Modern Care Journal
Year:2015 | Volume:11 | Issue:4|Papers Count:11

Appreciations go to Mr. Salehinia and his colleague for their criticism on the paper. This clinical trial included 82 breast-feeding women with nipple pain who were randomly allocated to two groups. Both groups were instructed the correct way to feed and use cream or milk. Nipple pain was measured and compared before the intervention and three and seven days after the intervention.In studies of this type, lack of education of the correct way of breastfeeding is considered as unethical; thus, there should not be a control group with instructions for incorrect way of breastfeeding. Instruction for the correct way of breastfeeding is not considered as an intervening factor because both groups were instructed at the beginning of the study, and almost all were aware on the third day of the research project. Nipple pain reduced from the third day which was a result of cream or milk application.Frequency of correct breastfeeding prior to the study was 34.1% in the milk group and 48.8% in the cream group. On the third day, these figures increased to 100% and 90.2% in the groups respectively and remained constant until the end of the study (the 7th day). Since 9.8% of the mothers (n=4) did not follow the instructions for correct breastfeeding, 2.4% were still complaining of severe pain on the seventh day. As Cadwell’s (1) and Morland-Schultz and Hill’s (2) studies indicate, instruction of correct breastfeeding is very effective in reducing nipple pain. Comparison of the correctness of breastfeeding showed that there was not a significant difference between the two groups (P=0.17), suggesting the similarity of the two groups. In the current study, the mothers in both groups reported different degrees of pain, and no one reported zero pain. In the milk group, there was 2.4% complete pain removal on the third day, and the percentage of mothers who had severe pain on the first day reduced from 39% to 2.4%. On the seventh day, the overall recovery rate reached 46.4% (and 44% increase in recovery from the third day), and heavy pain was reported to decrease from 2.4% to zero. It can be said that this increase in recovery can be exclusively because of the application of mother's milk.In the cream group, complete recovery from pain was 4.9%. The number of women with severe pain reduced from 41.5% to 4.9%, and on the seventh day, complete recovery rate reached 58.5% (53.6% increase in recovery from the third day), and heavy pain was reported to decrease from 4.9% to 2.4%. It can be concluded that this increase in recovery in the seventh day can be exclusively related to the application of mother's milk.There was not a significant difference as for nipple pain severity between the cream group (5.67±1.86) and the milk group (5.09±2.15) (P=0.22). On the seventh day, the mean score in the cream group (0.74±1.15) was less than the milk group (1.19±1.78) although the difference was not significant (P=0.22).Although breastfeeding was not corrected in 9.8% of mothers in the cream group, the effect of cream was more than milk though not significantly. There was no bias in this study, and it should be emphasized that Calendit-E cream and breast milk seem both to affect nipple pain removal equally. Firm conclusions in this regard, however, require more extensive study.

Background and Aim: Psychological empowerment, which is the sense of control over and motivation in work, plays a critical role in nursing professional competence. As a new motivational approach, its dimensions and factors affecting it seem necessary to be determined. This study aimed to determine psychological empowerment and some relevant factors of the nursing personnel of educational hospitals in Birjand.Materials and Methods: In this analytical-descriptive study, 180 nurses of educational hospitals in Birjand were selected by stratified–random sampling method. Data collection initiated using the standard 15-item Spreitzer’s Psychological Empowerment Questionnaire and completed by interviews with participants. The reliability of the questionnaire was 0.79. The obtained data was analyzed in SPSS (version 16), using oneway ANOVA, independent t test, and Range Tukey at the significant level of P<0.05.Results: The total mean score of psychological empowerment was 41.29±11.9. The highest mean score in psychological empowerment belonged to the meaning dimension (9.8±3), while the lowest mean score belonged to the impact dimension (6.6±2.7). Empowerment mean score was greater in men than in women and more in general wards than critical care wards. In addition, there was a significant correlation between psychological empowerment and age, years of service, job satisfaction, type of ward, and satisfaction with supervisor (p<0.05).Conclusion: Given the results of the study and the role of psychological empowerment on organizational efficiency, managers of hospitals are recommended to pay special attention to the empowerment of their nurses.

