Journal of Multidisciplinary Care
Volume:4 Issue: 1, 2015

Head nurse as a manager has an important role in achieving treatment goals in her/his organization. Todays; BARS method، the new method of evaluation، is based on criteria that are job specific behavior. Nursing managers can promote nurses’ function by determination the rate of management function and barriers of managerial performance of head nurses. The present study aimed at assessing scales and barriers of managerial performance of head nurses based on BARS performance evaluation model. This cross-sectional study was undertaken in 2011 on 32 head nurses from medical-surgical wards of five educational hospitals in Rasht. Data were collected via checklist of head nurses managerial skills based on BARS principles. The findings revealed that 31. 2 percent of staff did not participate in any management training classes. 100% of head nurses had poor management performance and the largest obstacles in implementing comprehensive care management was lack of coordination between services (87. 5 %)، financial resources (71. 9 %) and lack of awareness of job descriptions (75%). According to the poor management performance of head nurses، it is necessary to، be more focus on promotion of their key and specific management skills. Moreover، planning to improve coordination between services، necessary financial resources، and training of their job descriptions be performed.

Mastectomy in patients with breast cancer can cause negative body esteems by reducing control on the body. On the other hand, hope plays a significant role in stressful life events. This study was aimed to assess correlation between body esteem and hope in patients with breast cancer after mastectomy. This study was a descriptive-analytic research. 100 patients with breast cancer after mastectomy were selected in Seyed Alshohada Hospital of Isfahan by convenience sampling. Questionnaires of Body esteem and Herth hope was used to collect data, and investigate body esteem and hope in patients. According to total score of body esteem and the overall average score (36.46±14.91), patients had low body esteem. Most patients (49%) showed moderate hope, and only 24% had high hope. In this study, according to the results of the Spearman correlation coefficient, there was a significant positive relationship between body esteem and hope (P<0.001, r=0.583). Based on the findings of the study, the effect of mastectomy to the body esteem and hope was undeniable. Nurses can consider the vital needs of patients in this topic by identifying high risk groups in terms of body esteem and continuous hope. They can propose educational programs for this group to prevent difficulties of due to mental health by advice and attitude change towards her new body.

Non-pharmacological approaches such as foot reflexology massage for reducing complications and costs in different patients have been the focus of researchers. This study aimed to investigate the effect of foot reflexology on anxiety and agitation in patients undergoing mechanical ventilation after open heart surgery. This study was a double blind three-group randomized controlled trial. This research was conducted in two hospitals affiliated to Baqiyatallah University of Medical Sciences in Tehran from February 2014 to April 2015. 96 patients were recruited and randomly allocated to the experimental group received 20 minutes foot reflexology (n=34), placebo group simple surface touching (n=30), and the control group (n=32). Foot reflexology massage for 20 minutes was provided to patients in the experimental group on the reflection points in the heart and lungs. The rate of anxiety and agitation based on Faces of Anxiety Scale (FAS) and the Richmond Agitation Scale (RSAS) were recorded in 6 stages. Data from 92 patients (31 in the intervention group and 30 in placebo group and 31 in the control group) were collected. Data from 92 patients, intervention, placebo and control groups (31, 30, and 30, respectively) were collected. Friedman test indicated that there were statistically significant differences between the mean of anxiety and agitation level in groups at different stages of time (P<0.001). The Kruskal-Wallis test indicated that there were not statistically significant differences between the level of anxiety and agitation among the three groups at different stages of time (P>0.05). Foot reflexology massage in reflection points of the heart and lung in patients after surgery did not reduce anxiety and agitation in patients.

Individual accountability and its positive and negative effectiveness are the most challenges of organization subjects. The root of some medical staff's behaviors and activities is individual accountability. So, the present paper was conducted with the aim of identifying the relationship between individual accountability with job stress and work deviant behavior with mediating role of personality trait of conscientiousness. In this descriptive-analytic study, 175 employee nurses of Ayatollah Kashani and Hajar hospitals were entered in this research in 2014. Data were collected using Hochwarter, Casta, Mackgor, Mulkr, Robinson and Bennett, and House and Rizzo standard questionnaires. The structural equations model was used to study the relationship between Latent variables and the measured ones in conceptual model. The results indicated that there is a significant positive correlation between the perception of individual accountability and personality trait of conscientiousness (P<0.05 and r = 0.25). The results showed that the relation between accountability and job stress and work deviant behavior was observed. The significant negative correlation between conscientiousness and job stress and work deviant behavior was confirmed (P> 0.05 and r = - 0.26, r = - 0.36). According to the present theoretical and research foundations at hand, individual accountability directly affects job stress and work deviant behavior among employees, and on the basis of the findings of the present study conscientiousness bears a significant negative causal effect on job stress and work deviant behavior. It is concluded that conscientiousness decreases the negative causal and potential effect of accountability on stress and work deviant behavior.

