نسرین الهی

Osteoarthritis (OA) is the most common joint disorder in adults, which gradually reduces the joints and increases the pain, leading to disability in daily activities. The purpose of the study is to determine the effectiveness of self-care training in a combined method on the nature of pain and daily activities of patients with knee osteoarthritis.

In this semi-experimental study, 70 patients with osteoarthritis of the knee referred to the Orthopedic and Rheumatology Clinic in Ahvaz were randomly divided into two self-care training groups using a combined method and a control group based on the inclusion criteria. The control group received self-care training in the usual way. In the test group, self-care training was conducted by a combined method (film, lecture, use of pamphlets, SMS) during 5 sessions in groups and individually. The research samples were followed up in person and by phone for three months. The data of the study were completed by using three questionnaires on the nature of Mag Gill pain, pain intensity VAS and WOMAC daily activity before, during one month, two months, and three months after the intervention. The results of the study were analyzed using SPSS 23 software and using descriptive and inferential statistical tests.

Self-care training in a combined method caused a significant decrease in the intensity of pain in the intervention group compared to the control group (P=0.001). Daily activity showed a significant difference between the two intervention and control groups (P=0.001), which indicates improvement in activity in the intervention group. However, there was no significant change in the nature of pain after the intervention compared to before (P=0.01).

According to the results of the research, combined training can be used for self-care and disease management to improve and modify the lifestyle, and improve the health and performance of patients.

 Clinical education plays an important role in achieving clinical competence of nursing students. One of the parameters of the clinical environment that seems to help in achieving the goals of internships is moral intelligence. The current research aims to determine the relationship between moral intelligence and clinical competence in nursing students in Khuzestan province 2019.

 This practical study was conducted in 2019 with the participation of nursing students in Khuzestan province. The method of data collection and analysis is descriptive and correlational. The sample size was estimated to be 321 people based on Morgan's table, which by removing distorted information. The number of 299 people was calculated. The sampling method is random-stratified and the data collection tool is the moral intelligence standard questionnaire and the nursing clinical competence questionnaire in the clinical period. Data were analyzed using Pearson's correlation coefficient.

 The findings showed that students have an average status in terms of honesty, responsibility, forgiveness and compassion. Also, there is a positive and significant relationship between moral intelligence and clinical competence (P<0.001, r=0.602). All dimensions of moral intelligence had a positive and significant relationship with clinical competence (P<0.001).

 Due to the fact that moral intelligence is acquired and related to clinical competence, trainings that lead to the growth of students' moral intelligence can increase clinical competence and ultimately raise the academic level of the university.
Keywords: moral intelligence, clinical competency, nursing, student.

Hospitalization of patients in Intensive Care Units (ICU) often causes anxiety and psychological problems in family members. The aim of this study was to determine the effect of communication skills training to nurses on the anxiety in family members of patients admitted to ICUs.

This semi-experimental study was performed in the ICU of Golestan Hospital in Ahvaz in 2017.The population consisted of nurses and family members of patients of admitted to internal and neurology ICU. Internal ICU and neurology departments were randomly divided into two groups. The nurses of the internal ICU department were in the intervention group and the nurses of the neurology department were in the control group. Fifty-five family members of patients from each department were selected through convenience sampling method. A communication skills training workshop was held for the nurses of the intervention group in three consecutive days. Family members’ anxiety was evaluated using Spielberger's State-Trait Anxiety Inventory the day of admission and the sixth day of hospitalization.

The results showed that there was no significant difference between the average anxiety scores of the intervention and control groups before the intervention (P=0.38), but there was a statistically significant difference between the average anxiety scores of the intervention and control groups after the intervention (P<0.001). The results showed that there is a significant difference between the average anxiety scores of the intervention group before and after the intervention (P<0.001), but in the control group, there was no statistically significant difference between the average anxiety scores before and after the intervention (P=0.61).

