مقالات رزومه:
دکتر میترا ذوالفقاری
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مقدمه
ویژگی اصلی و اساسی آموزش الکترونیکی، علاوه بر دسترسی آسان به اطلاعات، ویژگی ارتباطی و تعاملی آن است. بدون برقراری تعامل، یادگیرندگان انگیزه ای برای ادامه دوره در خود نمی بینند و یادگیری به وقوع نمی پیوندد. این پژوهش با هدف شناسایی موانع تعامل در یادگیری الکترونیکی و ارایه راهکارهای ایجاد و بهبود تعاملات از دیدگاه اساتید و دانشجویان رشته های مجازی دانشگاه علوم پزشکی تهران انجام شد.
روش هادر این مطالعه ی کیفی با روش تحلیل محتوا، 22 نفر مشارکت کننده از طریق نمونه گیری هدفمند تا رسیدن به اشباع اطلاعات، از میان استادان و دانشجویان دانشکده مجازی دانشگاه علوم پزشکی تهران انتخاب شدند. داده ها از طریق مصاحبه نیمه ساختار یافته عمیق گردآوری و تحلیل داده ها (با رویکرد قراردادی) براساس مدل گرانهایم و لاندمن(Granheim and Lundman) سال 2020، انجام شد. اطمینان از صحت و استحکام پژوهش با استفاده از معیارهای لینکلن و گوبا (Lincoln and Guba) انجام گرفت.
نتایجیافته های حاصل از موانع در 6 طبقه ی اصلی: فرآیند ناقص ارایه ی آموزش، موانع انگیزشی و نگرشی، موانع زیرساختی، چارچوب های فردی، ضعف در گستره ی دانش و شناخت و برنامه ریزی و سیاست گذاری ناقص ساختاری و 16 طبقه ی فرعی قرار گرفت. از میان گزاره های مربوط به موانع بیشترین تاثیر از دیدگاه پاسخ دهندگان مربوط به فرآیند ناقص ارایه ی آموزش بود. بعد از آن موانع انگیزشی و نگرشی، موانع زیرساختی، چارچوب های فردی، ضعف در گستره ی دانش و شناخت و در نهایت برنامه ریزی و سیاست گذاری ناقص ساختاری توسط افراد صاحبنظر ارایه شد.
نتیجه گیرینتایج این مطالعه موانع تعامل در یادگیری الکترونیکی را از دیدگاه اساتید و دانشجویان تبیین نمود. شناخت این موانع در جهت برطرف کردن آن با هدف ایجاد و توسعه تعامل در یادگیری الکترونیکی، کمک کننده خواهد بود. تقویت تعامل در آموزش های مجازی با هدف تسهیل یادگیری قویا پیشنهاد می گردد.
کلید واژگان: یادگیری الکترونیکی, تعامل, موانع, راهکارها, آموزش مجازیIntroductionCommunication and interaction are the main features of e-learning. Without interaction, students cannot be motivated to continue the course which undermines their learning. This study endeavored to identify barriers to interaction in e-learning and providing solutions for creating and improving interactions from the point of view of professors and students of virtual fields at Tehran University of Medical Sciences.
MethodsTo identify barriers and strategies for creating and improving interaction in the e-learning, qualitative study with qualitative content analysis method was employed. Twenty-two participants with maximum diversity were selected from faculty and students through purposive sampling with theoretical approach, sequential and gradual method until data saturation. To analyze in-depth semi-structured interviews, a commitment approach of Granheim and Lundman model was used in 2020. The accuracy and robustness of the research was confirmed through Lincoln and Guba criteria.
ResultsAccording to faculty members and student’s point of view the barriers were divided to 6 main categories which related to the incomplete educational process, motivational and attitudinal barriers, infrastructure barriers, individual frameworks, weakness of the knowledge and cognition incomplete structural planning and policy as well as 16 sub-categories.
ConclusionAs to the barriers, the most influential were related to the incomplete educational process, after that related to motivational and attitudinal barriers, infrastructure barriers, individual frameworks, weakness of the knowledge and cognition and incomplete structural planning and policy. The results of this study help educators, educational administrators and curriculum planners, professors and students in the field of e-learning to remove existing barriers and develop interaction in e-learning.
Keywords: Learning, E-Learning, Interaction, Barriers, Strategies -
این مطالعه با هدف تبیین تجربه دانشگاه علوم پزشکی تهران در ارایه آموزش مجازی در طی دوران بحران کووید-19 انجام شد. فرایند اجرای آموزش مجازی در دانشگاه علوم پزشکی تهران با روش اقدام پژوهی و با رویکرد مشارکتی در پنج مرحله که به ترتیب شامل تجزیه و تحلیل موقعیت، برنامه ریزی، توسعه، اجرا و ارزشیابی نتایج حاصل است انجام گرفت. بر اساس نتایج از اقدامات ضروری در ارایه اثربخش تدریس مجازی در شرایط همه گیری کووید-19، برگزاری دوره های آموزشی توانمندسازی اساتید و دانشجویان، برنامه ریزی برای تهیه زیر ساخت های مورد نیاز برای ارایه آموزش مجازی، تدوین و اجرا سیستم حمایتی-پشتیبانی و انگیزشی، و ارزشیابی و پایش کیفیت برنامه های آموزش مجازی است. با توجه به آنکه فرایند آموزش پزشکی در نتیجه بروز بحران کووید-19 با تغییراتی مواجه شده است، پیشنهاد می شود تا دانشگاه های مختلف علوم پزشکی به عوامل زیر بنایی تاثیرگذار در دستیابی به کیفیت آموزش مجازی توجه نمایند.
کلید واژگان: مجازی, آموزش, کووید-19 -
Introduction
Endotracheal intubation, as one of the most important methods of airway management, is of great importance and can lead to saving the patient's life. Hence, the training of this skill is highly considered. The present study aimed to design an educational simulator software in this field and to determine its impact on improving the performance of undergraduate students of anesthesia in Tehran University of Medical Sciences.
MethodsIn this experimental study, 17 undergraduate anesthesia students were selected from Tehran University of Medical Sciences in the second semester of 96-97 (2017-18) and randomly divided into control and intervention groups. The control group was evaluated without any intervention, while the intervention group was evaluated after receiving the simulated content and its reviewing several times in the skill lab. The data were collected by a demographic questionnaire and a validated and relied evaluation checklist. The scores of both groups were evaluated using the SPSS-22 software, descriptive statistics (absolute and relative frequency, mean and standard deviation), and t-test, in order to determine the effectiveness of the simulator in improving the performance of anesthesia students in this regard.
ResultsThe results indicated that the average score of students' performance in patient preparation for intubation was (22.22±10.17) and (36.75±6.78) in the control and intervention groups, respectively, indicating a significant difference (P=0.004). In addition, the average score of students' performance in laryngoscopy skill was (24.09±9.02) and (41.16±12.1) in the control and intervention groups, respectively, which was a significant difference (P=0.008). Finally, the average total score of students' performance in patient preparation for intubation and improvement of laryngoscopy skill was (48.67±20.09) and (78.50±17.78) in the control and intervention groups, respectively, indicating a significant difference (P=0.006).
ConclusionBased on the results, the use of computer-based simulator could improve students' performance in patient preparation for intubation and improvement of laryngoscopy skill by up to 50%. Therefore, this method can be used as a complementary training method to improve the students’ performance in similar clinical skills in medical sciences.
