Advances in Nursing and Midwifery
Year:2018 | Volume:27 | Issue:4|Papers Count:9

Introduction: Diabetes is one of the most common chronic diseases that is also highly prevalent among adolescents. The present study was conducted to determine the relationship between demographic characteristics and self-management in adolescents with type 1 diabetes. Methods: This descriptive-analytical study was conducted on 426 adolescents with type 1 diabetes aged 13 to 18, and diagnosed for at least one year. The research tools included a demographic information form covering the patients’ personal, family, and health details, and the Self-Management of type 1 Diabetes in Adolescence (SMOD-A) with five subscales of collaboration with parents, diabetes care activities, diabetes problem-solving, diabetes communication, and diabetes goals. The content validity of the measure was then evaluated by a group of experts and found to be acceptable (SCVI = 98%). In the assessment of the measure› s reliability, the intraclass correlation showed an overall Cronbach’ s alpha of 0. 88. The test-retest showed a consistency of 0. 73 for the measure. Results: The results obtained showed that the presence of another diabetic member in the family leads to higher levels of self-management in some dimensions, including problem-solving, communication, and goals, yet to lower levels in some others, including collaboration with parents and diabetes care activities. A direct relationship was observed between the duration of time since the diagnosis and the scores obtained by the adolescents. An inverse relationship was observed between the type of physician in charge and the scores obtained in the subscales of collaboration with parents, problem-solving, communication, and goals. The scores obtained were directly related to having a school health record and having access to diabetic care tools at school. Family income was found to be directly related to diabetes care activities and inversely to problem-solving, communication and goals. P of ≤ 0. 05 was considered significant for all relationships. Conclusions: Self-management was found to be moderate to good among Iranian adolescents with type 1 diabetes; however, it could be further improved with the support of both families and medical teams involved.

Introduction: Ostomy is a surgical procedure performed to divert feces and urine output in cases of anorectal anomalies. Although this procedure is a crucial intervention with excellent treatment effect, it is associated with complications, such peristomal skin lesions. This study aimed at evaluating the effect of providing ostomy care education to mothers of infants with peristomal skin complications. Methods: Forty mothers of neonates with intestinal stomies were informed about the aim of this study and invited to participate. The sampling was conducted in accordance with the quota sampling method. The participants were randomly and equally allocated to the control and experimental groups. The mothers in the experimental group attended a three-session educational program, whereas the mothers in the control group received information about routine care methods used by the study settings. The peristomal skin conditions of the infants in both groups were examined before discharge and 30 days after discharge using the Telegram Software or in person, according to an established checklist. Data were analyzed with the SPSS 21 software to obtain descriptive and analytical statistics. Results: Prior to discharge, the majority of the neonates in both groups had healthy peristomal skin. In the control group, five neonates had acute dermatitis and one had chronic dermatitis. In the experimental group, four neonates had acute dermatitis and two had chronic dermatitis. The χ-square test showed that the two groups were not significantly different (p-value = 0. 94). After discharge, most of the neonates in the experimental group had intact peristomal skin and only four neonates had chronic dermatitis. In contrast, in the control group, only six neonates had intact peristomal skin. The results of Fisher’ s exact test indicated that the two groups of study were significantly different (p-value = 0. 013). In the experimental group, 16 and 14 neonates had intact peristomal skin before and after discharge, respectively. In the control group, 14 and 6 neonates had intact peristomal skin before and after discharge, respectively. The results of McNemar’ s test revealed no significant differences in the experimental group before and after discharge (p-value = 0. 69), whereas the control group showed significant difference in this context (p-value = 0. 021). Conclusions: Providing mothers with education on proper ostomy care significantly decreased the occurrence of peristomal skin lesions in neonates with intestinal ostomies.

Introduction: The decline in fertility and childbearing tendency in Iran is due to various demographic, economic, social, and cultural variables. The present research was conducted to review studies carried out on factors affecting the decline in childbearing. Methods: This systematic review searched for articles published from 2011 to 2017 in all the available Iranian and foreign databases, including SID, Magiran, Irandoc, Medlib, Pubmed, Google Scholar, Science Direct, and Proquest using the following keywords, “ childbearing” , “ fertility” , “ fertility decline” and “ population decline” . The search ultimately led to the inclusion of 53 studies. Results: The main factors affecting the decline in childbearing discussed in the 53 reviewed articles were divided to three general categories: 1. Personal and family factors, including aging, older age at marriage, current number of children, the duration of marriage, the mean birth spacing, gender preferences, hopefulness, marital satisfaction, and quality of life, 2. Socioeconomic factors, including social support, education, occupation and social participation, especially of females, place of residence and the effect of social networks, 3. Cultural factors, including modernity, urbanization and industrialization, attitude change towards the value of children, changes in family values and religion. Conclusions: To intervene in the decline in childbearing and to increase the success rate of the designed plans and strategies, policy-makers and planners should provide strategies to deal with all the three noted groups of factors affecting childbearing.

