فهرست مطالب s. a. saadatjoo

Heart failure is a chronic disease that affects the physical and psychological aspects of life. Psychological adaptation of patients needs follow-up and training. The purpose of this study was to determine the effectiveness of an educational program based on Roy adaptation model on the psychological adaptation in patients with heart failure.

This clinical randomized trial was performed on 60 patients with heart failure admitted in Vali-e-Asr Hospital and Heart Research Center in Birjand in 2013. The patients were selected through the convenience sampling and randomly allocated to an intervention group and a control group (30 individuals in each group). The data was collected using Roy assessment form and Mental Health Inventory (MHI-38) whose reliability are confirmed in previous studies. The content validity of the Mental Health Inventory was first confirmed. Later, in order to check for its reliability, it was given to 20 individuals for which Chronbach's alpha was 0.91. The intervention group received an educational program based on maladaptive behavior and stimuli which was followed by a follow-up period of one month. The control group received the regular service. The data were analyzed in SPSS (version 15) using independent t test, paired t test, Mann Whitney, Wilcoxon, Fisher Exact Test, and Chi square.

Mean scores for maladaptive behaviors and the number of maladaptive behaviors showed no significant differences before the intervention, while the difference was significant after the intervention in the two groups (p<0.001). In the intervention group, the dimensions that had significant decrease included physiological (p<0.001), self-concept (p<0.001), interdependence (p<0.004), and role function (p<0.001). The psychological adaptation scores mean significantly increased in the intervention group (p<0.001). However, there was no significant difference in the control group in the different dimensions (p>0.05).

Using an educational program based on Roy adaptation model can be effective on the psychological ad aptation and reduc tion of maladaptive behaviors in patients with heart failure. In this regard, nurses can play a more effective role in improving the psychological adaptation of patients using the educational program.

Nurses plays an important role in the development of health care and treatment. Thus, a main task of a nursing director is to pay attention to the motivational energies of nurses. This study aimed to determine the job motivation of nurses working in Valiasr Hospital of Birjand in 2013.

This descriptive cross-sectional study was conducted on 117 nurses in Valiasr Hospital of Birjand who were selected by census. Data were collected using the Herzberg's Motivation- Hygiene Questionnaire which consisted of 30 items and 11 components with 5 Likert scale. Its reliability and validity were confirmed in previous studies. Data were analyzed in SPSS (version 16) using independent t test and ANOVA at the significant level of p<0.05.

In this study, nurse's overall score for job motivation was moderate with a mean score of 2.9±0.5. Intrinsic motivation al factors were more important than health factors (extrinsic) in creating job motivation. The most and least important motivational factor from among the components of motivational factors were the nature of work (3.8±0.8) and identification (2.3±0.9) and from among the components of health factors, related cooperation (3.8±0.7) and job security (1.8±0.8). There was no statistically significant difference in the overall motivation mean score in terms of demographic characteristics.

In light of nurse's job motivation and intrinsic motivational factors, it is recommended that nurse managers pay more attention to factors such as staff appreciation, economic problems, security, and working conditions.

Life quality is a criterion of social and physical function as well as mental health and is considered as one of the most important factors and characteristics of health. Life quality and blood sugar metabolism control are two important indexes in diabetes treatment. The present study was done to compare the quality of life in diabetic and non-diabetic patients.

In this descriptive analytical study, 100 type 2 diabetics aged 20 yrs were selected through systematic randomized sampling out of the patients referring to Vali-e-Asr hospital clinic and their quality of life was compared with that of 100 non-diabetics (controls) who were matched with the cases regarding demographic variables by means of SF36 quality of life questionnaire. The obtained data was analysed by means of SPSS statistical software (version 15) and statistical tests c 2, Mann-Whitney, and Kruskal-wallis at the significant level P<0.05. Result s: There were no meaningful statistical differences between demographic variables in the case and the control groups. Diabetic patient's quality of life was significantly lower in all aspects than that of non-diabetics. Women's quality of life was better than men's in both groups (P<0.05). Single's life quality was better than that of the married ones (P<0.05). Quality of life worsened in diabetics with increase in age (P<0.001).

Planning for treating interventions and more accurate and perfect care in order to manage diabetes and its complications, in a better way, to promote diabetic patients quality of life is proposed.

Substance abuse have crossed many social, economic, and geographical borders today, and is among major health problems that endanger a multitude of population groups including the pregnant mothers because of their untoward maternal and fetal outcomes. This study was conducted to determine the prevalence of substance abuse and maternal, fetal outcomes. A descriptive and analytic cross-sectional study (October 2006 – December 2007) was conducted on 4647 women who had the criteria for admission to labor wards of educational hospital of Birjand -Iran. Data was collected by questionnaire. The obtained data was statistically analyzed by SPSS software using Descriptive statistical and Logistic regression tests at the significant level (α<0.05). The results showed that the prevalence of addiction among pregnant women was 0.69% and The mean age of addiction women was 29.4 ± 1.32 years and 45.5% were in 20-29 years. In addiction group, 11.4 abruptio placenta, 10% still birth and 37.6% fetal distress was reported. The mean of Gestational Age was 34.6 ± 1.34 weeks and premature delivery was significantly more common in the group of pregnant addicts (31.3 vs. 7.1%). Addiction pregnancies present a small but high-risk group according to perinatal outcome. Appropriate obstetric and neonatal care can reduce the rate of complications in these pregnancies and improve perinatal outcome. Therefore, preventive educational programs during pregnancy should focus on reduction or replace of using such Substance with safe drugs.