Iranian Journal of Nursing and Midwifery Research
Year:2011 | Volume:16 | Issue:4|Papers Count:11

BACKGROUND: There are two types of primary dysmenorrhea (spasmodic and congestive) which differ from each other in terms of the occurrence time in menstrual cycle, pain quality and other symptoms. The present study aimed to determine the effect of acupressure at the Sanyinjiao point (SP-6) on severity of menstrual symptoms (primary outcome) and the duration of resting time as well as the number of ibuprofen consumption (secondary outcome) in the two types of primary dysmenorrhea.METHODS: This was a clustered randomized controlled trial on 72 eligible students residing in dormitories of public universities of Tabriz. Determining the type of primary dysmenorrhea using a Menstrual Symptoms Questionnaire (MSQ), 36 participants which suffered from each type of dysmenorrhea were enrolled from the four dormitories. The dormitories were randomly divided into intervention and control groups. No intervention was carried out at the first cycle. During the two next cycles, Sanyinjiao point of the subjects in the intervention group was pressed for twenty minutes at the time of pain. The subjects in both groups were allowed to consume ibuprofen, if needed. During these three cycles, the participants recorded and reported menstrual symptoms severity, duration of resting time and the number of the used ibuprofen.RESULTS: The severity of menstrual symptoms and duration of resting time in the 2nd and 3rd cycles were significantly reduced more than control groups for both spasmodic and congestive types of primary dysmenorrhea. In addition, the average numbers of ibuprofen pills taken by both intervention groups was significantly less than the control groups. There was no significant difference between the two intervention groups in terms of any of the outcomes.CONCLUSIONS: Acupressure is effective on lowering the symptoms of dysmenorrhea and duration of resting time almost equally in both spasmodic and congestive types. Therefore, using this method either alone or along with other methods is recommended to treat dysmenorrhea.

BACKGROUND: Pre-pregnancy care is considered as the services assessing and reducing the pregnancy risks through providing medical care and mental support. Therefore, a pre-pregnancy counseling protocol was prepared based on a series of guidelines. This study aimed to determine the effect of the protocol on pregnancy and labor indices.METHODS: This was a four-phase field study conducted in four randomly selected urban and rural health centers in Shahreza.In the first phase, the information including pregnancy and labor indices was extracted. The participants were all the women who had a delivery in the year before the study (census). In the second and third phases (3 and 6 months after implementing the protocol in the case centers), the process of implementing the protocol was assessed. In the fourth phase (a year later), pregnancy and labor indices were determined in case and control centers (on all the women who had labor in the year before) again and the results were compared in case and control groups as well as before and after implementing the protocol.Data was collected by reviewing documentations and using data collection forms. It was then analyzed by descriptive and analytical statistics using SPSS13.RESULTS: The obtained results indicated the positive effects of pre-pregnancy cares on cesarean indices, percentage of underlying diseases, pregnancy over the age of 35, and pregnancy intervals of less than 3 years.In addition, the protocol had been implemented correctly in 8.2% of the cases in the second phase, and in 30.2% of the cases in the third phase.CONCLUSIONS: The positive effects of pre-pregnancy cares on some of the indices raised the necessity of seriously considering and integrating this program in the routine women's health care programs. Considering that less than one-third of the staff members of the case centers had completely conducted the pre-pregnancy cares, monitoring the staff’s performance is essential for improving the effectiveness of the care.

BACKGROUND: Health systems search for ways of making their services more responsive to patients and the public The new framework of the World Health Organization (WHO) for assessment of health system performance has determined health, responsiveness and fairness of financing as the main goals. This study aimed to compare patients’ and nurses’ view points about responsiveness among a sample of public and private hospitals of Isfahan, Iran.METHODS: A descriptive study was conducted on 160 nurses and also equal number of patients. Data were collected by a valid and reliable questionnaire designed by WHO. Data were analyzed using SPSS software. Scores were reported as mean (standard deviation).RESULTS: Mean score of responsiveness was 2.4 (0.58) in nurses and 2.3 (0.54) in patients but the difference was not statistically significant (out of a maximum of 4). The corresponding figures were significantly different (p=0.009) regarding patients' viewpoints in public [2.2 (0.4)] and private hospitals [2.3 (0.5)].CONCLUSIONS: Proper satisfaction about responsiveness was not provided in studied hospitals, based on the nurses’ and patients’ points of view. Public hospitals, in spite of their high costs, had a worse situation about responsiveness, the improvement of this situation necessitates managerial policies.

