Nursing And Midwifery Journal
Year:2021 | Volume:19 | Issue:2 (139)|Papers Count:8

Background & Aims: Hemodialysis is the most common treatment for patients with chronic renal failure and one of the problems reported in these patients is their non-adherence to diet and fluid restriction. This study aimed to determine the effect of teach back method training on dietary adherence and fluid restriction in hemodialysis patients. Materials & Methods: In this study, 60 patients undergoing hemodialysis referred to Urmia teaching hospitals in 1399 were randomly assigned to the control and intervention groups. In the intervention group, in addition to routine training, the patient was given feedback-based training in two areas of diet and fluid restriction during 3 sessions for 45 to 60 minutes. The control group received only the usual training in the ward. Data collection using demographic questionnaire and adherence to treatment of patients with end-stage renal disease (ESRD-AQ) subscale of diet and fluid restriction in three stages: pre-test, post-test (7 days after intervention) and follow-up (30 days Was performed after the intervention. Data were collected using SPSS software version 16, Chi-square, independent t-test, repeated measures analysis of variance tests. Result: There was a significant difference between the intervention and control groups in the mean score of fluid restriction (P <0. 001). This means that at first the means of both groups were almost the same. In the control group, the means were almost similar during the following times and did not change significantly with each other, but in the intervention group in the following times, the mean score of fluid restriction increased and also the mean scores of compliance with fluid restriction in each intervention group. The two stages of post-test and follow-up were significantly higher than the control group (p = 0. 001). There was no significant difference in the mean score of diet adherence between the intervention and control groups (P <0. 01). Conclusion: The present study showed that teach back method education has a significant effect on adherence to fluid restriction in patients undergoing hemodialysis, but has no effect on adherence to the diet of these patients. It is suggested that nurses working in hemodialysis wards increase patients' perception of their disease by increasing the number of teach back-oriented training sessions and as a result can play an important role in self-care of hemodialysis patients and their adherence to diet and fluid restriction.

Background & Aims: Nowadays, obesity and overweight due to unhealthy foods and inappropriate lifestyle in adolescents has a significant effect on the quality of sleep and psychological state in students. This study aimed to investigate the role of body mass index on the mental health of female high school students in Tehran in 2019. Materials & Methods: This descriptive study was conducted in 2019. Based on the inclusion criteria, 270 students were selected randomly. Data were collected using a three-part questionnaire including demographic information and psychological health (SCL-25). Data were analyzed by SPSS-24 using descriptive and analytical statistics (ANOVA). Results: Based on the findings, 60 percent of students had normal weight and 3. 3 percent were obese. In addition, most adolescents had mild problems with most of the criteria for assessing psychopathology. The highest percentage of adolescents (46. 7) had mild problems and the lowest percentage (6. 7) had no problems in the field of phobia. Finally, studies showed that there is a significant relationship between body mass index and phobia disorder in adolescents. Conclusion: Obesity can affect the mental health of adolescents such as physical complaints, depression, anxiety, and paranoid thoughts. It is necessary to take basic measures and plan to improve the lifestyle and nutritional patterns as well as to improve the mental health of students.

Background & Aims: The progressive nature and chronic complications of diabetes provide complex conditions that require special attention to change health behaviors, including self-management, and achieving it requires the use of valid instruments. The aim of this study was to translate and assess the psychometric properties of the diabetes self-management questionnaire-Revised form (DSMQ-R). Materials & Methods: This psychometric evaluation of the “ diabetes self-management questionnaire-Revised form” used a methodological study design. Using convenience sampling, a total of 180 patients with type 1 and type 2 diabetes from the Diabetes Association and two teaching hospitals in Urmia entered the study. The original version of the Diabetes Self-Management Questionnaire-R was translated from English to Persian language using the Backward-Forward translation method. The validity of the instrument was determined by assessing face validity, content validity, and confirmatory factor analysis. Reliability of the instrument was reported by the Alpha Cronbach coefficient. The SPSS (v. 16) and LISREL were used to analyze the data. Results: According to the results of confirmatory factor analysis, all of the factor loading items were significant and the 4 subscales of the original instrument were verified with acceptable scores. The internal reliability of the total scale was determined by the alpha Cronbach coefficient (0. 88) and it was 0. 66-0. 85 for the subscales. Conclusion: The results of this study indicated that the Persian version of “ Diabetes Self-Management Questionnaire-Revised form” with 27 items is a valid and reliable instrument and it can be used as a reliable instrument in patients with diabetes.

