Journal of Multidisciplinary Care
Volume:6 Issue: 2, 2017

Patient adherences with therapeutic regimens reduce the severity of desease negative complications and its non-adherence as a barrier to achieving the medical. The aim at this study was to determine the correlation between medication adherence and quality of life of Rheumatoid Arthritis patients in Shariati hospital in 2016.
This study was descriptive-correlational that population consisted of all Arthritis patients in Shariati hospital in Tehran. 252 patients were recruited by convenience sampling. Three questionnaires were used to collect data including the demographic characteristics questionnaire, the medication adherence “CQR” and SF-36. The validity and reliability of SF-36 in similar studies and the validity and reliability of CQR by researcher was approved. Data were analyzed by SPSS.
The results showed the levels of medication adherence with an average of 65.86±5.85 and the quality of life of patients with an average of 51.96±9.73. Spearman correlation coefficient showed that no significant correlation between medication adherence and quality of life of patients (P=0.663, r=0.02). Medication adherence had a significant correlation between energy/fatigue subscales of quality of life (P=0.035, r=0.13).
Due to the fact that medication adherence was not a predictor of quality of life in patients with rheumatoid arthritis Therefore, it cannot be poured programs for these patients to improve their quality of life due to medication adherence.

Care services to infants in the length of primary time after birth has much effect on the health and decrease of their mortality and morbidity. This study aimed to assess the care provided to the healthy newborn in the normal vaginal delivery (NVD) and the cesarean section (CS) in the hospitals affiliated with Shahrekord University of Medical Sciences.
This descriptive study has been performed upon 282 healthy term infants (104 CS and 178 NVD cases) through direct observation and using the health care evaluation checklists. Data were analyzed using , SPSS software and t-test and Mann- Whitney tests.
The average of total health infant services among all of the samples was 58/3% and the percentage of agreement with standard of healthy infants care was more in NVD than CS labor (P=0.011). The emergency acts to retrieve and supporting services to feed infants with mothers’ milk in the CS group were more than NVD infants, but these infants received poor care in the area of primary procedures and assessment, and procedures to contact to mothers and infant. Also, the length of skin contact time between infants and their mothers after delivery and initiating to feed infants with mothers’ milk in the primary time in the CS group was lower than NVD infants(P=0.000).
Assessment of care services to healthy infants in hospitals under study had average quality and its quality was even lower in CS labors than NVD labors. Therefore, it can be performed more procedures to promote quality of care services to infants by health approaches in mothers education to develop NVD and reduce active CS.

Delivery in addition to being stressful situations for a pregnant person, it is an important phenomenon in the life of the mother and pain result from it, is unavoidable and is also more severe and longer in nulliparous women. Due to unfavorable labor, to investigate the factors influencing is important.
This research is a correlation study that for the implementation among nulliparous women referred for delivery to Bushehr Persian Gulf Martyrs Hospital, a sample of 120 subjects was selected by convenience sampling in the period between February 2016 and June 2016. Samples were evaluated using Percent Behavioral Intensity (PBI), Visual Analogue Scale (VAS), Ahvaz hardiness inventory (AHI), Connor-Davidson Resilience Scale (CD-RISC) and Philips Social Support Inventory (PSSI). The data were analyzed using linear regression analysis with enter and stepwise method by SPSS.
The results showed that psychological hardiness, social support and resiliency are able to predict the severity of visual and behavioral changes of feeling labor pains in nulliparous women, So that these variables have a positive effect on labor in nulliparous women.
According to research findings, it seems to promote resiliency, hardiness and social support in a pregnant woman can be effective in pain management and by overcoming on negative emotions and fear is provided a pleasure experience for women. It affects to prefer a normal delivery compared to cesarean section.

To predict the nursing workforce needed to care for patients in hospital wards, the workload of nursing care should be specified. In this regards, clarifying the concept of "nurse workload" can expand professional contributions of nurses in the health care system. The aim of this study was to assess the multiple dimensions of nursing workload, define its characteristics and functions in nursing, and ultimately provide a conceptual definition of nursing workload.
Walker and Avant (2011) eight-step method of concept analyze was used for clarifying the concept of "nurse workload". Using “nursing” and “workload” keywords, electronic databases including Pubmed, SCOPUS, CINAHL, OVID, Persian Scientific Information Database (SID), Iranian Research Institute for Science and Technology (IranDOC) and MAGIRAN publication database were searched without time limit based on the inclusion criteria, and 8 studies included into review.
The nursing workload was defined and the five dimensions of this concept were determined. Workload dimensions were the amount of time, knowledge, skills and behavior (nursing competence); nursing intensity (direct patient care); physical activity; mental and emotional processes; and the ability of nurses to change the treatment plan during their shift. Nursing workload includes direct and indirect activities that nurses do on behalf of the patient. Workload was defined as the need for nursing care or nursing skilled to meet the caring needs of patients.
Nursing workload is amount of time and care that a nurse performs (directly or indirectly) to patients, work setting, and professional development. Therefore, the whole time of nursing that nurses need to perform in both of nursing and non-nursing activities should be considered in the nursing workload measurement. By understanding the nursing workload, nurse managers can take appropriate action to improve nurses working conditions. In addition, the fair distribution of the nurse's workload will maximize their productivity.

