Nursing And Midwifery Journal
Year:2020 | Volume:18 | Issue:6 (131)|Papers Count:8

Background & Aims: One of the methods of training in nursing is telenursing. The most common use of telenursing is for home care. The purpose of this study is to determine the effect of telephone followup after discharge on symptoms, complications, and readmission in the patients after coronary artery bypass graft surgery in Hamadan. Materials & Methods: This quasi-experimental study was performed in 2019 on 70 patients after coronary artery bypass graft surgery in Farshchian Heart Hospital in Hamadan, Iran. Patients were divided into two groups of 35 and they were labeled as intervention and control groups based on random blocking. Patients in the intervention group received telephone calls weekly for up to 4 weeks. The follow-ups included postoperative symptoms and complication checking through questionnaires; additionally, necessary training instructions were given. Research tools included a demographic information checklist, readmission, and a cardiac symptom survey. Data were analyzed by SPSS 16 software, and descriptive statistical tests, paired t-test, and Mann-Whitney test were used for data analysis. Results: The results showed that there was a statistically significant decrease in symptoms and complications in the experimental group at the end of the fourth week (p <0. 001). Also, there was no significant difference in symptoms and complications in the experimental and control groups after one month, despite the decrease in the mean score in the experimental group (p <0. 05). There was no significant difference in postoperative readmission between the two groups, but the findings of the study showed that patients in the control group were hospitalized longer to improve the complications. Conclusion: Post-discharge telephone follow-up is effective in reducing the incidence of postoperative symptoms and complications of the coronary artery bypass grafting and it is recommended to use telephone follow-up as one of the training methods to provide services to patients.

Background & Aims: Although infertility is a medical condition, its dimensions and consequences go beyond the biological and physical realms and have psychosocial dimensions and consequences. This is especially important for women, given the socio-cultural requirements of Iranian society. The aim of the present study is to explore the psychosocial challenges of infertility from the perspective of Iranian women. Materials & Methods: The present study is of qualitative type and based on grounded theory. Data were collected through in-depth interviews with 33 infertile women referred to Milad fertility clinic and health treatment Center in Mashhad. The process of collecting data continued until the theoretical saturation of the data. All interviews were recorded with the prior consent of the participants. The analysis of the present research data was performed by Strauss and Corbin method using MAXQDA software. Results: Analysis of interviews with participants led to the emergence of three main classes of microsystem, mesosystem, and macrosystem and 12 sub-classes of emotional challenge, physical challenge, information challenge, relationship with spouse, relationship with family, relationship with family friends, the influence of society and culture, the influence of religion, and the influence of the macroeconomic system. Conclusion: Diagnosis and treatment of infertility is a difficult experience for women. In addition to the personal challenges such as shock from diagnosis and depression, infertility affects social relationship with others such as spouse, family, and friends, as well as the worldview of infertile women. Each of these topics can be considered as a potential therapeutic goal and used to design therapeutic interventions.

Background & Aims: Squamous cell carcinoma (SCC) accounts for 85% of laryngeal cancers. In some cases, lymph nodes do not show any specific symptoms despite being involved by cancer. Previous studies showed that patients undergoing selective neck lymph node dissection (SND) had significantly lower recurrence rates. We investigated the prevalence of occult neck lymph node involvement in patients with laryngeal SCC, and this is an important step in performing targeted selective neck lymph node dissection (SND) in these patients. Materials & Methods: This is a descriptive, retrospective, cross-sectional study involving the clinical records of patients with laryngeal carcinoma referred to Amir Alam Hospital from 2012 to 2017. Clinical and radiologic data showed that 66 patients had laryngeal SCC and were in the N0 stage. This group of patients was considered as the statistical sample of the study. A number of patients with similar status were excluded because of incomplete case data. Data analysis was done with SPSS v. 22 software. Results: Of the total number of patients 29(44%), were diagnosed with glottic cancer, 29 (44%) with supraglottic cancer and 8 (12%) with subglottic cancer. 26 (39. 5%) of these patients had lymph node metastasis (occult metastasis approved by post-operative pathology report). No metastasis in lymph nodes was found in 40(60. 5%) patients. Of the 66 targeted patients, only 13 underwent radiotherapy before surgery. Of the 26 patients who had lymph node metastasis, 11 were diagnosed with glottic cancer and 13 patients with supraglottic cancer and 2 cases with subglottic cancer. Conclusion: Considering the nearly 20% prevalence of occult lymph node metastasis in patients with laryngeal squamous cell carcinoma who are in the N0 stage, it is recommended to selectively excise the neck lymph nodes in addition to the tumor surgery as this will reduce the recurrence rate of the disease.

Background & Aims: The use of outsourcing policy by the public sector has increased significantly in recent times. The study of outsourcing experience shows that despite the positive achievements, unfortunately for some reasons in some cases this causes problems and issues at the organizational level as well as at the macro level of the country and therefore the predetermined goals are not achieved. Therefore, this study was conducted to identify the outsourcing stimuli of Hospitals Services with the approach of formulating the relevant policy. Methods: This study was a qualitative research. Semi-structured interviews were used for data collection and thematic analysis method was used for data analysis. The sample size was 13 relevant experts and specialists who were selected by snowball sampling method. Results: Based on the findings of this study, upstream documents with 2 sub-themes, challenges variable with 5 sub-themes, infrastructure variable with 6 sub-themes and motivational and inhibitory stimulus variables with 4 sub-themes were obtained. Conclusion: In formulating an outsourcing policy, if all aspects are not considered and the various dimensions of this issue are not considered, not only will it fail in implementation but it may incur irreparable costs.

