فهرست مطالب tayebeh negahban bonabi

Although there is a defined role for family members in the development of the hospital safety policies, family participation in the health care is a challenging concept and few studies have focused on its role in patient safety. This study designed to determine the effect of the participation of family member's in nursing care on patient safety in the intensive care unit (ICU). The study used a randomized controlled audit. Seventy one ICU nurses, patients and their relatives were selected purposefully, from October to December 2021, in Rafsanjan, Iran. Eligible nurses assigned into 2 study groups (with and without family members' participating in nursing care), by the random minimization method. The ICU nurses' compliance with patient safety standards in nursing care was measured by a checklist. Data were analyzed using SPSS software version 22, by Shapiro and Wilk tests, Chi-Square and t-test for independent groups. A significance level of 0.05 was considered. The study groups were similar in terms of demographic characteristics and baseline scores. The mean ±SD of nurses' observance of patient's safety score in with family participation group (119.20±13.64) was higher than in without family participation group(116.97±13.26), but no statistical difference was observed between the study groups (p=0.488) Also, in the subgroups, no significant statistical difference was observed between the two groups after the intervention (p>0.05).  ICU nurses observance of standards in patient safety during caring is not affected by the participation of family members in the nursing cares. These results guide managers and policymakers of the health system to find stronger influencing factors on the level of patient safety compliance during nursing care.

There is no clear consensus on the effect of natural sounds on elderly sleep quality, as one of the most common causes of disability in them. This study aimed to determine the effect of natural sounds on elderly sleep quality.

In this randomized controlled trial, 100 elderly were selected based on the inclusion criteria from comprehensive health care centers and then divided into two equal groups by simple random sampling method. The intervention group listened to the natural sounds in MP3 format every night for 2 weeks, 30 minutes before going to bed, through mobile phone and hands-free. The control group did not receive any intervention. The PSQI was measured before and after the intervention. Data analysis was done in SPSS software (version 22) applying the Shapiro-Wilk test, Chi-square, and Fisher Exact test, Independent Samples-t test, Wilcoxon Signed Ranks test, and Mann Whitney U test. A confidence level of 95% was considered.

In the intergroup comparison, in the baseline, groups were the same in terms of the total sleep quality score as well as other components (P>0.05). After the intervention, there was a significance difference between the two groups in terms of global sleep quality (P=0.048), sleep latency (P=0.001), habitual sleep efficacy (p= 0.012), and sleep disturbance (p=0.01).

Based on the our results, natural sounds could improve the sleep quality in the elderly.

 Fears about the future and uncertainty in multiple sclerosis (MS) can affect the patients’ adaptation and well-being.

 This study investigated the effect of collaborative care on the fear of disease progression in MS patients.

 In this randomized controlled trial, patients and their main caregivers were assigned into study groups (36 in the intervention and 43 in the control group) by randomized minimization method. For the intervention group, the collaborative care model was implemented in seven sessions over nine weeks. The data were collected using the Fear of Progression Questionnaire-Short Form (FOP Q-SF). Data analysis was done using descriptive statistics, Shapiro-Wilk, chi-square, Fisher Exact, independent, and paired t-tests.

 A near-significant difference was found between the groups after the intervention (P = 0.051). However, in intragroup comparisons, the FOP score significantly decreased in the intervention group (P = 0.001) and increased in the control group after the intervention (P = 0.001).

 Collaborative care could potentially be an effective strategy for managing FOP in patients with MS.

Context: 

The family‑centered round as a dimension of family‑centered care has become a challenging issue in adult patient settings. There is insufficient evidence of the impact of the presence of the adult patient’s family members during the teaching round on their anxiety.

 The aim of this study was to evaluate the effect of family presence during teaching rounds on their anxiety in cardiac intensive care units (CICUs).

Settings and Design:

 This interventional study was conducted at a CICU in Ali ibn Abi Talib Hospital in Rafsanjan, Iran, from May to August 2018.

 Sixty hospitalized patients at CICU were selected based on inclusion criteria and then, randomly assigned into two equal‑sized groups (with and without family members’ presence during teaching rounds). The anxiety score of family members was measured before and after rounds using the Spielberger State‑Trait Anxiety Inventory (STAI).