Keywords: Simulator Software, Electronic Learning, Endotracheal Intubation, Psychomotor Skill -
زمینه و هدف
با توجه به اهمیت ارتباط در پرستاری، این مطالعه با هدف تعیین تاثیر حمایت آنلاین پس از ارایه محتوای الکترونیکی بر مهارت های ارتباطی پرستاران با بیماران انجام گرفته است.
روش بررسیدر این مطالعه نیمه تجربی، با طراحی قبل و بعد تعداد 100 نفر از پرستاران شاغل در بخش های ارتوپدی بیمارستان شهید دکتر چمران، وابسته به دانشگاه علوم پزشکی شیراز در سال 1397 به صورت تصادفی در دو گروه 50 نفری قرار گرفتند و محتوای الکترونیکی آموزش مهارت های ارتباطی را دریافت کردند. در گروه مداخله علاوه بر دریافت محتوای آموزشی، حمایت آنلاین از طریق رسانه اجتماعی به مدت چهار هفته با حضور روان شناس انجام یافت، به طوری که با طرح سوالات و مشکلات واقعی و یا سناریوهای شبیه سازی شده، به بحث و بررسی پیرامون رفتار مناسب در آن موقعیت می پرداختند. قبل و بعد از هشت هفته، مهارت های ارتباطی در هر دو گروه توسط پرسشنامه Burton J.E بررسی و داده ها با آزمون های آماری تی مستقل و آنالیز کوواریانس چندمتغیری با نمرات افتراقی مورد مقایسه قرار گرفت.
یافته هانتایج پژوهش نشان داد که قبل از انجام مداخله تفاوت معناداری بین دو گروه در نمره مهارت های ارتباطی وجود نداشته و هشت هفته پس از دریافت محتوای الکترونیکی نمره شرکت کنندگان در هر دو گروه افزایش یافته است. این افزایش در گروه تحت حمایت آنلاین میزان بیش تری را نشان داد (001/0p<)، در واقع حمایت آنلاین سبب تفاوت (637/0) در نمره مهارت های ارتباطی بین دو گروه شد.
نتیجه گیرینتایج این پژوهش نشان داد که ارایه محتوای الکترونیکی به همراه حمایت آنلاین منجر به بهبود دانش مهارت های ارتباطی نمونه های مورد مطالعه شده است. پیشنهاد می شود علاوه بر آموزش از طریق ارایه محتوای الکترونیکی، استفاده از رسانه های اجتماعی با توجه به مزایای آن ها از جمله سهولت استفاده، در دسترس بودن و نسبتا کم هزینه بودن، در برنامه های توانمندسازی تیم درمان از جمله ارتقای مهارت های ارتباطی مورد استفاده قرار گیرد.
کلید واژگان: مهارت های ارتباطی, پرستاران, یادگیری الکترونیکی, حمایت آنلاینHayat, Volume:27 Issue: 1, 2021, PP 28 -44Background & AimConsidering the importance of communication skills in nursing, we aimed to study the impact of online support and e-content on communication skills of nurses with patients.
Methods & MaterialsIn this quasi-experimental study with pre- and post-design, 100 nurses employed in the orthopedic wards of Chamran hospital affiliated to Shiraz University of Medical Sciences in 2018 were selected randomly and assigned into two groups of 50. Both groups received the electronic content of communication skills. In the intervention group, in addition to receiving educational content, online support was provided through social media for four weeks with the presence of a psychologist, so that by asking real questions and problems or simulated scenarios, appropriate behavior in that situation was discussed. Before and eight weeks after the intervention, communication skills in the both groups were assessed by the Burton Jaychr('39')s Communication Skills questionnaire, and data was compared using independent t-test and analysis of covariance.
ResultsThe results showed that there was no significant difference between the two groups in the communication skills score before the intervention, but eight weeks after receiving the e-content, the participantschr('39') scores increased in the both groups. This increase was greater in the online support group (P<0.001). In fact, online support caused a difference (0.637) in the communication skills score between the two groups.
ConclusionThe results of this study showed the provision of e-content along with online support has led to the improvement of communication skills. It is recommended that in addition to education through e-content, social media be used in the empowerment programs of the treatment team including communication skills improvement, due to their advantages such as ease of use, availability and relatively low cost.
Keywords: communication skills, nurses, e-learning, online support -
Background and Objectives
Health needs assessment can improve the quality of service delivery. The aim of This study was to compare the effect of Elearning and workshop training methods on the performance of experts.
Keywords: Virtual Education, Workshop Training, E-Learning, Health Needs Assessment -
Background & AimDelirium is prevalent in the intensive care unit (ICU), especially among mechanically-ventilated patients. Delirium is associated with a significant increase in adverse outcomes but it usually remains undiagnosed, making it necessary to develop and validate diagnostic tools. This study determined the validity and reliability of the Persian version of the Confusion Assessment Method for Intensive Care Units) CAM_ICU( in Iran.
This cross-sectional study was conducted in open-heart ICU of three university hospitals of Tehran, Iran. After piloting the translated CAM-ICU on 10 patients and refining the translated scale accordingly, 40 ventilated patients were consecutively selected and screened for delirium by two independent evaluators (applying CAM-ICU), and one psychiatrist (using DSM-IV criteria for diagnosis). Inter-rater reliability between the two evaluators was assessed by the Kappa coefficient. Validity indices (i.e., sensitivity and specificity) of the Persian-CAM-ICU and 95% confidence intervals were calculated, given the psychiatrists’ diagnosis as the reference standard. Data were analyzed in Stata software (v. 11).
Methods & Materials
ResultsOf 40 selected patients, CAM_ICU detected delirium in 30%. The Persian-CAM-ICU had a sensitivity and specificity of 75% and 96%, and a positive and negative predictive value of 92% and 85%, respectively. Youden’s J statistic of the scale was 71%. Each of the four domains of the CAM-ICU showed a sensitivity and specificity of more than 69% and 90%, respectively, suggesting acceptable construct validity. There was good agreement between the two evaluators in terms of delirium diagnosis with the Persian-CAM-ICU (kappa coefficient = 0.74, P<0.0001).
