نشریه پرستاری ایران
پیاپی 45 (بهار 1385)

Management theorists insist on the importance of the participation of employees in decision making processes, as it will affect their performance and the output of the work to be done in an easier way.The aim of this study, was to determine head nurse's level of participative decision making and its relationship to their satisfaction level. his study was a correlational study in which, head nurse's level of participative decision making and satisfaction levels were measured respectively. The data collection tools were Participative Decision Making (PDM) and Satisfaction of Participative Decision Making (SPDM) scales. Self report questionnaires were completed by head nurses, inside their work settings. In this study, 94 nurses with baccalaureate science in nursing (BSN) degree who have been working in teaching hospitals of Iran University of Medical Sciences were recruited. One of the inclusion criteria was working history of more than the period of 6 months in the work setting that selected by census method of sampling.Nurses obtained a moderate score in (PDM) and in (SPDM) scales. Findings, showed that a relatively strong statistically significant relationship between the two major variables of the study (r=0.661 P=0.000). Among the demographic variables, sex, educational level and job position, influenced more in this significant relationship.The results showed that, there is a statistical significant relationship between head nurses participative decision making and their satisfaction level. This study finding, helps the managers to facilitate participation of workers in making decisions in order to promote the efficacy of the organizations. The researcher strongly suggest furthur studies on participative decision making among other health professionals that might be necessary and could influence on quality of health care system organizations and the related outcomes.

Families of patients with Schizophrenia endure remarkable hardship for coping with their patient's psychotic symptoms and they confront several physical and emotional stresses. Regarding the importance of family's role in supporting patients in community-based services, the present study was conducted to determine correlates of quality of life in the family caregivers of schizophrenic patients with hope in Medical Education Centers, Tehran, 2006. This correlational study, was carried out on 260 family caregivers of patients with schizophrenia who had been referred to Medical Educational Centres in Tehran. A convenience sampling method was used and the study conducted in April- June in 2006. The data collection tool consisted of demographic questionnaire, Quality of Life Family Version and Miller Hope Scale (MHS). Data were analyzed using SPSS Soft Ware, descriptive statistics, c 2 and Spearman correlation coefficient. The result, showed that 27.3% of family caregivers had inappropriate quality of life, 64.2% of them had good quality of life and 8.5% of them had very good quality of life. 53.5% of family caregivers had high level of hope, 45% of them had moderate hope and 1.5% had low level of hope. There was a significant direct relationship between quality of life and hope (c 2 = 56.80, P =0.000 & r =0.679, P=0.000) in the subjects. Quality of life was correlated with economic status (c 2 = 17.61, P= 0.0001), and education status (c 2 =15.09, P= 0.020). In this study regarding the correlation between quality of life and hope, the researchers recommended that using coping strategies may improve quality of life and the level of hope among family care givers of patients with schizophrenia.

Hypertension is seen as a serious risk factor in modern societies. Thus, population's screening, with modifying lifestyles, especially in nutrition, and the patient's follow- up are the most essential strategies for the control of this disorder. This interventional study was undertaken to determine the effect of participation of health intermediators Diet and Drug consumption in patients affected by hypertensive dis orders under the auspices of medical health care. The sample consisted of hypertensive patients (92 in intervention group, 92 in control group). All the subjects, were selected from Health Centers in the West District of Tehran. Intermediators had five home visits for each patient from intervention group. The questionnaires were completed before and after the intervantion. In this study, we used kappa, McNemar, independent sample t-test and chi-square (c 2) tests. The study, findings showed that 73.5% of intervention group and 75% of the control groups were women. The majority of the subjets in both groups were married, house wives, with either illiteracy or elementary education. 62.3% of the intervention group and 50% of the control group had high cholesterol background. Kappa test showed a significant difference concerning self-care related to nutrition control, as namely adding salt at the time of cooking (P=0.007, P=0.0001) and adding salt at the time of serving the food (P=0.007, P=0.0001) before and after intermediatories participation. Also kappa test showed a significant difference concerning self. Care related to health habits, as hypertension control (P=0.012, P=0.000) before and after intermediaries participation. Also there was a significant difference regarding to drug usage and consultation with physician in the intervention and control group. In general, hypertension control is very important. Thus, it would be necessary that we have an effective caring program for these patients. Because intermediors participation, in relation to patient education is important, we recommend that the pationts should receive routine continuing education and actively participate in nursing home visits. We believe that in this context, they can play an important role in work force for benefit of health promotion in the community.

