Advances in Nursing & Midwifery

Background and aim

Pressure ulcer and its related factors are associated with such complications as decreased quality of life of patients and increased cost of health system as important issues of nursing care. This descriptive study was conducted to determine the incidence of pressure ulcer and its related factors in patients at orthopedic wards in 2009.

Materials and methods

330 patients with no pressure ulcer at the time of admission, no movement due to therapeutic interventions or movement only with assisting devices were selected through convenience sampling at orthopedic wards of hospitals affiliated to Shahid Beheshti University of Medical Sciences. A demographic questionnaire, “National Pressure Ulcer Advisory Panel“ grading scales and “Braden Pressure Ulcer Assessment Scale” were used for data collection. The tools were validated by content method and inter-rater reliability method was used for the grading system and Braden Scale. Data were analyzed by SPSS 15.

Findings

46 patients (%13.9) developed pressure ulcer of which %76.1, %21.7 and %2.2 were at stages 1, 2 and 3 respectively. The most common locations of the ulcers were in sacrum (%34), ischium (%34.8), heels (%17.4) and both sacrum as well as heels (%10.9). The related factors included medical diagnosis, type of therapy, decreased activity and immobility.

Conclusion

The incidence of pressure ulcers in Tehran is similar to other reports around the world. Risk factors in this regard are old age, lengthy hospitalization, medical diagnosis, type of therapy, decreased activity and immobility.

Keywords: Pressure ulcer, Risk factors, Braden Scale.

^*Corresponding Author: Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences. Tehran, Iran.

E-mail: bolourchi@sbmu.ac.ir

Background and aim

One of the reliable criteria for evaluating health status of children is appropriate growth and development particularly in the first 2 years of life. This descriptive study was carried out to determine the patterns of growth and development of children under 2 and some related factors brought to Shahid Shafiee Health Center at Yasooj (a city in Iran) in 2007.

Materials and methods

225 children brought by their parents for health checkups were selected through convenience sampling. A questionnaire was completed by interviewing with their mothers and an examination form was used to document weight, height and head circumference of children. Different statistical tests such as independent t, Chi-square and one-way ANOVA were used for data analysis. Data were analyzed by SPSS 15.

Findings

108 subjects (%48) were female and the rest (%52) was male (SD=9.4±5.5). %65.8 was born through vaginal delivery while %34.2 with caesarian. %75.1 was breast-fed. Mean birth weight was 3071.6±517.7 gm. No significant difference was found between means and standard deviations of weight, height as well as head circumferences between girls and boys. Such developmental indices as means of age for neck holding, sitting, tooth growing, standing and walking were 3.5±1.5, 7.6±2, 9.7±1.8 and 10.9±2 months respectively. In all age groups, the medians of weight and height for age were less than National Center of Health Statistics (NCHS) standards with less difference between 0-6 months and more difference between 1-2 years. Growth patterns of children had a significant relationship with the type of birth and occupation of their fathers (p<0.05).

Conclusion

Lower growth and development indices from international standards may be due to unsuitable environmental as well as health conditions and malnutrition. Lower difference of the indices from the standards in infants before 6 months may be attributed to the role of breast milk as the primary food at this age.

Keywords: Growth and development, Infants, Related factors.    

^*Corresponding Author: Mitra, Safari. Lecturer, Dept. of Midwifery, Faculty of Nursing and Midwifery, Yasooj University of Medical Sciences. Yasooj, Iran.

 E-mail: mitra_safari39@yahoo.com

Background and aim

For different reasons, children may experience hospitalization. With respect to the importance of human relationships and verbal communication in this group for creating confidence and a sense of security with healthcare team, this descriptive study was conducted to identify the quality of verbal communication of the team with hospitalized children under 3 in 2008.

Materials and methods

253 nurses and 87 physicians working in pediatric wards of hospitals affiliated to Tehran University of Medical Sciences took part. Data collection tools included a demographic questionnaire and a verbal communication checklist in 3 levels: good, moderate and poor. The checklist was designed for 2 age groups (0-1 and 1-3) to evaluate age differences and communication needs more accurately. Chi-square and exact Fisher tests were used for data analysis. Data were analyzed by SPSS 11.

