Journal of Multidisciplinary Care
Year:2018 | Volume:7 | Issue:1|Papers Count:9

Background and aims: Sensitivity to ethical issues is one of the criteria for human care of the patient and the professional competence of the nurses. In addition, promoting the principles of professional performance through emphasis on teaching ethical foundations is one of the ways to strengthen nurses' moral sensitivity. The current study was aimed to determine the effectiveness of nursing ethics training on moral sensitivity in nurses. Methods: The current research was a quasi-experimental study (using pretest-posttest and control group). The samples consisted of 30 nurses selected from among all nurses of Tabriz Madani hospital in 2014 using available sampling method and randomly assigned to experimental and control groups (15 individuals for each group). After completing the moral sensitivity questionnaire as a pre-test and completing a 4-session nursing ethics training (weekly 90-minute for one month) in the experimental group, questionnaires were completed in both groups as a post-test. Data were analyzed using analysis of covariance by SPSS. Results: Covariance analysis showed that nursing ethics training had a significant effect on increasing nurses' moral sensitivity in the experimental group compared to the control group (P=0. 001). Conclusion: The training of nursing ethics can increase nurses' moral sensitivity. So, this training method is recommended to enhance nurses' ethical sensitivity.

Background and aims: Nowadays, finger pulse oximetry has been used for continuous monitoring of oxygen saturation. However, finger pulse oximetry cannot be always applied on fingertips. In such condition, the same sensor of finger pulse oximetry on the ear could be applied for reading the oxygen saturation. Regarding the difference of ear and finger tissues and the fact that finger pulse oximeter has been designed for the finger structure; So, the present study was aimed to determine the precision of finger pulse oximeter when used at finger and ear among the patients who were under Vasopressor treatment. Methods: In this comparative descriptive-analytical study, 33 Vasopressor-treated patients in the intense care ward of Kashmar hospital were were selected based on simple and convenience and entered into the study according to inclusion criteria in 2016. Two finger pulse oximetry sensors were used; one was attached to the fingertip and the other on upper part of auricle. They simultaneously sampled arterial blood. The obtained data were analyzed by SPSS software through Spearman correlation and variance analysis tests on observation replicas. Results: The findings showed that there is a statistically significant difference between SpO2 of the ear (94. 03± 3. 79), fingertip (86. 81± 4. 82) and SaO2 (90. 88± 3. 65) in the Vasopressor-treated patients (P<0. 001). Also, there is a statistically significant relationship between oxygen saturation percent and the time of capillary refill. Conclusion: The results of this study demonstrated that in Vasopressor-treated patients, application of finger pulse oximetry on ear would lead to results that are more accurate on oxygen saturation as compared to its application on fingertip.

Background and aims: One of the common problems in patients undergoing lumbar disc surgery is pain, which leads to undesirable consequences in some patients. The use of analgesics is the most common intervention in relieving pain, which can have complications for the patient. Therefore, the use of non-pharmacological pain relief methods, such as foot massage, is used to reduce pain in patients. The aim of the current study was to investigate the effect of foot reflexology massage on pain of patients undergoing lumbar disc surgery. Methods: This interventional study was performed on 60 patients undergoing lumbar disc surgery, 2017. Patients after selecting, they were randomly divided into intervention and control groups. The intervention group from the second to fourth day after lumbar disc surgery and after at least 4 hours of receiving the last pain relief, foot reflexology massage for 20 minutes and 3 sessions (once a day). It was done by a physiotherapist trained the reflexology method. In the control group, only routine treatments continued. Also, once a day without applying any pressure on the points mentioned, both patient's feet oiled with baby oil that no odor and no color and no analgesic effect. Data were collected using a demographic questionnaire and VAS pain questionnaire. Data were analyzed using SPSS software, ANOVA, Chi-square, Independent t-test, and paired t-test. Results: The mean age of the patients in the experimental group was 59. 43± 8. 16 years in the age range of 44 to 77 years, the mean age of the control group was 57. 56± 9. 19 years in the age range of 39 to 77 years. The two groups did not differ significantly in age, sex and body mass index (P>0. 05). According to the results, in both groups, the intensity of pain after intervention, on the second, third and fourth day, significantly decreased. However, the mean in decreasing pain intensity in the experimental group was higher than the control group (P>0. 001). The mean pain severity after the intervention in the second, third and fourth days in the experimental group was significantly lower than the control group (P>0. 001). Conclusion: The findings of this study showed that foot reflexology massage significantly decreased the pain intensity of patients undergoing lumbar disc surgery, which it can be used as a branch of complementary medicine to reduce the pain of these patients.

