مراقبت های پیشگیرانه در پرستاری و مامایی
سال:1391 | دوره:2 | شماره:2 |تعداد مقالات:8

Background: Dialysis adequacy is one of the most important factors in determining the survival rate and mortality of dialysis patients.Objectives: The aim of this study was to determine the dialysis adequacy of patients undergoing chronic hemodialysis at dialysis centers located in the province of Zanjan, located in northwest Iran.Methods: This descriptive cross-sectional study was performed on 257 patients undergoing chronic hemodialysis with an available sampling method in 6 dialysis centers in the province of Zanjan. The hemodialysis sessions were performed for 3 to 4 hours using via synthetic filters and bicarbonate dialysate.To determine the adequacy of dialysis, serum BUN levels were assessed before and after dialysis. The standard software provided by the Ministry of Health was used to calculate the adequacy of dialysis and Kt/V was considered to be at least 1.2.Results: The most common underlying causes of chronic dialysis were hypertension (41.2%) and diabetes mellitus (35.8%), respectively. Mean Kt/V and URR were 1.26±0.34 and 63.55±9.5%, respectively. The difference among these indexes was significant between men and women (p<0.05). Also, dialysis adequacy was significantly associated with increased dialysis frequency, blood flow rate, interdialytic weight gain, vascular access and dialysis shift (p<0.05).Conclusion: Despite the relatively favorable dialysis adequacy among patients, this index is highly variable based on patient gender, the dialysis center, location, frequency of dialysis, blood flow rate, interdialytic weight gain, type of vascular access and dialysis shift. Therefore, serious attention and greater caution are recommended among the dialysis centers of the province.

Background: Thalassemia is one of the most common genetic diseases in Iran with different physical and psychosocial consequences which affect these patients quality of life.Objectives: The purpose of this study was to investigate the effect of resilience training and stress management on the quality of life in patients with thalassemia major in Kerman-Iran.Methods: In this quasi-experimental study with pre-test and post-test design and a control group, 30 patients referred to Samen-al-Hojaj (AS) charity group, were selected by convenience sampling method and randomly divided into two experimental and control groups (each of 15 patients). After completing the pretest, the experimental group received 10 sessions of training and stress management. Control group received no intervention. The data collection tool was the questionnaire of quality of life (SF-36). Data were analyzed by SPSS software using the covariance analysis.Results: The results of the covariance analysis in the studied variables indicate that the effect of the group (experimental intervention) on the post-test of physical function, general health, the role limitation for physical and emotional health were significant and respectively were (P=0.005 and F=11.22), (P=0.001 and F=16/02) and (P=0.049, F=4.3). However, the effect of the group on the post-test of role limitation for emotional reasons, physical pain, social function, and fatigue or vitality were not significant and respectively were (P=0.20 and F=1.741), (P=0.774 and F=0.085), (P=0.674 and F=0.183) and (P=0.288 and F=1.203).Conclusion: According to the results, based on the effectiveness of stress relief and management on some components of the quality of life in patients with thalassemia major, this study can be used to reach an effective solution to improve the quality of life and generally improve the mental status of patients.

Background: The Postpartum depression has a negative effect on the infant’s developmental and behavioral performance, mother-child relationship and mother‘s health, and its etiology is also very complicated.Objectives: This study was conducted to investigate the role of maternal emotional cognitive strategies and newborn gender preference in the postpartum depression in primiparous women.Methods: This descriptive-correlational study was performed on 205 primiparous women referring to health centers in Kerman city the center of Kerman province of Iran from 1April to 31 June 2015. Primiparous women according to presence (n=103) or absence (n=102) of postpartum depression (PPD<12: without depression) were selected using purposeful sampling. The measurement tools included the demographic questionnaire, Edinburgh postpartum Depression Scale (EPDS) and Cognitive Emotion Regulation Questionnaire (CERQ). The data were analyzed using SPSS software and the logistic regression method.Results: The results showed positive cognitive strategies including acceptance, positive re-focus and refocus on planning have a negative relationship with the postpartum depression (P<0.001). Also, the strategies of self-blame, catastrophizing, rumination and blame for others have a positive relationship with the postpartum depression (P<0.001). There was no significant relationship between dissatisfaction with newborn gender and postpartum depression (P>0.05).Conclusion: According to the results of this study, postpartum depression can be predicted by emotional regulation cognitive strategies.

