Iranian Journal of Nursing and Midwifery Research
Year:2008 | Volume:13 | Issue:2|Papers Count:9

Background: The first stage of the accreditation, process as the most important way of assurance and improvement of the quality of high education process is collection of standards. To describe present and desirable quality of nursing and midwifery postgraduate education via accreditation process in Iran, we decided to compile applicable standards in this field, using available international standards as well as suggestion made by nursing and midwifery education experts in Iran.Methods: This was a multiple triangulation study carried out in the years 2005-2006. First, international standards were extracted from the World Wide Web; then, these standards were used as well as the viewpoints of supervisors to set appropriate national standards. In the third stage, Delphi method was used to take votes. 50 experts in nursing and midwifery postgraduate education of the country were selected by purposive sampling and their suggestions, regarding desirability and applicability of these standards in Iran were used. Results of this stage were analyzed via descriptive statistics using SPSS software.Results: 90% of international standards had appropriate level in Iran. Final comments suggested 28 standards and 224 criteria in master level and 21 standards and 81 criteria in 6 distinct domains in doctorate level of nursing and midwifery.Conclusion: The necessary changes were made in standards based on the experts’ viewpoints and the proposed Iranian national standards in nursing and midwifery postgraduate education system was conducted.

Background: Hypertension is one of the major chronic disorders. Hypertensive patients have various disease-related experiences, based on personal and social characteristics, life style and other effective factors. Nurses face different situations during their activities process and presentation of these experiences obtained during working with patients can help them to improve the clinical activities. The purpose of this study was to determine the experiences of hypertensive patients.Methods: This was a qualitative phenomenological survey. The study population was hypertensive patients referred to hospitals of Isfahan University of Medical Sciences. The sampling method was purposeful. The data collected by in-depth interviews and data analysis was done by Collis’s seven-staged method.Results: The findings of the interviews classified in 133 codes and the thematic analysis revealed three major clusters as: 1. clinical experiences about the disease; 2. social experiences of the disease; and 3. mental-psychological experiences.Conclusion: Hypertensive patients had mostly experienced chronic situations and treatment process as well as their surrounding problems such as diet and life style. Life style is an important criterion for our physical health and it should be changed so that hypertensive patients feet relatively healthy, fine and peaceful in the rest of their life. Patient indicated beliefs about their disease and experienced its psychological signs.

Background: Coronary artery bypass graft (CABG) surgery is very traumatic and makes patients very nervous. Since it is a main task of nurses to improve patients' comfort and safety, this study investigated the effect of therapeutic touch in cardiovascular patients' anxiety before CABG surgery.Methods: In a controlled clinical trail study the simple random sampling was used to select 44 patients from two separated lists of random numbers of women and men among the patients waiting to undergo CABG surgery at Shiraz Namazi Hospital in 2006. Data was collected using the Spielberger's Anxiety Inventory. In the case group, therapeutic touch was performed by the researcher for 20 minutes and the state anxiety test was taken before and after the therapeutic touch session by the research assistant. In the control group the anxiety was measured twice with 20 minutes gap in between, without any intervention. Data were analyzed using student t-test, paired t-test, and descriptive tests via SPSS software.Results: Results showed a significant difference between the mean of anxiety before and after therapeutic touch in the case group (p<0.001); but there was no significant difference in anxiety mean in the control group. It was a significant difference between the mean of anxiety of the two groups of case and control (p<0.001).Conclusion: Therapeutic touch is a safe and effective intervention to reduce the anxiety of patients. This technique is very simple, inexpensive, feasible, and applicable in all health centers and hospitals and even in patients’ residences.

Background: Polycystic ovaries syndrome (PCOS) is the most common disorder in infertile women with ovulation sterility. There are some instances of abnormal endocrine in the women stricken by this syndrome and so the clinical results of ovulating induction in them, because of severe response of ovary against ovulating induction, are very discussing and may lead to different results from those with normal ovary. In this research the effect of ovulating induction among this group of women was compared with the women with normal ovary and tubal sterility. Methods: This prospective cohort study performed on 260 infertile pairs with PCOS and tubal factors under treatment using fertility assistance techniques in IFIC. The numbers of oocyte, concentration of testosterone and andrestandion, fertility rate and embryo quality were compared. Results: The mean of oocyte retrieved, concentration of andrestandion in follicular and LH0 phases, and testosterone in LH0 phase were higher in PCOS patients (p<0.05), but the fertilization rate indicated no difference between two groups. According to the results there was a significant association between the concentration of andrestandion and testosterone phase LH0 and the embryo quality. Conclusion: The ovulation induction in PCOS by increasing the serum androgen concentration would lead to undesirable influence on oocyte, so that the achieved embryo has a lower quality and the ratio of good-quality embryo decrease, but because of the high number of oocyte and the number of achieved embryo in the women with PCOS the chance of growing more good-quality embryo is high.