Findings

%41.9 and %60.8 of nurses had poor communication with children 0-1 and 1-3 respectively. %42.3 of head nurses had good communication with children 0-1 and 1-3. %38.4 and %48.9 of physicians had good communication with children 0-1 and 1-3 respectively. A significant correlation was found between the verbal communication quality of nurses and such demographic variables as having children, educational level and shift time as well as of head nurses and educational level (P<0.05).

Conclusion

According to findings, verbal communication quality of most nurses with children under 3 was poor while most head nurses and physicians had good quality in this regard.

Keywords: Communication, Talk, Healthcare team, Hospitalized children.

^*Corresponding Author: Zahra, Goodarzi. Lecturer, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.

E-mail: godarziz@sina.tums.ac.ir

Background and aim

Menopause entails many complications on women’s quality of life. Hot flashes is the most common and bothersome effect, mainly treated with hormonal therapy. However, because of its side effects, there is controversy over its administration. Thus, therapies with fewer complications such as herbs warrant investigation. The aim of this randomized double-blind clinical trial was to determine the effects of licorice root extract on the number of nocturnal hot flashes in menopausal women referring to healthcare centers affiliated to Shahid Beheshti University of Medical Sciences in 2008.

Materials and methods

68 women were selected with purposive sampling method and randomly divided into 2 equal experimental and placebo groups. After taking their consent, data were gathered with a questionnaire and information forms validated through content method. Reliability was ensured by using standard brands for meter band, weights, stethoscope and sphygmomanometer calibrated according to guidelines of manufacturers. Both experimental and placebo groups took capsules containing 330 mg licorice and starch 3 times a day (morning, noon and night) over 4 weeks respectively. The numbers of nocturnal hot flashes were measured from 2 weeks before the intervention to the end of it. Data were analyzed by SPSS 11.5.

Findings

Means of age, duration of amenorrhea and duration of hot flashes were 53.13, 1.65 and 1.65 respectively. The numbers of hot flashes in the experimental group were 4.82 before the intervention and 1.05 after it with a significant difference. However, no significant difference was found before and after the intervention in the placebo group.

Conclusion

Licorice as an herb may decrease the number of nocturnal hot flashes in menopausal women, increasing their physical and psychological health.

Keywords: Hot flashes, Menopause, Licorice.  

^*Corresponding Author: Fatemeh Nahidi. Lecturer, Dept. of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

 E-mail: nahidifateme@yahoo.com

Background and aim

Anemia is the most common nutritional deficiency in women at reproductive age. In spite of taking iron and folic acid during pregnancy, women suffer from it with a high incidence. Obesity has been suggested as one of causative factors of anemia in recent studies. The aim of this analytical study was to determine the relationship between anemia and body mass index (BMI) before gestation in women before pregnancy referring to Fatemieh Health Center affiliated to Hamadan University of Medical Sciences in 2007.

Materials and methods

159 women selected with purposive sampling were divided in terms of hemoglobin levels at 38-40 weeks of gestation into 2 groups (70 anemic, less than 11gr/dl and 89 normal, equal or more than 11gr/dl). BMI was calculated in terms of weight before the 8^th week of gestation in kilogram and height in meter. Both groups were matched for intervening variables. Mann-Whitney and chi-square tests were used for data analysis. Data were analyzed by SPSS 13.

Findings

A significant difference was found in the hemoglobin levels of the groups, i.e. 1 unit increase of BMI would increase the likelihood of anemia 1.6 times (CI=%95, 1.2 to 1.9 times)(P>0.001).

Conclusion

Obesity may be a risk factor leading to gestational anemia.

 Keywords: Anemia, Body mass index (BMI), Gestation.  

^*Corresponding Author: Sedigheh, Amir AliAkbari. Lecturer, Dept. of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti Universityof Medical Sciences, Tehran, Iran.

 E-mail:Asa_akbari@yahoo.com

Background and aim

Midwifery care plays an important role in provision and promotion of maternal health. Therefore, its evaluation is necessary and one of the ways for that is to measure satisfaction of mothers with the care given to them. This descriptive study was conducted to identify the level of satisfaction of mothers with midwifery care in labor and delivery rooms at hospitals of Zanjan city.

