Journal of Multidisciplinary Care
Year:2013 | Volume:2 | Issue:3|Papers Count:9

Background and aims: According to the evidences patients are suffering due to not having information their operation before and after surgery. This study was aimed to compare verbal education effects of face to face and leafletson the patients, knowledge scheduled for un emergency operation.Methods: This clinical trial randomized study was carried out by 90 patients scheduled for operation and assigned randomly to three groups (two intervention groups and one control group). Two intervention groups received education via leaflet and face to face by a doctor. The control group received routine education. The level of preoperative knowledge of patients before operation was composing the research variable that was evaluated by multiple- choice knowledge test before and after operation.Results: The findings of the study showed that respect to knowledge level,  the mean scores of both interventional groups were significantly higher than that in control group after the intervention (P<0.05), but there was no significant difference between experimental and control groups (P>0.05).Conclusions: The results suggest that both face to face education by a doctor and using leaflet can equally help patients to acquire necessary knowledge for an elective operation. So, in the hospital setting, where staffs interfaces to time pressure, leaflet can educate patients without seeing a doctor or a nurse.

Background and aims: The need for innovative nurses in intensive care wards is felt to provide exclusive complex care to very ill patients. The present study aimed to determine the level of innovation in critical care nurses and the individual and organizational factors associated with it.Methods: In this descriptive - analytical study, 205 subjects were selected by consensus included critical care nurses of educational-therapeutic centers in Rasht in 2013. Data collection instrument included Kirton Adaption - Innovation Inventory with questions related to individual and organizational characteristics. Questionnaire scoring was based on five-point Likert scale Results: Mean score of “innovations" score in nurses was 120.88 ±15.15 and 95.24% of nurses were innovative. Also, among personal factors, the level of innovation was significantly related to variables such as gender (p=0.012), educational level (p=0.039) and age (p=0.037), and in organizational factors, management experience (p=0.006), having education course on creativity and innovation (p=0.014) and type of critical care ward (p £0.001) employed were significantly correlated.Conclusion: According to large proportions of innovative nurses, healthcare managers and policymakers must create a receptive, trusting and appropriate atmosphere to facilitate the implementation of original and creative ideas of nurses to solve some of health care system problems.

Background and aims: Breast feeding is the best nutrition for infants, because it provides the health numerous benefits both mother and infant. Infant massage in many countries is used as a part of routine care in many cultures, for the first few months of life. Infant massage training is considered part of routine care. The aim of this study was to test the effects of infant massage on frequency and duration of breast-feeding with normal infants over a period of 8 weeks.Methods: This study was a randomized clinical trial conducted on 80 infants of nulliparous women referred to health centers of medical sciences university in 2010. Infants were randomly divided into two groups of 40. Massage by parent groups 2 times a day (morning and evening) for 8 weeks and each time was 15 minutes, while the control group received usual care. Data collection included interviews and diaries form the parents of the infant. The frequency and breastfeeding duration in both groups 1 and 2 months after delivery were studied. Data analysis was performed using SPSS software.Results: After 4 and 8 weeks of massage, there were significant differences on duration   breast feeding between the two groups (P<0.05). There were also significant differences on frequency breast feeding (P<0.001) in 4 and 8 weeks of massage between the two groups.Conclusion: Overall, the results of this study reassure that infant massage facilitates the mother-infant interaction for infants and mothers and increases duration and breastfeeding frequency who give massage to their baby.

Background and aims: Pain and fatigue are common among patients following CABG (Coronary artery bypass graft) surgery. The aim of this study was to determine the effectiveness of massage therapy on pain and fatigue of patients after coronary artery bypass surgery.Methods: In this clinical trial study, 72 patients, who were underwent coronary artery bypass surgery in Isfahan Chamran hospital were selected. Then, the patients were randomly assigned in two case and control groups. The patients of the case group(n= 36) received light pressure stroking massage, from 3 to 6 days after the surgery. The patients in control group received only the routine care. Variables pain and fatigue before and after the intervention was recorded in 1, 2, 3 days by the use of the visual analogue scale.Results: Results showed that there was a significant differences in pain levels before and after the intervention between case and control groups (P<0.001), that decrease of  pain and fatigue from first to the fourth day after surgery in intervention group was more than control group. Conclusion: The use of Light Pressure Stroking massage therapy can decrease pain and fatigue of patients after coronary artery bypass surgery and due to low cost and simplicity of this method, it can perhaps be used as a complement to drug therapy and postoperative interventions used in these patients.

Background and Aims: Socialization is an acceptation process of professional role and a true method of improving professional identity. The aim of this study was the explanation of concept in clinical nurse specialists.Methods: In this study, a phenomenology approach was used. Participants were 10 clinical nurse specialists employed in Shahrekord and Tehran educational hospitals. Data were collected through semi structured interviews which were analyzed by Van mannen method.Results: Six themes were emerged by the analysis of professional socialization interveiws of clinical nurses which was illustrated: "flotation of competence", "practical autonomy", "clinical dynamic", "being supported to society", "professional belongingness", and "passive group participation". Conclusion: The study findings show that descriptions of clinical nurse experiences provide planning practical guide for educational mangers to reassess socialization programs and nursing managers to improve resocialization programs after role transitions. This study not only explains socialization concept of nursing profession, but also it creates starting point for more concept research and developing body of professional nursing knowledge.

