مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و نهم شماره 3 (پیاپی 79، تابستان 1400)

Drug interactions are one of the problems caused by the irrational administration of drugs and one of the common causes of morbidity and mortality in patients. Since drug interactions are usually predictable, they are therefore avoidable and manageable. This study aimed to evaluate the frequency of drug interactions and their related factors in hospitalized patients of the intensive care unit in the Hamadan Besat hospital, Iran.

 This cross-sectional study was performed on the clinical records of patients admitted to the intensive care unit (2019-2020) of Besat Hospital in Hamadan, Iran. Data were analyzed to determine the type of drug interactions based on the interactions available on the Up To Date and RxList databases. Other information was obtained from the patientschr('39') clinical records. Completion of information was recorded in the Pre-Design checklist. Finally, the data was analyzed using SPSS software version 22 and appropriate descriptive-analytical methods.

 The mean number of total drug interactions per prescription was 5.94 ± 4.91. Most interactions were type C (63.89%), Moderate (67.66%), Fair (70.96%) and Significant (44.76%).

According to the results, prolonged stay in an intensive care unit, the elderly, and polypharmacy are the main important factors associated with the occurrence of drug-drug interactions. These results indicate the importance of paying more attention to the monitoring and control of prescribed drugs in these patients.

 Post-term pregnancies are pregnancies that last more than 42 full weeks (294 days) from the first day of the last menstrual period. With increasing gestational age, the rate of maternal and fetal morbidity and mortality significantly increases. Among medical methods, misoprostol is widely used to prepare the cervix in post-term pregnancies. But today, due to the high side effects of misoprostol, especially the increasing need for cesarean section, some complementary medicine methods are used to prepare the cervix. The aim of this study was to compare the effect of Misoprostol and Evening primrose oil capsule with Misoprostol on delivery method in post-term pregnancies.

 This study was performed as a single-blind randomized clinical trial on 130 pregnant women with post-term pregnancy referring to the delivery ward of Besat Hospital in Sanandaj, Iran. The samples were selected by available sampling method and assigned to the intervention and control groups by random sampling method. In the intervention group, a 500 mg capsule of evening primrose oil was given vaginally and 25 micrograms of misoprostol were given sublingually, and in the control group, an ineffective capsule was given vaginally with 25 micrograms of misoprostol sublingually. Demographic data, clinical characteristics and delivery method were used for data collection. Data were analyzed by SPSS software version 21 and statistical tests such as Chi-square, t-test and ANOVA. P-value less than 0.05 was considered significant.

 Findings showed that there was no significant difference between the two groups in terms of demographic and midwifery characteristics and the two groups were homogeneous in this respect (P>0.05). But in the evening primrose oil and misoprostol group, the mean bishop score was significantly increased compared to the misoprostol group (P<0.05). Also, in the evening primrose oil and misoprostol group (12.3%), the need for cesarean section was lower than placebo and misoprostol group (41.5%) (P<0.0001).

 The results of the study showed that the use of vaginal capsules of evening primrose oil with misoprostol compared to misoprostol alone while helping to ripening the cervix is associated with a lower rate of cesarean section.

 Self-care in hypertension is one of the most significant strategies in order to control the disease; moreover, health literacy and social support are regarded as effective factors in this case. Therefore, considering the necessity and need of society in promoting the level of health literacy and social support, as well as the role and importance of self-care in hypertension, the aim of the present study was to determine the relationship among self-care behavior and health literacy and social support in patients suffering from hypertension.

 The descriptive-analytical study was cross-sectional and was conducted on 400 patients with hypertension referring to the specialized heart clinic of Tohid Hospital in Sanandaj, Iran, using the convenience sampling method. The Four-part Demographic Questionnaire, the Self-Care Behavior Assessment Questionnaire, the Health Literacy for Iranian Adults Questionnaire and Social Support Questionnaire were used so as to collect the data. To analyze the data, SPSS software version 21 and parametric tests of Pearson correlation coefficient and non-parametric Kruskal-Wallis analysis were used.

 The findings indicated that mean and standard deviation of Self-Care Behavior Score and Health Literacy and Social Support were 38/64 ± 8/83, 63/10 ± 11/16 and 91/54 ± 6/93, respectively. There was a Positive significant relationship between Self-Care Behavior and Health Literacy (r=0/491, P=0/00), Self-Care Behavior and Social Support (r=0/322, P=0/00), Social Support and Health Literacy (r=0/337, P=0/00).

