فصلنامه حیات
سال هفدهم شماره 4 (پیاپی 51، زمستان 1390)

Hypothermia is a main side effect during surgery in which blood pressure, heart rate, intra cranial pressure, oxygen consumption, pain and discomfort increase. The rate of cesarean section in Iran is three times more than global standard. This study aimed to investigate effect of pre-warmed intravenous fluid therapy on prevention of shivering after general anesthesia in cesarean section. Methods & Materials: A total of 62 women undergoing general anesthesia for elective cesarean section were randomly allocated into two intervention and control groups. In the intervention group, patients received pre-warmed serum (37°C) and in the control group, patients received serum at room temperature (25.5°C). The postoperative shivering and some homodynamic parameters of the participants were assessed in recovery room.

The mean of body temperature in the intervention and control groups were 35.9°C±0.48 and 35.42°C±0.6, respectively (P<0.05). The incidence of post operative shivering in the intervention and control groups were 13% and 35%, respectively (P<0.05).

Infusion of pre-warmed serum (37°C) would prevent postoperative shivering and could improve nursing care for women underwent general anesthesia in cesarean section.

This study aimed to assess the relationships between iron and copper levels in maternal and cord serums together and with pregnancy outcomes. Methods & Materials: An Analytical cross-sectional study was conducted among 370 pregnant women in labor and their neonates in Maryam, Akbarabadi and Imam hospitals in Tehran, Iran. Copper concentrations were measured using the standard atomic absorption spectrophotometer method and Iron concentrations were measured by a kit through RA 1000 method. Data were collected using a questionnaire and were analyzed using Spearman correlation, Chi- square and Logistic regression tests. The mean copper concentrations in the maternal and cord bloods at delivery were 114.52±37.4, 22.4±11.6 (μg/dl), respectively. The Iron levels were 119.2±64, 164.3±65.3 (μg/dl), respectively. Of all the mothers, 54.3% had copper deficiency, 1.1% Iron deficiency and of all the newborns, 44.7% had copper deficiency and 3.5% Iron deficiency. The Spearman Correlation analysis showed significant positive correlations between concentrations of each element in maternal serum with cord serum and also between maternal iron with maternal copper, and maternal iron with cord copper. The Chi-square analysis showed that there was a significant relationship between maternal copper deficiency and gestational hypertension (P<0.001). There were no significant relationships between these trace element levels at delivery with premature rupture of membranes and preterm labor. Logistic regression analysis showed a significant negative relationship between maternal copper levels and gestational hypertension (odds: 0.98, 95%CI: 0.97-0.99). Maternal copper deficiency was rather high in the participants of the study (54.3%), and was related to incidence of gestational hypertension. These findings illustrated importance of trace elements during pregnancy. Providing suitable dietary recommendations and giving supplements during pregnancy can help to decrease maternal and fetal mortality and morbidity.

Postoperative nausea is a common problem after general anesthesia, especially in ambulatory surgery. In ocular surgeries including strabismus surgery, intraocular pressure increase may lead to eye damage. Drug therapy has various side effects. The purpose of this study was to evaluate acupressure on nausea in patients undergoing strabismus surgery. Methods & Materials: In this double-blinded clinical trial, 60 patients undergoing strabismus surgery were allocated into intervention and control groups. In the intervention group, a sea-band was placed on the P6 point of patient's wrists 30 minutes before induction of anesthesia. In the control group, the sea-band was placed in the opposite position of the patient's wrists. Data were collected during six hours after surgery in the recovery room. Data were analyzed using Chi square, t-test, and Mann-Whitney tests. There were no differences in demographic and surgical characteristics between the two groups at baseline. The intensity of nausea in the recovery room (P=0.002) and six hours after surgery (P<0.001) were significantly less in the intervention group than the control group. Based on the findings of this study, acupressure decreases post operative nausea. Acupressure is a simple, noninvasive and cost- effective intervention which can be applied by nurses to prevent post operative nausea.

Although caring is a complex concept with various definitions, there are no agreement on the exact meaning among researchers. The aim of this study was to compare caring behaviors of nurses from patient's and nurse's perspectives. Methods & Materials: The study was conducted among 150 patients hospitalized in Boushehr hospitals and 50 nurses caring for them. Data were collected using quota sampling method via Caring Behaviors Inventory (CBI). Findings showed that there were significant differences between patient's and nurse's perspectives on the subscales of the instrument including assurance of human presence and attentiveness to other's experiences. Moreover, there was significant difference in total scale of caring behaviors of nurses between patients and nurses (t=2.559, P=0.011). Nurses believed that they provide care for patients without making estimations of their expectations. It seems that nurses should attend to standard care to fill the gap.