Based on the findings of the present study, communication skills training for nurses reduced the anxiety of patients' family members. Moreover, since the favorable mental state of families has a significant effect on caring for the patient, the use of this method is recommended as an effective strategy in supporting patients' families.

Nasogastric tube (NGT) insertion in anesthetized patients and in patients with depressed levels of consciousness is a challenging process with a high rate of failure. Therefore, the current parallel clinical trial study was conducted with the aim of investigating the effect of the lateral position on the success rate of nasogastric tube insertion in patients with low level of consciousness.

The current study type was a randomized clinical trial in which 170 patients with low level of consciousness and admitted to intensive care and general departments of Ganjavian Hospital in Dezful city were randomly selected and divided into two groups using permutation blocks of six according to the inclusion criteria. Control (85) and intervention (85) were allocated. The data collection tools included demographic and medical information forms and checklists. SPSS version 16 was used for data analysis.

The results show that the duration of tube placement in the intervention group was 64.63 seconds and in the control group was 99.80 seconds, the most common complication is gag reflex in the intervention group 35.30% and in the control group 52.94% The placement of the first time in the intervention group was 63.53% and in the control group was 30.59%. Complications duringtube placement (P=0.002), time spent (P<0.0001), number of attempts to succeed in tube placement (P<0.0001) in the intervention group significantly less than the group Was in control. In general, the success rate of tube placement in the intervention group was significantly higher than the control group (P=0.001).

According to the findings of the present, using lateral position for NGT insertion in patients with depressed level of consciousness is recommended to the treatment team, especially nurses because this method reduces the complications and the number of attempts to achieve successful intubation, in addition to increasing the success rate and saving nurses’ time

Clinical competence is one of the main goals of nurses' training which has a significant role on the quality of patient care. Therefore, identifying the related components can be effective in improving the quality of care. Spiritual health has also been considered as an important factor in the efficiency and success of nurses.The aim of this study was to determine the relationship between spiritual health and clinical competence of nurses working in teaching hospitals of Ahvaz Jundishapur University of Medical Sciences (2017).

Methods & Materials:

This descriptive-correlational study was performed with the participation of 165 nurses in teaching hospitals of Ahvaz by multi-stage sampling method in 2017. Data collection tools included a questionnaire of demographic characteristics, clinical competence and spiritual health. Data were analyzed using descriptive and inferential statistics in SPSS 22 statistical software.

The results showed that the level of clinical competence and spiritual health of the nurses was moderate. The results of Pearson correlation test showed that there is a significant and positive correlation between spiritual health and clinical competence of nurses (r=0.176, P=0.023) .Also, the field of quality assurance had the lowest average score and the field of education and management had the highest average score of clinical competence.

Considering the significant relationship between spiritual health and clinical competence of nurses, it is necessary to design appropriate educational programs for nurses' empowerment and in order to promote spiritual health and clinical competence of nurses.

Reflection is one of the basic methods of education that is effective in raising the level of awareness and skills in clinical situations. The aim of this study was to investigate the effect of family nursing education using reflection method with the help of situation simulation through video screening on learning and perspective of nursing students.

This quasi-experimental study was performed with the participation of 144 nursing students. Basic content was presented in the first sessions. Students were divided into groups of four. In the intervention group, family nursing education was performed with the help of situation simulation through film screening and in the control group, traditional education was conducted through lectures and questions and answers. To evaluate the results, a survey and comparison of scores of the two groups were used. Data were analyzed using SPSS software version 20.

There was a statistically significant difference in the mean score of the final exam between the two groups of family nursing education with the help of situation simulation through film screening and the traditional education group through lectures(p<0.05). From the perspective of nursing students, rethinking method on practical and effective learning, increasing job knowledge, increasing the opportunity to provide appropriate feedback from the teacher and reducing errors in the real environment, increasing knowledge of crisis and vulnerable families and removing barriers to home visits in terms of Legal and cultural issues had a greater impact.