ConclusionThe Persian version of the CAM_ICU is an effective, valid and reliable diagnostic tool in critically ill ICU patients. Application of the scale is recommended for the prompt diagnosis and prevent potential delirium in ventilated patients.Keywords: delirium, intensive care units, confusion, CAM-ICU, Iran -
Interdisciplinary Journal of Virtual Learning in Medical Sciences, Volume:9 Issue: 1, Spring 2018, P 1BackgroundThe efficacy of electronic continuing education courses in comparison to lectured based methods requires further evaluation. This study aimed at comparing the effect of electronic (e-learning) and face-to-face conventional instruction on level of knowledge of general dentists on bleaching of discolored teeth.MethodsIn this quasi-experimental controlled trial study in 2017 (1396) with post-test and control group design, firstly, a lecture-based continuing education courses at Shahid Beheshti University on discoloration of a single tooth was carried out for general dentists (as the control group, N = 35). Then, a continuing education online course with the same topic was done for the second group (N = 35). Convenience sampling was used to select participants of each group. Data were collected by a researcher-made questionnaire, which consisted of 2 parts (post-test with 10 questions and a satisfaction questionnaire with 10 questions). Content validity and test-retest reliability (r = 0.8) of both was determined. Data analysis was performed using the t-test and Pearsons chi square test using the SPSS 23 software. The level of statistical significant was considered at P = 0.05.ResultsThe mean knowledge score after education was 7.02 (2.87) in e-learning and 6.77 (1.23) in the conventional group. The difference between the 2 groups was not significant (P = 0.63). Overall, 91.4% in the e-learning and 91.5% in the conventional group believed that the educational course obviated their occupational needs.ConclusionsE-learning was as effective as conventional instruction for bleaching of a single discolored tooth in terms of knowledge score (post-test score) and self-reported satisfaction and attitude of dentists.Keywords: Education, Dentistry, E, learning, Tooth Discoloration, Knowledge
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BackgroundWithout the meaning in life and setting goals, the life will be full of pain and suffering. Hence, psychologists try to discover patients meaning in life and guiding it. A good questionnaire is very important to identify and measure meaning in life. Therefore, the present study focused on design and psychometric assessment of meaning in life questionnaire in patients with SCI.MethodsA total of 258 patients with spinal cord injury in 2014-2016 were selected using the available sampling method. Waltz (2010) method was used for designing the questionnaire: 1) a copy of the questionnaire was designed based on the literature review, 2) face and content validity confirmation of the questionnaire by 10 experts, 3) exploratory factor analysis for construct validity was done, and 4) internal consistency of the questionnaire was confirmed by Cronbachs alpha coefficient. The SPSS version 16 software was used for analyzing the data.ResultsEstimation of CVR and CVI revealed the content validity to be 0.81 and 0.9, respectively. Finally, the questionnaire was extracted with 38 items based on 4 factors: the first factor (positive perception) with 13 items, the second factor (sense of meaning) with 9 items, the third factor (purposefulness) with 7 items, and the fourth factor (spirituality) with 9 items.ConclusionConsidering the existence of a valid and reliable questionnaire, it is recommended that studies be conducted on the meaning of life in various diseases and should be designed to support these patients.Keywords: Meaning in life, Spinal cord injuries, Perception, Iran
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IntroductionChronic kidney disease (CKD) is a challenging health problem. The present study examined impact of self-care education through e-learning on improving kidney function among individuals with CKD.Materials And MethodsThe studied population consisted of CKD patients receiving care at 10 centers for treating noncommunicable diseases in Tehran. Three centers were randomly selected and 39 patients with a glomerular filtration rate (GFR) less than 60 mL/ min/1.73 m2, minimum education of grade 9, minimum of 2 years of referrals, and computer literacy of the individual or a firstdegree relative were included in the study, while 92 patients were assigned into the control group. Changes in GFR were compared after 6 months following an e-learning program for the patients in the intervention group.ResultsThe mean change in GFR was 7.5 ± 8.9 mL/min/1.73 m2 for the intervention group after the e-learning intervention, while this was -2.3 ± 8.5 mL/min/1.73 m2. The two groups were also significantly different in terms of age, marital status, education level, mean arterial pressure, and serum high-density lipoprotein level, and therefore, multivariable comparison of GFR was made incorporating these factor into the analysis and showed a significant improvement of GFR in the intervention group.ConclusionsAccording to the results of this study, effects of the e-learning educational intervention on improvement in kidney function and CKD treatment were established.Keywords: e-learning, chronic kidney disease, intervention
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مقدمهپرستاران بخش های ویژه نوزادان جهت ارائه مراقبت های ماهرانه و کیفی باید دانش تخصصی مورد نیاز را در طول زندگی حرفه ای خود کسب و حفظ کنند. این پژوهش با هدف بررسی تاثیر آموزش مبتنی بر فضای مجازی بر توانمندی روانشناختی پرستاران بخش های مراقبت ویژه نوزادان سطح 2 انجام شد.روش هادر این مطالعه نیمه تجربی 80 نفر از پرستاران شاغل در بخش های مراقبت ویژه نوزادان سطح 2 بیمارستان های تحت پوشش دانشگاه علوم پزشکی تهران در سال 1394 با استفاده از روش تصادفی به دو گروه تجربی و شاهد تقسیم شدند. سطح توانمندی روانشناختی پرستاران با استفاده از پرسش نامه توانمندی روانشناختی اسپریتزر (Spreitzer) در روز اول مطالعه و پس از پایان دوره اندازه گیری شد. در گروه تجربی محتوای آموزشی سطح دو مراقبت ویژه نوزادان تدوین گردید و بر روی سامانه نماد دانشکده مجازی دانشگاه علوم پزشکی تهران به مدت دو ماه ارائه شد. تحلیل داده ها با استفاده از آزمون های آماری تی زوج، تست دقیق فیشر، کای دو و تی مستقل صورت گرفت.نتایجواحدهای پژوهش از نظر تمام متغیرهای دموگرافیک به جز سابقه کار در بخش نوزادان همگن بودند. میانگین و انحراف معیار نمره توانمندی گروه شاهد و تجربی قبل از مطالعه به ترتیب 8/7±57/61 و 386/6±74/56 (از مجموع نمره84) و بعد از مطالعه به ترتیب 595/7±71/60 و 6/5±60/63 بود. نتیجه حاصل از آزمون های آماری تی زوج و مستقل نشان داد، بین میانگین امتیاز توانمندی روانشناختی دو گروه مطالعه پیش از مداخله (006/0p=)، گروه شاهد قبل و بعد از مداخله (001/0p≤)، گروه تجربی قبل و بعد از مداخله (001/0p≤) اختلاف آماری معناداری وجود داشت.نتیجه گیرییافته های این مطالعه حاکی از موثر بودن آموزش مبتنی بر فضای مجازی بر افزایش توانمندی روانشناختی پرستاران بخش های ویژه نوزادان سطح 2 است. با عنایت به مزایای آموزش فضای مجازی، به کارگیری آن در برنامه های آموزش مداوم پرستاران توصیه می شود.کلید واژگان: فضای مجازی, توانمندی روانشناختی, پرستار بخش نوزادان, آموزشIntroductionNeonatal care unit nurses should acquire and maintain the necessary specialized knowledge for providing skillful and high quality care during their professional career. This study aimed to examine the impact of virtual-based education on nurses psychological empowerment in the level II neonatal care unit.MethodsThis quasi- experimental study was carried out in 2015 on 80 nurses working in level II neonatal care units of hospitals affiliated to Tehran University of Medical Sciences; subjects were randomly assigned to two groups of intervention and control groups. The level of nurses psychological empowerment was measured using Spreitzers psychological empowerment questionnaire on the first day of study and after the course. For the intervention group, the educational content of level II neonatal cares was developed and presented on Namad System of the virtual faculty of Tehran University of Medical Sciences (TUMS) for two months. Data were analyzed using paired t-test, Fishers exact test, chi-square and independent t-test.ResultsThe research units were homogeneous in all demographic variables except work experience in the neonatal unit. The respective mean scores and standard deviations of empowerment in the intervention and control groups were 61.57±7.8 and 56.74±6.386 (out of 84) before the intervention and 60.71±7.595 and 63.60±5.6 after the intervention. The results of the independent t-test and paired t-test showed that there was a statistically significant difference in the mean scores of psychological empowerment of the two groups before the intervention (p=0.006), of the control group before and after the intervention (p≤0.001), and of the intervention group before and after the intervention (p≤0.001).ConclusionThe results indicated the effectiveness of virtual-based education on nurses psychological empowerment in level II neonatal care units. With regard to the benefits of virtual-based education, its application is recommended in continuing education programs for nurses.Keywords: Virtual education, psychological empowerment, neonatal unit nurse, education
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Background andPurposeSelf-care can help patients with diabetes to reduce complications of the disease. The purpose of this study was to compare the effectiveness of diabetes self-care educational programs through tow podcast and pamphlet methods.
