فهرست مطالب mostafa javadi

Milk bank is one of the most important emerging issues in neonatal health. The present study aimed toimprove the attitude and inclination of mothers with premature neonates to feed their suckling with milk donatedfrom the milk bank by comparing the effect of face-to-face training and an educational package.  In this randomized clinical trial, 66 mothers of premature neonates hospitalized in the neonatal intensivecare unit were included and assigned to two groups of 33 mothers. The samples completed the demographicinformation questionnaire and questionnaire of attitude and inclination toward feeding with milk donated from themilk bank. The first group received direct face-to-face training, and the second received an educational package. Thedata was statistically analyzed with SPSS 22. The attitude and inclination scores increased significantly in face-to-face and educational package groups. Theattitude score in the face-to-face group was higher after the intervention compared to the educational package group(P=0.003). Besides, the inclination score in the face-to-face group was higher than that in the educational packagegroup, which was statistically significant (P<0.001). Both face-to-face training and educational packages effectively improved the inclination and attitude ofmothers with premature neonates to feed neonates with donated milk. Considering the more significant impact of faceto-facetraining compared to the educational package, it is suggested that this accessible and affordable method beapplied along with other training to increase the effectiveness of the training.

One of the most common cardiovascular diseases is coronary heart disease. Key issues facing cardiovascular patients are their psychological problems and perceived stress. Stressful situations lower self-efficacy and increase dependence on others, including family members. The aim of this study was to investigate the effects of a family-centered empowerment program on self-efficacy and stress perceptions in acute coronary syndrome patients at Yazd Social Security Hospital. This education-oriented and semi-experimental study was conducted on patients with acute coronary syndrome referred to Yazd Shohadaye Kargar Hospital in 2018-2019. Eighty-four patients with acute coronary syndrome who were eligible to participate in the study were selected and randomly assigned to experimental and control groups by random assignment software. The experimental group underwent individual self-efficacy sessions and stress perception training in the presence of active family members, followed up by telephone, and held four group sessions every two weeks. There was no statistically significant difference in pre-intervention self-efficacy mean scores between the experimental and control groups, but self-efficacy mean scores in the experimental group were higher immediately after the intervention and after two months interval than in the control group (p <0.001). Also, there was no statistically significant difference between the perceived stress mean scores before the intervention in the experimental and control groups. But immediately after the intervention, the perceived stress mean score in the experimental group appeared to be higher than the control group (p <0.001). Implementing a family-centered empowerment program can improve self-efficacy and reduce perceived stress in patients with acute coronary syndrome, lasting up to two months after the intervention. This affordable and low-cost intervention can thus be used to improve the health of acute coronary heart disease patients.

Diabetes is the most common metabolic disease in the world, and self-care is one of the main strategies for controlling the disease. Several studies point to the lack of optimal self-care in diabetic patients as psychological barriers, and emotional distress seems to be one of the factors affecting it. Therefore, this study was conducted to determine the relationship between self-care and emotional distress in patients with type 2 diabetes.

In this descriptive cross-sectional study, 380 patients with type 2 diabetes were selected from among those referring to Yazd Diabetes Research Center in 2018. A demographic questionnaire, an emotional distress questionnaire, and a self-care questionnaire for diabetic patients were utilized for gathering data. The collected data were analyzed by SPSS software version 21, and descriptive statistics and Pearson correlation coefficient were utilized.

The results showed that the mean score of self-care patients was 56.65 ± 13.13 and the mean score of emotional distress was 40.82 ± 15.15. Therefore, self-care and emotional distress were moderate in most patients. Based on the Pearson correlation coefficient, there was a negative correlation between self-care score and emotional distress in diabetic patients (r = -0.25, p = 0.01).

Reducing emotional distress is one of the factors affecting the improvement of patients' self-care behaviors, therefore it is necessary to pay attention to it in educational and counseling programs to prevent complications of diabetes and to increase the self-care behaviors of patients.

Kidney transplant recipients, as chronic patients, need lifelong self-management. Therefore, identification of the effective factors is helpful in strengthening the individuals' adherence and planning self-management in the post-transplant period. However, the empirical research on this area is limited. The purpose of this study was "Explaining self-management determinants in kidney transplant recipients according to the health belief model".

