Advances in Nursing & Midwifery

Background and Aim

Access to the resuscitation environment depends on attitudes of staff of emergency rooms (ERs). Attitudes of health personnel differ to let family witness cardiopulmonary resuscitation. The aim of this study was conducted to determine physicians' and nurses' attitudes toward witnessing resuscitation by family in the ERs of hospitals affiliated with Tehran, Iran and Shahid Beheshti Universities of Medical Sciences & Health Services.

Materials and methods

This research was a descriptive study. 120 nurses by quota sampling method and all 60 physicians in emergency rooms of the hospitals were selected. Data were collected over two months by a questionnaire in 2 parts including 13 items for demographics and 31 questions for the attitude. Content and test-retest methods were used for validity and reliability (r=0.78) of the tool respectively.

Findings

60% of the subjects were male, 55% had work experience between 1and 5, 43.9% was single and 83.9% was between 25 and 35. 70% of the physicians and 91.7% of nurses had previous reading regarding the presence of a family member during resuscitation. 53.3% of the physicians and 56.7% of the nurses had no tendency to let a family member stay in the ER during cardiopulmonary resuscitation (CPR). No significant difference was found between the attitudes of physicians and nurses in this regard. 66.2% had no view in this respect.

Conclusion

One of the basic needs of clients and their family members is advocacy in critical situations and one of these situations for them is CPR. Clinical staff should provide the opportunity for the presence of a family member during CPR and support patients and their families.

Keywords: Attitude, Physician, Nurse, Presence of a family member, Cardiopulmonary                    resuscitation

^*Corresponding Author: Azam Dabiriyan. Dept. of Community Health Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences & Health Services, Tehran, Iran E-mail: aazamdabirian@yahoo.com

Background and Aim

Many patients referring to health centers because of chest pain do not require hospitalization at CCUs (Coronary Care Units). The aim of this study was to assess the rate of resource utilization and cardiovascular outcomes in patients with low risk chest pain admitted to CCUs of hospitals affiliated with Shahid Beheshti University of Medical Sciences and Health Services.

Materials and methods

In this descriptive study, all patients with chest pain admitted to CCUs of 6 hospitals were selected with purposive sampling method. Of 550 patients, 95 were considered low-risk using "Thrombolysis in Myocardial Infarction (TIMI)" scale and assessed in terms of hospital stay, costs and cardiovascular outcomes over 30 days after discharge. A questionnaire validated with content and face methods was used for data collection. The scale was made reliable with inter-rater method (r=0.8). Data were analyzed with SPSS 16.

Findings

Mean age of the subjects was 46.95 year and 66.3% of them were male. The lowest stay and bed occupancy rates were related to hospital 3 and the highest rates to hospital 1 and 2. Mean length of stay was 3.04 days. ANOVA showed no significant difference between length of stay and expenses in 6 hospitals. No cardiovascular complication was seen 1 month after discharge in 89.5% of patients with any report of death.

Conclusion

With respect to the high rate of bed occupancy by the subjects and wastage of material and human resources with no cardiac complications over 1 month following discharge, appropriate triage of patients in the emergency unit can prevent unnecessary hospitalization in the CCU.

Keywords: Low-risk patients, Chest pain, Resource utilization.

^*Corresponding Author: Hossein Shiri, .Dept. of Community Health Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran E-mail: Shiri.hossein@yahoo.com

Background and aim

One of the fundamental concepts in the development of character with especial importance in adolescence is the concept of self. Therefore, self-concept warrants investigation. The aim of this study was to compare the self-concept of normal and criminal adolescents between 12 and 14 at Tehran.

Materials and methods

In this descriptive-comparative study, 200 adolescents including all available 50 criminals and 150 normal adolescents selected by purposive sampling took part in the study. Governmental schools from selected districts of Tehran and Disciplinary and Education Center were the places of study. A questionnaire in 2 parts, demographics and items related to self-concept derived from Piers-Harris Questionnaire was used for data collection. Although this questionnaire is considered a valid and reliable tool to measure self-concept in children and adolescents, it was validated again with content validity index (90.12) in this study. Data were analyzed by SPSS 11/5.

