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   2014| November-December  | Volume 19 | Issue 6  
    Online since October 25, 2017

 
 
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ORIGINAL ARTICLES
Effect of applying cold gel pack on the pain associated with deep breathing and coughing after open heart surgery
HamidReza Khalkhali, Zahra Ebrahimi Rigi Tanha, Aram Feizi, Shahyad Salehi Ardabili
November-December 2014, 19(6):545-549
Background: Coughing and deep breathing after sternotomy causes severe pain. This study was conducted to assess the effect of cold therapy on the pain in patients undergoing open heart surgery. Materials and Methods: In a randomized controlled trial (RCT) with crossover design, 50 eligible and consenting patients were recruited and randomly allocated to gel pack and non-gel pack groups on the first postoperative day. All patients performed four episodes of deep breathing and coughing (DB and C) every 2 h. Pain intesity was measured and compared at rest and after DB and C in both groups. At the end of the study, all patients were asked about their preferences for the cold gel pack application prior to DB and C. The study hypotheses were analyzed using repeated measures analysis of variance (RM-ANOVA). Results: Data analysis showed significant reduction in pain scores (P < 0.001) after cold gel application. Forty-five (90%) patients were inclined to reapply the gel pack in the future. Conclusion: Cold gel pack can reduce the pain associated with DB and C in cardiac surgery patients.
  1,357 92 -
The effect of lavender essential oil on anxiety level in patients undergoing coronary artery bypass graft surgery: A double-blinded randomized clinical trial
Zahra Seifi, Ali Beikmoradi, Khodayar Oshvandi, Jalal Poorolajal, Malihe Araghchian, Reza Safiaryan
November-December 2014, 19(6):574-580
Background: Open heart surgery can cause high levels of anxiety in patients. Nowadays, lavender essential oil is widely used in medical research. This study was conducted with an aim to investigate the effects of lavender essential oil to reduce the anxiety of patients after coronary artery bypass surgery. Materials and Methods: This research is double-blinded randomized controlled trial on 60 patients who had undergone coronary artery bypass surgery in a 2-day intervention targeting reduction of anxiety. This study was conducted in Ekbatan Therapeutic and Educational Center, Hamadan city, Iran, in 2013. The patients in the inhalation aromatherapy group inhaled two drops of 2% lavender essential oil and those in the control group inhaled two drops of distilled water as placebo for 20 min on the 2 nd and 3 rd days after surgery. The level of anxiety was evaluated by Spielberger's State Anxiety questionnaire before and after intervention and the vital signs were documented as well. Data were analyzed using Stata 11 (Stata Corp., College Station, TX, USA) by independent t-test for continuous variables and Chi-square test for categorical variables. Results: The mean score of anxiety in the aromatherapy group was 48.73 ± 5.08 and in the control group was 48 ± 6.98 before the intervention (P = 0.64), which reduced after the intervention to 42.6 ± 5.44 and 42.73 ± 7.30, respectively. On the 3 rd day after surgery, the mean score of anxiety in the aromatherapy group was 46.76 ± 4.07 and in the control group was 46.53 ± 7.05 before the intervention, which reduced to 41.33 ± 3.65 and 41.56 ± 6.18, respectively, after the intervention. However, there was no statistically significant difference in the mean scores of anxiety between the aromatherapy and control groups. Conclusions: Lavender essential oil has no significant effect on anxiety in patients after coronary artery bypass surgery, although it decreased the level of anxiety in the patients.
  1,319 85 -
Effect of subcutaneous Enoxaparin injection duration on bruising size in acute coronary syndrome patients
Khadije Dehghani, Zahra Najari, Hamideh Dehghani
November-December 2014, 19(6):564-568
Background: Bruising is an unpleasant result of subcutaneous injection of Enoxaparin, which causes physical discomfort, limitation of injection site, patient's refusal of treatment, and distrust in nurses' ability. The application of techniques which reduce patients' fear, anxiety, and physical damage is one of the tasks of nurses. This clinical trial investigated the effect of duration of subcutaneous Enoxaparin injection on the bruising size in acute coronary syndrome patients. Materials and Methods: Seventy 35-75-year-old acute coronary syndrome patients hospitalized in Coronary Care Units were selected randomly. Each subject received 10- and 30-sec duration of injections by a single researcher on both sides of the abdomen in 12-h intervals. The bruising size was measured using a transparent millimeter measuring paper, 24 and 48 h after each injection. Data were gathered by a data recording form (demographic and measurements data) and analyzed by descriptive statistics and non-parametric tests through SPSS. Results: Results showed that the mean bruising sizes at 24 h after 10- and 30-sec injection were 33.26 mm 2 (72.77) and 48.96 mm 2 (99.91), respectively, and at 48 h were 15.61 mm 2 (142.02) and 52.48 mm 2 (143), respectively. There was no significant relationship between the two techniques (P > 0.05), although the effect of age on bruising size was significant (P = 0.01). Conclusion: According to the findings of the present study, length of Enoxaparin subcutaneous injection has no effect on the bruising size.
