نشریه پرستاری ایران
پیاپی 44 (زمستان 1384)

In Holistic Nursing, human being is a complex multidimensional creature. Spiritual dimension is the most prominent aspect of human being, which affects individual's health. Therefore, it seems that providing spiritual focused-care is an important domain of nursing performance. The purpose of this study was to determine and to compare, the perspectives of the first and fourth year baccalaureate nursing student regarding spiritual well being and spirtual care. The design was a comparative study, and the data collection instruments, were Spiritual Well-Being (SWB), Spiritual Perspective Scale (SPS) and Nursing Spiritual Care Perspective Scale (NSCPS). From 350 students of first and fourth year of Nursing Schools of Iran, Tehran and Shahidbeheshti universities, 283 students participated in the study. The results showed that, there were not any significant differences between the two groups considering their spiritual well-being. In other words, 98.8% of the first year and 100% of the fourth year students were in the group of moderate spiritual well-being. Besides, the mean and standard deviation of spiritual scores were 4.45 (0.65) and 4.33 (0.76) for the first and fourth year students respectively, which was not statistically significant. Although fourth year students had been involved in a 4-year nursing education curriculla, their scores of spirituality were the same as the first year students. So, the researchers strongly suggest that the revisions of the curriculum may be necessary in a way to investigate the spiritual aspect of life with nursing education programs. Further studies need to be undertaken to gain more insights into longitudinal investigations and the use of new tools as data collection instruments, especially suitable to Iranian Culture. Other studies is recommended to evaluate the effect of education on spiritual development in students.

Eye trauma is a major problem in emergency rooms that could be prevented in the world. Over 0.5 milion individuals lose their vision due to eye trauma. Eye trauma is a major cause of monocular blindness. After occupational trauma, eye trauma at home, is a second cause (15-41%) of blunt trauma. Therefore in this study, we investigated home eye trauma in the emergency unit of Alavi Eye Center, in Tabriz. The design was a retrospective study from March, 2003 to December, 2003 to investigate 305 patients with eye trauma that occurred at home and refered to the emergency unit of Alavi Hospital. In this study, SPSS used for data analysis. About 53.8% of the patients participated in this study were males and 46.2% were females. Mean age of the patients was 26.3 years. Most of the cases were children under 10 years old (with 7.9% females and 15.4% males). There was a significant relationship between eye trauma at home and age. Corneal abrasion was the most common type of trauma (32.7%), and blunt trauma was the most common cause of the eye trauma (20.7%) that were similar results with the other studies. With regard to the prevalence of home eye trauma at younger age, the investigators concluded that education of mothers is a key measure. In fact nurses play an important role to previde the information regarding eye trauma prevention.

Home, the most fundamental institution in the society, is established for comforting and security feelings. Therefore, WHO in a Fact Sheet of the "Maternal Support" in 1986, emphasized that home: "is the most suitable place for majority of Laboring Women and delivery for child birth". To determine the women's reasons of home delivery preference and its complications in koohdasht city 750 women were selected in the year 1381 in this study.The design was a descriptive study and the data were gathered through a questionnaire.The study findings revealed that the woman's reasons for home delivery based on the financial problems (32%), personal willingness (39.9%), past home delivery positive experience (37.2%), short time delivery duration because of the fear of complications during transportation to hospital (35.7%), unavailability of their husbands during labor (20.5%). A also adverse pregnancy outcomes, such as early hemorrhage, inertia, constipation, urinary retention, perineal laceration, in women with home delivaries were perceived less than the women with hospital deliveries. Because many complications occur in the home deliveries, it is recommended that low risk pregnant women should be under support and midwifery care of educated midwives as well as organized, health care systems.

Women are vulnerable population, particularly in their menopause period. During the last few decades, one of the health care concerns in women is the phenomenon of menopause with its complications and psychological disorders. Seemingly, knowledge regarding signs and complications of menopause could help women to cope and may improve quality of life in this period. This research was a quasi experimental study (before and after). The aim of this study was to investigate the effect of health education training program on quality of life of women with menopause. In this research, the data gathering instrument was a questionnaire consisted of knowledge and menopause quality of life (MENQOL) items. A health education program design based on the pretest data and the post test data was within two weeks after the last session of performing the educational program. Data analysis showed that, the mean and standard deviation of participant's age were 45.5 yeary and (2.15) and the mean and standard deviation of knowledge scores, before education was 13.7 (2.4) and after education was 17 (2.92). The overall knowledge score, significantly improved after the education (t=4.39, P<0.000). The finding of this research, showed that quality of life of the women after intervention consisted of four dimensions, vasomotor (t=2.12, P<0.04), psychosocial (t=4.17, P<0.000), physical (t =4.6, P<0.000), and sexual (t =2.1, P<0.004) that significantly improved as well. Also, this study showed that the knowledge of women about signs and complications of menopause were less than the level expected. It is suggested that women should receive special education programs regarding menopause to increase their knowledge. It can be concluded that, it is necessary to educate the women, before the menopausal stage occurs, through lectures, radio, TV programs, magazine, newspaper etc. That could improve women's quality of life.