Materials and methods

100 women were randomly selected from obstetrical units after delivery. A questionnaire in 2 parts, namely, demographics and maternal satisfaction, was used for data collection. Its validity and reliability were achieved by content and Cronbach’s α methods respectively. Data were analyzed by SPSS 14. Different statistical tests including chi-square, Pearson coefficient of correlation and t-student were used for data analysis.

Findings

Mean age of the subjects was 25.80±4.58. Total satisfaction was %74.6 in which %35, %53 and %12 had high, moderate and low levels of satisfaction respectively. No significant correlation was found between the level of satisfaction and such demographic characteristics as age, level of education, occupation, parity and sex of newborns.

Conclusion

Satisfaction of mothers with midwifery care in labor and delivery rooms was moderate to high. High satisfaction of mothers in this study may indicate an appropriate and desirable care provided by midwives. Thus, employing midwifery work force is essential for maternal health promotion.

Keywords: Satisfaction, Midwifery care, Delivery.

^*Corresponding Author: Lecturer, Islamic Azad University, Zanjan Branch. Zanjan, Iran

E-mail: Ahamdi.Zahra4@gmail.com

Background and aim

Burn is the third leading cause of death leading to decreased quality of life and disability. Deformity and dysfunction in afflicted patients make their return to community hard. They often apply inappropriate coping strategies, resulting in incompliance with the disease, lack of seeking assistance and impairment of health condition. This descriptive-correlational study was conducted to identify the correlation between coping strategies and health condition of burned patients after discharge at burn centers of Tehran in 2009.

Materials and methods

89 patients experiencing moderate to severe burns over the age of 15 after at least 1 month or at most 5 years were selected with convenience sampling method. 3 questionnaires including “Personal Characteristics,” “Burn Specific Health Status Scale” and “Coping with Burn” were used for data collection. After identifying content and face validities of the questionnaires, their reliabilities were identified by internal consistency. Data were gathered by self-report and medical records of patients and also were analyzed by SPSS 14.

Findings

Most subjects (%41.6) had moderate health status. None had very good health status. Physical domain (%44) was better than other aspects. Psychological (%40.2) and socioeconomic (%39.3) domains were in the second and third ranks. In addition, most subjects (%56.8) had used avoidance coping strategy after discharge while least of them (%51) had used emotionally-focused strategy. A correlation was found between health status and coping strategy. Those using avoidance had weaker heath condition than others with a statistical significance in psychological domain (P=0.01).

Conclusion

Findings showed that the subjects had better status in physical domain than socioeconomic one. Most of them had used avoidance strategy and health status was correlated with coping strategies.

Keywords: Coping strategies, Health status, Discharge, Burn patient.

^*Corresponding Author: Lecturer, Faculty of Nursing and Midwifery, Shahid Beheshti

University of Medical Sciences, Tehran, Iran.

 E-mail: zahrasb16@yahoo.com

Background and Aim

Adjustment to illness is an important concept in nursing. Numerous studies have been conducted in this regards, however, available literature still shows controversy about the process of adaptation to illness and its criteria. This has resulted in different models for the process of adaptation to illness. This review article was intended to examine the concept of adjustment to illness, its different models and their strengths as well as weaknesses.

Materials and methods

 For conducting this study, a comprehensive review of published literature in different Iranian and international databases including Iran Medex, PubMed, Elsevier, Scopus, Science Direct, ProQuest, and Ovid was  carried out using keywords such as adjustment, adaptation, coping, and models of adjustment to illness. There was no time limitation for date of published literature.

Findings

Available studies and literature showed that there are three groups of biomedical, behavioral, and cognitive models are more applicable to nursing. Biomedical models consider such aspects of disease as its causes, symptoms and therapeutic interventions. Behavioral models describe patients' behavioral responses to illness. Cognitive models emphasize on cognitive appraisal of patients and their coping strategies.

Conclusion

 Although these models provide valuable information about different aspects of adjustment to illness, they also have some limitations for clinical practice. By knowing them, nurses can plan, intervene and evaluate their care to facilitate adaptation to illness.

Keywords: Adjustment, Adaptation, Adjustment to illness, Cognitive adjustment, Coping, Stress and coping model, Self-regulating model.