Background and Aim: Depression is a mental disorder, and cognitive therapy is a client-centered approach to relieve depression. This study was performed with the aim to systematically review the studies which have focused on the effect of cognitive therapy on depression.Materials and Methods: In this systematic review, electronic searching was conducted in Cochrane, Medline, Google scholar, and EMBASE databases for clinical trials written in English from 2003 to 2013 using the keywords “cognitive therapy” and “depression” in the title and abstract of articles. The same was performed in SID, Magiran, and IranMedex databases during the same time-span for Persian papers. Results: In total, 20 full-text articles were subjected to final review. After searching, screening and evaluation, the final results showed that from the studies, 16 had reported positive effects of cognitive therapy on depression, and only 4 researches had indicated no effect on the improvement of depression. In 13 studies, cognitive therapy was used as an intervention for depression in 9 cases of which the intervention led to a decline in depression. Also, findings indicated that cognitive therapy is useful for reducing depression in both clinical and nonclinical groups, although the usefulness was different in each group.Conclusion: The studies covered here were conducted in small sample sizes with different cognitive therapy interventions and different cultural contexts. According to the findings, cognitive therapy was effective on symptoms of depression. Further studies, however, are needed in order to reach firmer conclusions about the effect of cognitive therapy on depression.

Background and Aim: Patient education plays an important role in controlling diabetes. Non-attendance education is not limited by time and space but facilitates the relationship between patient and health-care providers, making it an effective, simple, and cheap method. The aim of this study was to determine the effects of non-attendance information therapy on the control of HbA1C in type 2 diabetic patients in Isfahan.Materials and Methods: The applied study has a quasi-experimental design with pre-test, post-test and control group. Accessible population included type 2 diabetic patients of Isfahan Endocrine and Metabolism Research Center, from which 64 were randomly selected and allocated to the case and control groups. The preliminary data were collected using HbA1C test and collection data form. After the case group received the training package and SMS for 3 months, HbA1C was again measured in both groups. Data were analyzed in SPSS (version 20) using independent t-test, paired t-test, Mann-Whitney and chi-square tests.Results: Results showed that diabetic patients’ HbA1C level in both case and control groups did not differ significantly (P<0.97). After the intervention, HbA1C level decreased significantly more than before the intervention (P<0.001). However, there was not a significant different in HbA1C level of the control group before and after the intervention (P<0.37). A significant difference was also observed between the HbA1C level of the two groups after the intervention (P=0.048).Conclusion: Follow-up of education of patients with type 2 diabetes through training packages and SMS had significant effects on the control of patient's HbA1C. Given the low cost and high efficiency of this method, patient education is recommended to health-care providers and treatment groups.

Background and Aim: The sublime objective of higher education at all educational levels is to promote the creativity power and academic achievement in university students to which learning style is the complementary half. This study aimed to investigate the relationship between physiological learning styles, creativity, and academic achievement among students at Birjand University of Medical Sciences during 2013-14 academic year.Materials and Methods: This correlational study included 322 students who were selected by randomized stratified sampling. Kolbe's standard physiological learning style questionnaire and Abedi's 60-item creativity questionnaire were used to collect data and students' total score means were used to determine their academic achievement. The data were analyzed in SPSS (Version 14) using Pearson's correlation, ANOVA, and independent t test at the significant level of p<0.05.Results: The total mean scores of female and male students were 16.21±2.16 and 15.1±2.76 respectively. There was a significant relationship between students' learning styles (visual style, audio style), creativity, and their academic achievement (p<0.05). However, there was no significant relationship between movement learning style and academic achievement (p>0.05). Creativity and academic achievement did not correlate significantly in terms of faculty and gender (p>0.05).Conclusion: Given the result, students are recommended to get familiar with physiological learning styles such that they can adopt the style(s) appropriate for them. Professors should also pay attention to learning styles at the time of teaching.

