Evidence-based Care Journal
Year:2012 | Volume:2 | Issue:3 (4)|Papers Count:8

Background: The practice of surrogacy is one of the most controversial procedures in infertility treatment. Despite increasing of using this technology in Iran, there are few practical data about surrogacy. There isn't any study assessing experiences of commissioning mothers about surrogate mother selection.Aim: The purpose of this study was exploring of commissioning mothers' experiences in selection of surrogate mother.Method: This study has been done with qualitative approach in 2010-2012. The method of data collection was unstructured interview and sampling was purposeful. Generally 32 interviews were done with 15 commissioning mothers with gestational surrogacy and 5 infertility centers' personnel. Environment of research was Royan Research Center in Tehran and other governmental or nongovernmental infertility centers, hospitals and clinics that have done surrogacy in Iran. Data analysis has been done by use of conventional content analysis method. Also the research process reported point by point for verification, credibility, transferability and audit research. Approval of the ethics committee and obtaining of informed consent from participants was including ethical considerations of this study. Results: Finally three main themes were revealed that were indicative of partnerships' essence and dimensions of their experiences about choosing the surrogate mother. They were including 1."Challenge of surrogate mother selection" 2. "To benefit of helper/backer" 3. "Inefficient support"Conclusion: Selection of surrogate mother is the most challenging stage of surrogate motherhood and also the supportive system isnt efficient. Presentation of context based findings could help to attendants for accurate planing.

Background: The challenges experienced by mothers of children with cerebral palsy usually are multiple and ongoing. These challenges affect the mental health of mothers. Thus they need to be supported with supportive programs.Aim: This study was carried out to determine the effect of a designed- supportive program on mental health of mothers who have children with cerebral palsy. Method: In this quasi-experimental study 60 mothers who had children with cerebral palsy were firstly selected by convenience sampling method and then allocated to two groups of experimental (n=30) and control (n=30). Data collection tools included the demographic and General Health Questionnaires (GHQ-12). Designed supportive program was implemented for experimental group through three steps including assessment of needs, giving support and evaluation. Data were analyzed with SPSS software Version 16 using Chi-square, t student and paired t-test.Results: Chi-square showed no significant difference in terms of demographic variables between two groups. Independent t-test showed that there is a significant difference between two groups in relation to mean scores of mental health after intervention (P<0.001). Based on Paired t-test there was a significant difference between mean scores of mental health before and after intervention in experimental group (P<0.001), but this difference was not seen in control group.Conclusion According to the findings, applying a designed- supportive program could affect positively the mental health status of the mothers who had children with cerebral palsy. So it is suggested that designed- supportive programs to be applied as an effective method to promote mental health of mothers of children with cerebral palsy.

Background: Among the non-surgical methods of preventing conception, taking oral contraceptive pills is the most common way. Some of the studies have shown that contraceptive pills due to containing estrogen and progesterone cause lipid peroxidation and as a consequence increase the level of oxidative stress.Aim: To compare the level of plasma Malone dialdehide in LD contraceptive pill and condom users.Method: In this study, 80 women who were taking LD contraceptive pills to prevent pregnancy and 38 women who used condom were selected from clients who referred to Shiraz health centers (Mehr& Samenolaeme) Plasma Malon dialdehyde was measured by thiobarbituric acid method. Data were analyzed with SPSS Software version 17, using Mann-Whitney and t-test.Results: The mean level of plasma Malon dialdehyde in contraceptive pill users was (4.19±0.836 Ng/ml) and in condom users was (3.32±0.758 Ng/ml). In order to evaluate the differences between two groups t-test showed statistically significant difference in the level of plasma Malon dialdehyde in contraceptive pill and condom users. Conclusion: This study showed that oral contraceptive pills increase plasma Malone dialdehide.

Background: Diabetes Mellitus is a heterogeneous group of different metabolic disorders that are characterized by chronic increase of blood glucose, cardiovascular diseases, and proteins, lipids and carbohydrate metabolism disorder. Leptin, that is a marker of fat mass in the body, has an important role in the body total metabolism and glucose homeostasis.Aim: To investigate the effect of 12 weeks of aerobic exercise on leptin and glucose homeostasis in patients with type II diabetes. Method: In this quasi-experimental study, 40 men with type II diabetes referring to Mashhad Parsian Clinic were allocated into two groups: aerobic (20 participants) and control (20 participants). Aerobic group performed selected exercises in 12 weeks (three 40 min sessions per week with %60-%70 heart rate reserves). The levels of leptin, fasting glucose, insulin and insulin resistant factor were measured. Data were analyzed with SPSS version 11.5 using t student and Paired t test, and also Mann-Whitney, and Wilcoxon tests. The level of significance was considered to be 95% (p<0.05).Results: The mean age of experimental group was 40.4 in experimental vs 38.3 in control group. The mean duration of diabetes mellitus was 5.38 and 5.20 in experimental and control group, respectively. There were significant differences in leptin (P<0.001), Fasting Blood Sugar (P<0.01), insulin (P<0.015) and insulin resistant factor (P<0.035) between aerobic exercise training and control group.Conclusion: Regular aerobic exercise causes insulin resistant reduction and glucose metabolic elevation and also reduction of leptin level in serum so that could have an important role in reduction of cardiovascular diseases and improvement of glucose metabolism in patients with type II diabetes mellitus.

