Advances in Nursing & Midwifery

Background

Pain is one of the most common complaints, putting the balance and health of patients at risk.  Episiotomy is a frequent surgical procedure causing pain. Pharmacological and non-pharmacological methods are used today for pain relief.

Purpose

This double-blind clinical trial was conducted to determine the effects of aromatherapy with chamomile essence on episiotomy pain in primiparous women referring to Shaheed Norani Hospital at Talesh town in 2007.

Methods

88 pregnant women undergoing episiotomy were selected by convenience sampling method and divided into 2 experimental and control groups. The experimental group was given sitz bath twice a day with chamomile essence while the other group used the same procedure with placebo. Both groups were taught pain severity assessment with a 10-point scale. The severity was assessed and documented in both groups on the 1^st, 7^th, and 14^th days.  A questionnaire, a health facility assessment form, a visual scale for pain and an analgesic consumption sheet were used for data collection. Content validity and inter-rater reliability were used for the tools.

Results

The severities of pain in the experimental and control groups on the 7^th and 14^th days were [2.20±0.79, 2.30±0.82] and [0.48±0.59, 0.73±0.66] respectively with no significant difference.   

Conclusion

It seems that chamomile essence have no effect on the relief of episiotomy pain. Further studies in this regard are warranted.

Keywords: Episiotomy pain, Chamomile essence, Aromatherapy.

Background

School buffets are considered as important facilities in providing snacks for students. In addition, the consumption of junk and unhealthy foods in the snacks is prevalent.

Purpose

This qualitative study was carried out to identify the views and performance of students concerning having breakfast as well as snacks and assessing school buffets in Tehran in 2006.

Methods

240 students from 12 secondary schools in district 4 of Tehran were selected by purposive sampling method. 24 focus group discussion sessions, each lasted 60 minutes with 8-10 students were held and recorded for each group. All session notes were compared and controlled by recorded files for identifying the main themes to be encoded, classified and analyzed.

Results

More than half of the students ate snacks to reduce lack of energy and satisfy hunger. About 50% of girls took cake, waffle and milk while some boys ate fruits, sandwich and cake. Most students believed that buffet is necessary at school and considered its condition from moderate to bad. More than half of them stated that the snacks and foods in buffets were invariable, expensive, unhealthy and nonnutritive.

Conclusion

With respect to undesirable snack patterns of students, improving the condition of school buffets to have more nutritious foods is a significant step in altering eating habits of them.

Keywords: Adolescent, Snack, Buffet, Focus group discussion (FGD)

Background: Aging is inevitable, starts gradually as the last stage of development in all people leading to alterations in body compounds and decreased efficiency of organs and affects on physical ability at different levels. Deterioration of physical abilities and its resultant limitations reduces the independence of the elderly and increases their reliance on others. WHO reports suggest that inactivity or immobility in living is a leading cause of morbidity and mortality worldwide.

Purpose: This descriptive study was conducted to assess physical activities of the elderly and identify their problems and needs in nursing homes of Sanandaj. A healthcare plan was then developed according to their needs.

Methods

88 elders (over 65) from 2 governmental and private nursing homes took part in the study. A questionnaire (Independence in Daily Living Activities) developed in 2006 with 20 items describing all daily physical activities was used for data collection. It was completed by observation and interview. It divides independence into 2 levels and a 5-point Likert scale (from 0 to 4 points) including absolutely independent, relatively independent, relatively dependent, absolutely dependent, and inactive because of nonphysical problems is used for scoring. The scores range between 20 and 80 or less.       

Results

51% of the elderly was male, 56% between 65 and 75, 88% illiterate, 61% from other towns and 42% resided at nursing homes less than 3 years. 6 (6.82%), 51 (57.95%), 26 (29.55%) and 5 (5.68%) elders were absolutely independent, relatively independent, relatively dependent and absolutely dependent respectively. The last group needed constant care for all of their daily activities.

Conclusion

Being in nursing homes requires daily activities and some tasks for self-care. Activities of the elderly for mobility and self-dependence help maintain their health but inactivity can increase their need to carers and assisting or ambulatory devices. The importance of activity limitations is revealed when their physical mobility is assessed by an appropriate tool to provide a criterion for predicting as well as planning healthcare services and, finally, for their self-care and health promotion. The tool applied in this study is recommended.

Keywords: Activities of daily living, Elderly, Nursing homes.     

Background

End-stage-renal-disease (ESRD) patients treated by hemodialysis require major lifestyle changes and self-efficacy in the treatment regimen to comply with their chronic illness. Clients’ perception of being self-efficient results in increased self-care activities and adherence to medical regimen. Although client’s self-efficiency can affect on outcomes of the disease, few study is available in this regard.

Purpose

This descriptive correlational study was carried out to identify self-efficacy of hemodialysis patients and its related factors.

