Journal of Research Development in Nursing and Midwifery
Year:2013 | Volume:10 | Issue:1|Papers Count:12

Background and Objective: Coma due to brain injury is an important complication resulting in unconsciousness and reducing the capacity of responding to the environment. This study aimed at examining the effect of organized voice auditory stimulation, which was performed by a nurse, on the length of coma in the patients suffering from head injury.Material and Methods: This clinical-trial study was applied on 40 patients in the critical care unit of Panje Azar Hospital. The patients were randomly recruited to one of the two groups (each group 20 patients). The intervention group was stimulated by the voice of a male nurse. Hearing stimulation was conducted in the morning and night shift about 15 minutes each time for 10 days.The patient consciousness was measured by GCS scale and analyzed by ANOVA and t-test (P<0.05), using SPSS Soft ware.Results: The average age of intervention and control group was 28.20 ± 11.49 and 27.8 ± 13.22, respectively. Before stimulation in the first day, there is no significant difference between the GCS of intervention group (5.95±0.68) and that of control (5.95 ± 0.64). The results indicate that the intervention group has become consciousness from the 5th day (GCS of 8.25±1.19) and control group (GCS of 7.80±1.96) from the 10th day.Conclusion: The study show that the auditory stimulation in the intervention group compared to control group gives rise to the improvement of the level of consciousness in comatose patients.

Background and Objective: Injection of subcutaneous low molecular weight heparin often causes some local reactions such as bruising, hematoma, and pain, directly related to inappropriate injection method. This study aimed at determining the effect of injection duration of Subcutaneous Enoxaparin Sodium on the size of bruising and the severity of injection pain.Material and Methods: This experimental study was conducted on 36 patients medicated by subcutaneous Enoxaparin Sodium (60mg). They were randomly divided into two groups. The first group received routine method of subcutaneous anoxaparine injection (10 second duration injection technique) and in the second group in addition to routine method, “10 second waits” before removing needle was performed. Data collection was carried out by using a researcher-made check-list consisting of a section for demographic data and a section to record the extent of bruising and pain intensity. The Extent of bruising was measured by using a clear flexible ruler within 24, 48 and 72 hours and pain intensity by visual analog scale (VAS), immediately after injection. We analyzed the Data by independent T test and Chi square.Results: The Results indicate that the mean of pain intensity in second group (3.05±1.71) is less than first group (3.86±2.75).There is no significant difference between two groups for the extent of bruising in 24, 48 and 72 hours (P>0.05).Conclusion: with regard to pain intensity and the size of the bruising, the two groups are not significantly different.

Background and objective: Adolescence is a significant stage of social and psychosocial development. This particular period of crisis involves some problems; one of the most important ones is the loss of self-esteem. Hence, this study aimed at investigating the effect of group cognitive behavioral hypnotherapy on increasing adolescents' self-esteem.Material and Methods: The research population (n=250) of the current study is the adolescents living in a boarding school of Taibad city, Iran, in 2012 academic year. Using convenience sampling, the subjects were selected and asked to fill out Copper Smite self-esteem Inventory, and considering the cut-off point of 23, 30 adolescences with the lowest self-esteem were randomly placed in two groups of control and experimental. The subjects of experimental group were taken part in 8 two- hour- long sessions of cognitive behavioral hypnotherapy while the ones of control group did not receive any training. At the end of this period, the subjects’ self-esteem was measured again and compared with pre-test by Ancova test, using SPSS soft ware (version 19).Results: Ancova test analysis indicates that the self-esteem score in group cognitive behavioral hypnotherapy compared with the control group is significantly increased (p<0.01).Conclusion: Group cognitive behavioral hypnotherapy can lead to increased self-esteem in teenagers. Further researches accompanying by periods of follow-up are recommended.

Background and Objective: Breast cancer is the most frequent cancer among women worldwide. The objective of the current study was to assess the breast cancer screening behaviors adherence rate and its relation with perceived susceptibility and perceived severity in Gorgan, Iran.Material and Methods: In a cross sectional study, 300 women referring to two health centers were selected through cluster sampling.Data gathering instrument was a questionnaire including demographic, knowledge and practice questions related to breast cancer screening behaviors.Perceived susceptibility and perceived severity measured by Champion’s Health Belief Model Scale.Results: The subjects are 18 to 60 years (30.3±7.3). In knowledge part, 88.3% could not answer any question. In practice section, they have breast self examination (33%), clinical breast examination (11.3%) and mammography (5%) in their past history. Four- point -seven percent have high level of susceptibility and 46.7% high level of severity. Higher susceptibility was significantly associated with mammography (p=0.042) performance and not associated with breast self examination and clinical breast examination.Conclusion: The participant's knowledge about breast cancer screening was inappropriate.Meanwhile, the majority of them have low level of perceived susceptibility. It is a necessity to improve the knowledge and perceived susceptibility for enhancing the breast cancer screening behaviors.

