Advances in Nursing & Midwifery

Abstract

Background and aim

Addiction to drugs and substance abuse is considered a psychosocial health problem. Its prevalence in women has dramatically increased in the past two decades, who are mostly at reproductive age. The aim of this study was to determine the reproductive health status of women referring to addiction centers at Tehran in 2009.

Materials and methods

In this descriptive study, 200 addicted women were sequentially selected by a nonrandomized sampling method. A questionnaire with items related to demographic information, drug abuse, obstetrical history, menstruation and family planning was used for data collection. Its validity and reliability were achieved by content and test-retest (r=0.98) methods respectively.

Findings

Opioid and crack were the most common drugs. 34% of cases had started substance abuse between 14-20 years old. The mean of parities was 2.95±1.83. The outcome of 27.6% of pregnancies was low birth weight with 7% of neonates having physical malformation. 145 women (72.5%) were at reproductive age. 82% had had regular menses before addiction  and 91.7% experienced dysmenorrhea in the menstruations. The amount of bleeding and the intervals of cycles had changed after addiction in 45.5% and 33.1% of the subjects respectively. 66.2% of reproductive women with sexual activity used a contraceptive method and withdrawal method was the most common one.

Conclusion

According to the results, reproductive health status of addicted women is in need of further assessment and supervision. Therefore, it is recommended to attend more to these women by planning appropriate programs to improve reproductive health services for them.

Keywords: Reproductive health, Women, Addiction.

^*Corresponding Author: Sedighe AmirAli Akbari, Lecturer, Dept of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

 E-mail: asa_akbari@yahoo.com

Effects of humor therapy on fatigue and depression of multiple sclerosis (MS) patients

Moshtagh Eshgh, Z.¹* (MSN); Naghavi, B.² (MS); Rashvand, F.³ (MSN); Alavi Majd, H.⁴ (PhD),

Bana Derakhshan, H. (MSN)⁵

1. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti

    University of Medical Sciences, Tehran, Iran. *(Corresponding Author) e-mail:z.moshtagh@yahoo.com

2. Lecturer, Dept. of Basic Sciences, Faculty of Nursing and Midwifery, Shahid Beheshti University of

    Medical Sciences, Tehran, Iran.

3. Lecturer, Azad University of Abhar, Abhar, Iran.

4. Associate Professor, Dept. of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of

    Medical Sciences, Tehran, Iran.

5.Lecturer, Dept. of operating room & Anesthesia, Faculty of Nursing and Midwifery, Shahid Beheshti

    University of Medical Sciences, Tehran, Iran.

Abstract

Background and aim

Multiple sclerosis (MS) is the most common disabling condition in young adults, which is caused by an inflammatory demyelination process in central nervous system. Fatigue and depression are the primary symptoms leading to dysfunction as well as disability in activities of daily living and decreased quality of life. Because of many drug-associated complications, applying other methods to lessen the symptoms seems reasonable. The aim of this study was to determine the effects of humor on fatigue and depression of clients referring to Iranian MS Society.

Materials and methods

In this one-group before-after clinical trial, 30 MS clients were selected by convenience sampling method. A 4-part questionnaire including demographics, items related to the condition, Fatigue Severity Scale (FSS) and Beck's Depression Inventory was used for data collection, validated and made reliable by content and test-retest methods respectively. The clients took part in humor therapy sessions 3 times a week, each lasting 30 minutes for 12 weeks. The sessions were hold during the day with entertaining and funny programs recorded on compact discs (CDs). The clients completed the questionnaire before and after the intervention. Data were then analyzed by different statistical methods.

Findings

A significant decrease was found in mean severities of fatigue and depression after the intervention (P<0.01). Therefore, the hypothesis of the study denoting the effects of humor therapy on severity of fatigue and depression in clients with MS was verified.

Conclusion

The study revealed that humor therapy may decrease the fatigue and depression of clients with MS. Humor as a simple, low-cost and noninvasive method can be used to overcome many problems of these clients and ultimately lead to decreased fatigue and depression.

