صدیقه ایرانمنش

Background &

Breast cancer is a critical and potentially traumatic experience and one of the most common and serious problems in women's health. Cancer is a physical disease in which cancer cells stop multiplying and do not grow in a controlled manner. Cancer is one of the fundamental problems in the field of health and treatment all over the world, It is considered the third cause of death and the second most chronic non-communicable disease in the world, as a regular and continuous process, creates challenges in the lives of affected people. It creates many problems for a person. According to the increasing trend of cancer, it is predicted that the incidence of cancer will reach more than 28 million people in the next two decades with a 47% increase compared to 2020. Breast cancer is one of the main causes of cancer-related death in women all over the world. Cancer is associated with mental stress and negative emotions of anxiety. According to this, the current research was conducted with the aim of comparing emotion regulation, emotional control and rumination in women with and without cancer.

This causal-comparative research was conducted with the aim of comparing emotion regulation, emotional control, and rumination in women with and without breast cancer. The statistical population of the present study included all patients diagnosed with breast cancer from Rasoul Akram Hospital in Tehran. The sample of this research consisted of 40 women with breast cancer who were selected purposefully. First, a list of 134 breast cancer patients was prepared. Then 100 people were selected from among them in a targeted manner, and out of these 100 people, 40 people cooperated and participated in the research, with 40 people from the general population who had Demographic characteristics (age, sex, education and marital status) were comparable with the affected subjects, provided they were not diagnosed with breast cancer or any other type of disease. The criteria for leaving the research were age below 30 years and above 65 years, a history of damage to the central nervous system during the past year, and mental disorders requiring immediate treatment (such as psychotic symptoms and drug addiction). The research tools were Garnevsky's Emotion Regulation Questionnaire, 2006, Hallen Hoeksma's Rumination Questionnaire, 1991, and Williams' Emotional Control Questionnaire, 1997. The statistical method of multivariate analysis of variance (MANOVA) was used to analyze the data.

The variable of rumination (examination, preoccupation, and depression) had a significant difference between the normal and patient groups (p<0.001 and F=5.19). There is a significant difference between the normal group and the patient group in terms of expression (p<0.01 and f=7.71), in the thought of depression (p<0.01 and f=10.57). There is a significant difference between the normal and sick groups in terms of anger (p<0.05 and f=5.65), depressed mood (p<0.01 and f=4.07), and anxiety (p<0.01 and f=12.84). There is. between normal and sick groups at least in terms of one of the dependent variables of emotion regulation (self-blame, acceptance, focus on rumination, positive refocus, refocus on planning, positive reevaluation, perspective taking, catastrophizing and other blame) there is a significant difference (p<0.001 and F=5.06) so the first hypothesis is confirmed. The amount of difference or influence is equal to 0.375%; That is, 37.5 percent of the individual difference in scores between the two groups is related to group membership. On the other hand, statistical power was obtained for group 1, which indicates that there is no possibility of type 1 error and the sample size is sufficient.

Different types of psychopathology, mental health issues and problems, disruption in interpersonal relationships and mental health performance, and physical problems and other diseases can be considered as the result of not regulating emotions. According to the data of pain theory, the descending and central pain of neurons can be changed by positive and negative emotional data. Negative emotions increase pain and positive emotions reduce pain intensity. Therefore, according to this theory, positive and negative emotions may indirectly play a role in pain management, because negative emotions increase pain, and vice versa, positive emotions reduce the intensity and severity of pain. Therefore, according to This theory suggests that positive and negative emotions may indirectly play a role in pain management. Depressed mood in women with breast cancer is significantly higher than normal people. In the explanation of this result, it can be stated that the depressed mood is based on separating from inaccessible motivations and incentives and being open to new stimuli, it is predicted that the depressed mood is an adaptive part of the process of separating the person from the driver. Depressed mood is common among cancer patients, and according to the American Cancer Society, one out of every four cancer patients has depression. As a result, it can be said that physical, mental, and emotional problems in patients can be an important factor in increasing rumination in these patients. Usually, the mechanisms created by rumination are risk factors for mental problems, such as the reduction of social support and optimism in people and the increase of neuroticism. Therefore, knowing and being aware of this topic can help people's mental health. The results showed that there is a significant difference between emotion regulation, emotional control, and rumination in women with and without breast cancer. Positive emotion regulation is lower in women with breast cancer. Rumination is more common in women with breast cancer. Anger, anxiety, and depressed mood are significantly more in women with breast cancer. But there was no significant difference in terms of positive emotion.