Background and Objective: Delirium is a kind of fluctuating cognitive destruction, disorientation and a common problem for inpatients, which leads to increased mortality, prolonged hospital stay, increased cost and decreased rehabilitation. This study evaluates the incidence of delirium and its associated risk factors in open heart surgery.Material and Methods: This descriptive-analytical study was conducted in six month (2011), via convenience sampling, on 404 patients undergoing elective cardiac surgery in the heart center of Fatemeh Zahra in Sari, Iran. Using Neecham questionnaire and demographic checklist, delirium was evaluated from the first till the fifth day of surgical operation. We used survival analysis (Kaplan-Meier and Cox regression) to analyze the findings, using SPSS software version18.Results: The incidence of delirium is reported 28.5%. There is a significant relation between the incidence of delirium and variables such as age, lower education, rural, history of kidney failure, heart failure, stroke, hearing disorder, atrial fibrillation, increased serum potassium and increased serum urea.Conclusion: According to the results, screening for delirium is a matter of the utmost importance. With attention to individual profile and preoperative factors related to delirium, it is necessary to train elder and lower education patients, to maintain electrolyte balance before operation and to eliminate sensory deprivation in order to lessen the incidence of delirium.

Background and Objective: Urinary tract infection is one of the most common bacterial infections during pregnancy and has also been implicated as a risk factor for adverse maternal and prenatal outcomes. The aim of our study was to determine the relation between maternal urinary tract infection and adverse maternal, prenatal outcomes in pregnant women of Ardabil, Iran.Material and Methods: This retrospective-case-control study was conducted on prenatal file records of pregnant women in Ardabil (2011). The pregnant women who had a positive urine culture in their prenatal files (N=211) were considered as a case group and 232 ones without urinary tract infection as a control. Using a research- made questionnaire, the data related to present pregnancy and prenatal information was collected and analyzed by KrusKal Wallis, Chi-Square and Fisher statistical tests.Results: Maternal age of under 25 (%61.6 vs.56.5), body mass index of more than 30 (%18.3 vs.15.6), primigravida (%55 vs.48.8), hypertension (%2.4 vs.1.3), hyperemesis Gravidarum (%14.8 vs.12.6), frequency and dysuria (%1.9 vs.0.9), low birth weight (%95.4 vs.93.2), congenital malformation (%3.5 vs.1.8), artificial milk feeding (%6.5 vs.2.7), neonatal death (%0.9 vs.0.0) are higher in urinary infection group, however the differences are not statistically significant. Other maternal and prenatal adverse outcomes such as diabetes, pre-eclampsia, hemoglobin level, prematurity, abortion and stillbirth have not significant relation with urinary infection.Conclusion: Because of low level of adverse maternal or prenatal outcomes reported in our study, we conclude that screening and treatment of urinary tract infection in Ardabil health service is appropriate; therefore, no change is needed for present screening or treatment processes.

Background and Objective: Nurses should be so determined and competent that, in the dynamic and changing conditions of the patients, they could use their technical skills and professional knowledge to make a rigorous clinical judgment about the patient's health status.Accordingly, a study was conducted to assess the health status of patients and nurses in the hospitals affiliated with the social security organization in Tehran, Iran.Material and Methods: This descriptive – analytical study was conducted on 96 nurses working in medical-surgical and emergency wards of the hospitals affiliated with Social Security Organization in Tehran. The instrument was a questionnaire including two parts of demographic data and 11 questions for assessing nurses' performance. To analyze the data, we used descriptive and inferential statistics.Results: The mean age is 7.15±32.8 and 75% of the patients are females. Their (53.1%) work of experience is between 73-96 months and their (52.1%) performance is observed poor. There is significant correlation between nurses' performance and variables such as gender, age, marital status, work experience and ward of hospital.Conclusion: Because of low performance of the nurses, it is important for nurses to assess the health status of patients, the same as physicians using screening forms on the file of patients.

