نشریه پرستاری و مامایی ارومیه
سال سیزدهم شماره 6 (پیاپی 71، شهریور 1394)

Nowadays, new technology, Particularly computer technology, Provides the health care system with opportunities for organizing the treatment of illness and disease in ways that might improve the health and quality of life of patients, and Provide cost-effective health care services. Entrance these technologies required to design and implement correctly and user participation have a major role in the design and implementation, so our purpose of this study is survey participation rate of users in HIS development. Method and materials: This is a descriptive-analytic study. The study population was the personnel of the urmia nontraining hospitals. The data were gathered by questionnair. that validity was confirmed by expert and rliability reviewed and approved by Cronbach′ alpha method. Collected data analyzed by appropriate statical test were used in software SPSS 20. The highest participation rate of users in the four – stages development of the HIS related to analysis phase (2.23) and the lowest participation related to implementation phase(1.53). also, by calculating the desirability of participation rate of users in the development of HIS were identified that There is a significant difference, between desirable of user participation in the development of HIS. according to the diffrerence, participation rate of users is lower than desirability reported (p-value: 0.000). The most important factor influencing of participation rate of users in the development of health information system related to understanding and awareness of the development benefits of HIS. Essential to the success of hospital information system is the user participated in the all of the stage of HIS development. According to the result of this study, it is necessary to observe this point that managers and health care authorities before purchasing or designing HIS, users have become aware of the benefits of system development and support and training necessary to engage more staff, expend and upgrade their systems. Keywords: hospital information system, user participation, design, analysis, implementation, evaluation.

Although cesarean birth is performed as a necessary and life-saving solution, the overuse of this procedure has lead to a health concern in most developed and developing countries, including Iran. The aim of this study is to determine the effect of educational interventions on knowledge, perceived efficacy, self-efficacy, behavioral intention and mode of childbirth in pregnant women of two groups of study, experiment and control. The present study is a field trial one with 572 low risk pregnant women participating from all health care services all over the city of Shahroud. Continuous sampling using random allocation was done. Participants in experiment group were instructed the fear management and pain reduction skills in 8 sessions by qualified midwives. The level of knowledge, perceived efficacy, self-efficacy and behavioral intention were measured using the structured questionnaire at the beginning and the end of educations. Women in control group completed the same questionnaire two times between at least 8 weeks time lag, and they were given routine prenatal care. Finally, questionnaire’s variables, mode of childbirth and pregnancy outcomes were compared in two arms of the study. The mean score of the questionnaire’s variables had significant differences before and after educations in the experiment group. The mean score for knowledge was significantly higher in the second time than the first time in control group, yet we did not observed such a finding for other variables. Cesarean section rate was higher in control group compared to the experiment (52.5% vs. 35.9%). The odd of normal vaginal delivery was significantly higher in experiment than control group (OR = 1.98, 95% CI= 1.41–2.70). A logistic regression analysis showed that women with at least one previous normal vaginal birth and participation at educational sessions before 28 weeks of gestational age were the most likely to deliver vaginal birth. Perinatal outcomes were similar in two arms of study and we did not observe a significant difference between them. The findings indicated that educational opportunity focusing on non-pharmacological pain management methods to pregnant women can enhance their positive attitude toward vaginal birth, empower them against the fear of childbirth and decline the maternal request for unnecessary cesarean childbirth.

Loneliness is one of the major psychosocial concerns among patients with cancer. Diagnosis, acute treatment and complications of breast cancer may create experience of loneliness. Hope is an essential factor in the lives of cancer patients. Realistic hope, felt with the awareness of the problem, is an important factor for coping with the problems of the patient in an efficient manner. Social support is an important aspect of modern cancer cares. Social support plays a major role in adaptation with chronic and serious illnesses, such as cancer. The purpose of this study was to investigate the effect of dimension of social support on hope and loneliness in patients with breast cancer.

