear regression. (p<0.05) The mean age of the patients was 50.39 ± 11.86 (22-76 year). The findings showed that score of self-care were 33.14±4.93, anxiety 9.86±3.59, depression 8.59±3.30. Majority of patients (70.6%) had favorite general self efficacy and anxiety and depression of moderate to severe. Also, there is a significant relationship between self-care with age (p<0.05) and anxiety with job (p<0.04). Based on our findings, depression and anxiety are common findings in patients undergoing hemodialysis, which will affect their quality of life, The self efficacy is one of the factors that control and achieve the outcomes expected by patients, thus increasing self-efficacy can increase patients self care.

Quality of life is an important criterion in indicating the effectiveness of health care. Despite evidence of the effectiveness of self-management interventions in chronic diseases, few studies have been made regarding the value of self-management programs in patients undergoing hemodialysis. The aim of this study was to evaluate the effectiveness of self-management program on the quality of life in patients undergoing hemodialysis. This study is a randomized clinical trial. The sample consisted of 82 patients undergoing hemodialysis admitted to the dialysis ward of Taleghani Hospital. After purposive selection, the patients were randomly assigned to the experimental and control groups. The data were completed 12 weeks before and after of intervention by using the demographic information, and kidney disease quality of life questionnaire. Then they were analyzed by using descriptive statistics, independent samples t-test and paired t test. The results showed that there was a significant difference between the intervention and control groups in the mean quality of life after the intervention in the aspects of diseases symptoms, the quality of social interactions, encouraging the dialysis unit staff, physical role, pain and emotional role (p <0.05), but there was no significant difference in the other aspects of quality of life. The results of this study showed the effectiveness of self-management programs on some aspects of the quality of life in hemodialysis patients. Due to the shortage of nursing staff, and the importance of participating patients in the management of chronic diseases, developing self-management programs can be an alternative to the traditional training methods as well as the mentioned challenges.

Breast feeding is very useful for child, mother and community. Breast milk is superior to other milks in composition, amount of food, emotional effects, and protective factors. This study aimed to assess the effect of face to face education and pamphlet giving on mothers’ knowledge about breast feeding in Khoy. In this quasi experimental study, 105 mothers were included in the study by convenience sampling method, then they were allocated into three groups. Intervention was carried out by face to face education in one group, and by pamphlet giving in the other group. The control group did not receive any intervention, and they received routine hospital services. Data collection tool was a questionnaire containing demographic questions and knowledge questions. Data were analyzed by using descriptive and inferential statistics in SPSS 14. The mean age of samples was 25.9 ± 4.93. The majority (30.5%) of them were undergraduate (high school diploma), 71.4% working at home, and 61.9% had a natural child- bearing process. Mothers in intervention groups had more knowledge than control group. The face to face education was the most effective method. There was no significant statistical relationship between mother's knowledge and their age, job, educational level and child birth order. Since the educational methods could improve the mothers’ knowledge about breast feeding and according to results the face to face education method was more effective, so it is highly recommended to use proper and cost benefit methods to improve mothers’ knowledge and continuing breast feeding.

Multiple sclerosis is the most common neurological disorder in young adults who have various mental and physical manifestations. Anxiety is a mental symptom of the disorder that is correlated with exacerbation of MS. This study aimed to determine the effect of self-management program on anxiety of patients with multiple sclerosis. This experimental study is a pre and post test. 80 patients with multiple sclerosis who had inclusion criteria were randomly selected and divided into two groups of control (40) and intervention (40). STAI anxiety questionnaire was completed before and after the intervention. Self-management program was planned based on the results of the assessment and were held in intervention groups in four sessions for each group of 10 persons for a total of 16 sessions in two months. Data were analyzed by SPSS software version 16 and were performed using descriptive and inferential statistical tests. The findings showed that there is a statistically significant difference between two groups in their anxiety mean scores in patients with MS (0.020 = P). Anxiety mean scores of patients in the intervention group decreased after self-management program that independent t-test showed a significant reduction between the two groups (0.024= P). Self-management program is effective in reducing anxiety in patients with MS. The results of these studies show the necessity of self-management program in the long-term to reduce mental health problems which is recommended in patients with multiple sclerosis.

Patient education is one of the most important principles in the care and treatment process programs. Previous studies indicated that many patients are not given the proper education. The aim of this study is to evaluate nurse's opinions about the patient’s education barriers, and providing some strategies to improve it, in Kashan, in 2012. This cross sectional study was done on 250 nurse and 20 nurse managers in the hospitals affiliated to Kashan University of Medical Sciences. The data was collected by questionnaire including demographic characteristics, barriers and facilitators to patient education. Data were analyzed by descriptive and analytic (Analysis of variance (ANOVA) and chi-square) statistics, and by a confidence interval of 95% by SPSS v16.0. The most important barriers for patient education are as follows: lack of proportionality between the number of patients and number of nurses, Lack of time and excessive workload, nurses’ insufficient satisfaction with working shifts and hours, conducting unprofessional works, and insufficient overcome.A significant difference was found between conducting unprofessional works and position, so that nurses mentioned it as a barrier to patient education, but nurse managers did not. According to the results, in order to improve the quality of patient education, barriers with higher frequency should be modified and adequate budget and equipment should be provided educational needs for the nurses.

