Journal of Multidisciplinary Care
Year:2016 | Volume:5 | Issue:2 |Papers Count:9

Background and aims: Preterm delivery is associated with significant perinatal morbidity and mortality. This study aimed to determine the effects of intravenous (IV) hydration on time interval from rupture of membranes to delivery (latency period) in pregnant women with Preterm premature rupture of fetal membranes.Methods: 24 pregnant women during their 28 to 34 weeks of gestational age with singleton live pregnancy whose baseline amniotic fluid index (AFI) was³5 cm were randomized into 2 case and control groups. The study group (Amniotic Fluid Index) received one liter intravenous fluid bolus of isotonic Ringer serum during 30-minute period. The control group received expectant management. The time interval from rupture of membranes to delivery was studied. Independent t-test and paired t-test were used to compare 2 groups and mean latency period before and after hydration, respectively.Results: The results of this study demonstrated that AFI decreased significantly at 90 minutes in both control and study groups. The mean between time intervals and delivery was 196.41 h and 140.58 h in the study and control groups, respectively, But this differences were not statistically significant (95%: 75.9-316.9 CI 95%: 10.2-270.9) (P=490).Conclusion: This study did not show any significant impact of hydration on AFI and consequently latency period as a prophylactic method. So, further studies with a larger sample size and at different time intervals seem to be needed to clarify the effect of hydration on latency period in PPROM.

Background and aims: breast cancer is the most common cancer among women in Iran and many countries; but in recent years, survival rate was longer in patients and yet there is a greater emphasis on their quality of life. Therefore, this study was aimed to evaluate the effect of nurses’ supportive and educative care on the quality of life in breast cancer patients.Methods: This is a quasi-experimental, pre- and post- study.45 patients with breast cancer referred to radiotherapy clinic of Seyedoshohada hospital were studied in 2013. The instruments used in this study were demographic and quality of life questionnaires from Backman institute completed before and after the training and support for patients. Questionnaires were completed and finally the obtained data were analyzed using SPSS software and statistical tests.Results: Based on the results obtained on the overall quality of life, it was observed that the average score for the quality of life in the sample was 51.73±13.91 before the intervention and 60.46±13.80 after the intervention (P<0.001). Also, the average scores in all four domains of quality of life after the intervention has increased, but the difference was significant only in two dimensions, physical and mental health (P<0.001).Conclusion: The results confirm the positive effect of nurses’ supportive and educative programs on the promotion of quality of life in patients with breast cancer. Therefore, planning and implementation of such programs on a broader basis and based on the educational and supportive patients' needs is recommended.

Background and aims: Breastfeeding is one of the most effective behaviors to health promotion. One of the factors that affect on successful breastfeeding is mother's self-esteem. With regard consequences of low self-esteem that have negative impact on interpersonal relationships, thinking, feeling and person, practice, this study aimed to determine self-esteem and its related factors in primiparous women.Methods: In this descriptive study, 300 Primiparous lactating mothers with children less than 6 months, referred to health centers in the Mashhad city were selected by multistage random sampling. Data collection was completed by Rosenberg Self-esteem questionnaire. Data were analyzed by SPSS software through Spearman correlation test, Kruskal-Wallis and Mann-Whitney.Results: The mean and standard deviation of maternal self-esteem were 28.98±2.76. Most of women (94.33%) had the average level of self-esteem and only a small percentage of women (1.33%) had high self-esteem. Based on the results, there was a negative significant relationship between self-esteem and the child's age (P=0.01). In other cases, the relationship between self-esteem and variables such as age, education and income were not significant (P>0.05).Conclusion: The results of this study showed that the self-esteem mean score of most nulliparous women during breast-feeding was moderate and due to the fact that the self-esteem affects their self-efficacy, feeling and performance, it is suggested that midwives and other health professionals consider psychosocial aspects that they affect self-esteem of breastfeeding mothers and do some measurements on self-esteem of these individuals in order to increase it.