Methods

200 patients referring to healthcare setting affiliated with Iran Medical University were selected by convenience sampling method. A tool, Guidelines for Health Promotion, was used to assess self-efficacy in the treatment regimen. The tool was made reliable by test-retest method.

Results

Findings showed that self-efficacy was correlated with educational level, dialysis duration and weight difference between 2 dialysis sessions. In contrast, no correlation was found between self-efficacy and age as well as sex.

Conclusion

The study showed a significant relationship between self-efficacy and some personal characteristics of patients. Thus, it is necessary for nurses to assess self-efficacy of their patients. In addition, nurses are in a key position to influence on self-efficacy of their patients and improve self-care activities of them. To achieve these, they can provide necessary instructions for their clients to control stress and emotional as well as physical stimulations.

Keywords: Self-efficacy, Chronic renal disease, Hemodialysis, Nursing.

Background

Pain control is intended to prevent pain and suffering of women and to increase the quality of life. Successful pain control is achieved by accurate pain assessment and for doing this, proper and valid tools should be applied.

Purpose

This descriptive cross sectional study was performed to identify the problems of nurses in applying pain assessment tools in children.

Methods

30 nurses in emergency ward of clinics of Oil Company voluntarily took part in the study. A questionnaire in 3 parts including demographics, barriers of nurses to apply the tools and information regarding pain assessment was used for data collection. Content method was used for validity of the tool. Its reliability for the second and third part was measured by test-retest and internal consistency methods respectively.

Results

72.3% and 26.7% of nurses were male and female respectively. 73.3% had baccalaureate and 26.7% had associate degrees. Their mean age was 37±5. 60%, 20% and 20% of the nurses had moderate, weak and good knowledge regarding pain assessment respectively. The most common barriers were environmental [facilities and manpower (lack of a pain assessment tool and inadequate personnel to assess pain)], administrative (lack of regulations to assess pain and lack of inclusion of it in annual personnel evaluations), educational (inadequate programs in this regard) and personal or motivational (work overload of nurses) according to the subjects.

Conclusion

 Results showed that nurses face with many difficulties in assessing pain from different aspects. The analysis and suggestions indicate that the most significant solution for this problem is to establish pain control nursing committee at the setting.

Keywords: Nursing, Pediatric, scale, Pain assesment, Commission.

Background

Pregnancy due to its nature is associated with some problems, which may increase the need for drugs. Drug self-treatment can cause severe complications and lack of information of mothers concerning the indications of drugs may have detrimental effects on family as well as society.

Purpose

This descriptive study was conducted to identify knowledge, attitude and practice of pregnant women regarding self-treatment with drugs in healthcare settings affiliated to Shaheed Beheshti Medical University in 2006.

Methods

180 pregnant women referring to healthcare centers were selected in 2 steps by cluster sampling method. The stage of their gestational period was not important. An information form was used for data collection.

Results

Findings showed that 98.3% of women knew the forbiddance of chemical drugs during pregnancy without prescription. 70.6% agreed chemical drug prescription by a professional. Of 180 women, 100 (55.5%) took chemical drugs during their pregnancy and 97.8% used the drugs by prescription. 11.1% took herbs by prescription while 84.2% used them without prescription and by recommendation of their acquaintances or their own views. 4.7% took herbs by suggestion of herbalists.

Conclusion

It can be concluded that despite good knowledge of women about indications of chemical drugs, their information regarding herbs is not satisfactory. Therefore, developing appropriate educational plans in media, healthcare settings and prenatal clinics to improve their knowledge seems necessary.

Keywords: Knowledge, Attitude, Practice, Self-treatment, Pregnant women.

Background

Preeclampsia is a syndrome specific to pregnancy, resulting in decreased organ perfusion due to vasoconstriction endothelium activation. Migraine is also a benign and recurrent syndrome with headache, nausea and vomiting or other neurological dysfunctions. Some studies suggest that women with migraine are more likely experience preeclampsia.

Purpose

This study was performed to review literature regarding possible associations between migraine and preeclampsia and to provide an analysis concerning similar mechanisms underlying both of these unknown conditions.

Methods

Various sources were reviewed in order to collect data on the two conditions and underlying mechanisms involved.

Results

Although primary mechanisms of both conditions are not clearly known, abnormal platelet activity and altered vascular function have been suggested. Peripheral dysfunction in preeclampsia also occurs in cerebral vessels during migraine attacks. Patients with migraine or with altered gestational blood pressure are similarly influenced by the same drugs and interventions.

Conclusion

Identifying the risk factors of preeclampsia and predicting them on time can prevent its occurrence. Meanwhile, the association between migraine and preeclampsia may be a key to discover the unknown etiologies of them.

Keywords: Pregnancy, Preeclampsia, Migraine.