فهرست مطالب محمدعلی یادگاری

Background and Aim:

 Cardiovascular complications in diabetes mellitus are one of the most common complications of this disease. The aim of this study was to determine the cumulative probability of occurrence of cardiac complications in type 2 diabetes mellitus using survival analysis in patients referring to the Diabetes Clinic, Bu-Ali Hospital, Zahedan, Iran.

This was a descriptive and analytical historical cohort study using the survival analysis method in 2020 on 410 patients referring to the Diabetes Clinic, Bu-Ali Hospital, Zahedan, Iran. Data were collected and analyzed using the SPSS-v21 software, the statistical tests being descriptive tests, followed by the Kaplan-Meier method and the Cox proportional hazards model of survival.

The results of this study showed that 122 individuals (29.7%) of the diabetic patients had cardiac complications. The median survival time (in months) of the occurrence of cardiac complications was found to be related to fasting and two-hour postprandial blood sugar levels (p<0.05). Further analysis of the data showed that two variables, namely fasting blood sugar and regular visits, remained in the final model of the multiple Cox regression.

The findings of this study showed that the cardiac complications of diabetes in the population studies are relatively high. Therefore, it is essential to plan and implement interventions aiming to change lifestyle and control regularly blood pressure, cholesterol and blood sugar in the patients in order to prevent the disease

Diabetes is a common disease that causes eye complications and leads to vision loss and blindness. Diabetic retinopathy is one of the main causes of blindness in the world and the most common cause of new cases of blindness. Predicting the occurrence time of this complication in diabetic people is one of the health priorities of society. The purpose of this study was to determine the cumulative probability of the occurrence of type II diabetes retinopathy using survival analysis in Zahedan City, Iran.

This was a historical cohort study using the survival analysis method, which was carried out descriptively and analytically on 410 patients in 2019. Data were calculated using SPSS22 software and descriptive tests, followed by the Kaplan-Meier method and the Cox proportional hazards model of survival.

The results of this study showed that 103 (25.13%) patients had retinopathy. The median survival time (months) of the occurrence of cardiac complications was related to marital status, fasting blood sugar, smoking, hemoglobin A1c, and blood lipids (P<0.05). The variables of fasting blood sugar, A1c, and two-hour blood glucose remained in the final model of the multiple Cox regression.

The findings of the current research showed that the prevalence of retinopathy in the studied population was relatively high and had a significant effect on reducing survival time. Therefore, it is necessary to make interventions in lifestyle changes, and regular control of blood pressure, cholesterol, and blood sugar to prevent the disease and reduce complications related to diabetes

Social networks have become an integral part of most people's lives, exerting influence across all aspects of human existence. During the COVID-19 pandemic, virtual networks played a significant role in informing, educating and disseminating news related to the disease. Therefore, the aim of this research is to explain the role of virtual networks in adhering to COVID-19 health protocols.

Methods & Materials: 

This is a qualitative study that was conducted using the content analysis method. Fourteen participants were included in the study by purposive sampling. Data collection was carried out via semi-structured interviews. The data analysis procedure adhered to the method outlined by Graneheim and Lundman (2004).

From the analysis of the interviews, three main categories and eight subcategories were identified, including "facilitating knowledge sharing", "information screening" and "behavior shaping".

The study findings explained the role of virtual networks in adhering to health protocols. These findings can be used as a basis for designing preventive health programs.

Regarding the position of ethical principles in professions such as nursing, which provides care services and is related to the patient health, the need to address the nursing students' moral reasoning ability and its improvement, which leads to making ethical decisions in clinical situations, is revealed. Therefore, the present study aimed to compare the ethical reasoning ability of undergraduate and graduate nursing students of Zanjan University of Medical Sciences.

This was a descriptive -analytical study that was conducted at Zanjan University of Medical Sciences. The participants included 87 undergraduate nursing students and 46 master's students in nursing at Zanjan University of Medical Sciences who were selected by census sampling. The data was collected using the demographic characteristics questionnaire and the nursing dilemmas test (NDT). Descriptive statistics (number, percent, mean, standard deviation, and descriptive tables) and inferential statistics (t student, ANOVA, and Pearson correlation coefficient) were used regarding data analysis. Data was analyzed using SPSS Ver.16

The average ethical reasoning score of nursing master's students were 43.6±4.1 and undergraduate students was 40.6±5.1 and there is a significant difference between the moral reasoning of nursing undergraduate students and nursing master's students. It was also found that there is no significant relationship between the individual-social characteristics and the ethical reasoning ability of nursing students.