Background: Personal protection equipments (PPEs) should be easily accessible to decrease contact with infecting factors and also should be used purposefully to effectively keep the health care personnel in a safe distance from the patient blood and body fluid which can easily infect the operating rooms personnel. This study aimed to find the operating rooms' personnel compliance with standards of two PPE items, mask and eye/face protection and the effective factors on their compliance.Methods: This was a descriptive correlative study. Sampling method was simple and 250 operating room personnel were selected. Data were collected by a questionnaire consisting of three parts; demographic characteristics and standards usage of mask and eye/face protection. Participants were divided into four groups of perfect, favorable, relatively acceptable and deficient based on their scores of their compliance with standards in the second and third parts of the questionnaire.Results: The favorable compliance with standard usage of mask and eye/face protection was 33.9% and 46.4%, respectively. Participants said that lack of mask and eye/face protection was the main effective factor for their compliance. There was no significant relationship between work place and educational degree, and the personnel's compliance with standard usage of eye/face protection and mask.Conclusion: Compliance with standard usage of mask is not acceptable and is almost in agreement with other studies. The important point is that there is no significant difference between personnel's compliance with standard usage of mask and eye/face protection in high risk and low risk environments.

Background: Midwives are responsible for providing preconception care for couples, they should have adequate knowledge and decision making skill in this regards. This study aimed to determine the knowledge and decision making skill regarding preconception care in midwifery students and also the relationship between the mentioned items.Methods: In a cross sectional study, all undergraduate midwifery students in their last year of study at "Tehran", "Iran" and "Shahid Beheshti" medical universities were included through headcount sampling (N=40). A questionnaire with 26 multiple choice questions used to evaluate the level of knowledge; a computerized patient management problem (CPMP) questionnaire with 9 questions, required short answers, was also used in form of a computer software to assess clinical decision making. The results were analyzed using descriptive statistics, Pearson and Spearman’s correlation coefficients, and χ2 tests via SPSS software Regression used to determine the share of each field of knowledge and decision making in the aggregate level. Results: In a scale of 100, the mean score for knowledge of preconception care was 54.23 (±9.04) and for clinical decision making 35.62 (±7.01). All units remained at average in both cases. A significant relationship was seen between the level of knowledge and the decision making skill (p=0.017, r=0.36). Conclusion: The knowledge and decision making skills of midwives were in an average level. Much attention should be paid to their education and new methods such PMP should be used in training and evaluating them.

Background: Today, liver transplantation is a routine procedure in the treatment of patients with end stage liver disease and its survival rate is high. In order to promote health, nurses and other health care professionals need to discover the meanings of lived experiences after liver transplantation. It is important for nurses to know what patients really experience; appropriate nursing intervention can be extracted from such understanding. This study aimed to describe the meaning of lived experiences of liver transplant patients after discharging from hospital.Methods: A Phenomenological approach was chosen for the study. Unstructured and open–ended interviews were conducted with 9 liver transplant patients. The method of analysis described by Colaizzi (1978) was utilized.Results: According to Colaizzi, seven categories emerged: support, gradual adaptation, transplant outcomes, concerns, fallow up, gratitude and waiting for transplant. The patient’s physical and mental problems prevented them to fulfill personal goals before transplant. Although they had some concerns such as fear of graft rejection, they were at the peace with the world after transplantation. Lifelong medications were identified insignificant for the participants. Social support was essential for recovery and meeting other recipients in the same situation as well as sharing health and life experiences is an important aspect among liver transplant patients. Health professionals were universally praised in the study however the fallow up care they received from them was not desirable.Conclusion: Health professional especially nurses should take a more active role in continuing care for such clients. Also, the support patients give each other should be encouraged and aided by health care team.

Background: An important question of nursing trainers regarding clinical education is "why some students, in spite of good clinical education, are not able to perform nursing skills in suitable level?" An educational method to solve this problem is mastery learning. The aim of present study was to compare the effect of mastery learning and composed clinical teaching method on performance of nursing students in intensive care unit.Methods: In a quasi-experimental study with pretest–posttest design, fifty-one last-year nursing students participated and divided into experimental and control groups. After pretest, control groups educated with composed clinical teaching method and the experimental groups educated with mastery learning method for 9 clinical days. For assessment the performance of nursing students in selected clinical procedures four checklists was prepared. For statistic analysis Mann-Whitney and Wilcoxon tests was used via SPSS software.Results: In comparison the pretest-posttest differences of two groups, the average score of experimental groups in all procedures was further than control groups (p=0.001). Also, in the end of clinical education many of experimental students reached to mastery level, but, few students in control groups reached to mastery level.Conclusion: Due to significant effect of mastery learning method on clinical performance of nursing students, we suggest that nursing trainers use this method as a basic clinical teaching method especially to educate fundamental nursing skills.

Background: Improving the neonatal health and reducing the neonatal mortality rate is valuable for not only health reasons, but social, psychological and economic reasons. It has advantages not just for the neonatal period of life but for the whole life. Unfortunately in Iran, in spite of efforts, there has been little success in decreasing the neonatal mortality rate. Since investigating the causes of neonatal mortality is important for planning interventions, this study aimed to find the reported causes of neonatal death in the hospitals of Isfahan province.Methods: This was a cross-sectional descriptive study in which all the neonates who died in the hospitals of Isfahan province were selected by headcount method and data were extracted from their files by using a questionnaire.Results: The most neonate death was in the hospitals with NICU wards (43.4%) and most frequent reasons for neonatal death were problems of prematurity (44.6%, 42.6%) and congenital malformations (23.5%, 21.3%) in hospitals with and without NICU departments in Isfahan city, respectively; in hospitals of other cities in the province, most frequent reasons for neonatal death were problems of prematurity (47.5%) and Respiratory Distress Syndrome (18.1%). Conclusion: To achieve the important goal, reducing the neonatal mortality rate, there should be more efforts to improve the number and quality of NICU departments and prevent preterm birth. Also, there should be emphasis on necessity of health care before and during pregnancy and genetic consultations.