Background and Objective: Drug administration is considered an important aspect of patient care process and reporting the errors is needed to maintain safety. We aimed to investigate “Perspectives of Nurses about refusing to report the medication errors in Emergency Ward”.Material and Methods: In this descriptive study, 94 Emergency nurses were recruited by census in 2011-2012. The instrument was a researcher-made questionnaire including demographic data and questions related to the causes and factors affecting the reporting of medication errors. Using SPSS-16 software, the data was analyzed by applying descriptive and inferential statistics.Results: The nurses who did not report medication errors are 72%. The most common type of medication errors are infusion rate (33.3%) and wrong- drug dosage (23.8%). The most important reasons of medication errors are shortage of nursing staff (47.6%) and lack of pharmacological information (30.9%). Most common reasons for refusing to report the medication errors are fear of its negative effect on financial advantages, inappropriate or negative attitude of managers toward reporting errors and lack of importance of reporting from nursesי perspective.Conclusion: Considering the high rate of refusing to report, it is needed to be created some appropriate conditions to enhance the rate of reporting and removing the barriers. Nursing managers should have positive reaction to nurses’ reporting.

Background and objective: Postpartum is a critical and stressful period accompanying by fatigue, mood changes and sleep disorders. The purpose of this study was to describe sleep during the second and sixth week of postpartum in the women with cesarean and those with vaginal delivery.Material and Methods: This cross-sectional study was conducted on 96 women in the second and sixth week of postpartum period (48 after cesarean and 48 after vaginal delivery). The instruments were demographic data sheet and Pittsburgh Sleep Quality Scale.Results: The Results show that the subjects are correlated with each other on the basis of both parents’ and neonates’ demographic characteristics. Variables such as subjective sleep quality, sleep latency, actual sleep time, sleep efficiency, sleep disturbance, and daily disfunctioning indicator are significantly different in two groups. The mean of Pittsburgh Sleep Quality Index for vaginal delivery is higher than that of cesarean, which can be a good reason for better sleep quality of the women with vaginal delivery.Conclusion: Mothers with Cesarean have lower sleep quality than those with normal delivery; therefore, they should be educated to select normal delivery and intervened for improving sleep quality in postpartum period.

Background and objective: In accordance with general studies, the prevalence of psychological disorders is increasing worldwide in that it is the cause of one percent of mortality rate in the world esp. Iran. Because of susceptibility of women to psychological disorders and fewer studies in this field, this study aimed at evaluating mental health status of over- fifteen- year- old women in urban population of Gorgan, Iran.Material and Methods: In this study, 1088 women aged over 15 were selected by randomized cluster sampling. The data was collected by demographic data sheet and General Health Questionnaire (GHQ-28), and analyzed by Chi Square and Fisher Exact test.Results: Based on our findings, the prevalence of psychiatric disorders is 17.5%. Based on cutoff score of 6 for each of the four disorders, Anxiety disorder and insomnia are with the highest prevalence (5.5%) and depression is with the lowest (3.1%). The Prevalence of disorders has positive significant relationship with variables like age, marital status and family history of addiction.Conclusion: The prevalence of present study is average compared to similar reports.Nevertheless it is a necessity to have further attention to the mental health of women and it is essential to train efficient workforce and provide appropriate facilities in order to give mental health services to both rural and urban population.

Background and Objective: Cesarean section has some adverse effects on maternal and neonatal health. The knowledge of pregnant women about disadvantages of cesarean can affect on the use of cesarean delivery. The aim of this study is to determine the knowledge of pregnant women about disadvantages of cesarean section.Material and Methods: In this descriptive study, we studied 360 pregnant women referring to obstetric and gynecology clinics, via convenience sampling. The women who were physicians or midwives were not assessed. We used a questionnaire including demographic part and eighteen questions about knowledge. The data were recorded by SPSS version 11.5 then analyzed by use of t- test and Chi square.Results: The mean of knowledge is (12.23±4.0). There is a significant relation between knowledge and education level (p=0.008). But it is not significant for other variables (p>0.05).Conclusion: In terms of our findings, the knowledge of pregnant women is not very good about cesarean disadvantages that it can affect on the selection of delivery type. Therefore, it is a necessity for health officials to perform appropriate programs to increase the knowledge about disadvantages of cesarean section.

Background and Objective: Self-medication is one of the health predicaments, especially among pregnant women due to the risk of fetal abnormalities caused by drugs. We consider it necessary to study self - medication status in pregnant women referring to health centers in Saghez city, Iran.Material and Methods: This cross- sectional study was carried out in 2011. The subjects (N=116) selected via convenience sampling were the pregnant women referring to health centers in Saghez city. The data collected by a questionnaire and interview was analyzed by using descriptive and inferential statistics.Results: The results indicate that 27.6% have the behavior of self- medication. The most common reason for self- medication mentioned by 47.4% is “it (medical problem) is so little considering”. Using Chi-square, there is no significant correlation between self-medication and variables such as insurance status, educational level and career status.Conclusion: Due to the high expenses of drugs and the side effects of over the counter, esp. for pregnant period, which may cause abnormality, measures should be taken to educate mothers and prevent from this unsafe behavior.