Support of parents of children with cancer requires health care personnel to be knowledgeable about the psychosocial risks among parents of children with cancer. This study thus was conducted to fulfill this aim.
Using the Psychosocial Assessment Tool- Revised (PAT-R) for parents of children with cancer, 200 parents of these children in two hospitals supervised by Kerman University of Medical Sciences was assessed.
In PAT-R, the total mean score was 0.56. There were correlations between religious, mother's age, number of children, type of cancer, gender of children with cancer and duration of cancer and PAT-R. A difference was found between parents in category of "parent's stress reaction, so that "stress reaction" of mothers was higher than that of fathers.
The total mean score of PAT-R in this study was lower than that in previous studies and stress reaction of mothers was higher than that of fathers. More study is needed to elucidate the parents’ experience of having children with cancer.

In recent years، the number of children with incurable diseases and their EOL care requirements has increased alongside the developments in technology. Throughout history، nurses have sought ways to improve EOL care. Gaining an increased understanding of nurses’ perceptions of changes that would facilitate appropriate EOL care is important to improve quality care. This study، therefore، was conducted to determine pediatric nurses’ perceptions of intensity، frequency of occurrence of supportive behaviors in providing pediatrics EOL care. Using a translated modified version of (NSCCNR-EOL) questionnaire perception of 151 convenient nurses of supportive behaviors intensity and frequency was assessed. The highest/lowest PSM scores belonged to items respectively: “providing a peaceful، dignified bedside scene for family members once the child has died” (5/75) in health – care professional related category and “letting the religious leader take primary care of the grieving family” (1/08) in organizational related category. Some demographic characteristics of nurses including family and close friends'' death experience (P=0/01)، number of dying children cared for (P=0/01) and previous education toward death and dying (P=0/01، 0/04، 0/04) was positively correlated with PSM scores. The result may indicate a long distance between what nurses believe to be facilitating and what actually happens. Creating a reflective narrative environment in which nurses can express their feelings about death and dying may be an effective approach. A continuing palliative care education adding to nursing curriculum can improve the EOL care quality.

Due to incomplete physical development، premature infants are susceptible to various sources of stress. Therapeutic touch is considered as an effective method to reduce stress in neonates. This study aimed to compare the effects of Yakson therapeutic touch and routine nursing care on the behavioral response of premature infants. This quasi-experimental study was conducted on 60 premature infants aged 26-34 weeks، admitted at the neonatal intensive care unit (NICU) of Afzalipour Hospital of Kerman، Iran. Subjects were randomly selected by minimization and equally divided into two groups of intervention and control (N=30). Infants in the intervention group received Yakson massage therapy for 5 days، twice daily for 15 minutes، and infants in the control group received routine care. Behavioral responses of infants، including the status of sleep، waking and restlessness، were evaluated using Anderson Behavioral State Scale (ABSS) before and after intervention. In this study، mean scores of ABSS in preterm infants of the intervention and control groups was 10. 63±0. 14 and 4. 83±0. 14، respectively. Moreover، there was a significant difference between the scores of behavioral response after the intervention between the groups (p=0. 001). According to the results of this study، increased scores of sleep status in the infants of the Yakson therapy group indicated that this method could be effective in the provision of nursing care for premature infants admitted at the NICU.

