Journal of Holistic Nursing and Midwifery
Volume:25 Issue: 3, 2015

Self-esteem is one of the necessities of human life and most professionals consider it as a major factor in social and emotional adjustment. Low self-esteem in students causes academic failure، loneliness، drug abuse، away from reality and self-destructive behaviors. This study aimed to determine the level of self-esteem and its related factors in high school students in Rasht city. In this descriptive-analytical study، 489 high school students in Rasht city were randomly chosen and surveyed. Method of data collection was a questionnaire consisting of two parts. Part one included standard questionnaire of Cooper Smith Self-esteem Inventory which surveyed 4 domains (general، education، familial and social) and second part was a researcher made questionnaire covering related factors to self esteem including two parts of personal and familial factors (age، gender، height، weight، order of birth، grade level، major، last year’s Great Point Average، religious activities، physical and emotional illness، apparent problems، number of family members، education، occupation and age of parents، family monthly income، place and condition of living). For data analysis descriptive statistics and Kruskal-Wallis and Mann-Whitney U tests were used. Findings indicated that only 37. 8% of cases studied had good self-esteem. Also a significant relationship was shown between self-esteem، sex P< 0. 04)، bound to religious practice (p=0. 0001) and family monthly income (p<0. 006). Considering the low level of self esteem among most cases، more attention of teachers and parents is necessary to promote adolescents’ self esteem

Cool dialysate solution is an important factor in maintenance of cardio–vascular stability in hemodialysis patients. This study aimed to determine the effect of dialysate temperature on vital signs، comfort and adequacy of dialysis in hemodialysis patients. This study is a clinical trial conducted on 30 hemodialysis patients hospitalized in hemodialysis ward of one of Hamedan hospitals. Eligible patients were selected by simple sampling method and then three sessions of interventions were done. Patients were dialyzed at 37º C in first level and 35ºC and 36ºC in the second and third levels during three sessions. Patients’ blood pressure and pulse rate were controlled before and after dialysis and in the first، second and third hour during dialysis. But patients’ body temperature was controlled before and after each session. In the third session، patients’ blood samples were collected before and after dialysis to assess the KT / V. At the end of session، patients were assessed for comfort using visual criteria. For data analysis repeated measurement، variance analysis and Tukey test were used. P value less than 0. 05 was considered statistically significant. Research findings showed that although with reduction of dialysate temperature، systolic blood pressure of patients slightly increased، but this increase was not statistically significant. Patients'' pulse reduced significantly by decreasing. Patients were more comfortable at lower temperature. And only 6. 7% of patients preferred 37C º temperature. Dialysate temperature did not matter to 20% of patients while the rest preferred cool dialysate. Patients’ KT/V showed a significant increase at 35C º temperature compared to 36ºC and 37ºC. According to the research findings although reduced dialysate temperature may not be useful for all patients but considering its benefits، it is recommended considering patient’s condition and comfort level، dialysate with lower temperature be usedAccording to the research findings although reduced dialysate temperature may not be useful for all patients but considering its benefits، it is recommended considering patient’s condition and comfort level، dialysate with lower temperature be used.

Rabies vaccination after animal bite is the most important method for prevention of rabies. Delay in rabies vaccination increases the risk of rabies after animal bites. This study aimed to determine incidence rate of rabies vaccination delay after dog bite and its related factors in Guilan province. In this cross-sectional descriptive analytical study conducted over one year period from July 2011 to June 2012 we surveyed all those with at least 16 years of age with dog bite who referred to rabies vaccination centers in Guilan province. A researcher-made questionnaire was used for data collection and data were analyzed by descriptive statistics، Chi square test، independent t test and logistic regression. During research period 1604 cases of dog bites were surveyed of whom 13. 8% of cases had at least 24 hour and 5. 5% had at least 48 hour delay for receiving rabies vaccine. Having superficial injury (OR: 2. 16، CI: 1. 34-3. 48)، incidence in rural area (OR: 1. 69، CI: 1. 05-2. 72) and lack of knowledge about necessity of rabies vaccination after dog bite (OR: 1. 45، CI: 1. 07-1. 97) significantly led to delay of rabies vaccine after dog bite. Based on this study results it is necessary to inform people on rabies and also the need of rabies vaccination after dog bite in order to reduce delay.

Providing proper and qualified nursing care for patients as members of society has turned patient safety to an important issue in quality health care in country. This study aims to determine the relationship between patient safety culture and professional behavior of nurses within the framework of the implementation of clinical governance in all health centers in Rasht. This study is a descriptive and correlational study whose statistical population consisted of nurses in health centers in Rasht city، of which 322 patients were selected randomly as samples. Data collection tool included nurses’ professional behavior taken from Wakefield instrument and Research Agency questionnaire and quality of health care for patient safety culture. Data were analyzed using descriptive statistics and Pearson correlation coefficient. Findings indicated from respondents'' views، nurses’ professional behavior and patient safety culture in educational health centers in Rasht was at moderate level. The results also showed a significant and direct relation between professional behavior of nurses and patient safety culture (P <0. 01، r=0. 6). Patient safety culture will improve as nurses’ professional behavior increases. It seems to an enabling program can create an atmosphere in which people feel more responsible conducting professional behavior and increase culture of patient safety.

