JOURNAL OF HEALTH PROMOTION MANAGEMENT (JHPM)
Year:2012 | Volume:1 | Issue:3|Papers Count:8

Introduction: Hemodialysis in chronic renal failure, which has affected all aspects of the incidence of disease and disorders such as, depression. One of the ways to have an appropriate quality care in hemodialysis units is to employ nursing care model. This study aimed to determine the effect of multi-dimensional model of psychiatric rehabilitation care on hemodialysis patients who were depressed.Materials and Methods: This study is a quasi-experimental study of two groups before and after the sampling method based on 35 hemodialysis patients of Razi hospital in Rasht (test) and 35 hemodialysis patients from Shahid Beheshti Hospital in Anzali (control). Intervention was based on psychiatric rehabilitation of multi-dimensional model with a doctor, nurse, psychologist, nutritionist, and comprehensive client and family as a team and with consideration of physical, mental, social and spiritual clients separately and each was done in three months. The instruments included a questionnaire for collecting demographic and the Beck Depression Inventory (BDI), which was measured before and three months after the intervention. Then the data were analyzed using SPSS 16 software and descriptive statistical, paired t-test, independent t-test, analysis of covariance, Chi-square and Fisher test.Findings: Data analysis between the mean depression score of samples before (8.285±30.11) and after the intervention (10.309±24.20) group showed a significant difference (p<0.001).Conclusion: The multi-dimensional model of psychiatric rehabilitation care, a significant difference in depression scores in hemodialysis patients is caused, so the implementation of this model of care is associated with better living conditions in hemodialysis patients.

Introduction: Nurses are the largest group of health care professionals in health systems. Nurse's shortage and turnover lead to big problems in care of patients, quality of care and treatment costs. The aim of this study was to determine assessment of some factors related to leave in nurses and their demographic information in educational hospitals of Shahid Beheshti University of Medical SciencesMaterials and Methods: In this, descriptive-correlative study, 350 nurses were randomly selected. Personal demographic questionnaire (11 items) and Anticipated Turnover Scale (ATS) (12 items) were used to collect data. Content validity index and reliability were measured by internal consistency (a=0.80) and test- retest (r=0.81). Samples of 12 teaching hospitals and in different shifts were selected and questionnaires were distributed and collected at nurses rest time. Data was analyzed by SPSS-16.Findings: Results showed that 88 percent of nurses were women and 92 percent had a bachelor's degree. Also they age range was between 57-23 and 48.3 percent of them worked in medical-surgical ward. Results indicated that nurses had a moderate intent to leave their work. In addition, between age with intent to leave (r= - 0.114) and work experience(r= - 0.158) with turnover, was a negative significant correlation. In addition, there was a significant correlation between organizational level and intent to leave (P= 0.007), shift and intent to leave (P = 0.001).Conclusion: Given the high turnover of Iranian nurses than similar studies in abroad and according to previous research that showed a direct relationship between intent to leave and the actual turnover of nurses, need more attention.

Introduction: Applying proper supervision model is an important factor in promoting the outcomes of the patient education which improves nursing care. The aim of this study was to assess the effect of Clinical Supervision Model on the outcomes of implementing patient education. (Patients’ Attitude Toward Education by nurses, patient satisfaction from nurses' education and quality of patient education documentation).Materials and Methods: This quasi-experimental study was conducted using static groups' comparison in which the control and experiment groups were compared by a post-test. Study samples included 72 patients who were matched and assigned into two distinct groups. Clinical Supervision Model was implemented through three steps in 3 wards of Samen-al-Aemme hospital in Mashhad for 6 months. The data were gathered by instruments including patient demographic information, patients’ Attitude toward Education by Nurses Questionnaire, Patient Satisfaction from Nurses' Education Questionnaire and Quality of Patient Education Documentation check list. Validity of instruments was measured by content validity and reliability by split half and inter-rater. Data was gathered through interview and observation methods and analyzed by SPSS 11.5 software.Findings: The results showed significant difference in the quality of patient education documentation before and after implementing Clinical Supervision Model (P=0.0001). Furthermore, results showed significant difference between patient satisfaction before and after implementing Clinical Supervision Model (P =0.02). However there were not any significant differences between patients’ attitude toward education before and after implementing Clinical Supervision ModelConclusion: Implementation of Clinical Supervision Model can develop nurses' knowledge and skills in patient education through organizing, implementing, and feedback. More studies are required in order to assess the effect of this model on other aspects of nurses' practice.

Introduction: Bed sore is an important nursing diagnosis in patients in ICU which delay recovery and increase costs of patients and their family. The best method for bed sores is dressing. The aim of the study was to compare the effect of honey dressing with Hydrocolloid dressing on pressure ulcer healing in ICU patients.Materials and Methods: In this randomized clinical trial research, 29 patients with total of 40 pressure ulcers were participated. After selecting the patient based on inclusion criteria, hospitals were divided randomly in two control and intervention groups. Intervention group with total of 20 pressure ulcers were received bed sore care with honey dressing in Shohada hospital and control group with total of 20 pressure ulcers were received bed sore care with Hydrocolloid dressing in Farabi hospital. Ulcers state were measured with Pressure Ulcer Scale (PUSH) at the beginning of hospitalization and then weekly for 5 weeks. After intervention by comparing PUSH score in two groups, were measured. Data were analyzed by SPSS.Findings: The results showed that the two groups were statistically similar with regard to baseline and wound characteristics. After 5 weeks of treatment, patients who were treated by honey dressing had similar PUSH tool scores with patients that were treated with Hydrocolloid dressing. However, recovery in group with honey dressing was faster, but there was not any significant difference.Conclusion: Results showed that healing among patients that were treated with honey dressing were statistically similar with the comparison group. But easy accessibility, economical and neutrality makes honey dressing treatment as choice for pressure ulcers treatment.