Background and objective: Low blood pressure and muscle cramps are the most common complications of hemodialysis. These complications during hemodialysis cause patient intolerance. One approach that has recently been proposed to prevent this complication of dialysis is to change dialysate sodium concentration and remove the velocity of fluid, a procedure called sodium-ultrafiltration profile. The purpose of this study was to investigate the effect of linear sodium-ultrafiltration profile on patients' tolerance during hemodialysis.Material and Methods: This was a clinical trial with a crossover design in which 30 hemodialysis patients with inclusion criteria referring to Be’sat Hemodialysis Center in Hamadan were selected. Each of the patients received routine treatment for two sessions (where dialysate sodium concentration of 138 mmol/l remains constant from the first to the last day of dialysis, and ultrafiltration rate will not change) and two sessions of Profile 1 Na plus profile 1 ultrafiltration upon the physician’s order (sodium concentration dialysate at the beginning of dialysis was 146 mmol/l which was linearly decreased at the end of dialysis to 138 mmol/l; ultrafiltration also decreased in an automated and linear manner over dialysis). Data were analyzed in SPSS (version 16) using Paired t-test, ANOVA with repeated measurements, Tukey Post Hoc and Wolcoxon. The significant level was set for P<0.05.Results: The mean age of patients was 50.83±16.71 years, and 53.3% of them were female. The results showed that the incidence of hypotension was significantly lower during linear profiles than the routine approach (P<0.05), while the comfort level was greater. However, there was no significant difference between the incidences of muscle cramps in the two procedures.Conclusion: Given the simplicity, cost-effectiveness, and increased patient tolerance of sodium and ultrafiltration profiles during dialysis, we recommend using sodium and ultrafiltration profiles instead of the routine method.

Background and Aim: Health promoting behaviors are among major determinants of health. Theory of planned behavior provides a useful framework for predicting and understanding health behavior. Integrating self-efficacy to the model will contribute to the prediction of behavior and intention. This study aimed to investigate the relationship between “Integrated model of planned behavior and self-efficacy” and health promoting behaviors of working women at reproductive age.Materials and Methods: This research was a correlational study aimed to model testing. Two hundred female workers working in 5 different factories were selected using random sampling method. The valid and reliable health promoting behavior scale was used as a tool in this research. LISREL 8.5 was used for data analysis.Results: The path analysis showed a significant path from self-efficacy to behavior. A significant negative path was observed from daily hours of working and perceived controlled behavior to behavior. The path from subjective norms and self-efficacy to intention was significant. The path from education level to attitude was significant. The path from working days to self-efficacy was negatively significant. Model fit indices indicated that the data were a good fit to the model..Conclusion: In total, the integrated model of planned behavior and self-efficacy is appropriate for predicting health promoting behaviors among working women of reproductive age.

Background and Aim: In developing countries, cervical cancer is the second most common cancer in women and in Iran the third is allocated between common cancers. Therefore, regular screening for the prevention of this disease is of great value. This study done، aimed to determine Pap smear screening behavior in women, according to the Trans-theoretical Model.Materials and Methods: In this cross-sectional study, selected 800 women referred to urban health centers Gonabad, with quota sampling method. The instrument was a researcher-made questionnaire including: demographic information, knowledge about cervical cancer and stages of change behavior pap smear screening of prochaska's model. The obtained data were analyzed by SPSS 16.Results: Mean age±SD of women was 36.76±9.25 years. The results indicate that 10.3, 8.4, 5.1, 13.1, 32.6 and 30.5 % of the women studied were in the stages of Pre-contemplation, Contemplation, preparation, Action, Maintenance, and Relapse, respectively .While 54.3 percent of subjects had experienced uterine infection , only 33.2% were aware of cervical cancer and how to recognize it. The statistical analyses show that there were significant difference between Pap smear screening behavior stage of change and age, marriage age, pregnancy age, pregnancy number, delivery number, child number and education, education and uterine infection background (P<0.005).Conclusion: Since over half of the women in this study did not perform Pap smear screening behavior (i.e., Pre-contemplation, Contemplation, preparation, and Relapse), it seems essential to devise appropriate educational programs based on stage of change model in order to make women aware of the significance of Pap smear screening behavior.