BACKGROUND: Anxiety is the one of the most common problems before the surgery. Its prevalence rate ranged from 11 to 80 percent in all the adult patients. Delay in wound healing and increasing use of narcotics and anesthetics are some of the other accompanying problems. Aromatherapy is one of the complementary medicine components. It is applied by special type of oil extracted from aromatic plants for medical objectives. This study aimed to investigate the effects of inhalation aromatherapy on anxiety level in preoperative patients.METHODS: This was a clinical study done on 72 patients candidate for heart and abdominal surgery admitted in Golestan and Imam Khomeini hospitals. The patients were selected according to our study objectives and inclusion criteria. Then, they were divided in two case and control groups. The Spielberger scale was used for evaluating the anxiety level. Twenty minute of inhalation with handkerchief containing lavandula was used in the case group and placebo also (water) in the control group.RESULTS: The average of anxiety level in inhalation aromatherapy group decreased from 51.00 to 38.61 from before to after the intervention. This average in the inhalation group with placebo was 50.67 before the intervention and decreased to 49.53 after the intervention. The results of independent t-test statistically showed a significant difference between the two groups after the intervention.CONCLUSIONS: The findings showed that inhalation aromatherapy was effective on reduction of anxiety level and this method can be applied as a complementary medicine on the clinic.

BACKGROUND: One of the significant issues in health studies is violence. Although violence against nurses has been recognized as a major occupational problem, its magnitude and extent is not clearly defined. The aim of this study was to determine the extent and types of violence during clinical training of nursing students.METHODS: In this descriptive and cross-sectional study, 180 sophomores, juniors and seniors of Shahid Beheshti, Tehran and Iran Medical Universities were selected by quota sampling method. A questionnaire was used for collecting data regarding violence over the past year. Content and test-retest methods were used for evaluating its validity and reliability, respectively.RESULTS: Findings showed that 6.7%, 8.3% and 39.4% of the students experienced physical assault, physical menace and insult, respectively, over the past year. Most cases of the assaults (66.7%) were done by patients, most menaces by staff as well as patients’ attendants (18.1%) and most insults by staff (33.7%) and patients (31%). No significant relation was found between the sex as well as the educational year of the students and the experience of insult.41.6% of the assaults were due to the effects of disease in assailants. However, no specific reason was found for physical menace and insult in most cases.66.65%, 26.6% and 39.4% of the students reported physical assault, menace and insult to their tutors, respectively.CONCLUSIONS: Nursing students are subject to more violence because of young age and inadequate experience. Therefore, devising educational programs regarding occupational violence as well as its prevention and providing necessary support and consultation following violence are essential.

BACKGROUND: Hope is an important factor in the recovery of cancer patients. Few Iranian studies investigated the level of hope in cancer patients. Therefore, the present study aimed to investigate the level of hope in Iranian cancer patients and the related factors.METHODS: In a descriptive correlational study, 150 cancer patients were selected by a consecutive sampling method. Hope in patients was measured by the Herth Hope Index. Data analysis was performed using descriptive and inferential statistics.RESULTS: Results indicated that 61.1% of the patients had high levels of hope, 35.4% had moderate levels of hope, and 3.5% had low levels of hope. Hope has a statistically significant relationship with family support, but it is not statistically associated with other patient characteristics.CONCLUSIONS: Many cancer patients had a high level of hope. However, further studies are recommended to investigate the relation between hope and patient characteristics.

BACKGROUND: Chronic nature of thalassemia causes changes in different aspects of life in patients, including their quality of life. Because of the important role of family in caring for children with thalassemia, this study was done to evaluate the effect of family-centered empowerment model on quality of life of the children aged 6-12 years with thalassemia in Kerman Thalassemia Center.METHODS: The present experimental study was carried out on 86 thalassemic children aged 6-12 years who were randomly divided into case and control groups. Data collection tools consisted of demographic and general quality of life questionnaires in children that included physical, emotional and social aspects in addition to school functions. The questionnaires were used after determination of content validity and reliability by internal correlation method. This model was performed in test group according to four steps (threat perception, problem solving, educational participation and evaluation). Quality of life was measured 1.5 months after the intervention.RESULTS: The results showed that the average quality of life of thalassemic children before the intervention was 26.23 in test group and 27.62 in the control group and they were not significantly different (p>0.05). However after performing the model, the average quality of life in the test group reached 35.19 while it was 28.02 in control group and the observed difference was statistically significant (p<0.05).CONCLUSIONS: According to the impact of this model on quality of life in thalassemic children, it is recommended that evaluating the effectiveness of this model should be considered in further studies of other ages and other chronic diseases.

