Nursing and Midwifery Studies
Volume:1 Issue: 4, Oct-Dec 2013

Context: Medications are taken to ease, control or cure ailments. They are effective and safe if used correctly. In the elderly, disorders that occur as a result of ageing, frequently require treatment, resulting in increased use of medications. Polypharmacy is common among the elderly and although it can be therapeutic in nature, is linked to adverse events such as falls..Evidence Acquisition: A review of the literature was conducted. English articles in Cinahl, Medline and Healthsource (2000-2012) were searched for links between polypharmacy and falls in older adults aged 65 years old and over. Articles not meeting the age criterion were excluded. Search terms included falls, polypharmacy, medications, multiple medications, medicines, elderly, aged. A total of 120 articles were retrieved from the Literature search.. Sixteen articles were included in the literature review. Four literature reviews, three observational prospective cohort, three cross-sectional, three case-control, one longitudinal study and two retrospective cohort studies were examined. Many studies were able to demonstrate a link between the number of medications taken and risk of falls however the potential for bias resulting from confounding by indication was high due to study design in many cases.. Polypharmacy as an independent variable has been linked to falls in older people, however there appears to be a stronger link between falls and the type of medications taken (e.g. medications known to increase risk of falls), rather than polypharmacy on its own. Polypharmacy can sometimes be therapeutic and it may be more beneficial to consider terms such as ‘inappropriate prescribing’ or ‘ potentially inappropriate medications’ when considering the effects of medication on falls in older adults. Polypharmacy in older people is often viewed in a negative light due to the increased risk of adverse events, including falls. This article examined current knowledge on the characteristics that define polypharmacy, its effect on falls in elderly people and provided recommendations for future research. Further research utilizing prospective and intervention studies are needed to clarify the causal relationship between polypharmacy, comorbidities and fall risk..

Gastrointestinal complications are the main complication in patients after cesarean section. Previous studies have reported different results about the effect of early post cesarean feeding on vomiting, nausea, flatulence and illus.. To identify the effect of early post cesarean feeding on gastrointestinal complications.. This randomized controlled trial was conducted on 82 women who underwent cesarean section in Mashhad Omolbanin hospital. They were randomly assigned to two equal experimental and control groups. The experimental group started oral fluids four hours after surgery, followed by a regular diet after bowel sounds returned. Mothers in the control group received fluid intravenously during the initial 12 hours, and then if bowel sounds were heard, they were permitted to receive oral fluids and they could start a solid diet if they had defecation. Vomiting and flatulence were assessed with a visual analog scale. Nausea was assessed with an observation questionnaire and illus was assessed via bowel sounds, gas passing and defecation 4, 12, 24, 36 and 48, hours post surgery in the two groups. Also, they were studied for the time of gas passing, bowel sound return, defecation, sitting, walking and breast-feeding. Data were analyzed using the chi-square, Fisher''s exact test, t-test and Man-Whitney U test.. No mother experienced nausea, vomiting and illus. Flatulence severity 4 and 12 hours after surgery was similar in both groups (P = 0.856, P = 0.392). However, flatulence severity 24, 36 and 48 hours after surgery, was less in the experimental group (P = 0.030, P = 0.016, P = 0.001). Also, bowel sound return, time of gas passing, defecation, sitting and walking were less in the experimental group (P = 0.001).. This study showed that early feeding decreased post cesarean gastrointestinal complications.

Results of several studies suggest that prone position is beneficial in improving the preterm infants’ cardio-respiratory status. Previous studies showed opposite results, and also there is not any available clear study about the effect of this position on cardio-respiratory rates of Nasal Continuous Positive Airway Pressure (N-CPAP) treating premature infants.. This study aimed at comparing supine and prone positions on cardio-respiratory rates of premature infants with respiratory distress syndrome (RDS) who were treated using N-CPAP..Patients and This was a cross over study which was performed in 2010 on 44 hospitalized 29-34 weeks gestation premature infants who were receiving N-CPAP in Neonatal Intensive Care Unit of Al-Zahra Hospital of Tabriz University of Medical Sciences. Infants were randomly assigned into two groups, and the first group was placed in prone at first and then in supine, and the position of second group was at first supine and then prone. Infants’ Heart Rate (HR) and Respiratory Rate (RR) were assessed three times in each position for 30 minutes. The data was recorded in a data-collection form, and demographic data was analyzed using t test, Chi square and Fisher exact test. Also, repeated measurement ANOVA and Tukey post-hoc tests were used.. There was a significant difference in HR and RR of premature infants who were similar in gestational age and clinical condition and placed in two positions. Premature infants’ HR and RR became lower at prone position than supine in both groups. So it can be concluded that prone position could decrease infants HR and RR, but supine position might increase them (P < 0.05).. Our findings support prone positioning for premature infants. Therefore, it is advisable to NICU staff that if there is no obstacle for changing the infant’s position, prone position in infants with respiratory complications during receiving N-CPAP in NICU can be useful. Regarding the fact that prone position is a risk factor for sudden infant death syndrome, prone position should be only used when the newborn is being supervised carefully..

