Advances in Nursing & Midwifery

Abstract

Background and aim: Depression is an affective disorder which  is a common reaction to problematic events. Chaos and disturbance in family processes are considered as risk factor of depression. The aim of this study is to assess the family processes in depressed patients attending to psychiatric clinics of Shahid Beheshti university of medical sciences in Tehran, Iran.

 Methods and materials. A descriptive design was used for the study.  A purposive sample of 180 depressed patients were included in the study. Data were collected by a questionnaire which consisted of two sections. The first section included demographic information and the second part consisted of “ Iranian version of family processes scale”. Validity of the instrument was assured by content validity and reliability was assessed by calculating internal consistency. Data were analyzed by statistical software SPSS17.

Results : The overall family processes score for 72.3% of respondents was moderate. The scores for most of patients was highest in religion subscale and lowest for decision making in the family. There was a significant association between religious beliefs and gender. A significant association was also found between decision making and family coherence with marital status ,communication skills and number of siblings.                    Keywords: Depression. Family processes .Psychiatric clinics

Abstract

Introduction: Increase of premature newborn, cause to develop research for this group of newborns. However, despite this progress, low weight and prematurity of newborns are the most important reasons for death, during the first year of their life. It seems to be important to pay close attention to the psychological and social effects of premature newborn on parents. On the other hand, investigations have showed that emotional responses of mothers in relation to premature infants born are more than fathers. Concerning special status of nurses in NICU, they have more effects in decreasing parents stress. Therefore this study has been performed to recognize viewpoints of mothers and nurses about stress in NICU for decreasing parental stress.

Method: This is a comparative-descriptive study, that has been done during the first 6 months in year 2007, and the study population consisted of nurses (n=32) and all mothers with premature newborn, hospitalized in NICU (n=300) in three training centers - Health in Tabriz (Taleghani, Alzahra, Koodakan). Sampling method was census and data collected by PSS (parent stressor scale) questionnaire, developed by Margaret Miles et al in 1998. Validity of scale was determined by content validity with cooperation of ten faculty members of Nursing-Midwifery college of Tabriz, and validity of translation assessed by one English language expert. Reliability of scale was evaluated by participation of 30 mothers and 6 nurses which the related method was Cronbach's alpha, (for mothers calculated, 0/87 and for nurse 0/94). Data was analyzed by SPSS version 13.5 software.

Results: For viewpoint of mothers and nurses, Mann-Whitney U test showed that, there are significant difference between three ranges of stressors, and for viewpoint of mothers, Friedman test showed that, the most stressor sources were “relationship of parents and parental role” and for viewpoint of nurses, were “baby appearances and behavior, and special treatments” and “relationship of parents and parental role”.

Conclusion:

Accurate researches of parent stressor, specially, mothers who have premature newborn, to introduce solutions for family cares and satisfaction increase is very necessary and important.  

Keywords: Premature infant .Stressors. Mother. Nurse .Intensive care unit

Abstract

Background and aim: Nursing education as a part of higher education has been expanding very rapidly in recent decades in the world. This situation caused to increase concern about quality of nursing education. This study aimed to identify indicators of evaluation in nursing education.

Materials and methods: This research is a qualitative study, with content analysis approach which was done in three stages. In the first stage, semi-structured interview was done with 21 members of Nursing board, Deans, Deputies and evaluation committee's members in Nursing and Midwifery schools of type No.1 in Iran. Texts of interviews were analyzed through content analysis method and their understanding of evaluation of nursing education was determined. In the second stage, seven forms in the field of evaluation in nursing education at nursing schools and ministry of health have been collected and were studied by using content analysis method. In the third stage, by using comparative study and searched in databases of international nursing associations and scientific in the field of evaluation of nursing education, 11 forms available on the evaluation and accreditation in nursing education were identified and then, by using content analysis methods were studied. Domains and indicators of evaluation were extracted.

Results: In the first phase, 16 themes related to evaluation’s challenges and 21 themes related to requirements in effective evaluation in nursing education were identified. In second phase, evaluation’s domains and indicators in documents and evaluation forms in Iran were identified and extracted. In third phase, evaluation’s domains and indicators in documents and evaluation forms at the level of international scientific associations and education were identified and extracted. Domains and indicators in the second stage were chosen as the base framework and then third stage findings were gradually added to it. Finally, after considering the challenges and requirements of evaluation, findings of research in three areas including of input, process and output, 9 domains and 141 indicators were classified and developed.

Conclusion: Dynamic educational system requires the dynamic method evaluation. As in this study the indicators of evaluation were revised, these indicators can be used in internal evaluation, external evaluation, ranking and accreditation of nursing schools and nursing educational systems.

Keywords: Evaluation Indexes; Nursing Education; Qualitative nursing research

  Abstract

Background and Aim: Managers by adopting effective management styles can improve  efficiency and quality of care  and empowerment of personnel .The aim of  present research is to examine  the correlation  between  management   styles  of head nurses  with  nurses' empowerment  in  medical  and   surgical  wards  in  hospitals  of   NEZAJA  Health and Medical Services  in Tehran 1388.

Material and  Method: This research is a descriptive correlational study.A sample of 57 sataff nurses, 26 head nurses and 5 senior managers participated in the study.A questionnaire which consisted of three sections was used for gatherind data. These sections includeds :1 (Nurse clinical competence scale  for assessing nurses' empowerment  2) Psychological empowerment questionnaire to study nurses' Psychological empowerment  3) questionnaire of Leader Effectiveness and Adaptability description to study head nurses  management styles. Content validity andface validity were used for  assuring the validity of questionnaires.Reliability of tools  was obtained by test re-test. Data were analyzed by SPSS14 software.

