خدیجه یزدی

The present study was designed to investigate the relationship between sleep quality and post-traumatic stress disorder (PTSD) in family caregivers of patients admitted to the intensive care unit (ICU).

The current cross-sectional study was conducted on immediate family members of patients admitted to the ICU. Pittsburgh Sleep Quality Questionnaire and PCL-C questionnaire were the instruments for measuring post-traumatic stress disorder and sleep quality, respectively. The PTSD questionnaire was completed by the caregivers after the patient's admission. The sleep quality questionnaire was filled out by the caregivers after the admission and one month later. For statistical analysis, correlation analysis and paired t-tests were used with a significance level of 0.05.

The total number of participants in this study was 120 people (66 men and 54 women). The mean score of post-traumatic stress disorder was 67.8 ± 5, indicating a high level of stress among the participants. The score of sleep quality at the time of hospitalization in the participants was 3.9±1.8 (acceptable sleep quality) and after 1 month it was 9.3±2.5 (impaired sleep quality), which had significantly worsened (P<0.001). However, there was no significant relationship between sleep quality and post-traumatic stress disorder (P<0.05).

Post-traumatic stress disorder of family caregivers was recorded at a concerning level, which could have destructive effects on physical and mental health. Also, the sleep quality of the caregivers was strongly influenced by the admission of patients to the ICU, and psychiatric interventions are inevitable for family caregivers.

The availability of information regarding people's experiences of returning to work after heart surgery, taking into account the socio-cultural context of Iranian society, is limited. The aim of this study is to discover the process of returning to work after heart surgery.

Methods & Materials:

A qualitative study using the grounded theory approach was conducted between 2021 and 2022. Through purposive and theoretical sampling, 21 participants who had undergone heart surgery and were in the process of returning to work were selected. They were chosen from the cardiac surgery ward of Amiralmomenin Hospital in Kordkuy, as well as among patients seeking treatment from cardiac surgeons in Golestan province. Data were collected through conducting semi-structured interviews and taking field notes. Data analysis was conducted using the method proposed by Corbin and Strauss in 2015.

"Feeling of doubt about return-to-work", "perceived psycho-social support", "personal and occupational factors", "unfavorable consequences of heart surgery" and "limited support from governmental/non-governmental institutions" were determined as contextual factors influencing the process of return-to-work. Moreover, "effort to adjust the job", "situation evaluation" and "self-management" were introduced as strategies, while "adaptability to the job" were identified as the consequence of returning to work. Finally, the core variable of the study was determined to be "the thoughtful effort to match the job".

Based on the results, it was determined that several individual and environmental factors influence the process of return-to-work for people who have undergone heart surgery. To facilitate a successful return to work, it is crucial to provide psycho-social support from both the family and work environment. It is recommended that policy makers in the health and social affairs sectors take active steps to empower people during the post-recovery period. Additionally, fostering collaboration between the Ministries of Labor and Health, as well as insurance organizations, can greatly facilitate the return to work of individuals after heart surgery.

Holistic nursing is a care process based on mutual interactions that lead to consciousness, empowerment, and well-being of the client, and also plays an important role in improving the performance and skills of nurses, promoting their professional status and independence and self-confidence. The aim of this study was to describe holistic nursing based on Dossey's Theory of Integral Nursing. 

 This is a narrative review study that was done in 2021 by searching databases such as PubMed/Medline, Scopus, Google Scholar, AND SID and using key terms /words of “integral nursing”, “integral theory”, “holistic nursing”, “nursing theory”, “Theory of integral nursing” in date interval January 2007  to 2021 October 2021. A total of 3 articles and 3 books were selected for review, after reviewing the retrieved literature and removing duplicated and unrelated items.

This grand theory is based on the philosophy and legacy of Florence Nightingale and the principles of the Holistic approach. Its building blocks are healing, the meta-paradigm of nursing, patterns of knowing, and the four quadrants that adapted from Wilber's integral theory consist of the individual interior (personal /intentional), the individual exterior (physiology /behavioral), the collective interior (shared / cultural), the collective exterior (systems /structures). 

