فهرست مطالب سیده فاطمه حق دوست اسکوئی

Stressful experiences related to the workplace and organizational missions cause stress, psychological burden, and physical injuries in police officers. The continuation of these experiences will affect the quality of work-life of police officers. This study aimed to explain the concept of quality of police work-life and factors behind it based on the lived experiences of police officers.

This qualitative study was conducted in 2018–2019 the police organization using the conventional content analysis approach. Participants were police officers who were selected through purposeful sampling with maximum variation. Data were collected from 13 police officers through in-depth semi-structured face-to-face interviews. Interviews were recorded, transcribed verbatim, and analyzed through the conventional content analysis method proposed by Graneheim and Lundman. MAXQDA software was used for analysis and organization.

The factors behind police officers’ quality of work-life were categorized into three main themes namely, "effective management and leadership", "working in bottleneck", and "accepting the working conditions". Each theme consisted of two to six subthemes.

Quality of work-life of police is a contextual, multidimensional concept affected by the type of management and leadership, existence of refreshment and supportive facilities, and the degrees the staff accept their working conditions. Authorities are responsible to improve the police staff’s quality of work-life so that they enjoy their organization and work. Improving the organizational atmosphere by creating pleasant working conditions can help improve the police staff’s quality of work-life despite their difficult working conditions.

The β-Thalassemia major is a chronic disease that needs a regular blood transfusion. The blood transfusion is a complex process with high probability of human errors during the process which results in serious adverse events in patients. Nurses should deliver care based on the best available evidence or best practice. The aim of this study was to develop an evidence-based clinical guideline of blood transfusion in children with thalassemia. Methods & Materials: This study was conducted during 16 months from 2013 to 2014 based on three-step process of guideline adaptation including set up, adaptation and finalization. During these steps, topic and aims of the study were clearly identified. Then health questions were designed based on the PIPOH method. After conducting systematic searches, quality of the retrieved clinical guidelines was evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument and a committee consisting of experts and policy-makers in nursing field. After external review, expert panel meetings and consensus between members, the final version of the guideline was developed. The criteria of clinical practice regarding stages of blood transfusion were determined based on the evidence, cultural and health conditions; and were presented in twelve sections. This clinical practice guideline developed based on evidence can guide blood transfusion process in clinical practice.

First encounter with a disability is in the family environment and the quality of interactions and adaptation processes of the family can determine their quality of life. this study was conducted with aim of assessing quality of life and its associated factors in primary caregivers of children with physical disabilities under supervision of Welfare organization iran-Ilam.
This descriptive-correlational study was done in 2012,a sample size determined as 145 primary family caregivers of children with physical disabilities based on census approach in the city of Ilam. Data collection tool was demographic information questionnaire and quality of life questionnaire of WHOQOL-BREEF. For data analysis, SPSS v.16 software and descriptive and inferential statistics were used.
The results showed that the overall quality of life scores of family caregivers (39.16) is low, and they experienced a poor quality of life status in all four domains of physical health, mental health, social relationship and environmental health.
research findings showed that these families are facing the challenges of care giving to their disabled children that has deteriorating effects on their health and quality of life. thus it is imperative that preventive and supportive programs and services be considered for these vulnerable families to improve their overall quality of life.

The aim of this study was to review the physical and social environment monitoring of the intensive care unit and examine how it affects the physiological status of the patient and family needs. Knowledge and skill in providing nursing care are the main factors affecting the recovery of patients in the intensive care unit (ICU). While a nurse or nursing unit can possess perfect critical care skills and knowledge، those are not the only factors that influence patient recovery. Including nursing skills in ICU is environmental monitoring and creating a pleasant environment with minimal stress. This monitoring includes control of light، sound، color، landscape، music and social support. This review was conducted by searching electronic databases and hand searching of library resources. Finding articles and research projects was conducted by using keywords on the internet and relevant sites. Improvement of the environment in which care is provided not only helps in the healing process for patients، but also increases employee satisfaction and families affected. Environmental monitoring reduces stressful factors from ICU to rectify the effects of these wards for patients and also، reduces staff stress. The use of research findings is an important part of improving the quality of care for patients in intensive care units and their families. The ICU setting has the potential to afford patients the best possible opportunity to heal if key stress-reducing elements are incorporated into its physical design. Such elements may reduce noise، offer privacy، add full-spectrum lighting، and assimilate color. As well as considering the physical design، a critical program that integrates the family and other healing measures is essential to the milieu of a healing environment.