Material andMethodsThe present study was quasi-experimental research conducted in Tehran Aboozar Diabetes Center (2014). 90 patients with type II diabetes were selected and randomly divided into two groups of podcast training group (n = 45) and pamphlet group (n = 45). In both groups, the data were collected using the researcher-made questionnaire. In the podcast group, five audio training files were transferred via Bluetooth to the patients mobiles, and the pamphlet group was given an educational pamphlet with a quite similar content. After 12 weeks, the two groups were assessed by the same questionnaire. The collected data was analyzed using SPSS Software, version 16, through statistical t-test at a significance level of P ≤ 0.05.ResultsThe mean of adherence to exercise programs, drug treatment, and diabetic diet were 15.53, 23.92, and 48.20, respectively, for Podcast Group, while these values were 14.48, 24.04, and 46.54 for Pamphlet Group, respectively. After the intervention, the mean of adherence to exercise programs, drug treatment, and diabetic diet increased as follows: Podcast group (20.00, 23.95 and 57.12); Pamphlet group (21.26, 25.40 and 55.59).ConclusionThe use of podcast such as pamphlet is recommended to increase the adherence rate of self-care behaviors of diabetic patients. Due to the great satisfaction of patients with podcast, the method is suggested as an effective, simple, and attractive method to control diabetes and compliance with care practices.Keywords: Diabetes, Auditory training, Pamphlet, Self-care, Podcast -
Background and AimCaregivers education should be an active and dynamic process. Updated training programs are essential. This research was conducted to assess the effectiveness of virtual education on health care practitioner's self-efficacy in the neonatal unit.
Methods & Materials: In this quasi-experimental research, hospitals affiliated with Tehran University of Medical Sciences that had level one neonatal unit were divided into two intervention and control groups. Sampling was conducted based on the inclusion criteria from all the nurses and midwives who were employed at these units. The intervention group received two months of asynchronous virtual education using learning management system. The control group did not undergo any specific training program. Data of both groups were collected using demographic questionnaire and Schwarzer & Jerusalem' Generalized Self-Efficacy Scale (GSE10) at the first day of the study and two months after the start of the intervention in the form of pre-test and post-test and were statistically analyzed.ResultsBoth of the intervention and control groups were similar regarding their demographic variables. Results showed that there was no significant difference between the mean score of self-efficacy of the two groups before the intervention (p=0.717); but there was a significant difference between the mean score of self-efficacy of two groups after the intervention (PConclusionThe results of this research demonstrated that virtual education programs are effective in increasing the health care practitioner's self-efficacy at level one neonate units. As a result, applying this method of education is recommended to managers and training planners.Keywords: distance education, e-learning, virtual training, self-efficacy -
مقدمهآموزش عامل مهم در پیشرفت دانش در حرف مراقبتی بهداشتی است. دوره های آموزش مجازی به دلیل انعطاف پذیری این نظام آموزشی، امکان خوبی را برای گسترش محتوای علمی و افزایش عمق یادگیری فراهم می کند.این مطالعه به منظور ارزیابی تاثیر آموزش مجازی در افزایش دانش و اثربخشی آن در پرستاری از نوزادان صورت گرفته است.روشدر این مطالعه نیمه تجربی 80 نفر از پرستاران شاغل در بخش های نوزادان سطح سه مراقبت های ویژه نوزادان بیمارستان های منتخب دانشگاه علوم پزشکی تهران با استفاده از روش تصادفی(به شیوه قرعه کشی) به دو گروه مداخله و شاهد تقسیم شدند و سپس با استفاده از سامانه نماد مجازی(ازطریق سیستم مدیریت یادگیری) دانشکده مجازی دانشگاه علوم پزشکی تهران گروه مداخله2 ماه از طریق سامانه به صورت غیرهمزمان با استفاده از محتوای آموزشی چند رسانه ایی دیداری( وادکست)، شنیداری(پادکست) و نوشتاری آموزش دریافت کردند. مطالعه در طی 5 ماه در سال 1394 انجام شد. داده ها با استفاده از پرسشنامه جمعیت شناختی و توانایی مراقبتی (Caring Ability Inventory)در روز اول و دو ماه پس از شروع مداخله به صورت پیش آزمون و پس آزمون جمع آوری شد.یافته هاواحدهای پژوهش در دو گروه مداخله و شاهد، از نظر تمامی متغیرهای جمعیت شناختی، همگن بودند. نتیجه حاصل از آزمون های آماری تی زوج و مستقل نشان داد، بین میانگین امتیاز توانایی مراقبتی دوگروه مورد مطالعه، پیش از مداخله (0/001p= )اختلاف آماری معنی داری وجود داشت.همچنین اختلاف بین میانگین امتیاز توانایی مراقبتی گروه شاهد قبل و بعد از مطالعه (0/071p= ) معنی دارنبود. اما بین میانگین امتیاز توانایی مراقبتی گروه مداخله قبل و بعد از مداخله( 0/001P <) و بین میانگین امتیاز توانایی مراقبتی دو گروه مورد مطالعه، پس از مداخله (0/001P <)، اختلاف آماری معنی داری وجود داشت.نتیجه گیرییادگیری الکترونیکی به عنوان یک شیوه انعطاف پذیر، که امکان دسترسی به محتوای آموزشی چند رسانه ای و جذاب را در هر زمان و مکان برای پرستاران فراهم می سازد، جهت آموزش پرستاران نوزادان و سایر بخش ها توصیه می شود.کلید واژگان: آموزش مجازی, یادگیری الکترونیکی, توانایی˓ مراقبتی, مراقبت های ویژه نوزادانIntroductionEducation is an important issue in improvement knowledge of health care professionals. The Web-based education could be considered because of the flexibility of the education system, a good opportunity to extend, and deepen learning of scientific content providers. This study aimed to assess the impact of virtual learning in increasing knowledge and its effectiveness inNICU.MethodIn this quasi- experimental study,80 nurses working in the neonatal intensive care in third unite of chosen hospital of Tehran University of Medical Sciences using random samples method (lottery)were divided into two experimental and control groups. And then use virtual symbol system [ through learning management system(LMS)] of the virtual school of Tehran University of Medical Sciences, the experimental group received two months of training through an asynchronous online learning method using the educational content in the form of visual (multimedia files), audio (podcasting) and text files (PDF) were. The study was conducted during 2 months in 2015-2016. Data collected by demographic questionnaire and caring ability scales CAI on the first day and two months after intervention for pre-test and post-test were collected.ResultsSubjects in the intervention and control groups in terms of demographic variables were matched. The results of the independent and paired samples T test showed, between the unmeant score of caring ability in two groups before the intervention(p=0.001) And between the mean caring ability before and after the study (p =0.071), there was no statistically significant difference. But between the mean caring ability intervention group before and after the intervention (PConclusionE-learning can be used as a flexible manner, which allows access to multimedia and interactive educational content at any time and place to provide for nurses, and using to train for newborn' nursing and other sectors.Keywords: E- learning, Virtual training, Caring, Ability. NICU