The theory of integral nursing guides the science and art of nursing for integral practice, education, research, and health-care policy. Also, it provides individualized care for clients, expands the professional roles of nurses to a global level, and improves inter-professional relationships. Acquainting nurses with this new approach to holistic care and developing nursing education programs based on it can improve the quality of patient care;The development of professional independence, the promotion of inter-professional cooperation and ultimately the expansion of global health.

schizophrenia is a chronic condition that leads to debilitating consequences, is associated numerous challenges. So families need long-term psychosocial support.

the study was performed by interpretive descriptive method. Using purposive sampling, 30 participants participated in the study. Data were collected through individual interviews and coded, codes with similar themes are categorized.

six categories related to community support challenges were identified, including "lack of protectionist laws, lack of media in public education, lack of economic support, negative attitudes and cultural misconceptions, lack of awareness, are the mirage of social support."

these families, due to vulnerability in various aspects, needs help from formal and informal social source.but, there are shortcomings and they suffer from a lack of social support. With the insufficient support resources of the society, they wander and feel lonely and helpless to save themselves from their oppressive conditions.

Job burnout among nurses is a global concern caused by frequent and round-the-clock encounters with stressful situations. This study aimed to specify the status of using a specific questionnaire in assessing the occupational burnout among the nurses.

This was a cross-sectional descriptive-analytical study conducted on 637 Iranian nurses in 2019. The cluster sampling method was used to collect data. The data collection tool was a specific nursing burnout questionnaire. The frequency, mean, and standard deviation were assessed using SPSS- 16, and after proving abnormality with inferential tests such as Mann-Whitney and Kruskal-wallis tests, data were analyzed.

Most of the nurses participating in this study (85.4%) were female. The mean age and work experience of participants were 33.29±7.07 and 8.14±7.46 years, respectively. The mean score of job burnout among the participants was 123.60±18.20. The highest mean was related to the consequences (40.74±10.01) and organizational antecedents (32.76±4.38), whereas the lowest mean was related to the individual’s toughness (21.08±2.74). Regarding demographic variables, marital and employment status, the number of children, and working shifts had a significant relationship with job burnout (p<0.05).

The results of this study indicated that the mean of burnout among nurses was moderate, and most of the subscales related to burnout were seen under the subscales of consequences and organizational antecedents. Therefore, it is essential that nursing managers identify the causes of burnout and consider plans and workshops to reduce and eliminate the causes of burnout, and maintain the safety and physical and mental health of nurses.

Comfort is a basic human need in all stages of life .It has a multidimensional and holistic concept in care. So that whenever the need for comfort is provided, patients are more able to develop healthy behaviors .Patient comfort is an integral part of nursing and nursing art.

This article is a review study that was conducted in 1400 by searching databases 10 years (from 2010 to 2020). After deleting articles that were not in Persian and English or the entire article could not be accessed, 14 articles were found as a result of the search.

Kolcaba defines comfort in three types of comfort needs (relief, ease, Transcendence) and four areas of human experience (physical, mental, environmental, and social). Comfort theory has become popular because of its simplicity and its applicability to various ices.

The most important need of patients and families, especially in difficult and stressful conditions, is comfort. This convenience includes a range of actions. Nurses, as the people who have the most contact with patients and family, also play an important role in creating comfort.

Coronary disease is the most common life-threatening among chronic diseases. Coronary angiography is one of the most important diagnostic procedures that have complications similar to other invasive procedures. This study was performed to determine the effect of changing sandbag weight on complications of femoral artery catheterization and patient comfort.

This single-blind clinical trial was performed on 140 patients who were referred to Amir Al-Mochr('39')menin Kordkoy hospital in northern Iran. Patients were randomly assigned into four groups consisting 35 patients. After angiography, sandbags with different weights (control group, first intervention, and second intervention, third intervention with weights of 4, 3.5, 3 and 2.3 kg) were placed on the angiography site for 6 hours. Bleeding, hematoma, pain and comfort of patients were recorded and compared immediately, 2, 4, 6, 8 and 24 hours after angiography.

