مجله آموزش پرستاری
سال دوم شماره 4 (پیاپی 6، زمستان 1392)

One of the major complications of valve replacement، is valve dysfunction wich occurs in thrombolytic complication and systemic embolism. Therefore، these patients should take anticoagulant with warfarin. Incorrect use of anticoagulant is the cause of thrombotic complications and bleeding in patients with mechanical valves due to very low levels of adherence to the medication. This research was done with the perpose of comparison of the effect of two types of short message service (interactive and non-interactive) on patient compliance with anticoagulant regimens in patients with prosthetic heart valves. This study is a clinical trial performed on 90 eligible patients referred to Imam Khomeini hospital in Tehran، Iran for a perdiod of three months. The patients were divided into three groups of 30 patients، contorol، interactive and non-interactive. Self-report questionnaires were completed and International Normalized Ratio (INR) levels were recorded. Educational leaflets were given to all of the patients، their phone numbers were taken and they were instructed about using short message service. The control group did not receive SMS. Four educational messages were sent to the non-interactive group every week for a period of three months. In the interactive group، in addition to sending educational messages، patients were able to communicate with the researcher and ask their questions. After three months، all three groups completed the self-report questionnaires again. Then anticoagulant adherence was evaluated using questionnaire and INR levels. Data were analysed using fisher exact test، Chi-Square، paired T test، and analysis of variance. Before the intervention all three groups did not have a significant difference in the mean of drug (P=0. 43) and diet (P=0. 84) adherence. But three months after intervention، three groups had significant differnece in the mean of the anticoagulant adherence (P≤0/001). The mean of adherence in interactive group was higher than the other two groups after intervention. PT and INR between three groups did not indicated any significant differences (P=0. 18). Paired T test results showed that after the intevention PT and INR in the non-interactive with (P=0. 008) and in interactive group with (P≤0/001) had significant mean and in control group the differences was not significant (P=0. 9). Using interactive short message service can increase anticoagulant adherence of patients with prosthetic heart valves.

Nutrition is an important factor in the treatment of patients with chronic renal disease and inappropriate dietary regimen can decrease quality of life and increase morbidity and mortality in these patients. This study was aimed to investigate the effect of diet education on the laboratory parameters in patients undergoing hemodialysis. In this quasi experimental study، 99 patients undergoing hemodialysis were randomly assigned into experimental and control groups. Demographic form and testing checklist was used for data gathering. Dietary face to face education was conducted for experimental group but the control group received routine education. After three months، laboratory variables in patients were evaluated and recorded. Data were analyzed using Chi-squared test، independent T-test and Paired T-test. Demographic variables of the two groups were not significantly different (P>0. 05). There was no significant difference between the values of Hb، FBS، Cr، Na، K، Ca، Phosphor and albumin between two groups before intervention (P>0. 05)، but after the intervention، there was a significant difference in these laboratory parameters (P<0. 05). Study results indicate positive effects of dietary education on the laboratory indicators in the intervention group compared to the control group. Considering this، dietary education to nurses and other relevant personnel is needed to improve conditions for patients undergoing hemodialysis.

Change in one''s life when there is chronic kidney disease need support to change behavior. Non-compliance with treatment regimens in chronic kidney disease is common، and it is more rapid disease progression and mortality in this disease. This study aimed to determine the effect of nutrition education on dietary adherence in non-dialysis CKD is done. It was a quasi-experimental before-after nonequivalent comparative group study. Eighty non-dialysis chronic kidney disease patients with Glomerular Filtration Rate of 15-60 ml/min/1. 73 m2 were recruited and assigned by randomly sampling either to comparison or experimental groups (n=40). The experimental group received food diet training package and the control group received only usual care. Before and after 12 weeks، patients were evaluated by a questionnaire made by the researcher. The data were analyzed by descriptive and inferential statistics (t-test and chi square) and repeated measure method using SPSS-PC (v. 16). After 12 weeks، the mean of the experimental group (54. 45) than the mean in comparison group (43. 40) showed a greater increase. After intervention independent t-test and repeated measure method showed significant differences between the intervention and comparison groups (p= 0. 001). Chronic kidney disease awareness such practices in the educational use of diet is effective in improving adherence. So the nurse as a member of the medical team plays an important role in promoting awareness of the patients.

Seeking health information is of salient importance in management of cardiovascular diseases (CVDs). The present study aimed to explore and reveal the information needs of patients with cardiovascular diseases when seeking healthcare information. Our data sources were patients’، family caregivers’ and healthcare providers’ experiences. In a qualitative research approach، content analysis method was used. There were 31 participants comprising 16 cardiovascular patients، 5 family caregivers، and 10 healthcare providers. Required data were gathered through semi-structured interviews and purposeful sampling، and continued until data saturation. Analysis of data was performed concurrently with data collection and through a comparative method. Four central themes including disease-related، healthcare-related، health system-related and life-related information needs emerged out of content analysis. The results showed that information seeking in patients with cardiovascular diseases is holistic and is beyond physical health and the disease. Some of the important findings of this study are seeking information about prognosis، role playing، mental and sexual health، healthcare system performance، modern medicine، Islamic and traditional medicine. Therefore، providing information through various modes of communication for meeting patient needs، having their participation in decisions for treatment، and optimal management of life is necessary.