  1,322 70 -
Experiences of adult smokers from the concepts of smoking: A content analysis
Hossein Ebrahimi, Mohammad Hasan Sahebihagh, Fazlollah Ghofranipour, Jafar Sadegh Tabrizi
November-December 2014, 19(6):550-557
Background : Smoking cigarettes is a risk factor for many physical and mental diseases. About five million people die of smoking every year. Understanding the concept of cigarette smoking can help people develop their knowledge with regard to smoking. A qualitative research seems essential to detect these concepts. Therefore, the present study aims to take into account the experience of adult smokers with regard to the concept of smoking. Materials and Methods: This is a qualitative content analysis study conducted on 12 smokers in four selected cities in Iran. Data were collected by in-depth, semi-structured interviews, transcribed verbatim, and simultaneously coded. Subsequently, they were analyzed using the content analysis method. Results: In the present study, eight concepts (themes), 22 subcategories, and 81 codes have emerged. The obtained concepts are physics of a cigarette, addiction and dependency, habit, feel the need, pleasure, seeking peace, mental involvement, and self-induction. Conclusions : The participants' experiences with regard to cigarette smoking can affect their understanding of the concepts of smoking. The understanding of these concepts by nurses and smokers can enhance their knowledge about the existing facts of smoking, which can act as a foundation for designing preventive methods and smoking cessation programs.
  1,312 76 -
Iranian nurses' experience of essential technical competences in disaster response: A qualitative content analysis study
Fatemeh Aliakbari, Masoud Bahrami, Fereshteh Aein, Hamidreza Khankeh
November-December 2014, 19(6):585-592
Background: Today disasters are a part of many people's lives. Iran has a long history of disaster events and nurses are one of the most significant groups within the Iranian disaster relief operations, providing immediate and long-term care for those affected by the disaster. However, the technical competence of Iranian nurses and their training for this work has received little attention. This article presents the results of a study that aims to explore this context. Materials and Methods: A qualitative study was conducted using in-depth interviews to collect data from 30 nurses, who were deliberately selected from the health centers affiliated to the Isfahan University of Medical Sciences. Themes were identified using the conventional qualitative content analysis. The trustworthiness of the study was supported by considering the auditability, neutrality, consistency, and transferability. The study lasted from 2011 to 2012. Results: Data analysis undertaken for the qualitative study resulted in the identification of five main themes, which included: (1) Management competences, (2) ethical and legal competences, (3) team working, and (4) personal abilities and the specific technical competences presented in this report. Conclusions: This report presents an overview of the nursing technical capabilities required for Iranian nurses during disaster relief. It is argued that additional competencies are required for nurses who care in high-risk situations, including disasters. Nurses need to prepare themselves more effectively to be responsible and effective in nursing care.
