Iranian Journal of Nursing Research
Year:2009 | Volume:4 | Issue:12-13|Papers Count:12

Introduction: Adolescents’ development is one of the excellent goals of societies. Adolescence is peak of health, however there are risk factors address adolescents and developmental characteristics at this age which some are based on family’s condition. These developmental changes impose new situations for the families which can result different functions. Identifying adolescents’ perspectives and families’ functions in that regard is nurses’ responsibilities. The study aimed at exploring adolescents’ perspectives on healthy family in Zanjan. Method: Using qualitative method (content analysis), semi-structured interviews were conducted with a purposeful sample of 27 adolescents, range in age from 10 to 27 to reach the data saturation level.Results: Adolescents emphasized on family role in categories o f communications within the family, healthy family, limitations, facilities and religious beliefs. The adolescents point out the importance of being understood by parents, the necessity of close relationships with them, having tolerance for their children mistakes, religious beliefs, not being limited as characteristics of a healthy family.Conclusion: Healthy family is crucial for adolescents’ health. It is a fundamental issue in prospective health which require strategies for social and cultural reforms. Nursing is an interdisciplinary science and nurses have an extensive role in both adolescents’ and families’ health. Policymakers can provide realistic plans to facilitate family health issues by understanding adolscents’ perspectives.

Introduction: Cigarette smoke increases risk of adult cancer. However, the association between parental smoking and cancer in childhood is unclear. Therefore, the present study was designed to determine the relationship between parental smoking and childhood cancer.Method: A case-control study was conducted comparing 98 childhood cancer cases with 100 matched controls on age and sex. Data were gathered through face to face interviews using a questionnaire, in 2007-2008. All statistics were computed by the SPSS software (version 14) using chi–square, independent t-test and odds ratios. Results: It was revealed that maternal smoking (before, during and after pregnancy) was not associated with an increased risk of cancer childhood. Although, maternal exposure to passive smoke during pregnancy was associated with cancer childhood (odds ratio=3.6, 95% confidence interval: 0.4-5.0). Postnatal smoking of fathers was not associated with risk of cancer but fathers smoked more than 11 cigarettes during pregnancy, increased the risk of cancer (odds ratio=2.7; 95% CI, 0.3–4.4).Conclusion: The study indicated that paternal smoking increases the risk of childhood cancer. Therefore, nurses can help to have healthy children by educating parents to quiet smoking or smoke outside children’s rooms and their environment.

Introduction: Breast cancer is the most common cancer and the second major cause of cancer deaths in women. Detection of breast cancer in its early stages is amenable to almost complete cure. Breast cancer screening comprises breast-selfexamination (BSE), clinical breast examination (CBE) and mammography. The purpose of this study was to examine the performance conditions of screening methods among women referring to health centers of Tabriz in 2008. Methods: Using descriptive- analytic study method, 400 women aged 20-50 years were selected through random clustered sampling. The samples were drawn from Tabriz health centers and their active records. The data were collected through a questionnaire consisting personal and social characteristics and a self-examination observational checklist. Descriptive and inferential statistics (Chi square and fisher’s exact test) were used to analyze the data by SPSS software (version13).Results: The study demonstrated that only 18.8% of women performed breast self examination. 19.1% had clinical breast examination and 3.3% mammogram. The main reasons for women who didn’t perform breast cancer screening were being unaware of breast self examination, not having a breast problem and not feeling its necessity. Performing of BSE was significantly correlated with level of education, employment, income, number of children, breastfeeding history, breastfeeding quality and family history of breast cancer. There were also significant relationship between performing of CBE and history of benign breast tumor as well as between performing of mammography and family history of breast cancer and history of benign breast tumor (P<0.05).Conclusion: The finding revealed that the performance of breast cancer screening methods was not satisfactory. Providing essential education regarding breast cancer screening methods through health personnel especially during pregnancy, post partum and even during counselling sessions befor marriage, seems to be necessary.

Introduction: Nursing is a practicing discipline. Clinical instructors need to acquire competence of an effective clinical instructor in order to make students ready to face the real world of providing care. Such characteristics get affected by sociocultural background. In spite of many international quantitative studies, such characteristics haven’t been defined clearly yet. The present study, therefore, aimed at investigating effective clinical instructor characteristics from the perspective of students and clinical instructors, qualitatively. Methods: Using qualitative method, semi-structured interviews were conducted with ten students and clinical instructors. All interviews were reordered and transcribed. The data were analyzed using constant comparative methods through qualitative content analysis method.Results: Following themes were identified in data analysis: (1) recognition; (2) making clinical environments attractive; (3) communication skills; (4) clinical competencies (5) personal trait and (6) role model. Conclusion: Effective clinical instructors attract students to clinical education by identifying effective factors on clinical education, applying innovative methods in education, implement theoretical content in practice and having patient-center approach. They play as a role model for students with regard to their altruism, communication skills and having clinical competencies.