Background: Diagnostic and therapeutic procedures such as Endoscopic Retrograde Cholangiopancreatography (ERCP) is stressful for the patient.Aim: to determine the influence of Orientation technique on anxiety levels and pulse rate in patients before ERCP in Talaghni hospital in 2011. Method: This study was a randomized controlled clinical trial which carried out on 70 subjects with gastrointestinal disorders hospitalized in Taleghani Hospital, Tehran, who were randomly allocated in two groups (35 experimental and 35 control group). The subjects in the experimental group were received orientation technique while control group were only received routine care in their ward. The anxiety level and vital sign was measured in both groups and analyzed with SPSS Version 13 using inferential statistics. Results: There was no difference between two groups in terms of demographics variables based on Chi square test. Before applying Orientation technique, there was no significant difference in the average score of situational anxiety and vital sign (BP and P) scores of the subjects in the experimental and control group (P>0.05). However, after applying Orientation technique, a significant difference was seen in the situational anxiety average score and pulse rate of the subjects in two groups (P<0.05).Conclusion: Use of Orientation technique was useful in decreasing the anxiety level of patients undergoing ERCP. It is therefore recommended that Orientation technique to be used by health professionals as a non therapeutic and cost-effective intervention before performing medical procedures like ERCP.

Background: The Trauma is one of the most important health problems and a leading cause of death in 4th decade of life. Mortality due to accidents has a critical situation in Iran and mortality rate is increasing 10-15% annually.Aim: To assess the relationship of shock index with trauma patient’s mortality after first 24 hours of admission at Khatam-al-Anbia Hospital in Iranshahr.Method: A cross-sectional design was carried out on 240 traumatic patients to predict mortality of trauma patients after 24 hours of hospitalization at Khatam-Alanbia Hospital in Iranshahr. The shock Index is calculated by dividing heart rate on systolic blood pressure. The normal range is 0.5-0.7. SI was calculated at the beginning of admission to hospital and after 24 hours mortality was assessed. Data were analyzed with SPSS Software version 15, using logistic regression and Chi-square test.Results: 74.2% of trauma was due to accidents from which 38.3% experienced multi trauma. 2.1% of patients expired during 24 hours of admission. The minimum and maximum scores and mean of SI were 0.31, 59.1 and 0.71, respectively. There was a significant relationship between SI and mortality of trauma patients within 24 hours of hospitalization (P=0.000). The highest rate of mortality was seen in patients with SI higher than 0.9. Conclusion: The SI is a useful instrument for mortality prediction. So it is recommended to reduce errors in mortality prediction SI to be used along with other kinds of triage instruments.

Background: job stress is associated with many factors and different hypotheses have been proposed respectively. However, empirical evidence is needed to support these assumptions to guide nursing practice.Aim: To test the hypothesis derived from a related grounded theory study in order to determine the relationship between frequency and intensity of nurses' confrontation with intra-organizational factors of burn centers and their job characteristics.Method: It was a cross-sectional and correlational study. Nurses working in Shahid Mottahari Burn Center (N=98) were recruited by census during 2010. Data were collected by intra-organizational questionnaire and job characteristics form, derived from the previous grounded theory study of the researcher and analyzed with SPSS-PC version 14 using Pearson correlation, ANOVA, Spearman, and Stepwise Regression tests. Auxiliary tests such as Tukey and Scheffe were used for some significant relationships.Results: The majority of sample (%56.1) was nurses and worked in wards (%69.4). Most of them (%51) were working in either evening or night shifts and the duration of their contact with patients (%63.3) was too long. ANOVA test identified that just job category was related to the frequency (F=7.61, P=0.001) and intensity (F= 7.35, P= 0.001) of nurses' confrontation with intra-organizational factors. Finally, Scheffe test revealed that the difference was only significant for nurse assistants.Conclusion: The frequency and intensity of confronting with intra-organizational factors was only related to the job category, though other job characteristics made some changes in this variable, but they had no significant role. Accordingly the researcher's previous conceptualizations were modified.

Background: Anxiety is one of the most common problems in patient with cancer that could be increased by chemotherapy and its side effects. Group education despite having many advantages is less used in these patients due to their desire for not being in the group.Aim: To compare the effect of individual and group self-care education on the anxiety in patients receiving chemotherapy in Omid Hospital between 2006 and 2008.Method: In this randomized controlled clinical trial one hundred and two patients with breast, esophagus and stomach cancer referred to Chemotherapy Unit in Omid Hospital was randomly assigned to two groups including individual (51) and group self-care education (51). Individual self-care education group received three education sessions. Three group educations were also conducted for the second group. The anxiety level was measured through interview in three sequential cycles of chemotherapy using EORTC anxiety questionnaire. Data were analyzed with SPSS version 14 using Chi-square and repeated measurement test. The level of significance was considered to be 95% (p<0.05).Results: The mean age of the individual and group self-care education groups were 46.6±3.9 and 48.7±1.32, respectively. Using repeated measurement test, no significant difference was found in the anxiety scores over time between the two groups in three sequential cycles of chemotherapy.Conclusion: Despite the impact of chemotherapy on the anxiety level, self care education could maintain the anxiety level during chemotherapy period the same as pre-chemotherapy level. In this regard there was no difference between two groups. Health care providers could use these two methods interchangeably according to the institute conditions and the patients' needs and preferences.