Multiple structural factors preside over burn units influence nurse's quality of care and their activities. The complexity and multy-dimensional nature of nursing care in these units, creates many challenges. Understanding the perspectives of people's involved is recommended. This study, with a theory-to-research approach, was conducted to assess the frequency of confronting intra and extra organizational factors preside over burn units, the intensity of its related pressure, and correlations among these variables from nurse's perspectives. Methods & Materials: In this cross-sectional, correlational study, 98 nurses working in the Shahid Mottahari burn center were recruited by census. Data was collected using the intra and extra organizational factors instrument, provided based on the previous grounded theory study of the researchers. Intra-organizational factors questionnaire consisted of 58 Likert type statements in eight subscales and two dimensions of frequency (α=0.94) and intensity (α=0.96). Extra-organizational factors questionnaire consisted of eight Likert type statements (α=0.74). Data were analyzed using the SPSS version 14. The results revealed that the frequency of nurse's confrontation with factors related to environment and patients as well as its intensity were more than other factors. Moreover, the intensity of the whole factors was more than its frequency. All the extra- organizational factors were significantly correlated with all intra-organizational factors except for the "absence of employment permission" (P<0.05). This study explained the importance of intra-organizational factors of a burn center in inducing stress on nurses. In addition to verification of some relationships in the previous mid-range theory, the results of this study also modified some of its aspects. Therefore it added to the existing body of knowledge about organizational factors and job stress in burn units. Moreover, it produced some evidences to use in nursing administration and service, and finally it resulted in some directions to control stress in nurse's jobHAYAT2012;18(2): 11-26 Original Article[Frequency and Intensity of Nurse's Confrontation with Intra and Extra-Organizational Factors Governing Burn Centers][Article in Persian]Forough Rafii* (Ph.D) - Seyedeh Fatemeh Haghdoost Oskouie** (Ph.D) - Fahimeh Mohammadi Fakhar*** (MSc.) - Mohammadreza Zarei*** (MSc.) - Hamid Haghani**** (MSc.). * Dept. of Medical and Surgical Nursing, Center for Nursing Care Research, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran ** Dept. of Public Health Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran *** Dept. of Medical and Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran **** Dept. of Biostatistics, School of Management and Information Technology, Tehran University of Medical Sciences, Tehran, Iran Corresponding Author: Forough Rafii e-mail:[email protected] Received:February 4,2012Accepted: May 1,2012Available online:June 6,2012 Abstract: Multiple structural factors preside over burn units influence nurse's quality of care and their activities. The complexity and multy-dimensional nature of nursing care in these units, creates many challenges. Understanding the perspectives of people's involved is recommended. This study, with a theory-to-research approach, was conducted to assess the frequency of confronting intra and extra organizational factors preside over burn units, the intensity of its related pressure, and correlations among these variables from nurse's perspectives. Methods & Materials: In this cross-sectional, correlational study, 98 nurses working in the Shahid Mottahari burn center were recruited by census. Data was collected using the intra and extra organizational factors instrument, provided based on the previous grounded theory study of the researchers. Intra-organizational factors questionnaire consisted of 58 Likert type statements in eight subscales and two dimensions of frequency (α=0.94) and intensity (α=0.96). Extra-organizational factors questionnaire consisted of eight Likert type statements (α=0.74). Data were analyzed using the SPSS version 14. The results revealed that the frequency of nurse's confrontation with factors related to environment and patients as well as its intensity were more than other factors. Moreover, the intensity of the whole factors was more than its frequency. All the extra- organizational factors were significantly correlated with all intra-organizational factors except for the "absence of employment permission" (P<0.05). This study explained the importance of intra-organizational factors of a burn center in inducing stress on nurses. In addition to verification of some relationships in the previous mid-range theory, the results of this study also modified some of its aspects. Therefore it added to the existing body of knowledge about organizational factors and job stress in burn units. Moreover, it produced some evidences to use in nursing administration and service, and finally it resulted in some directions to control stress in nurse's job.