Findings

51.3% of normal adolescents had negative self-concept (31.3%, negative and 20%, very negative) and 48.7% had positive self-concept. In all (100%) criminal adolescents, self-concept was very negative. Therefore, a significant difference was found between self-concept of the two groups (p=0.001).

Conclusion

In general, normal adolescents had higher self-concept than criminal ones, which may be related to psychological and familial differences in the 2 groups.

Keywords: Crime, Self-concept, Adolescents.

Background and aim

Fetal weight is an important factor in delivery since many preventable risks can be detected by accurate estimation of it before delivery. Accordingly, the risk of death and maternal as well as neonatal complications related to birth weight can be reduced by quick referral to more equipped centers. The aim of this study was to determine prediction of birth weight before delivery according to characteristics of mothers at Fatemieh Hospital in Hamedan.

Materials and Methods

In this descriptive-correlational study, 220 women with no complication in pregnancy and gestational age between 37-41 weeks were selected by convenience sampling. A questionnaire, a checklist, a meter band and a scale were used for data collection. The first 2 were validated by content method. The scale was validated with 2 standard scales, 1 with the brand of Rasa calibrated by Farid engineering Co. made in Iran for weighing mothers and the other with the band of Seca made in Germany. To validate the band, a standard, firm, flexible and inextensible one was used. Test-retest was applied for the reliability of the questionnaire and inter-rater method for the checklist and the meter band. The scales were also made reliable with appropriate protocol. A multiple regression analysis was performed to evaluate predictive value of characteristics in 10 pregnant mothers including weight, height, gestational weight gain, body mass index, fundal height, abdominal girth, arm girth, gestational age and fetal sex to identify an optimal combination for estimating birth weight. Data were analyzed by SPSS 11/5. 

Findings

Of 10 factors under investigation, 4 including gestational age, height of mother, fundal height and fetal sex explained in combination the birth weight up to 44%. Press index showed that the following equation has proper prediction accuracy:

Birth weight (g) =-2643.91+8.02 (gestational age in day) + 844.46 (mother's                                height) (m) +65.23 (fundal height) (cm) +144.25 (fetal sex) (boy=1, girl=0)

Conclusion

Birth weight can be correctly estimated with the resulted regression equation in terms of maternal characteristics before delivery.

Keywords: Prediction, Birth weight, Characteristics of pregnant mother, Delivery.

^*Corresponding Author: Mahboobeh Ahmadi Doolabi .Dept. of Community Health Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences and Health services, Tehran, Iran E-mail: mah1372@yahoo.com

Background and aim

The main goal of health care providers is to gain satisfaction of patients. Accordingly, one of the criteria in assessing quality of maternity care is satisfaction of mothers. The aim of this study was to determine satisfaction of mothers with the performance of health care providers in postpartum wards of selected hospitals at Zahedan.

Materials and methods

 In this descriptive study, 72 women with normal vaginal delivery were selected via quota sampling method in two hospitals. A questionnaire completed by interview from mothers in 4 parts including demographics and satisfaction with the performance of physicians, nurses as well as other staff was used to collect data. Its validity was determined by content method and its reliability by internal consistency. Data were analyzed by SPSS 15.

Findings

Mean age of the subjects was 23.65±5.49. Mean amounts of satisfaction with the performance of physicians, nurses and staff were 68.32%, 60.81% and 68.40% respectively. The highest means of satisfaction were related to the knowledge and skills of physicians as well as nurses and the lowest to the conduct of physicians and responsiveness of nurses.

Conclusion

With respect to the proper satisfaction of mothers with the competency of clinical staff which cannot be authentically cited due to their limited information regarding professional medical services, the conduct and responsiveness should be well attended.

Keywords: Satisfaction of mothers, Postpartum care, Nursing care, Staff performance.

^*Corresponding Author: Torkzahrani, SH. Dept. of Community Health Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences & Health Services, Tehran, Iran E-mail: zahranishahnaz@yahoo.com

Background and aim

Decreased mobility and physical activity are threatening factors of health and spinal cord as the basic axis of the body is of critical importance in this regard because any injury of deformity of it can cause body malfunction. The aim of this study was to assess abnormalities of spinal cord and some of their related factors in male students of Islamic Azad University at Semnan.