Introduction: Endotracheal suctioning is one of the most frequently used methods for airway clearance in patients receiving mechanical ventilation. Chest physiotherapy techniques before endotracheal suctioning can be used to facilitate mobilizing and removing airway secretions. The study was conducted to determine the effects of expiratory rib cage compression before endotracheal suctioning on airway-secretion removal in patients receiving mechanical ventilation. Methods: A clinical trial study design was undertaken with a sample of 70 mechanically ventilated patients drawn from intensive care units and emergency department of Hazrat-e Rasool Hospital in Tehran. They were selected through purposive convenience sampling. All participants received two endotracheal suctioning with and without rib cage compression. There was at least three hours interval between the two interventions. Expiratory rib cage compression was performed for five minutes before endotracheal suctioning. Sputum was collected in a pre-weighed sputum trap attached to the suction catheter. Data were collected using data recording sheet. All statistics were computed by the SPSS software data (version 11.5), using Paired T-test.Results: Mean of removed airway-secretions by rib cage compression was 3.66 compare to 3.21 without rib cage compression. Significant differences in airwaysecretion removal between the two methods (P<0.0001) were demonstrated. Conclusion: Findings indicated that expiratory rib cage compression before endotracheal suctioning improves airway-secretion removal, compare to performing only endotracheal suctioning. The study recommends performing expiratory rib cage compression before endotracheal suctioning in patients receiving mechanical ventilation.

Introduction: Time management skills are considered as determinant factor of managers’ success. Promoting abilities and performance of nurses are demands of human resource improvement in health sectors. The study aimed at investigating the impact of workshop training on time management skills application of head nurses affiliated to university hospitals in Golestan province.Methods: All nurses working in one of the university hospitals in Golestan province (n=76) were participated in this quasi–experimental study. Data were gathered through self-administered questionnaires assessing four skills of time management: goal setting/ prioritizing, time mechanic, control on time and organization before and after the education. Data were analyzed by wilcoxon and man-Whitney tests.Results: The study indicated that most of participants were female (70.1%), married (85.7%), with bachelor degree in nursing and mean age of 37.4±5.4 year. Average of professional experience and employing as a head nurse were 13.7±6.3 and 6.1±5.4 years, respectively. Participants were using goal setting (91.8%) and organization skills (98.4%), time mechanic (5%) and control on time (19.4%) prior to intervention. While the values converted to 91.8%, 98.4% and 32.3% for goal setting, organization and control on time, respectively after the intervention. No significant difference was found between skill of time mechanic before and after the education. Applying the skills before and after the intervention was just significantly different in control on time and organization (P<0.05).Conclusion: Considering the results and importance of time management skills' application in nursing management, teaching such skills through continuous education programs could be contributed in improving head nurses’ performance.

Introduction: Nutrition plays an important role in maintaining health and preventing diseases. Students’ attitude toward foods can also have an important role in their nutritional behaviors. The study aimed at exploring the stages of dietary change with regard to socio-demographic variables (age, sex, marital status, year/field of education and BMI) and the nutrition attitudes of nursing and midwifery students of Fatemeh faculty of nursing and midwifery in Shiraz.Methods: This descriptive study was conducted on 300 freshmen to senior students of nursing and midwifery who were studying varyingly in first year of education to four. Trained interviewers interviewed the subjects based on the transtheoretical Prochaska model, by which the subjects are classified in six stages of changes in nutritional behaviors. Nutrition attitudes were assessed by three questions. All statistics were computed by the SPSS software data.Results: It was found that 29.3% of the students were in the precontemplation stage and 50.3% of the students are in the dynamic stage (including contemplation, decision and action). 11 and 9/3 percent of students were in the maintenance and relapse stages, respectively. Most of the students with average age of 21.5 were in the dynamic stage. Most men (48.8%) were in the precontemplation stage, and most women (53.6%) were in the dynamic stage. Most single and married subjects were in the dynamic stage (48.8%, 58.1% respectively). Most freshmen to senior students (47.8%, 55.9%, 49.4%, 47.8% respectively) were in dynamic stage. Most of the subjects in the underweight, normal weight and overweight categories were in dynamic stage (53.9%, 49.6%, and 51.8% respectively). Regarding eating attitude, the results demonstrated that most of the nursing (51%) and midwifery students (59%) feel a need to change their diet. Moreover, they think about the dietary aspects of their food (78.4%, 82% respectively). In addition, they expressed their agreement to the item of seeking information regarding healthy diet (83.3%, 85.9% respectively). Conclusions: The status of nursing and midwifery students considering stages of dietary change and their nutrition attitudes were positively appropriate. To consider nutrition principles for teaching to students, who are educating to manage patients’ issues regarding their nutrition, seems to be an important factor in achieving such results. The study recommends duplicating the study on other nursing and midwifery students as well as in other university programmes.