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BackgroundSelf-efficacy has an influence on nurses professional progress, motivation, effort, perseverance, and time spent by learners on learning. It is also an interface between knowledge and practice. This study aimed to assess the impact of virtual-based education on self-efficacy of nurses in level II neonatal intensive care.Materials And MethodsIn this quasi-experimental study, after determining the sample size (n = 80), nurses working in level II neonatal care unit of hospitals affiliated to TUMS were randomly divided into two groups. The study was conducted in 2015. Nurses self-efficacy level was measured in the two groups by using Coates self-efficacy questionnaire on the first day of the study. For the intervention group, education content of level II neonatal care was developed and run on Namad system of the virtual faculty of TUMS for two months. No specific intervention was performed for the control group. At the end of the education course, nurses psychological empowerment was reassessed in both groups by using the mentioned questionnaire. Data analysis was performed by using the paired t-test, Fisher exact test, chi-square, and independent t-test in SPSS 23.ResultsResearch units were similar in terms of all demographic variables other than work experience in neonatal unit. Mean and standard deviation of self-efficacy scores in the control and intervention groups before the intervention were 129.7 ± 13.973 and 118.05 ± 11.104, respectively, while mean and standard deviation of the two groups after the intervention were 128.09 ± 12.363 and 136.11 ± 9.830, respectively. There was a statistically significant difference in the mean score of self-efficacy between the two groups before the intervention P ≤ 0.001), self-efficacy mean score in the control group before and after the intervention (P = 0.002), self-efficacy mean score in the intervention group before and after the intervention (P ≤ 0.001), and self-efficacy mean score between the two groups after the intervention (P ≤ 0.004).ConclusionsThe results of the present study indicate the effectiveness of virtual education in increased self- efficacy of nurses in level II neonatal intensive care unit. With regard to the advantages of virtual education, it can be employed as a modern educational method to provide necessary requirements and tools for training nurses and other healthcare givers.Keywords: Virtual Education, Self, Efficacy, Neonatal Unit Nurse, Education
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BackgroundCoronary artery diseases are among the most important causes of disability and coronary artery bypass graft (CABG) surgery is considered as one of the most important methods of treatment. The improvement of post-surgery adherence to treatment plan is one of the main healthcare objectives.ObjectivesThe present study attempted to determine the effect of family-centered empowerment model on the adherence of patients undergoing CABG to the treatment plans.MethodsThis research was a clinical trial and a quasi-experimental study, including pre and post tests with a control group performed on 102 patients and active family members of the patients hospitalized at the intensive care unit (ICU) of Imam Khomeini hospital of Tehran, Iran in 2014. For the experimental group, the family-centered empowerment model was implemented with four steps. The control group received only common care. The rate of patients adherence to the treatment plans was then investigated in three areas of diet, medication, and physical activities before and after the intervention, and the data were analyzed using PASW Statistics V18 software.ResultsThe two groups were similar in terms of demographic variables. After the intervention, there was a significant difference based on the results of the independent T-test in terms of mean scores of adherence to the treatment plan in the three areas mentioned above (P = 0.000). Also, before and after the intervention, a significant difference was observed in the experimental group in terms of the above mean scores (P = 0.000).ConclusionsBased on the research findings, the family-centered empowerment model seems to be practical and feasible for the patients under CABG, which can bring improvement or correction of adherence to the treatment plan.Keywords: Family, Centered Empowerment Model, Coronary Artery Bypass Graft, Adherence to the Treatment Plan
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مقدمهیادگیری الکترونیکی مورد اقبال جهانی قرار گرفته، در عین حال به کارگیری آن مستلزم تغییرات رفتاری در اعضای هیات علمی است. یکی از گام های اجرا و پایش یادگیری الکترونیکی، تجزیه تحلیل مخاطبان است. این مطالعه با هدف تعیین دانش، نگرش و عملکرد اعضای هیات علمی دانشگاه علوم پزشکی تهران درباره یادگیری الکترونیکی انجام شد.روش بررسیمطالعه با استفاده از پرسشنامه پژوهشگرساخته انجام شد. روایی صوری پرسشنامه با استفاده از نظر متخصصان، همسانی درونی آن با استفاده از محاسبه آلفای کرونباخ و روایی ساختاری بخش نگرش آن با استفاده از تحلیل عاملی اکتشافی بررسی شد. پرسشنامه به اعضای هیات علمی دانشگاه علوم پزشکی تهران که دارای پست الکترونیکی آکادمیک فعال بودند ارسال گردید. 218 نفر به پرسشنامه پاسخ دادند.نتایجآلفای کرونباخ پرسشنامه 79/0 به دست آمد. در تحلیل عاملی بخش نگرش، کلیه سوالات در یک عامل بارگزاری شد و 53% از واریانس را تبیین می کرد. نگرش اعضای هیات علمی درباره یادگیری الکترونیکی بیش از نیمی از نمره کل (8/3 از 5) بوده ولی میزان آگاهی و عملکرد ایشان کمتر از نیمی از کل نمره قابل کسب بود. بین نمره دانش، نگرش و عملکرد شرکت کنندگان بر اساس جنس، رتبه و سابقه کار تفاوت معنی داری مشاهده نشد ولی بین دانشکده ها تفاوت معنی دار بود.نتیجه گیرینتایج این مطالعه نشان دهنده وضعیت دانش، نگرش و عملکرد اعضای هیات علمی دانشگاه است. دانشگاه علوم پزشکی تهران در زمینه یادگیری الکترونیکی طی سال های گذشته بسترسازی مناسبی نموده و ضمن راه اندازی سامانه های آموزشی و رشته های مجازی، کارگاه های توانمندسازی متعددی برای اعضای هیات علمی برگزار کرده است؛ و نتایج این مطالعه می تواند ضمن ارزیابی وضعیت موجود دانش، نگرش و عملکرد اعضای هیات علمی، برای بازبینی نیازهای آموزشی اعضای هیات علمی و برنامه های توانمندسازی آنها به کار گرفته شود.کلید واژگان: یادگیری الکترونیکی, آموزش از دور, دانش, نگرش, عملکرد, عضو هیات علمیIntroductionE-learning is used in the worldwide in higher education to improve the quality of the learning experience by students; at the same time using this approach requires behavioral changes in the faculty members. One of the steps in the implementation and monitoring of e-learning, is audience analysis using techniques such as knowledge, attitude and practices (KAP). This study investigates the knowledge, attitude and faculty members performance of Tehran University of Medical Sciences (TUMS) on e-learning.MethodsThis descriptive, cross-sectional study was conducted in 2014-15 through a research-made questionnaire. Face validity was determined by expert opinion, Cronbachs alpha was measured to assess the reliability and its construct validity was investigated through exploratory factor analysis. . The questionnaire was e-mailed to all TUMS faculty members . 218 faculty members responded to the questionnaire.ResultsThe reliability score of the questionnaire was assessed using Cronbach alphs, and it was 0.79. Exploratory factor analysis of the attitude part of the questionnaire produced a single factor that explained 53% of the variance. The results showed the positive attitude of faculty members regarding e-learning, although their knowledge and practice scores was less than half of the total score. There wass not found any meaningful differences between knowledge, attitude and performance of the participants based on sex, rank and work experience. ANOVA test showed that the difference of scores among schools was statistically significant ( = 0.000; = 0.003 and = 0.000, respectively).ConclusionThe findings of this study showed the state of knowledge, attitude and faculty members performance of TUMS on e-learning. Over the past years, TUMS has established suitable e-learning infrastructure such as educational websites and virtual programs as well as training workshop for faculty members. The results of this study can help the revision and improvement of the faculties educational programs.Keywords: E, Learning, Distance Education, Knowledge, Attitudes, Practice, Faculty Members
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Background and AimLack of adherence to prescribed medication is a main concern in medicine especially in chronic diseases. The aim of present study was to determine the effect of supportive text message on the adherence to treatment of depression.