Introduction: The Objective Structured Clinical/Practical Examination (OSCE/OSPE) is one of the best assessment methods for measuring the students’ realization of their educational goals in cognitive, emotional, and psychomotor domains. Given that gender may influence the evaluation of medical sciences examinations, the present study was conducted to compare the female and male nursing students of Shahid Beheshti University of Medical Sciences during years 2011 to 2015 in terms of their OSCE/OSPE scores for the biochemistry laboratory. Methods: This study had a comparative descriptive design. All of the students participated in this study from 2011 to 2015 (census). Over these four years, 649 students took this examination and their scores were recorded. The data collection tools included a demographic information questionnaire and a researcher-made checklist. Pearson’ s Correlation Coefficient was calculated for determining both the criterion validity and the internal consistency (r = 0. 732). The Pearson correlation coefficient confirmed the testretest reliability of the test (r = 0. 88). The data were analyzed using the SPSS-22 software with descriptive statistics, the independent t-test, the one-way Analysis of Variance (ANOVA), and Scheffe’ s post-hoc test. Results: The scores of 361 female students and 288 male students were assessed in this study. The mean score was 11. 6 ± 1. 83 in female students and 11. 2 ± 1. 75 in male students (out of 14). The difference between the female and male students’ OSCE/OSPE scores in biochemistry laboratory skills was significant (P = 0. 02). Comparing the mean scores of the female and male students in biochemistry laboratory skills according to OSCE/OSPE by year of admission showed a significant difference between the genders in the students admitted to the school during year 2012 (P = 0. 01). There were also significant differences between the age groups of < 20 and 25-29 and the other age groups in terms of the mean OSCE/OSPE scores (P < 0. 05). Conclusions: There was a significant difference between the two genders in the mean crude scores obtained and the female students had slightly higher scores. Future studies are recommended to investigate the students of other disciplines, academic levels, and schools to improve the generalizability of these findings.

Introduction: Mothers’ participation in the Neonatal Intensive Care Unit is important in promoting neonatal care and good outcomes for neonates and their mothers. The present study was conducted with the aim of assessing the effect of empowering mothers of hospitalized neonates on the level of their participation in neonatal care. Methods: This quasi-experimental single-group study with before-after design recruited 59 mothers of neonates hospitalized at the NICU, selected according to the study inclusion criteria. Data were collected using educational needs questionnaire and the maternal participation checklist. The questionnaire was completed by mothers and the participation checklist by the researcher before the intervention. The empowerment program was then implemented over 2 to 4 days. Results: Comparison of participants› checklist scores before and after the implementation of the empowerment program in 3 domains of care needs, information needs, and bonding, and attachment needs, showed significant increases in the level of mothers› participation. The comparison of checklist participation scores showed that the Mean (M) and Standard Deviation (SD) of scores before and after performing the mothers› empowerment were respectively 7. 61 ± 3. 66 and 12. 38 ± 1. 31 in the care area, 1. 47 ± 0. 99 and 3. 13 ± 0. 66 in the information area, and 4. 77 ± 1. 42 and 5. 70 ± 0. 59 in the area of attachment and dependency. Conclusions: Implementation of the empowerment program for mothers based on their educational needs significantly increased mothers› participation in neonatal care. This empowerment program could be applied for a broad range of population of mothers at the intensive care units of neonates.

