Advances in Nursing & Midwifery

Evaluation of the Clinical Performance of Nurses Employed in the Neonatal Intensive Care Units.........1 Fateme Amiri Simkoii, Anahita Masoumpoor, Azam Shirinabadi-Farahani, Bagher Pahlevanzadeh The Effect of Reproductive Factors on Coronary Artery Disease in Women..............................................9 Soodabeh Darvish, Saeed Sadeghian, Azizeh Ghaseminejad, Reza Mohebi The Study of Nurses Knowledge and Performance Quality of Qazvin Hospitals about the Process of Blood Transfusion.......................................................................................................................................14 Fatemeh Nemati, Amirhosein Maali, Mohammad Hossein Ahmadi, Hoda Poorkarim, Hanieh Rahmani, Zahra Sadat Tabatabaei, Mehdi Azad The Effect of Employment of Nursing Students on their Academic Achievement in the School of Nursing and Midwifery of Shahid Beheshti University of Medical Sciences.............................................19 Feryal Esnaashari, Tahereh Fathi Najafi, Nasrin Razmkhah, Mehri Ardakani The Evaluation of Functional Quality in Bachelor Midwifery Students based on Objective Structured Clinical Examination (OSCE) in Islamic Azad University-Mashhad Branch...........................................23 Hajar Beirami, Hadi Rezghi Shirsavar Prediction of Mental Health in MS Patients: The Role of Psychological Resilience and Cognitive Integration...................................................................................................................................................29 Maryam Kazemi Correlation between Spiritual Leadership and Occupational Conflict.....................................................33 Masoumeh Namdar, Mansoureh Zagheri Tafreshi, Foroozan Atashzadeh-Shoorideh, Maliheh Nasiri Relationship between Spiritual Experiences and Organizational Commitment with Perceived Stress at the staff of Tehran Oil Hospital..................................................................................................................39 Mohammad Reza Yavari, Soraya Zarrini Application of Photovoice in Qualitative Researches................................................................................46 Alireza Nikbakht Nasrabadi, Fatemeh Najafi, Leila Mardanian-Dehkordi

Introduction: Nurses are as the most important health care providers who require extensive knowledge and skills in this field. Despite the high importance of the issue, our knowledge of the current status of clinical performance and levels of nursing skills in the neonatal intensive care units is very low. The present study was done with the aim of determining the status of clinical performance of neonatal nurses in the NICU. Methods: The present research is a descriptive study, through which the clinical performances of 96 neonatal nurses were observed in eight areas. Data collection was done using a researcher-made Scale. The data were analyzed with SPSS version 21. Results: The neonatal nurses’ clinical performances were acceptable (69.74%) in all the areas which includes vital signs control, daily cares, respiratory cares, infants feed, vessels' access, medicine prescription, phototherapy and using required equipment for neonates (such as warmer, Infusion pump, Defibrillator, Incubator, Ventilator and Phototherapy).The highest and lowest practices were assessed in the fields of infant nutrition (84.11%) and equipment utilized (51.93%), respectively. Conclusions: The nursing skills in the study areas seems within an acceptable range, which could be due to the NICU nurses’ interests in this field. In order to improve the performance of nurses in areas where there is a weakness, we suggest considering the importance of these care and disadvantages due to negligence.

Abstract Introduction: There is a sex discrepancy in cardiovascular physiology. In this study, we aimed to investigate the effect of female reproductive factors on coronary artery disease (CAD) beyond the known CAD risk factors. Methods: In a case-control study, women referred to Tehran Heart Center for coronary artery angiography from 2012 to 2014 were enrolled. Of these, 80 premenopausal and 100 postmenopausal females with CAD in angiography were randomly selected as cases and 80 premenopausal and 100 postmenopausal females without CAD in angiography were selected as controls. A questionnaire including reproductive history and known CAD risk factors was filled for every subject. Analysis was performed separately for pre and postmenopausal women and a final adjustment for coronary artery disease risk factors was done. Results: Among reproductive factors, oligomenorrhea (OR= 6.72) was a significant risk factor for CAD in premenopausal women and history of oral contraceptive (OCP) use had a protective effect on CAD in pre and postmenopausal woman (OR= 0.24 and 0.20, respectively). Conclusions: Since oligomenorrhea has a strong association with insulin resistance and diabetes, a conventional risk factor of CAD, women with oligomenorrhea should be treated not only for cyclic irregularity but also for prevention of CAD.