  1,311 67 -
The effect of progressive muscle relaxation method on test anxiety in nursing students
Maryam Zargarzadeh, Maryam Shirazi
November-December 2014, 19(6):607-612
Background: Concerning the prevalence of test anxiety among nursing students and presence of stress in nursing education years, this study was conducted to determine the effect of progressive muscle relaxation method on test anxiety among nursing students of Isfahan University of Medical Sciences in 2013. Materials and Methods: This was a quasi-experimental study conducted in three stages on 49 male and female nursing students divided into two groups (study and control). In the pre-test stage, demographic data and Sarason anxiety questionnaires were filled by 94 students (of terms 3 and 4). Then, in the intervention stage, the students having test anxiety were assigned to two groups (study and control), and the progressive muscle relaxation method was performed in the experiment group in four sessions. Then, the students did this method two times a day until final exams, immediately following which they filled the self-reported checklists. On the first day of the final exams, test anxiety questionnaire was filled by the two groups again. The collected data were analyzed by the statistical tests, i.e. χ2 , paired t-test, independent sample t-test, Mann-Whitney and Wilcoxon tests, using SPSS 18. Results: Independent t-test showed a significant difference in the mean scores of test anxiety after intervention between the two groups of study and control (P = 0.00), but this difference was not significant before intervention (P = 0.76). Also, in the study group, there was a significant difference in the mean scores of test anxiety before and after intervention (P = 0.00), but this difference was not significant in the control group (P = 0.09). Mann-Whitney test showed no significant difference in categorization of test anxiety scores before intervention in the study and control groups (P = 0.60), but the difference was significant after intervention (P = 0.00). Wilcoxon test showed a significant difference in categorization of test anxiety scores in the study group before and after intervention (P = 0.00), but the difference was not significant in the control group (P = 0.083). Conclusions: Generally, the results showed that performing progressive muscle relaxation method was effective in reducing test anxiety among nursing students. It is suggested to conduct educational programs concerning this method in the faculties of nursing to decrease the test anxiety of nursing students.
  1,306 70 -
Effects of needs-assessment-based psycho-education of schizophrenic patients' families on the severity of symptoms and relapse rate of patients
Gholam Reza Kheirabadi, Mahnaz Rafizadeh, Victoria Omranifard, Azam Yari, Mohammad Reza Maracy, Tayebe Mehrabi, Sima Sadri
November-December 2014, 19(6):558-563
Background: Family psycho-education is one of the most effective interventions for preventing relapse in patients with schizophrenia. We evaluated the efficacy of a needs-assessment-based educational program in comparison with a current program (textbook based) in the treatment of schizophrenia. Materials and Methods: Patients with schizophrenia and their families (N = 60) were allocated to needs-assessment-based education (treatment) and textbook-based (control) programs; both included 10 sessions of education within about 6 months. Symptoms were assessed by the Positive and Negative Syndrome Scale (PANSS) prior to intervention and every 3 months for a total of 18 months. A 25% decrease or increase in total PANSS score was considered as response or relapse, respectively. Results: Forty-two cases completed the study. The total PANSS score was significantly decreased in both groups with more reduction in the treatment group. Positive and negative scale scores were reduced in the treatment group, but not significantly in the control group. Response rate was higher in the treatment group and relapse rate was lower (15% vs. 27.2%, P = 0.279). In logistic regression analysis, needs-assessment-based psycho-education was associated with more treatment response. Conclusions: Needs-assessment-based psycho-education is more effective than textbook-based education for treating schizophrenia. We recommend psychiatric care centers to conduct needs-assessment and develop their own program for family psycho-education.
  1,272 86 -
"Parents a dead end life": The main experiences of parents of children with leukemia
Rahmatollah Jadidi, Davood Hekmatpou, Aziz Eghbali, Fereshteh Memari, Zohreh Anbari
November-December 2014, 19(6):600-606
Background: The quantitative studies show that due to the widespread prevalence, high death rate, high treatment expenses, and long hospital stay, leukemia influences the families and their children to a great extent. In this regard, no qualitative study has been conducted in Iran. So, this study was conducted in Arak in 2011 with the aim of expressing the experiences of the parents whose children suffered from leukemia. Materials and Methods: Using qualitative research approach, by applying content analysis method, 22 participants were interviewed in two educational hospitals during 2 months. The study was started by purposive sampling and continued by theoretical one. The data were analyzed based on the content analysis method. Resluts: Data analysis showed that insolvency, knapsack problems, cancer secrecy, trust on God, self-sacrifice, adaptation, medical malpractice, and hospital facilities were the level 3 codes of parents' experiences and "parents a dead end life" was the main theme of this study. Conclusion: In this study, the experiences of the parents whose children suffered from cancer were studied deeply by the use of qualitative method, especially by the use of resources syncretism rather than studying quantitatively. "Parents a dead end life" emerged as the main theme of this study, emphasizing the necessity of paying further attention to the parents. On the other hand, making more use of parents' experiences and encouraging them helps make the treatment more effective. It is suggested that these experiences be shared with parents in the form of pamphlets distributed right at the beginning of the treatment process.