Statistical Analysis Used: 

Data were analyzed by the Statistical Package for the Social Sciences (SPSS) software using Kolmogorov–Smirnov test, Chi‑square test, independent‑sample t‑test, and paired sample t‑test, at the significance level of <0.05.

 Two groups were similar in terms of demographic variables. The STAI score in the family members’ presence group significantly decreased after intervention (P < 0.001). However, the STAI score in without the family presence group did not change significantly (P = 0.175). After the intervention, the STAI score in the family members’ presence group was significantly lower than the without family presence group (P = 0.016; effect size = 0.642).

 Family presence during teaching rounds at CICU can reduce their anxiety.

Pain and anxiety as predictable features of abortion process can reduce the quality of clinical care. Therefore, this study was performed aimed to determine the effect of acupressure at LI4 point of pain and anxiety during abortion.

This randomized clinical controled trial studywas done in 2021 on 120 women during abortion hospitalized in Niknafs maternity hospital in Rafsanjan. The subjects were equally divided into three groups of intervention, touch and control. In the intervention group, acupressure at LI4 point was applied bilaterally during 10-second periods of pressure and 2-second rest for 20 minutes. In the touch group, the above point was touched without pressure. Before, immediately and half an hour after the intervention, pain and anxiety scores were measured by Visual Analog Scale(VAS) and Spielberger state anxiety questionnaire, respectively. Data were analyzed by SPSS software (version 22) using one-way analysis of variance (ANOVA), Kruskal-wallis, Repeated Measurement. P< 0.05 was considered statistically significant.

The results showed that the three groups were similar in demographic characteristics, except for the number of abortions and deliveries. After adjusting the effect of the number of abortions and deliveries, the mean score of pain within the groups (time effect) (p = 0.291), and between the groups (group effect) (p = 0.572) and the trend of pain score changes between the groups in consecutive measurement times (p = 0.262) were not significantly different. After adjusting the effect of the number of abortion, number of delivery and baseline anxiety score, comparison of the trend of changes in anxiety scores of the three groups in two consecutive measurement (interaction effect of time and group) did not show a statistically significant difference (p = 0.896).

Based on the results of this study, acupressure intervention could not manage the pain and anxiety of women during abortion.

Although basic life support (BLS) has been taught in school by a variety of professionals, it is still unclear that, whether the instructor’s previous cardiopulmonary resuscitation (CPR) experience is an important factor. This study aimed to compare the effect of BLS training, based on trainer experience in actual situations, on knowledge and skills of secondary high school students.

In this randomized controlled trial, 150 high school students were selected based on the inclusion criteria and then assigned into two groups, (76 in Group A), and (74 in Group B) randomly. Both groups were trained according to adult BLS: 2020 American Heart Association guidelines on mannequins in three 60 min in‑person training sessions. The knowledge and skill scores were measured for both groups before, immediately, and 1 month after intervention by a questionnaire. Data were analyzed by the SPSS software version 22, using Chi‑square, Mann–Whitney U, repeated‑measure ANOVA tests, and statistically modeling at a significance level of 0.05.

There were no significant differences between groups regarding demographic characteristics. The knowledge and skill scores in both groups increased significantly compared to baseline immediately and 1 month after the intervention (P = 0.001). However, there was no significant difference in knowledge scores between groups (P = 0.076(. However, at the immediacy and 1 month after the intervention, the skill score in “Group A” was significantly higher than the “Group B” (P = 0.001).

The trainer’s experience of CPR in the actual setting in the transfer of BLS knowledge is not important, but it improved Student’s BSL skill acquisition score.

Understanding the way nurses' informatics competencies affect their mastery of professional competencies can help provide high quality care and design contents for continuing nursing education. This study aimed to determine the association between nurses' informatics and their clinical competencies.

A total of 150 nurses who met the inclusion criteria were enrolled in this descriptive study from three general public hospitals in Rafsanjan, Iran, using stratified random sampling method. Self-reporting data collection was performed applying three questionnaires of (1) personal and job characteristics, (2) the Self-Assessment of Nursing Informatics Competencies Scale (SANIC), and (3) the Competency Inventory for Registered Nurses (CIRN). Data were analyzed using SPSS 22.0 and Kolmogorov-Smirnov, Chi-square, Pearson's correlation coefficient, and linear regression statistical tests at the significance level of 0.05, were applied.