Background and aims: Nephrotic syndrome is the most common manifestation of glomerular damage in children. Due to being a chronic disease as well as the need to continuing the provision cares to reduce the recurrence of disease, this research was aimed to determine the effect of continuous care model on parents’ knowledge and controlling symptoms and recurrence in children with nephrotic syndrome.Methods: This research is an experimental study which 66 children with nephrotic syndrome qualified for inclusion in the study, were randomly classified into 2 groups: Case and control. Data were collected by a researcher-designed questionnaire, and checklist for recording blood pressure, weight, blood lipids and the presence or absence of recurrence in children in the 2 groups before and after intervention. Continuous care model was carried out on test group for 6 months. Data were analyzed by SPSS software using descriptive statistics, Chi-square, and Independent t-test and McNamara tests.Results: The proportion of disease recurrence after the intervention in both case and control groups showed no significant difference (P=0.787), but mean of systolic blood pressure in both groups after the intervention showed significant differences (P=0.011). Also, the level of parents' knowledge ratio in both groups after the intervention showed significant differences (P=0.0001).Conclusion: According to the study results, it is suggested that children care needs with nephrotic syndrome will be met by using the implementation of continuous care model.

Background and aims: Multiple sclerosis, as a chronic and progressive disease of central nervous system, affects different aspects of patient’s life. Considering importance of fatigue in these patients and on the other hand, increasing acceptability of complementary therapies in health care system, this study was aimed to determine the effect of group cognitive behavioral therapy on the severity of fatigue in women with multiple sclerosis that was conducted during 2014.Methods: This study was a two-group, three-stage (before, right after and a month after the intervention) clinical trial that was conducted on 66 women with multiple sclerosis who had the inclusion criteria and referred to medical centers of Isfahan. After convenient sampling, participants were equally divided into two groups of control and intervention by random allocation. The intervention group received eight 90-minute group sessions (a session per week) for cognitive behavioral therapy. Control group along with receiving the usual drug therapies, participated in 3 group sessions and expressed their feelings and experiences. Data was gathered using a questionnaire and fatigue severity scale (FSS) and was analyzed by SPSS software using independent t-test, Mann-whitney, Chi square and one-way ANOVA tests.Results: There was no significant difference between the mean score of severity of fatigue in both groups before the intervention (P=0.532), but this score was significantly lower in the intervention group than the control group right after the intervention and a month after the intervention (P=0.03). Also, the results of post-hoc LSD showed that the mean score of severity of fatigue in the intervention group right after the intervention and a month after the intervention was significantly lower than before the intervention (P<0.001).Conclusions: Considering the effect of cognitive behavioral therapy on the severity of fatigue in patients with multiple sclerosis, the use of this therapeutic method, as a clinically beneficial, effective, cost effective and reasonable method, is recommended.

Background and aim: Infertility and its treatment affect as a crisis on various aspect of quality of life in women that is the most important aspects of quality of life of emotional issues and social connection. The aim of this study was to determine the effect of continuous care model on emotional health and social connection in infertile women.Methods: In this semi-experimental study, 80 infertile women referred to infertility centers affiliated with Tehran University of Medical Sciences during 2015 were entered into study by simple (convenient) sampling method. The data were collected by demographic characteristics questionnaire and fertility quality of life questionnaire (FertiQol).2-3 training session was held for implementation of continuous care model. Quality of life in infertile women was evaluated during two stages: before intervention and 2 months after intervention in evaluation stage. Data were analyzed using SPSS by the Independent t-test, Paired t-test, Chi-square and Exact fisher test and p<0.05 was considered significant.Results: in the case and control groups, mean of quality of life in emotional health after the intervention was 16.75±3.572 and 8.85±3.971 and in social connection was 17.98±2.922 and 11.45±3.672, respectively. A significant difference between intervention and control group was observed (P=0.002). In the control group, a significant decrease in scores on emotional and social areas after the end of the intervention was observed (P<0.001).Conclusion: Implementation of continuous care model improves emotional health and social connection in infertile women. It is recommended that continuous care model to be used as a easy, affordable and available care model.