Coronary artery disease is one of the most common forms of cardiovascular disease. In attention to high prevalence of cardiovascular disease، coronary artery bypass grafting is a common technique for its treatment. Contrary to belief of most patients، this method has the effect of relief and not treatment. Therefore adherence to care instructions after surgery is very important. Several factors can affect the adherence of care instructions. This study aims to determine the status of adherence and its related factors in patients undergoing coronary artery bypass surgery. In this cross-sectional study، 217 patients referring to Dr Heshmat educational therapeutic center undergoing coronary artery bypass surgery in more than 6 months ago were selected by systematic random sampling method and studied through telephone interviews using the adherence of care instructions and illness perception questionnaire. For data analysis Chi-square and Fisher''s exact test were used and multiple logistic regressions were used to determine the factors associated with adherence. Findings showed that majority of patients had appropriate adherence to smoke cessation (88%) and physical activity (60. 8%)، but most study cases had inappropriate adherence to diet (88. 5%). Regression results showed that predictive factors for adherence to smoke cessation included sex (P=0. 003) and illness perception (P=0. 04)، and in regard to adherence of physical activity also sex (P<0. 0001) and illness perception (P=0. 057)، and adherence to diet only sex (P=0. 048) were indicated as predictors. According to the study results، adherence to care instructions is not complete. In attention to study results، rehabilitation of these patients after CABG is important and health care systems can prevent additional costs for patients and community by creating rehabilitation system.

Despite the emphasis of World Health Organization on limiting antibiotics، its use is increasing worldwide. Since studies have shown that personality has a role in determining individuals’ health behavior، thus it is possible to change one’s health behaviors like self medication through suitable interventions. Present study aims to determine the relationship between personality characteristics and self use of antibiotics among students. In this co relational descriptive study، 405 students of Qom universities entered the study by available sampling method and were asked to complete both questionnaires of Neuroticism Extraversion Openness Inventory and demographic information. Data were analyzed through descriptive and inferential statistics such as t-test، Mann Whitney and chi-square. Study participants consisted of 255 female and 150 male students with an average age of 21. 76 ± 4. 39 years. 53. 8% of students stated using antibiotics in last three months and of which 49. 8% obtained antibiotics by physician prescription، and the rest (50. 2%) without a prescription. The most common cause of antibiotic use was symptoms of cold and rhinorhea and Amoxicillin was the most used antibiotic. No feeling of need to refer to physician during illness was listed as the most common reason for self-medication with antibiotics. Study results indicated that participants had moderate level of neuroticism، extraversion، agreeableness and conscientiousness. The mean score of personality dimensions showed no significant difference in two groups of self-medication users and non-users (P>0. 05). Considering the high prevalence of self-medication among students، it is necessary to increase awareness and promote development of students'' attitudes and performance through proper interventions. Also، further studies seem necessary on impact of personality characteristics and psychological aspects on self medication of antibiotics.

Overweight and obesity is one of health related problems that its prevalence in developed and developing countries is on rise and has become a public health problem. This study aimed to determine the predictors of overweight and obesity in children beginning elementary schools in the city of Rasht. This descriptive cross - sectional study was conducted on 426 children aging 6-7 years old، who were selected by stratified randomized method from two districts of Rasht city from all children who referred to National program of children health measurement. Data collection instrument consisted of a researcher made questionnaire to assess predictors of overweight and obesity and sample’s demographic characteristics. Data were analyzed using t-test and ANOVA and Pearson correlation test. The results showed that 8. 6% of boys and 14 percent of children are overweight and 19% of boys and 15. 3% of girls are obese. There was a positive relationship between children’s overweight and obesity with family history of obesity (p<0. 001)، maternal BMI (p<0. 02)، amount of food eaten in comparison with same age children (p<0. 001) and the amount of physical activity for children (p=0. 02). Four variables of family history of obesity، maternal body mass index، and parents’ view on food taken compared with other same age children and hours of physical activity were shown as predictors of overweight and obesity in children entering elementary school. It is necessary to teach parents and children prevention of obesity.

Use of progressive technology، clinical skills and caring methods appropriate to critical situations of patient in intensive Cardiac Care Unit is probably related to professional errors and disorder in patient safety. There is a little data about this subject. The aim of this study was to explore professional errors and patient safety in Cardiac Care Unit. This study was conducted using qualitative approach and conventional content analysis method. Fifteen Cardiac Care Unit nurses participated in this study during 2012-2013. Samples were selected purposefully and data collection method was through semi-structured interview. Data analysis of extracted contexts، the main theme abstracted was «teamwork». Subthemes included «empowerment»، «job satisfaction» and «supporting management». Study results indicated that providing teamwork is very important in reducing errors، maintaining and improving patient safety in Cardiac Care Unit. Also necessity of supporting management regarding suitable confrontation with error، empowerment and increasing nursing job satisfaction are basic principles of professional error prevention and provision of patient safety.

Accumulation of secretions in airways is a serious complication in intubated and mechanically ventilated patients. Tracheal suctioning which is done with the aim of secretion removal can be used in conjunction with physiotherapy for effective airway clearance and improving gas exchange. The aim of study was to determine the effects of rib cage compression before suctioning on respiratory parameters in mechanically ventilated patients. In this crossover clinical trial study fifty mechanically ventilated patients were randomly divided to two groups. Each patient received two interventions of endotracheal suctioning with and without rib-cage compression in expiration time with a minimum of 3-hour interval between the two interventions and ten times with three respiratory cycle intervals. Oxygen saturation and dynamic compliance were measured before، 5 and 25 minutes after and data were analyzed using paired t-tests and Greenhouse Geisser and Sphericity. Average cumulative dynamic compliance a minute before، 5 and 25 minutes after intervention with compression was 30. 06، 32. 14 and 30. 93 and 30. 42، respectively and without compression، 32. 26 and 32. 81. Arterial oxygen saturation a minute before، 5 and 25 minutes after the intervention was 97. 67، 98. 09 and 97. 94 respectively in suction with compression and 98. 12، 98. 27 and 98. 17 without compression which were almost similar in the 3 step evaluation and there was no statistically significant difference. In attention to lack of significant differences in oxygen saturation and dynamic compliance in two methods of suction with and without chest compressions، further research is needed in this area.