Introduction: Medication errors are the most common type of medical errors that can cause serious problems for public health and are considered a threat to patient safety. This study was conducted to determine the effectiveness of patient safety training on nurses’ medication errors at the emergency department of a hospital of Golestan Province in Iran. Methods: The present quasi-experimental study was conducted from March to September 2016. The study population consisted of nurses working at a hospital affiliated to Golestan University of Medical Sciences and a sample of 40 nurses at the emergency department of this hospital were selected through a census. The data collection tools used included a demographic questionnaire and Wakefield’ s Medication Error questionnaire for nurses (consisting of 21 domains), which were used once their reliability was confirmed. A patient safety training program was designed and implemented for the selected emergency nurses in the form of a two-day workshop. The obtained data were analyzed using the SPSS-18 software with the Wilcoxon test. Results: Results showed that the rate of medication errors (80. 62%) of nurses were at a low level. The majority of nurses (80. 62%) scored low in terms of the frequency of medication errors; after the training, a significantly greater number of nurses scored low in terms of this index (90. 31%; P < 0. 001). The analyses showed the effectiveness of the patient safety training program for nurses in the two domains of wrong time error and missed dose error (P < 0. 001); however, the training had no significant effects in the other domains. Conclusions: As patient safety training can be effective on nurses’ medication errors, retraining courses on safe medication administration are necessary regarding nurses’ significant role in the prevention of medication errors.

Introduction: Adaptation to the maternal role is an important factor for health of mothers and infants. With regards to numerous stresses after childbirth and effect of social support in modifying stresses, the present study was conducted for detecting the correlation between adaptation to the maternal role and social support in primiparous females. Methods: This cross-sectional study was performed on 260 primiparous females, who had referred to public health centers of Shahid Beheshti University of Medical Sciences in Tehran, during year 2016. Data gathering tools included the «Demographic Questionnaire», «Adaptation to the Maternal Role in Iranian Primiparous Women Questionnaire», «Multidimensional Scale of Perceived Social Support», and Edinburgh Postnatal Depression Scale. Data analysis was done using the SPSS software (version 22) and it was based on descriptive statistics and statistical independent t-test, Analysis of Variance (ANOVA), Spearman correlation, and linear regression. P value < 0. 05 was considered significant. Results: The score of adaptation to a maternal role had a significant correlation with a total score of social support and its subscales (P = 0. 001). Also, the adaptation to a maternal role had a reverse significant correlation with the mother and father’ s education and the rate of family income, yet the results of the linear regression demonstrated that only two variables, “ social support” and “ mother’ s education” , were significant in predicting the adaptation to a maternal role (P = 0. 001), and they could predict 15% of variance for adapting to a maternal role. Conclusions: Social support is an effective factor for adaptation to the maternal role in primiparous females. Therefore, providing an appropriate situation for these supports is recommended. Also, it is required for health care providers to make sure about an adaptation to a maternal role, especially in mothers with higher education.

Introduction: The aim of this study was to explain how the spiritual leadership model could be used as a paradigm for nursing leadership. Nursing leaders play a critical role in the management of the health care system. Spiritual leadership is a new area that has recently been considered in nursing management. Methods: In this review article, electronic databases (PubMed, Scopus, Google Scholar and Science Direct) were searched from September 2014 to July 2016 to find relevant articles using keywords, such as spirituality, leadership, management, nurses and motivation. In this regard, the articles that fulfilled the goals of the study that were written in English or Persian, had their full texts accessible, and were published in the intended time interval were entered in the study. The articles without authors’ names and dates and non-scientific papers were excluded from the study. On the whole, a total of 120 articles were obtained, of which 48 were selected and analyzed. Results: A review of the literature focusing on spiritual leadership demonstrated that the spiritual leadership model has been examined in different countries, various fields of the industry, trade training, and the health system with positive individual and organizational consequences. It seems that the characteristics of this style of leadership fits the nursing profession as well. Of course, more large-scale future studies for testing this model of leadership in the field of nursing will bring about more promising results. Conclusions: Spiritual leadership could improve the organizational productivity and employees’ satisfaction. Nursing leaders should have paid greater attention to this type of leadership to achieve positive organizational outcomes; therefore, they need more training in this issue.

Introduction: Psychological disorders are the leading cause of disabilities, social harms, and reduced quality of life in patients with Multiple Sclerosis (MS). This qualitative study was conducted to describe the concerns of females with MS. Methods: In this qualitative study, 16 females with MS at the reproductive age with medical records at the MS Society of Tabriz were selected using the purposive sampling technique and underwent semi-structured in-depth individual interviews. All interviews were recorded, transcribed, and analyzed using conventional content analysis. Results: In this study, 23 codes were identified from transcribed interviews and categorized to two sub-categories, fears and feelings. These two sub-categories formed the main category, named concerns. Conclusions: Regarding concerns of these patients, their regular health monitoring by physicians and healthcare providers is recommended in an attempt to alleviate these concerns.