Journal of Clinical Research in Paramedical Sciences
Year:2014 | Volume:3 | Issue:2|Papers Count:8

Background: Problem-based learning (PBL) is an active educational strategy established on two bases, learner and problem. This study aimed to determine the effect of the Emergency Severity Index (ESI) triage education via PBL on the triage nurses' performance and the patients’ length of stay in the Emergency Department.Methods: In this interventional, the ESI-triage education was done via PBL for all 12 triage-nurses in the Besat Hospital. The tools were the observational time-recording checklist developed according to the Swailes et al. study and the ESI form. The validity of the tools was confirmed by experts. The observer reliability was defined by the inter-rater reliability. The Length of stay and ESI triage level of 72 patients before and 72 patients two weeks after intervention were recorded. Data was analyzed by t-test, Mann-Whitney and ANOVA with 95% confidence by the software SPSS-20.Results: The majorities of the triage nurses were men (75%), with a bachelor’s degree (91.7%), mean age 31.5±5.51 and work experience 6.72±8.00 years. The ESI-triage education via PBL strategy significantly lead to the decrease in the "triage by the nurses” duration (P<0.001) and the nurses’ performance improvement (P<0.001). Following the intervention, the reduction in the length of the “patient’s entry to the triage starting by nurse” and the "door –to-doctor” duration phase for all patients were noticeable.Conclusion: Considering the positive influence of the ESI triage, PBL strategy is proposed to train other emergency personnel.

Background: Orthopedic injuries are the most common types of injuries. To identify the main causes of injuries, collecting data in the standard manner at the national level are needed, which justifies necessity of making a minimum data set. The aim of this study was designing a minimum data set for orthopedic injuries.Methods: This research was applied and performed in a descriptive and cross-sectional manner in 2013. Data collected from hospitals affiliated to Tehran University of Medical Sciences that had orthopedic department, insurance, medico-legal and emergency centers, and so internet and library. Research documents were orthopedic injury records in 2012 and documents that retrieved from the internet. Records with Random sampling by S22-S99 categories from ICD_10 were selected, and the related Internet sourced data was evaluated entirely. Data collected using a checklist. In order to make a consensus about the data elements the Delphi technique was applied, using a questionnaire. The content validity of questionnaire was assessed using expert’s opinions and reliability by test-retest method.Results: A minimum data set of orthopedic injuries divided into two categories: administrative with six classes including 142 data elements, and clinical with 17 classes including 250 data elements.Conclusions: This study showed that some of the essential data elements that were in other country’s MDS or required for organizations and health care providers was not included. So a complete list of a minimum set of data elements was created. Existence of comprehensive data about the causes and mechanisms of injuries enables public health policy-makers to be informed about injuries occurrence, and taking rationale measures to deal with these problems.

Background: There is a relationship between stress levels with motor activity and food habits in different ways. The present study aimed to determine the role of motor activity and food habits in stress management of students of Ilam University of Medical Sciences.Methods: Through a cross-sectional study using randomized allocation sampling, 400 medical students in Ilam University of Medical Sciences were recruited. The "HPLP II" questionnaire including stress management and other variables was administered. Collected data were analyzed using ANOVA and linear regression tests in SPSS software.Results: Mean and standard deviation of age and stress management score was 20.94±1.9 years and 2.47±0.5, respectively that 59.3% were female. In general, poor, middle and good stress management were estimated to be 14%, 68.5% and 17.5%, respectively. There were significant relationships between students’ stress management with motor activity and food habits but not with age and gender. Linear regression showed that by improving motor activity and food habits score, the students’ stress management score has increased significantly. Eventually, food habits showed that has a more important role in relation with stress management.Conclusions: Health education in advanced levels considering motor activity and in particular a good nutritional status can have an important role in improvement of students’ stress management.