Female nurses had higher CIRN scores than male ones (p = 0.027). The results of the Pearson's correlation coefficient showed a moderate significant positive association between SANIC and CIRN scores (r = 0.341, p = 0.001). Furthermore, results of the linear regression analysis showed that about 11% of the CIRN score was associated to the SANIC score (P = 0.001). After adjustment based on gender (p = 0.060) and education (p = 0.064), the correlation was not significant.  

Given the effect of gender and level of education, there was no significant association between Nursing Informatics Competencies and nurses’ competency. The level of application of informatics in nursing should be reviewed contextually.

Limited studies have examined the effect of reflexology on pain and fatigue in thalassemia major patients. The aim of this study was to determine the effect of foot reflexology on pain and fatigue in patients with major thalassemia.
In this double-blinded randomized controlled trial, 90 patients were assigned into 3 groups equally (reflexology, touch, and control) by the minimization method. The reflexology group received an entire foot massage three times a week, for 2 weeks, for 10-15 minutes. No intervention applied in the control group, and in touch group touching was applied with the same pattern as the intervention group. The pain and fatigue score was measured before, immediately and 2 weeks after the intervention on the NRS and FSS scales respectively. Data was analyzed by SPSS version 22, using Chi-square, Fisher Exact, Mann-Whitney U, repeated measure ANOVA tests and statistically modeling at a significance level of 0.05.
There were no significant differences between the groups regarding demographic characteristics. On the reflexology and touch group, the mean score of the pain and fatigue decreased significantly (p=0.001) both at the immediate measurement and two weeks after the intervention. In intergroup comparison, the pain score in the reflexology group was significantly lower than in the two other groups. But the fatigue scores did not make any significant changes.
Reflexology could be used safely in management of pain in major thalassemia patients; but it could not reduce the patients' fatigue.

Failure to adhere to drug therapy in patients with high blood pressure can endanger their lives.

The aim of this study was to determine the effectiveness of smartphone-based medication reminder application on medication adherence of patients with essential hypertension. Settings and Design: This clinical trial study was conducted in Yazd Cardiac Research Center.

Seventy-eight patients with essential hypertension were assigned to intervention (39 patients) and control (39 patients) groups using a random sampling method. In the intervention group, the DaroYab 2.1.0 was installed on the patient’s smartphone. The control group received routine care. Data were collected using demographic characteristics form and Morriskey’s medication adherence scale (MMAS-8). The MMAS-8 completed prior to and 3 months after the intervention. Statistical Analysis Used: Data were analyzed using IBM SPSS, American multinational technology company, Armonk, New York and nonparametric tests including the Wilcoxon test and Mann–Whitney U-test.

The mean age of the 78 patients who completed the study was 46.6 ± 7.98 years. All of the participants had a history of drug forgetfulness and 92.5% of them had poor medication adherence before the intervention. Three months after the intervention, the ratio of good medication adherence and medication adherence scores was significantly improved in the DaroYab software group (P < 0.001).

Considering the positive impact of DaroYab as a simple, practical, and inexpensive drug reminder, on medication adherence it is recommended that health-care providers introduce this application to of hypertensive patients and encourage them to use it.

The family members’ presence during teaching rounds is introduced as a challenging issue. The outcomes of family presence during teaching rounds in adult care settings is an under investigate issue. The propose of this study was to determining the effect of family presence at teaching rounds on patient’s anxiety and satisfaction in cardiac intensive care unit (CICU).

In this double‑blind randomized controlled trial, 60 patients who were hospitalized in CICU were selected based on inclusion criteria and then assigned into 2 groups (with and without family members presence during teaching round), equally by the random minimization method. The patient’s anxiety score was measured before and after rounds on the Spielberger State‑Trait Anxiety Inventory (STAI). Furthermore, the patient’s satisfaction about various clinical aspects of round was measured by a self‑reported questionnaire. The data were analyzed by SPSS software using Kolmogorov–Smirnov test, Chi‑square test, independent sample and paired sample t‑test, at the significance level of 0.05.