Support of parents of children with cancer requires health care personnel to be knowledgeable about the prevalence posttraumatic stress symptoms among parents of children with cancer. This study thus was conducted to fulfill this aim. Using the Impact of event Scale- Revised for parents of children with cancer، 200 parents of these children in two hospitals supervised by Kerman University of Medical Sciences was assessed. The total mean score of posttraumatic stress symptoms was 41. 70. Among all categories of the Impact of Event Scale- Revised، the highest mean belonged to the category of “intrusion” 16. 03 (SD = 6. 24) and the lowest one belonged to the category of “hyperarousal” 10. 68 (SD = 4. 58). Based on the results، mothers had higher posttraumatic stress symptoms compared to fathers (P < 0. 05). Adjusted odd ratio showed that the prevalence of posttraumatic stress symptoms among mothers was 2. 49 times more than that among fathers (P= 0. 01). The results of following study revealed that posttraumatic stress symptoms among mothers of children with cancer in Iran are higher compared to the fathers. There were no association between socio-demographic data and posttraumatic stress symptoms. More study is needed to elucidate the Iranian parents’ experience of having children with cancer.

Development in technology and pharmaceutical treatments have increased the number of children with life threatening conditions as well as their end of life care requirements. These children and their families require comprehensive and appropriate end of life care. Nurses are faced with challeng in their efforts to provide end of life care. This study was aimed to assessment of Barriers in providing end of life care to terminally ill pediatric patients in kerman hospital. In a descriptive analytic study،151 nursing staff were Selected with Purposive sampling. A translated modified version of (NSCCNR-EOL) and demoghraphic questionnaire was used to data collection. The highest perceived barrier magnitude score was «families not accepting poor child prognosis” (5/40) and the lowest perceived barrier magnitude score belonged to the item “Continuing to provide advanced treatment to dying child because of financial benefits to the hospital” (2/09). Between Participants’ family and closed friends’ death experience positively correlated with perceived organizational-related barriers magnitude (p=0/02). Also participants’ nursing experience positively correlated with perceived health-care professional related barriers magnitude (p=0/02). The study findings showed that lack of education and experience as well as some cultural and professional limitations may have contributed to some deficiencies in providing end of life care. So developing end of life and Palliative care education may enhance nurses’ knowledge and skill to face the challenges of end of life care. Establishing Palliative care units in the community as well as developing of palliative home care programs that focus on family members، who play an important role in children’s care may have positive effect on pediatric end of life care.

Introduction and Life satisfaction is the individual’s attitude towards life and is closely related to the welfare and prosperity. The aim of this study is to compare Life satisfaction of elderly between nursing home residents and seniors who living in their own homes in Isfahan. The population of this analytic – cross sectional study was elderly over 60 years old who live in fourteen area of Isfahan as well as seniors living in the Sadeghieh nursing home. Participants in this study were 300 elderly people in which 102 samples were from nursing home residents and 198 samples were from seniors living in their own homes. The elderly living in the community were selected through cluster sampling method and elderly from nursing home residents were selected via convenience sampling method. Data were collected using LSI-Z life satisfaction questionnaire and were analyzed by statistical parametric test such as chi-square and independent t-test. life satisfaction mean score of elderly group inhabited in their own homes reported at 45. 9 ± 19. 8 and was significantly higher than nursing home residents (p= 0. 007). Life satisfaction of elderly in nursing home is not satisfactory. Therefore، what should be considered by the relevant authorities is not only to prolong life but، it is also very important to provide comfort، good physical، social and psychological health for the remaining years of aging.