Introduction: Supplying blood and blood products, maintenance, transfer and injection of each component have its own specific process. Therefore, those responsible must at least have the awareness that relates to the transfusion medicine. The safety and effectiveness of blood transfusion depend on the knowledge and skills of nurses, who have taken the responsibility. The aim of this study is to assess the educational needs of nurses in the field of blood transfusion that leads to creating a good medical process for nurses in clinical departments of hospitals. Methods: In this cross-sectional study, 124 nurses who participated in, were selected through random sampling in Qazvin hospitals in 1396. A questionnaire including 25 questions was used to evaluate the knowledge and performance of their awareness of different aspects of blood medicine, including maintenance, transferring, injection and post blood transfusion reactions. The scores of knowledge and performance encoded in three levels: low, medium, and good. Data analysis and correlation of variance were performed by using the software SPSS version 20. Results: Research results showed that most of the subjects are in the age group 20-30 years (68.7%) and females (93%) and have a bachelor's degree in nursing (95.6%). Results showed that the mean score of knowledge was 9.58±2.13, and score range was 9 (between 3 to 12). The mean score of performance was 38.96±2.17, with range 10 (scores were between 30 to 40). The analysis of variance used to examine the relationship. The results suggested that there was a significant relationship between performance and knowledge of subjects (P<0.05). Conclusions: According to this study, nurse’s knowledge level and awareness of blood transfusion are the media. Therefore, training, managers controlling and supervision programs seem to be necessary due to the great importance of the blood transfusion process and threaten the safety of patients. So, we recommend that this issue must be seriously included in academic courses and retraining in the field of blood transfusion, according to the latest available standards at the time of the nurse’s employment.

Introduction: The present study was conducted to assess the effect of nursing students' employment on their academic success in the School of Nursing and Midwifery of Medical Sciences University. Methods: In the present descriptive correlational study, the statistical population comprised all 1521 students of School of Nursing and Midwifery of ShahidBeheshti University of Medical Sciences in the academic year 2016-17. Sampling was performed by proportional stratified random method. Using Cochran equation, sample size was determined 309 students. Data were collected using demographic and academic success questionnaire and analyzed in SPSS-18. Results: The results showed that academic achievement has relationships with gender, marital status, and employment status of student, their spouse’semployment status and education, marital life, family housing, appropriate studying setting, and job relevance with academic discipline. According to logistic regression test, variables such as gender, marital status, spouse's education and marital life were able to predict academic achievement. Conclusions: Personal and family status are highly effective on students' academic achievement.

Abstract Introduction: Objective Structured Clinical Examination (OSCE) is one of the standardized and accepted methods for the certification of undergraduate midwifery in the world. OSCE is a type of examination often used in health sciences (e.g. midwifery), which is designed to test clinical skill performance and competence in skills such as clinical examination, medical procedures / prescription, exercise prescription, manipulation techniques. The aim of this study is to evaluate the quality of midwifery students’ performance before the final exam through the OSCE method in Islamic Azad University of Mashhad. Methods: This cross-sectional study was conducted in the summer of 1396 on 75 midwifery students before entering the final exam. Checklists for evaluation of skills were analyzed by the experts’ panel to increase the validity of checklists. For examining the reliability of the exam in studied population, the spilt-half method was used. Evaluation of the quality of students’ performance in various areas of pregnancy and childbirth, gynecological diseases, maternal and child health and they were carried out at three levels of diagnosis, decision making and therapeutic interventions. The exam was also carried out in 12 sections along with a rest one. Results: 75 volunteers were divided equally according existing stations. 89/3% were under the age of 25 years old 48% were single and 52% were married. The average score was calculated, when the students were able to answer 50% of the items in each domain. If the volunteer answered more than 50% of the items, she would be in good shape, while the volunteer answered fewer than 50% of the items, she would be weak. The performance of midwifery students was moderate and good at all stations except for Pap smear in gynecology domain, fetal health evaluation in pregnancy and childbirth domain, and Vaccination in maternal and child health domain. (PV<0.848, PV<0.666, PV<0.711 respectively both diagnosis and decision making level. Conclusions: Since the OSCE examines the strengths and weaknesses of students, this study indicated that weakness of midwifery students of Mashhad Azad University lied in some important areas such as, fetal health evaluation, Pap smear and Vaccination which should be more considered and emphasized on by the instructors and educational planners.

Abstract Introduction: Multiple Sclerosis is a chronic disease of the central nervous system in which myelin damage occurs locally. This study was conducted to predict the mental health of patients with MS regarding cognitive integration and psychological resilience. Methods: In a correlational-descriptive study, all people with MS disease in the west of Iran in 2015 were studied. Hundred people were selected from medical and clinical centers by using easy sampling method. They filled out acceptance and action of Bond et al (2011), cognitive incongruity Gillanders et al (2014), mental health (GHQ-12) and Demographic Information Sheet questionnaires. Pearson correlation factor and regression efficiency factor were used to analyze data with SPSS V. 22 software. Results: The results showed that mental health has a negative correlation with psychological integration (r=-0.438, P<0.001) and positive significant correlation with psychological resilience (r=0.487, P<0.001). Regression analysis showed that 24.3% of mental health variance factor is predicted by psychological resilience (P<0.001). Conclusions: According to the results, information and knowledge could be provided by holding training courses to increase psychological resilience, so that mental health of MS patients would be provided.

