Advances in Nursing & Midwifery

Abstract

Background

Schizophrenia is the most disabling mental disorder and patients with it experience much stress. Coping strategies, therefore, play a significant period in this regard and these patients may have difficulty in applying them. They usually use ineffective coping strategies.

Purpose

This descriptive study was conducted to determine coping strategies in schizophrenic patients referring to psychiatry clinics at hospitals affiliated to universities of medical sciences in Tehran in 2006.

Methods

90 schizophrenic patients were selected at two stages by quota and convenience sampling methods. The Ways of Coping Questionnaire was used0.

 for data collection after identifying its content and face validities and its reliability by internal consistency. Data were collected by self-report method and review of medical records.

Results

Findings showed that “resignation” (50.11%) and “self - soothing” (47.06%) were the first and second common strategies respectively. “Considering (41.38%),” “Positive reappraisal (40.86%),” “Ignoring (40.67%)” and “Acting (37.03)” were the third common strategies. Most subjects also used “Avoidance” and the minority of them applied “Problem-oriented” strategies.

Conclusion

Most subjects used “Avoidance” coping strategy.

Keywords: Schizophrenic patients, Coping strategy, Psychiatry clinic.

Background

Mood fluctuations and pregnant women’s needs at workplace lead to such different problems as fatigue. In fact, female workforce has been tripled over recent decades. However, current antepartum care particularly for employed women does not cover the issue of fatigue and its management.

Purpose

This longitudinal study was conducted to determine the severity of fatigue and its related factors in women referring to maternal clinics affiliated to Isfahan Medical University.

Methods

Women had domestic income or were employed outside home. Data were gathered by a questionnaire in two parts including demographic and obstetric questions in the first part completed by researchers at first visit. If they fulfilled including criteria, the second part regarding fatigue was given to the mothers to complete it weekly from the 32^nd week of pregnancy to delivery on a specific day. Different statistical tests were used for data analysis.

Results

Of 70 mothers, 67.6% had moderate and severe fatigue, 12.8% had more than 1 job and, from the mothers working outside, 34.8% had shifts. 90% of the subjects stood more than 3 hours and 58.2% of them stated that they had continued their work in spite of having fatigue. 93% of them faced with fatigue resources, 10% experienced premature delivery (gestational age less than 37^th week) and 18.5% delivered low-birth-weight (less than 2500gr) newborns.

Conclusion

Two-third of employed mothers experienced moderate to severe fatigue, which may influence on pregnancy outcomes. This can be reduced by some interventions such as rest intervals and instruction of fatigue management methods like relaxation at work.

Keywords: Fatigue, Employed women, Pregnancy.

Background

Hyperbilirubinemia occurs in most neonates. Most cases are benign but newborns should be monitored because of potential toxicity of bilirubin and possible occurrence of severe hyperbilirubinemia and, in rare cases, acute bilirubin encephalopathy or kernicterus. Maternal, neonatal and perinatal factors provide evidence for the possibility of severe neonatal hyperbilirubinemia.

Purpose

This cross-sectional study was conducted to determine the incidence rate and maternal as well as neonatal factors associated with hyperbilirubinemia at Hedayat Hospital in Tehran.

Methods

All neonates (1292 newborns) from 21^st of December to 19^th of March were selected. A questionnaire was used for data collection.

Results

The incidence rate was 19.9%. Maternal factors in newborns with hyperbilirubinemia included age=26.6 years; gravidity=1.6 times, pregnancy duration=38.8 weeks, labor duration=8.19 hours, oxytocin dosage= 22.85 units and premature rupture of membrane duration=6.66 hours. Most mothers had blood group O (52.1%), positive Rh factor (92.5%), no familial history of jaundice (88.7%), normal vaginal delivery (53.5%), epidural anesthesia during normal delivery (95.2%), general anesthesia during Caesarian section (60.7%) and no instrumental delivery (69.9%). Neonatal factors in newborns with hyperbilirubinemia included weight=3016.4 gr., rank of birth=1.44, age=3.5 days, bilirubin amount=15.3 mg/dl, nutrition frequency=12.53 times and bowel elimination frequency=4.4 times in 24 hours. In addition, most affected neonates were male (54.6%), with no labor injuries (95.5%), exclusive nutrition of breast milk (100%) and initiation of nutrition in less than 2 hours after birth (99.6%). A significant relationship was found between gravidity as well as Rh factor from maternal risk factors and age as well as bowel elimination frequency from neonatal risk factors and neonatal bilirubin (P<0.05).

Conclusion

Eliminating these and other risk factors is critical for health promotion of society.

Background

Unwanted pregnancy as an effective factor on population explosion and maternal as well as child health is one of the major problems in developing countries. The population of many poor countries will double in less than 20 years because of different factors including unwanted pregnancy.

Purpose

This descriptive study was carried out to determine the prevalence of unwanted pregnancies and some of its related factors in women referring to the urban health centers in south of Tehran in 2006.

Methods

300 women took part in the study. Data were collected by a questionnaire completed by interviewing the subjects. Chi-square and T-test were used for data analysis.

