Modern Care Journal
Year:2011 | Volume:8 | Issue:1 (29)|Papers Count:9

Background and Aim: Researches show that to teach thinking skills is a priority in educational programming of education centers. Critical thinking is one of the thinking education methods. The aim of this study is to determine the effect of Critical thinking on bedridden patients care process in nursing students.Materials and Methods: This case-control study was done on 30 female nursing students in clinical training of Gastroenterology as the case group of critical thinking and further 30 control students as the traditional system. The mean of improvement in the 2 groups was compared by independent t test and the mean of the scores before and after education.Results: The results showed that the mean age and the two previous semester scores were not significantly disparate in the case and control groups. The mean of study improvement scores had a significant increase after education in both groups (P 0.005), though the increase was more considerable in the case group (P 0.05 versus P 0.4).Conclusion: The results showed that educational status in the two groups developed but not so much in the case group versus the control. We propose a study on graduated nurses received a high level of critical thinking for a long time in future.

Background and Aim: Post cesarean endometritis and wound infection remain significant morbidities despite use of strategies to prevent these complications. Cesarean delivery is the most common major abdominal surgery. We investigated the effect of preoperative vaginal preparation with Povidone-Iodine on postcesarean endometritis and wound infections.Materials and Methods: In this randomized clinical trial, 526 women undergoing cesarean delivery were selected randomly. Exclusion criteria were: Preterm pregnancy, (GA<37), placenta previa, severe anemia (Hct<30), Chorioaminoitis, Diabetes, Meconium Amniotic Fluid, Obesity (w>114b Kg), Multifetal gestation, Prolonged induction (>10h), Arrest descending in station 0, Prolonged premature rupture of membranes (>18h). Subjects received either standard abdominal scrub alone or abdominal scrub with an additional vaginal preparation with povidone-iodine solution. All subjects received prophylactic antibiotic at the time of umbilical cord. Each subject s postoperative course was reviewed for development of endometritis (temperature 38.4 accompanied by fundal tenderness occurring beyond the first postopereative day in the absence of evidence of other infection), and wound infection.Results: Postcesarean endometritis occurred in 3.4% of subjects who received a preoperative vaginal preparation and 4.6% of controls (P=0.50).Wound infection occurred in 1.5%of subjects who received preoperative vaginal preparation and 1.9% of control. There was no measurable effect of a vaginal scrub on the development of postcesarean endometritis or wound infection.Conclusion: Preoperative vaginal scrub with povdone-iodine before cesarean had no effect on the incidence of endomeritis or wound infection.

Background and Aim: Arteriovenouse fistula (AVF) is the most suitable vascular access in hemodialysis patients. Dysfunction of fistulae is the most common reason for a second intervention and recurrent hospitalization. The aim of this study is to ascertain duration of function and complications of arteriovenousfistula in the hemodialysis patients.Materials and Methods: This is a descriptive study. We studied 94 patients who underwent hemodialysis in Emam Reza and 17 Shahrivar hospitals of Mashhad. The data collecting instrument was questionnaire that has two parts. The first is demographic and the second part is related to documents for example cause of renal failure, duration of fistula and age of patients). The data was analyzed with by chi-square, t test and Pearson correlation.Results: Results showed that from 94 participated patients, 56 patients (59.6%) were male and 36 patients (40.4%) were female. The mean age of the patients was 50.3±16.8 year with minimum 18 years and maximum 86 years. The mean duration of function fistula was 34.3±45.19 month, the minimum duration of function fistula past of using has been 2 week and maximum 280 month (until the research). The most common sequel was aneurysm (58.5%). The most common reason of Fistula failure was surgical technique.We find significant relation between site and AVF survival rate (P=0.003). AVF survival rate at the wrist was more than elbow and thump. We did not observe any significant difference between duration of function fistula with ages, sex and diabetes (P>0.05).Conclusion: Our results showed that complication of fistula is lower in the wrist, so distal Vascular is not recommended for high complications. The rates of complication no correlate with age. Since this finding isn't correlated to pervious studies and little sample, we purposed to perform this study in higher sample.

Background and Aim: Preterm Premature Rupture of Membranes (PPROM) is one of the most common obstetric complications and the most difficult problem in neonatal medicine, which makes mother and her fetus at risk. It is also the main cause of mortality and morbidity in infants. Despite its frequent occurrence, there are some controversies how to treat it. This study was performed to determine the effect of antibiotic versus corticosteroid, antibiotic and tocolytic consumption for patients with PPROM (in 28-32nd week of conception) on short term neonatal outcomes.Materials and Methods: This study was a randomized controlled clinical trial in which a total number of 64 women with PPROM were divided into two groups of case and control. In the case group, mothers received corticosteroid, antibiotic and tocolytic and the Control group just received antibiotic. By using SPSS software data were analyzed in independent t tests and chi square in P 0.05.Results: There were not any significant difference in the mean upgar scores (P=0.32), sex distribution (P=0.8), birth weight of neonates (P=0.67), the mean length of hospitalization (P=0.07), and prevalence of infant death (despite being less in case group) (P=0.67) in the two groups.Conclusion: Results showed that the incidence of neonatal outcomes was not significant in the two groups but though they were less in control group. We suggest more clinical trial studies to clarify the results of corticosteroid antibiotic and tocolytic treatment on neonatal outcomes.