Prenatal care utilization is a very important factor in improving pregnancy outcomes and maternal health infant. In fact, barriers to prenatal care utilization have been linked to inadequate prenatal care and poorer health outcomes. The purposes of this study were to assess prenatal care utilization and factors affecting to receive prenatal care. The aim was to examine the relationships between demographic variables and other selected variables to the adequacy of prenatal care utilization (APNCU) among women. The design of study was descriptive cross-sectional study. The pupolution of the study was recepient of prenatal care that attending to the two Health Centers of Iran University of Medical Sciences. The samples size was 400 women that were selected consecutively from the year of 1383 to 1384. The age of children of the subjects was maximum 1 year old. In this study, the prenatal care utilization (APCU) was assessed by Kotelchuck’s index. The finding indicated that 83% of the women had inadequate or intermediate utilization of prenatal care services. According to the factors affecting the prenatal care utilization, women who agreed that prenatal care was important, utilized the services significantly more than other women (P=0.005). There were significant relationships between utilization of the services with women age (P=0.001), husband's age (P=0.016), job (P=0.000), number of family members (P=0.002), number of children (P=0.006), income level (P=0. 053) and gestational age (P=0.000).Despite improvements in prenatal services, a great number of women do not receive prenatal care adequately. Some of the factors from the subjects perspectives were, lack of information concerning how to obtain care, time of providing care and lack of confidence of care providers. Barriers to prenatal care varied by demographic group therefore, identifying the characteristics of the recipients (clients) who need prenatal care seems important, regarding to reduce barriers of utilization prenatal care.

The injury due to the minor and moderate burn is allocated highest rates of intense nursing. There is possibility of posttraumatic stress disorder (PTSD) among the burned patients. This study is performed with the aim of determination and comparison rate of PTSD in two groups of minor and morderate burn. This was a comparative cross-sectional study. Eighty patients with burn injury were studied in two groups. Group 1, injured with minor (Less than 15% TBSA) and the group with moderate (15-25% TBSA) burn injury was included in the second group. The sampling method was sequential and the study was conducted from March to July 2006. A questionnaire was used for assessing the rate of PTSD that completed by an interview with the subjects. The study findings, showed that the highest rate of PTSD occured in the moderate burn (47.5%). There was a statistically significant relationship between the rate of PTSD and moderate burn (P=0.024) in patients. It seens that, severity of burn indicate the rate of PTSD (posttraumatic stress disorder). This is very important matter that injured patients should be detected as soon as possible to receive appropriate nursing care plan. With a view to PTSD recognition, implementation of care plan must be initiated appropriately.

Generally, increased number of old people is because of increased life expectancy. This large group of population in communities with regard to their physiological and psychological needs, necessitate special care by positive attitude from health care providers towards them. In fact, the attitude of nurses as health professionals will affect their assessing of old patients is prominent. The aim of the study was to determine nursing students and clinical nurse's attitude toward elderly patients care. This study was a comparative descriptive design in which a self-report questionnaire was used as data collection tool. Through continues sampling method, 522 subjects participated in this study. The study results revealed that there were significant differences of attitude toward old patients care between the first and third year nursing students and clinical nurses (P=0.000, c 2 =182.13). Besides, clinical nurses had positive attitude and nursing students had neutral attitude toward old patient care (P=0.000, F=149.94). In other words, the mean scores of attitude toward old patient care among clinical nurses was the highest and in the first year students was the lowest, score. Also, there were positive relationships between attitude toward old patient care and the time period of nursing employment (up to 15 years) in clinical nurses, and living with an old relative in the first year students. Moreover, female nurses had more positive attitudes toward old patients care than male nurses. According to the study findings, an extensive plan to improve nurse's attitude toward old patients is recommended. The researchers suggest that intervention to promote positive attitude in nursing, would be possible by implementing different strategies including curriculm revision.

Premarital health counseling for couples, especially in females is very important in community's health. In the premarital counseling, females are educated regarding reproductive health, such as methods of prevention of breast and cervical cancer that helps to family health promotion. The aim of this study, was to determine the effect of premarital health counseling on the female's awareness towards methods of prevention of breast and cerviced cancers. This study was a quasi experimental design. The aim of the study was to determine the difference of the subject's awarness about methods of prevention of breast and cervical cancer at preintervention and post intervention. The mean & standard deviation of the achieved scores related to the awarenss were calculated. The sample size was 600 subjects who were attending in premarital health counseling program in selected health centers. The sampling method was consequence and the study tool was a questionnaire. The study finding, showed that the mean and standard deviation of samples’ age was 21.82 ± 3.94 and 47.4%. The majority of the subjects had a level of diploma degree in education and, 76.6% were housewives. The differences between the mean of their scores of the subject's awarences in the two groups (who participated in the counseling and who did not) were significant (P<0.0001). Considering the importance of prevention methods of breast and cervical cancer, the researchers suggest to conduct a prospective study for assassing the effect of premarital health counseling program on female's practice. The study findings showed, a high efficacy of the premarital counseling regarding the subjects awareance about prevention methods of breast and cervical cancer. Thus, the researchers recommend further studies of the efficiency of the premarital counseling on long-term outcomes among females, attending premarital counseling.