Background and aims: The quality of service and knowledge transfer is very important in health sectors due to the specific atmosphere in health centers and the presence of nurses as the largest treatment group. In this research, the aim of the study was to investigate the effect of innovative organizational climate on the transfer of knowledge and quality of clinical services from nurses' point of view. Methods: This is a descriptive-survey study. The statistical population includes the nurses from Guilan province in 2016 that 350 nurses were selected as a statistical sample by randomization sampling. Three questionnaires innovation climate: 9 dimensions and 50 questions. Quality of services Questionnaire: 5 dimensions and 21 questions and knowledge transfer Questionnaire with 12 questions were used for collecting data. The reliability of the research tools was 0. 89 for the innovation climate, knowledge transfer 0. 89 and service quality 0. 88, respectively. Data analysis was carried out using structural equation modeling using smartpls 2 software. Results: The results showed that the atmosphere of innovation, service quality, and knowledge transfer with an average of 3. 4, 3. 3, and 3. 08 have a good status. Also, the atmosphere of innovation on knowledge transfer and service quality with path coefficients of 0. 67 and 0. 33 has a positive and significant effect. Conclusion: Improvement in the areas of innovation climate can help improve the quality of hospital services and knowledge transfer. Therefore, managers and decision makers in the field of health should consider these issues.

Background and aims: Quality of life is an important concept in how to play the role of nursing care. In addition, the performance and job satisfaction of nurses as components of the effective health systems to provide better services to clients are in a particular significance. The aim of this study was to investigate the effectiveness of cognitive-behavioral intervention on the quality of life, organizational performance, and job satisfaction of nurses. Methods: The current study is a quasi-experimental research with pre-test and post-test with control group. The first experimental group received cognitive-behavioral training and the second group without training is studied. Both groups response the pre-test and post-test at the same time. The population studied in this research study comprised nurses who were working in Tabriz hospitals in the second half 2016. The primary samples in this study were 205 nurses who were determined in convenience after the implementation of a pilot study. 40 nurses first with lower scores on tests were selected and divided into two experimental and control groups (each 20 people). Tools of the research were questionnaires of The World Health Organization Quality of Life, Paterson Organizational Performance, Berry Field and Ruth job satisfaction questionnaire and Content of the Sessions of Cognitive Therapy Group. Data were analyzed using SPSS software and multivariate covariance analysis test. Results: The results of the research showed that the education of cognitive-behavioral intervention on the variables of quality of life, job satisfaction and organizational performance nurses have a significant positive effect (P<0. 05). Conclusion: Regarding the effectiveness of cognitive-behavioral intervention training, it is recommended interventional programs for nurses be used in order to improve quality of life and increase job satisfaction and their organizational performance.

Background and aims: Pregnancy seems a pleasure time of women`s life, but this time considers as an experience of the high levels of stress. About stress and coping strategies, one of the important concepts is spiritual health. Therefore, the present study was aimed to predict specific styles of coping with stress during pregnancy based on spiritual health in pregnant women referred to health centers in Hafshejan. Methods: The study was a descriptive correlational research. The surveyed sample was 200 pregnant women referred to health centers in Hafshejan who selected by convenience sampling. For data collection, Spiritual Well-being (Paloutzian and Ellison) and Billings and Mouse questionnaires were used. Collected data were analyzed using Pearson correlation and multiple regressions tests. Results: The results showed that the mean age of pregnant women was 27. 68± 4. 75, the mean number of pregnancies in mothers was 1. 73± 0. 79, the mean pregnancy interval was 68. 22± 44. 17 and the mean number of children was 0. 71± 0. 73. Also, the results showed a positive significant linear correlation between spiritual well-being and coping styles (r=0. 457, P<0. 001). Multiple regression analysis showed that spiritual well-being was able to predict the coping styles with stress during pregnancy. Conclusion: Considering the positive relationship between spiritual health and coping styles during pregnancy, more attention of women's health care specialists on the methods to promote spiritual well-being is emphasized during pregnancy.

