فهرست مطالب اندیشه حامدی

Chronic renal failure directly and indirectly changes the quality of life of the patients. To maintain the quality of life, self-efficacy plays an effective role. Investigation of the relationship among stress, quality of life, and self-efficacy can help nurses to apply suitable ways to improve the quality of life of patients. Therefore, the present study aimed to determine the severity of stress and its relationship with self-efficacy and quality of life in hemodialysis patients in Imam Khomeini Hospital in Shirvan, Iran.

This cross-sectional correlational study was carried out on 77 hemodialysis patients in 2022. The research tools included demographic characteristics and quality of life questionnaire, alongside human stress and general self-efficacy measurements. The collected data were analyzed in SPSS software (version 19).

Mean age and weight of the participants were 56.5 ± 14.73 years and 66.48 ± 17.15 Kg, respectively. Moreover, 59.7% of the patients were male and 41.6% of them performed dialysis for 1-3 years. There was a significant relationship between the mean stress score and score of some dimensions of quality of life (P<0.05). However, there was no significant relationship between the mean score of stress and self-efficacy. In addition, there was no significant relationship between the average of self-efficacy score and some dimensions of quality of life (P≥0.05).

According to the results, the quality of life of hemodialysis patients improves by reducing the stress intensity. Meanwhile, people who have a higher level of self-efficacy experience less stress. Therefore, the effort of the treatment staff is to identify the aggravating factors and use suitable interventions to reduce them with the aim of improving the quality of life of patients.

Schools and universities in China were closed to prevent further spread of the virus as the coronavirus began to spread. And virtual education replaced face-to-face education. The use of virtual education alone faced challenges that affected its attitude, satisfaction and effectiveness. Therefore, this research was conducted with the aim of investigating the attitude, satisfaction, effectiveness and challenges of virtual education from the perspective of nursing and midwifery students of North Khorasan University of Medical Sciences during the Covid-19 pandemic.

Methods & Materials:

This cross-sectional research was conducted with the participation of 177 nursing and midwifery students of North Khorasan University of Medical Sciences. The tools used included: demographic information questionnaires, measuring attitude, satisfaction and effectiveness of virtual education. Data were analyzed with spss software version 19, Kruskal-Wallis and Mann-Whitney statistical tests at a significance level of 0.05.

In this research, there were 126 female participants (73.3%) with an average age of 27.22±2.6. The average score of attitude, satisfaction, effectiveness and challenges of virtual education from the students' point of view were respectively, 11.84 ± 3.34; 13.59 ± 5.21; 16.94 ± 5.75 and 25.37 ± 5.81. A statistically significant relationship was found between the average score of attitude with satisfaction, effectiveness, and also the average score of satisfaction with the effectiveness of virtual education. (p<0.05)

The use of virtual education, as a new educational method, has faced many challenges; Considering the low level of its effectiveness, it is possible to improve the attitude, satisfaction and effectiveness of virtual education by strengthening the infrastructure.

Chronic and prolonged illnesses and disorders, such as addiction, lead to a crisis in the lives of people with disabilities and can lead to a decrease in their quality of life. Therefore, in this study, we decided to compare the quality of life of individuals with substance use disorders who participate in Narcotics Anonymous, therapeutic Community session with Methadone-treated groups.

This cohort study was conducted on detoxified patients attending Narcotics anonymous, therapeutic community sessions and Methadone-treated place. Quality of life of subjects measured at baseline and 1.5 months after the start of treatment. Data were analyzed by SPSS19 software using ANOVA, paired t-test, Chi-square analysis.

The mean score of quality of life between three groups was not significantly different at the beginning of the study, but the mean score of quality of life among individuals with substance use disorders participating in the sessions of Narcotics anonymous and therapeutic community group increased significantly (P <0.001) 1.5 months after the start of treatment.

The results of this study indicate that the presence of detoxified persons in sessions of Narcotics anonymous and therapeutic community was effective in improving their quality of life. However, this effect is greater in Narcotics Anonymous. Therefore it was suggested that individuals with substance use disorders participate in these meetings.

Health care authorities are able to arrange proper planning on prevention programs and optimized management of antidote stockpiles by identifying regional pattern of poisoning. So this study was designed to evaluate the pattern of acute poisoning cases treated in a tertiary care hospital in north- eastern Iran.

This cross sectional study was conducted at emergency department of Mosabn-Jafar hospital in Quchan during December 2017 to the end of November 2018. All cases of poisoning admitted to the hospital were included in this study. The patients’ data were obtained from medical records and were documented on a pre-structured proforma. 

