فصلنامه پرستاری، مامایی و پیراپزشکی
سال چهارم شماره 4 (بهار 1398)

Today, leave of profession is regarded a challenge in the healthcare organizations. Nurses are a major part of workforce in the healthcare system, and their leave of profession imposes heavy costs on the health system. This study aimed to systematically review the factors related to nurses’ intention to leave. In this research, articles published during 2000-2018 were assessed. In this regard, we searched the databases of ProQuest, Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Cinahal, Scienctific Information Database (SID), Iranmedex, Nindex, and Magiran. In total, 50 articles were selected and analyzed. According to the results, individual (e.g., gender, age, level of education, work experience, and marital status), and organizational (e.g., interpersonal relationships at work, work life quality, occupational stress, occupational satisfaction, organizational commitment, occupational burnout, leadership style, moral distress, work-family conflicts, unsuitable work conditions, as well as violence and justice at work) factors were correlated with nurses’ intention to leave. According to the results of the study, recognizing factors affecting the nurses’ intention to leave and attempting to eliminate them are effective an effective policy and method to maintain human resources.

Nurse-patient communication is one of the important factors in providing high-quality nursing care. Therefore, recognition of barriers to this type of communication is of paramount importance. This study aimed to evaluate and review the challenges of nurse-patient communication in Iran. In this research, Iranian articles published were derived from the databases of MagIran, SID, PubMed, Web of Science, Scopus, and Google Scholar using the keywords of nurses, clients, patients, and communication. In total, we assessed 10 qualitative and 4 quantitative articles. It is notable that four articles were published in foreign journals while 10 papers were published in domestic journals. Results were indicative of disagreements and agreements between the views of nurses and patients in determining the barriers to communication. The challenge of establishing nurse-patient communication was classified in four areas of individual and social factors, occupational features, clinical conditions of patients and environmental factors. Considering the establishment of an important aspect of nursing care by creating communication, it is essential to address and eliminate the challenges by healthcare managers through proper planning. Evidently, improved nurse-patient communication will enhance the quality of service provided by nurses and positively affect the diagnosis, treatment, and qualitative improvement of nursing cares.

The heart rhythm is controlled by the autonomic nervous system from the pathway of the heart's sinoatrial node. This study aimed to evaluate the heart rate fluctuations in academic active men after performing a short period of continuous aerobic exercise using two frequency and time domain techniques. In total, 30 healthy young men were selected and randomly allocated to groups of control, aerobic training, and water aerobic training. All heart rate variability parameters were measured before pretest and after the intervention. In addition, repeated measures ANOVA was exploited to compare the differences in research stages. In this study, aerobic training significantly increased the high frequency waves (HF), low frequency waves (LF) and ratio of low-frequency to high-frequency waves (LF/HF) while reducing total power (TP) and time-domain parameters of heart rate variability, including SDNN, SDANN, pNN50, and rMSSD, compared to the control and water aerobic training groups (P=0.001). Furthermore, water aerobic training reduced the ratio of LF to HF waves, compared to other studies, which was not significant (P=0.07). It is recommended that aerobic exercises (out of water) be performed in comparison to water aerobic exercises in order to have a better heart rate variability.

Self-medication is the most common form of self-care, which is affected by social and cultural factors. Due to underlying physical and mental diseases, the elderly people are more prone to use self-medication, compared to other age groups. Therefore, this study aimed to evaluate self-medication and related factors in the elderly population of Sanandaj, Iran. This descriptive and analytical cross-sectional research was performed on 275 elderly people in Sanandaj in 2018. Subjects were selected through convenience sampling, and data were collected using the researcher-made questionnaire of self-medication. In addition, data analysis was performed in SPSS version 16 using descriptive statistics, independent t-test, Chi-square, and logistic regression. Moreover, P-value of 0.05 was considered significant. In this study, 28.5% of the elderly subjects used self-medication in the past three months. According to the results, there was a correlation between being employed (P=0.004) and living with the spouse and children (P=0.047) with self-medication. Some of the most important causes of self-medication among the elderly population included financial problems and difficulties in scheduling doctor appointments. Furthermore, the most commonly used drugs were analgesics (43.1%), cold tablets (26.4%) and cardiovascular drugs (20.8%). According to the results of the study, there was a high prevalence rate of self-medication among the elderly population. Considering the damages caused by self-medication, designing specific education programs for the elderlies seems essential.

