Preventive Care in Nursing and Midwifery Journal
Year:2021 | Volume:11 | Issue:4|Papers Count:8

Background: Cardiovascular diseases are the leading cause of mortality worldwide. Therefore, it is important to predict the future consequences of the disease in patients who have recovered. Objectives: We sought to determine the relationship between troponin-I level and 6-month clinical consequences (i. e., re-infarction, death, re-angiography and coronary artery bypass grafting) in patients with acute coronary syndrome (ACS). Methods: This prospective cross-sectional study was performed among 60 patients with ACS admitted to Ayatollah Mousavi Hospital in Zanjan, Iran. The participants were chosen using the convenience sampling method. Troponin-I level in these patients was initially evaluated. Afterwards, they were followed up for six months in terms of clinical consequences. A checklist was prepared to collect the required data. The receiver operating characteristic (ROC) analysis was conducted to determine the predictive power of high-sensitivity troponin I for the mentioned consequences. Iodine index was calculated to determine the cutoff point for this enzyme in order to predict the consequences. Results: In general, 66. 2% of the participants were male and the mean age was 60. 46 ± 12. 78 years. We found that 21. 2% of the participants experienced one of the four clinical consequences in the follow-up period of 6 months. The sub-curved surface was calculated to be 0. 705 for the prediction of consequences. The cutoff point for the prediction of consequences was 32. 5; the negative predictive value for the cutoff point was 32. 5, which was equal to 89. 8%. Conclusion: Troponin-I has an acceptable predictive power to identify 6-month consequences of ACS. Moreover, considering the negative predictive value of troponin-I, it is recommended to use this biomarker in patients with ACS. In addition, healthcare providers should pay more attention to the follow-up of patients after discharge and design preventive programs.

Background: The education level of individuals in a community is one of the indicators explaining the health of that community, and the performance of schools plays a significant role in promoting health and observing the educational justice of students and individuals in the community. Objectives: The present study aimed to compare the performance of support and public (rural) schools in Qom province concerning the preventive role of selected components in students’ health. Methods: The present research is a descriptive comparative survey study. The statistical population included 17 Profit and Non-profit Rural schools in Qom province with 110 teachers and principals. First, the regions and schools were selected by cluster sampling method; then, through stratified sampling among profit and non-profit schools the proportion of gender and school type was observed, and through simple random sampling, 44 teachers and principals were chosen from among the selected schools. The research tool was a researcher-made questionnaire. To analyze the data, an independent t-test in SPSS version 16 software was used. Results: According to the findings of this study, the age range of participants was 22 to 51 years. Twenty-four participants (54. 5%) had 1-10 years of teaching experience. Based on the data, the performance of profit schools was better than public (rural) schools in terms of the dimensions of planning, empowerment, health promotion, and physical education, and the performance of public (rural) schools was better than profit schools regarding the dimensions of education, learning, and executive and administrative affairs, which this difference was statistically significant (p≥ 0. 001). There was no significant difference between the performance of profit schools versus public (rural) schools in the dimensions of developing participation in the school as well as the educational and complementary activities (p≥ 0. 05). Conclusion: Given the differences in the dimensions of planning, education, learning, empowerment, health promotion, and physical education by this study, the officials’ planning seems to play a preventive role in addressing the weaknesses in schools. However, performing more research in this regard is recommended.

