Journal of Shahid Sadoughi University of Medical Sciences
Year:2003 | Volume:11 | Issue:3 SUPPLEMENT (SPL ISS 2, NURSING AND MIDWIFERY)|Papers Count:17

Evidence Based Nursing »EBN« is the process by which nurses make clinical decisions using the best available research evidence their own clinical expertise and patient performance. Nursing research began to focus on »EBN« in the mid 80, s. The » National Institute for Nursing Research »and« The International Society for Nursing Research« have stressed the use of »EBN«. Three models for research utilization in nursing which serve as a foundation to understand »EBN« are: The conduct and utilization of research in a nursing project, the Stetler model and the Lowa model. Because most of the »EBN« literature focuses on quantitative methods, it is important to think about qualitative study. It is very important to consider criteria for critical appraisal of qualitative studies and the barriers to the use of »EBN« by nurses.

Burns are tragedies that occur every day and are one of the main health problems of the world today. Dressing of wounds and debridement are the most stressful, painful phenomena after burns. Therapeutic massage is an effective non-pharmaceutical method for controlling pain, but it has not yet been considered in burn patients. This present study was done with the purpose of studying the effectiveness of therapeutic massage on levels of pain and anxiety in burn patients before dressing of wounds. 35 patients admitted since 4 days at Shahid Sadoughi Burn Hospital in Yazd were randomly selected and divided into two groups;case and control. For the subjects in the case group, therapeutic massage was performed before dressing of the wounds and a questionnaire for assessing the pain and anxiety of patients was completed immediately after dressing of the wounds. The result of this study showed that massage before wounds resulted in decrease of pain and anxiety in the patients. It is therefore recommended that therapeutic massage be performed for burn patients and future researches are required to be done for studying the effectiveness of therapeutic massage on other parameters too.

Blood pressure measurement is one of the most common tools for the diagnosis of health problems and it has, by itself, been used in treatment decisions for patients with hypertension. Suitable diagnoses and optimal treatment of hypertension depend on the accuracy of measurement by physician and nurses. Numerous factors influence an individual’s BP measurement, one of which is body position. The aim of this study was to determine the effect of leg position on the blood pressure. Blood pressure measurement in 158 healthy persons was compared in two different leg positions. At first, blood pressure was measured while the subjects were sitting on the chair and their feet were flat on the floor (Normal position). After 3minutes,the blood pressure was measured again with the subjects leg crossed at the knee(research position).All of the blood pressure measurement methods carried out were based on a standard check list. The results were analyzed using SPSS. It was revealed that the mean systolic blood pressure in normal position was109.17, while in the research position it was 113.40. The T-test with mean difference (-3.87) showed a significant difference between the mean systolic BP in normal and research positions (p<0.001) Also, the mean diastolic BP in normal position was 69.70 and in the research position, it was 73.15. The t.test with mean difference (-3.44) showed a significant difference between the mean diastolic BP in normal and research positions (p<0.001). Other results showed that BP increased with increase in   age and there was no difference between the BP of single and married people, but BP in females was higher than in males (p<0.001).Considering the obvious difference in BP in the two leg positions, it would be better to measure the blood pressure in the sitting position with both feet flat on the floor. By educating patients (those who measure their own BP at home) about the proper techniques of blood pressure measurement, we can decrease the rate of errors during BP measurement.

Thalassemia is responsible for undesirable negative effects on individuals, families and society as a whole. The aim of this study was to evaluate the behavioral patterns of mothers with children suffering from thalassemia. 61mothers of thalassemic children referring to the hospital were evaluated using a specially formatted questionnaire. Results showed that the mean number of pregnancies was 4.61 and the mean number of children was 4.5.Nearly 67% were not aware about their own or their husbands carrier status. A significant statistical relationship was observed between the level of literacy and the total number of children, age at marriage and number of affected children .It is concluded that the behavioral patterns of these women is not successful in preventing birth of thalassemic children .A very important point is that none of these women were successful in preventing birth of thalassemic children. It is very important that all those in contact with this group of individuals, including doctors, nurses and midwives should try to increase their educational & awareness levels and bring about a change in their attitude towards fertility behaviors.

Coronary diseases are one of the most important diseases in the world and coronary angiography is the most important diagnostic test. In this semi-experimental study, the effectiveness of two methods of pressure bandage and sand bag in reducing local complications was studied. The level of pain was measured 2.48 hrs post – angiography, while the bruise extent was measured 6&48 hours post angiography. The amount of bleeding was also measured. Results showed that the average amount of bleeding 2 and 4 hours after angiography was less in the bandage group. There was no significant difference in the extent of bruising, but the amount of pain was significantly lower in the bandage group. It is therefore concluded that using pressure bandage after angiography is better as it significantly reduces pain and bleeding in the patients.    