  1,302 51 -
Risk of early menopausal symptoms in clinical workers
Seyedeh Negar Assadi
November-December 2014, 19(6):569-573
Background: Workplace exposures as in clinical work can cause disorders. Some organ systems are at risk. This work may be a risk factor for early symptoms of menopause. The objective of this study was to compare the early symptoms of menopause between hospital personnel who work in clinical and office settings. Materials and Methods: This was a historical cohort study conducted on clinical and office workers of hospitals. The  study was conducted using a flexible interview conducted with a questionnaire among personnel of age 40 years and above. According to their menopausal status, they were divided into three phases: premenopause, perimenopause, and postmenopause. Symptoms in 10 items were assessed and scored from 1 to 10, and were compared. Data were analyzed with SPSS 16, t-test, and Chi-square tests and were calculated considering P < 0.05 as the significant level. Odds ratios were calculated along with 95% confidence interval. Results: Frequency of menopausal symptoms was higher in the clinical group than in the office group. In the clinical group, the odds ratio for menopausal symptoms like flashing and sweating was 1.879 (1.457-2.423) and in the office personnel, it was 0.192 (0.030-1.238). In the clinical group, the odds ratio for anxiety and irritability was 2.029 (1.660-2.481) and in the office personnel, it was 0.116 (0.017-0.779). Conclusions: Clinical personnel had higher risk for early menopausal symptoms such as flashing, sweating, anxiety, and irritability. Assessing the health of these personnel may help to improve their reproductive health. The person with reproductive risk factors is not suitable for clinical work.
  1,276 72 -
The evaluation of reproductive health PhD program in Iran: The input indicators analysis
Mahshid AbdiShahshahani, Soheila Ehsanpour, Nikoo Yamani, Shahnaz Kohan
November-December 2014, 19(6):620-628
Background: Appropriate quality achievement of a PhD program requires frequent assessment and discovering the shortcomings in the program. Inputs, which are important elements of the curriculum, are frequently missed in evaluations. The purpose of this study was to evaluate the input indicators of reproductive health PhD program in Iran based on the Context, Input, Process, and Product (CIPP) evaluation model. Materials and Methods: This is a descriptive and evaluative study based on the CIPP evaluation model. It was conducted in 2013 in four Iranian schools of nursing and midwifery of medical sciences universities. Statistical population consisted of four groups: heads of departments (n = 5), faculty members (n = 18), graduates (n = 12), and PhD students of reproductive health (n = 54). Data collection tools were five separate questionnaires including 37 indicators that were developed by the researcher. Content and face validity were evaluated based on the experts' indications. The Cronbach's alpha coefficient was calculated in order to obtain the reliability of the questionnaires. Collected data were analyzed by SPSS software. Data were analyzed by descriptive statistics (mean, frequency, percentage, and standard deviation), and one-way analysis of variance (ANOVA) and least significant difference (LSD) post hoc tests to compare means between groups. Results: The results of the study indicated that the highest percentage of the heads of departments (80%), graduates (66.7%), and students (68.5%) evaluated the status of input indicators of reproductive health PhD program as relatively appropriate, while most of the faculties (66.7%) evaluated that as appropriate. Conclusions: It is suggested to explore the reasons for relatively appropriate evaluation of input indicators by further academic researches and improve the reproductive health PhD program accordingly.
  1,268 75 -
Investigating the effect of an education plan based on the health belief model on the physical activity of women who are at risk for hypertension
Habibollah Hoseini, Fatemeh Maleki, Mahin Moeini, Gholam Reza Sharifirad
November-December 2014, 19(6):647-652
Background: Hypertension is the main risk factor of many diseases and the main reason of death all over the world. Because the signs of hypertension are not clear, people do not feel its dangers and do not believe they are at risk. This problem makes preventing hypertension a great challenge for the health system. One factor that is related to lifestyle and is effective in preventing hypertension is increasing exercise. The aim of this study is investigate the effect of an education plan based on the health belief model on the physical activity of women who are at risk for hypertension. Materials and Methods: This is a field experimental study. Field of study was two health care centers in Isfahan, which were selected through simple random sampling. Ninety-two females who were at risk for hypertension were the subjects of study. Subjects were selected through systematic sampling. Beck questionnaire was used to evaluate the physical activity of both experimental and control group subjects before and 2 months after the intervention. The intervention plan was three education sections that were conducted in 4 weeks. The data were analyzed by descriptive statistical tests and inferential tests of repetitive variance analysis and t-test through SPSS. Results: The results showed that the average of physical activity increased significantly in the intervention group 2 months after education (P = 0.03). Conclusions: The findings of the study confirm the efficiency of education plan based on the health belief model on the physical activity of women who are at risk for hypertension.
