فهرست مطالب زهرا فرج زاده

The present study was performed to evaluate the fatty acid profile of the oil extracted from Sajama, Giza1 and Redcarina varieties of quinoa seeds cultivated in Iran.Sajama, Giza1 and Redcarina quinoa seeds varieties were obtained from Seed and Plant Breeding Research Institute, Karaj, Iran.In order to extract oil from the seeds, Soxhlet method was used. First, the process of methyl esterification of fatty acids was performed and then the profile of fatty acids was evaluated using GC-Mass.The results showed that Sajama quinoa cultivar had the highest (10.19±0.98%) and Redcarina cultivar (2.55±0.21%) had the lowest amounts of extracted oil.Linoleic acid was the most abundant fatty acid known in the seeds of quinoa cultivars.The frequency of linoleic acid in Giza1, Redcarina and Sajana cultivars of quinoa seeds was 60.17±5.37%, 57.30±5.15% and 52.27±4.92%, respectively.Palmitoleic acid and tricosilicic acid were not found in the in Giza1 and Redcarina cultivars of quinoa seeds.Decosahexanoic acid and tricosanoic acid fatty acids were not found in Sajana quinoa seeds.The highest amounts of myristic, palmitic, hexadecanoic, stearic, oleic, linoleic, gamma linolenic, alpha-linolenic, arachidic, eicosadnoic, behenic, erosic, cervonic and tricosilicic fatty acids were seen in Redcarina, Sajama, Sajama, Sajama, Giza1, Giza1, Sajama, Redcarina, Sajama, Sajama, Sajama, Giza1, Redcarina, respectively. Quinoa seeds seem to be a good alternative to some cereals for example rice due to high content of essential fatty acids.

Motivation is a complex process of the individual; organizational and social factors and the performance of employees is a function of their ability and motivation. Identifying and analyzing motivational factors is very important. This study was conducted to explain the experiences of nursing managers on factors affecting job motivation.

This study, which is a contract content analysis, was conducted by in-depth and semi-structural interviews with nursing managers of hospitals affiliated with Birjand University of Medical Sciences. The participants' statements were recorded with their consent by voice recording, and then handwritten word for word. The number of participants was eight depending on the data saturation, and saturation was achieved when new information was not obtained during data analysis and coding. Data analysis was performed simultaneously with data collection using the content analysis method and Grinheim method.

Content analysis of nursing managers' experiences of factors affecting job motivation five categories including individual self-motivation factors, professional motivational abilities, motivational support, organizational, motivational factors and financial motivational factors and ten subcategories including motivational personality dimensions, Ethical motivators, professional competence, functional ability, motivational support of the workplace, motivational support of the family, management structures, the system of encouragement and punishment of the organization, receiving appropriate salaries and rewards were extracted.

According to the results of this study, nursing managers can take a step toward maintaining and promoting nurses' job motivation by giving more importance to internal motivation factors and improving the quality of nursing care, and useful and constructive solutions for the development of health organizations. That plays a key role in community health.

The structure is the organizing principle on which the basic elements of the text are ultimately interpreted. Thus, literary critics have always paid attention to it. Nevertheless, it seems that despite the researches that are focused on structuralism and the importance of the general structure of poetry, there is no systematic research that deals with the configuration or the general structure of Atashi's Poem. Therefore, in the present study, an attempt has been made to use a descriptive-analytical approach to extract the various relationships between the components of a structure. In this research, accordingly, we first provide the theoretical bases of the configuration and relying on such principles as visual symmetry, syntactic symmetry, and nonstructural cohesion, we read Manouchehr Atashi's poem "Vasvaseh" and try to clarify the factors which lead to the special configuration of its general structure. In this research, it is revealed that the poet applies such principles in the configuration of his poetry. That is why, the reader encountering a poetic text, while thinking on the devices available in the text, comes to an understanding of the work

Nursing care and patient satisfaction are the two basic components of nursing and the result is the promotion of public health and faster recovery of patients. Therefore, the aim of this study was to determine patients' satisfaction with nursing care in university hospitals. Medical sciences were performed in Birjand.

