Iranian Journal of Nursing Research
Year:2007 | Volume:1 | Issue:3|Papers Count:8

Introduction: Clinical competency is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions and values in the clinical environments. Competency is a complex concept that encompasses such attributes as knowledge, skills, and attitudes. Acquirement of competency is final outcome and product of an educational system. The purpose of this study is to determine the viewpoint of nursing students about clinical competency and its level of achievement.Methods: A Descriptive-analytic design was applied for 91 undergraduate nursing students from Tehran school of nursing and midwifery. The data was collected by a questionnaire consisted of two parts: 1) demographic characteristic, 2) clinical competencies included: systematic assessment and data gathering, care planning, ethical points, professional improvement, client and family comfort, effective care management, and collaboration with health team. (p<0.05). Results: Among 91 students, 70 cases participated in this study .The results showed that most of the students were agree with the competencies: systematic assessment and data gathering 81.4%, care planning 78.65%, ethical points 81.4%, professional improvement 78.6%, client and family comfort 84.3%, effective care management 77.5%, and collaboration with health care team 80%. Also the most participants had amoderate view about their achievement to systematic assessment and data gathering 58.6%, care planning 52.9%, ethical points 68.6%, professional improvement 64.3%, client and family comfort 60%, effective care management 64.3%, and collaboration with health team 60%.There were not any significant correlations between demographic characteristic of participants and their view about clinical competency and its level of achievement.Conclusion: The results indicated that all participants had not any agreement about production of clinical competency by current nursing education program. On the other hand the achievement level of competency by nursing students was moderate and weak. This study can be useful as a guideline to determine practical solutions of changing students' view and their achievement to the clinical competency.

Introduction: Cerebrovascular accidents (CYA or strokes) are the third leading cause of death after myocardial infarction and cancer in western countries, most of which result from emboli or thrombosis. In addition to mortality, they lead to lifelong inability manifested by various ambulatory, physical, verbal, visual, memory, and... disorders. Along with routine supportive interventions at hospitals to reduce these problems, complementary therapies such as massage as one of the most important interventions are also applicable. The goal of this study was to determine the effects of massage therapy on systolic and diastolic blood pressures in patients with CVA in 2005.Methods: In this quasi-experimental study with 2 groups, a prospective design at 2 stages was used. Subjects included 50 patients with CVA at neurology unit of Shariati Hospital in Isfahan, selected by convenience sampling method and randomly divided into 2 equal experimental and control groups. Inclusion criteria were confirmed diagnosis of CVA, ability to speak, complete consciousness, hospital stay at least for I week and desire to take part in the study. In the experimental group, massage technique was instructed to their attendants and after confirmation of its correctness, they performed it 7 times a day. Blood pressure of the subjects was measured before and after each massage. No specific intervention was performed in the control group except routine procedures. Data were collected by standard stethoscope and sphygmomanometer and compared in the two groups at the end. Results: Paired t-test showed a significant decrease in the blood pressure of the massage group while the pressure significantly increased in the control group (P<0.05).Conclusion: The results showed a decreasing effect of massage on blood pressure of CVA patients. Therefore, this therapy can be recommended as a complementary method along with routine treatments for better recovery and welfare of these patients.

Introduction: Disease or injury affects not only specific structures and physiological or psychological mechanisms but also integrated human functioning. When integrated functioning is seriously affected, the ability of an individual disturbs permanently or transiently for self-care. Vegetative state is one of severe and periodic states of unconsciousness and complete unawareness of self and surrounding environment. The patient loses his self-care ability and requires a. complete compensative care system. The aim of this case report was to describe a successful long-term dependent care of a vegetative patient by family members according to Grem's theory. Qualitative and quantitative data were gathered by interviewing with care givers, observing nursing care and examining the patient.Case: The case was an Iranian 34-year-old injured man in persistent vegetative state for 17 years after an explosion leading to head injury at war. His immediate care giver was his 58-year-old father with primary education. In physical examination, his integumentary, respiratory, and urinary systems were normal. Laboratory tests including blood cell counts, urinalysis, urine culture and electrolytes were also normal. Immobility complications (bedsore, contractures...), malnutrition and infections were not found.Conclusion: This study confirms the healing nature of family care that ensures living by love and hope. According to Grem (2001), love is a positive human emotion that moves people beyond their situations. Benevolence as an active part of a perfect love enables nurses (care givers) to unite with their patients and this helps to realize specific life situations and to struggle to solve them. In critical conditions, the family power dominated by human love should be considered more than before by formal providers of care to empower family role. In addition, with respect to the role of human emotions in providing complete and effective care, developing humanistic attitudes and emotions should be of great concern in nursing education because caring needs not only professional knowledge but also human love, emotions and attitude.

Introduction: Suicide is a primary health problem, requiring evidence-based information for prevention. Suicidal clients have difficulty in coping skills. Coping skills have important role in mental health. Cognitive therapies such as problem solving can improve coping skills and may be useful in the prevention of suicide. The Purpose of this study was to assess the effects of problem solving training on coping skills of suicidal clients. Methods: In this quasi-experimental study, subjects consisted of 80 suicidal clients selected by purposive sampling and randomly divided into two equal case and control groups. A demographic questionnaire and Coping Skills Scale (Blinghs and Mous) were used for data collection. Reliability and validity of the questionnaire were obtained by Cronbach's alpha, stability reliability and content methods. Both groups were first assessed in terms of their coping skills. 7-10 training sessions in the case group were hold 4 times a week for each client individually each lasted 30-45 minutes. Gholdfried and Davidson's method in problem solving training was provided for them. 2 weeks after completion of the training, coping skill test was carried out in both groups.Results: Findings showed no significant difference in coping skill variables (emotion and problem focused) before the intervention (P>0.05) but the difference became significant after the intervention (P=0.000) in the case group.Conclusion: Problem solving training has significant effects on coping skills and, therefore, can be applied in the treatment of behavioral disorders. It may also prevent suicidal attempts in clients and promote their health condition.

