Advances in Nursing and Midwifery
Year:2012 | Volume:22 | Issue:77|Papers Count:10

Background and aim: High ethical reasoning ability is one of the main requirements of nursing profession.This ethical reasoning should be improved in nursing student during educational period. It should be further evolved during their independent clinical work as a nurse. Limited evidences are exist about the level of ethical reasoning of nursing students and nurses in Iran. Therefore, the purpose of this study was to compare the ethical reasoning of nursing students and nurses in Tabriz University of Medical Sciences.Materials and Methods: This descriptive-comparative study was performed on 115 nursing students and 269 nurses who were selected by census. Nursing Dilemma Test NDT questionnaire was used for data collection. It consists of 6 scenarios. Ethical reasoning score (Nursing Principled Thinking NP) was the sum of scores of fifth and sixth levels of Kohlberg ethical development questionnaire. The scores varied from 18 to 66. The data were analyzed using SPSS and by descriptive and inferential statistics.Findings: Ethical reasoning score of nursing students (48.9±6.5; mean±SD) was significantly higher than the score of nurses (46.6±6.7) (p=0.02). Also it was found that NP scores of nurses working in medical wards are significantly higher than scores of other wards nurses (p=0.02). NP scores were declined by increasing of clinical experience (p= 0.04).Conclusion Lower NP scores of nurses comparing with NP scores of nursing students is an alarm for nursing managers and need a special attention.

Background and aim: Prenatal care is one of the most confident and basic services to protect feto maternal health. This study aimed to evaluate the effect of physical exercise on level of general health of pregnant women.Materials and Methods: This was a quasi-experimental clinical trial study. The research samples included 60 primigravid women referred to the prenatal-care clinic of Baghiatallah hospital in Tehran. The participants were randomly divided to two experimental and control groups. The experimental group was trained for 1.5-2 hours in groups with 3 to 4 members and then they began to practice. No training was performed for control group. Level of general health of two groups was investigated by general health questionnaire (GHQ-28), before and 8 weeks after the intervention. Data were analyzed by analytic and descriptive statistical testes.Findings: Sixty primigravid women with average age of 26.77 years and average gestational age of 8.13 weeks participated in the study. The education level of majority of participants was highschool diploma and they have no history of exercise during pregnancy. Before intervention, the total scores for GHQ were 38.06 and 29.46 in experimental and control groups, respectively. After intervention, the total scores were 19.2 and 27.5 in experimental and control groups, respectively. T test showed a significant difference between two groups his before and after the intervention (p<0/05). The mean scores for all dimension of general health showed significant difference between two groups of study (p<0/05).Conclusion: Results showed the positive effects of physical exercises on physical and psychosocial dimension of general health of pregnant women.

Background & Aim: Ethics is an integral part of nursing practice. Nurses and other professional caregivers are increasingly recognizing the issue of moral distress. The aim of this study is to describe Iranian nurses' experiences in moral distress.sMaterials and Method: In this study the qualitative phenomenological approach was used. 11 nurses from teaching hospitals of Hamadan University of Medical Sciences participated in the study. The data were collected by in-depth interviews. Transcripts were analysed by constant comparative constant analysis.Result: The results sorted into 4 content areas: individual characteristics of team care (including knowledge, ability, experience, responsibility and…), mental-affective reactions (including faulty, defensive reactions, lack of motivation and…), laws and officials (including, limitation of laws and contradictory of laws with ethics, religion, knowledge and ability) and circumstances of workplace (including physical circumstances, manpower, facilities and equipments).Conclusion: It is necessary that nurses become familiar with ethical problems, nursing code of ethics and promote the skills for encounter to moral distress.

Background and aim: Tuberculosis is a major public health problem in the world, affecting 30% of the world’s population. Treatment of tuberculosis is the most effective strategy to stop the spread of the disease. However, non-adherence remains an important cause of treatment failure. It is believed self-efficacy may affect patient’s compliance to treatment regimen. The purpose of this study is to determine the correlation between self-efficiency and treatment compliance in tuberculosis patients attending to medical centers of Kurdistan University of medical sciences Kudistan, Iran Materials and Method: A descriptive-correlational design was used. The sample of the study consisted of 161 tuberculosis patients attending to health centers in Kurdistan province .Data were collected using a self efficacy questionnaire and the review of patients' medical records. he validity of the questionnaires were determined by 12 experts through the content validity and formal validity methods. The minimum index of content validity for self-efficiency questionnaire was calculated to be 75.5 percent and that of compliance was 83.5 percent. The reliability of the questionnaires was determined using the Krunbach's Alpha-Test. The coefficient of reliability for self-efficiency questionnaire and compliance questionnaire were 0.94 and 0.97 respectively. Data were analyzed using the SPSS 16 software Findings the average age for patients was 58±12 years old. 61.5 percent of studied samples were male and the rest were female. The amount of compliance by patients was moderate (average scores of 30.23) and correlated to age, marital status, job, income level, education and place of living but, its relation to gender was not statistically significant. The amount of self-efficiency of the majority of patients was moderate (41.6 percent) and it was also related to age, marital status, job, income level, education and place of living but its relation to gender was not statistically significant. There was a direct and strong correlation between self-efficiency and compliance (P<0.001, r=0.90).Conclusion: The reason why the compliance level in this study has been higher with respect to the previous similar studies could be due to the implementation of direct supervision and control system over treatment. In this study there was a significant correlation between compliance and self-efficiency which was in consistency with most studies in this field while in Hamilton (2000) no significant correlation between the two variables was reported. Given that the correlation coefficient of Pearson in this study ispositive and close to 1 (P < 0.001, r = 0.90), it indicates a direct and strong correlation between the two variables of self-efficiency and compliance.