Background and Aim: Palliative care is one of the most important concepts in nursing. The aim of this study was to interpret palliative care concept, its barriers and facilitators using meta-synthesis..Materials and Methods: In this meta-synthesis, a systematic review was conducted and qualitative articles related to palliative care concept in Medline, Elsevier and Ovid in the period from 2002 to 2012 were selected. To facilitate the search, the terms “palliative care” and "qualitative research” were used by MeSH system. Then, articles that had exactly studied palliative care concept and its related factors, and were published in English, were selected for analysis and compared. In this study, 553qualitative articles related to palliative care concept were found and 44 articles were in close relation to palliative care concept which included 22 articles from Medline, 3 articles from Elsevier, and 19 articles from Ovid databases. In total, from among the 44 qualitative articles in the period from 2002 to 2012, full texts of 16 articles were selected and reviewed in an interpretive manner. Data were analyzed using open coding style. Results: Results from interpretation of palliative care concept, its barriers and facilitators were categorized in 3 themes consisting of palliative care concept, palliative care facilitating, and palliative care threatening factors. In general, 35 codes were introduced as the most important elements in the context of palliative care.Conclusion: The results show that palliative care is a complex and multi-dimensional concept. Multiple factors are related to it, which can facilitate or threaten it. In addition, the results of the present metasynthesis showed that palliative care is not bounded by a specific time or place but enjoys a team and interdisciplinary approach.

Background and Aim: Although breast feeding is one of the most important ways to improve child health, many mothers stop breastfeeding due to multiple factors and replace supplemental feeding. Therefore, it is important to apply appropriate methods for timely training of mothers in this area. This study compared the effectiveness of empowering mothers based on BASNEF model for breastfeeding during two periods, before and after delivery, on duration of exclusive breast feeding among primiparous mothers referring to Shariati Hospital in Isfahan, 2013.Materials and Methods: In This quasi-experimental study, 99 nulliparous women attending Shariati Hospital were selected by convenience sampling method. After giving written informed consent, they were allocated to two intervention groups (i.e. group 1 before and group 2 after delivery) and one control group. The empowerment program which was based on BASNEF model components and behavioral objectives was conducted in one session where the participants were provided with a booklet and a phone number for later consultation. Duration of exclusive breast feeding was checked by telephone call during the 2nd and 4th months after delivery. Data were analyzes in SPSS (version 19) using descriptive statistics and inferential statistical tests including one-way ANOVA, chi-square, Bonfroni Follow-up at the significant level of a=0.05.Results: The mean duration of exclusive breastfeeding was significantly more than those in the group that was significantly more in the 1st group than the 2nd or the 3rd group (p<0.05). This was more in the 2nd than the control group, but this difference was not significant (p>0.05).Conclusion: Empowering mothers for breastfeeding prior to delivery is more effective in the promotion of exclusive breastfeeding than the postpartum period. So it is suggested that health officials use educational program for training mothers prior to delivery.

Nowadays is an era whose mental structure is overwhelmingly oriented towards deepening knowledge and attention to the creative and knowledge-based human resources. knowledge management and creativity in nursing and other health-related professions will result in improvement in patient care. This study aimed to investigate the relationship between knowledge management indices and creativity in Isfahan-based hospitals. This study is descriptive and corelational. The population included head nurses of some selected hospitals in Isfahan who were selected by census. Research instruments in this study consisted of two knowledge management and creativity questionnaires. There were 80 respondents in the study. The data were statistically analyzed by descriptive statistics (frequency, mean and standard deviation) as well as inferential statistics (corelational index and multiple regression).The results of the study indicated that there was a statistically significant relationship between knowledge management indices and creativity (r=0.532) which was significant (p<0.01). However, there was no significant relationship between mean scores of knowledge management and creativity in terms of tenure, gender and age.It is necessary for hospitals to apply more seriously approaches which are based on knowledge management so that creativity can be obtained by more effective application of knowledge and mental resources.