In this descriptive-analytical study, 249 patients were admitted to Birjand hospitals in 1398 were selected by multi-stage method and the data collection tool was a questionnaire developed by the Deputy Minister of Nursing of the Ministry of Health and Medical Education. Data were analyzed using SPSS 22 statistical software and descriptive statistics and Chi-square test at the significant level of 0.05.

In this study, the majority of patients were female (58.2%), married (93.2%), aged 41-50 years (20.5%), undergraduate education (55%), resident of the city (63.9%) and possessed good experience from previous hospitalization (49.2%). Their level of satisfaction in general and its components is moderate. The highest mean score of patient satisfaction is related to the component of moral and emotional competence (3.56 61 0.61) and the lowest mean is related to the component of patient education (2.89. 0.82). The mean total patient satisfaction score was 3.31. 0.63.

In this study, patients' satisfaction with nursing care and the dimensions of medical care, patient education, therapeutic communication and moral and emotional ability was moderate. With the planning of managers and nurses, a step can be taken to improve the quality of nursing care and satisfaction Patients harvested.

Effective communication between nursing managers with nurses plays an important role in improving the quality of nursing care. The aim of this study was to investigate the effective factors on the relationship between nursing managers and nurses from the viewpoints of nurses.

In this descriptive-analytical study among nurses working in Birjand's Vali-e-Asr Hospital who met the inclusion criteria, 100 patients were selected by random sampling and entered the study. Data collection tools included a demographic form and a researcher-made questionnaire. Data were analyzed by SPSS software using independent t-test and one-way ANOVA. Structural equation modeling was used to determine the effective relationship between nursing managers and nurses by human, organizational and communication factors.

Human, organizational and communication factors are effective in explaining the effective relationship between nursing managers and nurses. Among the human factors components, the highest mean score related to the individual characteristics component and lowest mean was related to the social characteristics component. Also the mean score of organizational factors in the dimensions of organizational structure and organizational culture were[1] (3.58 ±0.64) and (3.42 ± 0.57) respectively and mean score of communication factors in communication channel dimensions and communication styles were (3.06 ± 0.60) and (3.39 ± 0.50) were obtained.

Effective factors in creating effective communication between nursing managers and nurses include human, organizational and ultimately communication factors. Therefore, holding workshops to familiarize and pay more attention to managers' effective communication is an effective step in improving communication interactions.

Managing managerial skills effectively guides and promotes employee performance in line with organizational goals. Nursing managers play an important role in enhancing nurses' empowerment, Efficiency, motivation, job satisfaction and job stress.
this study was conducted to evaluate the performance of nursing managers from nurses' viewpoints in the hospitals of Birjand University of Medical Sciences in 2017.

In this descriptive-analytical study, 140 nurses working in Imam Reza and Vali- Asr hospitals of Birjand who had the criteria for the study were randomly selected via quota sampling method. The questionnaire consisted of demographic characteristics (gender, age, marital status, educational level, service record, employment status) and manager performance completed by nurses. Data were analyzed using SPSS 15 software and descriptive statistics.

About half of the nurses assessed the performance of head nurses and matrons as desirable in general and its domains and evaluated the level of supervisors’ performance as average. The results also showed that head nurses and supervisors obtained the highest score in the performance evaluation (Respectively 18.78±4.34, 15.21±4.85) and lowest score in leadership and management (Respectively 17.76±5.47, 13.58±4.85). In assessing matrons’ performance from the viewpoint of nurses, the planning domain had the highest score (19.26±4.48) and leadership and management had the lowest score (18.13±5.23).

From the viewpoints of most of the nurses studied, the level of performance of head nurses and matrons was desirable and the level of performance of supervisors was moderate, and nursing managers received the lowest score in leadership and management. Given that nursing managers as educated leaders play a significant role in improving and empowering nurses, it is recommended to take effective steps by holding workshops for improving their performance especially in the domain of leadership and management.