Diabetic foot is one of the late complications of diabetes. As a multifactorial disease, factors such as diabetic neuropathy, structural deformity, wound infection and peripheral vascular disease are involved. Self-care implementation and preventive practices have an important role in reduction of its complications. The aim of this descriptive practical study was determination of feet self- care status in diabetic patients referring to Yazd Diabetes Research Center between August 2001 and February 2002. A total of 231 patients were entered in the study and they completed the self- care practice questionnaire which included some demographic questions and self-care practice status.  They also had a face to face interview. The results showed that majority of the patients had no educational history and the practice of self- care was not implemented in a significant number of patients. There was a significant relationship between the educational level and self-care status. History of education about self- care had a significant effect on self-care practice status.    

Nowadays, Chronic Renal Failure (CRF) is considered as one of the common diseases of mankind. CRF threatens the well being and health of patients. One of the main stressors that the patients with CRF may experience is the continuous and permanent treatment with dialysis. Also, as the treatment takes time and is invasive, patients frequently lose their jobs. The main objective of this descriptive study was to evaluate the relation of coping strategies with psychological complications in hemodialysis patients. A total of fifty – five patients were randomly selected and the information was collected using a questionnaire and a standard from of  SCI90. The results showed that there was a significant correlation between coping methods of escape and depression, aloofness and aggression, pickiness nature, depression and sensitivity.(p< 0.05). Therefore, a significant correlation exists between psychological complications and coping methods.

The purpose of this descriptive survey was to compare the efficacy of povidone iodine and 70 % Ethyl alcohol for sterilization of the skin before veni puncture in obstetrics and surgical units of Faghihi hospital. For this purpose, sixty four subjects (32 men, 32 women) were randomly selected by the required criteria. Collection of data was conducted according to the sociodemographic information and specimens were obtained for cultures before and after sterilization. The povidone iodine swab was more efficient than the alcohol swab; the former yielded an 85. 7%sterilization rate, whereas the latter resulted in a rate of 79.6%. Bacillus spp (non pathogenic) was the predominant organism after either swab. Other organisms, including staphylococcus aureus and epidermidis, however, grew after alcohol but not after povidone iodine sterilization. Although, there was no statistically significant difference between the use of alcohol and povidone iodine (z2 =1.31, p=0.19), the outcome of this comparison was clinically significant.

Cardiovascular system is one of the most sensitive systems of the body which changes blood pressure and heart rhythm immediately after any environmental or emotional changes such as stress, anxiety, fear, fury or happiness. One of the major sources of stress for patients with acute myocardial infarction (AMI) is the stress resulting from hospital discharge. It is therefore important that transfer and discharge of the patient takes place in completely safe and relaxed conditions and methods should be applied to encounter the bad effects of stress. Furthermore, tools for assessment of stress resulting from discharge of patients with AMI from hospital should be applied to make the patient ready for dealing with that stress. This research was a semi-experimental study with the aim of studying the effect of AMI Benson’s Relaxation technique on hemodynamic parameters and discharge time stress in AMI patients hospitalized in the CCU ward, Shahid Rajaei Heart Hospital, Tehran in 2002. In this study, a sample volume of 60 patients with AMI were studied in two groups; case and control. Tools for gathering information comprised of sample specification slips, observations & registration of hemodynamic parameters .Tools for assessment of intensity in two reports related to the amount of chest pain and the extent of relaxation. After providing for necessary readiness on the first day, Benson’s relaxation tape was recorded with the researcher’s voice. On the second day, it was given to the patients with a headphone for relaxation at due hours and their vital signs were assessed four times a day for a period of nine days. Then, utilizing variance analysis, repeated measurement, independent T, Chi – square, and Fisher exact were tested. Results reflected that in the two groups of case and control, hemodynamic parameters (radial pulse, Apical pulse, blood pressure , mean arterial pressure , pain intensity, and ventricular extra systole , PVC in minute ) showed meaningful difference from statistical point of view . (p<0.05). But, in general, mean decrease in the aforesaid parameters was more in the case group as compared to the control group. Also , the amount of stress mark for discharge time of patients with AMI showed a decrease in case group in comparison with the control group , (p<0.001) . It is therefore suggested that Benson’s Relaxation technique should be considered in the care plan of patients for betterment of hemodynamic parameters, decrease in pain and stress attenuation for the discharge time from the very first day the patients with AMI are hospitalized in the cardiac care unit.