Methods & Materials: This quasi-experimental study was conducted on sixty eligible patients with diagnosis of depression who referred to a psychiatry clinic in Shahrekord. The patients were allocated to supportive text message and control groups. The patients in both groups were treated with the same antidepressants; however, the patients in supportive text message group additionally received daily text messages for six weeks. The adherence to medication was assessed by a researcher-made questionnaire and the severity of depression was assessed by Beck depression inventory.ResultsImmediately after intervention, average score of depression showed a significant improvement in both groups (PConclusionDaily supportive text message in this study could not improve antidepressant adherence and depressive symptoms in patients with major depression.Keywords: depression, treatment refusal, text messaging, adherence, medication -
Delphi as a consensus development technique enables anonymous, systematic refinement of expert opinion with the aim of arriving at a combined or consensual position. In this study, we determined the criteria and their weights for Iranian Medical School's ranking through a Delphi process. An expert committee devised 13 proposed criteria with 32 indicators with their weights, which were arranged hierarchically in the form of a tree diagram. We used the Delphi technique to reach a consensus on these criteria and weights among the deans of 38 public Iranian medical schools. For this purpose, we devised and sent a questionnaire to schools and asked them to suggest or correct the criteria and their weights. We repeated this process in two rounds till all the schools reached an acceptable consensus on them. All schools reached a consensus on the set of 13 criteria and 30 indicators and their weights in three main contexts of education, research and facilities, and equipment which were used for Medical Schools ranking. Using Delphi technique for devising the criteria and their weights in evaluation processes such as ranking makes their results more acceptable among universities.Keywords: Delphi technique, Consensus development methods, Ranking, Criteria
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هدف. این مطالعه با هدف بررسی تاثیر به کارگیری ابزار ارزیابی خطر ابتلا به زخم فشاری ”بریدن“ بر عملکرد پرستاران بخش های مراقبت ویژه بود.
زمینه. مدیریت زخم فشاری که پدیده ای شایع در بیماران بستری در بخش های مراقبت ویژه است،مشکل است. بنابراین، استفاده از ابزارهای پیش بینی کننده زخم فشاری در این بیماران می تواند به پیشگیری از بروز این پدیده کمک کند.
روش کار. این مطالعه از نوع نیمه تجربی بود و در سال 1392 روی 68 پرستار شاغل در بخش های مراقبت ویژه داخلی و جنرال بیمارستان های منتخب دانشگاه علوم پزشکی تهران (بیمارستان های شریعتی و امام خمینی) انجام شد. پس از تعیین حجم نمونه و اخذ مجوز از کمیته اخلاق دانشگاه علوم پزشکی تهران، واحدهای پژوهش به صورت نمونه گیری در دسترس و بر اساس معیارهای ورود انتخاب شدند. عملکرد پرستاران در پیشگیری از زخم بستر بیمارانی مورد ارزیابی قرار گرفت که در زمان مطالعه در معرض خطر ابتلا به زخم بستر بودند. بر اساس انتخاب تصادفی، بخش مراقبت ویژه یکی از بیمارستان ها به عنوان گروه مداخله (به کارگیری ابزار بریدن) و بخش مراقبت ویژه بیمارستان دیگر به عنوان گروه آزمون (بدون به کارگیری ابزار بریدن) در نظر گرفته شدند. در هر دو گروه پس از جمع آوری مشخصات دموگرافیک واحدهای مورد پژوهش، عملکرد آنها در مدیریت بیماران در معرض خطر ابتلا به زخم فشاری با استفاده از چک لیست مشاهده ای روا و پایا بررسی شد. پس از جمع آوری داده ها، از آمار توصیفی و تحلیلی در نرم افزار SPSSنسخه 19 استفاده شد.
یافته ها. بین گروه های مطالعه از نظر مشخصات دموگرافیک اختلاف آماری معناداری وجود نداشت. پس از مداخله، میانگین امتیاز عملکرد پرستاران در گروه مداخله، 66/21 با انحراف معیار 0/47 و در گروه کنترل، 62/59 با انحراف معیار 1/31 بود (0/0001≥p). همه افراد در گروه کنترل، در وضعیت مطلوب و در گروه مداخله، در وضعیت بسیار مطلوب قرار داشتند.
نتیجه گیری. به کارگیری ابزار ارزیابی خطر ابتلا به زخم فشاری ”بریدن“ می تواند حساسیت پرستاران را نسبت به احتمال ایجاد زخم در بیماران بخش های مراقبت ویژه افزایش دهد و پرستار را تشویق به انجام اقدامات مراقبتی استاندارد و به دنبال آن، پیشگیری از ایجاد زخم کند. پیشنهاد می شود از این ابزار جهت ارتقای کیفیت مراقبت در بیماران در معرض خطر زخم فشاری استفاده شود.کلید واژگان: زخم فشاری, ابزار مشاهده ای بررسی عملکرد, مدیریت زخم فشاری, ابزار بریدنAim. This study aimed to examine the effect of application of Braden pressure ulcers risk assessment tool on performance of critical care nurses.
Background. Pressure ulcer is a common phenomenon in patients admitted to intensive care unit. The management of pressure ulcers in these patients is a challenging task. Therefore¡ pressure ulcer prediction tools are used when dealing with these patients.
Method. This quasi-experimental study was conducted in the intensive care units. The study sample consisted 68 critical care nurses working inintensive care units of selected hospitals of Tehran University of Medical Sciences in 2013. After determining the sample size and obtaining permission from theethics committee of Tehran University of Medical Sciences¡ the participants were recruited through convenience sampling based on inclusion criteria. Critical care nurses of two intensive care units of general hospitals of Tehran University of Medical Sciences were selected as experimental and control group. In both groups¡ after collecting demographic characteristics¡ their performance in the management of patients who were at risk for pressure ulcers was evaluated by the checklist whose validity and reliability was evaluated by the faculty members of Tehran University of Medical Sciences. The data were analyzed by descriptive and inferential statistics in SPSS version 19.
Findings. There was no statistically significant difference between the groups in terms of demographic characteristics. After the intervention¡ the mean score of nurses performance in the experimental group was 66.21±0.47 and that of control group was 62.59±1.31 (p≤0.0001). After intervention¡ all nurses in the experimental group had very good performance and nurses in the control group had good performance.
Conclusion. Using the pressure ulcers risk assessment tool (Braden scale) increases the sensitivity of critical care nurses to the risk of ulceration in the intensive care unit patients and forces them to comply with the standard caring measures and consequently¡ lead to prevention of bed sores. It is recommended to use this tool in order to enhance the care management of patients prone to pressure sore.Keywords: Pressure ulcers, Observational performance evaluation tool, Pressure ulcers management, Braden scale -
Effectiveness of Multifactorial Intervention on Observance of Physical Restraint Standards of the Patients Hospitalized in Intensive Care UnitsBackgroundOne of the important duties of nurses is to protect patients against any injuries. In most cases, physical restraint is applied as one of the immunity tools. In cases that other actions are not possible, physical restraint seems to be one of the acceptable interventions to protect patients or personnel of the unit.ObjectivesThe current study aimed to assess the effectiveness of multifactorial intervention on observance of physical restraint standards of patients hospitalized in intensive care units.