Keywords: Humor therapy, Fatigue, Depression, Multiple sclerosis (MS)

^*Corresponding Author: Zahra Moshtagh Eshgh. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

 E-mail: z.moshtagh@yahoo.com

Knowledge, attitude and practice of children and young adults on road traffic injuries

Mahfozphour, S.¹ (PhD); Soori, H.²* (PhD); Einy, E.³ (MS); Iranfar, M.⁴ (MS), Amiri, Z.⁵ (PhD); Hadadi, M.⁶ (PhD); Hydar, F.⁷ (BS)

1. Assistant Professor, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2. Professor, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3. Lecturer, Dept of  Midwifery, Research Center for Safety Promotion and Injury Prevention, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4. Researcher, Research Center for Safety Promotion and Injury Prevention, Shahid Beheshti University of Medical

    Sciences, Tehran, Iran.

5. Associate Professor, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

6. Supervisor, Center for Accident Prevention and Safety Promotion in Center for Accident  and Emergency

     Management of The Ministry of Health, Tehran, Iran.

7. Expert and Police Officer, Applied Research Office of Traffic Police, Shahrak Azmayesh, Tehran, Iran.

Abstract

Background and aim

According to records, the rate of road traffic injuries among children and adolescents is high. The aim of this study was to determine knowledge, attitude and practice of children, adolescents and young adults between 9 and 30  regarding traffic accidents in 2008.

Materials and methods

In this descriptive study, 304 children and adolescents between 9 and 14 as well as 327 young adults between 15 and 30 were randomly selected according to their distribution in 19 educational districts and all universities of Tehran in 2008. Data were collected by a 3-part questionnaire validated and made reliable by content and test-retest methods respectively after taking the informed consent of the subjects. The scores were divided in 3 ranks: Good (above 75%), moderate (50%-75%), and poor (below 50%).

Findings

Means of age in the first and second groups were 11.7±1.6 and 20.7±4.3 respectively. Overall, 50.7% was male. The practice score of females in the first group (9-14 years old) was better than males (P<0.001) and, among males in the second group (15-30 years old), attitude as well as practice scores were higher than females (P<0.02).  Attitude scores in high school students were better than primary school students (P<0.043). In university students, attitude and practice scores were higher than others (P<0.001). Knowledge and practice scores were higher in police assistants at primary schools than high schools (P<0.003).

Conclusion

The findings revealed the need of both groups for more educational programs regarding traffic accidents and injuries.

Keywords: Knowledge, Attitude, Practice, Traffic accidents, Children, Young adults.

^*Corresponding Author: Hamid Soori. Professor, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

 E-mail: hsoori@Yahoo.com

Physiologic indices of patients before, during and after visit in       coronary care unit at Imam Khomeini hospital in Ardebil

Kamrani, F.¹* (MSN); Seyedjavadi, M.² (MSN); Abedsaeedi, Zh.³ (PhD); Ezzati, Zh.⁴  (MSN); Alavimajd, H.⁵  (PhD);  Hosseinian, A.⁶ (MD)

1. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti

    University of Medical Sciences, Tehran, Iran.

2. Alumnus, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science,

    Tehran, Iran

3. Assistant Professor, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid

    Beheshti University of Medical Science, Tehran, Iran.

4. Lecture, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti

    University of Medical Sciences, Tehran, Iran.

5. Associate Professor, Dept. of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of

    Medical Sciences, Tehran, Iran.

6. Cardiologist, Faculty of Medicine, Ardebil University of Medical Sciences, Ardebil, Iran.

Abstract

Background and aim

Visit is an essential issue in hospitals and of patients' basic needs in coronary care units (CCUs). However, there is no evidence regarding its physiologic effects on  them. The aim of this was to determine the physiologic indexes of patients before, during and after visit at CCU of Imam Khomeini Hospital in Ardebil.

Materials and methods

In this descriptive study, 50 patients with acute myocardial infarction were selected through convenience sampling method. A questionnaire and a cardiac monitoring device were used for data collection. Content method and calibration the device were used for validity and reliability of the tools respectively. ANOVA with repeated measurements was used for data analysis.