  1,260 72 -
The effect of earplugs and eye mask on patients' perceived sleep quality in intensive care unit
Ahmad Reza Yazdannik, Ahmad Zareie, Marzieh Hasanpour, Parviz Kashefi
November-December 2014, 19(6):673-678
Background: Sleep is one of the basic human needs and sleep deprivation causes numerous undesirable effects on the human body and mind, especially in the intensive care unit (ICU) patients. It seems that noise and light are important environmental factors interrupting sleep in these patients. This study was carried out to determine the effect of earplugs and eye mask on Iranian patients' sleep quality in ICU. Materials and Methods: In this cross-over clinical trial, 50 patients in the ICUs of  Al-zahra Medical Center in Isfahan in 2012 were selected by convenient sampling method and randomly assigned to two groups. In group A, patients wore earplugs and eye mask in the first night during their sleep and slept without earplugs and eye mask in the second night, and the intervention was conversely conducted in group B. Verran and Snyder-Halpern Sleep Scales were used to measure the patients' sleep quality. The data were analyzed by paired t-test, independent t-test, one-sample t-test, and one-way analysis of variance (ANOVA) through SPSS version 18. Results: Effect of the intervention on sleep effectiveness was positive, and there were significant differences (P < 0.001) between treatment night and control night, and also within each group (P < 0.001). Effect of the interventions on sleep disturbance was positive, and there was a significant difference at treatment night compared to the control night between groups and within each group (P < 0.001). Also, the mean scores for sleep supplementation were measured after the second night, and the results showed the scores significantly increased in the intervention group compared to the control group (P < 0.001, ER = 47, F = 22.1). In addition, carryover effects for sleep efficiency and sleep disturbance were positive, but periodic effects for sleep efficiency and sleep disturbance were negative and positive, respectively. Conclusions : Although wearing earplugs and eye mask is a cost-effective and safe method and can improve perceived sleep quality in ICU patients, further research is needed to demonstrate the effect of this method.
  1,209 76 -
Comparison of the effect of aromatherapy with Jasminum officinale and Salvia officinale on pain severity and labor outcome in nulliparous women
Maasumeh Kaviani, Shahla Maghbool, Sara Azima, Mohammad Hosein Tabaei
November-December 2014, 19(6):666-672
Background: Using non-pharmacological pain relief methods for reducing labor pain has always been one of the major concerns in obstetrics and gynecology. Objective: Comparing the effects of aromatherapy with jasmine and salvia on pain severity and labor outcome in nulliparous women. Materials and Methods: In this randomized clinical trial, 156 nulliparous women in labor were randomly selected and divided into salvia, jasmine, and control groups (52 in each group). The study duration was 6 months (from October 2009 to March 2010). Each group underwent aromatherapy using an incense mask for 15 min (distilled water for the control group). Pain severity was measured before and 30 and 60 min after the incense aromatherapy. Also, duration of the first and second stages of labor, first- and fifth-minute APGAR scores of the baby, and the frequency of labor type were measured and recorded in each group. Results: In comparison to the other groups, pain severity and duration of the first and second stages of labor were significantly lower in the aromatherapy group of salvia 30 min after the intervention (P = 0.001). However, no significant difference was found among the three groups regarding pain severity 60 min after the aromatherapy, first- and fifth-minute APGAR scores of the baby, and the frequency of labor type. Conclusions: The results of the present study indicated that aromatherapy with saliva had beneficial effects on pain relief, shortened the labor stages, and had no negative impact on the baby's APGAR score.