The study groups were similar in terms of demographic variables. In the family members presence group, the STAI score significantly decreased after intervention (P = 0.001). Furthermore, in this group, the after‑intervention STAI score was significantly lower than family absence group (P = 0.011). The mean changes of patient’s satisfaction about quality of round score in family member presence group were significantly higher than family absence group (P = 0.001).

Family presence during teaching rounds led to patient’s lower anxiety and higher satisfaction score.

Today, despite of emphasis on family-based care strategies, there is little understanding of the adult patient's perception of the presence of family members during emergency care and invasive procedures. The aim of this study was to comparing the effect of family presence and their training before the presence on the anxiety of patients undergoing invasive nursing procedures in the emergency department.

In this randomized clinical trial, 90 patients candidate invasive nursing procedures  and their family members were selected based on inclusion criteria and allocated randomly in three groups of 30 (with the presence of trained family members, with the presence of untrained family members And without the presence of family members) by   minimization method.  The data were analyzed by SPSS software using Kolmogorov-Smirnov test, Chi-square test, Kruskal Wallis Independed-sample, paired sample t-test, and ANOVA at the significance level of 0.05.

The three groups were similar in terms of demographic variables. All three groups had significantly lower anxiety scores in the post-intervention phase than before the intervention (P= 0.001). There was no significant difference between the mean and the standard deviation of the patient's anxiety scores before (P = 0.131) and after the intervention (P = 0.309) in the intergroup comparison.

The presence of family members and their training before presence did not reduce the anxiety of patients under nursing invasive procedures.

There are limited reports available on preferred chest physiotherapy methods in patients with coronary artery graft (CABG) surgery.

The aim of this study was to compare the effect of active cyclic breathing technique (ACBT) and routine chest physiotherapy on pain and respiratory parameters in patients undergoing CABG surgery.

This randomized clinical trial was carried out from July to November 2018. Seventy patients were selected randomly after CABG according to inclusion criteria and then assigned in two groups (35 in ACBT and 35 in routine physiotherapy) by random minimization method. The arterial blood gas levels, pain, heart rate, and respiratory rate were measured for both groups before and after the intervention on two consecutive days after surgery. Data were analyzed by SPSS software V.22, at a significance level of 0.05.

The two groups were similar in terms of demographic variables. In within group comparison in the physiotherapy group, the level of PaO2,HR,RR, and pain increased significantlyonboth days (P = 0.001), SaO2 onthe first day (P = 0.005) and second day (P = 0.001), and PaCO2 on the first day (P = 0.02). In ACBT group, the level of SaO2, HR, RR, and pain increased significantly on both days (P = 0.001),HCO3 on the first day (P = 0.021), and PaO2 on the second day (P = 0.001) post intervention. In between group comparison, on the first day, the level of PH (P = 0.034), and on the second day HCO3 (P = 0.032) decreased, while RR (P = 0.011) increased significantly in the physiotherapy group, at post-intervention phase.

ACBT and routine physiotherapy had similar effects on arterial oxygenation, HR, and pain perception following CABG surgery. The physiotherapy on the second day increased the RR to an abnormal range.

Considering the contradictory results on the role of complementary therapies in correcting post-operative side effects, the aim of this study was to evaluate the effect of acupressure on pain severity in patients undergoing coronary artery graft admitted to a coronary care unit.

In this double-blind, randomized, clinical trial, 70 patients were selected randomly after coronary artery bypass grafting (CABG) surgery based on inclusion criteria and then assigned to two groups (35 in acupressure and 35 in control) randomly by the minimization method. The intervention group received acupressure at the LI4 point for 20 minutes in 10-second pressure and 2-second resting periods. In the control group, only touching was applied without any pressure in the same pattern as the intervention group. Pain severity was measured before, immediately, and 20 minutes after applying pressure and touch in both groups using the visual analogue scale.

The results of repeated measures analysis of variance (ANOVA) showed a decrease in the pain score in the intervention group (group effect) during multiple measurements (time effect) and a reduction in the mean pain score in the various measurements taking into account the groups (the interaction between time and group; P = 0.001).

