Nursing And Midwifery Journal
Year:2020 | Volume:18 | Issue:8 (133)|Papers Count:8

Thyroid hormones are essential for normal development of fetus. After birth changes in thyroid hormone enable the neonate to be adapted for postnatal life. Accordingly, attention to the level of neonatal thyroid hormones at birth is important. Several maternal and environmental factors influence this adaption. Various studies have shown the association of different neonatal, maternal, and pregnancy-related factors with TSH in neonates. This review study was performed to investigate the relationship between delivery mode and labor pains with neonatal thyroid hormone levels at birth. In this narrative review, the PubMed, Web of Science and Scopus, as well as SID, Irandoc, and Magiran (Persian databases) were searched with appropriate keywords for the English and Persian related articles. In this narrative review that was conducted up to December 2019, of 67 records retrieved through primary searching databases, 14 eligible studies were evaluated. The majority of the studies (9 studies out of 13 studies) revealed that vaginal deliveries (instrumental or natural) lead to higher levels of cord TSH compared to elective cesarean section. It seems that stress during vaginal delivery may lead to elevated TSH in cord blood. These adaptations may act as a stimulus for rising the thyroid hormones in the first hours after the birth of neonates. This assumption needs to be evaluated by further comprehensive well-designed studies.

Background & Aims: The relationship between obesity and reproductive function is well known and the obese women have no response to usual treatment and need assisted reproductive technique (ART). In this study, the pregnancy outcome of women resistant to Clomiphene Citrate (CC) with different BMI was evaluated in IUI cycle. Materials & Methods: This cross-sectional study was conducted on 107 infertile CC-resistant women who were referred to Babol Infertility Center and were candidate for IUI. Patients' BMI was classified as normal, overweight, and obese. All women received CC 100 mg from the third day of menstruation. It continued with HMG 75mg for three days and more according to the size of follicles, and then IUI was performed. The relationship between different BMI groups with IUI outcome was examined. The p-value <0. 05 was considered significant. Results: The mean age of the subjects was 25. 5 ± 3. 5 years and the mean duration of infertility was 4. 8± 2. 1 years and the mean BMI of the subjects was 28. 7 ± 3. 7. About 37% of the patients underwent CC + HMG. The overall pregnancy rate was 24% (24). There was no significant relationship between the number of pregnancies and the BMI classification. There was a significant relationship between infertility type (primary or secondary), regular or irregular menstrual cycle with BMI (p = 0. 002 and p=0. 004, respectively). Conclusion: Positive IUI outcome was compared in the different classifications of BMI; however, a significant relationship was observed between the irregular menstrual cycles and primary infertility with BMI classifications.

Background & Aims: One of the important aspects of the health system reform plan is the protection of households and patients against medical expenses. They suffer from the financial burden of paying for medical expenses, as well as their illness. This study aimed to estimate the out-of-pocket payment of patients for medical expenses in Urmia in 2017. Materials & Methods: In this descriptive-analytical study, to estimate out-of-pocket, data were collected in three stages from 400 households who were selected randomly from the four main health care centers in Urmia. Data were gathered through questionnaires and interviews with the head of the household, hospital records, insurance organizations, and medical tariffs, and were analyzed using SPSS software version 16. Results: According to the results, the average amount of out-of-pocket direct payment was calculated to be 53. 07%. Basic insurance, supplementary insurance, and self-treatment were allocated 32. 79%, 11. 17% and 2. 94% of total treatment costs, respectively. Conclusion: The results of the study and comparisons with pre-implementation health reform plan studies showed that this plan is very successful in the inpatient area and the OOP rate is significantly lower than the designated target; but in the outpatient area, the plan is not successful, mainly due to the high costs in the dental services sector and the lack of support by insurance organizations.

Background & Aims: Today, the elderly population is on the rise, and incurable and chronic diseases such as osteoarthritis are one of their main problems. On the other hand, some high-risk health behaviors, such as smoking, are also common among the elderly. Given the role that social support can play in controlling chronic diseases and high-risk health behaviors such as smoking, the present study aimed to determine social support and smoking in the elderly patients with osteoarthritis. Materials & Methods: This cross-sectional study was performed on 384 elderly patients with osteoarthritis who were referred to the clinics of Tabriz University of Medical Science. Sampling method was two stages cluster sampling. After completing the questionnaires, the data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation) and analytical statistics (independent t-test) by SPSS16 software. Results: The results of the present study showed that 16. 8% of the elderly with osteoarthritis were smokers and 83. 2% of the elderly with osteoarthritis were non-smokers. The rate of social support (family and others) in the non-smoker elderly with osteoarthritis was higher than smoker elderly and among different dimensions, the highest rate was related to family support. Conclusion: Due to the higher rate of smoking in the elderly with osteoarthritis and the important role of social support, especially family support, the importance of supportive social communication for families should be clarified through educational interventions to reduce the prevalence of smoking.