Physiologic signs of anxiety usually change hemodynamic variables in patients undergoing heart catheterization. This study carried out to determine the effect of Orientation Program on hemodynamic variables in patient undergoing heart catheterization.Methods & Materials: In this experimental study, 60 patients undergoing heart catheterization were randomly assigned to either the test or control group. Data were collected using the demographic checklist and a hemodynamic variables checklist for recording hemodynamic variables. The collected data were analyzed using the Chi-square, repeated measurement, and independent t test in the SPSS.

According to the results, there were significant reductions in the systolic and diastolic blood pressures, pulse rate, respiratory rate and systolic left ventricle pressure in the intervention group after the intervention (P<0.05). There were no significant statistical difference between the two groups in systolic aorta pressure (P=0.173), diastolic aorta pressure (P=0.104), and end diastolic left ventricle pressure (P=0.886).

Orientation program had positive effects on most of the hemodynamic variables in the intervention group. The Orientation program is recommended to be used during invasive diagnostic procedures in order to prohibit anxiety's physiologic complications.

It has been known for many years that there is a high risk of relapse after treatment of drug abuse. This has made addiction more complicated. Knowledge of related factors allows the health care professionals to initiate much broader, client – centered, relapse prevention strategies. This study had a descriptive design. The sample comprised 200 addicts who all were male and had at least one relapse episode after treatment. Data were collected by structured face-to-face interviews. The related factors to relapse are divided in two groups as individual and environmental factors. The intensity of related factors was asked as "not any", "a little", "medium" and "very much". The results showed that 33. 5% of the subjects had 1 relapse, 38% 2-3 relapse and 28. 5% more than 3 relapse. Also, 53% of them relapse in less than 3 month after treatment. Only 12% could avoid drug use for more than 1 year. The mean time of abstinence was 6. 3±3 month. According to Friedman test, insomnia and temptation were the most important individual factors (P<0. 000), and simple access to drugs, family conflicts and noncompliance with treatment were the most important environmental factors (P<0. 000). With respect to results, since psychological factors were the most important (mean= 1. 6 ± 0. 5), mere detoxification is not efficient enough and may end in client’s relapse. Treatment services should be developed further and strengthen relapse prevention and relapse coping skills among drug misuser’s and pschological health is the first thing that should be notified by them.

Caring is a multidimensional nursing concept that can be actualized within the baccalaureate nursing curriculum through the purposeful teaching and student centered learning of core values. Although, the learning of caring is widely accepted, it has not been proved through research. The aim of this study was to assess and compare the effectiveness of clinical practice of fundamental nursing through role-play and traditional methods on the caring behaviors of sophomore-level students in the Faculty of Nursing and Midwifery- Iran University of Medical Sicences (IUMS). This is a quasi-experimental pilot study using an equivalent control group and post-test design. Fifty one nursing students were randomly assigned in either experimental or control groups. The clinical experience of the experimental group occurred in nursing skill lab and the control group experienced their clinical practice in hospitals affiliated to IUMS on a routine basis. Then, caring behaviors of the two groups were observed in their first clinical practice of medical-surgical nursing using Caring Behaviour Inventory, CBI. This article has been allotted to the comparison of caring behaviors of the sample following clinical practice through these methods. Findings indicated that behaviors related to the subscale of "Respectful difference to other" and "Professional knowledge and skill" were, respectively, the most and least frequent behaviors in both groups. Man-Whitney test indicated a statistically significant difference between the two groups in the subscale of "Assurance of human presence"(P= 0.038). The same test indicated no statistical significant difference between the mean of the total scale of caring behaviors of the two groups. Regarding the absence of any difference between caring behaviors of the two groups, making changes in the future research designs and testing new approaches to approve the probability of learning of caring is needed. Moreover, using approaches for maintaining interpersonal aspects of caring in nursing curricula, increasing the time of clinical experience, changing the teaching styles of practical aspects of nursing, and integrating theory and practice, appropriately, is recommended.