The nurse or patient effective communication is one of the most important factors in the care. So understanding the obstacles, important and essential, as the nurses  better be able to have effective communication. Review and understanding of the barriers to effective communication between nurses and patients from the nurses ' perspective the aim of this research. This cross - sectional survey was carried out in Sarab in the winter of 1396. 100 of the nurses working in various parts of the imam khomeini hospital were selected and studied by accident.In this between 100 nurses working in different parts of the hospital of Sarab,  were randomly selected and studied. In order to collect the necessary information, a researcher-made questionnaire was used. SPSS software version 24 was used to analyze the data. The shortage of nurses (4.42), work hardness (4.37), do not appreciate the racists the authorities of the Saints (3.88), the intellectual and emotional concerns (3.84) and high expectations of patients from nurses (3.68) the most important barriers to effective communicating between the nurse and patients were announced. Solving communication barriers between nurses and patients is very important and nurses need to provide the necessary training.

Quality of life in people with thalassemia is impaired; thalassemia young adult cannot success in their life in society because of problems. This study investigated health-related quality of life of young adult with beta thalassemia major. This descriptive cross-sectional study was conducted on 55 young patients with thalassemia major referred to thalassemia center in hospital of Dezful. For assessment quality of life SF-36 questionnaire was used. Data analysis with SPSS-18 software using T-test, ANOVA, Pearson and Spearman correlation coefficient at significant level p<0.05 was used. A total of 55 young patients with thalassemia (33 males and 22 females) were enrolled. Mean of quality of life in these patients was 16.70±72.35. The average physical and mental health scores in these subjects were 76.27±16.03 and 69/99±19.44, respectively. The lowest and highest quality of life scores related to general health (61.68) and pain (85.86), respectively. Also in this study was found between general health and emotional well-being, there was a significant relationship with level of education (p>0.016). Positive correlation between income and pain was significant (p= 0.02) (r= 0.3). The results of this study demonstrated the quality of life of young adult with thalassemia in some aspects is not acceptable. Their physical and mental health should also be considered and so health systems should strive to improve the quality of life of these young people.

Non-immune injections are a health pill that is a constant threat to patient's safety. Therefore, the aim of this study was to investigate the effect of multimedia training program on Golestan nurses' attitudes about safe injections. In this semi-experimental study, 50 nurses were enrolled in a hospital in Golestan University of Medical Sciences. A demographic and researcher-made questionnaire was used to collect information. The attitude questionnaire was completed before the intervention by nurses. A multimedia tutorial on safe injection for nurses was then implemented. Six weeks after the intervention, the attitude questionnaire was completed by nurses. The data were analyzed by SPSS version 16 and Paired T test. The results showed that the mean and standard deviation of nurses' attitude toward safe injections before training was 7.8±7.41 and 92.30±7.39, respectively. In other words, paired t-test showed a significant difference between nurses attitude before and after intervention (P<0.05). Based on the results, multimedia education contributed to the positive attitude of nurses towards safe injections. Therefore, it is recommended to reconsider the traditional nursing education method and to use a multimedia intervention that is cost effective and simple. It is used in the clinical setting.

Uterine round ligament fibroma is an extremely rare condition with an unknown etiology. There is no specific mean age for the formation of this tumor and it may occur from adolescence to the end of life. Despite the similar clinical characteristics of benign and malignant tumors in the vulvar region, its early diagnosis and treatment are crucial. The case was a 78-year-old woman with a very large right uterine round ligament fibroma. The patient underwent right inguinofemoral lymphadenectomy, mass radical resection, and right vulvectomy. The problem, diagnosis, and treatment of this case had important and significant notes, which are mentioned below. Sometimes fibroids appear in abnormal patterns and unusual locations, which leads to misdiagnosis in radiologically and clinically. Despite their rare nature, round ligament fibroids must always be considered as a case.