Findings showed that the moral reasoning ability of nursing master's students is higher compared to undergraduate students. The worrying finding is that the nursing students are not at the appropriate level of ethical reasoning. Nursing education policymakers should increase the ethical reasoning ability of nursing students in the field of solving ethical dilemmas by providing appropriate educational programs, including holding clinical ethics workshops in clinical environments, taking advantage of the experiences of experienced nurses, and using prominent ethics professors.

Prehypertension is a warning sign in young people since it is an indicator of the risk of hypertension in adulthood. This study aimed to determine the prevalence of hypertension and prehypertension, as well as their related factors, among health, medical and administrative staff in Birjand, Iran.

This is a descriptive-analytical cross-sectional study carried out on 1,180 health and administrative staff under 40 years old. Data were collected through a standard World Health Organization STEP questionnaire, measuring blood pressure, as well as height and weight, by the researcher and trained interviewers. To ensure the accuracy of the measurement, the employees with hypertension and prehypertension were re-evaluated according to the JNC7 criteria two weeks later. The data were analyzed using t-test, One-Way ANOVA, Chi-square, and logistic regression in the SPSS software (version 20).

The prevalence of hypertension and prehypertension was 5.3% and 34.2%, respectively. The mean for systolic blood pressure was 114.2±11.03 mmHg. Based on logistic regression analysis, age, gender, workplace, and family history had a significant relationship with hypertension, while body mass index and socioeconomic status had a significant relationship with prehypertension (P<0.05).

This study showed that a significant percentage of employees at young ages had prehypertension; however, they were unaware of their disease due to a lack of screening and that they were asymptomatic. Therefore, this group should benefit from intervention programs to prevent and control high blood pressure among them. The findings also suggest that this issue should be considered more seriously in the staff of other departments, compared to the medical staff. Moreover, the findings indicated that obesity can also play a role in prehypertension.

Motivation is essential for increasing the quality of nursing education. This study aims to review published evidence on management of classrooms for unmotivated students.
An integrative review of evidence based on Broom protocol was conducted in three stages; literature search, data evaluation and data analysis. Databases of SID, Magiran, IranMedex, Irandoc, MEDLINE, EMBASE, EBSCO and CINAHL were all searched. The searched key words were classroom management, unmotivated, students, management style in classroom and instructional skill. Of 1464 full texts and abstracts identified 43 articles were chosen based on inclusion criteria. For data analysis, data extracted from primary sources, after comparing one by one, data were integrated, ordered, categorized and summarized.
there are variety of challenges and solutions for classroom management to boost student's motivation, which categorized in three themes: use of modern teaching methods, improve the learning environment and improve interaction and communication.
A new instructional strategy should be used for the improvement of classroom management to motivate unmotivated students.

The essence of nursing is protecting the public and nursing profession believes that receiving high quality and safe services, is the community’s right. During the past decades nursing has been considered as a significant profession with characteristics such as autonomy, professional commitment, expertise and responsiveness (1). The body of contemporary nursing is consisted of knowledge and skills, value system, academic education and professional socialization. Autonomy has been defined as nurse’s capacity for determining their action through independent choosing in all the fields of nursing practice and self-regulatory in nursing practice is necessary for achieving professional freedom of action (2).
Professional self-regulatory is the decision-making power for determining the inclusion criteria for the members to enter the profession and start their activity in that profession. It will determine who, with what specialties and how much knowledge and skills have the inclusion criteria for the profession (3).

Having no adherence to medication regimen in patients suffering from Epilepsy is lead to an increased mortality rate in these patients. The present study evaluated the effect of educational program on drugs self-management in patient with epilepsy. This study was a randomized clinical trial with control group. The samples (n=60) were selected from the neurology clinic of Valiasr hospital in Zanjan. The patients were randomly assigned into the intervention (n=30) and the control (n=30) groups. The intervention group received four educational sessions with the two stages of continuous care model that including epilepsy and self-management plan. All patients completed the epilepsy self-management scale pre intervention and one month post intervention. There was no statistically significant difference in demographic characteristics and drugs self-management scores between two groups. After intervention; there were a Significant statistical difference between the epilepsy drug self-management scores in intervention and control groups (p<0.001) and the intervention group showed an increase in their drug self-management. Nurses can increase the drug self-management of epileptic patients by using the simple and inexpensive technique of group education and thus avoid from many problems of these patients and help to improve their health.