Clinical competence is the qualification use of knowledge skills and attitudes which are the nursing necessities and values in the care of a patient who has received more attention recently due to its importance. So, regarding to the increasing importance of the nursing competence, the awareness of its related factors specially, job stress seems necessary. The aim of this study is to determine the relationship between clinical competency and job stress in hospitals of university in in Ahvaz university hospitals, 2013. This cross- sectional study was conducted in 2013. 80 nurses working in Ahwaz hospitals were selected through random sampling. The tools of data collection were Osipows job stress and Benner clinical competence questionnaires that were completed by self-report. Assessment of clinical competence and its relation to occupational stress were determined. The results show that the majority of nurses (81.3 %) have moderate stress. The total score mean of clinical competence was 61.15±18.48. Pearson correlation test showed that in its all areas, there was negative and meaningful correlation between job stress and clinical competence (P<0.01). Moreover, there was a meaningful relationship between job stress rate and applying the clinical competence (P<0.001). According to the results of this study, increasing nurses’ job stress is related to decreasing their clinical competence that should be considered by managers.

To identify factors associated with nurses’ job satisfaction due to the stress of their job is important. This study aimed to examine the role of spiritual well-being and coping strategies in predicting job satisfaction of nurses. In this analytic descriptive study, population of all nurses was 42 males and 53 females in Imam Khomeini and Aras Hospital in Parsabad city, 2013. 93 nurses were selected by convenience sampling. Data were collected using the questionnaires spiritual well-being, coping strategies and job satisfaction and the role of spiritual well-being and coping strategies in predicting job satisfaction of nurses and relationship between variables were determined. The results showed that spiritual well-being and coping strategies are related to job satisfaction (P<0.01). Moreover, the spiritual well-being (β=0.30) and variable coping strategies with stress (β=0.23) is able to predict job satisfaction of nurses. Nurse's job satisfaction is predictable by the spiritual well-being and coping strategies with stress. Therefore, it is suggested that psychologists and counselors consider the role of spiritual well-being and coping strategies to promote the level of nurses’ job satisfaction.

Gestational diabetes, with an incidence of about 7 percent of pregnancies, is limited to pregnant women and causes glucose intolerance in these patients. Lack of diagnosis and early treatment can cause serious complications for both mother and fetus either during pregnancy or delivery. This study aimed to perform an educational needs assessment of gestational diabetes in pregnant women for safe delivery of healthy baby. In this descriptive cross-sectional study, 101 pregnant women referred to health centers of Shahrekord University of Medical Sciences, were selected to educational needs assessment using convenience sampling. A questionnaire made by researcher was used for data collection consisted of 40 questions on demographics, knowledge assessment and educational needs assessment. The level of knowledge and educational needs of pregnant women on safe delivery of healthy baby was assessed. Women with an associate degree, as well as the women who have at least one diabetic case in their family had higher level of information about diabetes. 92.1% of women correctly answered the questions, while an average 7.9% failed. Regarding to the educational needs assessment, 64.1% declared that they need to learn about gestational diabetes whereas 35.9% did not need. A total of 87.3% of women had moderate to high level of knowledge on serious outcomes of gestational diabetes on fetal and neonatal health and 12.7% percent had poor knowledge. Pregnant women younger than 35 years who are not aware of their low level of information are at higher risk. Therefore in order to have a safe delivery and a healthy baby birth, they need more education on gestational diabetes.

Premenstrual syndrome is a set of physical and emotional psychological symptoms which occur periodically during the secretory phase of the menstrual period and this study was aimed to determine the effect of Vitagnus on physical/emotional symptoms of PMS. This clinical double-blind study was conducted on 72 girls suffered from premenstrual syndrome at a dormitory of Shahid Chamran. The samples were then randomly divided in two 36-member groups, case and control. Case group was prescribed with 40 drops of Vitagnus daily for three menstrual cycles, while the control group was given placebo. Data collection tools were collected using questionnaires, menstrual daily records and grading symptoms and physical/emotional symptoms of participants before and after intervention were registered and compared. The findings of this study revealed that a significant improvement in physical symptoms including breast pain and tenderness, acne, flatulence, headache, hand and foot swelling, muscle and joint pain was observed based on score mean before and after intervention in case group (P<0.05). Moreover, the mean score of motional symptoms in premenstrual syndrome (sleep disorder, difficulty in thinking and remembering, loneliness, feeling of being unattractive, hopelessness, craving for sweet or salty food, restlessness and feeling nervous) was showed a significant difference between two groups, case and control, before and after intervention (P<0.05). Findings revealed that taking Vitagnus before a menstrual cycle can relieve emotional and physical symptoms of PMS. So, regarding the little side complications, consumption of Vitagnus has a useful effect on premenstrual syndrome.