Design and implementation of family nursing education through reflection method, promoting students' learning and perspective. By simulating the situation with the help of film screening, students' understanding of the situation of vulnerable families can be improved. Students take a deeper look at family problems, which can increase their ability and responsibility to solve family-centered problems in the future. Therefore, this educational method is recommended for use to managers and lesson planners.

Self-care and self-management, as two effective strategies play an effective role in controlling pain and quality of life. Therefore, considering the characteristics and dimensions of these two concepts, this study aimed to compare the effect of self-care education and pain self-management on the nature of pain and quality of life in patients with sickle cell disease.

 In this clinical trial study, 75 patients with sickle cell disease, referred to the thalassemia clinic of Baqaei hospital 2 in Ahvaz and Shahid Beheshti hospital in Abadan, were selected and randomly divided into three groups of 25 people (self-care, pain self-management and control groups). The two intervention groups (self-care and pain self-management) were divided into groups of five people, and received specific training during four sessions for three months. The nature of pain and quality of life of patients were assessed four times (before the intervention, one month, two months and three months after the intervention) using the McGill Pain Questionnaire and Quality of Life Questionnaire. The SPSS software version 22 was used to analyze the data.

The results showed that pain self-management and self-care programs were effective in improving the quality of life and pain of patients with sickle cell. However, there was no statistically significant difference between the two intervention groups in the nature of pain and quality of life.

Self-care and pain self-management have similar effects on reducing patients’ pain and improving their quality of life.

Assessing professional commitment and the teaching-learning process of faculty members requires valid tool that appropriate to the prevailing culture. The aim was to design and validate a questionnaire to assess the ability of faculty members of the University of Medical Sciences.

This methodological study was conducted in 2018 in Ahvaz Jundishapur University of Medical Sciences. First, the concept of empowering faculty members was explained using content analysis method. For building the tools, the results of the literature review, measurement tools and interviews were extracted and appropriate phrases were developed that covered the various dimensions of the concept. To determine the validity of the questionnaire, face validity, content and structure were used. The exploratory factor analysis was used to determine the underlying structure of the questionnaire and KOM index and Bartlett test were used to assess the adequacy of the number of samples and the appropriateness of the analysis to identify the structure, respectively. 210 students and 20 faculty members were randomly selected and participated in the study.

Sixty-eighth items were approved by experts and stakeholders. In the process of validity and reliability assessment number of items were reduced to 41. The ratio and content validity index were 0.79 and 0.92, respectively. Validity by exploratory factor analysis was performed. Exploratory factor analysis suggested a six-factor model items including: comprehensive performance in teaching, educational responsibilities, empowering evaluation, professional cooperation and communication, research performance, and management-professional activities. These six factors explained 75% of variance empowerment of faculty. Therefore, internal consistency and test-retest method were used to determine the reliability of instrument (α=0.94), (ICC=0.992).

The present study showed that the researcher-made questionnaire has good validity and reliability and can be used to measure the ability of faculty members of medical universities.

Evaluation is an essential element of any training program that can guide training from a static to a dynamic process. It depends on the evaluation method that leads to the quality of the learning outcomes. This study aimed to determine the effect of structured objective evaluation of clinical skills on anxiety, satisfaction, and performance of nursing students in the course of health assessment

This quasi-experimental study of two post-test groups was performed on 100 nursing students of Ahvaz Jundishapur University of Medical Sciences in 2017-2018 with an available sampling method in two semesters. The control group was 52 people and the experimental group was 48 people. The routine evaluation was performed in the control group and the OSATS method in the experimental group. Data collection tools included the Satisfaction Questionnaire, Spielberger Anxiety, and Performance Score. By SPSS20 and independent and Chi-square and Mann-Whitney t-tests were used to analyze the collected data.