This qualitative content analysis was conducted in Kohgiluyeh and Boyer Ahmad province. The participants were included in the study by purposive and theoretical sampling methods until theoretical and classical saturations were achieved. The data were collected and analysed using 24 semi-structured interviews by 19 participants (14 transplant recipients, 4 family members, and a patient with a history of transplant rejection). The MAXQDA10 software was used to organize and manage the data.
Results. After analysing the data, 264 primary conceptual codes were extracted. The findings were reported in 20 sub- categories and in accordance with six categories of the health belief model (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to actions).

The findings of this qualitative study provided a profound understanding over the experiences of kidney transplant recipients and their family members about self-management determinants. The findings confirmed the health belief model constructs and its application in predicting these patients' self-management. In addition, the findings can be  a guide for health planners and policy makers to select the suitable interventions and strategies to improve the adherence to recipients' self-management.

Background and Body's natural capacity is usually reduced with aging. Elderly people are usually faced with different physical and psychological problems. Studies have shown that recreational activities positively influence the welfare of elderly. This study aimed at exploring the efficacy of brain teaser on increasing happiness in elderly attending ýdaycare nursing homes in Yazd, Iran.
In this clinical trial study with pretest and posttest design, 60 elderly from four daycare nursing homes were randomly assigned into intervention (n=30) and control (n=30) groups. The intervention group participated in brain teaser sessions, twice a week, for one month. The control group did not receive any intervention. Happiness was evaluated at three stages: before, immediately after, and one month after the intervention, using demographic and Oxford Happiness Inventory scale. Data analysis was done in SPSS V19 applying Independent T test, Repeated Measure ANOVA, and LSD test.
The mean ages of the experimental and control groups were 70.23±7.21 and 69.30±6.76 years, respectively. Before the intervention, there was no difference between the two groups in mean scores for happiness, But compared to the control group, the mean scores for happiness in intervention group significantly increased immediately after (P Brain teaser in elderly may improved their happiness. This intervention is recommended in nursing homes as it is simple, cheap, and easily done.

Suction causes complications, such as tachycardia and hypertension due to stimulation of the sympathetic nervous system or complications, such as bradycardia and hypotension due to vagal nerve stimulation. The aim of the present study was to compare the effect of open endotracheal tube suction with two different sizes of suction catheter on changes of heart rate and blood pressure in patients hospitalized in intensive care unit.
This clinical trial study was performed as a pretest-posttest study using comparative intervention and random sampling. Thirty-six patients hospitalized in intensive care unit of Yasuj Shahid Beheshti Hospital underwent suction with two catheter sizes of 12 and 14. Changes in blood pressure and heart rate (before, during, and 5 and 20 minutes after the suctioning), was recorded. To compare the amount of changes in heart rate and blood pressure at different stages of suction, repeated measures ANOVAwas used.
In this study, the heart rate increased more during suction with catheter 14 compared to the catheter 12, and the difference was significant (p=0.000). Increase in heart rate up to 20 min after suction, was higher with larger catheter compared to the smaller catheter, and the difference was significant (p=0.000). Systolic blood pressure increased after suction with large catheter, and the difference was significant (p=0.050). The diastolic blood pressure had the highest increase in 5 min after the suction, but there was no significant difference between the two catheter (p=0.186).
The use of small size catheter during suction, causes less increase in heart rate and blood pressure.

artificial airway lead to weakened cough reflex and the loss of ciliated cells eventually that finaly lead to accumulation of secretions so patients need periodic suction. This study aimed to compare the effect of open suction endotracheal tube using two different size suction catheter on the arterial blood oxygen saturation in critical care patients were admitted.
In this clinical trial 36 patients in one group and under suction catheter with two size 12 and 14, respectively. Changes in blood oxygen saturation before, during, after 5 minutes and 20 minutes after suctioning was recorded. For Oxygen saturation suction compare changes in different stages, analysis with variance and repeated measures was used.
The results showed that oxygen saturation during small suction catheter is a significant difference (p=0/000). In addition to suction the blood oxygen saturation rate in the first episode there is a significant difference (p=0/000). 5 minutes after suctioning blood oxygen saturation in compare of 5 minutes before the suction has no significant difference (p=0/597) but blood oxygen saturation 20 minutes after suction in compare of 5 minutes prior to suctioning and suctioning episodes were significantly different(p=0/050).
Since the fall endotracheal suctioning of arterial blood oxygen saturation and the reduction in the episodes become more frequent suctioning, it is recommended to reduce the duration of suction.