  1,197 80 -
Quality of life in multiple sclerosis (MS) and role of fatigue, depression, anxiety, and stress: A bicenter study from north of Iran
Ghasem Salehpoor, Sajjad Rezaei, Mozaffar Hosseininezhad
November-December 2014, 19(6):593-599
Background: Although studies have demonstrated significant negative relationships between quality of life (QOL), fatigue, and the most common psychological symptoms (depression, anxiety, stress), the main ambiguity of previous studies on QOL is in the relative importance of these predictors. Also, there is lack of adequate knowledge about the actual contribution of each of them in the prediction of QOL dimensions. Thus, the main objective of this study is to assess the role of fatigue, depression, anxiety, and stress in relation to QOL of multiple sclerosis (MS) patients. Materials and Methods: One hundred and sixty-two MS patients completed the questionnaire on demographic variables, and then they were evaluated by the Persian versions of Short-Form Health Survey Questionnaire (SF-36), Fatigue Survey Scale (FSS), and Depression, Anxiety, Stress Scale-21 (DASS-21). Data were analyzed by Pearson correlation coefficient and hierarchical regression. Results: Correlation analysis showed a significant relationship between QOL elements in SF-36 (physical component summary and mental component summary) and depression, fatigue, stress, and anxiety (P < 0.01). Hierarchical regression analysis indicated that among the predictor variables in the final step, fatigue, depression, and anxiety were identified as the physical component summary predictor variables. Anxiety was found to be the most powerful predictor variable amongst all (β = −0.46, P < 0.001). Furthermore, results have shown depression as the only significant mental component summary predictor variable (β = −0.39, P < 0.001). Conclusions: This study has highlighted the role of anxiety, fatigue, and depression in physical dimensions and the role of depression in psychological dimensions of the lives of MS patients. In addition, the findings of this study indirectly suggest that psychological interventions for reducing fatigue, depression, and anxiety can lead to improved QOL of MS patients.
  1,192 73 -
Several food items and multiple sclerosis: A case-control study in Ahvaz (Iran)
Maryam Bagheri, Zahra Maghsoudi, Sadigheh Fayazi, Nasrin Elahi, Hamed Tabesh, Nastaran Majdinasab
November-December 2014, 19(6):659-665
Background: Multiple sclerosis (MS) is a complex inflammatory disease of the central nervous system. Despite extensive research, its exact cause is unknown. One of the roles of nurses is discovery and prevention of factors related to the disease. This study aimed to investigate several food items concerning the etiology of MS in a population of Ahvaz (Iran). Materials and Methods: This case-control study was conducted on 113 MS patients and 113 healthy women. Food information was collected through interviews using a standard designed questionnaire. Statistical analysis was performed by adopting descriptive tests (mean, frequency, standard  deviation) and inferential tests (Chi-square test, Fisher's exact test, logistic regression, and multivariate conditional logistic regression with a significance level of 0.05 and 95% confidence interval) through SPSS version 19. Results: Univariate regression analysis showed a significant association between MS and consumption of solid vegetable oil (P = 0.004), fruits (P = 0.002), vegetables (P = 0.016), dates (P = 0.02), and low-fat dairy (P = 0.009) more than five times a week. According to multivariate conditional logistic regression analysis, consumption of fruits (P = 0.03) and low-fat dairy (P = 0.04) more than five times a week had a protective role and solid vegetable oil consumption was significantly associated with a risk for MS (P = 0.01). Conclusions: This study suggests a protective role of consumption of fruits and low-fat dairy in MS and an increased risk of MS with solid vegetable oil consumption in Ahvaz (Iran).
  1,175 64 -
Comparative evaluation of the efficacy of herbal drugs (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea
Fatemeh Zeraati, Fatemeh Shobeiri, Mansour Nazari, Malihe Araghchian, Reza Bekhradi
November-December 2014, 19(6):581-584
Background: Different therapeutic methods have been applied for the treatment of dysmenorrhea and the method with the lesser side effects is preferred. The aim of this study was to compare the effects of herbal products (fennelin and vitagnus) and mefenamic acid in the treatment of primary dysmenorrhea. Materials and Methods: This ouble-blind clinical trial was carried out in 105 students with mild and moderate dysmenorrhea. The students were randomly divided into four groups which received the extracts of fennelin and vitagnus, mefenamic acid, and placebo, respectively. Severity of pain was detected by the Visual Analog Scale (VAS) during one cycle before and two cycles after the intervention. Data were analyzed by SPSS version 16 and (P < 0.05 was considered significant. Results: Demographic characteristics of the students were similar in the four groups. There was no significant difference in the mean of severity of dysmenorrhea during one cycle before the intervention between the four groups, but the difference was significant during two cycles after the intervention. Fennelin had similar effects as vitagnus on dysmenorrhea. Mefenamic acid had less effect than both the drugs (P <0.05). Conclusion: Fennelin and vitagnus had higher effect than mefenamic acid. Use of these products is suggested for dysmenorrhea.