Mean scores of the control group; Performance (14.02 ± 2.4), anxiety (46.35 ± 0.05) and satisfaction (17.67 ± 3.8) and in the experimental group the average performance score (14.02 ± 06, anxiety (43.8±6.45) and satisfaction (18.68 ± 18) was obtained. Statistical tests also showed a statistically significant difference in performance scores (P = 0.001) and anxiety (P = 0.047) between the two groups, but no significant difference was observed in satisfaction scores (P = 0.237).

Conclusion:

 Due to the importance of assessing the patient's health status in determining nursing diagnoses and providing optimal care and effectiveness of OSATES evaluation method on the performance and anxiety of nursing students, it is recommended to use this method in evaluating students' practical skills.

Evaluating clinical performance of nursing students as a resource to determine educational needs and decision-making is essential to change the educational environment and improve the quality of education. The aim of this study was to evaluate the professional behavior of nursing students in the clinical environment with the Small Scale Professional Assessment Tool (P-MEX). This descriptive cross-sectional study was conducted with the participation of 86 nursing interns of Ahvaz University of Medical Sciences in 2019. Data collection tools were demographic information questionnaire and P-MEX Cruess evaluation form. The validity and reliability of this instrument was evaluated by observers and was determined with Cronbachchr('39')s alpha coefficient of 76%. Data were analyzed using SPSS software version 20 and descriptive statistics, independent t-test, analysis of variance, and post hoc test. In professional skills, most participants in the first stage were 51.2% at the average and expected level and 48.8% above the expected level, and in the second stage, most were 84.9% at the average and expected level and 15.1% higher than they were as expected. In this study, based on the evaluation scores in two stages, although the average total clinical skills scores of most students were within the expected range of the 4-point Likert scale, the skill scores were lower in the special wards. Therefore, for the full development of professional skills, it is necessary to develop appropriate methods of planning and training in the field of professional behaviors.

health literacy can be defined as the ability to read, understand, and act according to health guidelines. Today insufficient health literacy is considered a global threat. Health literacy is an important issue for policy makers in enhancing health level of society and service quality in hospitals. Performance health literacy during patient's interaction with healthcare providers play an important role. The aim of this study was to investigate health literary level of patients hospitalized in Shustar and its determinants.

in this descriptive survey a sample of 280 patients hospitalized in Shustar's hospitals were chosen by convenience sampling. For obtaining performance, performance health literacy for adults questionnaire was used after modification and validation. Data was obtained by standardized test of performance health literacy for adults. Present data has been analyzed by independent t-test, one-way analysis of variance, Pearson correlation test, and SPSS v. 21.

findings showed a nearly average level of health literacy in calculation and reading comprehension in patients. Most surveyed patients had insufficient and marginal health literacy. Statistically, there were no significant difference in health literacy level between men and women, while significant differences were found between health literacy and variables like age, income, education level, and habitat neighborhood.

The results revealed that health literacy level of surveyed patients is not sufficient. This suggests a need to consider health literacy in health enhancement planning. Therefore major steps in developing skills and enhancing health literacy can be taken by providing easy-to-read educating materials and efficient educational participation.

To meet the growing and emerging new health needs, it is essential that nurses develop scope of their practices from hospital to community and be prepared for entrepreneurship roles in care different levels. Strong incentives are required to choose entrepreneurial career paths, risk-taking, tolerance for ambiguity and deal with a variety of obstacles.

The purpose of this study was to explore and describe the perception of Iranian nurse entrepreneurs from entrepreneurship motivators.

A qualitative design using a content analysis approach Graneheim and Lundman's (2004) was applied for data gathering and analysis in 2013-2014. In this study thirteen nurse entrepreneurs were selected through purposive sampling. Unstructured interviews were conducted to collect data.

The data analysis resulted in five main themes: professional promotion, social advantages, spiritual achievement, financial achievement and employment.

The findings shows that nurses to engage in nursing entrepreneurship need higher motivations such as professional promotion, social advantages and spiritual achievement. The findings can be used for tendency to nursing entrepreneurship in nurses and nursing students.