Severe nurse shortages and their turnover have made researchers focused on identifying the factors affecting the retention of nurses and relationships between these factors. The aim of this study was to investigate the relationship between organizational justice and Nurses’ job embeddedness in Teaching Hospitals. In this descriptive-analytical study, data was collected from 215 nurses working in two educational hospitals in city of Birjand who were selected by stratified random sampling. Crossley et al Global Job Embeddedness Scale and Niehoff and Moorman’s Organizational Justice Scales were used to measure the studied variables. Data was analyzed by SPSS 16 using independent t-test, one way ANOVA, Tukey’s post-hoc test, Pearson’s correlation coefficient and multiple regression analysis at a significance level less than 0.05. Based on the results, the level of job embeddedness of nurses was higher than the average (3.05±1.07), and men had more embeddedness than women. In this study, from dimensions of organizational justice, the dimensions of interactional justice showed the highest correlation with job embeddedness. Multiple regression analysis showed that interactional justice and distributive justice predicted 34.6% of changes in job embeddedness (F=37.20, P<0.001), and interactional justice was a better predictor of job embeddedness compared to distributive justice. The results demonstrated the necessity of implementing programs to improve the Nurses’ job embeddedness, especially female nurses, through increasing the perceived organizational justice, especially the dimensions of interactional justice and distributive justice.

Factors Affecting Food Price Index in Iran According to the of Nutrition in Economic Development, Food topics, Especially in the Developing Countries, are of Utmost Importance. One of the Most Important Determinants of Food Demand is the Food Prices. The Aim of This Study is the Most Important Determinant of Economic Factors of the Food Price Index in Iran Using the Latest Information Published in 2016. For this Purpose, Using Autoregressive Distributed Lag (ARDL) Method and Time Series Data for the Years 1983-2014 has Been Estimated Desired Pattern. Based on the Results, the Variable of Gross Investment, Trade Openness and Real Exchange Rate in the Short and Long Term had a Negative Impact and Liquidity and GDP Variables had a Positive Impact on the Food Price Index.
Keywords: Food Price Index, openness, real exchange rate, GDP

As one of the members of the care team, nurses are confronted with a lot of work-associated stress whereby they will experience depression if the situation continues. The aim of this study was to determine the effect of cognitive-behavioral group training on nurses' depression at 2017. In this randomized controlled field trial, 40 nurses from the teaching hospitals affiliated with Birjand University of Medical Sciences were selected through convenience sampling method and randomly allocated into two groups. The cases received logical cognitive behavioral group training for 8 one-and-a-half hour sessions. Nurses in both groups completed Beck Depression Inventory before, immediately after, and two months after the intervention. Data were analyzed in SPSS 18 software, using independent t-test, intra-group ANOVA, Bonferroni test, Mann-Whitney U test, Friedman tests, Wilcoxon test, and Fisher's exact test at the significance level of 0.05. The mean depression scores of the case group immediately and two months after the intervention reduced significantly compared with before the intervention; in the control group nurses, the score immediately after the intervention decreased significantly compared to before the intervention (p <0.05). However, the mean score changes before and after the intervention, and before and two months after the intervention reduced significantly in the case group compared with that of the control group (p <0.05). According to the results, this therapeutic approach can be used as an effective therapeutic activity in decreasing depression of nurses in order to promote health and care purposes.

Patient education is one of the fundamental aspects of patient care and is a necessity in the health care system. These trainings are aimed at helping individuals to improve their lives, reach maximum psychophysical development, and strengthen their self-confidence. The purpose of this research was to evaluate the efficacy of patient education delivered by nurses in the Birjand-based teaching hospitals in 2017. In this descriptive-analytical study, 303 eligible patients hospitalized in the Birjand-based Valiasr and Imam Reza hospitals were selected by quota sampling method. The data collection instruments comprised of a demographics form and Nurses’ Patient-Education Assessment Inventory whose validity is confirmed by the Nursing Deputy of Ministry of Health, Care and Medical Education via the notification letter on nationwide indices on nursing care quality. Its reliability is reported as 0.85 using Cronbach’s alpha coefficient. The data were analyzed by SPSS software using Friedman, Mann-Whitney, and Kruskal-Wallis tests. The highest mean score of knowledge was related to the identification of the physician and nurse (2. 57 ± 0.54), whereas the lowest belonged to the lifestyle dimension (0.69 ± 0.29). The total score of knowledge in the patients was 14.26 ± 3.54 (below average). The Friedman’s test showed that the mean scores of knowledge in the identification of the physician and nurse, disease recognition, drug consumption, lifestyle, self-care, post-discharge follow-up, satisfaction with the educational program delivered by the nurse, and manner of education were significantly different in the patients under study (p According to the results of this study, the necessity of planning of managers in terms of effective nursing education for patients, their supervision, and evaluation of the efficacy of nursing education is suggested.