  1,175 58 -
Comparison of childbirth training workshop effects on knowledge, attitude, and delivery method between mothers and couples groups referring to Isfahan health centers in Iran
Mahboubeh Valiani, Zohreh Haghighatdana, Soheila Ehsanpour
November-December 2014, 19(6):653-658
Background: The World Health Organization announced the acceptable level of cesarean section (CS) as 10-15%. In recent years, the rate of CS has been increasing irregularly. Lack of appropriate knowledge and attitude among couples plays a major role in this regard. This study tried to compare the effects of a childbirth training workshop on knowledge, attitude, and delivery method. Materials and Methods: The present study is a randomized clinical trial conducted in four stages on 180 subjects referring to Isfahan health care centers in three groups of mothers (alone), couples (mothers and their respective partners), and control. After sampling, a pre-test and intervention in the form of an educational workshop were conducted. Then, post-test was conducted immediately after, 1 month later, and in puerperium in all three groups. Data were analyzed by SPSS version 15. Results: The analysis showed that the knowledge mean was statically significant in mothers (P < 0.0001), couples (P < 0.0001), and control group (P < 0.0001) before and after intervention. Also, the attitude mean was statically significant in mothers (P < 0.0001), couples (P < 0.0001), and control groups (P < 0.0001) before and after intervention.   Analysis of delivery method showed that in mothers, couples, and control groups, normal vaginal delivery was the most preferred method in that order, w hich was significant (P = 0.017). Conclusions: Workshop education of pregnant women and their spouses was effective on encouraging them to natural delivery. Therefore, designing educational and counseling programs through collaborative methods for mothers and their spouses is suggested to reduce the rate of cesarean deliveries.
  1,158 64 -
The utilization rate of antenatal care after health sector reform implementation in rural areas of Islamic Republic of Iran
Narges Alikhasi, Reza Khadivi, Maryam Kheyri
November-December 2014, 19(6):613-619
Background : Improving the utilization rate of antenatal care is a critical strategy for achieving the reproductive health goals in Iran. The aim of this study was to assess the utilization rate of antenatal care (ANC) by women after health sector reform (HSR) interventions in rural areas of Islamic Republic of Iran (IR Iran). Materials and Methods: This is a retrospective cross-sectional study. The data were gathered by cluster sampling from 400 motherhood records of mothers whose last pregnancies had been terminated in the first 3 months of 2013. Data were collected from 21 rural health centers of Isfahan district during the year 2013. The utilization rate of ANC by mothers was assessed by the number of visits they had, the time of the first ANC visit, the occurrence of pregnancy- or delivery-related complications, and the number of postpartum visits. Results: The mean time of the first ANC was 9 ± 5.23 th week of gestational age. For 69.3% of pregnant women, the first ANC was before the 12 th week. Overall, the frequency of ANC visits ranged from 2 to 21, with the average of 10.6 ± 3.23 visits. 93.8% of the utilized ANC visits were adequate. 99.8% of the deliveries took place in the hospital. 99% of mothers had at least one visit in the postpartum period. 4% of the mothers had suffered from pregnancy-related complications. Conclusion: It seems that IR Iran has achieved to one of the important objectives by its reform in health care access, that is, more ANC for pregnant women.