Patients andMethodsIn this clinical trial study, 240 patients under physical restraint and hospitalized in intensive care units of Hazrat Rasool Akram hospital were studied in two control and intervention groups with convenience sampling. Observance of the physical restraint standards was first recorded with observational checklist. Then, the multifactorial intervention (education through pamphlet, installation of poster in the unit and physical restraint datasheet) was executed for one month. After that, observance of standards was recorded and compared with that of the control group. The collected data were analyzed using SPSS v.16 software with independent t-test and Chi-square test.ResultsThe findings showed that observance of physical restraint standards in the control group was undesirable in more than half of the patients (56.7%) and relatively desirable in the intervention group for the majority of the patients (73.3%). Result of independent t-test showed statistically significant difference in observance of standards between the control and intervention groups (P valueConclusionsConsidering the obtained results, multifactor intervention increased the observance rate of physical restraint standards for patients hospitalized in intensive care units. As a result, it is suggested to use multifactor intervention (education to personnel, recording restraint and installing poster) to improve immunity of patients and reduce the side effects of physical restraint in intensive care units.Keywords: Multifactorial Intervention, Physical Restraint Standards, Immunity of Patients, Intensive Care Units -
زمینه و هدفآموزش بالینی بخش مهمی از آموزش دانشجویان پرستاری بخصوص دانشجویان کارشناسی ارشد پرستاری مراقبت ویژه است. لذا دقت نظر در خصوص آموزش بالینی از اهمیت ویژه ای برخوردار است. این مطالعه با هدف تبیین تجارب و چالش های دانشجویان مقطع کارشناسی ارشد پرستاری مراقبت ویژه در خصوص آموزش بالینی طی رویکرد کیفی انجام شده است.روش بررسیاین مطالعه کیفی به روش تحلیل محتوای قراردادی در فاصله فروردین تا شهریور 1392 در دانشکده پرستاری و مامائی تهران انجام شده است. در مجموع 26 مصاحبه نیمه ساختارمند از 15نفر دانشجوی کارشناسی ارشد پرستاری مراقبت ویژه که با روش نمونه گیری هدفمند وارد مطالعه شدند، انجام شد. جمع آوری داده ها تا رسیدن به اشباع داده ها ادامه پیدا کرد. مدت مصاحبه ها بین 30 تا 60 دقیقه بود.تجزیه و تحلیل داده ها با روش آنالیز محتوای قراردادی انجام شد.یافته هااز 15 شرکت کننده در مطالعه، 9 نفر زن و 6 نفر مرد بودند. دامنه سنی آنان بین 25 تا 34 سال بود. در مجموع 310کداولیه از متن مصاحبه ها استخراج شده که به دلیل تقریب مفهومی دو طبقه اصلی عوامل درونی و عوامل بیرونی شکل گرفت. در طبقه عوامل درونی زیر طبقات عدم هویت حرفه ای، عدم انگیزه و تجربه قبلی، و در طبقه عوامل بیرونی؛ تعاملات حرفه ای، عدم همخوانی آموزش نظزی و بالینی و مربی ناکارامد قرار گرفتند.بحث و نتیجه گیریبا توجه به یافته های پژوهش، عوامل درونی و بیرونی متعددی در آموزش بالینی دانشجویان کارشناسی ارشد پرستاری مراقبت ویژه لازم است وتوجه به این عوامل درونی وبیرونی منجر به افزایش یادگیری دانشجویان این رشته می شود. توجه به عوامل درونی همچون انگیزه دانشجویان، تجربه قبلی و هویت حرفه ای آنها و همچنین عوامل بیرونی همچون انتخاب مربیان کارامد وشایسته، تعاملات حرفه ای و فراهم اوردن محیط مناسب می تواند در رفع چالش های آموزشی این دانشجویان کمک کننده باشد.
کلید واژگان: آموزش بالینی, دانشجو, کارشناسی ارشد, پرستاری مراقبت ویژه, آنالیز محتوای قراردادیIntroductionClinical education is an important part of the education of nursing students, particularly critical care nursing student. The advancement of nursing education is related to clinical education. This study was conducted with aim” exploring of experience and Challenge of education for critical care nursing students”.MethodsThis qualitative study was done from March to October 2013 in the school of Nursing and Midwifery of Tehran, Iran. A total of 26 interviews were conducted of the master of critical care nursing. Data collecting was continued until saturating data. Interviews were done for 30 to 60 minutes. Data analysis was performed by conventional content analysis method.ResultsParticipants were 9 women and 6 men. The age range of participants was between 25- 34. A total of 310 initial codes were extracted from the interview, which was formed two main categories: internal and external factors. In internal category appearance themes, lack of professional identity, lack of motivation, experience and external category appetence themes professional interactions gap of theory and practice, Instructor inefficient.ConclusionAccording to the research findings, it is necessary, be considered.external category enhance professional interaction and the formation of professional identity of students. It is also important to be careful in the selection of clinical teachers. Due to the demands of students in education can help a lot in solving educational problems. Also, internal category could be solved a lot of challenges for critical care nursing training graduate students.Keywords: Clinical education, Student, Critical care Nursing, Conventional content analysis -
BackgroundTraining methods that enhance nurses learning and retention will increase the quality of patient care. This study aimed to compare the effectiveness of electronic learning and educational booklet on the nurses retention of diabetes updates.MethodsIn this controlled trial study, convenience sampling was used to select 123 nurses from the endocrinology and internal medicine wards of three hospitals affiliated to Tehran University of Medical Sciences (Tehran, Iran). The participants were allocated to three groups of manual, electronic learning, and control. The booklet and electronic learning groups were trained using educational booklet and electronic continuous medical education (CME) website, respectively. The control group did not receive any intervention. In all the three groups, the nurse's knowledge was measured before the intervention, and one and four weeks after the intervention. Data were collected by a questionnaire.ResultsSignificant differences were observed between the mean scores of the three groups one and four weeks after the intervention (F=26.17, p=0.001 and F=4.07, p=0.020, respectively), and post hoc test showed that this difference was due to the higher score in e-learning group. Both e-learning and booklet methods could effectively improve nurse's knowledge (χ²=23.03, p=0.001 and χ²=51.71, p=0.001, respectively).ConclusionAccording to the results of this study, electronic learning was more effective than booklet in enhancing the learning and retention of knowledge. Electronic learning is suggested as a more suitable method as it provides appropriate interactions and attractive virtual environments to motivate the learners and promote retention.Keywords: Knowledge, Nursing Care, Distance Education, Booklet, Continuing Medical Education
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زمینه و هدفمراقبت از بیماران تحت جراحی بای پس کرونر (CABG) نگرانی های زیادی برای مراقبین خانوادگی ایجاد می کند. ارتقا توانایی مراقبت کنندگان به عنوان همراهان همیشگی بیمار، امری ضروری است. مطالعه حاضر با هدف تعیین تاثیر آموزش با رویکرد مشارکتی بر میزان خودکارآمدی و خودباوری مراقبین خانوادگی بیماران تحت بای پس عروق کرونر انجام گرفت.مواد و روش هادر کارآزمایی بالینی حاضر، 102 مراقبت کننده از بیماران بستری در بخش جراحی قلب یکی از بیمارستان های شهر تهران در سال 1390، به روش در دسترس انتخاب و به صورت تصادفی در دو گروه 51 نفره مداخله و کنترل قرار گرفتند. برای گروه مداخله 5 جلسه برنامه آموزشی با رویکرد مشارکتی اجرا گردید. قبل و 8 هفته پس از اجرای مداخله، خودکارآمدی و خودباوری مراقبین با استفاده از پرسشنامه های پژوهشگر ساخته اندازه گیری شد. داده ها با استفاده از آزمون های آماری تی مستقل، تی زوج، کای دو و آزمون دقیق فیشر تحت نرم افزار 18 PASW مورد تجزیه و تحلیل قرار گرفتند.یافته هادر گروه مداخله میانگین نمرات خودکارآمدی مراقبین پس از مداخله از 3/89 ± 29/49 به 1/93 ± 47/43 و میانگین نمرات خودباوری از 6/03 ± 93/49 به 18/52 ± 126/13 افزایش پیدا کرد (0/001 > P). همچنین نتایج آزمون آماری تی مستقل نشان داد خودکارآمدی (0/001 > P) و خودباوری (0/002 = P) مراقبین بین دو گروه مداخله و کنترل تفاوت آماری معنی داری داشته است.نتیجه گیریآموزش مراقبین خانوادگی بیماران تحت جراحی بای پس کرونر با رویکرد مشارکتی می تواند منجر به ارتقای خودکارآمدی و خودباوری و در نتیجه افزایش مشارکت آن ها در ارایه مراقبت کارآمد شود. به کارگیری این روش در فرایند آموزش پیشنهاد می گردد.
