Sadra Medical Sciences Journal
Year:2019 | Volume:7 | Issue:2 |Papers Count:9

Background: The most important key causes of parents’ stress regarding their infant’ s admission to the ICU include change in their role as the prime caregiver, feeling of quilt as to the suvival of their infant and his/her health, and the self-doubt of their ability to take care of their infant. The aim of this study was to determine the effectiveness of empowering mothers for their infant’ s discharge on their satisfaction and weight gain of their infant. Method: Pre-and post-test clinical trials were conducted and 60 premature infants and their mothers from Kermanshah Neonatal ICU were selected using convenient sampling method. Mothers in the control group received routine care. In the intervention or experimental group, in addition to the routine care, the desired intervention were offered, providing mothers information about washing hands, feeding, reinforcement baby sucking, taking medication, touching and massaging the baby, bathing methods, teaching infection perevention methods, warning signs, and neonates care). Data were collected using a questionnaire for maternal and neonatal demographic information, and Mothers Satisfaction Questionnaire with 13 questions which was distributed to mothers at the time of admission and before discharge. The weight of the newborn was also measured 15 days after the discharge. The data were analyzed using independent T-Test and paired T-Test. Result: The findings showed that the mean score of satisfaction of mothers in the control and intervention group before discharge was significantly higher than the beginning of the study (P<0. 001). Furthermore, the satisfaction rate of mothers in the control group was significantly lower than that of mothers in the intervention group (P<0. 001). Neonatal weight during discharge was not statistically significant in the intervention and control groups (P=0. 943). However, the weight gain of newborns 15 days after discharge in the intervention group was statistically significantly higher than that in the control group (p=0. 001). Conclusion: The results showed that the mother’ s presence on the infant’ s bedside was an active part in the care of the infant and the exchange of information with the mother, enhancement of mothers satisfaction and constant high-quality care at home will result in better infant growth and better weight gain.

Introduction: The stroke patients’ problems can lead to caregiver’ s challenges. Therefore, it is important to identify caregiver’ s spiritual well-being as a moderating factor in adapting to these challenges. The aim of this study was to determine the spiritual well-being of caregivers of stroke patients and to identify the factors affecting it. Methods: This was a cross-sectional study. One hundred and twenty two stroke patient caregivers were selected through convenience sampling. The Palutzian & Ellison Spiritual Well-being scale was used. Data were analyzed by SPSS software using t-test, ANOVA and Linear Regression analysis. Results: The mean score of spiritual well-being was 85. 29 (SD=13. 89). The spiritual well-being of caregivers was in moderate level, and the results showed the link between caregivers’ spiritual well-being and the patients’ age and education level. Caregivers’ spiritual well-being was associated with the patients’ ability to do personal activities and the way patient walked. In the case of those patients who were not able to do their personal activities, and who could not walk at all, their caregivers had higher mean score of spiritual well-being. The results of Linear Regression analysis showed an association between spiritual well-being and the patient’ s walking ability ( =0. 27, t=3. 22, p=0. 002) and their education level ( =-0. 22, t=-2. 59, p=0. 01). Conclusion: The findings showed that the caregivers’ spiritual well-being was in moderate level. In addition, levels of education, age, the patient walking ability, and the ability to do personal activities were the factors associated with caregiver’ s spiritual well-being. The patient's inability to walk and to perform personal activities were the factors that were associated to the caregiver spiritual well-being. Therefore, caregivers should try to increase their spiritual well-being when their patients are unable to move and have paralysis.

Background: Hand washing is one of the most efficient and effective ways to prevent the transmission of microorganisms from one person or one place to the patients. However, despite the importance of hand washing by the medical personnel, the results of some studies indicate lack of proper hand washing by them. The present study aimed to determine the barriers to hand washing from the viewpoint of nurses working in general hospitals affiliated to Shiraz University of Medical Sciences in 2017. Materials and Methods: This was a cross-sectional and descriptive-analytical study conducted on 312 nurses working in general hospitals affiliated to Shiraz University of Medical Sciences. The required data were collected using a valid and reliable questionnaire consisting of two parts, including the studied nurses' demographic characteristics and 48 items related to the hand hygiene barriers in four dimensions of individual barriers (12 items), managerial barriers (19 items), equipment barriers (10 items), and environmental barriers (7 items). The collected data were analyzed using SPSS 21. 0 through independent t-test and ANOVA. The p value of less than 0. 05 was regarded as statistically significant. Results: The results showed that equipment barriers and individual barriers had, respectively, the highest (2. 85 ± 0. 65) and lowest (2. 62 ± 0. 46) means. Also, there were significant relationships between the means of managerial and equipment barriers and the studied nurses' sex, between the means of individual and managerial barriers and the nurses' employment status, between the means of equipment barriers and the nurses’ marital status, and finally, between the means of managerial barriers and the nurses' working shifts (P-value<0. 05). Conclusion: According to the results, in order to remove the barriers to the nurses' hand washing, the following suggestions can be made: running adequate and appropriate training courses and developing a proper culture in the hospital wards to increase hand washing, using appropriate monitoring and motivational systems; providing timely, adequate facilities and equipment and also selecting appropriate disinfectants for nurses' hand washing, etc.