Findings

%72 of patients was male and %28 was female. Their mean age was 59.8. Significant differences were found between systolic, diastolic and mean arterial pressures; heart as well as respiratory rates; temperature; and oxygen saturation before, during and after the visits. Accordingly, the indexes increased significantly by the start of visits and turned back to the previous state after them with no significant difference in before-after amounts.

Conclusion

It seems that the physiologic indices of patients change in normal range during visits and return to their primary state after 30 minutes from the end of visits with no clinical importance.

Keywords: Visit, Coronary Care Unit (CCU), Physiologic indexes.

^*Corresponding Author: Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

 E-mail: comruni1338@yahoo.com

Effects of bladder irrigation with chlorhexidine and normal saline on prevention of bacteriuria in patient with foley catheter

Samimi, Gh. ¹ (MSN); Ezzati, Zh. *² (MSN); Sarokhani, M. R.³ (PhD); Mosalaii, S. S.⁴ (MD); Mehrabi, Y.⁵ (PhD)

1. Alumnus, Faculty of Nursing and Midwifery, International Branch of Shahid Beheshti University of

    Medical Sciences, Tehran, Iran.

2. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti

    University of Medical Sciences, Tehran, Iran.

3. Associate Professor, Dept. of Laboratory Science, Faculty of Health, Qazvin University of Medical

    Sciences, Qazvin, Iran.

4. Nephrologist, Bo-Ali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.

5. Professor, Dept. of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences,

    Tehran, Iran.

Abstract

Background and aim

Urinary tract infection (UTI) is the most common infection acquired in both hospitals and nursing homes and is usually associated with catheterization. The aim of this study was to compare the effects chlorhexidine 0.2% with saline for bladder irrigation on preventing bacteriuria in patients with foley catheter.

Materials and Methods

In this randomized clinical trial, 60 neurologic patients 50 years old and over in need of foley catheter for at least 14 days with no UTI at the beginning of the study were enrolled, catheterized by one of the researchers and randomly divided into two groups of chlorhexidine %0.2 and saline. Bladder irrigation was performed on days 3 and 10 following catheterization. A questionnaire and urine analysis as well as culture were used for data collection, each of which was validated and made reliable. Different statistical tests including T-student and Chi square as well as logistic regression were used for data analysis.

Findings

With respect to negative culture results in both groups on days 1 and 2, a significant difference was found between chlorhexidine (30%) and saline (77.3%) groups (P<0.001). All subjects contracted infection after 17 days. The relative risk for urinary tract infection in saline group was 2.4 times greater than the other group.

Conclusion

During the first 9 days, bladder irrigation with chlorhexidine 0.2% may lead to decreased rate of infection due to catheterization.

Keywords: Nosocomial infections, Bacteriuria, Foley catheter, Bladder irrigation, Chlorhexidine

                    0.2%

^*Corresponding Author: Zhale Ezzati. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

 E-mail: zh_ezzati_15@yahoo.com

Nurses' readiness in research utilization: Moving toward

evidence-based practice

Mehrdad, N.¹* (PhD); Salsali, M.² (PhD); Kazemnejad, A.³ (PhD)

1. Assistant Professor, Dept. of Community Health Nursing, Faculty of Nursing and Midwifery, Iran

    University of Medical Sciences, Tehran, Iran. *(Corresponding Author) e-mail: neda@iums.ac.ir

2. Professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

3. Professor, Dept. of Biostatistics, Tarbiat Modarress University, Tehran, Iran.

Abstract

Background and aim

Research utilization is a mechanism for transferring the results of research into practice and improving the quality of care in nursing. The aim of this study was to determine nurses’ readiness to utilize research needed for applying evidence-based practice.

Materials and methods

In this descriptive study, 375 nurses in all teaching hospitals affiliated with Tehran University of Medical Sciences were selected by stratified random sampling method. A 4-part questionnaire with open and close-ended questions including professional profile, research activities, research skills and access to research resources was used foe data collection. Content as well as face validities and Cronbach's α for reliability (0.82) were identified.

Findings

85.9% of nurses had weak readiness in research utilization. Both research activities and skills were also low (71.4% and 82.7% respectively). 44% of nurses had insufficient access to research resources. A significant relationship was found between nurses' educational level, participation in research activities as well as English language skills and their readiness in research utilization.