Although cesarean section has been considered as a way for reducing infant and mother mortality rate, it has been changed to a general dilemma, so that in Iran, cesarean rate is higher than World Health Organization standards. The aim of this study was to discover the process of decision making for selection of cesarean delivery by those whodid not have indication for cesarean. Twenty six pregnant women, experiencing the third trimester, were selected based on purposeful and theoretical sampling. For access to participants, the researcher referred to one teaching health care centers of Iran University of Medical Sciences and two private offices of gynecology in Tehran, Iran. The data were collected by semi-structured interviews. All data were audio taped and transcribed. Data collection and analysis was performed simultaneously. Constant comparative method was used to analyze data. The main categories were “fear due to not having knowledge”, “being painless, and physical and spiritual peace” and “unpleasant experience of others and their encouragement”, “being worry of complications”, “inappropriate communication of health care staff”, and “the feeling of loneliness and death”, “infant’s health”. Constant analysis of data revealed that women get through for creation balance in order to receipt the best result, process of to consider, making a lawful and to choice. Attentive to main theme that it is fear of labor and delivery is a physiology phenomenon. It is necessary to encourage methods for relieving pain and fear and for promoting self-esteem in order to make good decision by pregnant women. It is also important to encourage women for vaginal delivery.

Content analysis was used first in communication sciences. Today, it is frequently used in media analysis. In other sciences such as nursing, researchers apply this method in their studies. In spite of the importance of this method in nursing research, there was not enough Persian material on the subject. Therefore, this review study was conducted to clarify and describe definitions, classifications, principles and conceptual bases of content analysis. Persian and Enghlish foreign articles and books were used in this review study. Most scholars believe that content analysis is a research tool used to determine the presence of certain words or concepts within texts or sets of texts. Some categorize it as a data analysis technique. Texts can be defined broadly as books, book chapters,essays,nterviews, discussions, newspaper headlines and articles, and historical documents. Using content analysis, researchers analyze the presence of meanings and relationships of such words and concepts, then make inferences about the messages within the texts, the writer(s), the audience, and even the culture and time of which these are a part. Content analysis can be used in both quantitative and qualitative researches.

Despite tremendous progressions in medical science and technology, there is no way yet to escape death. Logical attitudes of nurses toward death could be influential on care giving of dying patients and their families. If the health care professionals view death as a terrible and dire thing, they couldn’t handle patients’ death in a fair and effective manner. So, it seems that the first step toward designing an appropriate care and support system for dying patients and their family is exploring nurses’ beliefs and point of views. The aim of this study was to determine the concept of death from Iranian nurses’ perspective to reach a new explanation for this concept in community. This study was conducted by qualitative research approach. Data collection was done via semi structured interviews with 12 Nurses from 4 hospitals. They had 2 to 18 years working experience in emergency departments, ICUs, CCUs and oncology wards. All interviews were taped, and then transcribed on paper and analyzed using Strauss and Corbin method. Four main categories emerged: non avoidable ending, ambiguity and uncertainty, feedback for personal behaviors, and changing attitudes toward life and death. This study showed that one of the most important ideas which help nurses to better dealing with death is belief in life after death. Recognizing death as fate of all lives could also bring peace to the man. This sort of attitude gives the nurse a peace of mind which helps to make dying patients and their families comfortable. The perspective of death which emerged from nurses’ perspectives in this research is a spiritual one. They believed that their occupation with nursing reinforces this attitude and decreases their uncertainty about life after death. This study provides a deep understanding about nurses’ point of view about death which could be a base for nursing education about death and dying