The 21st century is the era of continuous changes in the way modern medical and scientific world functions, thus the need for adaptation in complex systems becomes paramount. In such a dynamic society optimum standard of survival may depend on the ability of individuals and groups to investigate multiple alternatives or choices and finally make wise decisions. Therefore, the need for critical thinking skills is an absolute vitality for today’s health science professionals. Education is the most powerful tool in developing learning skills and the main aim of every educational institution is to assist students and trainees to achieve such end. Besides professional competency, the main aim of medical sciences education is to develop students’ ability in decision making ability and problem solving, and leading them to become efficient critical thinkers. Critical thinking skills are vital in coping with the unprecedented rapid changes occurring in health care field. In order to cope with the complexity of today’s medical issues, nurses and physicians need to equip themselves to critical thinking ability so that they can offer the most effective services and treatments for their patients and clients. It seems that there is challenge in training capable and skilful graduates in Iran medical education system. Hence, essential actions are needed to uplift the standard of medical education in this country. To this end, urgent priority should be given both to development and improvement of critical thinking skills of students and trainees of health field. First, based on authors’ experiences, some of the barriers for critical thinking skills nursing of students is reviewed. Then, based on literature review and panel of experts’ viewpoints a suggested solution in a graphical format, is suggested. Planning for an urgent action is also suggested to improve critical thinking skills of students and trainees in health field which seemingly is a challenge in iran nursing education system.

As a matter of the fact, patient with a disability and chronic diseases such as heart failure, suffer from many health related problems. Promoting health and quality of life of these patients will be feasible, if they could promote their self care behaviours. In order to assess self care behaviours of these patient and its relationship with quality of life, we conducted a correlationel descriptive study which 250 participants selected by random sampling, and a questionnaire used as a data gathering instruments. The study findings showed that a statistically significant relationship was existed between self care behaviours and the quality of life (P=0.00). We also found that 76.4% of the participants possessed undesirable and less desirable levels of quality of life. 74% of the patients had moderate and low scores of self care behaviours to sum up the results, the study findings showed that the majority of the sample group had unsatisfactory self care behaviours and quality of life scores. Therefore, systematic self care educational programs are of great need to be held by nurses,whom had been trained and academically educated for this goal.

Premenstrual syndrome is one of the most common disorder in women with reproductive age. The aim of this paper was to investigate the frequency and the intensity of this syndrome and the related signs and symptoms. Five hundred students who were enrolled at BS level in the academic year 1384 at the schools of nursing-midwifery as well as the school Management of IUMS, were included in the study. They were asked to complete the premenstrual daily symptom diary (PDSD) for 2 months. The students with PMS, were confirmed according to the APA criteria and their intensity were assessed by the mean of scorces of each sign which varied from 0 to 3. In this study, the response rate was about 50% (255). Out of the 255 students, 200 students (78.43%) were sufferring PMS to some degrees (62% mild, 36% moderate, 2% severe). Mood symptoms in 24% and the behavioral symptoms in 3% of the subjects were in severe level. None of the students suffered from sever physical symptoms. The study results revealed a significant positive relationship between behavioral symptoms and physical mood symptoms (r=0.55, r=0.398, P=0.00) respectively. Also there was a significant relatinship between physical symptoms and mood symptoms (r=0.305, P=0.00). In this study the investigators concluded that PMS can be considered as a common disorder in young iranian women at the reproductive age. To detect and diagnose the PMS related symptoms, could help provide the most effective treatment strategies. Future studies is recommended to find out the risk factors of the PMS and appropriate therapies.

The quality of health care mainly depends on how nurses work, which is the most important part of hospital services. The practical and clinical nature of nursing necessitates clinical education to be planed in order to provides the chance of observing, imitating, supervising and have a feed back for nursing students. Determining senior nursing student’s opinions about clinical skills level acquisited during their training period, a descriptive study was carried out in which data were collected through a self report questionnaire. The research focused on 251(221 female and 30 male) senior nursing students of Iran, Tehran and Shahid Beheshti Universities of Medical Sciences. The results revealed that the skills related to "assessment of vital signs" with the average of (87.5) was acquisited in level of "Experienced" or level (5). Skills related to "drug administration" and "infection control and wound care" with the averages of 77.76, 79.23 respectively were acquisited in level (4) or "Master". Moreover, more than 90% of the study sample had the opportunity to perform mentioned skills more than once. The skills related to "maintaining personal hygiene and movement", "collecting laboratory samples", "providing nutrition needs", "oxygenation and opening airways" and "providing urinary and bowel elimination" with the averages of 57.92, 61.65, 65.29, 65.46, 66.79 respectively were acquisited in level of "Supervised" or level(3). Meanwhile 20% of students never performed such skills the investigators. It is concluded that although the level of "Supervised" is known as an expected level, most clinical skills are gained at this level or higher, but most of the students did not accomplished this level at all. So it is suggested that the expected level has to be well defined and the achievement to this level be provided in training programs. It also would be beneficial if researchers conduct studies on other domain of nursing skill.