the creation of a favorable clinical environment for exploiting nurse's capabilities and identifying their potential capacities, necessitate playing efficient leadership role; therefore, this study aimed at studying the effect of development program of leadership style based on concept mapping on the components of nurse's leadership style in 2016.
In this experimental study, 30 head-nurses and 150 nurses of Vali-Asr and Imam Reza (AS) hospitals of Birjand who had inclusion criteria entered the study. In each hospital, half of the head-nurse assigned randomly to the experimental group and half to the control group. Head-nurses in experimental group received human resource development program based on concept mapping method over a period of 8 sessions. Clarke's Leadership style survey was completed by nurses and head-nurses before, one month and two months after the intervention. Data were analyzed using statistical software SPSS 15, independent t-tests, intra group analysis of variance and Bonferroni test at the significance level of 0.05.
the results of this study showed that in the viewpoint of both head-nurses and nurses, the mean score of leadership styles (autocratic, democratic and free-reign) was significantly higher in experimental head-nurses after intervention and in the follow-up in comparison to before intervention (p based on the results, development programs of leadership style based on concept mapping is influential on the leadership styles in the viewpoints of both head-nurses and nurses and result in the change of leadership style score. Therefore, it is recommended to use this method in training head-nurses and nurses.

Promoted quality of nursing education brings about improved quality of nursing care. Survey from graduates can facilitate the way to plan and modify current educational methods. This study aimed to determine the factors affecting the quality of education from the viewpoint of nurses working in Birjand hospitals. This descriptive study involved 115 nurses working in Birjand hospitals during 2011-12 academic year who were selected through quota sampling method. The data collection tool consisted of a self-made questionnaire consisting of two parts: a) demographic characteristics and b) viewpoints of graduate nurses about the influence of various factors on the quality of education in 5 domains and 32 items. Content validity and inter-item correlation coefficient were used to determine validity and reliability. Chronbach’s alpha was 0.92 overall, and 0.70 to 0.83 for the domains. Data analysis was performed in SPSS (version 15) using Friedman and Wilcoxon tests. The majority of the 115 participants were female (87.8%), married (76.5%), and graduated from state universities (68.7%). Maximum and minimum scores came respectively from personal characteristics of faculty members, and monitoring and evaluation domains. The most effective factor in personal characteristics of faculty members was related to their dominance of the course contents. Faculty members can improve the quality of education by grasping such features as dominance in the course contents and attention to the students’ problems. Furthermore, there can be elevated educational quality in case the evaluation system provides more objective measurement and feedback.

Vaccination is a most common painful problem during infancy, which is typically ignored. Regarding importance of pain control in children, this study was done to investigate impact of distraction technique on reducing the infants’ vaccination pain. In this clinical trial, 80 infants were selected from six-month-old infants who were referred to Sajadshahr health center of Birjand University of Medical Sciences, by convenience sampling and were randomly allocated to experimental and control groups. During vaccination, experimental group received a rattle as a distraction technique by the researcher 40 seconds before until 15 seconds after vaccination, control group received only routine vaccination interventions. Severity of pain was evaluated using the modified behavioral pain scale (MBPS), and duration of crying time was recorded. Data were analyzed by SPSS version 11.5 and Chi-Square, Mann Whitney U, Independent T Test and Spearman statistical tests with 0.05 significant levels. There were no significant differences in two study groups in sex, nutrition time before vaccination, previous experience of pain, weight, and bedtime before vaccination (P>0.05). Mean of pain severity and crying time in distraction groups was significantly lower than control group (P=0.0001). Regarding to decrease intensity pain and duration of crying in the experimental group, this method can be useful on reducing the infant’s vaccination pain.

Nurses plays an important role in the development of health care and treatment. Thus, a main task of a nursing director is to pay attention to the motivational energies of nurses. This study aimed to determine the job motivation of nurses working in Valiasr Hospital of Birjand in 2013.