Background: Since lumbar discopathy is a common disease and various traditional and ttherapeutic exercise methods are effective in treating it, the purpose of this study was a comparison of the effectiveness of eight-week acupuncture and aquatic exercise on the amount of pain, motor range and quality of life in patients with lumbar discopathy. Methods: The statistical sample in this study is comprised of 24 women who suffered from lumbar discopathy in Isfahan; they were divided into 2 groups of 12 people. After a specialist selected the subjects, the average score of pain, physical examination, physical evaluation of patients with low back pain and patient's quality of life were recorded by VAS, SLR test and quality of life questionnaire (SF36), respectively. The experimental group received a three-session aquatic exercise and acupuncture for 45-60 minutes for eight consecutive weeks. Then, to analyze the data, Kolmogorov-Smirnov test, T-test and independent t-test were used. Result: The results of this study showed that after eight weeks of acupuncture and aquatic exercise there was a significant effect on female patients’ pain, motor range and quality of life (P=0/00). However, there was no significant difference between the two groups in acupuncture and aquatic exercise (P=0/12) Conclusion: Acupuncture and aquatic exercise have a positive effect on reducing the amount of pain and improving the range of motion and quality of life in patients with lumbar discopathy. Therefore, individuals and patients suffering from lumbar pain should be advised to place acupuncture and exercise programs on the water in their daily programs to improve their pain, range of motion and quality of life.

Introduction: Due to the increasing difficulties and resource constraints in the field of health, the optimal use of health care facilities has received great attention. Therefore, using appropriate methods of management to avoid wasting limited hospital resources is of high significance. One of the key tools used as a lever to control and reduce health costs is to shorten the patient's length of stay. Accordingly, investigating the possible causes of prolongation of patients’ stay in the hospital and the proper use of hospital beds are among the most important issues with regard to the use of hospital facilities. Methods: The present study is an analytical-descriptive study, using a cross-sectional method to determine possible causes of prolongation of patients’ stay in the hospital after the issue of discharge order by physicians in Shahid Faghihi Hospital in 2016. The collected data were submitted to SPSS software and analyzed using t-test, Pearson correlation, and chi-square test. Results: The percentages of the patients who had extended their stay because of financial problems, unwillingness to leave the hospital, absence of insurance staff, lack of companions, lack of health insurance, and transference to other hospitals were 68. 4%, 0. 7%, 6. 2%, 7. 1%, 4. 4%, and 11. 1%, respectively. Conclusion: Hospital authorities’ awareness of the average prolongation of patients’ stay in the hospital and the reasons behind that can be effective in decision-making and planning for organizations. Recognizing such problems and proposing solutions to reduce patients’ length of stay and making plans for it can reduce unnecessary and excessive stays and hospitalizations; hence, reducing hospital costs.

Introduction: In the present era, listening to the employee voice has become very important for organizations; therefore, the purpose of this study was to identify the effective factors on facilitating organizational voice based on personnel perspective of governmental hospitals of Mazandaran and Semnan provinces. Research Method: First, by examining theoretical foundations of research, main and subcomponents and effective indicators on organizational voice facilitation were identified and developed in the form of a score-board checklist. Based on the Delphi approach, efforts were made to confirm the indices and components of the research. Then, based on the interpretative structural modeling, effective factors on organizational voice facilitation were designed. Findings: Based on the research background, four factors and 16 criteria were identified. The positive beliefs of managers (X1), leadership style (X2), supervisor behavior (X3), atmosphere of trust and sense of suspicion (X4), accountability (X6), maintaining status que (X10) in the group of dependent variables, the components of non-conformity with the community (X5), demographic characteristics (X11), group thinking avoidance (X7) and trust and optimism to the administrator (X8) in the group of autonomic variables, organizational structure (X12), feedback mechanism (X13), job promotion and development (X14), organizational communications (X15), organizational culture (X16) and attitude and personality characteristics (X9) are in the group of independent variables. Conclusion: The results show that in the group of dependent variables, the factors affecting organizational voice have weak penetration power but somewhat have high dependence. In the group of independent variables, the factors affecting organizational voice have high penetration power but somewhat have low dependence.

