Nursing and Midwifery Studies
Volume:5 Issue: 4, Oct-Dec 2016

One means of better understanding the variations in health systems among the four greater Mekong subregion (GMS) countries is to determine how the overall health environment influences the area’s health-service systems and health status..
The study examined the determinants that affect the health-service systems and health status of the Thai, Lao, Vietnamese, and Cambodian people in the GMS countries, as well as the determinants that best predict health-service-system quality and health status..
Patients and The sample groups consisted of 320 - 402 clients and 30 - 69 healthcare providers recruited from three hospitals with similar topographies to those in the respective countries. The sample sizes depended on the number of hospital beds and people in the study areas. The questionnaires included assessments of the perceptions of health-service-system quality and health status, as well as the affecting determinants; the analyses included descriptive statistics, Pearson product-moment correlation, and stepwise multiple regression..
The major findings included the following: first, for the clients’ perceptions, only the internal determinant that reflected the strengths and weaknesses of the hospital environment was shown to be a strong predictor of health-service-system quality of the GMS countries. Second, for both the clients’ and providers’ perceptions, we found no common determinant that could predict the health status of GMS people, although we did find a few similar and different determinants. Societal and cultural values affected health-service-system quality and the health status of Vietnamese people, as well the health status of the Lao people, while trade and investment only had an impact on the health-status perception of Lao clients. In addition, medical information and technology affected the health-service systems of Thailand and Vietnam, as well as the health status of the people of Thailand and Laos; the living and working environment influenced the health status of the people of Thailand and Vietnam. The strengths and weaknesses of the hospital also affected the health status of the people of Vietnam and Cambodia..
These findings may be used for further knowledge development and for various practical applications. Our findings recommend that a comprehensive and system-wide review of health-policy planning and strategic settings should be conducted in accordance with those particular factors to improve the health-service systems and health status of the GMS countries..

Some animal studies have reported that Achillea millefolium (A. millefolium) extract can affect intestinal movements in rats. However, no study is available on the effect of A. millefolium on recovery from gastroenteritis in human subjects..
This study aimed to investigate the effect of A. millefolium on recovery from gastroenteritis in patients over 12 years old..
Patients and A randomized controlled trial was conducted on 44 patients with gastroenteritis. The patients were randomly assigned to two groups of 22 each. The control group received the usual treatments. In addition to the usual treatments, the intervention group received 0.5 mL/kg of A. millefolium distillate every 8 hours. The duration of recovery was recorded for both groups. Descriptive statistics, Chi-square, Fisher’s exact test, and the t-test were used to compare the two groups..
The mean duration of recovery in the group receiving A. millefolium distillate was 1.31 ± 0.71 days, while it was 1.86 ± 0.71 days in the control group (P = 0.015)..
Adding A. millefolium distillate to the usual treatment for simple gastroenteritis was effective in shortening the recovery time..

A number of studies have reported that women as the head of the household suffer from poor physical health. Yet, a few studies are available on the effects of health-promoting interventions for this vulnerable group..
The present study was conducted to determine the effect of an intervention based on Pender’s model on health-promoting behaviors in women who were the head of their household..
A quasi-experimental study was conducted on 66 women, who were the heads of households with inappropriate physical health-promoting behaviors, selected by the consensus method and allocated to intervention and control groups using the randomized permuted block method. The intervention group received supportive-educational intervention according to Pender’s model. Posttest was carried out for both intervention and control groups two months after the end of the intervention. Data were analyzed using descriptive statistics and inferential tests, including independent samples t, paired t, Chi-square, Mantel-Haenszel tests and logistic regression analysis..
The subjects’ mean age was 39.58 ± 6.69 years, of whom, 47% were widowed; they were mostly housewives with a mean schooling of 7.97 ± 4.31 years, and 74.2% had insufficient income. Prior to the intervention, women who were the head of the household and had poor level of health-promoting behaviors were selected. There was no significant difference between the two groups in mean score of the components of the health-promoting model (P The supportive-educational intervention was effective on the physical health-promoting behaviors of women who were the head of the household. Thus, this model can be used as a framework for planning interventions to promote the physical health of such women..