Introduction: Coronary angiography is a routine cardiac diagnostic procedure. Patients are restricted to bed rest after the procedure due to potential vascular complications related to femoral approach. Many patients are required to stay at bed up to 24 hours. The effects of reducing this are still under investigation. The purpose of this study was to evaluate the effects of position change in bed on back pain and other complications in patients after angiography. Methods: In this experimental study, 120patients were randomly assigned equally either to a control or experimental groups. The control group received usual care, remaining supine and flat for 6 hours with the affected leg being straight. The experimental group changed their body position hourly, varying between supine, right side-lying, and left side-lying during the first 6 hours after coronary angiography. Results: Regardless of the group, back pain intensity increased with longer stay at bed. In addition, the control group reported higher levels of pain at all four assessment times. Other complications such as nausea, vomiting, bleeding from the femoral site and hematoma were not significantly different between the control and experimental groups.Conclusion: Findings suggest that patients may be able to safely change their position sooner in bed after coronary angiography. Changing position in bed may also reduce back pain and increase physical comfort. Not only does changing position not increase complications but it also decreases some of them.

Introduction: One of the most important factors in increasing patient satisfaction and improving healthcare outcomes is appropriate nurse-patient relationship. This quasi-experimental study was performed to determine the impact of training communication skills to nurses on patients' satisfaction with nurse-patient relationship.Materials and Methods: All 60 nurses working in medical and infection wards of Imam Khomeini and Vali-e-Asr hospitals were chosen and were divided into two control and experimental groups. Similarly, 80 patients were chosen from the same wards by convenience sampling and divided into two control and experimental groups at each stage' of the study. A questionnaire was used for gathering data collected before and I month after the intervention. After the first stage, nurses in the experimental group took part in communication-skill workshop for two days, each lasted 8 hours.Results: Findings showed a significant difference between patients' satisfaction before and after the intervention in the experimental group (P<0.001). There was also a significant difference in patients' satisfaction after instruction between experimental and control groups (P<0.001).Conclusion: It can be concluded that communication skill training in nurses has positive effects on patients' satisfaction. Thus, communication skill training programs is recommended for nurses to improve the quality of nursing care and increase patients' satisfaction.

Introduction: Psychological stress; decrease of physical, emotional and social function; sexual dysfunction and change of body image due to diagnose and cure of breast cancer influenced quality of life of patients and their family. This study was carried out in order to evaluation of physical, emotional and social dimensions of quality of life in breast cancer women undergoing chemotherapy. Methods: This study is Analytical- Descriptive- Cross-sectional study that was carried out on fifty six breast cancer women undergoing chemotherapy in cancer institute center of Tehran Imam Khomeini hospital in 2006. The research samples were selected through simple sampling method according to the determined characteristics for the research samples. Data collection tools include quality of life breast cancer version (QOL- BC) and demographic questionnaire.Results: In physical dimension of QOL, 62/5% of patients had good QOL and 37/5% had moderate QOL and in emotional dimension of QOL, 42/9% had good QOL and 55/4% had moderate QOL and 1/8% had poor QOL; whereas in social dimension of QOL 21/4% had good QOL and 71/4% had moderate QOL and 7/1% had poor QOL. The total mean of QOL of patients in three dimensions of QOL (physical, emotional & social) was moderate. Also data analysis showed that there were a statistically significant correlation between age with emotional dimension of QOL (P=0/049) and between recent time of chemotherapy with physical dimension of QOL (P=0/000) and total quality of life (P=0/001).Conclusion: The women are one of the most important branches of family and society so improvement of QOL in breast cancer women results in not only improvement of their survival but also results in increase of family QOL and more consistency of family and society construction therefore it is necessary that treatment team evaluate and improve QOL in this patients In this field emphasis on role of nurses.

Introduction: By Progress in new industry and technology and related problems psychic disease and disorders had much increased the same as somatic disorders.While psychic health of students is of great importance it is necessary to consider and study their emotional and psychic problems.Methods: This study is a cross-sectional analysis which was done an first and last grade students of Arnol Nursing Department (85 people). The data collection was through questionnaire including the following parameters: age, marital status, studying grade, residence status, family's address, studying status, general health questionnaire include 28 questions (GHQ-28).Results: Results obtained from analysis of student's answers to test GHQ-28 showed that 30.6 percent (26 people) of all students had psychic disorders, witch 65.4 percent (17 people) were last grade, and 34.6 percent (9 people) were first grade students. The percentage of last grade students was higher on somatic disorders, depression and anxiety. The so called students showed high percentage of disorders mentioned above (p<0.05)5.Conclusion: Studying nursing can result in disorder in one's confrontational mechanisms and appearance of neurosis or psychosis in students because of nature of their major and longtime psychic stress. Various studies showed that psychic health system universities are efficient in decreasing psycho-social problems and disorders in students.