Background & Aims: The application of qualitative methods is developing in different fields including the health science. One of the challenges for hermeneutic researchers is the issue of trustworthiness. Given that these studies do not target external reality in their process, traditional criteria to show the correspondence to reality have been reported as controversial. The current study aims to review the challenges of these criteria and introduce exclusive strategies corresponding to hermeneutic studies. Materials & Methods: Using the related keywords, English papers were searched in “ Google Scholar, PubMed, and Web of Science” in June 2020 and the sources were extracted. Having reviewed the abstracts and the full texts, 13 articles directly related to the subject under study were selected. Moreover, another set of 12 pieces of related literature were added by referring to other sources such as the related citations. The collected data were analyzed using a critical review approach. Results: Data analysis demonstrated differences in the suggested methods for trustworthiness in hermeneutic studies. Although some references indicate that application of “ credibility, dependability, transferability and confirmability” is possible in hermeneutics, the difference in theoretical and methodological frameworks have resulted in the introduction of new expressions such as “ balanced integration, openness, concreteness, resonance, and actualization” for trustworthiness in hermeneutics studies. Conclusion: No single criteria can be applied to assess trustworthiness in all qualitative methods. The application of general criteria for judging trustworthiness in hermeneutic studies has been reported as problematic. The present study results can assist researchers of qualitative inquiries particularly those engaged in hermeneutic researches to select appropriate criteria based on the research method. Although further scrutiny is needed, the criteria specifically compatible with hermeneutic studies such as those expressed by De Witt and Ploeg seem more appropriate than the traditional ones.

Background & Aims: The particular condition of retirement causes the elderly to experience it as a stressful life event of individual and social characteristics. One of the main challenges in retirement is the issue of quality of life (QOL). Therefore, the purpose of this article was to determine the predictive components of QOL among retired men in Urmia. Materials & Methods: In this descriptive-analytical study, 140 retired men living in Urmia were selected by cluster sampling method. The instrument used in this study was the Lipid quality of life questionnaire. Data were analyzed using SPSS v. 21 statistical software and descriptive and analytical statistical tests (mean and standard deviation, frequency and percentage, Pearson correlation coefficients, one-way ANOVA, and multiple linear regression) at the significance level of p <0. 05. Results: According to the results of this study, the mean and SD of total QOL was 71. 21± 10. 27. Also backward multiple linear regression model revealed that variables of life satisfaction, marital status, retirement length, and sleep disorder predicted 28. 8% of the variance of QOL. Moreover, age, marital duration, child's number, and education level were removed from the regression model. Conclusion: According to the results of the present study and other similar studies, it can be concluded that the negative factors in reducing the QOL among retired adults should be carefully identified and policymakers should try to develop appropriate programs to improve the QOL of retired older adults.

