Advances in Nursing & Midwifery

Background

With respect to physical and emotional alterations in pregnancy, alterations in sexual drive are of concern in sexual health of this period. 4 patterns of gestational sexual drive are suggested: 1. Increased drive; 2. Decreased drive in the 1^st trimester, moderate increase in the 2^nd, and decrease in the 3^rd trimesters; 3. Deceased sexual drive in pregnancy; and 4. Lack o drive.

Purpose

This descriptive study was conducted to identify changes in sexual drive of women referring to hospitals affiliated with Shaheed Beheshti Medical University in 2006.

Methods

400 women referring to prenatal clinics were selected by quota sampling for each hospital and simple random method in each setting. A questionnaire was used for data collection. Content validity and test-retest reliability were used for the tool. An expert with the Master of Science in midwifery interviewed the subjects to complete the questionnaire.

Results

Mean ages of women and their husbands were 26.1±4.8 and 31.6±5.7 respectively and their marital period was 5.9±4.8. 3%, 28.8% and 68.2% were in the 1^st, 2^nd, and 3^rd trimester of pregnancy. 61% had no specific problem at this stage. 58% considered their sexual contact disgusting. 96%, 92.2% and 94.1% experienced less pleasure than before from sexual relationships in the 1^st, 2^nd and 3^rd trimester respectively. 83.2%, 80% and 77% had decreased sexual contacts in the 1^st, 2^nd and 3^rd trimester. 50%, 41.7% and 56% experienced less arousal than before in the 1^st, 2^nd and 3^rd trimester respectively. 75%, 57.4% and 62.3% had less sexual desire than before in the 1^st, 2^nd and 3^rd trimester respectively. 49.25% believed that pregnancy had no effect on their sexual contact.

Conclusion

It seems that sexual drive decreases in pregnancy. Thus, proper instruction and consultation programs are recommended for better coping of couples to decrease related problems and complications.

Background

The increasing incidence of cardiovascular diseases and preventive or aggravating factors associated with it such as physical activities, feeling of malaise, stress, lack of well-being require ongoing investigations.

Purpose

This descriptive study was conducted to identify factors associated with physical activities in cardiac patients referring to health settings in Tehran.

Methods

400 patients were selected sequentially by a random multistage sampling method. A questionnaire in 3 parts including demographics, type of physical activities and restricting as well as facilitating factors was used for data collection. Different statistical tests were used for data analysis.

Results

Most patients (66.8%) had low to moderate daily activities and low to moderate exercise (70.4%). Restricting factors for physical activities included feeling of malaise (41%) and stress (35.7%). Facilitating factors including feeling of wellness and self-efficacy in exercise were inaccessible for 64.7% and 74.5% respectively. A significant relationship was found between restricting factors (P<0.005) as well as lack of facilitating factors (0.05) and physical activities.

Conclusion

Daily physical activities and exercise in cardiac patients are inadequate and worrying. The most significant factors in this regard include feeling of malaise, stress and lack of such facilitating factors as feeling of wellness and self-efficacy in exercise.

Keywords: Cardiovascular diseases, Daily physical activities, Exercise, Restricting factors,

Background

Domestic violence against women is now widely recognized as an important public health problem. The effects of it are of critical importance during pregnancy because the consequences are not limited to the woman but extend to her fetus and, later, her newborn. Evidence suggests that violence can also affect the ability of women for breastfeeding.

Purpose

The aim of this prospective cohort study was to evaluate the relationship between domestic violence during pregnancy with breastfeeding women referring to a healthcare center at Marivan in 2007.

Methods

240 women taking prenatal care were selected through a two-stage sampling process. At first, pregnant women were assessed during the last month of pregnancy for violence by a screening questionnaire and divided into two groups: violated and non-violated. Then, they were followed up postnatally in terms of feeding routes after 4-6 weeks.

Results

The prevalence rates of sole breast-feeding, mixed feeding and artificial feeding within 4 weeks after delivery were 52.1%, 47.5% and 4% respectively. No significant difference in the nutrition type was found between those with the experience of sexual and emotional violence than non-violated women. However, women with the experience of physical violence had a significantly lower rate of sole breast-feeding than mixed feeding or artificial feeding groups (P=.006).

Conclusion

The results suggest that physical violence during pregnancy can affect breast-feeding routes. Accordingly, midwives are in a key position for detection and intervention to encourage successful breastfeeding practice.        

Keywords: Domestic violence, Pregnancy, Breast-feeding.

Background

Domestic elderly abuse is a type of family violence and is now well recognized as a public health and a societal problem worldwide.