Background and aims: Diabetes Mellitus is the most common diseases of endocrine glands. Chronic duration and complications imposes financial burden on patients and diminishes quality of life among diabetics. So, this study with the aim of the effect of satisfaction of disease control and self-care behavior on quality of life of patients with type 2 diabetes was conducted.Method: This is a descriptive- analytic study which was conducted on 110 patients with type 2 diabetes based on convenience sampling in Bijar town. Data were gathered with the diabetics’ quality of life (DQOL). All data were analyzed using SPSS with descriptive statistics and Chi-square test, Fisher exact, ANOVA and t-test.Results: In this study, 54 patients (49.9%) were men and 56 (50.9%) were women. The mean of quality of life was moderate (47.2±5.6). There were significant correlations between quality of life with age, education level (P=0.001) and job (P=0.007). Between sex and quality of life no correlation was observed (P=0.078). The results showed a significant correlation between self-care behavior with job (P=0.03) and education level (P=0.008). There were significant correlations between consent of disease control with quality of life, education level, occupation and age (P=0.001).Conclussion: Due to the quality of life of the diabetic patients was in moderate level and diminished with increasing of age, and also because of the increasing number of elderly community, it can be considered careful planning in health promotion in the Ministry of Health, to deal with diabetic patients.

Background and aims: Nursing process is performance Standard for nursing cares. According to their conditions and facilities, various centers can choose and implement a nursing process that is more efficient for them. This study was aimed to determine the effect of nursing process the way "accessible care cards" on patients' satisfaction from care in intensive care units.Methods: This is a cross-sectional interventional study with plan case-control study that was conducted in Golestan hospital in Ahwaz in 2014. Considering the inclusion criteria and available sampling method, a total of 38 controls and 38 cases were selected for the intervention group were evaluated. Data were collected questionnaire made by researcher, which was assess the scientific validity, the content validity method were used validated. As well as its reliability using Cronbach's alpha test (a=0.9) was determined. Intervention was conducted by accessible care cards in nursing process for two weeks and its impact on patient satisfaction was measured. The control group was routine care. The collected data was analyzed by SPSS 19 and statistical tests. Descriptive statistics such as mean, and standard deviation was used. Chi-square test, Mann-whitney and t-test were used to compare groups.Results: Results showed that 28.90% of patients in the control group had great satisfaction of care, while the 97.36% of patients in the intervention group reported nearly excellent satisfaction. The observed difference in patients' satisfaction with nursing care in both the experimental and control group was statistically significant (P<0.001).Conclusion: Implementation of nursing process, in a manner of available cards led to an increase in patient satisfaction compared with the routine manner and the use of these cards makes the nursing process of a greater degree of mental state, to objectively state, that can help in saving a lot of time for nurses.

Background and aims: Thalassemia is the most common hereditary chronic anemia in humans. Stress caused by the disease leaves adverse effects on children’s self-efficacy in the care of family members, especially mothers. Therefore, this study aimed to determine the effect of stress management training, self-efficacy in mothers of children with thalassemia.Methods: This quasi-experimental study was conducted in Seyedalshohada hospital (clinic of imam Reza) in Isfahan in 2014.64 mothers of children with thalassemia were randomly assigned into two experimental and control groups. Demographic questionnaires and researcher-designed questionnaires of parental self-efficacy questionnaires dealing with the disease were completed at the beginning and end of the study and in the follow-up to the control group. Stress management training was conducted for experimental group of 8 sessions weekly. Data were analyzed using SPSS software and statistical tests of Mann-Whitney test, independent t-test and fisher exact test.Results: The results of study showed that there was no significant difference between the experimental and control groups in terms of self-efficacy score before the intervention (P=0.148), but self-efficacy score in the experimental group was significantly more than the control group after intervention as well as a month later, (P=0.001). Generally, self-efficacy in mothers after the intervention and one month later increased in comparison with pre intervention.Conclusion: The results showed that stress management training program can be a useful approach to increase self-efficacy in mothers of children with thalassemia. Therefore, it is recommended to improve the self-efficacy in mothers of children with chronic diseases such as thalassemia.