Background and Aim: ER nurses are at risk of violence due to the nature of their job and confrontation with a variety of patients as well as heavy workload. This can, in turn, leads to decreased quality of care. This descriptive study was conducted to identify prevalence and causes of violence toward nurses at ERs of hospitals affiliated with Medical Universities in Tehran.Methods 100 nurses with at least 1 year continuous experience at ER were included in the study. Data were collected by a questionnaire. The questionnaire contained items including demographics, frequency and characteristics of violence at work (physical, verbal, nonverbal) and the factors involved. Content and test-retest as well as internal consistency (Cronbach’s a methods were used for Validity and reliability of the questionnaire respectively. Data were analyzed by version 16 of SPSS package.Findings the most frequent type of violence was verbal (87%). The frequencies of nonverbal and physical violence were 70% and 28% respectively. The most common type of verbal violence was yelling (84%) and, in physical violence, it was throwing objects (33%). In nonverbal violence, insulting and threatening look (64%) and hitting on the table were very common. Verbal (48.2%) and nonverbal (65.8%) violence was committed mostly over the past month of the study and at nights. The subjects (38%) experienced verbal violence up to 5 times. The most frequent cause of violence (77%) was the lack of control over entrance of patients’ relatives. chi test showed a significant relationship between physical violence and night shifts (P<0.001) and between female sex of nurses and physical violence (P<0.005).Conclusion: ER nurses usually face with violence in a week and the most frequent types are verbal, nonverbal and physical, leading to decreased speed in delivering efficient care to patients and decreased quality of health care resulted from it.

Background and aim: Improving quality of life in a chronic disease such as hemophilia is a major goal of treatment. Hemophilic patients can be treated either prophylactically or on demand. Since haemophilia quality of life may be affected by the disease and treatment outcomes, comparison of these regimens in respect to quality of life outcomes provides useful information. The purpose of this study is to compare the quality of life between hemophilic children receiving prophylactic and on demand therapy in Tehran, Iran. Materials and method: A descriptive –comparative design was used. The sample of the study consisted of 60 hemophilic children which were recruited from haemophilia treatment centres in Tehran. Of these children 30 were receiving prophylactic therapy and 30 of them were treated ondemand .Data was collected by haemophilia-specific QoL questionnaire (HAEMO-QoL). The questionnaire consists of 8 dimensions: physical health, feeling, view of yourself, family, friends, others, sport and dealing with haemophilia.The questionnaire consists of 18 items using a5-point scale.The Higher scores represent a poorer quality of life and lower scores represent better quality of life. Data were analyzed by SPSS 15 statistical software. Findings: The mean age of children was 5.3±1.2 and 6±1 in prophylactic and on demand therapy respectively. The mean total score of quality of life was 40±9.8 and 58 ±10.9 for children in prophylactic therapy and on-demand treatment respectively. There was a significant difference between the quality of life scores in two groups. Analysis of subscale scores showed a lower quality of life score for family domain in prophylactic therapy group, while the scores for family and physical health subscsles in on-demand group showed a poor quality of life. Conclusion: Results of the study suggest that quality-of-life may be better for haemophilia children treated prophylactically.

Background and aim: Communication is one of the most essential needs of human beings. Mechanical ventilation compromises patients’ ability to communicate their needs. This research was conducted to assess the effect of three methods of communication with patients receiving mechanical on their satisfaction in Arak hospitals 1389 (2010).Method and materials: This randomized clinical trial was conducted in Intensive Care Units of Valey Asr, Amir Al Momenin and Ghods hospitals in Arak, Iran. 60 patients who were admitted in ICU and were receiving mechanical ventilation were included in the study. These patients were randomly allocated in three groups.During a 12 hours period researcher used 1 method of communication for each group of these patients. These mrthods of communication included: A. Communicational board (words &letters). B: Communicational board (pictures & letters). C: The conventional method. Data were collected using a questionnaire. The questionnaire consisted of three parts: demographic variables, medical history and satisfaction with communication method. Validity of the instrument was assured by content validity index, Cronbach's alpha was used to determine the reliability of the iinstrument. SPSS, version 16 was used for data analysis.Findings: There was not a significant difference among three groups in terms of age, gender, mean length of stay in the ICU before mechanical ventilation treatment. The mean satisfaction scores were 2.58, 3.83 and 4.10 for conventional communication group, communication board A (words & letters) and communication board B (pictures and letters) respectively. There was a significant difference among three groups in terms of their satisfaction with communication method (P<0.001). The one way analysis of variance indicated that using communication boards A & B significantly increased patient satisfaction.Conclusion: Using communication boards facilitates communication with mechanically ventilated patients and increase their satisfaction.

  Background and aim: By increasing the life expectancy, women experience longer menopause and more complications during this period of life. Men may also experience menopause. Improvement and treating the complications is based on the correcting the life style. The purpose of this study was to evaluate the effect of a counseling procedure on the life style of menopausal women and their husbands.Materials and methods: This was an interventional study. 120 couples of menopausal women and their husbands were selected from Mohammadiyeh medical health center in Hamadan participated in the study. The participants were randomly divided to control and interventional groups. Initially, life style information was collected by a questionnaire through interview. Counseling about nutritional habits and physical exercise was performed for one hour in participants' houses. After two months there was first post test. Another counseling session and post test was performed similar to first one. Data was analyzed by Mc Nemar, Paired T test, Wilcoxon, Independent T test and Chi- square tests, using SPSS 13.Findings: Results showed a significant difference in items such as food habits and physical activities of life style, before and after of first and secondary counseling process in women and men in intervention groups (P<0.05).Conclusion: Counseling has significant effects on nutritional habits and physical activities of the menopausal women and their husbands. Counseling with couples particularly in their houses, is an effective intervention for improving of participants' life style.