Web-based technologies provide new opportunities for education, research and professional development of nursing. Nurses have few opportunities to use the Internet due to manager's obligations not to use the Internet in work hours, and their traditional attitudes to nursing practice. Establishment of a national nursing portal is a useful way to resolve some of these problems. The purpose of the present study was to investigate the experiences of development of nursing portals in some countries and provide helpful recommendations. Methods & Materials: This was a descriptive- comparative study. Using systematic review of the literature, the least features for nursing portal structures and contents were identified. Then, the identified features were assessed in selected countries through observation or communication with the portal board.

Personalization, user's profile, search engine, platform-independent display, SSO capability, security mechanisms and collaborative capabilities, clinical guidelines, continuing education, electronic learning courses, and evidence-based nursing processes were common features in the nursing portals.

Development of a specialized comprehensive portal that has all of the desirable features can be achieved through clear definitions of strategies on portal development, maintenance, and analysis of user's requirements. The main requirement to integrate services and contents provided by the portal include specific and integrated structure of all entities in nursing services systems.

Hemodialysis is a common replacement therapy for patients with ESRD, worldwide. Effective and adequate hemodialysis can improve quality of life and reduce complications of renal failure. Enhancing quality of dialysis results in reducing the complications and mortality rate in patients with chronic renal failure. The aim of this study was to assess the adequacy of dialysis in patients undergoing dialysis with Bicarbonate solution in hemodialysis ward of a hospital in Sary. Methods & Materials: This cross-sectional study was conducted on 50 patients admitted in the hemodialysis ward with chronic renal failure diagnosis. A researcher-made questionnaire was used to gather data. The KT/V formula was used to assess the adequacy of hemodialysis. The URR common characteristic was also measured. Data were analyzed using statistical tests.

The mean age of patients was 54.76±12.55 years. The mean of KT/V and URR were 0.26±0.92 and 0.47±0.09, respectively. The kt/v ratio was lower than 1.2 in 85.2% of the patients; and the URR was lower than 65% in 97.8% of the patients.

The hemodialysis adequacy was low in 85.2% of the patients in the hospital and the hemodialysis efficacy indicators were lower than the standard measures. Assessment to find the reasons of low efficacy of hemodialysis is recommended.

Diet rich in fruits and vegetables is shown to be an important factor in prevention of chronic diseases. Adolescence is a critical period in adopting eating behaviors. Schools are important social environments in adolescent's lives; and are important settings for interventions that aim to improve eating behaviors, including fruit and vegetable intake. This study aimed to assess effectiveness of a school-based intervention based on social cognitive theory on fruit and vegetable (F&V) intake of female adolescents in Tehran. Methods & Materials: This experimental school based field trial was conducted on 296 female students aged 10-13 years old (157 in the intervention and 139 in the control groups). The intervention included classroom nutrition education on F&V and increasing availability of F&V through school buffet. Psychosocial characteristics of the students were assessed using a questionnaire and F&V intake were measured using 24-hr recall method, at baseline and after three months intervention. Descriptive and inferential statistics were used for data analysis. After the intervention, vegetable and fruit intake were 0.6 and 0.63 servings higher in the intervention group compared to the controls. Knowledge and self-efficacy scores were significantly higher in the intervention group compared to the control group. Home availability and observational learning scores were significantly decreased in the intervention group. Through the intervention process, many valuable experiences were gained to be used in future interventions.

Several factors have been reported to be influential in development of the premenstrual syndrome. There are no studies available on relationship between premenstrual syndrome with body mass index in Iran. This study aimed to determine this relationship among university students. Methods & Materials: This was a cross-sectional study conducted on a random sample of 500 students living in the dorms of Arak University of Medical Sciences. The participants had not stress, anxiety and severe depression on the basis of the DASS21. Data were gathered using Social Status Questionnaire, including demographic, menstrual status, reproductive and eating habits and body mass index measurement items. The participants completed the abbreviated form of premenstrual syndrome evaluation within seven days of bleeding up to two days after onset of bleeding for one cycle. Using logistic regression analysis, the association was assessed by adjusting for confounding variables. A majority of the students had normal BMI (<25) (90.8%). The results showed that the risk of premenstrual syndrome in the participants with high BMI was 2.43 times more than the participants with normal BMI (OR=2.43; CI=8.33-1.66). High BMI increased the risk of premenstrual syndrome. Interventions to decrease the BMI should be designed and implemented in overweight and obese patients with premenstrual syndrome.