There are a few studies to assess nurses’ sleep quality and sleepiness in the Iranian context. This study thus was carried out to examine the prevalence of sleepiness and sleep quality among nurses in South East of Iran. Subjects and The study applied a descriptive, explorative design.252 nurses randomly selected from Kerman University Hospitals during winter 2009. Using two questionnaires; Epworth Sleepiness Scale [ESS] and Pittsburgh Sleep Quality Index (PSQI) prevalence of sleepiness and sleep quality of sample was examined. The prevalence of sleepiness was 45.6%. Daytime sleepiness correlated with job experience (p= 0.028), education (p= 0.036). 84.5% of the participants reported that they have poor sleep quality. The PSQI component scores (mean ± SD) widely ranged. The highest mean scores belonged to sleep latency (1.8 ± 0.9) and the lowest belonged to hypnotic medication use (0.54 ± 0.97). However, there was no significant difference between gender, marriage status, education, job experience, and sleep quality. Pearson correlation coefficient showed a significant association between sleep quality and sleepiness (p=0.014) among participants. According to Binary logistic regression results, the risk of sleepiness among participants with poor sleep quality was 2.58 times more than that among those who had good sleep quality. The results indicate almost high prevalence of poor sleep quality and sleepiness among Iranian nurses. Therefore nurse managers and policymakers need to change the work organizational culture so that nurses, who work long hours, have sufficient time to sleep.

One of the problems of premature infants is oral muscles insufficiency and inadequacy of oral-feeding skills at birth. Use of supportive oral interventions such as olfactory stimulation can facilitate this increasing challenge in neonatal intensive care unit. This study aimed to check the effect of olfactory stimulation with breast milk smell on the duration of feeding transitional time from gavage to oral feeding in premature infants. In this randomized clinical trial study، 92 premature infants with the gestational age of less than 33 weeks hospitalized in neonatal intensive-care units of Valiasr and Jame Zanan hospitals in Tehran، Iran، during April to September 2013 were enrolled using available sampling method. They were randomly divided into 2 groups of 46، control and intervention (received mother milk odor during gavage periods) groups. A researcher-made checklist including demographic and primary (transitional feeding time، weighting، first breast feeding time، hospital stay) variables was used. The data were analyzed using independent t and Mann-Whitney tests via SPSS16 software. Olfactory stimulation of premature infants significantly reduced the feeding transitional time and length of hospitalization more in intervention group (11. 20 ± 3. 23 and 14. 65 ± 3. 57 days، respectively) compared to control group (21. 65 ± 6. 04 and 26. 20 ± 6. 50 days، respectively) (P < 0. 001 for both). Starting the first breast-feeding from mother''s breast was done more effectively in a shorter time in intervention group، too (P < 0. 001). According to reducing the gavage to oral feeding transitional time، training this simple and low-cost method to mothers can be effective in improving the quality of feeding in premature infants.

Multiple Sclerosis is the most common non - traumatic illness of central nervous system. Due to debilitating nature of the disorder, and its unpredictable progress, there is a great deal of uncertainty about the future health and well-being of MS sufferers. Therefore, this study aimed to assess the perceived uncertainty in patients with MS. This is a cross-sectional descriptive study. The study population consisted of 200 non- hospitalized patients With Multiple Sclerosis. Convenience sampling was applied in this study and data was collected via a questionnaire including background information and MUIS-Community questionnaire consisting of 23 items about uncertainty. Data analysis was performed by T-test and ANOVA test. Results showed that the most active patients (5/79%) were females and 5/67% were married. Overall mean score of uncertainty scale was 67.20 (12/35). The results related to uncertainty dimensions revealed that mean score of ambiguity was 32.24, mean score of complexity was 11.80, mean score of inconsistency was 4.79 and unpredictability was 2.78. The results related to relationship between perceived uncertainty and demographic factors show significant difference between the education level and residence with perceived uncertainty and ambiguity. Considering that MS patients experience the high levels of uncertainty that it will lead to depression and stress, therefore, with the emphasis on rigorous assessment of patient health and holding educational classes of uncertainty management especially for people with lower education level can be an effective step to reduce stress and depression in patients with Multiple Sclerosis.