Studies of the elderly population confirms the global epidemic of Alzheimers. Iran is also faced with the wave of increasing disease. Alzheimer's is a threating situation for the family and community in different dimensions such as health, social, political, economic and psychological position. Families are forced to take care of patients and as a result faced many problems. The aim of this study was to investigate the family's life experiences of the care of elderly with Alzheimer's in Isfahan.
This study is qualitative with phenomenological description approach. The study populations are elderly patients with Alzheimer's and their families in Isfahan. Purposive sampling method was used in the study. After interviews with10 participants, Colaizzi method is used to analyze the data.
After analyzing by Colaizzi Method, at first, 201 conceptual codes extracted. Then 20 sub themes extracted. Extremely 8 main themes emerged. Sacrifice, care burden, caregiver's captive, impaired family relationship, job disturbances, fear of stigma, maintaining excellence in patient, Puzzlement at the time and reactive feelings.
According to the findings of the current study, Alzheimer's Disease will cause psychological, physical, and economic and socially complications that a lot of these complications is tolerated on family care givers. Therefore, looking for solutions such as establishing institutes for elderly support, developing courses like elderly nursing, and psychological specific education to reduce the burden on family is essential.

Nursing is one the critical job in society and nurses pass an important part of their life in close relation with people and patients and optimal job operation guarantees health and improving many patients and people of society. So, identifying the effective factors on performance of nurses and trying to promote and improve them is so important. This study has been aimed to determine the interrelationship of job burnout and job performance of clinical nurses.
The current study is interrelation study type which is performed by sectional method and the research society is all the nurses of Shiraz Shahid Rajaei hospital. 150 persons of the nurses were entered to the study by method of head counting and according to the criterions of entry. In order to collect data, three questioners of Demographic characteristics, Maslach Burnout Inventory and Paterson Job Performance were used. Validity and reliability (0.90) and (0.84) of the two tools were confirmed in the similar studies in the country. The data were analyzed by SPSS statistical software and by using statistical independent T-test and Pearson’s correlation coefficient.
The findings show the frequency and intensity of job burnout respectively, with average of 21.37±1.55, 22.3±0.29 and job performance of nurses with average of 45.86±7.15. The results of Pearson’s correlation coefficient show that there is a negative and significant relation between job burnout and job performance of nurses (r=-0.52, P≤0.001).
The results of this study show that there is a negatively significant and direct relationship between job burnout and job performance of nurses and as high rate of job burnout can lead to a reduction in job performance. So, it is recommended to improve their job performance and increase the patients’ satisfaction and finally enhance nursing care by adjusting the causes of job burnout.

Natural and abnormal disasters and accidents have great influence on people's lifestyle and their health. Main object of hospitals is providing fast and timely health care to reduce mortality and complications by the disaster. The aim of this study is to evaluate preparedness crisis and disasters in centers of trauma of Kermanshah University of Medical Sciences.
The present descriptive, cross-sectional study was conducted in three hospitals (A,B,C) of Kermanshah university of medical sciences, Iran, 2016. The study data were collected using a self-administered checklist and questioner through observation and interview. The checklist included 220 yes/no questions in 10 domains of emergency (30 questions), admission (24 questions), evacuation and transfer (30 questions), traffic (15 questions), communication (16 questions), security (17 questions), education (17 questions), support (28 questions), human workforce (21 questions), and leadership and management (22 items). Scores 0 and 1 were given to “No” and “Yes” choices, respectively. Data were analyzed using SPSS and descriptive statistics.
Overall, the relative mean of disaster preparedness in the study hospitals A, B and C was 99.1%, 43.4%and 84.7%, respectively. Generally, the average readiness score for all hospitals was 75%. The most and lowest preparedness was related to the management and traffic, respectively.
According to the results, preparedness of hospitals was in the suitable level. Officials of medical centers have the necessary programs and educations in all areas of disaster preparedness for quick reaction and timely in hospitals.

One of the most important health procedures to control nosocomial infections is skin disinfection. This action is absolutely necessary to disinfect the skin before surgery. This action reduces the nosocomial infections significantly. Regarding the importance of this subject, in this study, two surgical areas: Preps with Betadine and Chlorhexidine has been compared.
This study was three stages, double-blind clinical trial that was performed on sixty-four patients who was electively candidate for hand surgery and randomly divided into two Povidone iodine 7.5% and Chlorhexidine groups. Sample for culturing was obtained from area, before, and after prep, and after operation. Data were recorded in checklist and analyzed using independent t-test, chi-square, and repeated measure of ANOVA.
Results show that bacterial levels significantly reduced and reached to zero when preparation of skin was based on chlorhexidine formulation (P=0.001). In the povidone iodine group the mean number of bacteria was reduced significantly (P=0.001) in three times. The average number of bacteria after preparation with chlorhexidine significantly reduced when compare to Povidone iodine, but after operation it not significant between two groups (P=0.770).
Although using antiseptic before surgery is essential, choosing the right solution in some cases faced with challenges. Chlorhexidine in prep before surgery could safely reduce the amount of bacteria. This study recommended using chlorhexidine rather than povidone iodine in surgical procedures, because it is more effective to reduce the number of skin surface bacteria.