نشریه پرستاری ایران
پیاپی 118 (تیر 1398)

Surgical site infection (SSI) is a common postoperative complication. The observance of the aseptic technique is an effective measure to prevent SSI. The knowledge and performance of surgical technicians and technologists play a pivotal role in the proper implementation of this technique. The present study aimed to compare the knowledge and performance of surgical technicians and technologists regarding the observance of the aseptic technique. This cross-sectional, comparative study was conducted during 2017-2018 on 235 surgical technicians and technologists in eight teaching hospitals in Isfahan, Iran. The participants were selected via stratified random sampling. Data were collected using a researcher-made questionnaire for the measurement of knowledge, which was completed by the participants. In addition, a researcher-made checklist was completed by the researcher after observing the performance of the participants in three surgical procedures. Data analysis was performed in SPSS version 22.0 using descriptive and analytical statistics. The mean score of the knowledge of surgical technicians and technologists was favorable, while their mean score of performance was average. The mean score of knowledge (P=0.047) and performance (P=0.01) was significantly higher in the surgical technologists compared to the surgical technicians. Moreover, a direct correlation was observed between the scores of knowledge and performance in both surgical technicians (P=0.027) and surgical technologists (P=0.032). According to the results, improving the knowledge of surgical technicians and technologists regarding the aseptic technique could enhance their performance in this regard. Therefore, the findings of this study could lay the groundwork for the proper supervision of the performance of healthcare providers in order to harmonize their knowledge and performance. Furthermore, considering the higher scores of knowledge in surgical technologists compared to the technicians, it is advisable that the latter be encouraged to continue their education. The implementation of effective training programs should also be considered in order to improve the performance of operating room personnel.

Assessment and application of new educational approaches are essential to the enrichment of educational programs. Problem-based learning (PBL) is a novel educational approach, which is based on the principle of using problems as the starting point for the acquisition and combination of new knowledge. The present study aimed to systematically review the studies on PBL in nursing education in Iran.  In this comprehensive review, all the articles published in Persian focusing on PBL in nursing were evaluated. The articles were retrieved by searching in databases such as Iran Medex, Magiran, Google Scholar, Iran Research Institute for Information Science (Irandoc), and Scientific Information Database (SID) using various keywords, including learning, teaching, problem-solving, PBL, problem-oriented, and nursing for the articles published during April 2001-2018.  In total, 45 articles were retrieved using the mentioned keywords. After a thorough review, 31 articles were selected based on the research objectives, which were published in Persian in national journals, and their full texts were accessible. The selected articles had five main themes, including the effects of problem-solving training on the ability of nursing students in the country, perceptions of nursing students toward PBL, influential factors in PBL, comparison of education based on PBL with other educational methods, and experiences of nursing students with PBL.  According to the results, several studies have confirmed the efficacy of PBL in nursing education and the empowerment of students, urging the extensive adoption and comprehensive incorporation of this approach into nursing education. Although few studies contradicted the positive impact of this educational approach, most of the studies in this regard indicated the satisfaction of nursing students with the use of PBL in their courses.

Job adaptability is essential to the successful employment of nurses, which could be largely influenced by psychological capital. The present study aimed to investigate the association between psychological capital and job adaptability in the nurses at Kashan University of Medical Sciences hospital, Iran. This descriptive-correlational study was conducted on 190 nurses at Kashan University of Medical Sciences hospital, who were selected via stratified random sampling. Data were collected using two questionnaires of psychological capital and job compatibility. Data analysis was performed in SPSS version 22 using descriptive and inferential statistics.   The mean psychological capital (5.41±0.77) was above average 4, and the mean job compatibility (3.23±0.43) was above average 3. Pearson's correlation-coefficient indicated a positive, significant correlation between psychological capital and job adaptability of nurses (r=0.43). In addition, the most significant association was observed between psychological capital and value orientation (r=0.43), while the least significant correlation was denoted between psychological capital and autonomy (r=0.15). According to the results, the implementation of programs for the improvement of psychological capital in the nursing community could result in the job adaptability of nurses. Furthermore, a supportive view within hospitals toward nurses and the subsequent perception of being supported on behalf of nurses could effectively enhance their job adaptability.

Failure in proper endotracheal suctioning may lead to hemorrhage, lesions in the tracheal mucosa, infections, atelectasis, and hypoxia, which are associated with increased mortality, length of hospital stay, and treatment costs in hospitalized neonates. Considering that nurses play a key role in the prevention of these complications, the present study aimed to assess the effect of training on the performance of nurses in the endotracheal suctioning of neonates. This quasi-experimental was conducted with control groups on 80 nurses, who were selected via continuous sampling, at selected hospitals affiliated to Tehran University of Medical Sciences and Iran University of Medical Sciences (two control hospitals and two intervention hospitals) in 2016. Before the training intervention, the performance of nurses was evaluated using a researcher-made checklist, which was developed with a demographic section and nursing performance section with 30 items based on guidelines and expert opinions. The contents of the checklist and educational contents were assessed and approved by a panel of experts. The performance of nurses was observed by the researcher in three stages. One month after the intervention, the performance of the same nurses was evaluated again by the same researcher in three stages. The score of nursing performance before and after the intervention was 51.38±8.70 and 72.19±4.16, respectively, which indicated a statistically significant difference (P<0.001). Considering that the performance of nurses was not optimal in the endotracheal suctioning of neonates, it is essential provide training to nurses based on the related guidelines and expert opinions in order to enhance the quality of care. In this regard, the provision of in-service training programs could promote the quality of neonatal care services for endotracheal suctioning.