Materials and methods

In this descriptive study, 240 students in their Physical Education Course 1 took part in the study. New York Test Posture Screen validated and made reliable by content and test-retest (r=0.80) methods respectively as well as Matiyas Test were applied for the assessment. A 3-grade scale including good, fair and poor was used for classification and those classified as good were regarded normal and those classified as fair or poor were considered as abnormal. Data were analyzed by SPSS 14.

Findings

91.3% of the subjects suffer at least from one of spinal cord abnormalities. The most common condition was falling shoulders (74.2%) and the least frequent was pelvic obliquity (2.5%). Matiyas test was negative in 58.8% (not able to remain in requested position). 33.3% was overweight and obese in terms of body mass index (BMI).

Conclusion

The results showed that the prevalence of spinal cord abnormalities in the subjects was very high (91.3%) mostly due to poor mobility, weakness in the muscles of upper extremities particularly those holding the spine and lack of exercise. Thus, planning for physical activities and exercise in the leisure time of students seems essential.

Keywords: Spinal cord, Spinal cord abnormalities, Exercise, Scoliosis.

^*Corresponding Author: Mohammad Rashidi. Dept. of Physical Education, Islamic Azad University, Semnan, Iran. E-mail: Mrashidi48@Yahoo.com      

Background and aim

Quality of care is a dimension of quality of services and Clients’ satisfaction is an outcome of quality. However, clients’ satisfaction is sometimes translated as quality of care. The aim of this study was aimed to identify a correlation between quality of care and clients' satisfaction in family planning units of healthcare centers affiliated with Shahid Beheshti University of Medical Sciences & Health Services.

Materials and methods

In this descriptive study, 200 Clients referring to family planning units of 11 healthcare centers took part in the study with a multistage sampling method. Data were collected with a checklist to assess quality of care and a questionnaire to identify clients' satisfaction in 2 parts: structure and family planning services scored by a Likert scale. Content and face validities of the questionnaire were checked and its reliability was calculated by Cronbach’s α (r=0.94) and inter-rater methods (r=0.91). Data were analyzed with SPSS 16.

Findings

56.73±10.96 percent of the services had conformity with standards; therefore, its quality was considered as moderate. The lowest and highest percents were related to education (35.43±16.14) and history taking (77.83±28.46) respectively. Clients' satisfaction was considered good (83.75±13.89). No significant correlation was found between quality of care and satisfaction.

Conclusion 

With respect to the results, factors other than the quality of care can influence on clients' satisfaction. Therefore, all aspects should be assessed and, according to the problems found, appropriate interventions may be planned and implemented.

Keywords: Quality of care, Family planning, Satisfaction.

^*Corresponding Author: Masoomeh Simbar, Assistant Professor, Dept. of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences & Health Services, Tehran, Iran. E-mail: msimbar@sbmu.ac.ir

Background and aim

Iron deficiency anemia is one of the main nutritional problems at different age groups particularly pregnant women and young children worldwide. The aim of this study was to compare the effects of daily with weekly iron therapy in infants between 6-24 months with iron deficiency anemia in the South of Tehran.

Materials and methods

In this clinical trial study, 160 anemic infants diagnosed by hemoglobin test were randomly selected and divided into 2 equal control and experimental groups. The control group was given 5ml ferrous sulfate syrup daily containing 40mg ferrous sulfate but, in the experimental group, iron was given in the same amount once a week on Friday mornings. Hemoglobin was measured at the beginning of the intervention, after 3 months and immediately after the therapy (6 months). A questionnaire, physical examination, home visit and laboratory tests were used for data collection. Data were analyzed by SPSS 11/5.

Findings

Both methods were effective on increasing hemoglobin level with no significant difference. Drug compliance in weekly method (77%) was significantly better than daily protocol (49%) for mothers.

Conclusion

Weekly administration of iron compared with daily consumption seems superior due to similar effects, better compliance of mothers and lower costs for the treatment of anemia in infants between 6 and 24 months.

Keywords: Anemia, Iron deficiency, Infants, Nutrition, Ferritin, Iron supplement.

^*Corresponding Author: Zahra Kargarnovin, Dept. of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran. Tehran, Iran. E-mail: zknovin@hotmail.com