کلید واژگان: آموزش خانواده محور, خودکارآمدی, خودباوری, گرافت بای پس عروق کرونرBackground And ObjectiveCare of patients undergoing coronary artery bypass graft (CABG) creates some concerns for family caregivers. Increasing the ability of caregivers as accompanies the patient is essential.The purpose of current study was to determine the effect of education with the partnership approach on the self-efficacy and self-esteem of family caregivers of patients undergoing coronary artery bypass graft.Materials And MethodIn this clinical trial study 102 caregivers of the hospitalized patients in cardiac surgery ward in one Hospital in Tehran, 2011 were selected through convenience sampling and randomly allocated into two intervention and control groups of 51 people. For intervention group, 5 sessions educational program with partnership approach were conducted. Self-efficacy and self-esteem of caregivers were measured before and 8 weeks after intervention through using the researcher-made questionnaires. Data analysis was done through PASW 18 Statistics and using independent and paired t-test, chi-square and Fisher exact test.ResultsIn intervention group, the mean score of caregiver’s self-efficacy was significantly increased from (29.49 ± 3.89) to (47.43 ± 1.93) (P < 0/001). As well as the mean score of caregiver’s self-esteem was increased from (93.49 ± 6.03) to (126.13 ± 18.52) (P < 0/001). Also, the results of independent t-test showed the significant difference concerning the self-efficacy (p < 0.001) and self-esteem (p < 0.002) between two groups.ConclusionEducation of family caregivers of patients undergoing coronary artery bypass graft with a partnership approach can lead to improvement the caregivers’ self-efficacy and self-esteem and thus the increasing of their participation in efficient care. Therefore, application of this method is recommended in the educational processKeywords: Family, based Education, Self –efficacy, Self, esteem, Coronary Artery Bypass Graft -
اهدافاکثر بیماران بستری دربخش های مراقبت ویژه درجاتی از بی قراری،گیجی ودلیریوم راتجربه می کنند. به نظر می رسد در شرایط مشخصی که سایر اقدامات امکان پذیرنباشد، مهار فیزیکی یکی ازمداخلات قابل قبول برای محافظت از بیمار یا کارکنان بخش است. هدف از این پژوهش «بررسی وضعیت رعایت استانداردهای مهار فیزیکی در بخش های مراقبت ویژه» بود.روش هاپژوهش حاضر یک مطالعه توصیفی، مقطعی است. با استفاده از روش نمونه گیری آسان تعداد 120 بیمار بستری در بخش های مراقبت ویژه بیمارستان های منتخب دانشگاه علوم پزشکی تهران که تحت مهار فیزیکی قرار داشتند، مورد مطالعه قرار گرفتند. ابزارمطالعه چک لیست مشاهده ای استانداردهای مهار فیزیکی بود. داده ها با استفاده از آمار توصیفی و استنباطی و نرم افزار آماری SPSS16 تحلیل شد.یافته ها65/8 درصد نمونه ها مرد بودند. 5/ 62 درصد در رده سنی پنجاه تا شصت سال قرار داشتند. بیشتر نمونه ها (چهل درصد) سطح هوشیاری کمتر از هشت داشتند. نتیجه آزمون دقیق فیشر نشان می دهد میزان رعایت استانداردهای مهار فیزیکی در بین سه مرحله (قبل از مهار، حین انجام مهار، طی مدت استفاده از مهار) و برحسب بخش بستری بیمار تفاوت آماری معنی داری مشاهده شد (p≤0.001) و میزان رعایت استانداردهای مهار فیزیکی بیماران بستری در بخش های مراقبت ویژه اندک (نامطلوب) بود.نتیجه گیریباتوجه به نتایج پژوهش و تفاوت نحوه عملکرد و اجرای مهار با اصول استاندارد به نظر می رسد آموزش به پرستاران به عنوان اولین تصمیم گیرنده برای انجام مهار و آشنا کردن کارکنان با راهنماهای بالینی استفاده از مهار فیزیکی ضروری است.
کلید واژگان: مهار فیزیکی, ایمنی بیمار, بخش های مراقبت ویژهAimsMost patients hospitalized in intensive care units suffer from restlessness, confusion, and delirium. Physical restraint seems to be the only acceptable measure for ensuring patients’ own and others’ safety in certain cases in which other interventions are not applicable or useful. The aim of this study was “to evaluate the application of physical restraint standards in intensive care units”.MethodsThis was a cross-sectional descriptive study. A convenient sample of 120 physically restrained patients was recruited from the intensive care units of selected hospitals of Tehran University of Medical Sciences, Tehran, Iran. The data collection tool was an observational checklist for physical restraint standards. The SPSS16 was used for calculating the measures of descriptive statistics and conducting statistical tests.ResultsMost of the participating patients were male (65.8%), aged 50–60 years (62.5%), and had a Glasgow Coma Scale score of less than 8. The Fisher’s exact test revealed a significant difference among the studied intensive care units and also among the three phases of using restraint (i.e. before, during, and after restraint use) regarding the rate of applying restraint standards (p≤0.001). Moreover, restraint standards were minimally applied in the study setting.ConclusionsEducating nurses—as the first decision makers for restraint use—and familiarizing them with restraint-related clinical guidelines are crucial.Keywords: Physical restraint, Patient safety, Intensive care unit -
Background and AimToday, one of the leading causes of pathogenicity and mortality in patients undergoing hemodialysis is their failure to follow the treatment plan. The present research was conducted to compare effects of patient-centered education with family-centered education on adherence with the treatment program.Methods & Materials: Methods & Materials: This clinical trial was performed between May-October 2012 in hemodialysis ward of Imam Khomeini and Amir-Alam hospital in Tehran, Iran. Research samples were 60 patients aged 18 - 65 years old, randomly assigned into two groups: training the patients (30 patients) and training the patients and one of close family member (30 people). Using a researcher made questionnaire, patients’ adherence (diet, pharmaceutical regimen and physical activity) was examined by self- reporting method in three stages (before intervention, 2 and 4 weeks after intervention). Data were analyzed using independent t test, Chi-square, and Fisher tests using SPSS software version 16.ResultsPrior to intervention, there was no significant difference between the two groups in terms of adherence to diet program (p = 0.2, mean difference 25.8 ± 25.7), to pharmaceutical regimen (p=0.6, mean difference 1.96 ± 0.61) and physical activity (p = 0.7 mean difference 1.33 ± 0.66). After two weeks family-centered education group had significantly more adherence to the diet program (p = 0.001, mean difference 43.1 ± 11.1), pharmaceutical regimen (p=0.04, mean difference 2.72 ± 0.5) and physical activity (p = 0.035, mean difference2.41 ± 0.89), and total adherence score (p=0.03) in comparison with patient-centered education group. After four weeks just the adherence to pharmaceutical regimen showed significant difference between groups (p<0.001).ConclusionThe results of the study showed that the family-centered education is more effective than patient-centered education on patients’ adherence to the therapeutic program particularly pharmaceutical regimen, which suggests, by having family centered education in hemodyalisis patients, the outcome could be improved.Keywords: family centered education, patient centered education, adherence to therapeutic regimen, hemodialysis
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