Background and Aim: About 10% of the world's population is affected by disabilities one third of which are children. Parental compliance with children's rehabilitation programs have important role in overall effectiveness of therapies. The purpose of this study was to determine the rate of parental compliance of disabled children who attended outpatient rehabilitation clinics in Birjand city.Materials and Methods: In this cross-sectional descriptive study, data was collected from parents of 92 disabled children who were attending outpatient rehabilitation clinics (occupational therapy, speech therapy and physiotherapy) in Birjand city by interview and using a semi structured questionnaire. The test-retest reliability and validity of which were 0.72 and 0.94, respectively. Parental compliance with regular attending to therapy sessions, doing exercises at home, providing rehabilitation equipments and providing educational materials were assessed. SPSS V.16 software was used for analysis of data.Results: About 48.8% (44 of 92 parents) were complied with regular attending to sessions (i.e. they took part in 90% or more of therapy sessions) and 70% (42 of 60 parents) were complied with performing exercises for children at home, (i.e. they had performed 50% or more of exercises). About 77% (47 of 61 parents) were complied with providing rehabilitation equipments and finally 72.7% (16 of 22 parents) were complied with providing educational materials facilitating rehabilitation (i.e. they had provided 90% or more of recommended items).Conclusions: It seems imperative to make every effort to find barriers of parental compliance with disabled children's rehabilitation programs and help parents to overcome those barriers.

Background and Aim: IUD is a reliable and impermanent method of contraception. Sometimes the complications lead to its removal. The aim of this study was to determine the incidence rate of IUD failure and its side effects during four years (2002-2007) among women referring to gynecological clinics in Birjand.Materials and Methods: In this descriptive- analytic study, all 500 IUD users that referred to Health centers were assessed. The questionnaire consisted of demographic characteristics and questions regarding side effects of IUD and the reasons for removal. The collected information was prepared as tables of figures after statistic analyzing by chi-square tests and regression logistic model (=0.05).Results: According to the findings, the mean age of the subjects was 31.4±6.1 year, the mean duration of use was 47.3±24.1 months, mean number of deliveries was 2.5±1.3 and the failure rate was 0.8%. The most common side effects were frequent bleeding and spotting (24.2%), infection (17.4%), pain (9.8%), the reasons for removal were frequent side effects due to IUD use and desire of person. There was a meaningful relation between incidence chance and education (P=0.006) and type of IUD (P=0.02), but there was not a significant relation between occupation (P=0.21), age of person (P=0.06) and the number of deliveries (P=0.09) with having side effects.Conclusion: The most common reason for IUD removal was side effects. These complications are preventable and education seems necessary to reduce them. The technicians should also receive sufficient training for insertion of IUDs, and thereby prevent early expulsions.

Background and Aim: Pain is one of the most common symptoms in various diseases. Morphine is usually used as a pain killer, which is very valuable in relieving the pain of patients who suffer from severe pain.However nurses fear of the side effects of morphine, act as an obstacle to its usage in relieving pain. So this study was performed to detect the nurses opinions toward the use of morphine for patient s pain relief.Materials and Methods: A descriptive design was used and 85 nurses who were employed in medical and surgical wards of Imam Reza, Ghaem and 17 Shahrivar hospitals in Mashhad, participated in this study. Data was collected by demographic information form, and McCoffery questionnaire that measures nurses opinions toward the amount time and side effects of morphine consumption.Results: %47of participants believed that the more amount of morphine is, the more pain relief would exist.%73 of nurses believed that prescribing opioids as PRN is more effective than their prescription in a specific hours. Only %5.9 0f nurses reports that bradypnea may occur in less than one percent of patients who get morphine.Conclusion: We suggest that it is necessary to setup workshops up-to-date nurses information about the properly use of morphine in relieving patients pain.

Background and Aim: Nowadays it’s determined that stress can cause efficiency decreasing through memory disorders, angry, low self esteem, hopelessness, increasing seclusion, and also physical problems such as changing in appetite, gastrointestinal disorders and nurses who work in psychological wards aren't except in addition to special environmental conditions. Therefore this study has done to assess occupational stress and coping strategies in these groups.Materials and Methods: A descriptive design and census sampling was used. The study population consisted of nurse who work in psychological wards with six months Work tenure in Razi hospital (n= 70). Data collecting tool has three sections, 1- Demographic information 2- stressor’s factors (physical and psycho-social) 3- coping methods, that completed by nurses. Validity and reliability determined by content validity and a-Cronbach.Results: Wilcoxon test, showed significant difference between two group (P=0.002) and physical stressors had created more stress.Conclusion: Although Stress decreasing benefits for staffs, also, it is benefit for employer and organization finally. Therefore, it’s necessary planning for decreasing of psycho-social stress complication such as depression and anxiety. And it’s always need to plan for necessary changes in job environment, education procedures and decreasing job stress.