Background: Breast cancer is the most common cancer in the world wide women, and the major leading cause of cancer death among them. According to the increasing incidence of breast cancer in women and many related modifiable risk factors, the present study was to assess the modifiable risk factors of breast cancer in Tabriz.Methods: A hospital-based case-control study was undertaken to identify breast cancer risk factors. The study consists of 140 cases confirmed on histopathology and 280 group matched controls without any malignancy, selected from clinics of Tabriz Imam Reza Hospital. Data were analyzed using descriptive and inferential statistics via SPSS software version 18.Results: In multivariate analysis, educational level, food high in fat, passive smoker, stress and migration were associated with significantly increased risk for breast cancer. Breast feeding and eating sufficient amount of fruits and vegetables had protective role against breast cancer.Conclusion: These findings suggest that life style factors such as nutrition and stress are considered as risk factors for breast cancer in Tabriz. Therefore, health worker’s more attention, especially nurses as the as the largest group of professional care system, to healthy lifestyle and providing education to change unhealthy lifestyle are recommended.

Background: Provided services for patients in pre-hospital emergency setting and their satisfaction from this services showed quality of pre-hospital emergency services. The main aim of present study was to examine level of patients' satisfaction from pre-hospital Emergency Medical Services (EMS) in ShahreKord city in 2012.Methods: In this descriptive study 450 patients that transported to the hospitals by EMS were selected with the using simple random sampling. Data were collected by using of satisfaction questionnaire. Data were analyzed in SPSS 15 software, with using descriptive statistical tests, independent t test, one way ANOVA and Pearson correlation test.Results: Satisfaction levels in all domains were higher than 50%, and in total were 71.1 percent. Results showed that patients satisfaction from EMS services in men, patients with low educational level, married, patients with a history of emergency services and urgent problem, were significantly higher than the others patients. Maximum and minimum level of satisfaction was related to efficiency of emergency domain with78.5% and functional domain with 58.7% respectively.Conclusions: Results of present study showed that level of patient’s satisfaction in various areas was in good level and for increase the patients’ satisfaction, EMS technicians should pay more time with their patients.

Background: Job satisfaction, as the main attitude, refers to employees’ judgment toward their job and organization. This research strives to determine the level of job satisfaction among Anesthesia and Operating room staffs of Kermanshah University of Medical Science.Methods: This is a descriptive- analytical research. All staffs (n=309) working in Anesthesia and Operating room of Kermanshah University of Medical Science constitute the population of this study. Data are collected and analyzed using a self-made questionnaire and SPSS software (Version 16).Results: the level of job satisfaction at different health and education centers were 52.4%. Job satisfaction had no significant relationship with any of the variables. The level of job satisfaction among anesthetics was more than operating room staffs.Conclusions: Results obtained in this study indicate that employee were in average level of job satisfaction. Thus, authorities are recommended to increase job satisfaction by reducing the causes leading to employee dissatisfaction.

Background: The aim of this study was to determine relationship between alexithymia and interpersonal problems in Kermanshah University of medical sciences.Methods: The design of research was descriptive-analytic correlation. The statistical population was the entire male and female students of Kermanshah University of medical sciences include 3470 persons. Use of Morgan table, 400 people was selected as statistical sample by stratified random sampling.. All participants were asked to complete Farsi version of the Toronto Alexithymia Scale (FTAS-20), and Inventory of interpersonal Problems (IIP-60). The data were analyzed by the use of descriptive statistics and Pearson–correlation coefficient and independent t. test.Results: Analysis of the data revealed a significant positive correlation between alexithymia with interpersonal problems(r=0.14, P=0.004). Also, Finding showed that there was positive significant correlation between alexithymia and assertiveness(r=0.19, P=0.001), sincerity (P=0.001, r=0.20), responsibility(r=0.25, P=0.001), controlling (P=0.02, r=0.11). But other components (openness and compliancy), were not significant. There is a significant difference in alexithymia between men (40.36) and women (37.35), but this difference was not significant for interpersonal problems.Conclusion: Based on finding of present study, alexithymia was correlated positively with interpersonal problems, so presenting educational planning can regulate emotion and prevent students' interpersonal problems.

Fall out of bed is a common problem in the hospitalized patients. This descriptive study carried out for evaluation the rate of patient falls out of bed in hospitalized patients in hospitals of Kermanshah University of Medical Sciences. A total of 28 falls including 17 man and 171 women. Most falls had been occurred in the night shift when the nurse or doctor was absent. Most falls were resulted to injuries consisted of 10 abrasions, 6 hematoma and 5 fractures. Survey of falls can be applied in organization of the environment and human factors and making a safe media for hospitalized patients.