Nursing care in burn centers requires a heavy work which is influenced by many factors. The quality care of nurses as the largest group care providers in burn centers is of great importance and complexity and pan dimensionality of the care in these centers requires multiple interpretations that necessitate exploring and describing the perspectives of whom involved in care giving to understand the factors affecting the quality of care. The study was carried out with the aim of exploring and describing the factors involved in quality nursing care in burn centers of Tehran. Grounded theory was used as method. Thirty- eight participants were recruited through purposeful and theoretical sampling. Data were generated by unstructured interviews and participant observations. Constant comparison was used for data analysis. Data revealed that two categories of structural factors including intra and extra organizational conditions have influenced the quality of care. Intra organizational conditions included conditions related to administrators, staff, financial problems, workload, team members, facilities and equipments, environmental elements, and patients. Extra organizational conditions included self-management of burn centers, lack of supportive organizations for patients and heavy expenses of treatment, high living expenditure and low salary of governmental personnel, lack of employment permission, inattention of senior managers and inspectors to the work processes and their over attention to documentation, troublesome rules related to official violations, physicians governorship, and negative social perspective into nursing profession. Interaction between intra and extra organizational conditions resulted in physical and psychological stress, loss of motivation and dissatisfaction of staff nurses and poor quality of care. Findings were suggestive of correcting and modifying the intra and extra organizational factors and implementing stress reduction programs.

Introduction and Caring is a multidimensional nursing concept that can be actualized within the baccalaureate nursing curriculum through the purposeful teaching and student-centered learning of core values. Teaching interpersonal issues is possible through various methods such as role-play. The current study was conducted with the aim of describing the caring behaviors of two groups of sophomore-level student nurses after implementing either role-play or traditional method as teaching method of choice. The researchers used quasi-experimental study design using an equivalent control group and post-test. Fifty one nursing students were randomly assigned in either experimental or control group. After that members of the experimental group performed their clinical experience using role play and members of control group did practice as routine, caring behaviors of two groups were observed using CBI. In general, findings indicated that caring behaviors related to subscales “respectful difference to other” and “professional knowledge and skill” were, respectively, the most and the least frequent caring behaviors in both groups. More frequent occurrence of interpersonal aspects of caring in two groups indicates that in the beginning of professional nursing care, the sophomore-level students give priority to altruistic values. So, using approaches to develop and maintain interpersonal aspects of caring in nursing curriculum, coupled with changing the teaching methods of practical aspects of nursing care and appropriate integration of theory and practice is recommended.

Nursing care in a burn center is demanding intensive care which provokes emotional responses among staff. Every nurse who cares for a patient with burn injury, knows that stress is a part of working in this field and organizational problems and issues related to the patients in these centers leads to intense reactions in the staff which finally results in burnout and exerts negative influences on nursing care. Therefore, the objective of this paper as part of an extensive research was identifying the nature of burn nurse's responses to burnout. Grounded theory was used in this study. Thirty- eight participants were recruited by purposeful and theoretical sampling and data were generated by unstructured interviews and participant observations. Constant comparison was used for data generation in this study. Participants represented negative dimensions in response to stress and burnout. These responses emerged as emotional, attitudinal, psychosomatic behavioral, and organizational dimensions. Emotional dimension included personal and professional desperation attitudinal dimension included depersonalization and negativity psychosomatic, responses included physical and psychological attrition behavioral response included intolerance and justification and organizational dimension included irresponsiveness care and declining performance. Burnout impressed all dimensions of participant's entities and in this way, influenced quality of nursing care negatively. The process of actions and interactions of the nursing staff emerged as a response to situations and context of burn centers during time period. These responses sometimes were represented spontaneously, and sometimes as means for reducing the influence of environmental stressors. Some of these responses focused on the kind of care, and some involved feelings and emotions of the participants. But the participant's bodies were also the target of some responses. Modifying macro and micro conditions governing burn centers is necessary. Nurse administrators concerning about signs and symptoms of burnout, and also executing stress management programs will reduce stress and distress in the nurses and also improve the quality of nursing care.