Since hospitalized patients intubated in the intensive care unit are not able to discharge secretions and require periodic suctioning and require periodic suctioning that is associated with different adverse effects, this study aimed to compare the effects of open endotracheal suction with two catheter sizes of 12 and 14 on the levels of pain and discharge in patients admitted to intensive care.
In this clinical trial, 36 patients in one group underwent suction with catheters of two sizes, 12 and 14. Pain level in the first to third episodes, was assessed based on the CPOT criteria. The secretions output after the suctioning was collected in wing container and weighed on scales. Data were analyzed using paired t-test and analysis of variance.
In this study, pain during suctioning in the third episode, had the highest score, which was significantly different between large and small catheters (p=0.000). The secretion drainage after suctioning by large catheter was more and significantly statistically different (p=0.000).
Based on the findings of this study, in patients with high pulmonary secretions, larger suction catheter is recommended to facilitate the discharge, but on the other hand, due to feeling pain caused by large catheter, use of small catheter is recommended for better control of intracranial pressure and pain levels.

Context: A review of the literature of recent decades has shown that few studies have been conducted on the effects of various types of complementary medicine on patients with leukemia. Therefore, the present study aimed to find research gaps in the use of different types of complementary medicine in patients with leukemia to be applied in future studies..
Evidence Acquisition: The present study was a review-type design based on a review of the literature on different types of complementary medicine in patients with leukemia, up to 2015. The search was conducted through electronic databases and search engines. According to the inclusion and exclusion criteria, 8 studies which had been conducted on the use of complementary medicine in patients with leukemia were selected for the identification of gaps..
The overall results showed that few studies have been conducted on the use of exercise, massage therapy, music therapy, acupressure, and healing touch in patients with leukemia, and these subjects are potential research areas for many different studies. However, no studies have been carried out on the effects of acupuncture, relaxation, and yoga on these patients..
The results of this review showed that the number of studies on the use of complementary medicine in leukemia patients is very limited (especially in Iran), and it can be the subject of numerous studies in the future..

Factors effective in the continuous nursing education process may motivate nurses to participate in continuous education programs, and thus, result in knowledge promotion and improvement of skills in clinical practice and improvement of patient care. However, they may also prevent the achieving of these goals. The precise recognition of these factors can result in constructive modification in continuous education programs and achieving of the goals of continuous education (improving patient care). Thus, the aim of this study was to explain the factors influencing the successful implementation of the continuous nursing education process based on the experiences of nurses. This qualitative study was conducted in 2012. The study subjects consisted of 28 individuals, including nurses, nursing supervisors, and nursing managers. The participants were selected using purposive sampling method. Data were collected through unstructured interviews and field notes. In addition, data analysis was conducted using content analysis. From the data, 3 main categories of "advantage of compulsory education", "appropriate context for education", and "passive training" were achieved. The sub-categories of these 3 categories consisted of compulsory training regulations and gaining advantage from training, various sources of education, suitable educational conditions, educational willingness, commitment to education and educational competency, insufficient educational motivation of employees and managers, inadequate educational qualification of nursing managers, and passive educational supervision. The identification of motivational factors and barriers of the continuous nursing education process based on nurses ' experiences can assist continuous education program policy makers and planners and nursing managers in the development of continuous education regulations based on effective programs and activities.