Old age is associated with several health threats, including falls, with fear of falling considered to be one of its major complications, especially after orthopedic surgeries, which may lead to limited daily activities, isolationism, and lack of social participation. The present study aimed to assess the fear of falling and its contributing factors in the elderly patients with the history of falls following orthopedic surgeries, who referred to the orthopedic clinics of selected hospitals affiliated to Iran University of Medical Sciences. This cross-sectional, descriptive-correlational study was conducted on 280 elderly patients referring to the clinics of the hospitals in Tehran, Iran. The patients were selected via convenience sampling. Data were collected using the abbreviated mental test (AMT), a demographic questionnaire, and the falls efficacy scale instrument (FES-I), which were completed via face-to-face interviews with the elderly. Data analysis was performed in SPSS version 20 using descriptive and inferential statistics, independent t-test, one-way analysis of variance (ANOVA), and linear regression analysis at the significance level of P≤0.05. The mean age of the elderly was 69.50±4.29 years, and 65% and 35% of the patients were female and male, respectively. The results of Pearson's correlation-coefficient indicated a direct correlation between the fear of falling and age (P=0.008; r=0.159). Direct, significant correlations were also observed between the fear of falling and hypertension, the number of the used medications, and pelvic fractures (P<0.05). In addition, 97.9% of the patients had more than one orthopedic surgery, which was directly correlated with the fear of falling. According to the results, the frequency of fear of falling in the elderly with the history of orthopedic surgeries was significantly high. Considering the adverse outcomes of the fear of falling in elderly patients, it is recommended that counseling training programs be planned for the elderly patients after orthopedic surgeries for the health promotion of these individuals and active old age, as well as the reduction of the fear of falling in elderly patients.

Premenstrual syndrome (PMS) is considered to be a common abnormality in the women of the reproductive age, which reduces efficiency in various professional groups. The present study aimed to determine the prevalence of PMS and its influential factors in the operating room technologists. This cross-sectional study was conducted on 112 operating room technologists in the teaching hospitals affiliated to Iran University of Medical Sciences during 2016-2017. The participants were selected via census sampling. Data were collected using three questionnaires of demographic characteristics, PMS symptom screening, and occupational stress. Data analysis was performed in SPSS version 23 using descriptive and inferential statistics (Fisher's exact test and Chi-Square). Approximately 57.1% of the operating room technologists had moderate-to-severe PMS. No significant correlations were observed between age, body mass index, education level, physical exercise, and regular exercise with PMS. However, there were significant correlations between PMS, type of physical exercise (P=0.027), and occupational stress (P=0.005). According to the results, PMS had a lower prevalence in the technologists with less occupational stress and those with physical exercise (especially endurance training) comparatively. Therefore, it is recommended that training interventions be implemented in order to reduce occupational stress and encourage physical exercise in these healthcare professionals.

Discharge of materials from ileostomy in a fluid, inconsistent form may lead to water and electrolyte imbalance and decreased nutrient absorption, followed by the risk of malnutrition. The present study aimed to investigate the effects of smartphone-based nutritional education on the biochemical indicators of patients with ileostomy. This quasi-experimental clinical trial was conducted with a control group on 72 patients with ileostomy in 2018. The patients were selected via continuous sampling and non-randomly allocated to two groups of intervention and control. After ileostomy implantation, both groups received training on proper dietary habits by the ward staff. In addition, the patients in the intervention group were provided with smartphone-based nutritional education by the researcher. Evaluation of biochemical indicators was performed one day before ileostomy implantation and three weeks after surgery by the researcher. Data were collected using demographic forms and biochemical indicator reports. Data analysis was performed in SPSS version 16 using descriptive and inferential statistics. Before ileostomy implantation, biochemical indicators had no significant differences in the intervention and control groups. Three weeks after ileostomy implantation, the only significant difference was observed in the level of C-reactive protein (CRP), which was significantly higher in the control group compared to the intervention group. Moreover, changes in the biochemical indicators in the study groups before ileostomy implantation and three weeks after the procedure indicated that the levels of albumin and total protein increased more significantly in the intervention group compared to the control group, while the level of CRP increased in the control group. Although statistically significant changes were denoted in the assessed biochemical indicators, the changes were not considered clinically significant and reliable. Therefore, the increasing of time intervals in larger sample populations with more generalizable results could determine the functional role of the training intervention, so that it could be applicable for patients with ileostomy.

Hemodialysis is currently a common treatment for chronic renal disease, which is associated with numerous limitations in the physical, mental and even social function of the patients. As such, self-care activities could significantly help hemodialysis patients to adapt to the course of their disease. The present study aimed to determine self-care agency and its influential factors in hemodialysis patients.Materials &

This cross-sectional was conducted on the patients referring to Razi Educational-Therapeutic Hemodialysis Center in Rasht, Iran in 2017. In total, 126 patients were selected via random sampling. Data were collected using a two-section questionnaire of sociodemographic characteristicsand modulated Chinese version of 28-statement self-care agency. Data analysis was performed using descriptive statistics (mean, standard deviation, frequency, and percentage) and analytical tests (independent t-test, correlation-coefficient, analysis of variance, and logistic regression analysis).

Approximately 71.4% of the patients had optimal self-care abilities, and a significant correlation was observed between age and self-care agency (P=0.013). Moreover, education level was significantly correlated with self-care agency (P<0.0001). The logistic regression analysis also indicated that the increased age of the patients from the mean age was associated with the reduction of their self-care agency by 1.5 times.

Although the majorityof the patients had optimal self-care abilities, the results also indicated that with increased age and due to the treatment procedure and disease complications, hemodialysis patients were faced with limitations in proper self-care. Therefore, it is recommended that proper measures be taken regarding the care program of these patients, so that they could fully contribute to their care process as a member of the healthcare team.