Background and Growth disorders in children are important amongst health issues resulting in serious complications. The aim of this case-control study was to determine factors related to growth disorders in 6 month to 2-year old children using multiple regression analysis. In this study 150 children with growth problems as cases, and 200 children with desirable growth as controls were randomly selected from ten primary health care centers. A questionnaire regarding demographic characteristics, fertility history and nutritional status was completed through face-to-face interview with selected children’s mother. The influence of different factors on undesirable growth was evaluated using multiple logistic regression in SPSS and Stata. The results indicated a significant correlation in type of pregnancy (wanted or unwanted) (OR= 2.58), mother’s age (<20) (OR= 1.52), number of pregnancies (OR= 2.7), gestational age (preterm) (OR= 3.8), breast feeding (OR= 3.3), type of labor (OR= 2.4), multiple pregnancies (OR= 2.02), low socioeconomic status (SES) (OR= 1.68), and conflicts in the family as a proxy of stress (OR= 1.66) with growth problems (P<0.05). Also, some variables such as conflicts in the family, type of pregnancy, birth weight and breast feeding, number of pregnancies and type of labor showed interactional influences. This study showed that some factors are highly associated with growth disorders among which some could predict the growth problems. Parental training on nutritional requirements of children, suitable time of pregnancy, supporting poor people and decreasing stress are recommended to enhance the health of children.

Family violence is an aggressive behavior happening among some couples. According to WHO reports، familial violence against women is a health priority and has many complications. This study investigated the physical، mental and sexual violence exposure among the married women in reproductive age in Zahedan، Iran. This cross sectional study carried out on 354 married women living in Zahedan city in 2009. The data was collected through interview and by using a valid and reliable questionnaire. At first، the subjects were categorized based on violence exposure level، and then the data were analyzed using descriptive statistic and chi square test. P-value<0. 05 was considered statistically significant. The results showed that the exposure prevalence with physical، mental and sexual violence was 5. 4%، 20. 9% and 9. 7%، respectively. The educational level of husband، number of children and age of marriage were related to all three types of violence (P<0. 04) and ethnicity، educational level and husband''s job were related to physical and mental violence (P<0. 05). Additionally، mental and sexual violence were associate with monthly income of family (P<0. 05). It seems that violence exposure among Zahedanian women is more than expected. That is probably due to low Socio-economic statues and illiteracy

Physical, psychological and social problem along with significant changes in life style, diminish stoma patients quality of life. At the meanwhile self-efficacy can improve these patients’ quality of life. The aim of this study was to assess the relationship between self-efficacy and quality of life in Ostomates. In this descriptive cross-sectional study, 84 Ostomates who referred to selected educational centers of Tehran University of Medical Sciences and Iranian Ostomy Society (IOS) were recruited by census. The data were collected with City of Hope Quality of Life–Ostomy Questionnaire (COH-QOL) and Stoma Self-efficacy Scale (Stoma SE Scale) and then analyzed using independent t-test, analysis of variance and regression analysis by SPSS-PC (v. 15). The half of patients, achieved 50-75% of overall self-efficacy score (84-112). The mean score of stoma care-self-efficacy (55.8 ± 11.6) was more than the mean score of social-self-efficacy (42.1 ± 13.2). Moreover, most of patients were scored 7(of 10) and above for overall quality of life and its dimensions. The mean range of quality of life scores in different domains varied from 6 ± 2 for social dimension to 7 ± 1.5 for physical dimension. a significant positive association were found between self-efficacy and physical (P=0.00, r=0.485) psychological (P=0. 00, r=0.655), social (P=0.000, r=0.694) and spiritual (P=0.00, r=0.393) dimensions and also with overall quality of life (P=0.00, r=0.687). Also the highest correlation was found between quality of life and social self-efficacy subscale (β=0.695, P=0.000). With regard to the significant correlation between self-efficacy and different dimensions of Ostomates’ quality of life in this study, it is suggested that nurses design and execute appropriate interventions to promote these patients’ self-efficacy, especially in social dimension which had the highest association with their quality of life and in this way help to improve these patients’ quality of life.