Bleeding and hematoma were not observed in any of the patients. There was a significant difference in pain and patients comfort between groups (P<0.05). The third intervention group had the lowest pain and highest comfort at 6 and 8 hours after angiography. Also, the control group had the highest pain and the lowest comfort.

Reducing sandbag weight leads to decrease back pain and improves patient comfort without increasing vascular complications.

Lack of adequate information related to disease and self- care after discharge leads to poor self-care, readmissions and low quality of life for patients. This study aimed to investigate the effect of training and post discharge follow-up on self- care behavior of patients with ischemic heart disease.
In this single blind randomized clinical control trial study (2015), 90 patients with ischemic heart disease hospitalized at Cardiac Care Units and were divided in 1 control group and 2 intervention groups by Block random allocation method. Control group received only usual training for discharge. One intervention group received usual post discharge training and call follow- up for 1 month. Another intervention group received complete training package and comprehensive follow-up for 1 month. Valid and reliable Miller self-care behavior tool for patients with cardiovascular diseases were used for data collection. They were completed at discharge day, 15 and 30 days after discharge for each patient.
In complete training package group with comprehensive follow-up, means of self-care score were 60.2 ± 13.6, 87.6± 6.5 and 86.9± 8.9 at discharge day, 15 and 30 day, respectively. Means of self-care score in usual post discharge training and call follow up were 64.7 ± 19, 82.9± 8.6 and 80.9± 9.5 at discharge day, 15 and 30 days, respectively. In control group, means of score were 69.6 ± 10.7, 82.6±6.2 and 78± 10.8 at discharge day, 15 and 30 days, respectively.
Results showed that self-care score was increased following 15 days and was decreased after 30 days. This reduction was subtle in the group receiving comprehensive training package with follow-up and reflects the impact of this program on the continuation of self-care.

Objectives Brain processing parameters during anesthesia result in induction of anesthesia with a low-dose of hypnotic drugs and reduce postoperative nausea and vomiting. The current study aimed at determining the relationship between the depth of anesthesia, and nausea and vomiting after the general anesthesia in patients undergoing elective abdominal surgery.
Methods In the current descriptive, analytical study, 57 patients candidate for elective herniorrhaphy were selected by the convenient sampling method in Beheshti Hospital, Sabzevar, Iran, in summer 2014. Depth of anesthesia was monitored by bispectral index (BIS) and recorded at 5-minute intervals during the maintenance period. The postoperative nausea and vomiting scores were recorded in the recovery and 6 hours after operation. Data were analyzed using appropriate statistical tests by SPSS software version 18; P>0.05 was considered significant.
Results A total of 57 patients with the mean ± standard deviation (SD) age of 45.54±13.46 years were studied, out of which 36 were male and 21 female. There was no significant difference between the amounts of anesthetic depth and severity of nausea and vomiting in patients during recovery (P=0.179).
In the first 6 hours after surgery, there were significant differences between the values of depth of anesthesia and postoperative nausea and vomiting (P=0.003).
Conclusion Monitoring and maintaining the depth of anesthesia reduced side effects such as nausea and vomiting after surgery.

In accordance with Article 2 of the Executive Bylaw of Organ Transplantation Law, diagnosis and confirmation of brain death shall be made by a neurologist, an internist, and an anesthesiologist. On the basis of the civil liability, those individuals who declare brain death; should indemnify the damages if they impose as a result of their diagnosis in this process. Islamic criminal law 1375 (1996) in article 319 was absolutely adjudged doctors accountable; however, Islamic criminal law 1392 (2014) in Article 495 has followed the theory of fault in doctors civil liability. Therefore, the doctor can defense not fault, proved third person fault and invoke assignment to external causes. Based on Articles 158, 495 and 496 of criminal law in 2014, when was obtained consent; if they meet technical and scientific criteria in brain death diagnosis in the government system in brain death diagnosis does not accept responsibility; but in spite of consent, if they do not comply technical and scientific standards and government regulations, they will be held accountable.