Background and aims: Mental health in nurses is always at risk because of stressful nature of nursing occupation. The aim of present study was to examine the association of organizational culture and job stress with mental health in nurses.Methods: Sample population of this cross-sectional descriptive study conducted in 2013 comprised all nurses of Hajar (peace be upon him) and Ayatollah Kashani hospitals of Shahrekord. 300 nurses were randomly enrolled as sample study. To measure the variables under study, we used questionnaire of job stress (Phillip L. Rice), 28-question questionnaire of general health (GHQ-28), and questionnaire of organizational culture (Denison) in addition to individual characteristics questionnaire. Results: In general, no significant reationship of organizational culture with job stress and mental health were found. But, there was a significant relationship between organizational culture and job stress (P<0.05). Demographic variables, being involved in job, mission, adjustment, and adaptability had a significant, negative associatin with job stres, and only adjustment had a significant associate in with mental health (p<0.05).Conclusion: According to the study results, it can be concluded that the use of cooperative organization culture in hospital benefits and cooperation of nurses in hospital affairs reduces stress. The assessment of organizational culture by hospital managers seems necessary to plan for organization and its success. Therefore, they can help nurses' mental health through holding courses for organizational culture promotion, creating a healthy environment, raising resistance power and individual adjustment, managing stress, and encouraging and supporting them financially. Using participatory organizational culture and having nurses participate in hospital affairs are helpful in decreasing job stress.

Background and aims: Today, the major changes in health care organizations create necessity of combined leadership and management skills. In addition, successes in patient care and obtain credit for hospital depends on nurse staff competent and appetence. This study aimed to determine the effectiveness of leadership and its relationship with the emotional stability in nurse managers.Methods: This descriptive study was performed on 128 nurse managers in educational hospitals of Isfahan University of Medical Sciences that subjects were selected through census method sampling. Data collection instruments were Leadership Effectiveness Questionnaire and Kentel Personality Questionnaire.Results: Findings showed that 77.8% of matrons, 66.7% of supervisors, and 72.1% of head nurses had powerful leadership effectiveness. Also, there was a significant and direct correlation between leadership effectiveness and emotional stability in supervisors (r=-0.39, p=0.02), but in the two other nurse managers' class didn't see this correlation.Conclusion: The result showed direct correlation between leadership effectiveness and emotional stability in supervisors. So, it is necessary to be considered personality characters in managers’ selection.

Background and aims: Patient's rights are one of pivotal elements of clinical governance and important indicators of quality care in health area. Patient's rights in Iran are stated in patient's rights charter and its establishing need to lying plots a set of prerequisites. The aim of this study was to survey prerequisites and to develop a bill for establishing patient rights in Iranian health centers using expert's ideas and comments. Methods: The study was conducted using the Delphi’s approach, and 30 purposefully selected participants include experts in law, medical groups and ethics, as panelists were enrolled in 4 rand Delphi technique. In first rand, the ideas of panelists in response to question" what prerequisites are needed to establishing patients rights in hospitals" were collected and then a bill including 7 domain was developed and then entered in Delphi process. The comments of panelist were collected by E- Mail and face interview through April 2012 to September 2013. Final document was developed in the end of 4th rand.Results: A consensuses bill for establishing patient rights was main result of this study that developed in 82 items in 7 domains including: academic education, research, supervision, process management, building, organization and manpower. At al, out of 178 items that judged by panelist, finally 51 items (34.8%) consist many suggestion were agreed and entered in final document.Conclusion: Results of this study recognize the areas which need to takeover and correction in order to improve patients’ rights observance. In addition, the results showed that goal of bill of patients’ rights can be achieved with minimal cost and changes such as correcting organizational processes and empowering staff.

Background and aims: Having no adherence to medication regimen in patients suffering from Epilepsy is lead to an increased mortality rate in these patients. The present study evaluated the effect of educational program on drugs self-management in patient with epilepsy.Methods: This study was a randomized clinical trial with control group. The samples (n=60) were selected from the neurology clinic of Valiasr hospital in Zanjan. The patients were randomly assigned into the intervention (n=30) and the control (n=30) groups. The intervention group received four educational sessions with the two stages of continuous care model that including epilepsy and self-management plan. All patients completed the epilepsy self-management scale pre intervention and one month post intervention. Results: There was no statistically significant difference in demographic characteristics and drugs self-management scores between two groups. After intervention; there were a Significant statistical difference between the epilepsy drug self-management scores in intervention and control groups (p<0.001) and the intervention group showed an increase in their drug self-management.Conclusion: Nurses can increase the drug self-management of epileptic patients by using the simple and inexpensive technique of group education and thus avoid from many problems of these patients and help to improve their health.