Advances in Nursing & Midwifery

Background

Since medical devices from different manufacturers with various qualities may affect on outcome of interventions, studies regarding the correctness of them in terms of material and function have always been a major topic.

Purpose

This clinical trial was conducted to compare cuff pressure changes in two endotracheal tubes (ETT) in contact with nitrous oxide gas, manufactured in Iran and Malaysia.

Methods

50 patients having elective surgery in Loghman Hakim Hospital and categorized in classes 1 and 2 according to American Society of Anesthesiology (ASA І, П) were randomly divided into 2 groups (27 and 23 subjects). In the first group with 27 subjects, Iranian tubes and in the other, Malasian ones were used. ETT cuffs were filled with air via minimal leak method and cuff pressures were measured by a cuff pressure indicator (VBM). It was connected to a pilot cuff until the end of anesthesia. Meanwhile, nitrous oxide 50% was prescribed for patients during anesthesia and the pressure was recorded every 20 minutes until 120 minutes of anesthesia.

Results

Mean and standard deviation of pressures in the cuffs of Iranian tubes before nitrous oxide administration were 96.43 and 8.23 respectively. The corresponding figures for pressures in Malaysian tubes were 17.32 and 97.4, which showed a significant difference (t=2.585, P=0.015). The standard deviation of Iranian tubes was significantly greater than Malysian ones (F=38.633, P<0.001).

Conclusion

It can be concluded that mean base pressures in the 2 types of tubes have no difference. This denotes that, at the beginning, there is no significant difference and the cuffs of Iranian tubes in spite of being filled with air like Malaysian ones show higher pressure difference. Mean base pressures of cuffs at different times indicate significant difference two by two.

Keywords: Cuff pressure of endotracheal tube, Nitrous oxide gas.

Background

Quality care has always been the concern of nursing managers. Characteristics of care givers may affect on the quality. On the other hand, clients’ views in this regard is considered as a quality measure.

Purpose

This descriptive correlational study was conducted to determine the relationship between clinical competency and patient's satisfaction from nursing care in hospitals affiliated to Zahedan Medical University.

Methods

47 nurses and 141 patients were randomly selected. The nurses provided direct care to 3 patients at least for 3 days. The patients were asked on discharge. A questionnaire was used for demographic data collection and completed by interview. Another tool was used for measuring clinical competency with 62 questions regarding managerial, professional, communicational and educational skills, which was applied by head nurses, supervisors, and researchers. Patients’ satisfaction was measured by a 37-item questionnaire concerning physiologic, security and social needs completed by interview. Different statistical tests were used for data analysis.

Results

Mean age of nurses and patients were 37.3±10.7 and 30.7±4.9 respectively. 74.5% of nurses as well as 53.2% of patients were female. Clinical competency of 17%, 75.5% and 25.5% of nurses was less than expected, in the expected range and more than expected respectively. 9.2%, 61% and 29.8% of patients were dissatisfied, relatively satisfied and completely satisfied with nursing care. Regression test showed a significant, linear and positive correlation between clinical competence and patient satisfaction. Two-way ANOWA showed a significant relationship between clinical competence, sex, education as well as marital status of patients and their satisfaction.

Conclusion

It seems that the more the clinical competency is, the more the quality care would be and this results in increased patient satisfaction. Therefore, by increasing clinical competence or applying more competent nurses, healthcare system can provide more satisfaction for the clients.

Keywords: Clinical competence, Patients’ satisfaction, Nursing care.

Background

The significant increase in Cesarean delivery around the world turns this issue to a major health concern. In Iran, Cesarean rate is 3 to 4 times higher than what is recommended by WHO. Determining knowledge and attitude of people is the first step in developing and enacting educational programs for health promotion.

Purpose

This descriptive study was performed to determine knowledge and attitude of pregnant women referring to Dezful health centers regarding mode of delivery in 2008.

Methods

120 women selected via quota sampling method participated in the study. A questionnaire completed by interviewing regarding demographic characteristics, knowledge about modes of delivery and attitude toward normal vaginal delivery (NVD) was used for data collection. Content and test-retest methods were used for its validity and reliability.

Results

Most subjects (54.2%) had moderate knowledge regarding mode of delivery. Their attitude (56.7%) toward NVD was neutral.

Conclusion

Since the majority of cases had moderate knowledge about modes of delivery and neutral attitude toward NVD, holding prenatal educational classes in this regard and supervision as well as follow-up for them are recommended.

Keywords: Knowledge, Attitude, Modes of delivery.

Background

Cervical cancer is the second common cancer after breast cancer in the world. It accounts for 18% of total deaths among women.

Purpose

This quasi-experimental before-after study was conducted to determine the effects of education based on Health Belief Model (HBM) on knowledge and attitude of voluntary health workers regarding Pap smear in urban centers of Qazvin.

Methods

120 health workers took part in the study. A questionnaire completed by the subjects was used for data collection. Different statistical tests including Qui-square, ANOVA, coefficient of correlation etc. were used for data analysis.