This cross sectional study was performed to evaluate the levels of professional self-concept in the nursing staff employed at the hospital of Kerman University of Medical sciences. 520 nursing staff were asked to complete a questionnaire (Ar thusrs ) which consisted of 26 specially formatted questions. Results showed that most of the participants had a positive attitude towards their profession. Age & type of job, work experience and level of education had a significant relationship with the level of self concept, while sex and marital status did not show a significant relationship.

Aging is a physiologic process and urinary incontinence is one of the most common diseases and problems in elderly period that is related to pelvic muscle weakness and leads to physical, financial, social and mental complications. This study was a quasi – experimental study that was performed with the aim of studying the effect of pelvic muscle exercises (Kegel) on urinary incontinence in 30 patients hospitalized at Gharazi & Emam Reza hospital. At the first visit, a comprehensive medical history, physical examination, diagnostic tests (U/A, U/C etc.) and genital examination were done by the researchers and hospital nurses and a questionnaire was completed for each patient. Then, they were educated about pelvic muscle exercises using pictures and a pamphlet. These exercises consisted of a series of 5 second contractions followed by 10 second relaxations to be performed 60 times a day (40 days). They were assessed weekly. At the end of the therapeutic program, the questionnaires were completed again.  The results showed that 66.6% of patients were male and 70% of them were in the 50 to 70 years age group. The most common signs were urgency, involuntary wetting on sneezing and wetting themselves before reaching the toilet. These signs decreased in the post education period. This difference was significant from the statistical point of view (p<0.05). Results showed that pelvic muscle exercises can be one of the most effective therapeutic methods for treating urinary incontinence patients.

The aim of this descriptive, analytical study was to compare two clinical methods (uterine fundal height multiplied by abdominal girth and Johnson’s Rule) for estimation of fetal weight in women who referred to Fatemieh hospital in Hamadan for delivery in 2000. In this study, 100 primipara and 100 multipara with normal pregnancies were chosen randomly. Measurement of the uterine fundal height multiplied by abdominal girth and Johnson’s Rule predicted the ‘large for birth’ neonates with a sensitivity of 83.3% & 66%, and specificity of 86.5%&86%, respectively. In prediction of ‘low birth weight’ neonates, the fundal height multiplied by abdominal girth and Johnson’s Rule showed sensitivity of 38.4% & 15.3% and specificity of 96.2% & 97.3% respectively. According to the results obtained, uterine fundal height multiplied by abdominal girth was better than Johnson’s Rule for estimation of fetal weight .The fundal height multiplied by abdominal girth has thus been found to be useful as a screening method for detection of abnormal size at birth.

Client satisfaction must be regarded as one of the most important baselines in the health system. Maternal satisfaction during delivery care is an important factor in family and society psychological health. This clinical trial was accomplished with the objective of surveying the effect of continuous professional support on the maternal satisfaction from the delivery experience. In this clinical trial, 62 healthy primigravida with full term pregnancy and healthy fetus who had no stressful event in the last 6 months , no difficulties with their husbands, and no education about delivery were assigned in two groups. In the experimental group, continuous professional support was given from admission until the second stage .The Control group only received routine cares 24hours after delivery. The interview forms were completed for assessing the satisfaction levels and knowing their view points from the delivery experience. Results showed that the experimental group had more satisfaction than the control group (p = 0.011) , and these mothers had more satisfaction (p=0.019) .Also, most of the mothers in the experimental group expressed that labor was much easier than what they had expected (p=0.0001),and they were also satisfied with breast feeding (p<0.014).Continuous professional support during delivery can thus have a noticeable effect on the level of maternal satisfaction. We therefore suggest one–to– one continuous professional support by midwifes for all women in labor.

The purpose of this study was to investigate the mental health of nursing students studying at Fatemeh college of Nursing and its effect on their academic achievement. Subjects consisted of 306 full-time undergraduate students [248 female and 58 male].The subjects were assessed by a demographic & general health questionnaire and total average of their grades. The results revealed that 25.8% of subjects had good mental health, 49.3% were average, while 24.8% had an unsuitable mental health. Also, the result revealed that 45.9% of subjects had a feeling of worthlessness and 13.4% had thought about suicide during the last month. There was a significant difference between total average of grades of the group with good mental health and the grades of those whose mental health was unsuitable (p=0.032).