Conclusion

Lack of skills and inaccessibility to research findings lead to weak readiness for research utilization. With respect to the importance of utilizing research findings, organizational and administrative support, continuing education programs, well-defined processes and pathways to facilitate research utilization need to be provided for nurses.

Keywords: Research utilization, Evidence-based practice, Nurses.

^*Corresponding Author: Neda Mehrdad. Assistant Professor, Dept. of Community Health Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

E-mail: neda@iums.ac.ir

Emotional adjustment in infertile people

Ramazanzadeh, F.¹ (MD); Noorbala, A. A.² (MD);  Abedinia, N.³* (MS)

1. Professor of Gynecology, Vali-e-Asr Reproduction Health Research Center, Imam Khomeini Hospital

    Complex, Tehran University of Medical Sciences, Tehran, Iran.

2. Professor of Psychiatry, Psychiatry and Psychology Research Center, Roozbeh Hospital, Tehran

    University of Medical Sciences, Tehran, Iran.

3. Clinical Psychologist, Vali-e-Asr Reproduction Health Research Center, Imam Khomeini Hospital

    Complex, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background and aim

Infertility has mental, social as well as reproductive consequences, among which depression, anxiety, aggressiveness, feelings of guilt, lack of self-esteem, lack of confidence, psychosomatic complaints, obsessions, relationship difficulties and sexual dissatisfaction are evident. Many authors consider the psychological consequences of infertility as responses to grief. The aim of this study was to assess emotional adjustment of infertile couples and psychological outcomes of infertility (depression, anxiety, relationship as well as sexual problems, and personality disorders) in different phases of treatment.

Materials and methods

The review of literature included most studies in the past 2 decades. Search terms were infertility,  pregnancy, depression, anxiety, psychology disorder, marital satisfaction, psychiatric as well as psychology interventions and personality disorders in such data bases as Pub Med, Scholar, Google, Scopus and Amazon. All data were in agreement with articles published earlier than 2006 and almost all of them are accessible.

Findings

Most studies have found that more than half of the infertile people (women, men, and couples) learn to some extent cope with this problem.

Conclusion

High prevalence of psychological disorders (particularly, anxiety and depression) appears as inappropriate emotional adjustment which requires psychiatric and psychotherapeutic interventions.

Keywords: Infertility, Emotional adjustment, Depression, Anxiety, In vitro fertilization (IVF).

^*Corresponding Author: Nasrin Abedinia. Clinical Psychologist, Vali-e-Asr Reproduction Health Research Center, Imam Khomeini Hospital  Complex, Tehran University of Medical Sciences, Tehran, Iran.

E-mail:  abedinia_nasrin@yahoo.com

Coherence in qualitative research

Vaismoradi, M.¹ (MSN); Salsali, M.²* (PhD)

1. PhD candidate, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran,

    Iran.

2. Professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background and aim

Coherence describes the fit between the aim, the philosophical perspective adopted, and the researcher role in the study as well as the methods of investigation, analysis and evaluation undertaken by the researcher. This review study aimed to elucidate one of the important qualitative methodology issues entitled coherence, which is usually undermined during a qualitative study.

Materials and methods

The authors logged on to some general and specialized search engines as well as conducted a library research in healthcare and social science textbooks to perform an in-depth study regarding coherence in qualitative research. The search resulted in 95 articles and 20 textbooks. In spite of the importance of coherence in qualitative methodology, 23 articles and 7 textbooks had more content regarding the subject, which were employed to write this paper.

Findings

The gathered data were classified into 4 categories: the definition of coherence; the proofs for incoherence in qualitative methodology; the causes of incoherence; and, finally, the strategies for coherence improvement in qualitative methodology.

Conclusion

Different factors may cause incoherence in qualitative research, which reduce the rigor and credibility of it. In addition, in the long run, it results in uncontrolled methodological diversities and inability to define criteria to judge qualitative research reports.

Keywords: Coherence, Rigor, Qualitative methodology.

^*Corresponding Author: Mahvash, Salsali. Professor, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran. E-mail: m_salsali@hotmail.com