The results of the present study showed that having health literacy and social support would influence the individual and the occurrence of self-care behaviors, and since these cases are highly effective in preventing and controlling hypertension, it is necessary to train and promote them in the health system.

Diagnosis of cancer can cause significant psychological stress for the individuals and their family. Research shows social support has a positive and significant relationship with cellular immunity variables and some variables of blood cell count. Using tools such as painting, a child experiences all the issues of his life, tests and builds himself. The aim of this study was to evaluate the effectiveness of painting on cognitive regulation of emotion, anxiety and blood cells (CBC) in children aged 7 to 12 years with cancer.

 This research was conducted for 2 months from May 2016. The research method was quasi-experimental with pre- and post-test design and a control group. Among 43 children aged 7 to 12 years with cancer who referred to Dr. Sheikh Hospital in Mashhad and volunteered to cooperate with the study, 30 were selected according to the entry and exit criteria and were randomly assigned to the experimental and control groups. Then painting and free therapy were performed in the subjects of the experimental group. Garnfsky et al. (2001) Emotion Regulation Questionnaire, Spence Childrenchr('39')s Anxiety Scale (SCAS) and blood cell count test were used to collect data in pre- and post-test. Analysis of covariance was used to analyze the data.

 Findings show that painting therapy is based on emotion regulation (F=293.8; P=0.001), anxiety (F=135.3; P=0.001), blood cell count test in WBC (F=13.2; P=0) and is effective in platelet count (F=152.77; P=0.001) in children with cancer. Performing painting therapy increases the components of emotion regulation and blood cell counting and reduces the components of anxiety.

The overall goal of painting therapists is to enable clients to grow and transform in a healthy and safe environment by using painting tools. Therefore, in this program, sick children are given the opportunity to express their thoughts and feelings and communicate with others. According to the research findings, this approach can be used to work with children with cancer in counseling centers, hospitals and schools.

Clinical education (mentorship program) is one of the most important aspects of education in the medical sciences. Therefore, this study was conducted to investigate the effect of mentorship program on self-esteem, anxiety and learning clinical skills of emergency medical students.

 This study was a quasi-experimental study in which 24 emergency medical students of Dezful University of Medical Sciences were enrolled by available sampling. Data collection scales were Coopersmith Self-Esteem Inventory, Spielberger State-Trait Anxiety Inventory and Clinical Skills Questionnaire. Data analysis was performed using SPSS-20 software and descriptive and analytical statistics.

 In this study, 70.8% of students (17 persons) got an average point of 15-17 and were 21 years old. Also, the mean scores of self-esteem (P <0.001), anxiety (P <0.001) and clinical skills (P <0.001) before and after clinical training were significantly different so that the mean of self-esteem, anxiety and clinical skills of students before Clinical education were 37.12, 90.29 and 112.29, followed by 46.92, 70.50 and 136, respectively.

After using the mentorship program, an increase in clinical skills, a decrease in anxiety and an increase in studentschr('39') self-esteem were observed. Therefore, it is necessary to develop a clinical education program that provides a path for scientific growth to acquire clinical competencies.

Women with breast cancer often experience alterations in their mothering roles both because of the disease and the reduced ability for child care. However, many women with breast cancer try to play their mothering roles as they did before the disease. This study aimed to discover the strategies used by Iranian women with breast cancer to manage their mothering roles in the process of the disease and survival.

 A qualitative content analysis study was conducted on 23 mothers with breast cancer. Semi-structured interviews were used to collect data and a conventional content analysis method was used to analyze the data simultaneously with data collection.

 Totally 1200 non-duplicate codes were extracted from the data and were categorized into four categories. Self-preparation was the first category and included three subcategories, namely, self-awareness for regaining the role, psychological mobilization to continue the role, and seeking informational support. Role reorganizing was the second category and had two subcategories, namely assigning to alternate people, and modifications of maternal duties. Self- and family-reconstruction was the third category and included three subcategories of energy conservation, communication development, and child protection. Playing a participatory-supervisory role was the fourth category and had two subcategories of participation and supervision.

Identifying the strategies used to play the mothering role can help health care professionals to support, provide advice, and train the mothers with breast cancer and their families. It also helps mothers to play their mothering role during the disease.