Infants’ exposure to stressors in neonatal intensive care unit (NICU) and its outcomes is a new issue since previous studies have only focused on painful stimuli. Taking into account frequency and severity of the stressors on each infant, short and long-term outcome of these stressors can be improved..
This study aimed to evaluate the cumulative stressors in premature infants hospitalized in a NICU..
In this descriptive study, 197 hospitalized preterm infants between 28 to 30 weeks of gestation were studied in terms of cumulative stressors during 10 days at the NICU of Tabriz Alzahra hospital. Consecutive sampling method was used. Demographic questionnaire and neonatal infant stressor scale were used. Descriptive statistics, repeated measures analysis and Pearson’s correlation coefficient tests were used to analyze the data..
The total mean of stress scores during 10 days was 99.44 ± 17.37. “Multiple attempts to insert intravenous and intra-arterial catheters and “intubation” were the most frequent procedures in the “extremely stressful” category among four categories of stressors. The highest scores of acute and chronic stress were related to the tenth and third day of hospitalization, respectively. There was no significant difference between infants’ characteristics and total mean stress scores. Repeated measures analysis showed that the mean acute stress scores were significantly different among the 10 subsequent days (P The results of this study demonstrated the frequent occurrence of various procedures in preterm infants hospitalized at the NICU. Although these procedures were done with the purpose of improving infants’ health, they can lead to problems and complications, which might postpone the infants’ recovery process..

Behavioral coping strategies may lead to either increased or reduced violence or associated stress, while also affecting psychological outcomes. To help abused Iranian women cope better with domestic violence and to provide better care for them, it is crucial to investigate their strategies for coping with domestic violence..
This qualitative study explores the strategies used by Iranian women to cope with domestic violence..
This study uses a qualitative design, based on a content analysis approach. The participants comprised 24 married women, selected from parks, health centers and two colleges located in Tehran, Iran. The purposive sampling method was used to recruit the participants and continued until data saturation was reached. Semi-structured interviews were carried out to gather data..
During the data analysis, a theme “situation management” emerged together with two categories, comprising “the strategies of violence control” and “the strategies of distress control”. The results show that the participants try to manage the abusive situation by controlling violence and or the distress it causes..
Unlike common stereotypes that reveal women to be submissive and passive in the face of violence, the results show that the participants in this study coped with violence using consciousness and creativity, and by relying on the available resources. An understanding of the coping strategies used by abused women could help health staff to provide better care for such women and encourage them to use more effective strategies..

A significant number of youths have insufficient awareness about sexual health; whereas, correct sexual information is the main factor to prevent adverse consequences..
The current study aimed to investigate the sexual knowledge and attitudes in a sample of Iranian premarital couples..
Patients and In this cross-sectional study, a sequential sample of 500 males and females who met the inclusion criteria was selected. This study was conducted in Kashan, Iran. Participants were in the age range of 16 to 40 years referred for premarital testing and educational classes. Two questionnaires containing demographic data and a culturally based sexual knowledge and attitudes scale were used for data collection. Data were analyzed using the Chi-square test, independent samples t-test, Mann-Whitney U, analysis of variance and multivariate regression..
About 50% of premarital couples had poor sexual knowledge and attitudes. The mean score of total sexual knowledge was 12.45 ± 8.54 out of a possible score of 33; and the mean score of total sexual attitudes was 121.63 ± 14.51 out of a possible score of 170. A significant association existed between the score of sexual knowledge and the level of education (P The majority of participants had poor sexual knowledge and attitudes regarding different aspects of sexual health..

Today, the role of expert clinical nurses is highlighted because their presence is necessary for guaranteeing the quality of nursing care provided for the patients. However, there are no proper instruments for measuring the clinical competence of postgraduate students in intensive care nursing..
The present study aimed at development and psychometric evaluation of the clinical-competence inventory for postgraduate students of intensive care nursing..
Patients and A methodological study was conducted at state nursing schools of Iran. The participants were postgraduate students of intensive care nursing, who were being trained at 16 nursing schools throughout Iran, during year 2014. After examining some relevant texts, the first draft of the inventory was designed with 60 items. In order to confirm its face and content validity, a panel of experts and students examined the inventory. The final draft, which contained 44 items, was distributed among postgraduate students of intensive care nursing, and 217 students answered the inventory. The construct validity was verified using exploratory factor analysis. The reliability of the inventory was verified using consistency tests..
Firstly an instrument with 60 items was developed. Next, the face and content validity of the instrument was assessed by 15 students and 11 experts. Overall, 16 items were removed through validity assessment and 44 items remained in the final draft. The content validity index of the final draft was 0.90. Moreover, the content validity ration of 44 items ranged between 0.75 and 1. The Cronbach’s alpha coefficient of the inventory was 0.95 and the intraclass correlation coefficient (ICC) of the test-retest results was 0.96. To examine the construct validity of the final draft, it was administered for 217 postgraduate students of intensive care nursing and five factors, with Eigenvalues above one and loading level equal to or above 0.4, were extracted through exploratory factor analysis..
The inventory developed in this study is a suitable index for evaluating the efficacy of postgraduate students in the field of intensive care nursing..