Tubal occlusion is one of the most frequent causes of infertility in women. The evaluation of the fallopian tube is necessary to determine the management plan for infertility. The two most important diagnostic procedures which are used for the evaluation of tubal patency are hysterosalpingography (HSG) and laparoscopy.. The aim of this study was to compare HSG and laparoscopic findings in the diagnosis of tubal patency.. Patients and In a prospective study sixty two infertile cases were examined by HSG as part of their routine infertility evaluation, three months after HSG, tubes status were assessed by laparoscopy as a gold standard method. The findings of HSG and laparoscopy were compared. The Laparoscopy findings were used as reference standard to calculate sensitivity, specificity, positive and negative predictive values for unilateral and bilateral no tubal patency.. The sensitivity and specificity of HSG on bilateral tubal patency or no bilateral tubal patency were 92.1% and 85.7% respectively. The positive and negative predictive values were 97.2% and 66.7%, and the accuracy was 91.1%. The sensitivity and specificity of HSG for evaluation of the bilateral tubal patency and unilateral or bilateral no tubal patency were 77.8% and 52.94%, the positive and negative predictive values were 81.4% and 47.4% respectively, and the accuracy was 71%.. HSG is considered to have a high sensitivity and specificity. HSG and laparoscopy are not alternative, but are the complementary methods in the examination of no tubal patency..

Quality of life differs for different people in different situations and is related to one''s self-satisfaction with life. Quality of life is affected by health status.. The current study examined the relationship between quality of life and depression in pregnant women in Kashan city..Patients and A Case - control study was performed on 112 depressed pregnant women (Case Group) and 353 Non-depressed pregnant women (Control Group) who referred to the prenatal health care centers of Kashan University of Medical Sciences. They completed Short Form 36 Health Survey (SF-36) to assess the quality of life and the Beck Depression Inventory to assess the level of depressive symptoms. T-test, chi-square and Pearson correlation coefficient statistical tests were used for data analysis.. The findings showed that there was an inverse relationship between quality of life and depression in pregnancy (P = 0.0001). Average scores in all eight domains of quality of life were significantly lower in depressed pregnant women compared to non- depressed women. The strongest relationship was observed between depression and vitality (r =-0.52, P = 0.0001), mental health (r = -0.50, P = 0.001) and social functioning (r =-0.38, P = 0.001).. Depressed pregnant women had a lower quality of life. The proper management of depression during pregnancy can improve the quality of life in women. It is recommended that antenatal services integrate screening for depression into routine antenatal care..

Methods learnt by nursing and midwifery students’ such as communication skills, optimisim and coping with stress would be used in their profeesional life. It is very important to promote their positive thinking and communication skills to raise coping with stress.. This cross sectional study was performed to examine the nursing and midwifery students’ communication skills and optimistic life orientation and its correlation with coping strategies with stress.. The study population included 2572 students who were studying in departments of nursing and midwifery in Istanbul. The sample was included 1419 students. Three questionnaires including Communication Skills Test, Life Orientation Test and Ways of Coping Inventory were used for data collection. The data were evaluated by calculating frequency, percentage, arithmetic mean, standard deviation and Pearson correlation coefficient.. Students’ total mean score from the Communication Skills Scale was 165.27 ± 15.39 and for the Life Orientation Test was 18.51 ± 4.54. There was a positive correlation between their Life Orientation scores and the scores for self confidence (r = 0.34, P < 0.001), optimistic approach (r = 0.42, P < 0.001), and seeking social help (r = 0.17, P < 0.001). Also there was a significant positive correlation between Communication skill scores and self confidence (r = 0.46, P < 0.001), optimistic (r = 0.37, P < 0.001) and seeking social help approaches (r = 0.29, P < 0.001), but there was a significant negative correlation between communication skill scores and scores for helpless (r = -0.29, P < 0.001) and submissive approaches (r = -0.36, P < 0.001).. As scores of students in optimistic life orientation and communication skills increased self confidence approach, optimistic, and social support seeking scores increased, whereas helpless, and submissive scores decreased..

The birth of a child is an event to be remembered. However, a premature birth may shock the parents and cause their grief. Understanding differences between mothers and fathers can help nurses in providing nursing supports.. This study was performed with the aim of comparing nursing behaviors which facilitate grief work for parents of premature infants hospitalized in the neonatal intensive care unit (NICU) from perspectives of mothers and fathers.. Patients and This comparative descriptive design was conducted among 40 pairs of mothers and fathers selected by convenience sampling method. The study was performed in 2011 using the Fordham Scale. Data were analyzed with «Wilcoxon ranks test» by using SPSS software version 13.. The mean scores of nursing behaviors which facilitate grief work were 2. 81 ± 0. 16 and 2. 82 ± 0. 29 in the perspectives of mothers and fathers, respectively. The Wilcoxon test did not show any statistically significant difference between mothers and fathers (P = 0. 55).. Despite expectations, provided nursing behaviors in mothers and fathers showed no difference in this study. Therefore, nursing policymakers and directors should take measures in order to provide appropriate services to the parents..