Introduction and On the one hand، increasingly growth of the elderly population and on the other hand، social – economic changes، personal and family lifestyles have caused increased number of the elderly protecting centers. The aim of the present survey is to compare fear of death among the elderly settled in elderly home and inhabited in city houses of Isfahan. This study is a analytic – cross sectional study and stasistical population are all of the elderly over 60 years inhabited in 14 – fold zones of Isfahan and the ones settled in Sadeghieh elderly home. Participants in this survey were 300 elderly people that 102 people settled in the elderly home (31 males and 71 females) and 198 people inhabited in the community (97 males and 101 females). The elderly inhabited in the community were selected through cluster sampling method and the ones settled in the elderly home through available sampling method and evaluated through questionnaire of Collett-Lester Fear of Death. In order to analyze collected data، parametric statistical methods of K – Square test and independent –T have been used. The finding of this survey showed that fear of death total score mean was 70. 5 ± 15. 5 in the elderly group inhabited in houses that significantly was more than that the elderly group settled in the elderly home (p= 0. 001). Disscusion and The results of this survey showed that fear of death in the elderly group settled in city houses is higher than elderly settled in elderly’s home. It is necessary that the authorities pay more attention to the sanitary systems in all levels، evaluate the causes and، try to get the aids of the relevant organizations in order to Reduced fear of death of elderly people.

Personnel of emergency departments in hospitals have direct encounter with many events that threat their own wellbeing during daily work and may cause post-traumatic stress disorder (PTSD). In the Iranian context، there are limited numbers of studies about the prevalence of PTSD among of hospital emergency personnel. This study aimed to fulfill this goal among in hospitals affiliated to the by Kerman University of Medical Sciences، Iran. Using Mississippi Scale for Combat-related post-traumatic stress disorder (M-PTSD)، the PTSD prevalence rate of all hospitals emergency personnel (n = 321) was assessed. Data were analyzed using Kolmogorov-Smirnov، chi-square، and Pearson correlation tests. 5 personnel (2%) had slight، 235 (94%) had moderate، and 10 (5%) had severe PTSD. Mean PTSD number of hospital emergency personnel was 97. 02. Discussion and The study suggests health care managers to organize systematic and dynamic policies and procedures in order to assist personnel to deal with post-traumatic stress disorder.

Throat of a healthy person is a rich environment of microbes and after 48 hours of hospitalization in intensive patients, pharyngeal flora changes of the Gram positive to Gram negative can lead to pneumonia. Additionally patients who are undergoing mechanical ventilation through contact with the leaked bacteria from around the cuff of tracheal tube are at risk for pneumonia. To compare of the effects of routine mouthwash and mouthwash as well as suctioning with chlorhexidine 0/2% on throat bacterial colonies among patients admited to trauma intensive care units of Kerman hospitals. This study is a quasiexperimental design and began with 90 patients undergoing mechanical ventilation that had inclusion criteria. Patient were divided by random numbers table to two control and intervention groups. Mouthwash in the control group was performed every six hours by applicator dipped with 0.2% chlorhexidine solution for 7 days every 6 hours and in the intervention group in addition to the use of chlorhexidine applicator dipped with 0.2% chlorhexidine, 10 cc of 0.2% chlorhexidine solution was poured into the patient's oral cavity and pharynx and after one minute the mouth and throat were suctioned. Throat culture from the secretion of patients throat in the first day of the intervention (before) and on the seventh day (end) taken and was sent to the laboratory. Bacterial colonies from the throat of patients on the seventh day in the intervention group were lower than the control group. (p<0.0001, control group mean: 0.93 and intervention group mean: 0.04) Chlorhexidine 0.2% mouthwash and suctioning with it is more effective on throat bacterial colonies in the ICU patients.

Pre-suctioning normal saline instillation into the trachea is a traditional nursing intervention. In this line, the present study has been carried out to “evaluate the effect of endotracheal suctioning with and without normal saline solution on heart rate and oxygen saturation”.

This semi-experimental study with crossover design was conducted on 50 trauma patients admitted to critical care unit of Shahid Bahonar Hospital of Kerman in 2010. For each patient, suctioning was performed once without and once with 5ml normal saline solution. Heart rate and oxygen saturation were measured and recorded at one, two and five minutes before and after suctioning by standard monitoring apparatus. Data were analyzed by SPSS17 statistical software using independent and paired t-tests.