Acupressure can be used as a complementary and alternative therapeutic approach to relieve post-operative pain in CABG patients.

Introduction The LI4 and SP6 acupressure points are the most common points to relieve post cesarean pain, but there is no consensus on the preferred point of pressure. Therefore, this study was performed with aim to compare the effect of acupressure at LI4 and SP6 points on the intensity of post cesarean pain.

This double-blind clinical trial study was performed on 90 women referred to the maternity hospitals of Rafsanjan in 2017. They were randomly allocated into three groups: LI4 point, SP6 point and control group. Intervention was performed bilaterally, in 10 seconds of pressure and 2 seconds of rest for 20 minutes sequentially. In the control group, the points were touched with the same pattern without pressure. The intensity of post cesarean pain before, immediately and one hour after intervention was determined by visual analogue Scale in three groups. Data was analyzed by SPSS software (version 16) and ANOVA and repeated measurement variance analysis. P< 0.05 was considered significant.

In this study, the mean score of pain at three times of measurement (the time effect) was significant different (p=0.33), but comparison of the mean of three pain score in each group was not significantly different with other groups (p=0.428). The result showed a decrease in pain score trend in the Li4 group during three time measurements and a decrease in pain score of in the Li4 group compared to the control group in 1 hour after the intervention (p=0.001).

The acupressure function at the LI4 point in relieving post cesarean pain is better than the SP6 compression point

Context: Today exclusive breastfeeding through the first 6 months of the infant's life has become a challenging issue in the health-care system. It seems the health literacy to be an important element in the women's ability to understanding, processing, and practice on health information. The aim of this study was determining the relationship between maternal health literacy and their breastfeeding pattern. Setting and Design: This cross-sectional study was conducted in comprehensive health-care centers in Rafsanjan, Iran. In this study, 461 mothers who had 6-month infants and referred to comprehensive health-care centers, from November 2015 to May 2016, were selected by quota and systematic sampling method. The data collection tools were the demographic and standard health literacy for Iranian adults and the breastfeeding pattern questionnaires. Statistical Analysis Used: Data were analyzed using descriptive statistics (mean, standard deviation, and frequency), Chi-square, ANOVA test at a significant level of 0.05. The rate of starting breastfeeding in the 1st h after birth was 70.1% and the exclusive breastfeeding rate until 6 months were 68.8%. Health literacy of 5.2% of mothers was inadequate, 71.8% were adequate and excellent.     There was no significant statistical relationship between breastfeeding in the early postpartum period and breastfeeding pattern with mothers' health literacy level. Breastfeeding pattern of mothers is independent of their health literacy and it seems to take place under the influence of other personal and social-cultural factors.

Self-medication is a challenging issue in health care systems and it seems that health literacy is a determining factor in safe self-medication behaviors. Limited studies are available in this field. Therefore, the aim of this study was to determine the relationship between health literacy and self-medicating behaviors among women referred to comprehensive health care centers
In this descriptive study, 540 women, who were referred to comprehensive health care centers in 2017, were selected randomly and their health literacy and self-medicating behaviors were assessed through self-reporting method. The data collection tools were the standard Health Literacy for Iranian ýAdults (HELIA), and the self-medication behaviors questionnairesý. Data were analyzed using chi-square, Mann-Whitney U, and Kruskal-Wallis H tests.
The results showed that the majority of women (94.6%) had inadequate health literacy. More than 89% of them approved self-medication and more than 98% of them performed self-medication. Older women and those who had a higher education level had lower mean health literacy scores (P = 0.021 and P = 0.001, respectively). There was no significant relationship between self-medication and demographic characteristics. Furthermore, there was no significant relationship between health literacy and confirmation and performance of self-medication.
The women had low health literacy levels and high incorrect self-medication behaviors. Self-medication behaviors are performed independent of health literacy. It seems a reform in women's health programs and the empowerment of women in the target population is necessary in order to promote health literacy skills and appropriate self-medication behaviors.