Background: As world's population is growing, quality of life (QOL) and related factors such as self-care keep gaining mounting attention as they may affect the lives of the elderly significantly. The majority of the elderly people suffer from at least one chronic illness which plays an important role in elderly QOL.Objectives: This study was conducted to investigate self-care and related factors to QOL among elderly clients with and without chronic disease who are protected by healthcare centers in Karaj, Iran.Methods: In this cross-sectional study 400 elderly people were selected. A randomized multistage sampling method has been used. The data were collected using a standardized QOL and the Self-Care Assessment questionnaires. Pearson correlation was used to analyze the relationship between QOL and self-care factors.Additionally, Linear regression was run to identify the association between QOL domains and the independent variables through SPSS (p<0.05).Results: The average age of the participants was 69.25±6.31. The majority of the participants were married and 48.5% were illiterate. The results related to the average dimensions of QOL were found to be as follows: physical health: 12.98±4.36; psychological health: 12.81±3.86; social relationship: 14.81±25.25; environment: 12.83±3.0; and total QOL: 19.33±4.63. The results also revealed that QOL decreased significantly among the surveyed elderly, while it increased in the case of married and educated without chronic diseases. Finally, there was a significant positive relationship between all dimensions of SC (except for professional dimension) and dimensions of QOL (P<0.05).Conclusion: Chronic disease, physical SC, and emotional SC can act as significant predictors of QOL among the elderly.

Background: Primary dysmenorrhea (PD) is characterized by painful cramps of lower abdomen without abnormal pelvic pathology. PD begins some hours before or simultaneously with the onset of menstrual bleeding.Objectives: The purpose of this study was to investigate the effects of separate and concurrent supplementation of fish oils (FO) containing n-3 fatty acids and Rosa Damascena extract (RDE) on PD symptoms.Methods: In this double blind clinical trial in 2015, through convenience sampling, 105 university students with primary menstrual pain in most recent years, without abnormal pathology, and with moderate/severe dysmenorrheal symptoms according to visual analogue scale (VAS) were randomly assigned into one of four groups: 1. FO 1000 mg/day (n=26), 2. RDE 1000 mg/day (n=27), 3. FO and RDE concurrently, with the same dose (n=27), and 4. Control group (n=25). All measurements were performed three times, at the beginning, 30th day, and 60th day. Symptoms including nausea, vomiting, diarrhea, bloating, cramp, low back pain, headache, fatigue, anxiety, sweat, weakness, dizziness, drowsiness, and feeling cold were measured by VAS.Results: After 2-month treatment, supplementation with RDE significantly reduced severity of bloating (p<0.001) and sweat (p<0.001), but FO supplementation had no significant effect on PD symptoms. The concurrent use of FO and RDE significantly decreased severity of diarrhea (p=0.038), weakness (p<0.001), dizziness (p=0.003), and feeling cold (p=0.049).Conclusion: Our results suggest that the concurrent supplementation of omega-3 fatty acids and RDE could be more effective than their separate use in decreasing PD symptoms; however, larger trials are warranted to confirm these preliminary findings.

Background: Rheumatoid arthritis (RA) is a chronic disease with a profound effect on the life quality of the patients due to its chronic, painful, and disabling nature.Objectives: This study aimed to determine the effects of progressive muscle relaxation technique on life quality in RA patients.Methods: This clinical trial was conducted in a rheumatologist office on 62 RA patients. The participants were randomly divided into two groups: progressive muscle relaxation group and control group. While the intervention group underwent a daily 20-minute relaxation period for 8 weeks, no intervention was given in the control group. Data were collected using a two part questionnaire including demographic characteristic form and SF-36 life quality questionnaire, completed at the beginning and the end of the intervention. Data analysed using Chi-square test, independent t-test and paired t-test with SPSS software version 19.Results: The findings of the study showed that, in the experimental group, the mean score of life quality changed from 37.84 to 54.54 after the intervention (p=0.0001), while, in the control group, it altered from 37.47 to 43.20. There fore, the difference between the two groups was not considered as significant before intervention (p=0.112). Moreover, there was a significant difference between experimental and control groups regarding the six aspects of life quality including physical function (p=0.041), vitality (p=0.029), social function (p=0.017), mental health (p=0.001), general health (p=0.002), and psychological health (p=0.002). However, no significant difference was found in case of bodily pain (p=0.149) and physical constraint (p=0.82).Conclusion: According to the findings, progressive muscle relaxation training could be an effective therapeutic method to improve quality of life in RA patients.

Background: Occurs as a result of long-term exposure to stress, job burnout threatens the health of personnel.Objectives: Considering the important role of healthcare personnel in maintaining and promoting people’s health, the current study investigated the job burnout frequency and its association with job performance among healthcare personnel.Methods: This correlational and cross-sectional study was conducted among all healthcare personnel of urban/rural healthcare centers in Health Office of Islam Abad-e-Gharb, Iran. A total of 136 personnel participated in this study. Data were collected using Maslach Burnout Inventory (MBI) and Hersey and Goldsmith’s job performance scale. Descriptive statistics and Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient tests were used to analyze the data (p£0.05).Results: The mean (SD) frequencies of job burnout and job performance were found to be 45.96±17.77 and 52.5±9, respectively. There was a significant inverse correlation between job burnout and job performance (p=0.000, r=-0.249). However, there was no significant association between job burnout and age, gender, marital status, education, and smoking factors (p≥0.05).Conclusion: The findings showed that most of the personnel experienced moderate to low levels of job burnout. Besides, job burnout was found to be a factor affecting job performance. Hence, this study calls for useful interventions to reduce job burnout and increase job performance consequently.