The method of study was descriptive-correlation. 100 patients with breast cancer were selected randomly and enter to study. The data were collected with GHQ, Miller Hope Scale, the UCLA Loneliness Scale and Social Support Questionnaire -Sarason. Data were analyzed with using Pearson correlation.

A positive relationship existed between social support and hope (r = 0/88) and negatively associated with loneliness (r = - 0/91). A negative correlation between hope and loneliness was found (r = - 0/93) (p<0.05).

The findings suggest that social support influence on hope and loneliness. Planning should be considered for social support of patients with breast cancer in order to heal psychological problems such as loneliness and hopelessness and to enhance the quality of life of patients.

The balance is most important factor in elderly people motor fitness. Without it, they cannot stand and walk correctly. The purpose of this study was to consider the effect of eight weeks combined exercises on standing and walking ability in sedentary males, 65 to 80 years old.

The method of this research was semi experimental with pretest-posttest pattern and with two experimental and control groups. In this method, 30 elder males (age: 72.23±4.45, height: 160.4±4.86, weight: 66.23±5.43, body mass index: 25.71±1.32) were selected subjectively, and they were divided randomly into experimental (n=15) and control (n=15) groups. The ability of standing of the participants was evaluated by Romberg test, and the ability of walking was evaluated by Time up & go test. Primarily, both groups were taken pretest, and then experimental group performed combined exercises protocol for eight weeks and each week for six sessions, and every session for one hour, while control group performed daily activities. This protocol included strength, durance, balance and flexibility exercises. After eight weeks, posttest was taken from two groups. To do statistical analyses, SPSS software (version 20) and Covariance Analysis (ANCOVA) was used.

The results shown that there are significant differences between experimental and control groups on doing posttests of Romberg & Time up & go tests (P<0.05).

According to the obtained results, combined exercises protocol can increase the standing and walking ability in sedentary males of 65 to 80 years old.

Sharp and cutting objects injuries are a major occupational hazard for healthcare workers, particularly nurses. Sharp and cutting objects expose nurses to dangerous viruses such as all types of hepatitis and HIV. The purpose of this study was to investigate injuries of hospital sharp and cutting wastes in nursing staff in Bushehr hospitals in 1392. This cross- sectional study was conducted among 68 nurses in Bushehr hospitals. Data collection was carried out by visiting the nurses in hospitals, and the questionnaires were answered by nurses from various sections of hospitals. Furthermore, sharp injury cases were reported and archived by each hospital from 1389 to 1392. Correlations between sharp injuries and parameters related to these events were investigated. Data were analyzed using the SPSS software version 19. The results of study showed that 58.8% of nurses had experienced sharp and cutting objects injuries. All of the nurses (100%) had been vaccinated against hepatitis virus. Most injuries (75.8%) were due to hitting the needle. Sharp injury events occurred more frequently in the 3-month period from Mehr to Azar (13 cases), on Monday (18 cases) and Wednesday (14 cases), and at the hours from 11:00 to 14:00 and after 16:00 (39 cases). Sharp and cutting wastes as well as their hazards should be further considered. Implementing a safe and effective strategy is essential for minimizing the injuries with sharp and cutting wastes. By promotion of knowledge and skill of nursing staff, we can minimize the injury rate.

Unfortunately, despite the emphasis of documents and contemporary theories on the belief that nursing is a science and an art in care, a review of published studies shows that only the nursing science has developed. Many experts believe that by recognizing and perceiving this concept the clinical field can develop aesthetic knowledge in the education of nursing students. Since there are no studies to explain perception of nursing art in Iranian nursing culture, so this research was conducted to explain the client's perception of nursing art.

This study was an interpretative phenomenological research. Unstructured interviews were used to gather the data. Participants in this study were 12 hospitalized clients that were purposefully selected. Their experiences were analyzed using Van Manen’s hermeneutic phenomenological framework.

13 clusters and five main themes were derived after thematic analysis of the phenomenon of nursing art. Emerged themes were: subjective description, overt spirituality, opening desperate impasse, unity of feeling and manifestation of capabilities beyond duty.