Heart rate was increased in both groups after the suctioning; however, it was slightly more in group receiving normal saline but not statistically significant. Negative changes in oxygen saturation were higher in saline group compared to the other (p<0.05).

Normal saline instillation prior to suctioning will be accompanied by reduced oxygen saturation, and it is recommended that more suitable approaches, such as moisturizing the inhaled gas, be used for diluting secretions to minimize the related side effects.

Backgrounds & Critically ill patients are high risk for pressure ulcers. Successful prevention of pressure ulcers requires that caregivers have adequate knowledge of this complication. This study was conducted to determine intensive care nurses knowledge about pressure ulcers in Zahedan and Kerman. In this cross sectional study that was conducted in Zahedan and Kerman, we surveyed 126 intensive care nurses‚ knowledge about pressure ulcers with use of Pieper’s Pressure Ulcer Knowledge Test (PUKT). This questionnaire had 41 items and assessed nurses’ knowledge about pressure ulcers in three categories including: sore classification/onset, wound characteristics and preventive measures. According to this questionnaire participants were expected to give 90% or more of correct answers for knowledge to be considered adequate. Data were analyzed whit descriptive, Pierson correlation test and chi square tests. Rate of correct answer by nurses was 67.52%. no relationship was found between sex and nurses‚ experience with level of knowledge about pressure ulcer. Results showed that level of knowledge about pressure ulcers among intensive care nurses was insufficient. And there is much need to improve their knowledge with educational programs.

When nurses can positive attitude to death and care of people dying to have a relationship with the humanitarian community to have people. Nurses in palliative care due to the success of their relationship with all patients, their willingness and interest to a dying patient can be. This study was aimed to determine attitudes of Iranian nurses toward caring for dying patients.In this descriptive analytic attitude Cancer Society and the hospital nurses, but Tehran age to the care of dying patients in 2007 using two questionnaires (DAP-R), (FATCOD) and examined demographic was. Questionnaires to 120 hospital nurses, but Cancer Center that evening and were introduced by the supervisors were given. 98% had answered questions in the questionnaire. Data analysis was performed by spss software. Data analysis using descriptive analysis techniques (frequency, mean and standard deviation) and inferential (Pearson) were performed. Most respondent's to death as a natural part of life and a way to achieve life after death were noted. Most nurses tend to take care of dying patients and emotional support from their families were but they did not like about death with patients or their family speak or give them training in this area. Many nurses did not like the patients or their families decide be willing to engage patients and their families in care. Personal look at nurses as their personal experiences influence their attitudes toward death and care of dying patients can be Lack of education and experience plus career and cultural constraints, creating a negative attitude towards death, the study nurses and care of dying patients were involved. Appears to be that nurses can create an interactive environment, their feelings about death and dying can express effective way to identify influential factors in nurses interacting with patients are dying. Continuing education for nurses in palliative care to improve the quality end of life care is needed by.

Finally the event of death of every human face is. But the nurses every day who witnessed the death of patients spend their final days of their lives. Nursing students also involved in the care of patients end their lives are the days spend will be involved. Attitude toward death is one of the most important factors on behavior related to health care professionals affects. To compare the attitude towards Kerman and Bam to death and care of dying patientsIn this cross - sectional study of Kerman and Bam attitude toward death and care of dying patients, using two questionnaires DAP-R (revised attitude towards death) and FATCOD (fromelot attitudes toward care dying patients) were studied. All questionnaires were collected. 98% of questions were answered. Data analysis was performed with SPSS software. Data analysis using descriptive analysis techniques (frequency, mean and standard deviation) and inferential (Pearson) were performed. Nursing students Bam death in January 2003 had the experience to nursing students near Kerman view that the death had not the fear of death were lower. In both groups of students about death and dying were trained compared to untrained students had more positive attitudes towards death were. Results showed that Bam and Kerman attitude towards care of dying patients is different. Although they live in a province and have similar cultures, this study suggests that palliative care education curriculum in nursing students be put to work quality of nurses even in the final days of life of patients will improve.