Findings: Finding  of the research showed that most head nurses(65/4%) reported that they use   selling management  style . The  empowerment level of nurses from the three view points (nurses ,  head nurses , their managers) were reported at good level ( 50- 70) and at very good level ( 3/1 - 4 ) for  nurses' Psychological empowerment .There was no significant association between head nurses’ management style with empowerment of nurses.

Conclusion Appropriate changes in organizational structure  andrelationships are necessary for achieving a dynamic system in organizations.

 Key words :management styles,empowerment,nurse  ,  Medical  and   Surgical  Wards

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  Background and Aim: Children healthcare is one of the most important aims of family-centered cares that cause children and family health promotion. Positive attitude of healthcare staff is essential to have parent effective participation in hospitalized children cares. This study was done to evaluate children hospital staff attitude, toward parent participation in physical and psychological cares for their hospitalized children.

Methods: This descriptive study was performed on 100 medical staff of Qom children hospital and samples were chosen by convenience sampling method. Data were collected by using questionnaires, including two parts: population specifications and parent participation in hospitalized children cares. Structured questionnaire was designed using a Likert scale with 5 categories ranging from, “completely agreement” to “completely disagreement”.Validity of scale was determined by content validity, and inner correlation method of Cronbach's alpha (R= 0.82) was used for reliability of scale. Data were analyzed by SPSS software.  

Results: Scores average and scale deviation (SD) of hospital staff attitude was 94.67±10.96 that is categorized in neutral group. There were no significant relationship between attitude score with age, gender, marital status and education stand.

Conclusion: positive attitude of healthcare staff is essential to have family effective participation in hospitalized children cares; so with continuing education courses and health care reform guidelines on children and hospital staff should take part in continuous training programs.

Keywords: Attitude, Parent participation, Family-centered care, Hospitalized child.

Abstract

Background and aim

A large proportion of stroke patients are maintained at home by their family. This study was conducted to evaluate life quality of caregivers of stroke patients after discharge period and its association with patient dependency in performing daily activities.

Materials and methods

This research is a descriptive study. A sample of 90 stroke patients hospitalized in Arak teaching hospital and care-givers were selected with convenience sampling method. By using a questionnaire, samples were collected, three times, at the time of discharge, also one month and three months after discharge. Quality of life was measured with brief quality of life questionnaire Of WHO. Then, quantity of patient dependency in performing daily activities was measured by using the Modified Barthel Index (MBI).

Results

Most of the care-givers were the spouse of the patient (77.77%) and the average age of them was 60.1 years old. After 1 and 3 months, their quality of life in four-domain (psychological and physically health, social relations and environment health) were significantly decreased. There was significant relationship between quality of life of caregivers and quantity of patients dependency in performing daily activities. Scores average and scale deviation (SD) of patients (Barthel patients) had no significant difference at the time of discharge, also one month and three months after discharge.

Conclusion

Quality of life of caregivers of stroke patients after discharge was decreased and was related to patient dependency in performing daily activities. Results indicated that caregivers of stroke patients need help and support to adapt to changes in lifestyle.

Key words: quality of life, caregiver, stroke, patient dependency

Abstract

Background and Aim: These days, use of Ultrasound in Prenatal Health Care is debatable. So, this research has been performed to study use of Ultrasound in prenatal health care.

Materials & Methods: This descriptive study was conducted in all mothers that were going to maternity hospital in Hamadan. Among them, 380 pregnant women were studied by the available Sampling based on all inclusion criteria. An information record sheet was filled for each patient through three methods: interview, studying the documents and observing the labor process according to the related case.

Results: At least, Ultrasound has been done one time in 98.7% of pregnancies. The average rate of Ultrasound examination in pregnancies was 2.61%. Maximum request for Ultrasound examination was 8 times in 0.08% cases. There are three main reasons for Ultrasound examination: routine examination in prenatal health care (53.3%), to control or follow up pregnancy complication (33.14%) and mother's request for knowing baby's sex (13.56%). Because of different reasons, as, mother's worries about unpleasant results of examination, 8% of all applied Ultrasound Examinations has not been performed. The final main finding demonstrated that 68.4% of pregnant women, who profit by prenatal healthcare including Ultrasound, were involved with a pregnancy complication such as Premature Rupture of Membrane (47.3%).

Discussion &Conclusion: Regarding the results, that show, due to the increased use of Ultrasound technology in Prenatal Care in Iran and all around the world, it is necessary to design an appropriate method for applying  Ultrasound to improve quality of Prenatal Health Cares.

Keywords: Sonography-Prenatal ultrasound - Prenatal care

Abstract:

Background and aim: Bacterial vaginosis is one of the most common infections of reproductive system ,which results from replacement of the hydrogen peroxide –producing lactobacillus species by various anaerobic bacteria. Metronidazole  is the choice of treatment for bacterial vaginosis, but it has many side effects. Drug resistance and recurrent  occurs in 30-50 % of patients  and new treatment options are needed to improve the efficacy of present treatment. Probiotics are recommended for treatment of bacterial vaginosis. Efficacy of probiotics is discussed here.

Method and materials. Electronic databases were searched for scientific publications about probiotics and bacterial vaginosis. These included: Pubmed,Ovid,Science direct and  scopus. 40 publications were selected and reviewed.

Results. Probiotics are live microorganisms, including Lactobacillus species, , that can be ingested and may beneficially affect the host. The mechanisms  of lactobacilli function as anti-infective defenses are still not fully understood. These mechanisms  may involve production of antimicrobial factors ,maintenance of a vaginal pH of ≤4.5, enhancing barrier integrity, blocking bacterial adhesion to epithelia cells ,improving immune system function producing vitamins and competing with pathogens. Probiotics can be used as probiotic  yoghurt  or oral capsules.

Keywords ; Bacterial vaginosis,Probiotics ,Lactobacillus .