Background & Aims: Continuous evaluation is necessary to evaluate the achievement of goals and determine the quality of educational programs. Accordingly, the present study was conducted with the aim of designing, establishing, and validating the evaluation tools for the specialized doctoral course in medical education based on the CIPP model. Materials & Methods: This descriptive study was performed in 2019 at Isfahan University of Medical Sciences. In order to design the questionnaire, internal articles in the field of curriculum evaluation, the latest version of the CIPP model checklist, and general specifications of the medical education doctoral program approved by the Ministry of Health were used. By determining the indicators of each domain, questions were designed in four domains: context, input, process, and output. After designing a questionnaire and selecting 10 samples by stratified random sampling method from three groups of faculty members, students, and graduates and 5 managers of the Department of Medical Education, face and content validity by Lavshi method and content validity index based on Waltz method and Bassel were examined. Finally, the reliability of the questionnaire was estimated by performing on 30 target groups in Shiraz, Tehran, and Iran universities of medical sciences based on Cronbach's alpha coefficient. Results: Based on the indicators, 71 questions were obtained for group managers, 88 questions for faculty members, 42 questions for students and 40 questions for graduates. The CVR value was 0. 98 for the three groups of faculty members, students, graduates and 0. 99 for the group managers. The value of CVI in terms of simplicity, clarity, and relevance for group managers (0. 98, 0. 99 and 0. 98, respectively) faculty members (0. 98, 0. 98 and 0. 97), students (0. 97, 0. 98, and 0. 98) and graduates (0. 83, 0. 97, and 0. 98) were obtained. To evaluate the internal consistency of the questionnaire, Cronbach's alpha coefficient was used. The values of 0. 97, 0. 95, 0. 83, and 0. 81 were obtained for the questionnaire of group managers, faculty members, students, and graduates, respectively. Conclusion: According to the results of the present study, it can be said that the tools designed to evaluate the specialized doctoral course in medical education had the necessary validity and reliability and can be used to evaluate and identify the strengths and weaknesses of this course in Tehran, Shahid Beheshti, Shiraz, and Iran universities of medical sciences.

Background & Aims: Nurses are exposed to many stressors with different sources due to their job nature, which is very important to identify in different situations. Therefore, the present study was conducted to investigate the factors related to job stress in different work shifts of nurses working in hospitals affiliated to Shahroud University of Medical Sciences. Materials & Methods: In this descriptive-analytical study, 139 nurses from hospitals affiliated to Shahroud University of Medical Sciences were included by stratified sampling method. To collect data, demographic characteristics and Taft Gray and Anderson job stress questionnaires were used. Data were analyzed by SPSS software using T-Test and ANOVA statistical tests. Results: The mean and standard deviation of job stress of nurses were 85. 28 ± 19. 87 and the stress level of most nurses was moderate. The most stressful area was related to "conflict with doctors ". The highest level of job stress was observed in the dominant morning shift and a significant relationship was found with the area of "patient suffering" (p=0. 04). In other shifts, the area of " conflict with doctors" was the most stressful area. There was no statistically significant relationship between demographic characteristics and mean job stress score of nurses (p> 0. 05). Conclusion: The results of the present study showed that the stressors of nurses in different work shifts are in the area of "patient suffering and death" and "conflict with doctors". Therefore, stress reduction interventions among nurses are of great importance and should be considered in hospital planning and management.

Background & Aims: Condition management, improving the outcomes of health care, preventing further disability, and reducing the cost of health care are essential for people with chronic illnesses. Adherence to treatment is one of the key components in the management of chronic diseases. The aim of this study was to investigate the structural pattern of self-efficacy in coping with cancer through social support for adherence to treatment in women with breast cancer in lorestan. Material & Methods: The method of this study was descriptive and the research design was structural equation modeling based on correlation. The statistical population included all female patients with breast cancer who were referred to Shahid Rahimi Hospital for follow-up treatment and 300 of them were selected using the available sampling method. Then, they completed the self-efficacy of appropriate drug use, the Cancer Behavior Scale, and the Social Support Therapeutic Outcome Questionnaire. The research data were analyzed by AMOS. Results: There was a significant relationship between self-efficacy in coping with cancer and social support with adherence to treatment. The results of the structural equation modeling revealed a good fit of the model with the experimental data and the basic hypothesis of the research was approved. Selfefficacy in coping with cancer has a significant direct effect on adherence to treatment. Also, selfefficacy in coping with cancer through social support showed an indirect and significant effect on adherence to treatment. Conclusion: This study showed the effective role of social support in the outcome of social and individual measures to increase treatment adherence in breast cancer patients.