Background: Although assessment of nursing students' perception of role function is very important, no questionnaire is currently available to measure this phenomenon. The aim of this study was to develop a students’ perception of nursing role function (SP-NRF) questionnaire and to test its psychometric properties. Methods: Developing the questionnaire and assessing its psychometric properties were performed through a cross-sectional study. The setting was School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. Nursing students participated in this study. In the instrument development phase, 21 nursing students were asked to explain the secondary role function of nursing. The data were then analyzed by content analysis, giving 14 categories with 55 items. Afterwards, content validity rate (CVR) and content validity index (CVI) were determined. In the questionnaire's psychometric evaluation phase, 134 nursing students filled out the 52-item questionnaire. The construct validity was assessed, as well. Internal consistency and test-retest methods were used to assess the questionnaire's reliability. Results: The SP-NRF questionnaire consisted of 51 items across the following seven subscales: “ professional ethical care activities", "holistic care activities", "educational and professional collaborative activities", "cultural and spiritual activities", "protective activities", "professional skills activities", and "supportive activities". The CVR and CVI in all the items were higher than 0. 60 and 0. 75, respectively. The final model in confirmatory factor analysis showed that this 51-item SP-NRF had a good fitness. Besides, Cronbach’ s α for the total questionnaire and test-retest reliability were 0. 967 and 0. 793, respectively. Conclusion: The SP-NRF is a valid and reliable questionnaire for identifying the students’ perception of nursing role function. Measuring the nursing students' perception of role function not only enhances our understanding of this phenomenon, but it also helps design better curricula and teaching strategies for nursing students in order to prepare them to accept their roles in future.

Background: Temporomandibular dysfunction (TMD) is one of the most prevalent jaw disorders, and it is considered as the main cause of orofacial pain of non-dental origin. TMD has different etiologies, which are not yet fully known. The morphology of the components of the temporomandibular joint (TMJ) has been discussed as an etiological factor of TMD. These parameters include the position of the condyle in the articular fossa, the horizontal angle of the condyle, and the slope, width and height of the articular eminence. The possible relationship between the TMJ morphology and the incidence of TMD has been reviewed in this study. Method: This paper is not a systematic review but is a review of literature on the relationship between TD and JM. A computerized search of five electronic databases, including PubMed, Medline, Scopus, Web of Sciences and google scholar from 1st January 1980 to June 2018 was conducted. “ Temporomandibular dysfunction” , “ Temporomandibular joint” and “ morphology” were used as key phrases. Results: The search revealed 102 papers that were screened in detail. Owing to a lack of relevance to the subject area, 59 papers were excluded. Thus, the review consisted of 43 clinically relevant papers that met all the criteria. Conclusion: Most of the selected studies included in this review article revealed that that TMJ morphology plays an important role in the pathogenesis of TMD. Therefore, the morphologic variation of the joint should be considered as an important element in the pathogenesis of TMD.

Pancreatic cancer is ranked as the fourth leading cause of cancer related death. The survival rate of patients is very low and the mortality rate in men is higher than that of women. Various hereditary and non-hereditary factors are involved in the formation of pancreatic cancer; one of the important non-hereditary factors is smoking. Besides, it is known that the risk of pancreatic cancer in patients with diabetes mellitus is twice as high as in the non-diabetic population. Hereditary conditions also include genetic (activation of oncogenes and inactivation of tumor suppressor genes) and epigenetic changes (lncRNA). The mutation in KRAS oncogene is observed in 95% of the patients with pancreatic cancer. Despite the common use of ultrasound and tumor markers in diagnosing pancreatic cancer, their importance as powerful diagnostic tools has been challenged. An innovation in common therapeutic strategies such as chemotherapy, immunotherapy, and gene therapy based on genetic vectors has provided a promising tool for treatment. Using oncolytic viruses with selective proliferation in cancer cells and minimal adverse effects has opened a new perspective on the future of treatment of this cancer. In addition, novel technologies in gene editing including CRISPR have allowed the genome manipulation of cancer cells to identify and regulate the molecular pathways involved in pancreatic cancer. Considering that multiple genetic and epigenetic changes play a role in the pathogenesis of this cancer, simultaneous control of these pathways with multiple therapies can be a useful therapeutic strategy for pancreatic cancer.