Background & Aims: Diabetes is an increasingly important health concern and causes serious complications. Most adolescents struggle with blood sugar changes due to the growing conditions of puberty and reduced adherence to treatment. Meanwhile, one of the problems of the health system is not following treatment among adolescents which is affected by social factors. Considering that training based on theoretical approaches is one of the most basic methods of treatment and control of chronic diseases, this study aims to influence the pattern of the parallel process developed on compliance with the diet of diabetic adolescents in Golestan province in 2019. Materials & Methods: This classical intervention study with pre-test and post-test with two intervention and control groups was conducted on 50 diabetic adolescents in Golestan province using simple random sampling method in 2019. In the intervention group, based on the developed parallel process model, the content of the training program was presented in 5 sessions of 45 to 60 minutes as a group in groups of 5-6 people twice a week. Data analysis was performed using SPSS software version 23 with the help of descriptive statistics (table, mean, standard deviation) and inferential statistics (independent t, even t, ANOVA). Results: ANCOVA test showed a significant difference (p <0. 01 and Eta = 0. 25) with the elimination of the pre-test effect so that probably 25% of the post-test changes are due to training and intervention. Conclusion: According to the findings, training based on the pattern of the parallel development process and follow-up after training sessions can increase compliance with the drug regimen for adolescents with diabetes. The findings of this study can be used to instruct and educate diabetic patients in clinics and medical centers.

Background & Aims: Pelvic floor disorder (PFD), which reduces quality of life, is a major health concern for women. The purpose of this review study is to assess the effect of childbirth on the pelvic floor muscles and its prevention strategies. Materials & Methods: In this narrative review, the articles indexed in the databases of PubMed, ProQuest, Science Direct, Springer, Google Scholar were searched. Keywords including Pelvic floor disorder, Pelvic floor dysfunction, Pelvic floor muscles, urinary & faecal incontinence, Pelvic Organ Prolapse, vaginal birth, Cesarean, and prevention were used. Results: Among the articles published in Persian and English language between 2000 and 2020, 32 articles were extracted, and among the available articles, 21 articles were reviewed and reported. Finally, the findings of this study showed that several factors are involved in the occurrence of pelvic floor disorders, but the use of prevention methods can help prevent the occurrence of these disorders. Conclusion: Pregnancy and childbirth are risk factors for the development of PFD. Instrumental delivery and the prolonged two stages of labor are the key risk factors. Women at high risk for PFD should be identified and given prevention strategies. Primary and secondary prevention strategies include Proper spacing between pregnancies through the use of contraceptive methods, proper management of the labor process, and recommending pelvic floor exercises during pregnancy and after childbirth. These measures play an important role in reducing the incidence of PFD associated with vaginal delivery.

Background & Aims: In addition to providing health care services, medical universities have an important role in training expert and skilled manpower needed by different sections of society. In order to do so, the general medical education curriculum should be constantly reviewed and improved by eliminating the shortcomings. The aim of this study was to design a curriculum model for teaching general medicine with a combined method (e-learning and non-e-learning) inspired by the Akker model. Materials & Methods: The present study was a mixed-use applied study. Features of combined curriculum elements for general medical education using data analysis from semi-structured interview texts with specialists and experts and systematic review of scientific resources and research at home and abroad and upstream medical education documents and medical education procedures were identified. Purposive sampling was utilized in this study. Based on the findings, the curriculum model was designed to train general medical students with a combined method (e-learning and non-e-learning) inspired by the Akker model. Results: Using inductive content analysis, the data obtained from the text of the upstream documents and medical training methods, the results of home and abroad researches and the transcription of the interview with the participants were analyzed. In the final analysis, the basic concepts were extracted. The main elements of the model, including the logic and purpose of the combined curriculum, goals, content, learning activities, competency and authority of the teacher, grouping, location and space, time and evaluation of the combined curriculum were identified and specified for general medical education. Conclusion: Curriculum planners and decision-makers in the field of education of medical schools are recommended to use the model designed in the development and presentation of medical curricula to improve the knowledge and abilities of general medical students.

Background & Aims: Pregnancy is sweet experience in a woman's life; however, a pregnancy loss can be a fatal story. About a quarter of all pregnancies end in miscarriage. One of the most beneficial things that can have a protective effect on these parents, especially mothers, is the existence of a strong support network from the family. The aim of this study was to determine the effect of individual advocacy counseling on the perceived social support from the family in mothers with pregnancy loss. Materials & Methods: This quasi-experimental study with control group was conducted in 2018 in Urmia. A total of 100 women with pregnancy loss participated in the study. Sampling was done via randomization manner by blocking method. The intervention group received 4 sessions of educational support intervention while the control group received the usual care. Data were collected using demographic information and social support for family scale in two stages (pre-test and post-test) and analyzed by SPSS-22 software and statistical tests with significance level of 0. 05. Results: The participants in two groups were well matched except for having a live child (p=0. 03). The mean social support scores in the intervention and control group were 10. 88 ± 2. 73 and 10. 28± 2. 89, respectively. This difference was not statistically significant (p=0. 28) at start of the intervention. After intervention, the mean scores in the intervention and control group were 16. 4± 1. 38 and 10. 56± 2. 82, respectively which was statistically significant (p<0. 001). Conclusion: Individual advocacy counseling in women with pregnancy loss will increase their understanding from social support, and this can facilitate the process of adaptation in these mothers.