  1,159 58 -
Sources of hope: Perception of iranian family members of patients in the intensive care unit
Mina Gaeeni, Mansoureh A Farahani, Nooredin Mohammadi, Naima Seyedfatemi
November-December 2014, 19(6):635-642
Background: Admission to an Intensive Care Unit (ICU) is recognized as a situation with emotional strain, uncertainty, and fear of losing the patient. In such stressful situations, it is hope that can promote psychological stability in the patient's family members. Related literature revealed that sources of hope in this situation have still not been discussed well in studies. The purpose of this qualitative study was to explore the sources of hope from the perspective of families of ICU patients in Iran. Materials and Methods: In this qualitative study that was carried out adopting the conventional qualitative content analysis approach, 19 family members of 13 patients hospitalized in the ICU from three teaching hospitals were selected, through purposive sampling. Semi-structured interviews were used for data collection. The interviews were transcribed verbatim and analyzed using conventional content analysis, through the process of data reduction and condensation, coding, and also generating categories and subcategories. Results: Analysis of the data revealed sources of hope in families of ICU patients. These sources appeared as two main categories- internal sources and external sources. The internal sources had two subcategories consisting of 'religious-spirituality beliefs' and 'positive attitude'. The external sources had four subcategories consisting of healthcare professionals' interactions, empathy of families and friends, patient's condition, and participation in care. Conclusions: The results of this study showed the sources of hope in the families of the patients in the ICU. These sources, as moderating factors, could reduce physical and psychological damages caused to the families. In the present study, the categorizations of the participants' in-depth experience could develop a new horizon for healthcare professionals, especially nurses, on the sources of hope, based on culture.
  1,145 62 -
The effect of a family need-based program on burden of caregivers of leukemia patients in Isfahan in 2013-2014
Saeed Pahlavanzade, Narjes Khosravi, Mahin Moeini
November-December 2014, 19(6):629-634
Background: The family of cancer patients experience burden of care because of their caring role. Therefore, appropriate and effective interventions are essential in order to decrease burden. The goal of the present research was to determine the effect of a family need-based program on the burden of care in caregivers of leukemia patients. Materials and Methods: In this clinical research, 70 caregivers of leukemia patients who referred to Sayed Al-Shohada Medical Center in Isfahan, Iran were chosen and divided, through convenient sampling method and using table of random numbers, into two groups, experimental and control. Caregivers of the experimental group attended five training sessions. The data collection tool of this study was the Zarit Burden Scale. It was completed by members of both groups before, immediately after, and 1 month after the intervention. The data obtained were analyzed with SPSS software. Results: During the study period, burden slowly decreased in the experimental group and increased in the control group. Mean burden of care score before, immediately after, and 1 month after the intervention was 63.6, 30.4, and 23.03, respectively, in the experimental group and 62.5, 67.3, and 68.8, respectively, in the control group. In addition, the mean burden score in the experimental group significantly decreased in comparison with the control group (P < 0.001). Conclusion: This family need-based program can decrease burden in caregivers of leukemia patients and may potentially improve the quality of life of both patients and caregivers.
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Effect of using static ultrasound technique on peripherally inserted central catheters' insertion success rate in neonates in a neonatal intensive care unit
Zahra Abdeyazdan, Elaheh Sheikhan-Sudani, Alireza Sadeghnia, Sedigheh Talakoub
November-December 2014, 19(6):643-646
Background: Peripheral insertion of central catheters can be difficult in neonates. We compared the success rates of peripherally inserted central catheters by two methods of using static ultrasound and traditional technique (vein visualization and palpation) in neonates. Materials and Methods: In a prospective randomized, controlled trial, 52 neonates with birth weight lower than 1500 g in a level 3 neonatal intensive care unit were enrolled. Neonates were randomized to undergo peripherally inserted central catheter placement using a traditional technique (n = 27) versus static ultrasound-guided technique (n = 25). In the ultrasound group, vein localization was performed and the skin overlying the target vessel was marked. Insertion of catheter was then immediately performed. We recorded and compared success rates in the groups. Results: Success rate after the first attempt was 68% in ultrasound group and 60% in traditional group. These rates for the second attempt were 50% and 40%, respectively. The overall success rates after two attempts were 84% and 76% in ultrasound and traditional groups, retrospectively (P = 0.24). Conclusions: There was no significant difference between the two groups regarding PICC success rates, probably because in the present study, most of the subjects were premature neonates whose vasculature was visually detectable.
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ERRATUM
An investigation on the association between students' knowledge and their tendency to take care of HIV patients among the students in nursing and midwifery school: Erratum

November-December 2014, 19(6):680-680
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LETTERS TO EDITOR
Nursing handover: Are its principles taught in universities during bachelor's degree?
Raheleh SabetSarvestani, Marzieh Moattari, Alireza NikbakhtNasrabadi, Marzieh Momennasab, Shahrzad Yektatalab
November-December 2014, 19(6):679-679
  909 61 -