Today empowerment of women by health literacy has become a necessity. Researchers have shown that women are active seekers of health information and seeking behaviors are driven by various motivational factors. Paying attention to women’s motivations for seeking health information could facilitate evidence-based policy making in promotion of public health literacy. As health information seeking develops within personal-social interactions and also the health system context, it seems that a qualitative paradigm is appropriate for studies in this field.. The aim of this study was to explore Iranian women’s motivations for seeking heath information..Patients and In this qualitative content analysis study, data collection was conducted considering the inclusion criteria, through purposive sampling and by semi-structured interviews with 17 women, using documentation and field notes, until data saturation. Qualitative data analysis was done constantly and simultaneous with data collection.. Five central themes emerged to explain the women’s motivation for health information seeking including: a) dealing with fear and uncertainly b) understanding the nature of disease and diagnostic/therapeutic procedures c) performing parental duties d) promoting a healthy life style e) receiving safer health care.. It seemed that respecting client’s concerns, providing comprehensive health information, as well as risk management and promoting safer health care is necessary..

Today, women empowering is an important issue. Several methods have been introduced to empower women. Health information seeking is one of the most important activities in this regard. A wide range of capabilities have been reported as outcomes of health information seeking in several studies. As health information seeking is developed within personal-social interactions and also the health system context, it seems that the qualitative paradigm is appropriate to use in studies in this regard. This study aimed to explore how women’s empowerment through health information seeking is done. In this qualitative content analysis study, data collection was done with regard to inclusion criteria, through purposive sampling by semi-structured interviews with 17 women and using documentation and field notes until data saturation. Qualitative data analysis was done constantly and simultaneous with data collection. Four central themes were emerged to explain women’s empowerment through health information seeking that included: a) Health concerns management with three subcategories of Better coping, Stress management, Control of situation, b) Collaborative care with two subcategories of Effective interaction with health professions and Participation in health decision making c) Individual development d) Self-protection with four sub- categories of Life style modification, Preventive behaviors promoting, Self-care promoting, and medication adherence. The results of this study indicate the importance of women empowerment through foraging their health information seeking rights and comprehensive health information management.

Equipping individuals with adequate knowledge on health can lead to optimal health outcomes. Scientific reports indicate client's challenges in trusting and accessing formal health information sources. This study was designed to determine the sources of Iranian women's health information. Study samples were selected through purposive sampling and with regarding to the inclusion criteria. Data were collected through semi-structured interviews with 17 women and using documentation and field notes until data saturation. Data were analyzed continuously and simultaneous with data collection using qualitative content analysis. The 5 central themes of health care professionals, social networks (with 2 sub-categories of peers and social interactions), culture and religion (with 3 sub-categories of religious teachings, traditional medicine information, and experiences of elders and seniors), mass media (with 3 sub-categories of electronic media, print media, and internet), and self-referencing (with 2 sub-categories of self-discovery-intuition and prior experiences) emerged from data analysis. These findings highlighted the need for respecting the cultural and religious beliefs of a community, and also emphasized on client's seeking rights, information needs, and empowerment in employment of formal and informal sources.

Preterm labor is a major risk of public health and important neonatal morbidity and mortality factor in world. Despite introducing its several risk factors, in 50% of cases, its etiology is unknown. From biological point of view, preterm labor and primary dysmenorrhea share common triggering mechanisms so primary dysmenorrhea can be considered as a preterm labor's predictive factor. In this study the relation between primary dysmenorrhea and spontaneous preterm labor is looked through in primiparous women in Rafsanjan. This case control study was conducted on 412 primiparous women was referred to Rafsanjan’s Nick Nafs hospital in 2010. In this Case-Control study, 205 women in control group (term delivery) and 207 in case group (spontaneous preterm labor) was enrolled in Rafsanjan’s Nick Nafs hospital. Two groups were matched in age, socio-economical status, smoking and BMI. Data were collected with questionnaire and analyzed in SPSS software, student's t-test, X2 test, adjusted odds ratio and Logistic Regression. Logistic Regression test did not show statistically increased risk of preterm delivery in women with history of primary dysmenorrhea (odds ratio=1.12). The risk of preterm labor in women with history of mild or moderate and severe dysmenorrhea was slightly strengthened (1.26) but statistically non significant (P value=0.45). The exact biochemical mechanisms that cause primary dysmenorrhea and spontaneous preterm labor are unknown.