Introduction: Today, Needle Stick Injuries (NSI) are very important occupational hazards experienced by healthcare workers lead to exposure to blood-borne viruses especially hepatitis B, hepatitis C and HIV. The aim of this study was to determine needle sticks injuries among health care workers in emergency medical centers in Tehran University of Medical Sciences hospitals (2007-2010).Materials and Methods: In this descriptive study 991 health care workers worked in emergency wards in Tehran University of Medical Sciences hospitals were followed for needle stick events from 2007 to 2010. Sampling method was census. Data were collected by a researcher-made questionnaire consisted of 32 questions included demographic variables and NSI included the event that leads to needle stick injuries. Content and face validity and also test-retest reliability (r = 0.71) were measured and data was analyzed by SPSS 16.Findings: The study population reported 167 needle stick injuries during the study period (167 health care workers exposure group, 554 health care workers not exposure group). Incidence rate of NSI was 16.85%. Majority of subjects in exposure group were female (50.89%), married (52.69%) and nurse (53.2%) and also the mean age was 35.3±6.4. In most cases, needles (55.08%) and vein catheter (22.75%) were responsible for injuries. IV access (24.7%) and recapping of needles (23.3%) were most common action resulted to exposure. There weren't statistically significant different in demographic variables except working experience between exposure groups and not exposure group.Conclusion: According to the results of this study, incidence rate of NSI among HCWs worked in emergency wards in TUMS less than other studies in different countries. This might be an indication of inadequate reporting. It is suggested that, NSI in hospitals should be managed through obtaining an appropriate reporting system and organizing blood and body fluid exposure surveillance system.

Introduction: Hemodialysis has been used as a replacement therapy in patients with end- stage renal failure for several decades. Insufficient and low efficient hemodialysis increases the mortality rate in the patients. The aim of this study to compare the dialysis adequacy in patient's that referred to Golestan province hemodialysis centers.Materials and Methods: In this descriptive-comparative study 389 patients that have been underling permanent hemodialysis in eight hemodialysis centers of Golestan province were selected as census sampling method. Demographic date form (7 questions) patient registered dates in dossier according to study purpose (12 questions) were used as date gathering tools. Blood samples obtained before and after hemodialysis. Before starting hemodialysis and five minutes after pump stopping, arterial Blood urea nitrogen (BUN) was measured and then KT/V was calculated according to Daugirdas II formula. Statistical tests such X2, one way ANOVA and post hoc Analysis with Scheffe´ test were used for data analyses in SPSS 13 environment.Findings: Mean of KT/V and URR in the eight hemodialysis centers of Golestan province were 1.33 and 63.22% respectively. Kalaleh hemodialysis center had highest level of KT/V (Mean=1.59) and Aghala hemodialysis center had lowest level of KT/V (Mean=1.03) and this difference was statistically significant (P<0.05). There was statistically significant correlation between KT/V and hemodialysis time, venous and arterial needle distance, venoarterial needle direction and blood flow rate (P<0.05).Conclusion: The study showed that, hemodialysis efficacy in this province is near to standard and it could be improved with some considerations such as increasing in hemodialysis time, venous and arterial needle distance and needle distance.

Introduction: Due to increase of accident work in Iranian women workers, safety attitude is an important factor at work and it should be considered. The aim of this study was to determine correlation between demographic characteristics and safety attitude of women workers in food factories.Materials and Methods: In this descriptive-correlation study, 171 woman workers were selected by multiphase sampling. Data was collected by 2-part questionnaire of demographic characteristics and “Safety Attitude to Work Questionnaire”. Validity of the questionnaires was evaluated by CVI (92.10) and CVR (91.11). In addition, face and reliability were determined by internal consistency (a=0.86) and test-retest (r=0.94)).Findings: Result showed that most of the samples had positive safety attitude (81.3 %). In addition, results showed they also indicated that there is a significant correlation between marriage and number of children with safety attitude to work (P>0.01). Contrary, there was a negative correlation between salary and work experiences with safety attitude (P>0.05). Other demographic characteristics did not have a significant relationship with safety attitude (P<0.05).Conclusion: Due to correlation between some demographic characteristics and safety attitude of women workers, further study is suggested for future research.

Introduction: The mission of professional nursing is that guarantee health promotion and recovery of patients. Several changes have occurred in the health care system and professional standards and nurses, as professionals, should pay attention to the changes and identify factors affecting their professional roles. The aim of this study was to clarify the nurse's viewpoint on factors affecting the professional roles.Materials and Methods: In this qualitative research, 7 nurses in various hospitals of Tehran were selected by purposeful sampling and sampling continued data saturation. Semi-structured interviews were used for data collection. All interviews were recorded and hand written and using the constant comparative method and content analysis were analyzed. Ability to verify data, hand-written overview of the method was used with participants and partners.Findings: Data analysis showed that six components; cultural characteristics - beliefs of patients and his family, nurses' job security, management and leadership, gap between the theories -practice, motivational factors of work environment and nurses' personal beliefs were introduced as factors affecting the nurses' professional role.Conclusion: The results of this study showed that some factors affecting the nurses’ professional roles that may be facilitated or inhibited the professional roles performance, and this requires a detailed understanding of the factors facilitating and hindering the nurse's professional role and planning to achieve health promotion goal.