This descriptive cross-sectional study was conducted on 117 nurses in Valiasr Hospital of Birjand who were selected by census. Data were collected using the Herzberg's Motivation- Hygiene Questionnaire which consisted of 30 items and 11 components with 5 Likert scale. Its reliability and validity were confirmed in previous studies. Data were analyzed in SPSS (version 16) using independent t test and ANOVA at the significant level of p<0.05.

In this study, nurse's overall score for job motivation was moderate with a mean score of 2.9±0.5. Intrinsic motivation al factors were more important than health factors (extrinsic) in creating job motivation. The most and least important motivational factor from among the components of motivational factors were the nature of work (3.8±0.8) and identification (2.3±0.9) and from among the components of health factors, related cooperation (3.8±0.7) and job security (1.8±0.8). There was no statistically significant difference in the overall motivation mean score in terms of demographic characteristics.

In light of nurse's job motivation and intrinsic motivational factors, it is recommended that nurse managers pay more attention to factors such as staff appreciation, economic problems, security, and working conditions.

Self-medication is an important part of peoples’ medical Behavior. The prevalence rates of self-medication are high all over the world. The aim of this study was to survey prevalence of self-medication amongst university students and the factors affecting it. 1048 students participated in this cross-sectional and descriptive study in Birjand (Medical Sciences، Birjand، Islamic Azad and Payame-Noor) Universities. The samples were selected randomly by self- designed questionnaire. The obtained data analyzed by SPSS software (V. 15) using descriptive- analytical statistics test and logistic regression. The prevalence of self-medication was 86. 7%. The most common reason for self-medication was previous experience (77. 2%)، the most common type was tablet (88. 7%)، the most common drug was palliatives (81. 7%) and the most common symptoms were allergy (36. 1%). The findings of the logistic regression analysis showed that Payame-Noor University students were less likely to use drugs for self-medication than the Medical Sciences students (P=0. 002). The students who had Tamin Ejtemaei and Military insurance were more likely to use drugs for self-medication than those who hadn''t any insurance (P<0. 05). Prevalence of self-medication is high in the educated youth، despite majority being aware of its harmful effects. It is necessary to pay more attention to the promotion of drug use continuing education، increase access to health services، including strengthening the role of the family physician and medical consultation universities and educational، especially for the young and vulnerable students and their motivation to correct the systematic treatment of the disease increased.

The use of hydrocolloid coatings is a suitable method to reduce oil uptake in fried foods. In this research, the effects of xanthan and guar gum coatings on reduction of oil uptake as well as sensory and physical properties of fried hamburgers were investigated. Hamburgers were coated with 0.5%, 1% and 1.5% of xanthan as well as 0.3%, 0.5% and 1% of guar. The effect of coatings on redguction of oil uptake, water retention, texture, color change, sensory acceptability of the hamburger samples was assessed. The results showed that the xanthan and guar coatings are the major factors affecting water retention, reduction of oil uptake, texture and color of the fried hamburgers. Coatings resulted in the reduction of oil uptake up to 25%. Data also did not suggest significant differences in sensory characteristics of coated and uncoated samples. The application of hydrocolloid coatings reduced oil uptake, whilst it did not affect the sensory characteristics of fried hamburgers. It was concluded that xanthan and guar gum coatings can improve the organoleptic and nutritional properties of fried food hamburgers.

Children malnutrition is one of the important health problems in developing countries. Assessing anthropometric indicators are the most important tools to evaluate growth and nutritional status in children. The aim of the present study was to determine prevalence of malnutrition in preschool children. This cross-sectional and descriptive analytical study was done on 1132 preschool children in Birjand selected through multistage cluster sampling. Data was collected using a questionnaire and by measuring weight and height of the children on the basis of the standard method. Nutritional status of the children was evaluated according to three indexes: weight for age (e. g. underweight)، height for age (e. g. stunting)، and weight for height (e. g. wasting). Then، the results were compared with WHO standards. The obtained data was analyzed using SPSS software and chi-square test، taking P<0. 05 as the significant level. 46. 5% of the children were boys and malnutrition prevalence regarding underweight، wasting، and stunting was 42. 8%، 61% and 19. 2% respectively. There was a significant relationship between malnutrition and mother''s age، gender، job، educational level، and residence with the three indices underweight، wasting، and stunting; and also between household size and stunting (P<0. 05). However، there wasn''t a significant relationship between malnutrition، household size، and birth order. Regarding high prevalence of malnutrition in preschool children and its relationship to socio-economic variables، the problem may be reduced through increasing families'' income and parents'' educational level.