BACKGROUND: Breast cancer is the first-rank malignancy in women. Although surgery is the most common method of treatment, patients experience many threats both from the cancer and from the surgery itself. Exercises such as walking can improve body mass index, attitudes and life quality of patients. The aim of the present study was to determine the effect of walking on physical aspect of quality of life (QOL) in mastectomy patients in 2007.METHODS: Thirty four mastectomy patients took part in the study. Walking was performed in a flat surface 3 times a week, each lasting 30 minutes over 6 weeks. Data were collected by a questionnaire before and after the intervention and a selfreport form. After identifying content and face validity of the questionnaire, its reliability was measured by Cronbach’s alpha (α=0.89) and test-retest (r=0.91) methods.RESULTS: Mean scores (standard deviations) of physical, psychological, social, economic and religious aspects of QOL before the intervention were 64.55 (8.10), 78.89 (5.81), 52.89 (10.74), 64.92 (8.64) and 64.76 (9.59), respectively. These aspects were 79.06 (25.62), 68.63 (16.29), 73.28 (15.32), 79.96 (12.57) and 82.54 (11.18) after the intervention, respectively.Total mean scores of QOL before the intervention was 66.16 (6.30) and increased to 75.74 (6.59) after the intervention with a significant difference in all aspects except the religious aspect. Therefore, this study showed the positive effects of walking on QOL of mastectomy patients.CONCLUSIONS: Patients with breast cancer experience physical as well as psychological malfunctions and fatigue during the condition and its treatment. Walking can solve many of their problems and, ultimately, improve their QOL.

BACKGROUND: Irregular population growth is considered as a serious threat to the international community and is also a major obstacle for nations’ social and economic development. Thus, one of the ways to have a healthy community is to control the population and provide safe and effective contraceptive methods. Hormonal contraceptives are the most effective method of birth spacing. The present study aimed to determine and compare satisfaction from hormonal contraceptives including depot medroxyprogesterone acetate(DMPA), Cyclofem and LD in women referred to selected health care centers of Isfahan in 2010.METHODS: This was a descriptive-comparative study with cross-sectional data collection method from 26 April 2010 to 28 October 2010. Simple non-probability sampling was used to select 150 individuals (divided into three groups of 50) among the females who referred to 8 selected health care centers in Isfahan to receive DMPA, Cyclofem, or LD for the first time, and/or those who had used contraceptives for three months. To assess satisfaction rate and its related factors, the standard ORTHO Birth Control Satisfaction Assessment Tool (BC-SAT) was completed three months after medicine consumption through interviewing. Data was analyzed using descriptive and inferential statistics (Fisher’s exact, chi-square, ANOVA, and LSD tests).RESULTS: There were no significant differences in terms of mean score of satisfaction between the three groups. Cyclofem (192.2) and DMPA (188.1) gained the highest and lowest mean satisfaction scores, respectively. Although the mean satisfaction score in areas of ease of use/appropriateness, interference in menstruation pattern, acceptance and continuation of the method had significant differences in three groups, no statistically significant difference was observed in lifestyle, confidence to the method, side effects, concerns about future pregnancies and total satisfaction.CONCLUSIONS: Generally, there was no difference in satisfaction from the three studied hormonal contraceptives.

BACKGROUND: One of the essential components of learning and educational program is evaluation or examination. There are various methods for evaluating clinical skills among which objective structured clinical examination (OSCE) has been recognized as the most reliable method for evaluation of the clinical skills.METHODS: This was a one-step single-group descriptive study which was conducted through a researcher-made questionnaire.RESULTS: Results indicated that the view of most of the students in OSCE test has been good in terms of equipment and facilities with relative frequency of 59.2 percent, conditions of holding the examination with relative frequency of 50.9% and total test with relative frequency of 55.1%, in terms of physical environment, students’ view was moderate with relative frequency of 469%.CONCLUSIONS: The results of the study showed that appropriateness of physical environment and equipment and facilities to hold OSCE can directly be involved in enhancing the quality of this test.

BACKGROUND: Along with emersion of the Internet, virtual education increasingly has been growing. Many studies discussed this method and its impact on learning. Present study investigated students’ attitude towards virtual education as well as its effect on learning.METHODS: This was a pretest-posttest quasi-experimental study. The nursing students, who had selected fluids and electrolyte disorders course, were randomly divided into two virtual and conventional education groups. The knowledge of students was assessed through a written exam and students’ attitude towards virtual education assessed by a researcher-made questionnaire.RESULTS: Mean scores of students in pretest were 0.8 (0.3) and 1.1 (0.59) in virtual and conventional group respectively [mean (SD)]. At the end of the semester their scores were 15.9 (0.58) and 16.51 (0.89) respectively. Mean attitude scores at baseline were 3.19 (0.48) and 3.21 (0.33) followed by 3.55 (0.45) and 3.21 (0.46) at the end of the semester in virtual and conventional groups respectively.CONCLUSIONS: Although the scores of conventional group at the end of the course were higher than virtual group, both methods acted similarly in terms of increasing the knowledge. Passing a virtual education course may improve the attitude of the nurses towards it.