Purpose

This phenomenological study was conducted to understand the basic concept of abuse in the elderly.

Methods

Benner’s interpretive phenomenology was chosen to describe elderly women’s understanding of the concept of abuse in the elderly in Tehran. Ten elders between 68 and 87 were interviewed 2-5 times in an unstructured format. They explained their experiences regarding this phenomenon. The interviews were tape-recorded and gathered data were transcribed and thematically analyzed.

Results

3 themes were derived including the nature of abuse toward the elderly, living with abuse outcomes and facing with abuse toward the elderly.

Conclusion

The findings can show a clear picture of abuse experiences in the study group.

Background

Today, AIDS or century plaque afflicts more than 35 million people in the world. Increased number of patients in Iran and advances in the management of the disease have led to higher survival rate. In addition, increasing number of hospital admissions and side effects of its drugs have heightened the incidence of opportunistic infections. The patients may fear from social isolation and the quality of their care may be affected by horror of contraction in nursing staff.

Purpose

This descriptive study was conducted to assess nursing care quality in the views of patients with AIDS at healthcare centers affiliated to Shaheed Beheshti and Tehran Universities of Medical Sciences in 2007.

Methods

70 patients hospitalized at least 3 days at one of infectious wards of Tehran were selected by convenience sampling method. A questionnaire with 55 items in different domains (demographics, 11; physical, 20; psychological, 14; and communication, 10) was used for data collection. It was validated and made reliable by content and test-retest methods.

Conclusion

27.9% of the subjects evaluated nursing care quality as moderate. 14.3%, 11.4% and 4.1% appraised the quality as weak, good and very good respectively. No significant relationship was found between age, sex, marital status as well as educational level and the views of patients. A positive correlation was found between hospital stay and the quality in the communication domain (r=0.333) while correlation between age and the quality in this domain was negative (r=0.304, P<0.01).

Conclusion

It can be concluded that nursing care given to patients was inadequate to satisfy the needs and expectations of patients with AIDS.

Keywords: AIDS, Quality of nursing care, Patients’ views

Background

Nursing records are considered as an indicator of care and its quality; therefore, any flaw in them can represent inadequacy of care. Peer review is an approach to authority submission by managers for nursing quality assurance.

Purpose

This quasi-experimental study was conducted to determine the effects of peer review process implementation on the quality of nursing records in critical cardiac wards (CCU and PCCU) at governmental hospitals of Arak in 2007.

Methods

4 wards (CCU and PCCU) at 2 hospitals in Arak were selected. 2 wards with more nursing staff (25 nurses) and the other 2 with less staff (19 nurses) were chosen as case and control groups respectively. Checklists for assessing the quality of nursing records were used for data collection. 35 checklists were completed by a colleague as a pretest. Raters had been instructed regarding the assessment 1 month before the intervention. The peer review process was then performed by the raters 1 month with direct and 1 month without direct supervision of researchers. The checklists were completed again for both groups as a posttest.

Results

No significant difference was found between the groups in terms of demographic characteristics (age, education, financial status,…). There was no relationship between these characteristics and the quality of records. However, a significant difference was found between the groups regarding the quality of records before and after the intervention (P<0.001).

Conclusion

 It seems that peer review process performance influences on the quality of records.

Keywords: Peer review process, Quality of nursing records.   

The traditional management skills of planning, organizing, directing and controlling are insufficient in the fast-pacing, constantly changing, and highly complex world of twenty-first- century organizations.

     The quantum age is upon us and no part of human life is unaffected by this change and its new realities. Its impact on management and leadership is just beginning to be defined. If leaders and their organizations are to thrive in the new era, a whole new mind-set and skill-set must emerge in managers. While a fall in the number of nursing leaders may be attributed to the current nursing shortage, studies have noted that there is also a significant deficiency in their number. We need nursing leaders to exert that influence and by nurturing both leadership as well as clinical skills, we can do it. In contrast, at the bedside, they rarely find the opportunity to apply even basic leadership principles.

     Based on quantum approach to management, managers need to have a new perspective to man, processes and things. Also, this model considers the connection between things, man and elements much more important than the parts themselves. New challenges in leadership are avoiding centralization, maintaining flexibility, repeated designing and establishing structure to support culture and goals of followers. The new definition of system, therefore, is a set of rotary processes moving between order and chaos according to required needs.  

     In quantum model for efficiency of leadership, seven skills, seven traits and seven principles are referred. This paper explains effective factors in quantum leadership and quantum organization.

Keywords: Quantum Model, Nursing, Leadership.