In recent years، internet is becoming an integral part of individuals، especially activities in everyday life. Continual technological change، first question that comes to mind is the internet addiction status among nursing students at universities. The aim of this study was to determine internet addiction and its related factors among nursing students in Tehran University of Medical Sciences in 2013. In this analytical study، 330 Nursing Students from Tehran Universities of Medical Sciences enrolled in the study. Data collection were carried out using Young''s Internet addiction test and demographic variables questionnaire and then analyzed using SPSS version 21. Based on our findings، 82. 3% of the students did not have Internet addiction. There were statistically significant relationship between internet addiction and demographic variables including gender، status، personal computers، science websites، personal blogs، personal websites، Webchat (chat)، listening to music، surfing the Web، making friends، playing online games، blogging، duration of internet use per hours per day، time of the week، time of Internet use (P < 0. 001). The findings of this study indicate that 17. 7% of the nursing students in this study had Internet addiction. Regarding the increased pattern of Internet use among students، appropriate training programs and effective Internet-based interventions to promote knowledge and inspire healthy behaviors in the nursing students، are essential.

Professional self-concept of nurses is as information and ideas that nurses have about their roles، values and behaviors. For better understanding of nurses and solve the crisis of nursing، there is a need to develop specific instrument for measuring Professional self-concept of Nurses. NSCQ (Nurse Self-Concept Questionnaire) which has been developed by Cowin is used to evaluate the professional self-concept of nurses. The present study aimed to determine the reliability and validity of the Persian version of this questionnaire and prepare it as an instrument for evaluating the professional self-concept of the Iranian nurses. In this cross sectional-analytic study of psychometric and validation of testing 200 nurses working at Jahrom University of Medical Sciences based on census method، completed the professional self-concept questionnaire. The reliability of the questionnaire was determined using split-half as well as Cronbach''s alpha coefficients، exploratory factor analysis، and inter-item reliability and Spearma Brown correlation coefficient. Spearman Brown correlation coefficient and Cronbach''s alpha were 0. 84 and 0. 97، respectively. Exploratory factor analysis through principle components method and equamax rotation demonstrated that the questionnaire contained six elements، including nursing self-esteem، communication، leadership، knowledge، care، and staff relations. These elements clarify more than 76. 63% of the total variance. Inter-item reliability of the questionnaire subscales was also confirmed. These coefficients ranged from 0. 41 to 0. 75 and were all significant. In conclusion، the questionnaire of nursing professional self-concept of Cowin could be used as a valid and reliable instrument for evaluating the Iranian nurses'' professional self-concept. Considering greater sample size and different groups of people are suggested in future research.

Clinical education is the most important part of nursing education and is expected to provide the students with necessary clinical skills. Nursing students face with many clinical education problems in pediatric ward. This study aimed to investigate the clinical education problems in pediatric ward. This cross-sectional study was performed on forth year students and graduate nurses affiliated to Bushehr University of medical sciences. Methods of sampling were census. Data gathering tool was a questionnaire consist of two parts: 1 - Demographic characteristics 2 - Inventory problems of clinical education in pediatric ward. Reliability and validity of the questionnaire were measured. Data analyzed using SPSS version 18. The most important difficulties in clinical education from the students’ viewpoint were deficiency of facilities، lack of access to the Internet، lack of pediatric scientific journals in the hospital library، unsuitable hospital library location، and lack of students'' evaluation based on training objectives by clinical educators، unclear curriculum and training objectives by clinical educators. It is recommended that nursing education administrators and planners improve students'' learning and motivation by application of the results of this research.

With ongoing change and advancements in the health care and intricate nature of clinical practice in nursing، Self-Directed Learning Skills are essential for success of nursing students. Determination of factors affecting Self-Directed Learning (SDL) can help improve self-Directed Learning. The aim of this research was to assess Self-Directed Learning and relationship between SDL and State Anxiety (SA) and self-esteem in baccalaureate nursing students of Islamic Azad University of Yazd in 2013. This descriptive-analytic study was performed on 265 baccalaureate nursing students of Islamic Azad University of Yazd in 2013. Data collection tool was consisted of four parts: demographic characteristics، Guglielmino’s Self-directed Learning Readiness Scale (SDLRS)، Spielberger State Anxiety Inventory and Rosenberg Self-esteem Scale. Data was analyzed by SPSS software (version 16) using descriptive and inferential statistics (ANOVA and Pearson). Results were considered statistically significant when p-value was P<0. 05. Mean scores of readiness for Self-Directed Learning was average in all four academic years. There was no statistically significant difference in Self-directed Learning Readiness score by academic year. Results showed that SDL is negatively correlated with SA (r= -0. 426، P=0. 0001) and is positively correlated with self-esteem (P=0. 122، r=0. 046) Therefore، nurse educators should pay more attention to self-directed learning in nursing courses to improve teaching methods and promote life-long learning. For this purpose educational goals need to be adjusted in stressful clinical situations after creation of self-esteem in students.