In spite of very brilliant achievements in Iran health system, there are some issues should be considered such as shortage and inappropriate distribution of resources and mismatching between the community health needs and the amount of human resources. An issue that is necessary to be considered by managers is appropriateness of human resources in service delivery units. Health Posts are one of these service delivery units. Different types of task division between midwife and family health worker in the Health Posts is totally possible. This study assesses the workload and number of required workforces in the Health Posts with different types of work division. Methods & Materials: In this study, a midwife’s workload was calculated and compared for different scenarios of task division in a Health Post in Kashan city using a combined approach considering need-based method of Pileroodi and utilization-based method of WHO named WISN method (Workload Indicator Staffing Need). If a midwife provides merely her own special services, the workload will be only 3.5% of overall family health workload in a Health Post with 12500 populations. If a midwife provides any services of maternal health program to all population of the Health Post in addition to her own special services, this proportion will be 24%. In these two scenarios one midwife and three family health workers are required. If a midwife provides special services to all population of the Health Post and provision of other services are divided between midwife and family health workers, their workloads are equal and just one midwife and two family health workers will be required. If a midwife provides any services of maternal health program to the Health Post populations completely, the workload will be less than that of family health worker. So dividing all of the services between midwife and family health workers, increases efficiency in addition to achieving equality in task division between staff and increasing accessibility.

According to the World Health Organization's emphasis on monitoring and evaluation of structure, process and outcome of the service, to improve quality and due to that no study has been performed in this area, we decided to do a study with the aim of the evaluation of midwifery care quality and satisfaction of its in labor and delivery units in Kashan University of Medical Sciences hospitals in 2011. In this descriptive study that study population included 300 low-risk pregnant women 18 to 35 years who were admitted to the maternity ward and they were selected with non-probability sampling.in this study data collection method was questionnaire that midwives information form completed by interviews with midwives, care observation forms completed by the researcher, structure form Consists of three parts personnel information, physical environment, equipment and medical facilities(Consists of three parts personnel information, physical environment, equipment and medical facilities) of labor also completed by the interview with head nurse of labor and finally satisfaction evaluation forms were completed by the patient at discharge and to analyze data we use from spss software version 16. Result showed equipment and structure of delivery have medium quality and quality of obstetric care in the four stages in most domains was not good.But percentage of satisfaction from service was very high. According to the findings of this study, authorities should apply to increase the quality of essential obstetric services with expert staff, increasing of medical staff and attention to psychological needs

Caring is a complex and critical component in nursing that is fundamental importance of nurses. Because health care is considered a personal relationship between patient satisfactions is important in the care and patients are receiving care about what they care about is important. Accordingly, the present study was to compare nurses 'and patient's perspectives on caring behaviors are prioritized.Methods & Materials: This is a descriptive – comparative that was conducted among 200 patients hospitalized in critical care unit's in Tabriz hospitals and 200 nurses caring for them. Data were collected using a questionnaire Larson (Care-Q), which gives caring behaviors in six subgroups examined. For data analysis, descriptive statistics that used SPSS v.21 software. Findings showed that there were significant differences between patient's and nurse's perspectives on the subscales of the instrument (P<0.05). The high ranking in patients’ group is about “availability” (p=0.02) and in nurses’ group is about “monitoring” (p=0.39). Due to the difference of opinion between the two groups, suggesting that nurses pay attention to needs of patients, particularly in the fields of emotional - psychological consider. Also, since patients are less informed about health care, quality of care is necessary to prevent the proper training and careful care of both by the authorities and the programmers’ managers.

Today, workplace violence (WPV) is one of the most complex issues of healthcare systems. The nurses, due to their central role in the health care team and consisting a very large population of hospital personals, are repeatedly exposed to violence, especially in Emergency Departments (EDs). Therefore, we decided to conduct a study to determine the extent and nature of violence perpetrated against nurses in EDs of Urmia university hospitals. This cross sectional study was conducted on 120 nurses in EDs of Urmia university hospitals (Imam Khomeini, Ayatollah Taleghani, Motahari and Seyed Al-Shohada). Data collecting instrument was a researcher-made questionnaire with 35 items in 2 parts: Demographic characteristics and WPV. After entering the collected data to the SPSS (19) software, data analysis was performed by using descriptive and analytical statistics (Chi square and Fisher's exact test). The highest rates of violence against nurses include verbal violence (92/5%), physical violence (34/2%) and verbal threats (31/7%). The main perpetrators of violence against nurses associated with patient’s companions (relatives or friends) (73/8%). 66/4% of nurses did not report exposure to violence to hospital authorities. Also, none of the nurses had received training or instruction on how to deal with violence. Due to the frequent exposure of nurses to WPV in EDs, effective steps should be taken to reduce this neglected problem of healthcare systems, such as: training and instructing the nurses about how to deal with violence, using written papers to report violence, improvement of laws and regulations, paying more attention by authorities to this issue, and using mass media for public education and promoting the culture of communication with hospital staff.