Emerged themes of client's perception from nursing art involved holistic care behaviors in the current literature on nursing with an emphasis on spirituality and skill. By identifying these behaviors, we can help nurses provide better care and respond to the realistic expectations of their patients.

Diabetic peripheral neuropathy likely affects up to one-third of adults with diabetes. All diabetic patients are likely to develop peripheral neuropathy if they live sufficiently long. Drug therapy has limited potential for controlling the associated pain. Alternative methods of treatment have thus far demonstrated limited success, so the aim of study was evaluating the effect of lifestyle interventions on diabetic neuropathy severity among diabetic outpatients that suffering diabetic neuropathy. This clinical trial was performed as time series on 76 patients with diabetic neuropathy, in Urmia in the year of 2013. After matching the study variables, the patients were divided equally and with random allocation to two experiment and control groups. The lifestyle interventions were performed for the experiment group beginning 4 educative sessions on diabetes self- care that emphasizes strategies for glucose monitoring, dietary and exercise habits, foot care, medication taking and coping. Each session was lasted for1.5 hours.Then, these patients were followed for 12 weeks. During these 12 weeks, they were given counseling on lifestyle interventions. Diabetic neuropathy symptom severity in both groups was measured by using Toronto Clinical Neuropathy Score at the beginning of study and then at the end of counseling for 12 weeks. The data were analyzed by SPSS 16.0 software using t-test. There wasn’t any difference between the mean of diabetic neuropathy symptom severity in both study groups before the intervention, but comparing the mean of diabetic neuropathy symptom severity after intervention, there was a significant difference (p<0.001) among the two groups of the study. These findings indicate that lifestyle interventions including diet and exercise counselling for diabetic neuropathy patients result in decreasing neuropathic symptom severity, and reducing pain.

Improving patients’ quality of care is the final goal of nurses. On the other hand, personal characteristics and beliefs of nurses can help in their effective role playing, which could affect the caring process. Therefore, this study was done to assess the relationship between nurses’ spiritual intelligence and their patients’ quality of care in educational hospitals of Gonabad University of Medical Sciences. This was a descriptive correlational study which was carried out on 200 nurses & patients who were selected by simple sampling. The applied Questionnaires included QUALPAC nurses’ quality of care, and Badie’s 42-questions spiritual intelligence. The validity and reliability of the test were verified by Alpha Cronbach’s method which was 0.85 & 0.8, respectively. The relationship between nurses’ spiritual intelligence and their patients’ quality of care was assessed by Pearson’s correlation test. Based on the nurses opinion, the mean number of spiritual intelligence and nurses’ quality of care were 117.2±16.0 and 177.4±40.0, respectively, while quality of care in patients viewpoint was 121.2±20.0. There was a positive significant correlation between spiritual intelligence and nurses’ quality of care (p=0.020, r=0.231). But there was no significant relationship between demographic characteristics such as gender, education, work experience and nurses’ spiritual intelligence and their patients’ quality of care. Improving spiritual intelligence can help in increasing patients’ quality of care due to encouraging nurses’ beliefs and personality. So, nurses’ mental health and upper spiritual health in clinical environment could improve their function, and it can affect their role playing which could improve clients’ health.

Applying novel educational techniques could enhance student’s motivation, and it can affect their understanding in a course subject. Therefore to examine this hypothesis, the current study aimed to examine and analyze the effects of the team based learning, and the conventional learning methods on the midwifery student’s perception of the children’s care course.

The current study is a semi-empirical research conducted on the undergraduate midwifery students of the Urmia University of Medical Science during 1392-93 (2013-2014). Students, randomly, are taught in two different categories of the team based learning and conventional learning methods during their training courses. The students’ perception of the children’s care course under team based learning was compared with their perception in the conventional learning group.

The students’ perception of the course work planning and organising, communication skills and relationship between the students and instructor, assignment presentation, examinations and evaluations, learning and supplementary learning methods, results of the course, students effort and participation in the course and effectiveness of the course in Team Based Learning method (TBL) was better (P<0.05) than the conventional method.