Around the world there is a growing consensus that student's rights must be protected, regardless of race, creed, color, sex, religion, and socioeconomic status. One of these rights is the educational equity. However, little is known about these phenomena in nursing education. The aim of this study was to explore the educational equity from the perspective of nursing students. A qualitative study was conducted. Thus, we purposefully recruited for in-depth interviews 13 nursing students (8 female and 5 male). All interviews were transcribed verbatim and analyzed by thematic analysis approach to identify categories and themes. Four main themes emerged from the data: Fair Educational Opportunity, fair evaluation, attempts to combat discrimination, and employing qualified teachers. It is argued that educational equity should be developed in higher education. Principles of equity and students’ rights may form the most basic rationale for all formal and informal efforts to extend the right of equal access to education.

Libraries are among main parts of universities as libraries of high quality lead to improvement in education and research within universities and the society. Assessing quality of services in educational systems is important to improve quality of provided services. This study was conducted to assess the quality of services provided by the central library of Kerman University of Medical Sciences from the faculty members and students’ point of view. In this study, 200 faculty members and students of Kerman University of Medical Sciences were chosen using stratified random sampling. The data was collected using LibQUAL+TM standard questionnaire after its validity and reliability were confirmed Our findings showed that the mean score of general satisfaction of the central library’s provided services was 6.13 out of 9. Among the three aspects of library service quality, information control was the most satisfactory factor (5.98) which was followed by efficacy of services (5.96) and the library’s atmosphere (5.89). Faculty members were more satisfied with the central library’s provided services in all aspects compared to students, although this difference was not significant. The most frequent referral to the central library and using references was once a month. Although the findings of this study were suggestive of faculty members and students’ relative satisfaction of provided services, improving quality of services necessitates better and more organized planning. Improvement of library service quality can lead to promoting faculty members and students’ scientific level in universities of medical sciences, medical knowledge, and medical education.

Clinical medicine is along with more ethical challenges or conflicts. Despite availability medical ethics consultations 95% of physicians are challenged with ethical conflict. The majority of physicians not only, no experience of a hospital ethics committee (H.E.C) and have not tendency the utilization of ethics consultation, lack of criteria for the determine the best individual for this action and uncertainty clinicians to their qualification. The purpose of this article, reviews core principle relevant to the practice of clinical medical ethic and describes models for conducting hospital based ethics consultations and the contribution of bioethics committees to high quality practice patient care in ICU. Family problems can cause lack of effective communication with the physicians in ICU. One of the attempts medical ethics committees, help resolving ethical conflicts in ICU. Improved communication can reduce conflict and increase patient and family and team care satisfaction. Suggestion for improved communication between patient and family and members of team care and resolution of conflict are seven step-approach include of prepare for the discussion, establish what the patient and family knows, determine how information is to be handled, deliver the information, respond to emotions, establish goals for care and treatment priorities, establish a plan care. Barriers the utilization of ethics consultations are lack of autonomy for the patient and team care. due to, duty of ethics consultations should develop open dialogue between physician and patient until deliver correct information to patient and misunderstand prevented. One of the benefits model ethics consultations is satisfaction in resolving ethical conflicts that as opposed, authoritarian model, individual thoughtful and medical decision-making not imposed. Hospital ethics committees possess with specific skills can resolve conflicts and cause improve clinical outcomes and increase patient satisfaction.

Nowadays obesity is assumed as a global health problem and its prevalence increased in recent decade. It is known as a risk factor for several diseases such as diabetes mellitus, hyperlipidemia, cardiovascular disease and cancer. This study was undertaken to evaluate the obesity and overweight in Bam students 330 students (140 male and 190 female) with mean age of 21.78±2.61 were selected from Bam educational centers in stratified sampling. Weight and height were measured without shoes and unneeded cloths. Weight and height were measured using a standard protocol and body mass index (kg/m²) was calculated. The criteria used to define body composition were based on BMI cut-off points of the WHO expert committee. The results shows the mean and SD BMI were 21.082±3.216 overall, and 22.08±3.08, 21.59±3.31, respectively, in male and female students. 14.1% of students were underweight, 70.9% normal weight, 12.1% overweight and 2.1% obese. 12.7% of females and 13.8% of males had visceral obesity. A significant relation between family history of obesity and BMI is seen (P<0.05). As results show some of female and male students are in a degree of overweight and obesity, therefore launching nutritional services and life style modification program are recommended..