Abstract Introduction: Nurses as the largest group among the healthcare staff sustain continual environmental pressures and changes. Hence, the incidence of conflict among nurses is something normal due to extensive interactions with various people. Managers can make the organizational activity more effective and efficient by the use of innovative leadership styles based on internal motivation and appropriate management of conflict. This study determined the correlation between spiritual leadership and occupational conflict of nurses employed at selected academic hospitals affiliated to Shahid Beheshti University of Medical Sciences in 2017. Methods: 287 nurses employed at various wards of academic hospitals of Shahid Beheshti University of Medical Sciences, Tehran, Iran, were enrolled in this descriptive-correlational study using convenient sampling method. The data were collected using two questionnaires; “Spiritual Leadership” and “Occupational Conflict” and analyzed with SPSS.18. Results: 261 nurses completed questionnaires and resend them. The findings showed that the maximum score obtained by nurses about their head nurse’s spiritual leadership style belonged to “altruistic love” (14.46 out of 25). In addition, the highest score about their occupational conflict belonged to “interclass conflict” (10.98 out of 16). Generally, there was a significant correlation between spiritual leadership and occupational conflict (P<0.001, r=0.522). Conclusions: The findings on the correlation between the nurses’ perspectives about spiritual leadership and occupational conflict indicated that the application of innovative styles such as spiritual leadership to reduce nurses’ occupational conflict in the Iranian healthcare system demands more investigations. It can serve as the managers’ guide in choosing the most effective leadership style to diminish occupational conflict among nurses and reach the highest levels of outcomes in the organization.

Abstract Introduction: There have been numerous researches carried out in the field of organizational health with the aim of identifying ways to counteract the negative effects of stress. The purpose of this study was to determine the relationship between spiritual experiences and organizational commitment with the perceived stress of the staff of the Tehran Oil Hospital. Methods: The research population of all Tehran Nursing Hospital nursing staff was stratified randomly based on the formula for determining the sample population in 2017. For data collection, standardized questionnaires were used to measure each variable and the extracted data were analyzed using SPSS 22 software. Results: Statistical analysis of the research data showed that there was a significant relationship between spiritual experiences and its components such as meaningful work, sense of correlation and alignment of values, and the pillars of the organizational commitment such as emotional commitment, continuous commitment and normative commitment with perceived stress at a significant level of P<0.05. According to the results of regression with multivariate correlation coefficient for linear combination of variables of spiritual experiences (work with meaning, sense of correlation and values alignment), organizational commitment and perceived stress were equal to MR =35.70and RS =0.19,Which is significant at P<0.0001. Conclusions: The results of this study showed that the spiritual experiences of employees have a positive and significant relationship with organizational commitment and reducing perceived stress. In other words, those with high spirituality feel less stress and more organizational commitment.

The concept of photovoice was at first invented in 1997, it is a visual participatory tool to collect data in qualitative studies that was widely used in different countries and various health issues [1, 2]. It employs contributors to take photograph of a subject of concern, critically reflecting on the subject, and yields solutions for these problems [3]. In this method of data collection, cameras are provided to contributors in order to share their facts, stories, and target commonplace issues in their lives [4]. It’s also been used to express needs, history, culture, problems and desires [5].
Photovoice's method is based on three theoretical foundations that overlap one another: documentary photography, feminist theory, and the critical awareness theory of Paulo Freire [2]. Photovoice has three main objectives: 1. encouraging and empowering people to record and give feedback on strengths and problems in their societies; 2. Promoting critical knowledge on important issues through group discussions on pictures and 3. Providing easier access to policy makers to change [1]. This process consists of several components. The researchers first set objective matter and select participants that are relevant to the object matter. At the beginning, participants will be provided with brief tutorials on photography skills, photovoice ethics and safety. After that photos which are provided by participants should be discussed through interviews, telling stories and big and small discussion groups which researchers evaluate the reasons of choosing their own images and feelings by using an integrated structures. The researchers then analyze the content and extract the relevant codes. Finally photos will published in magazines or websites if necessary [6, 7]. Photovoice has positive results on individual and community health, developing trust, making a sense of ownership, social skill development, increasing individual self-efficacy, learning together, building community capacities, creating community change and balancing research and practice [2, 6, 7]. The photovoice limitation is related to the inability of children to respond accurately to photos and how photos exhibit their experiences from the topic. To manage this limitation, researchers also used an evidence-based approach as complementary method [7].
Photovoice is proposed as one of the methods aimed at collecting data in qualitative studies to enrich the results of studies and provide an accurate understanding of the topic from the participants’ perspectives.