A total of 222 cases of acute poisoning were studied. The average of people age was 28.9+15.7 year old, most of the patients aged 11 to 30 years (60.3%) ,(50%) were  women, most of the patients reside in urban areas (68%), half of them were married (55%), diploma (33.7%) and unemployed (26.1%). Intentional poisoning or suicidal was the main cause of poisoning (44.6%), overload (31.1%) and Accidental poisoning was recorded for (24.3%) of cases. Pharmaceutical medication (60.4%), opioids (12.1%) followed by pesticides (8.5%) were the most common exposures. The most common drug used in all age was Benzodiazepine (38.8%). 

Attempted suicide was the most common route of poisoning which necessitates attention to psychiatric counseling.

Animal bite is a serious and dangerous threat to human health. The highest prevalence rate of animal bite in Iran is in Golestan, Ardabil and, then Khorasan. The present study examined the epidemiological characteristics and the trend of animal bites during 2014-2018.

This analytical cross sectional study was conducted on human cases suspected of rabies, which were collected by Shirvan Health Center. Data were described using descriptive statistics indicators (frequency and percentage, mean and standard deviation) and drawing appropriate graphs, and decomposition method was used in SPSS19 software to estimate the animal bites.

In this study, out of 3784 cases bitten by animals, 2821 happened by a sudden attack. Most reports of the animal bite were from dogs. Also, the trend of animal bite during 2014-2018 was increasing and the charts showed that the trend will continue to increase the next year.

Due to the increasing trend of animal bites, it is necessary to take basic measures such as training endangered groups, forming a committee to eliminate stray dogs, and strengthening the care system and immunization program.

Chlamydial infection is a common infection. This bacterium can cause complications such as: pelvic inflammatory infection (PID), ectopic pregnancy, infertility and abortion. This study was performed with aim to evaluate the prevalence of Chlamydia trachomatis infection in women with a history of abortion referred to Bental-Hoda Hospital in Bojnurd.

This descriptive study was performed on 90 women with a history of abortion who had referred to the Bental-Hoda Hospital in 2019. The research tool was the questionnaire and the study's sample was blood which was transferred to microbiology laboratory for ELISA test. Patient's demographic information and medical history including age, number of pregnancies, number of abortions, place of residence and number of successful deliveries were collected. Data were analyzed using SPSS software (version 19) and Chi-square and Fisher's exact tests. P<0.05 was considered statistically significant.

The prevalence of Chlamydial infection was 12.2% (n = 11). There was no significant relationship between the test's result (Chlamydial infection) and patients' age (p=0.92). The mean age was 27.7± 7.8 years in patients with chlamydia positive infection and 27.9±7.6 years in patients with negative infection. Also, no significant relationship was found between gestational age, number of pregnancies, place of residence, number of abortions and number of successful deliveries with test's result (chlamydial infection) (p<0.05).

Since in this study, the prevalence of Chlamydia infection was 12.2% in women with a history of abortion, in order to reduce the burden of disease in the community and prevent its complications, screening for Chlamydia by ELISA method can be considered as a part of routine care programs before and during pregnancy in all health centers.

Failure to thrive (FTT) is a global problem and one of the most common health problems in childhood that involves many other social, economic, and cultural factors. Considering the adverse effects of FTT in the future of children, we studied FTT and its related factor in children under the age of 2 years in Bojnurd (the capital city of North Khorasan province, Iran).

This study was a Retrospective cohort study on 1000 health records, born in 2008-2013. Stratified sampling method was applied and the data were collected using a checklist in the health centers. Finally, data were analyzed using Chi-square, Multiple logistic regression, and independent t-test in SPSS19 software. Significant level was set at 5%.

Incidence of FTT was calculated as 443 children (44.3%) in the children's first two years of life. A significant relationship was observed between FTT in children and head circumference disorders at birth (p=0.001), maternal age at delivery (p=0.01), mother's education level (OR=0.4   CI95% [0.2-0.8]  p=0.012), type of delivery (OR=0.5 CI95% [0.4-0.7]   p<0.001), unspecified gestational age (OR=3.6   CI95% [1.3-10.08   p=0.015]), and pregnancy under the age of 18 (OR=2.4   CI95% [1.1-5.3]  p=0.02). 

Considering the high incidence of FTT in children, increasing awareness about timely feeding, promoting households' health, preventing and controlling infectious diseases should be improved.

Preventive measures for psychiatric preparation are one of the nursing practices and are part of their duties before painful procedures. The aim of this study was to investigate the problems of nurses in the use of child and maternal psychological preparation before painful procedures for the child. This is a descriptive study that was conducted randomly in hospitals of Mashhad in 2017 in a random sample of 81 nurses working in pediatric wards who had a history of at least 3 months working. The data collection tool was a researcher-made questionnaire containing questions about demographic characteristics and the most important barriers and problems of nurses regarding the use of child and maternal psychological. Data were analyzed by SPSS 11.5 using descriptive statistics. Most of samples are women (96.7%) and the level of education were bachelors (90.7%). Nurses reported their problems from the most disturbing as:large amount of work in the section comparing to the number of nurses (93%), management not supporting nurses (86.75%),lack of sufficient toys and entertainment tools (73.3%), improper arrangement of working shifts (70%). Nurses in pediatric wards, can play a significant role in the psychological preparation of the child and the mother before the painful procedure by using the findings of this research, which itself improves the quality of the procedure.