The usual method of assessing depth of anesthesia, which is not sensitive and specific enough, is measuring hemodynamic parameters, autonomic changes and subjective symptoms including movement, sweating and lacrimation. This study aimed to determine the relationship between the depth of anesthesia and hemodynamic indices. This correlational study was conducted on 57 patients undergoing elective hernia surgery in Shahid Beheshti Hospital, Sabzevar in summer 2014. An identical anesthesia technique was used for all patients. Depth of anesthesia was monitored quantitatively by bispectral index (BIS) at 5-minute intervals, with simultaneous recording of heart rate and blood pressure. We analyzed the data using Anova and correlation coefficient. The mean age was 45.54±13.46. The patients were males (n=36) and females (n= 21). Only 59.6 % of the patients experienced a normal depth of anesthesia. Hemodynamic parameters were not significantly correlated with anesthetic depth except for heart rate in the first 5 minutes (P= 0.013). Given that hemodynamic parameters have some limitations in determining the acceptable depth of anesthesia, we recommend using the monitors based on brain signal processing.

Postoperative ileus is common after cholecystectomy, causes gas retension, distention, nausea, vomiting, and even pain. Chewing gum is a type of sham feeding that may reduce the duration of postoperative ileus. This study determines the effect of chewing gum in the immediate postoperative period to facilitate ileus recovery following cholecystectomy. This is a randomized controlled trial in 2009. Twenty-four patients undergoing cholecystectomy and they divided in to two equal groups (n=12). Patients in group A chewed sugarless gum there time after surgery, each time 20 miniutes in 4, 10 and 18 hours after finishing sugery. Demographics, intraoperative, and postoperative care data did not reveal any significant difference between two groups. The data resending the first passage of flatus, defecation and bowel sound in every 2 hours for each patient completed in questioning. Data were analyzed using SPSS software version-13.5 and student t-test. The first bowel sound heard 3 ±1.3 and 2.8 ±1.3 hours post-operatively in cases and controls, respectively. The above findings were not significant between two groups. Furthermore gas passing reported at 18.3±10.5 and 36.28±12.6 hours post-operation in case and control groups respectively. The first defecation was occured at 36.8 ±21.7 and 69.5 ±19.2 hours after operation in case and control groups, respectively (p =0.001). This study showed that the chewing gum can help bowel movement after cholecystectomy.

Postoperative ileus after appendectomy causes gas storage, distention, nausea, vomiting, and even pain. Gum chewing is one of the ways that can reduce the duration of temporary ileus. The aim of this study is to determine the effect of gum chewing on bowel movements following appendectomy. This randomized double-blind clinical trial was done on 46 patients undergoing appendectomy that were divided into equal treatment and control groups. The treatment group chewed gum three times, each time for 20 minutes, 4, 10, and 18 hours after recovery from anesthesia. The control group, however, did not receive any special treatments. The bowel sounds were monitored every two hours using stethoscope. Also, through running interviews with two hour intervals, data were collected regarding the first passage of flatus and defecation. Data were analyzed through SPSS and t-test. On average, the first bowel sounds in treatment and control groups were, respectively, heard at 2.08±0.41 and 3.13±1.45 hours, whereas gas passage in treatment and control groups was reported at 26.8±14.59 and 50.08±13.92 hours, respectively. Also, the first defecation in the treatment group occurred at 18.91±10.77 hour but in the control group this happened at 29.21±12.11 hour. Based on these observations, a significant difference was seen between the two groups in terms of the test results (p=0.002). The findings of this study showed that chewing gum can help bowel movements after appendectomy.