Background: Diabetes is a chronic disease that, without proper care, leads to a rise in blood sugar and, in the long term, disrupts the functions of various tissues and organs of the body. Therefore, self-care seems to be particularly important to reduce the injuries associated with this disease. Objectives: The aim of this study was to investigate the role of coping strategies, self-efficacy, and hardiness in predicting self-care behaviors in patients with type 2 diabetes. Methods: This was a descriptive-correlational study. The statistical population of this study included all patients with type 2 diabetes referred to medical centers in Khomeini Shahr, Isfahan-Iran, among whom 200 subjects were selected by convenience sampling. For data collection, Niknami (2013) self-care, Kubasa (1976) hardiness, Scherer self-efficacy, and Lazarus and Folkman coping strategies questionnaires were used. Data analysis was performed using stepwise multiple regression using SPSS software version 26. Results: The mean (SD) age of the participants was 48. 54 (7. 62) years, and women constituted 72% of the participants. The results showed that self-efficacy (53%, p=0. 001) and hardiness (31%, p=0. 008) had the largest shares in explaining self-care behaviors of patients with type 2 diabetes. The results also showed that coping strategies did not significantly influence the self-care behaviors of patients with type 2 diabetes (p<0. 05), so it was excluded from the model. Conclusion: According to our findings, self-care behaviors of diabetic patients can be improved by boosting their hardiness and self-efficacy.

Background: Missed nursing care is defined as required care that has been delayed, partially completed, or not completed at all. Objectives: This study aimed to investigate the causes of missed nursing care from the viewpoints of employees in public, private, and social security hospitals. Methods: This descriptive-analytical study was conducted on 453 nurses working in five educational hospitals, four private hospitals, and a social security hospital in Urmia in 2018. Regarding data collection, the “ missed care questionnaire” was distributed to nurses by convenience sampling method. The validity of the questionnaire was confirmed by the faculty members of Urmia Azad University, and the reliability of the questionnaire was assessed using Cronbach's alpha (0. 9). The results were analyzed using descriptive statistics, one-way analysis of variance (p<0. 05), and SPSS software version 16. Results: The most common reasons for missed nursing care in educational, private, and social security hospitals were the patients' emergency conditions (42. 9%), the insufficient number of nursing assistants (38. 7%), and an unexpected increase in the number of patients (18. 5%). Moreover, the causes of missed nursing care in all three areas of communication, financial, and human resources were significantly different between educational, social security, and private hospitals (p=0. 0001). Conclusion: Lack of nursing staff, patients' emergency conditions, and an unexpected increase in the number of patients are the main reasons for missed nursing care in educational, social security, and private hospitals. Therefore, it is recommended to apply appropriate policies to provide nursing staff, manage the admission, transfer, and distribution of patients to the hospital.

Background: Chronic diseases such as Multiple Sclerosis (MS), as one of the hot topics in the literature, have frequently been associated with sexual dysfunction. Objectives: The present study aimed to investigate the effect of mindfulness psycho educational group intervention on improving the sexual function of women with MS. Methods: To this end, 350 women with MS from Isfahan province, who had medical records in Kashani Hospital and Isfahan MS Center, were first screened out by the Female Sexual Function Index (FSFI), among whom the ones scored below 28 were clinically diagnosed with sexual dysfunction. Then 47 patients with sexual dysfunction were randomly assigned to experimental (N=24) and control (N=23) groups using the simple random sampling method. The experimental group received five sessions of Mindfulness-Based Group Psychotherapy; however, the control group received no treatment. The two groups were assessed by a pre-test, post-test, and two follow-ups (one and two months after the end of the intervention, respectively), and MANCOVA was used to analyze the data in SPSS software 16. Results: According to the results, mindfulness-based psycho educational group therapy was effective in improving the sexual function of women with MS in all the six domains (namely desire, arousal, lubrication, orgasm, satisfaction, and pain) and the total FSFI score (p≤ . 05)). Conclusion: The findings revealed the effectiveness of psycho educational group intervention in improving the sexual function of women with MS. Accordingly, clinicians and therapists working with this group of women are recommended to include mindfulness in their interventions.

