Iranian Journal of Nursing Research
Year:2009 | Volume:4 | Issue:14|Papers Count:9

Introduction: Kangaroo mother care (kmc) was first suggested in 1978 as caring for low birth weight infants. Few studies have been undertaken using it for term infants and assessing mother behaviors after birth. The present study, therefore designed to investigate the effects of kangaroo mother care on attachment behaviors (affection, caring, proximity) of Iranian primiparous mothers with their term new born immediately after birth.Methods: A clinical random trial design was undertaken with a sample of 790 primiparous mothers drawn from a hospital in Tehran. They were randomly divided to case and control groups. The infants in case group were placed in contact with their mothers’ skin immediately after the birth for 15-20 minutes and the mothers were asked to touch and feed them. The observant researcher recorded the mothers’ behavior using a checklist including affection, caring and proximity behaviors, for 15 minutes. The control group received the routine care. The samples were followed up within one and three months after delivery. All statistics were computed by the SPSS software data (version 14), using Chi square and t-tests. Results: The total mean score of affectionate attachment behaviors was 24 and 29 in case group, and 18 and 18 in control group, one and three months after the birth, respectively which showed a significant difference (P=0.001). The value of proximity behaviors in one and three months after the birth was 18 and 18 in case group and 13 and 18 in control group correspondingly which was a significant difference (P=0.001). The same value for caring behaviors was 5.9 and 5.7 for case group and 5.6 and 6 for control group which didn’t show any significant differences (P=0.2).Conclusion: It could be concluded that kangaroo method has positive impacts on mother attachment behaviors in long term. So the midwives, who are at the frontline of mother-infant contacts, should be perceptive to this sort of skin to skin contacts and prolong its duration.

Introduction: Diabetes as a chronic disease demands special self care behaviors lifelong. Self efficacy is a basis for promoting self care behaviors in diabetes which play a major role in treatment and control of the complications. The study aimed at assessing the self efficacy of diabetic patients and its related factors.Methods: This cross sectional study was conducted with 100 diabetic patients, recruited through simple random allocation. Data were collected using the DMSES Questionnaire as well as checking FBS and HbA1c at the laboratory of the center. All statistics were computed using the SPSS software (P-value<0.05). Results: Correlation between self efficacy [with a mean score of high: 147(11%), medium: 89(36%) and low: 57 (53%)] and diabetes diagnostic index (HbA1c= 10.24) was negatively significant (r=0.76). It was also significant differences between single and married as well as educated and illiterate persons regarding their self efficacy scores.Conclusion: Self efficacy in diabetic patients is not at a desirable level which needs to be promoted within self care programs.

Introduction: Urinary catheterization is a common procedure in the care and treatment of hospitalized patients and bacteriuria is associated with complications and decreased quality of healthcare services. Applying any safe and cost benefit action to reduce or prevent it is of great importance which using the antiseptic solutions, is one of them. It seems that doing the procedure with clean method alike to sterile method is safe and using water is preferred to antiseptic solutions due to economical reasons, availability, and not having side effects. The present study was therefore conducted to compare the effects of water vs. povidone -iodine solution for periurethral cleaning prior to urinary catheterization on bacteriuria.Methods: A clinical trial study design was carried out with a sample of 60 hospitalized women drawn from gynecology unit of Shaheed Sadoughi Hospital in Yazd. They were selected through random sampling, and were allocated in two groups. After registering the participants’ demographic data, the urine culture samples were sent to laboratory. The samples with more than 103 bacteriuria were recognized and the microorganisms were recorded. All statistics were computed by the SPSS software data.Results: Overally, 18.3% of the participants had shown bacteriuria which was 20% using water and 16.7% using povidone -iodine solution. The difference between the groups wasn’t significant (P=0.5). The contributor microorganisms in water group were Stafilococco aureo (6.65%), escherichia coli (10%), Enterococcus (3.35%) and in povidone -iodine solution group were gram positive cocci (3.35%), estafilococo (3.35%), streptococ (3.35%) and escherichia coli (6.65%) which weren’t significantly different (P=0.5).Conclusions: The findings indicated that there were no significant differences between groups. It seemed that using povidone -iodine solution didn’t reduce the rate of bacteriuria more than water. As applying water has no side effects and is more beneficial economically, it could be recommended for peri urethral cleaning prior to urinary catheterization in short term.

Introduction: Acquiring information regarding the extend and prevalence of pediatric behavioral disorders and their predisposing factors is essential in improving psychological services and establishing preventive indicators for children’s mental health. The present study was conducted to determine the prevalence of behavioral disorders of school age children and related epidemiological factors, in Gorgan city, in 2005-2006.Methods: A cross sectional study was carried out using multistage cluster sampling method to recruit 2600 school age children. Data were collected through Rutter’s parent questionnaire (RA2), a standard tool which parents completed. A cutoff point of 13 was considered and children with total score of 13 or more were regarded to be disordered. Descriptive statistics and odds-Ratio and chi-square tests were used to analysis the data.Results: Most of the samples were female (52.8%), first child with mean age of 9.25±1.5, having both parents living with them (94.5%) and were studying in governmental schools (72.7%). in view of the regarded cutoff point, 18.4% of children suffered from behavioral disorders. There was significant correlations between having behavioral disorder with being in single parent family, crowded and low income families, history of crisis during the previous year, job and education of the parents, and children schools (P<0.05).Conclusion: Considering the higher prevalence of behavior disorders found in current study compare to many others, investigating the explanations and reasons for as well as providing educational and consultation services is necessary.