According to the findings of the current study, it seems that in the team based learning method (TBL), the students’ understanding of the children’s care course were higher than those of the speech based method.

Infertility and its treatment can cause many problems on the infertile couples, especially women as birth attendants. Infertility can also affect the infertile people self-efficacy and self-esteem. These two factors can affect the involved reproductive treatment. This study tries to determine the level of self-esteem and self-efficacy in infertile women who undergone vitro insemination, and its outcomes. The study was carried out in Urmia University of Medical Science's affiliated infertility centers, in 2014. The study population was 210 iinfertile women who applied for IVF in UMSU infertility centers. Appropriate questionnaires of self-esteem and self-efficacy were used. The data were analyzed with SPSS software (version 20). Results showed that the mean scores of self-efficacy and self-esteem in infertile women were 22.25±7. 52, and 45.10±22.64, respectively. The level of education of the spouses with the mean score of self-efficacy and self-esteem, were positively significant. There were significant and positive association between self esteem and self efficacy (r=0.84, P ˂0.001). The mean of self esteem and self efficacy in employed women were more than that of house wife women (22.25±7.52, 63.03±18.36 VS 13.8±8.54, 21.91±41.12). Negative association were found between self esteem and self efficacy with duration of infertility (r=0.73, r=0.64, P ˂0.001). Data analysis also showed that in women who had higher mean of self-esteem and self efficacy (20.7±6.51, 59.18±18.9), the outcome of IVF treatment were positive (Pvalue˂0.001). The impact of self-efficacy and self-esteem on infertile women is clear. Improving these two qualities along with reproductive techniques can be highly useful in achieving successful pregnancy in infertile women.

In patients with chronic diseases, self-esteem is very high, so education should not be ignored in these patients to raise their self-esteem. This study was designed to compare the effect of two different methods of face to face training and video training on self-esteem in hemodialyzed patients of Imam Khomeini and Ayatollah Taleghani Hospitals in Urmia. This study is a before and after quasi-experimental study. 120 under treatment hemodialysis patients were selected randomly, and they were entered to the study, then they were divided into three groups of control (40), face to face training (40) and video training (40). Rosenberg Self-Esteem Scale questionnaire was completed before and two months after the intervention. Face to face training sessions were performed individually for each person based on the patient needs for 35 to 45 minutes during a week. Meanwhile, a CD was produced with similar concepts of face to face group for the group of video training. Data analyzed was performed by SPSS software version 16 using descriptive and inferential statistical tests. The results showed that the average scores in self-esteem in video training group has increased from 5.95 to 29.12, and in face to face training from 4.51 to 29.15. The difference between the two was not statistically significant (P<0.05), i.e., by comparing the two groups of face-to- face and video training by using Tukey test, it was shown that the difference is not statistically significant (P =0.449). The findings of this study demonstrated that the performance of both methods of face to face training and video training in hemodialysis patients can improve self-esteem. Therefore, it is recommended to use these two methods to increase self esteem in hemodialysis patients.

Nowadays substance abuse is increasing and, it affects all aspects of individual and social life negatively. Substance abuse usually associated with other psychiatric disorders such as psychotic, mood and anxiety disorders. The main purpose of this research was to determine the frequency of mental disorders in substance-abusing inpatients in Urmia psychiatric center in 1390. 170 inpatients participated in this descriptive cross-sectional research. All of them had substance abuse or dependency. The data gathered by using a demographic characteristic questionnaire and by psychiatric interviewing with participants. Descriptive statistical methods were used. 85/3 % of patients were male, and 14/7 % were female. The most common age-group was 21-40 years old(73/2 %). 44/1% were divorced and 32/9% were married. 64/1% had secondary and high school education, and 56/5% were jobless. 52/3% reported abusing of multi-substance. 61/8% had psychotic disorders, 15/3% had mood disorders and 57% had personality disorders(group B). Comorbidity of mental disorders and substance abuse is common. It should be noted the correct diagnosis of these disorders is really important for successful treatment of dependency and mental disorder.