Background: Many factors affect marital satisfaction as one of the determinants of mental health, and may even lead to marital dissatisfaction. Objectives: This study aimed to determine the relationship between the health of the family of origin and marital satisfaction and its components among women in Bojnurd, Khorasan, Iran. Methods: In this descriptive correlational study, 218 women who met the inclusion criteria referred to Bentolhoda Hospital in Bojnurd as inpatients or outpatients. They were selected using the convenience sampling method from January to April 2015. The data collection tools were the Family of Origin Health Scale (FOS) and Marital Satisfaction Index (MSI). Data analysis was performed using chi-square, t-test, Pearson correlation coefficient, and multiple linear regression at p=0. 05 with SPSS software version 16. Results: The study participants’ mean age and duration of marriage were 31. 40± 8. 90 and 11. 10± 9. 30 years, respectively. The coefficient of correlation between FOS (136. 52± 26. 93) and MSI (58. 73± 34. 20) was negative, and their relationship was statistically significant (r=-0. 365, p<0. 001). There was a statistically significant difference between the mean scores of MSI for individuals who had no familiarity and the family's income before the marriage (p<0. 001, p<0. 007), respectively. Conclusion: Given the undesirable level of marital satisfaction and the existence of problems in family relationships as one of the factors affecting FOS and MSI in this study, as well as the multifactorial nature of marital satisfaction, further multifactorial studies are recommended to determine the factors influencing marital satisfaction to improve this variable.

Background: Although clinical guidelines help in the prevention, diagnosis, and management of hypertension, individuals with hypertension often remain undiagnosed, or once diagnosed, may not receive adequate care and treatment. Objectives: In this study, we explored physicians‟ perspectives of the factors influential in implementing the Iranian Recommendations on Prevention, Evaluation, and Management of Hypertension (IRPEM-HTN). Methods: A qualitative descriptive study was conducted using the purposeful sampling method to enroll 30 physicians from October 2016 to May 2018. The physicians working in private offices or university-affiliated health centers/hospitals in the province of Isfahan, Iran, were included in this study one year after participating in the IRPEM-HTN program. The data were gathered through semi-structured interv iews. The transcribed data were thematically analyzed, and the rigor was ensured following the procedure outlined by Braun and Clark. Results: This themes identified were: 1) macro-and meso-contextual factors, emphasizing that a) policies at all levels affect guideline adherence, and b) environmental-contextual factors affect guideline adherence, 2) micro level factors, emphasizing that c) attributes of the guideline affect guideline adherence, and d) clinician-and patient-level factors affect guideline adherence. Micro-, meso-and macro-level factors influenced guideline implementation. Conclusion: The attitudes, awareness, knowledge, and capacity of clinicians, as well as a broader socio-cultural context should be taken into account for guideline implementation.

Background: Privacy is one of the basic human needs and is considered one of the most important rights of patients. There is little information about respecting the privacy of patients undergoing surgery in the operating rooms of educational hospitals in Zanjan Iran. Objectives: Determine the status of respect for privacy in operating room from the perspectives of patients and staff. Methods: This is a descriptive cross sectional study. Participants in the study included 204 operating room staff and 323 patients undergoing surgery who were selected by convenience sampling. Patients and staff viewpoints were gathered through combining Serenko Fan privacy questionnaires and Noorian in three physical, informational, and psychological dimensions using self-reporting method for staff and interviewing for patients. Data analysis was performed using descriptive statistics and SPSS software version 16. Results: The findings of this study showed that the rate of total respect for privacy from the patients’ perspective was 13. 6% moderate and 86. 4% good. In physical, informational and psychological dimensions, 77. 1%, 72. 8% and 12. 7% of patients, respectively, assessed the status of privacy as good. From the perspectives of the operating room staff, respect for privacy was generally poor in 0. 5% of cases, moderate in 5. 4% of cases, and good in 94. 1% of cases. In physical, informational and psychological dimensions, 89. 7%, 95. 1% and 71. 1% of operating room staff, respectively, assessed the status of privacy as good. Conclusion: The findings showed that the evaluation of respect for privacy from the perspectives of staff was better than that of patients. The lowest score given by patients and staff was related to the psychological dimension of respect for privacy. Despite the total favorable status of respect for privacy from the perspectives of patients and staff, taking the necessary strategies is required to improve the current status.