Clinical education is an integrated component of medical education program. Objective Structured Clinical Exam (OSCE) is one of the best educational evaluations of clinical competence. The present study was designed to determine the reliability and validity of OSCE in evaluating clinical skills of emergency medical students. In this descriptive-correlational study, twelve skills were evaluated by means of a checklist. 39 students performed these skills in 12 OSCE stations. In each station, an experienced inspector evaluated the skills matching them to the checklist. Validity was measured according to the correlation coefficient between OSCE scores and the theoretical and clinical performance scores of students, and reliability based on the correlation coefficient between scores reported by inspectors in two stations. The obtained data was analyzed by means of SPSS (version 15) at the significant level P<0.05. The correlation coefficient of OSCE scores and mean theoretical and clinical performance scores and total average scores were 0.46 (P=0.003), 0.61, and 0.56 (P<0.001), respectively. The highest and lowest correlation coefficient was 0.54, and 0.08 respectively in the two stations; i.e. log roll maneuver and hemorrhage control. Correlation coefficient between scores of those two inspectors at shock evaluation and respiratory resuscitation stations were 0.97 and 0.68 (P<0.001), respectively. OSCE is suggested as a reliable and valid method to evaluate the clinical skills of medical emergency students in all wards

Improvement in communication with patients can improve assessment and identifying patient's problems by promotion the interaction and active listening. This study was done to determine effective factors and barriers in communication with patients from nurse's perspective. In this descriptive-analytic study, 70 nurses working in Val-e-Asr hospital were selected randomly. Data was collected by 28 options questionnaire about effective factors & barriers. It is designed in 6 domains: nurse, patient, nurse-patient, environment, knowledge and skill and working condition. Data were analyzed by SPSS software, descriptive statistics and 2 test. The most effective factors in communication with patients are nurse factors (84.3%), knowledge & skill (75.7%) and patient’s factors (74.3%). The most effective barriers are nurses factors and knowledge & skill (75.7%) and environment (70%). There is significant relationship between sex and nurses factors (P=0.38) and in effective barriers there is relationship and working conditions (P=0.27, P=0.08). According to results, most effective factors are nurses, knowledge & skill so nurses, educational needs are important and it is recommended to plan for reliefing nurses, clinical problems and providing better care.

One of the most vulnerable periods of life which threatens one’s health more than any other is student days, this period is coincident with students’ entrance to a new atmosphere with different people. As, one third of country population are young people aging between 15-29 and most of them are studying in schools and universities so paying attention to their spiritual health is highly important. The current study was conducted to survey different aspects of general health of nursing students of Birjand University of Medical. In this descriptive-analytic study, sampling was done through census and GHQ-28 questioner was used for gathering data. 230 questioners were distributed among all nursing daily and nightly students and B.S students. 188 of them were completed and then were analyzed by SPSS and descriptive statistic tests, t-test and 2 (P<0.05). 80.3% of the population was healthy and 19.7% was sick. A meaningful relationship was not found between general health and students’ demographic characteristics, but such a relation existed between body condition of students and their sex (P=0.05) and the fathers’ job. Also there was a meaningful relation between social function disorder and their sex (P=0.03). Based on the findings, it can be observed that a high percentage of students have a good general health condition.