Introduction: Emergency department personnel are at a great risk of exposure to blood-borne pathogens such as Hepatitis B virus (HBV) and human immunodeficiency virus /AIDS because of their frequent contacts with blood, unknown status of patients and performing invasive procedures. However, studies have shown that Emergency Department (ED) personnel have a very low rate of compliance with universal precautions (UP). The present study was designed to examine the effect of education on  knowledge and performance of nurses regarding AIDS in emergency departments of hospitals affiliated to Shiraz university of medical science in 2008. Methods: A quasi-experimental study was conducted with a sample of 120 licensee nurses drawn from emergency departments (12 wards) of hospitals affliated to Shiraz University of Medical sciences including hospitals of Nemazi, Martyr Faghihi, and Chamran. The intervention was three one-day training workshops presenting through lectures and group discussion methods. A self-constructed questionnaire was used to assess nurses’ knowledge, in three occasions: three months prior to intervention, immediately after and one month after the intervention. Compliance with UP was measured through observation which was recorded by 10 items. One-way analysis of variance and paired t-test was used to assess nurses’ knowledge. To compare differences between their compliance and performance of UP, Wilcoxon signed ranks test, one-way analysis of variance and paired t-test were used.Results: It was revealed that knowledge of personnel significantly increased immediately and one months after the intervention (P=0.0001). Mean of nurses knowledge’ scores increased from 44.95±6.62 before training to 57.09±9.14 immediately and 54.36±14.32 one month after education (P=0.0001). Partcipants’ compliance with universal precautions procedures after edcational workshops was significantly different with before (P=0.0001) in the way, rates of using gloves was improved from 71.6% to 98.3 % and 75% to 99.1% for handwashing after taking care of patients, 53.3% to 83% for wearing mask, 78.3% to 87.5% for not using needle cutter. Conclusion: The training session significantly improved the nurses' knowledge and implementation of universal precautions in emergency departments. It is recommended to provide basic educational seminars and workshops on universal precautions for healthcare workers. Helathcare institutes should also supply materials needed to protect staffs against the risk of acquiring blood born infection in the course of providing health services to their patients.

Introduction: Cancer is a potentially life-threatening disease that engenders considerable distress in personal, familial and social dimensions of patient's life. Numerous changes in their life, communications and social activities, increase the need for social support. The study aimed at assessing size of social networks and sources of emotional support in cancer patients. Methods: Using a descriptive-correlational design, 220 cancer patients drawn from Firozghar, Rasoul-e Akram Medical Complex and cancer institute of Imam Khomeini Complex Hospital, were selected through Sequential sampling method. Data were collected using Nortouse Emotional support questionnaire from five sources of spouses, family members, friends, nurses and physicians. All data were computed by SPSS software (Version 13) using descriptive statistics, analysis of variance, Pearson correlation coefficients.Results: Mean of emotional support scores was 137.39 and mean score of social network’s size was 4.17. Patients had perceived the supports mostly from their spouses and family members, then from physicians, nurses and friends, consecutively. Analysis of variance test showed significant association between perceived emotional support with age, marital status, economic condition, job, ethnicity and size of social network (P=0.001).Conclusion: Family is the main emotional supportive source in cancer patients. Nurses must regard the patients a whole and consider all their existence domains including emotional supports, quality and quantity of their support sources and patients’ perception of such sources. They should accumulate the support sources of the community and family participation in order to improve support provisions to patients and decrease their tensions. This study didn’t include other domains of social support and personal characteristics as interferer factors in perceiving the supports, which needs to be investigated by further studies.

A case of sirenomelic newborn is reported. The newborn was stillborn and was having fused lower extremities with numerous anomalies. There are no information regarding internal anomalies as no autopsy was done. Considering the growing needs of people to getting aware of genetic issues, nurses need to be trained to provide such services.