Despite the importance of self-management in epileptics, no instrument has been developed or validated in Iran. Since self-management is a multi-dimensional construct, having a valid and reliable instrument for measuring this compound construct is crucial.. This study aims to validate the Persian version of the self-management scale and provide a valid and reliable tool to measure self-management of patients with epilepsy..Patients and This is a methodological psychometric study. Construct, face and content validity was calculated on 200 samples after translation. Tool reliability was examined by using two internal consistency and test-retest. Finally, the modified model was presented using exploratory factor analysis for the Iranian version of the tool.. The validity of all items was above 0.63 and their content validity indexes (0.81-1) were appropriate. Construct validity, exploratory and confirmatory factor analysis confirmed all the dimensions except for some safety and pharmacotherapy items. The overall tool reliability with internal consistency had alpha of 0.77.. Persian version of the self-management scale for patients with epilepsy is valid and reliable to measure the dimensions of self-management in Iranian patients and it can be used to measure epileptics’ self-management. Further research on the safety of this tool is recommended..

The nurses as the largest group among different groups of hospital workforce play a crucial role in success of the hospital activities and promotion of community health.. This study aimed to obtain an estimation of the necessary nursing workforce status in educational hospitals affiliated to Ilam and Ahvaz University of Medical Sciences based on the scientific formula.. This research was a cross sectional-descriptive study, which was done in hospitals affiliated to Ilam and Ahvaz University of Medical Sciences during 2010. Using three researcher-made forms, data was collected from all clinical, para-clinical, financial, administrative and support departments of hospitals. Data was analyzed in accordance to the standards of Iran''s Ministry of Health and Medical Education using the Excel software.. The results showed that the nursing staffs in the 42 wards (89.5 %) were lower than the standards, only one ward (2 %) matched the standards and the rest of the wards (8.5%) were higher than the standards. The organizational dislocation (utilization of nurses in non-related jobs) of nursing staffs obtained for Imam Khomeini of Ilam, Mostafa Khomeini, Taleghani, Razi and Imam Khomeini of Ahvaz Hospitals were 8, 5, 3, 8 and 21, respectively.. Generally, the studied hospitals were faced with a lack of nursing manpower and distribution of manpower was not appropriate. Proper planning and management of manpower in accordance with the lack of personnel, compensates and achieves the standards required for hospital’s nursing manpower and this would lead to an increase in the efficiency of hospitals activities and can provide satisfaction for the nursing staff..

Leukemia and hematopoietic stem cell transplantation (HSCT) create physical, psychological, social, and spiritual distresses in patients. Understanding this threatening situation in adults with leukemia undergoing HSCT will assist health care professionals in providing holistic care to the patients.. The aim of the present study was exploring the perceived threat in adults with leukemia undergoing HSCT.. Patients and This article is part of a longitudinal qualitative study which used the grounded theory approach and was conducted in 2009-2011. Ten adults with acute leukemia scheduled for HSCT were recruited from the Hematology–Oncology Research Center and Stem Cell Transplantation, Shariati Hospital in Tehran, Iran. A series of pre-transplant and post-transplant in-depth interviews were held in the hospital’s HSCT wards. Totally, 18 interviews were conducted.. Three written narratives were also obtained from the participants. The Corbin and Strauss approach was used to analyze the data.. Perceived threat was one of the main categories that emerged from the data. This category included four subcategories, «inattention to the signs and symptoms», «doubt and anxiety», «perception of danger and time limitation» and «change of life conditions», which occurred in linear progression over time.. Suffering from leukemia and experiencing HSCT are events that are uniquely perceived by patients. This threatening situation can significantly effect perception of patients and cause temporary or permanent alterations in patients'' lives. Health care professionals can help these patients by deeper understanding of their experiences and effective interventions..

Internet is one of the technologies of the modern era that is being extensively used around the world. It is believed that excessive Internet use can be pathological and addictive. Though, academic use of the Internet is primarily intended for learning and research, students are one of the groups at risk of Internet addiction.. Due to the expanding use of Internet among the university students, this study was conducted to examine the Internet addiction and its predictors among Guilan University of Medical Sciences students.. A cross-sectional study was conducted on 583 students during the first semester of 2012. A two-stage stratified random sampling was conducted and a two-part instrument was used for data collection. The first part of the instrument was consisted of questions about demographic characteristics and the second part was the Young''s Internet addiction inventory. Chi-square, Kruskal-Wallis testes, Spearman correlation coefficient and ranked logistic regression were used for data analysis.. About 5.7% of the students were moderately dependent to the Internet, while 44.1% were at risk for Internet addiction. Significant relationships were observed between the Internet addiction with age (P < 0.001), gender (P < 0.001), marital status (P < 0.001), major (P = 0.016), Grade point average (P = 0.017), semester of studying (P = 0.009) and student residence place (P = 0.014). However, no significant relationship was observed between the internet addiction score and level of discipline, parental job status and education level or the students’ accommodation.. About half of the participants in this study were at risk of Internet addiction. This finding can be a warning sign for the authorities in universities to pay more attention to this issue. A wide range of education along with empowering programs may be needed to inform the university students about the advantages and disadvantages of internet and the correct manner of using it..