Historically, comfort has been an optimal outcome in caring of hospital patients though, the concept of comfort from patient's perspective is rarely assessed. The aim of this study was to explore hospitalized Medical-Surgical patients’ experiences and perceptions regarding of comfort and discomfort. A qualitative approach using grounded theory was adopted in this study. The data collected by semi-structured interviews and participants’ observation, from a purposive sample of 31 medical-surgical patients, with 11 patient's accompanied relatives who were subjected to questions and constant comparative analysis. This study was conducted in five large teaching and semi-private hospitals in Iran. Date analysis covered a number of themes obviously included discomfort. In fact, experiencing discomfort was so persistent in the data, that it formed several categories including “physical, psychosocial and environmental discomfort”. Self help and organizing of informal caring web, and seeking help from others, were the participants’ main strategies to deal with discomfort. The finding indicated that hospitalization of patients is not always necessarily equivalent to effective deal with caring and therapeutic needs. Patients experience a lot of distress related to hospital's policies, regulations and priorities. Patients can have active role for discomfort management. In addition, it is highlited the roles of patient's relative and care-givers in hospitals. Therefore, without cooperation of care-givers (patient's relatives), the quality of nursing care could be disturbed seriously.

The 21st century is the era of continuous changes in the way modern medical and scientific world functions, thus the need for adaptation in complex systems becomes paramount. In such a dynamic society optimum standard of survival may depend on the ability of individuals and groups to investigate multiple alternatives or choices and finally make wise decisions. Therefore, the need for critical thinking skills is an absolute vitality for today’s health science professionals. Education is the most powerful tool in developing learning skills and the main aim of every educational institution is to assist students and trainees to achieve such end. Besides professional competency, the main aim of medical sciences education is to develop students’ ability in decision making ability and problem solving, and leading them to become efficient critical thinkers. Critical thinking skills are vital in coping with the unprecedented rapid changes occurring in health care field. In order to cope with the complexity of today’s medical issues, nurses and physicians need to equip themselves to critical thinking ability so that they can offer the most effective services and treatments for their patients and clients. It seems that there is challenge in training capable and skilful graduates in Iran medical education system. Hence, essential actions are needed to uplift the standard of medical education in this country. To this end, urgent priority should be given both to development and improvement of critical thinking skills of students and trainees of health field. First, based on authors’ experiences, some of the barriers for critical thinking skills nursing of students is reviewed. Then, based on literature review and panel of experts’ viewpoints a suggested solution in a graphical format, is suggested. Planning for an urgent action is also suggested to improve critical thinking skills of students and trainees in health field which seemingly is a challenge in iran nursing education system.

Nursing as a practice-based profession requires that the student nurses learn how to become professional in the clinical environment. Many studies have addressed student nurses’ clinical learning and related problems, but few have explored the whole clinical experience of being a student nurse. This paper is a partial report of the study was planned to understand and gain deeper insight into Iranian student nurses’ lived experience of clinical placement. Seven student nurses were interviewed about their clinical experience during clinical placement. The researchers analyzed the verbatim transcripts using van Manen’s phenomenological methodology, keeping in mind the recommended six research activities. One of the most prominent themes emerged was a caring-orientated relationship and captured by four sub themes: How to manage the patient, connected relationship, patient reinforcement, and empathy. The aim of qualitative research in general and phenomenology in specific is to produce knowledge regarding the phenomenon under study. The knowledge produced in this study would be helpful for other researchers to open other horizons around the phenomenon of student nurses’ clinical experience and also, as a guide for nursing clinical education.