Having comprehensive knowledge and skill of Cardio Polmunary Resuscitation (CPR) is necssary for all medical staff nowadays. Use of simulation training is a good method for improving students’ clinical skills in resuscitation. This method develops participants’ skills and helps them learn about new equipment and procedures. This study was designed to examine the effect of station training on students’ skills in CPR. In t his interventional study data was gathered in two phases, before and after intervention. Units of study were 37 senior students of nursing and midwifery in faculty of Booyeh. Data was gathered in standard checklists by observing students’ performance in basic and advanced CPR in stations of Objective Station Clinical Evaluation (OSCE) before and after station training. Data was analyzed by SPSS 11.5 software using descriptive statistic indices and Wilcoxon non-parametric test. Students’ performance in basic and advanced CPR demonstrates a significant difference before and after station training, considering their average information. Station training will enhance nursing and midwifery students’ knowledge of basic and advanced CPR, if taught correctly and practically.

Territoriality is a defined area that a person considers as its own and that he/she defends against intruders. We carried out this study to determine the patients attitude toward the respect of human territory in 5 Azar hospital, Gorgan, Iran.

This descriptive-analytic study was conducted on 272 in 2008. The instrument was a questionnaire including demographic data and territory-related questions (r=869). We used Mann Whitney, kruskal-Wallis, and spearman correlation to analyse the data.

The subjects are women (72.4%) with the mean age of 47.80 +17.28. The mean score of the patients' viewpoint is 2.97= 0.61. The rate of respect is 74%. There is no significant correlation between the attitude of patients and the demographic variables.

Based on the results, the respect of human rights and territory is always being considered by patients. Thercforc. further rescarch about the factors affecting on it is extremely important.

Thalassemia is an inherited and chronic hemolytic disorder. Like other diseases it can make psychological, social and financial problems for both patients and families. The necessity of this research is to teach the way of treating the psychosocial problems of this illness and to increase the quality of patients and families life. It is also a descriptive study to examine psychosocial and financial disorders and coping strategies among families with patients suffering major beta thalassemia

320 parents (229 of mothers and 91 of fathers) were included in this study. These families were those who were visited clinics associated with Gorgan's University. Data collection was done using a self structured questionnaire as well as Mc Cubin and Thompson scale for identifying coping strategies.

Findings revealed many problems, such as: stress for disease (82.8%) and the patient's vague future (81.8%). The mentioned problems were of psychological disorders. And about social problems: 33.8% of patients families were deprived of having picnics in their free times and helping the patient meddles the routine work of homes in 30.1% of families. The financial problems: the cost of traveling and providing the medicine (63.8%). In addition 97.5% of families had faith and reliance in God in order to help them and to believe their child's illness as a reality. It is apparent that families use different kinds of method in order to cope with psychological, social and financial problems and to face the disease.

Most of families have a strong belief in religion and as a result they believe that any kind of problems and especially disease is one of ways to reach God. This is the idea which helps them to face this disease stoutly.

High blood pressure (BP) is one of the most important health problem world-wide (2005), and risk factor of cardiovascular diseases. This study was determine the prevalence of high blood pressure (BP) among urban subjects in Golestan of province, during 2005. This cross sectional study was done on 5000 subjects of 17-70 years old in different towns of Golestan province during 2005. Two equal ratios of both sexes were selected on random clustering sampling in the morning and afternoon. A questionnaire consisting of demographic data and clinical information such as electronic presser gauge filled by trained persons. All of the data analyzed using spss-11.5 and descriptive statistics. The result showed that 2500 male (50%) and 2500 (50%) female, ethenicity were (4.6%) Torkaman, (18.9%), and Sistani (76.4%) Fars group from age of 17 to 70 years old. This study on this basis criterion JNC-5 (46.4%) all of studied subjects had blood pressure normal, (22.6%) blood pressure high normal (21.4%), blood pressure light (7.4%), blood pressure medium and (2.2%) blood pressure severe. The prevalence high blood pressure among the urban population in this province in this province was 31%. Which is slightly higher than other regions in Iran and other part of the world. This issue can be considered in the health planing and theraputic programs in the region.