Anemia is one of the major public health problems among pregnant women in the world. It causes low birth weight and maternal mortality during pregnancies. This study aimed to determine the prevalence of anemia and its associated factors among pregnant women. This cross-sectional study was conducted on 400 pregnant women in Shirvan city, Iran in 2015. For sampling, each of the three centers in this city were considered as a single cluster and the number of required participants from each center was selected proportional to the number of pregnant women covered by each center using systematic approach. Data collected from health records of families using a checklist were analyzed by descriptive statistics and appropriate statistical tests including chi- square, Fisher's exact, and McNemar's test. The age mean ± SD of the pregnant women was 29.9 ± 5.3 with a range of 16-40 years. Most of pregnant women were in the age group of 18-35 (84.5%) years, had high school education (65.8%), and were housewives (87.8%). The prevalence of anemia in pregnant women in the first and third trimester were 4.75% (CI95%: 2.66%-6.84%) and 16% (CI95%: 12.40%- 19.60%), respectively. Prevalence of anemia increased in the third trimester (p<0.01). Shirvan is one of the areas with a mild prevalence of anemia. However, iron deficiency anemia, as a nutritional disorder can be prevented. Therefore, community-based interventions should be implemented considering the identified associated factors.

Due to the high prevalence of depression in modern societies, particularly among female adolescents, and high sensitivity of this age, the current study aimed at determining the prevalence of depression among female high school students in Bojnurd.
The current cross sectional study was conducted on 384 female high school students in Bojnurd, North Khorasan Province, Iran in 2016. The data collection tool was a 2-part questionnaire; first part included demographic information and the second part was the Beck depression inventory. The questionnaire was completed by the students voluntarily. Data were analyzed with SPSS version 20 using descriptive statistics, the Man-Whitney U, Kruskal-Wallis, and Spearman correlation tests.
The mean age of the students was 16.1 ± 1.03 years; of the total 384 subjects, 5.1% reported parental divorce and 10.1% parental addiction. Most of the students (50.8%) were educated in public schools. The results of the current study showed that 43.7% of the study subjects had mild, 15.4% moderate, and 1.8% severe depression. A significant relationship was observed between the depression and age, grade, type of school (private/public), and parental divorce in the current study.
Based on the results of the present study, the prevalence of depression is relatively high among female high school students in Bojnurd. It is recommended to take necessary measures in order to promote self-esteem, as well as life and communication skills at family, school, and society levels in adolescents.

Obese and overweight women are more prone to gestational diabetes. Body mass index and weight gain during pregnancy play an important role in pregnancy and is considered as an important indicator of maternal and neonatal health. Because the prevalence of obesity in Yazd is remarkable, we studied the relationship between gestational diabetes with Pre-pregnancy BMI and weight gaining during pregnancy in pregnant women in Yazd.
This case-control study was conducted on 336 pregnant women who had just given birth, who they consisted of 168 pregnant women with gestational diabetes and 168 healthy pregnant women as case and control group, respectively. We gathered data from the information recorded in the health information system. In this study, Chi-square, independent t-test, and correlation test were used to analyze the data by using the SPSS23 software.
The present study showed that the average pre-pregnancy BMI and the average weight gaining during pregnancy until screening for gestational diabetes were significantly higher in cases than controls (P Since BMI is one of the modifiable risk factors, we should give all women good training on the quality of their diet for having proper weight before pregnancy and appropriate weight gain during pregnancy.

Because of uncertainty in interpretation of some tests for diagnosing TB, decision making for the tuberculosis treatment is based on multiple diagnostic tests. This study was conducted to assess the accuracy of Quanti FERON-TB Gold test in tuberculosis diagnosis.

The study was carried out on 30 cases and 46 controls. Statistical indices of sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, odds ratio and Receiver Operating Characteristics (ROC) curve were estimated.

Sensitivity of QFT-G was 90.0% (95% CI=73.0-97.6), specificity 95.7% (95% CI=83.8-99.3), positive predictive value 93.1% (95% CI=76.3-98.9), negative predictive value 93.6% (95% CI=81.3-98.4). The area under ROC curve was 0.942 (95% CI=0.88-1.00), that significantly differed from chance diagonal area (P<0.0001). The optimum cut point for the Quanti FERON-TB Gold test was 0.35 IU/ml, with sensitivity of 0.90 and specificity of 0.957.

The Quanti FERON-TB Gold test displayed good validity indices in this study. Since the utility of this test has a high cost therefore this test would not be offered for routine tuberculosis detection. It suggested that this test are applicable for smear and culture negative tuberculosis, child tuberculosis, and assessment of TB contact tracing.