Introduction: There is a growing movement towards more casual uniforms within pediatric Nursing. The study aimed at assessing the color preferences of nurses, parents and children regarding nurses’ uniform in selected university hospitals of Tehran City.Methods: A cross sectional study was conducted. Through non-randomized convenient sampling, 365 pediatric nurses, 744 pediatric patients and 480 parents, drawn from selected university hospitals of Tehran City were recruited to the study, during one year since 2007, summer. Data were collected using a questionnaire consisting demographic data and two questions regarding the participants’ color preferences. Five photos showing a nurse with different uniform colors (pink, white, light blue, dark blue and colorful) while checking a child’s pulse were used. Descriptive and inferential statistics (analysis of variance with repeated measurement, chi-square and Cochran’s test) were used to analysis the data by SPSS software (version 11.5).Results: Female children and their parents reported pink color as their first choice (45.2 and 45.6% respectively) while boys preferred light blue (31.4%). The first choice of nurses was dark blue (42.2%) which 10.6% of mothers and 17.6% of girls liked it as well (P<0.001). Nurses with less than ten years of nursing experience, preferred dark blue (49.1 vs. 32.9%; P=0.002). Fathers preferences of colors were not statistically significant (P=0.017).Conclusion: Pink and light blue were most preferred by children and their parents to dark blue of nurses. The study recommends changing the color of nurses’ uniforms in pediatric wards, considering children and their parents’ perspectives.

Introduction: Pain is often inadequately controlled for hospitalized patients specially children. There are barriers to pain assessment of hospitalized children such as lack of appropriate pain assessment tool, lack of specific regulations and policies and nurses’ insufficient knowledge and skills. The present study aimed at determining the effects of establishing a nursing commission of pain management on empowering nurses within pain assessment process. Method: A quasi-experimental study was conducted with a sample of 64 nurses who were recruited in the study through cluster randomized sampling method. The samples were drawn from Emergency room, Surgery & Orthopedic units of Vali-e Asr Hospital as the control group and Imam Khomeini Hospital as the intervention group, in 2007. Data was gathered using questionnaires of demographic information; nurses empowering tools on pain assessment process of children (consisted of recognition of pain assessment, self reporting of quality and quantity of pain assessment, pain assessment measurement, checklist on skills of documenting pain assessment). After taking pretest, nursing commission of pain management for nurses’ empowerment was established, which followed by undertaking a post-test. All statistics were computed by the SPSS software (version 12).Results: Findings revealed that mean scores of nurses recognition of pain assessment was increased from 7.7 to 12.9 in intervention group and from 8.4 to 8.6 in control group. Regarding self reporting of quality and quantity of pain assessment, the values turned from 1.9 to 2.8 in intervention group and 2.1 to 2.2 in control group. Pain assessment measuring increased from 0.11 to 0.72 in intervention group and.10 to 0.10 in control group. Pain assessment documentation skill improved from 0.03 to 0.72 in experimental group while there were no changes in control group (0.03). Nurses’ empowerment was progressed significantly after establishing the pain management commission (P=0.01).Conclusion: The results indicated that establishing pain commission increased nurse's competencies in assessing pain. Therefore, establishing the nursing commission of pain management in other hospitals is recommended to influence nurses’ empowerment and children pain assessments, considering its effectiveness and inexpensiveness, with no need for new staffs and budget.

Introduction: Frequent rehospitalization is one of the complications in treatment of schizophrenic patients. The present study was design to determine the effectiveness of home care service in preventing rehospitalization of schizophrenic patients. Methods: A semi-experimental study was conducted with 48 schizophrenic patients who were randomly allocated in two groups of intervention and control (20 patients in each group). Home care services after discharge were delivered to the intervention group for three months. Control group received routine services included appointing a date for next visit at psychiatric clinic. Both groups were followed up for six months, after discharge. They were compared for their rate of rehospitalization. Chi square and Student's t-test were used to analyze the data. Results: The results revealed that rate of rehospitalization after three month follow up was %25 (6 of 24 patients) in control group and zero in interventional group which was significantly different (P<0.001). Six months later, the rate turned to %21 (5 of 24 patients) in intervention group and %46 (11 of 24 patients) in control group which was significantly different (P=0.002) as well.Conclusion: Home care after discharge reduces rehospitalization of schizophrenic patients.

Introduction: Kangaroo method is a revolutionary way of taking a good care of infants, especially preterm infants. The studies have well demonstrated the positive effects of kangaroo method on physiological parameters of preterm infants. Skin to skin contacts can have effects on increasing the rate of oxygen saturation, decreasing the risk of hypothermia, stabilizing the heart rate, breath and sleep patterns.Method: A cross over clinical trail was utilized to expose the infants and their mothers to both traditional and kangaroo methods. Sixty infants were selected through simple random allocation and divided into two groups. The infants in first group were removed from the incubator by kangaroo method which followed by the traditional method, for breastfeeding and the second groups vice versa. The infant's physiological parameters were measured at different times.Results: The study demonstrated that the second group infants had different mean heart rate at 5th, 30th minutes, before removing from incubator and also five minutes after returning back (P=0.001, P=0.02, P=0.03). It was also revealed that other physiological parameters (Breathing, oxygen saturation and temperature) didn’t have any differences between groups. Mothers mostly preferred the kangaroo method to traditional way, especially those who had experienced infertility. All statistics were computed by the SPSS software (version 14).Conclusion: Kangaroo and traditional method showed the same effect on physiological parameters. However, since the mothers preferred Kangaroo method, the researchers recommend it as a substitute for current nursing care methods.