Iron-deficiency anemia is seen frequently in children. It's most common cause anemia in infants and children worldwide which can causes classic symptoms and also central nervous system disorders. According to the high prevalence of iron deficiency anemia in neighbor countries and its negative complications which are sometime irremediable, this study was performed to assess prevalence of iron deficiency anemia in 6 years old children in Birjand. This descriptive-analytic cross- sectional study, 300 children were randomly chosen among the children referring to test stations at the time going to elementary schools. After parents agreed, demographic characteristic form was completed. The blood samples were obtained to determine CBC and Ferritin in the laboratory. Data was analyzed by descriptive, t-test and chi-square in the significant level α= 0.05. The results of this study showed that anemia, iron deficiency and iron deficiency anemia in children were 13.3%,28.3% and 10.3%, also the average of Hemoglobin, MCV and MCHC and Ferritin were 12.34, 79.48, 32.68 and 19.19. In this study there were significant difference between the average ofMCV in girls and boys (P=0.02). There were not significant relationships between the frequency of iron deficiency and iron deficiency anemia with sex, and also prevalence of iron deficiency anemia with low weight index. According to the prevalence of iron deficiency in the children and its complications, it is necessary to provide a comprehensive program to prevent the development of anemia and its complications.

Patient's information is collected in assessment, fIrst step of nursing process and it helps nurses to determine nursing diagnosis and interventions implement them and evaluate their result. So Nurses need to learn skills and techniques of physical examination and they should be put in nurse's curricula and continue in their work period. This study was conducted to evaluate self-evaluation and nurse's educational needs about patient's physical examination in hospitals affiliated to Birjand University of Medical science. In this descriptive- analytic study nurses with BS degree who are working in hospitals affiliated to Birjand university of Medical science were selected through simple random. Data was collected by a questionnaire including two parts; fIrst: 9 questions related to demographic characteristics, second: 38 questions about main goals of study. The fIndings were organized in two parts; First: related to self evaluation in 5 steps (very good, good, average, bad, very bad) and second: related to determine level of educational need in 3 steps (advance, average, basic). Data was analyzed through t test and Pearson corolational coefficient by SPSS. From 104 Nurses were participated (88.5%) were female, with mean age 30.44±6.2 and had work experience 7.27±6.35 years. Most of them worked in ICU (15.4%), general medicine (13.5%), CCU and emergency department (10.6%). The highest and scores of self evaluation was related to preparation in preducers clinical blood, urin tests and electrocardiograph (EKG) and the lowest scores of self evaluation was related to procedure and indication of Trans ilominator. The majority of Nurse's educational needs in advance level (55.8%) was related to clinical blood, urin, stool tests and in average level (51.9%) was preparation for chest x ray and abdominal- pelvic sonography and in basic level (30.8%) was preparation and indication (MRI). Female nurses evaluate themselves better than males and there was no signifIcant statistical relation between self- evaluation with age and work experience. Since one of main methods for stable care is systematic, results showed determining nurse's educational needs, workshops and continuous education for improve quality of care is important.

Hospital is an institute whose main strategy is providing diagnostic and treatment services for different medical situations, surgical or non- surgical. Staff is the most essential work force constituting health and treatment organizations and nurses, the largest professional group in a health care system, provide the largest part of direct care for patients, so they playa very important role in maintaining and improving the health of the society. Critical goals of hospitals will not be achieved unless the required numbers of qualified nurses are provided in proper time and place. The present study was conducted to survey the size and combination of nursing staff in affiliated treatment centers to Birjand Medical University and comparing with the complied standards of the ministry. We hope that the present study be able to take a step towards planning and reaching those standards and eventually improving quality of care. In this descriptive- comparative study the size and combination of nursing staff in affiliated treatment centers to Birjand Medical University in 2006 were investigated. Data was collected by the cheek list staffmg estimation table based on the systemic approach of the ministry. Then, the present personnel situation was compared with that of the standard one. The results shortage rate (or ratio) of nursing staff to available active beds, which themselves are less than the standard number per population, is in Imam Reza (AS) hospital 49.67%, in Vali-Asr (AS) hospital 29.6% and in Qaen hospital 47.3%. In Nehbandan, Sarbisheh and Sarayan, there are treatment centers, which are working as day- and- night (24 hours) clinics and have a number of beds in the emergency room and in the clinic. Regarding to the active beds nursing shortage in Nehbandan, Sarbisheh and Sarayan, was 55.8%, 57% and 70.6% respectively. Also, the results show that the maximum shortage of staff is in professional nurses. Since the most important factor in improving quality of care is providing sufficient number of staff, so standardizing size and combination of nursing staff can take an effective step towards the satisfaction of patients, clients and nursing personnel.