Patients’ comfort is an integral part of nursing care and a valued outcome of nursing actions. This article is part of a larger study which aimed to explore patients’ experiences and perceptions of comfort and discomfort. A qualitative approach using grounded theory was adopted. Data was collected via semi-structured interviews and participants’ observations. A purposive sample of 31 medical-surgical patients, and also 10 relatives who were subjected to questions and constant comparative analysis were selected from 5 educational health centers. Data analysis uncovered a number of themes. The theme of patients’ perceptions and experiences with nurses is the subject of this paper. The other four themes of a comforting nurse were: availability, monitoring, humanistic approach and providing physical comfort. The findings of this study help nurses to know the patients and their needs better and also to find what comfort means to them. Consequently, nurses can plan, imply and evaluate nursing interventions most appropriately.

Lengthened pregnancy after the 41st week will create problems for mother, fetus and newborn. Assessing the outcomes of prolonged pregnancy are research priorities. To determine the maternal, fetal and neonatal outcomes of prolonged pregnancy. Design: This was a case -control study in which the data were collected through record sheets. Sample: There were 1800 samples in this research of which 600 women (prolonged pregnancy) made the case group and were selected through continuous sampling. Control group included 1200 women (normal pregnancy) which were chosen by simple random sampling. The findings indicated there was significant relationship between maternal outcomes (i.e. such as induction of labour, responding to induction in the 1st and 2nd days, spontaneous and cesarean child birth, postpartum hemorrhage, and duration of second stage of delivery) and prolonged pregnancy (P<0.05). There were also significant relationship between prolonged pregnancy and fetal outcomes such as fetal distress, meconium passage, decreased fetal movements in admission time, and decreased volume of amniotic fluid (P<0/05). Regarding to neonatal outcomes, there was a significant relationship between prolonged pregnancy and admission in neonatal intensive care unit (NICU), and infant weight at birth (P< 0.05). Based on the findings, increased labour induction, responding to induction in the second day, preference of child birth through cesarean, increased postpartum hemorrhage, prolonged second stage of delivery, fetal distress, meconium passage, decreased fetal movements in admission time, decreased volume of amniotic fluid, and increased infant birth weight were known adverse outcomes of prolonged pregnancy. Therefore, the termination of prolonged pregnancy after 41st is recommended. This termination is recommended to be done at areas equipped with special cares and facilities (i.e. child birth, after child birth, infant resuscitation, and NICU facilities).

Ectopic pregnancy is one of the medical and serious threatening problem to women's life at the present time, It's risk factors have discussed since ancient times.

To determine the risk factors of ectopic pregnancy. Design : This research was a case- control study. The information about the case group (ectopic pregnancy) and the control group (normal delivery) were gathered form the medical charts, between 1995 to 2000, and were recorded in the data record sheet that was composed of 4 parts: demographic, individual characteristics, infertility treatment technologies and contraceptive methods. The variables were statistically analyzed in two group. Samples : The all of 290 women with ectopic pregnancy who had been hospitalized in the central and southern districts of Tehran mead the case group and 870 women who had normal delivery at the same time were selected randomly as the control group of this study.

The finding showed that there were statistically signification between ectopic pregnancy and following variables: age, parity, the history of pelvic, abdominal and tubal surgeries and pelvic inflammatory disease, history of infertility, smoking and the use of contraceptive methods with the happening of pregnancy concurrently.

According to the results of this study, older ages, ground parity, history of ectopic pregnancy, pelvic, abdominal and tubal surgery, pelvic inflammatory disease, history of infertility, smoking and failure of contraceptive methods were confirmed as risk factors for ectopic pregnancy. It is recommended that the risk factors of ectopic pregnancy be assessed in all of pregnant women who come to prenatal care unit in early pregnancy by use of a short questionnaire, It is also recommended to study the risk of each factors by two matched group prospectively.