Background and aims: Self-esteem is a powerful and important factor in creating health, satisfaction and happiness, and is an important determinant factor of the coping capacities of women during labor and delivery. The aim of this study was to determine the effectiveness of group counseling on cognitive-behavioral approach on the self-esteem in primiparous pregnant women. Methods: This randomized clinical trial was conducted on 46 pregnant nulliparous women in one of the hospitals in Tehran. Women who were in the first pregnancy and had a self-esteem score of zero or less selected after taking written inform consent. Then, they were randomly divided into two groups in the intervention and control group. The intervention group participated in 7 sessions of cognitive-behavioral group counseling, while the control group received only the routine pregnancy care. Two weeks after the last session, the Rosenberg’ s Self-Esteem questionnaire was recompleted by both groups. Data were analyzed using descriptive (percent and mean) and inferential statistical tests (Wilcoxon test, Mann-Whitney, t-test and K2 and using SPSS. Results: The results showed that difference between mean age among women in the intervention group (28. 32± 3. 26), and the control group (25. 88± 4. 24) was significant (P=0. 035). The selfesteem scores mean of the intervention and control groups was (4. 77± 4. 07) and (-1. 79± 2. 26), which difference was significant (P<0. 001). Conclusion: It seems that cognitive-behavioral group counseling can increase the self-esteem of women during pregnancy. So, it is recommended to use counseling methods to improve the mental health of pregnant women in childbirth preparation classes.

Background and aims: In clinics, nurses spend most of their working shifts « hours with different if they do not follow the general principals of prevention, they will have greater share of transmission of infection to patients and others. Therefore, the aim of this study is determining the extent of contamination in nursing staff's jewelry and their level of awareness of using these objects in Shahrekord medical university hospitals. Methods: This study is a analytical discriptive study which was done on 220 nurses, who were selected by cluster sampling, in Shahrekord hospitals. For data collection, a questionnaire included demographic information and assessment of the level of awareness about the terms of using jewelries in clinical environments was used. The reliability of this questionnaire was obtained 0. 86 based on Cronbach's alpha, and confirmed. After that, the nurses' palms and the jewelry used by them were sampled and cultured in vitro. After 48-72 hours, the samples were examined and the data were analyzed by the use of SPSS Software and descriptive and inferential statistical techniques such as Cross tab. Results: The results of this study revealed that only 7 (3. 2%) of the participants did not use jewelry in the workplace. In the in vitro cultures from the jewelry used by participants in the study, Staphylococcus Epidermidis had the highest frequency and candida albikans had the lowest frequency. Also, the materials used in watches had a significant role in the level of microbial contamination but this relationship is not seen in other jewelry. (r=259. 84, P=0. 000). There is a relationship between the gender of the participants and the level of microbial contamination in the watches. (r=24. 913, P=0. 000) This relationship is more in women comparing with men. Although more than 75% of nurses have a good awareness of the abandonment of using the jewelry in clinical areas, yet the use of jewelry is at a considerable extent. Conclusion: The results of this study show that the hands and various types of jewelry used by nurses are contamined with various pathogens, while applying the defined professional principles for controlling infection is the most important principles of clinical programs. Therefore, the results of this study can be used by the managers of the hospitals to emphasize more desirably on the compliance of the rules and regulations for controlling of infection in clinical environments.

Background and aims: The conflict between values transforms a situation or problem into an ethical challenge. Due to high workload, nurses are frequently confronted with the ethical challenges and despite having different specialities, they are incapable of confronting ethical challenges. The aim of this study was to investigate ethical challenges in nursing profession. Methods: This is a review article that was done in 2016, data were collected by searching through online databases such as Scopus, web of science, PubMed, Iran medex, iranpsycho Magiran and SID with the keywords challenge, ethics, nursing with no time limit. 27 articles were included in the present study. Results: The results of the study were categorized into three categories: Ethics fundamental (autonomy, avoidance of Damage, Usefulness, equality), moral decision making (moral uncertainty, Moral distress, ethical tension), and ethical challenges (professional, communication and educational challenges). Conclusion: Sensitivity to ethical issues and challenges in the professional practice of nursing practice is vital and must be entered in training, clinincal and nursing research.