Because of the scarcity of studies on the effect of dignity therapy in patients with depression, and the conflicting results of the available studies, it is still unclear whether dignity therapy improves perceived dignity in patients with major depression disorder..
This study aimed to examine the effect of dignity therapy on the perceived dignity of patients with major depression disorder..
In this randomized controlled trial, 58 patients with major depression disorder were randomly separated to an intervention group (28 patients) and a control group (30 ones). The intervention group received dignity therapy, according to a standard protocol and the control group only received routine care. A questionnaire for examining perceived human dignity was implemented immediately before and two months after the intervention. Descriptive statistics, Fischer’s exact test, Chi square, independent samples t-test, paired t-test, Mann-Whitney and Wilcoxon tests were used in data analysis..
Of the 58 patients under study, 65.5% were female. No significant difference was found between the mean overall perceived dignity scores of the intervention group (100.2 ± 6.6) and the control group (99.8 ± 4.5) before the intervention (P = 0.78). However, two months after the intervention, the mean overall dignity scores were significantly different in the two groups (intervention group: 87.2 ± 3.8, control group: 98.9 ± 3.7, P Dignity therapy can improve perceived dignity in patients with major depression disorder. Therefore, this method can be implemented to improve perceived dignity in patients with major depression..

Fatigue is one of the most common complications of Multiple Sclerosis (MS). However, a few studies are available on the effect of nutrition education on fatigue and Activities of Daily Living (ADL) in patients with MS..
This study aimed to assess the effect of nutrition education on fatigue and ability to perform ADL in patients with MS..
This quasi-experimental one group, pretest and posttest study was performed on 40 patients with MS, who were conveniently recruited among patients, registered at the Iranian MS Society. Data were collected through a demographic questionnaire, the Fatigue Severity Scale (FSS), a standard ADL scale, and a 24-hour food recall for two days. The instruments were completed at the start and two months after the intervention. Descriptive statistics and paired t test were used to analyze the data..
Sixty percent of the patients had severe fatigue before the intervention while, 90% of them reported mild fatigue after the intervention. The mean posttest ADL was increased by 12.45 units after the intervention when compared with the pretest value (P The present study showed the beneficial effects of nutritional training on fatigue and ADL in patients with MS. Therefore, nurses and dietitians should regularly assess the patients’ dietary pattern and train them and their families about appropriate diet..

Quality of work life (QWL) is one of the most important factors for motivating humans and improving work. As one of the main assets for a university, faculty members should have a good QWL. However, few studies have been done concerning the QWL in faculty members and there are differing results from these previous reports..
This study aimed to investigate the faculty members’ QWL in the Kashan University of Medical Sciences..
This cross-sectional study was conducted on 65 faculty members of the Kashan University of Medical Sciences during 2012. Faculty members were randomly selected from a list that was prepared through the Kashan University of Medical Sciences website. The data-gathering instruments consisted of two parts. The first part consisted of questions concerning demographic information, while the second part was the Walton’s quality of work life questionnaire. For statistical analyses, t-tests and one-way analyses of variance were used..
The subjects consisted of 64.6% men, 33.8% were in the medical college, 43.1% lived in a personal house, and 43.1% were instructors. The results of the study showed that faculty members’ overall QWL was 72.98 ± 9.62. No significant differences were observed between the subject's mean QWL with regard to place of work, scientific ranking, and living location..
QWL has an important impact on attracting and retaining employees, thus, it is necessary to pay greater attention to the faculty members’ QWL..