Background & Aims: Adherence to standards in neonatal care, especially in the operating room and immediately after cesarean section, is essential to prevent neonatal complications, reduce costs, and length of hospital stay. The purpose of this study was to evaluate the standards of care of newborn infants by operating room technologists. Materials & Methods: This was a descriptive and cross-sectional study conducted on 212 staff members of the operating room of Isfahan University of Medical Sciences in 2019. In this study, three steps of evaluation (preparation of standards of care, determination of existing status and comparison with standards) were considered. The questionnaire consisted of 3 parts including operating room processes (before, during and after cesarean section), postpartum room processes, and maternal and neonatal room processes. Results: The results of this study showed that the operating room nurses' compliance with care standards was 79. 24% at optimum level, 87. 73% at moderate level, and 8. 49% at undesirable level, and zero% at low level. Conclusion: The present study showed that surgical technologists do not apply newborn care standards completely, so training classes and tests conducted in accordance with up-to-date protocols regarding infant care standards are necessary not only for nurses and midwives but also for operating room personnel who are in direct contact with infants who were delivered via cesarean section.

Background & Aims: Support services are the key element in the lifecycle of information systems and their effective use by users. In fact, proper support services can increase the reliability, security, and cost-effectiveness of the information system and ensure the success of implementation and user satisfaction. The purpose of this study was to evaluate users' perceptions of the quality of support services provided by hospital information systems in the educational and treatment centers of Urmia University of Medical Sciences. Materials & Methods: This is a qualitative study that was conducted in 2020. The study population included HIS users in the educational and medical centers of Urmia University of Medical Sciences who were selected using purposive sampling. Data were collected through semi-structured individual and face-to-face interviews. Data analysis was performed through content analysis using MAXQDA software. Results: A total of 19 HIS users from different job categories were interviewed. The content analysis results of these interviews showed that the most important support services of HIS vendors include: fixing system technical problems, meeting new user needs, training on how to use the system, updating and upgrading the system, protecting information confidentiality and system security, as well as the skills and competence of company support staff. Conclusion: Hospitals should carefully evaluate the quality of support services after the implementation of HIS from the perspective of end-users and focus on issues such as providing proper and timely support services, prioritizing user problems, considering new hospital needs, and upgrading HIS and maintaining system security by HIS vendors.

Background & Aims: Breast cancer is the most common cancer in women worldwide. Illness perception is an important issue that affects cancer control and management. The aim of this study was to determine the illness perception and its predictors in women with breast cancer undergoing chemotherapy and radiotherapy. Materials & Methods: This cross-sectional study was conducted on 190 women with breast cancer who were referred to the oncology centers of Arak, Iran, for chemotherapy and radiotherapy. Participants were recruited using convenience sampling method from September 2017 to May 2018. Data were collected using demographic and disease characteristics questionnaires, and Illness Perception Questionnaire. Data were analyzed using SPSS ver. 24. The one-way ANOVA, independent t-test, Pearson correlation coefficient, and multivariate linear regression were utilized. Results: The mean (standard deviation) score of illness perception was 38. 9 (13. 1) (range from 0-80). There was no significant difference in terms of illness perception between patients in the chemotherapy and radiotherapy groups (p>0. 05). The type of breast disease and the last time the cancer diagnosed, spouse’ s age were predictors of illness perception. Conclusion: Due to the passage of time from the diagnosis of the disease, the intensity of illness perception and the resulting stress decrease, so more psychosocial and social support is required to adjust the breast cancer at early stages of the disease.

Background & Aims: One of the occupational hazards and serious concerns among health workers is the damage caused by sharp objects and contact with discharge. It is one of the main elements in employees' feelings, abilities, and performance skills. Therefore, the aim of this study was to determine the effect of staff performance skills training on exposure to sharp objects and medical discharge in nurses working in emergency departments. Materials & Methods: In this quasi-experimental study, 90 emergency nurses of Khoy were completely counted in 2019 and then randomly divided into two groups: intervention and control. The intervention group consisted of 42 nurses working in the emergency department of Imam Khomeini Hospital and the control group included 48 nurses working in the emergency department of Qamar Bani Hashem Hospital. The nurses of the intervention group were divided into four groups based on the shift and working time of the nurses and were trained in 3 training sessions based on the model of self-awareness and empowerment in the amphitheater of Imam Khomeini Hospital. To collect information, the questionnaire was used before and after the intervention. The collected data were analyzed using SPSS software version 20 and non-parametric Chi-square tests. Results: Based on the findings, there was no statistically significant difference between the two groups with regard to sharp objects and secretions before the training program (p = 0. 647). After the implementation of educational skills programs based on the model of self-awareness and empowerment, there was a statistically significant difference between the two groups (p = 0. 024) and in the intervention group the rate of the exposure decreased. Conclusion: Research findings showed that the implementation of operational skills training programs based on self-awareness and empowerment development models allows nurses working in other departments to continue with your new components and their discharge. . It is recommended to use training programs in order to reduce and manage exposure to sharp objects in health care systems.