Pregnancy causes many physical and psychological changes. Therefore, pregnant women may face many issues and problems, including a lack of reduced sexual function. This study was prepared to compare the effectiveness of cognitive-behavioral couple therapy training and the EIS (empathy, intimacy, and sexual satisfaction) model on sexual function in pregnant women.

 This was a semi-experimental study with pre- and post-test design. A total of 60 people among the statistical population, who met the inclusiojn criteria were chosen, and randomly divided into three groups of 20 (two intervention groups and one control group). The intervention participants were trained using cognitive-behavioral and EIS model in 8 sessions of 90 minutes, while the control group did not receive any training during this time. The tool used to collect data in pre- and post-test was the Womenchr('39')s Sexual Performance Index (FSFI). Data were analyzed using SPSS 23 at a significance level of 0.05.

 Findings showed that both cognitive-behavioral approaches and the EIS model are practical on sexual function and its subscales (sexual desire, sexual arousal, vaginal moisture, orgasm, sexual satisfaction, painful intercourse) (P<0.05). There is a difference in their effectiveness in this regard. The EIS model with a mean and standard deviation of 24.08 ± 1.85 had a more significant effect on sexual function than the cognitive-behavioral approach with a mean and variation of 17.58 ±1.1.

Therefore, it can be concluded that despite the differences between these two approaches (cognitive-behavioral approaches and EIS model), both are useful in terms of sexual function and its subscales. However, due to the greater effectiveness of the EIS model, it can be used during pregnancy besides the other cares.

 Nursing is recognized in all countries as a job with high occupational stress. Therefore, the existence of tools to assess this occupational stress can contribute research into nurses’ mental health. The aim of this study was to investigate the psychometric properties of Persian version of the Condensed Nurseschr('39') Occupational Stress Scale (NOSS).

 In this cross-sectional study, 224 nurses working in two hospitals in Shiraz, Iran, which were chosen as care centers for patients with coronavirus, were selected by convenience sampling method and completed the Condensed Nurseschr('39') Occupational Stress Scale. SPSS 22 and AMOS software were used to analyze the data.

 The results of exploratory factor analysis using principal components method and confirmatory factor analysis confirmed the two-factor structure of “stresses related to environmental-organizational factors” and “stresses related to high workload’ in the Persian version of the Nurseschr('39') Occupational Stress Scale. In addition, Chronbach’s alpha and McDonald omega were used to determine internal consistency, Chronbach’s alpha and McDonaldchr('39')s omega coefficients for the whole scale (α: 0.94 and ω: 0.95) and two subscales of “stresses related to environmental-organizational factors” (α: 0.91 and ω: 0.91) and “Stresses related to high workload” (α: 0.90 and ω: 0.91) were within acceptable limits.

Condensed Nurseschr('39') Occupational Stress Scale has acceptable psychometric properties in Iranian society and can be used as a useful tool in research related to nurseschr('39') occupational stress.

Pregnant women are one of the vulnerable groups against COVID-19. Understanding the affected population characteristics helps to identify risk factors and set more effective treatment goals; in this regard, the present study tries to review demographic characteristics, clinical signs, radiological and laboratory findings in pregnant women with COVID-19 in southern Iran.

 This descriptive cross-sectional study was conducted on 30 pregnant women with COVID-19 who were selected from teaching hospitals in Fasa, Jahrom, and Shiraz in Fars province. Sampling was done through the convenience method from March to July 2020. A researcher-made checklist was applied to gather the required data which were analyzed using SPSS 22 software and descriptive statistics.

 The mean age of patients was 28.30±9.96 years. Of patients, 60% were in the first trimester of pregnancy. The average length of stay in a hospital was 8.47±4.37 days. Fever (46/66 %) was the most common clinical finding, increased C-reactive protein (CRP) levels (50%) was the most common laboratory finding, and Ground Glossy Opacity (GGO) (56/66 %) was the most common radiological finding in both lungs. Of pregnant women, 80% with COVID-19 had an underlying disease. The most common underlying diseases were 36.66% for asthma and 20% for diabetes. Of normal deliveries, 53.33% and 3.33% of neonatal and maternal deaths were reported.

 The most common time for COVID-19 in pregnant women was reported in the first trimester of pregnancy with clinical signs of fever and a history of asthma and diabetes. Therefore, the findings of this study highlight the importance of paying attention to pregnant women as one of the most at-risk groups in the COVID-19 pandemic. Health policy makers can use the findings of this study and the reported outcomes to develop appropriate health protocols for health care of pregnant women in the COVID-19 pandemic.