Results

Mean scores of knowledge and elements of HBM (perceived sensitivity, benefits, barriers and severity) about Pap smear test in the subjects before and after intervention and within the elements showed a significant correlation. No significant relationship was found between the elements and such variables as the age and number of children of the workers. A significant relationship was found between the elements (perceived sensitivity and benefits) and educational level of the subjects before the intervention and also (perceived sensitivity and barriers) after that.

Conclusion

Instructing prevention based on HBM can increase knowledge and make attitude positive in voluntary health workers.

Keywords: Health Belief Model (HBM), Knowledge, Attitude, Pap smear.

Background

Coronary heart diseases are increasing and one of the gold standards for diagnosis is catheterization. This method is associated with vascular complications such as bleeding, hematoma and arterial thrombosis. To prevent these complications, patients are restricted to bed for 6 hours after the procedure. This practice has been associated with back pain.

Purpose

This clinical trial was conducted to determine the effects of bed rest reduction after angiography on vascular complications and back pain of patients at Taleghani hospital in 2007.

Methods

130 patients were selected by convenience sampling and randomly divided into two equal control and experimental groups. Bed rest durations were 6 and 4 hours in the control and experimental groups respectively. A checklist was used for vascular complications as well as hemodynamic status and the numeric pain intensity scale was applied for data collection.

Results

None of the patients in both groups developed vascular complications or hemodynamic alterations. However, the intensity of back pain was significantly lower in the experimental group (P<0/001).

Conclusion

Reducing the time of bed rest after cardiac angiography holds no risk and is possible. This involves no further vascular complication while increasing relaxation and reducing back pain in these patients.

Keywords: Coronary angiography, Bed rest, Complications, Back pain.

Background

Aging has always been concerned throughout history. The second half of the 20^th century has been referred as population graying due to increased number of elderly people. Of related familial and social outcomes is the upsurge of antisocial behaviors and violence. Domestic elder mistreatment or abuse as a major health problem is a type of familial violence with a significantly increasing incidence in the last 2 decades. Since there is no specific organization to be responsible for this problem in developing countries like Iran, no information or evidence is available and limited studies are only limited to developed countries.

Purpose

This descriptive study was conducted to determine the degree and types of domestic abuse in the elderly referring to parks of Tehran.

Methods

400 elders 60 years and over including men and women from all parts of Tehran took part in the study. A questionnaire in 3 parts including demographics, types of abuse and open questions was used for data collection. The tool was validated by face and content methods and made reliable by internal consistency as well as test-retest methods. The questionnaire was completed by the researcher through interviewing the subjects.

Results

Findings showed that 28% of the elderly was between 70 and 74, 38.2% had secondary education, 65.1% was married and 32.9% lived with their spouses. 87.8% of them experienced at least 1 type of abuse, 12.2% no abuse and 24.9% all 4 types of abuse. 84.8% experienced emotional abuse; 68.3%, neglect; 40.1%, financial exploitation; and 35.2%, physical abuse. A positive correlation was found between age and abuse. In contrast, no relationship was found between abuse and sex, educational level, marital status, living condition as well as geographic area.

Conclusion

It can be concluded that domestic abuse is a widespread social problem which requires urgent, continuous and fundamental interventions. Clarification of the issue from different aspects, identification of predisposing and preventive factors and recognition of at-risk elderly are of high priorities in this regard.

Keywords: Elderly, Domestic abuse, Parks.       

Background

In spite of different studies for identifying risk factors in cardiovascular diseases, mortality rate resulted from them is worrying. It is estimated that by the year 2020, the rate will reach to 75%. At present, such risk factors as urban lifestyle, stress, diabetes, obesity, immobility, smoking, increased lipids, BUN, creatinine, hypertension etc. have been identified and are under investigation.

Purpose

This cross-sectional study was carried out to determine identified and probably unknown risk factors in the faculty and educational staff of Islamic Azad University in Karaj city.

Methods

242 subjects including 81 (33.5%) faculty members and 161 persons (66.5%) from educational staff were randomly selected. A questionnaire in 2 parts and some clinical as well as paraclinical tests were used for data collection. All data were gathered between 8 AM and 12 MD during heavy workload.

Results

It was revealed that 44% of the faculty and 46% of the staff had marginal body mass index (BMI). In addition, 14% as well as 26% of the subjects had abnormally higher BMI respectively. In both groups, 63% had higher BMI than normal. Waist circumferences of 62% of the faculty and 76% of the staff were 80 cm or more. 65% had normal blood pressure while it was more than 140/80 mm Hg in 22%. However, in 9% of the faculty and 4% of the staff, the pressure was 100/50 mm Hg. 96% and 91% of both groups did not smoke and fell within normal ranges for blood sugar and urine. The amount of urea and creatinine showed a significant difference between the groups (P=0.000, P=0.009).       

Conclusion

Some known risk factors such as blood sugar and lipids were controlled in the groups but some of them have not been identified as risk factors for cardiac diseases, e.g. BMI, waist circumference, urea and creatinine. A significant relationship exists between blood pressure and job stress as well as coping strategies. This denotes that educational authorities and administrators should modify their plans to control stress and risk factors. 

Keywords: Cardiac risk factors, Stress, Faculty members, Educational staff.