Results

The proportion of unwanted pregnancy in the subjects was %31. A significant relationship was found between this type of pregnancy and their age (P=0.011), education (P=0.01), husbands’ age (P=0.017), husbands’ occupation (P=0.02), gravidity (P=0.00), parity (P=0.00), number of children (P=0.00), quality of prenatal visits (P=0.04), contraceptive method (P=0.043), simultaneous occurrence of pregnancy with contraception (P=0.00), oral contraceptives (P=0.024) and knowledge regarding the oral contraceptives (P=0.024).

Conclusion

With respect to the results and high percentage of unwanted pregnancies, informing women regarding contraceptive methods and providing consultation about their correct use are necessary and recommended.

Keywords: Unwanted pregnancy, Contraceptive methods, Family planning.

Background

Stroke is the first neurologic problem worldwide and the most common disabling neural disorder with severe complications threatening the life of patients and their families and affecting on their quality of life (QOL).

Purpose

This descriptive-correlational study was conducted to identify QOL of stroke patients referring to Kamkar-Arabnia Hospital affiliated to Qom University of Medical Sciences in 2002.

Methods

70 stroke patients (27 Women and 43 men) between 40 and 90 with no history of chronic diseases and aphasia were selected by convenience sampling method. The patients suffered from the condition at least 2 months and at most 14 months (1-year duration). Data collection tools included a questionnaire in two parts: demographics and QOL domains.

Results

Mean age of the subjects was 63.7. Most patients considered their physical and psychological condition moderate but their socioeconomic condition weak.

Conclusion

Stroke lowers QOL in all physical, psychological, and socioeconomic domains. Therefore, it is suggested that health centers revise their plans to promote QOL while evaluating their therapeutic as well as supportive programs.  

Keywords: Quality of life (QOL), Stroke, Domains of QOL

Background

Cardiovascular diseases are one of the leading causes of death in Iran. Patient education program is one of the most important programs in prevention and treatment of these disorders and it is directly related to culture of those working with patients. Since cultural factors influencing on patient education for coronary artery diseases have not yet been studied in Iran, identifying them can be very effective in improving the quality of the related programs.

Purpose

This qualitative program was conducted to explore the effects of cultural beliefs and behaviors of patients with coronary artery diseases on their education.

Methods

35 subjects including 18 nurses as main informants, 4 medical doctors, 9 patients and 4 family members of them as ancillary informants were selected by purposive sampling method and interviewed at two teaching hospitals in Tehran between 2005 and 2006. The interviews were continued until data saturation stage and analyzed in content.

Results

The subjects expressed a variety of influential factors on education in coronary artery diseases. Five themes were derived from data analysis: 1. cultural beliefs and patients’ habits of life style; 2. patients’ and health team’s beliefs regarding the condition and management; 3. hiding the diagnosis; 4. beliefs of patients, their families, nurses and physicians regarding educator; and 5. inability of educator in communicating with different ethnic groups.

Conclusion

Findings showed that cultural beliefs can precipitate and aggravate the disease. Identifying and explaining these beliefs are essential for effective patient education.

Keywords: Cultural beliefs, Patient education, Coronary artery diseases, Qualitative approach.

Background

Currently, with the omission of speculum in vaginal examination, noninvasive methods to diagnose gonorrhea and chlamydia by urine tests are available. It is now possible to diagnose bacterial vaginosis, candidiasis and trichomoniasis by vaginal swabs directly without speculum examination.

Purpose

This quasi-experimental study was conducted to compare the results of two sampling methods with or without speculum of vaginal discharge in diagnosing gynecological infections.

Methods

100 patients between 18-49 with vaginal discharge and other manifestations of vaginosis referring to gynecology clinic of Taleghani hospital were selected by convenience sampling method. One vaginal swab was used before examination with speculum and one during it to collect the discharge for diagnosing trichomoniasis, candidiasis and bacterial vaginosis. Both samples were observed under microscope by blind method and compared in terms of sensitivity.

Results

Sensitivities of discharge collection with and without speculum for diagnosing bacterial vaginosis, trichomoniasis and candidiasis were %81 and %71, 69% and %62.5, and %86 and %77 respectively with no significant difference. Agreements between the two methods for the diagnosis of bacterial vaginosis, trichomoniasis and candidiasis were 0.89, 0.85 and 0.72 respectively.

Conclusion

Gynecological infections can be detected without examination by speculum. This is helpful for those who fear from this type of examination and delay their visits.

Keywords: Gynecological infections, Sexually transmitted disease (STD), Pelvic in flammatory disease (PID), Vaginitis

Background

Nurse faculty members are the backbone of nursing schools to move toward their mission and goals. Therefore, their performance should be identified and evaluated to identify the attainment of organizational goals.

Purpose

The purpose of this qualitative study was to identify main performance evaluation domains of nurse faculty members.

Methods

Data were collected by individual semi-structured interviews with authorities and inspection of actual evaluation forms, procedures and policies. The qualitative content analysis was applied in 22 transcriptions of the individual interviews and 26 sets of actual evaluation documents. The purposive sampling method was used for the selection of experts and all actual evaluation forms, procedures and policies were collected.

Results

Three main domains including personal competencies of lecturer, process of task accomplishment as well as task outcome and their components were abstracted by the analysis.

Conclusion

Evaluation of the three domains emphasizes on mix combination of three primary systems for performance evaluation of nurse faculty members, namely, personal competencies, process-based and mission-based.   

Keywords: Performance evaluation domains, Nurse faculty members, Qualitative content

                  analysis.