مجله تحقیقات نظام سلامت حکیم
سال چهاردهم شماره 4 (پیاپی 55، زمستان 1390)

Clinical supervision is an essential way of support and advances professional roles of nurses. Clinical supervision includes objectives and positive functions and is an effective support system within many challenges in nursing. The aim of this study was to investigate factors affecting processes of clinical supervision from perspectives of nurses.

In this qualitative and content analysis study, 18 participants including supervisors and nurses were selected purposively. Data were collected using semi-structured interviews, document reviews, and observations. Data were collected from September 2009 to October 2010. Data were analyzed using content analysis method.

The results of the study showed that implementation of clinical supervision by supervisors were affected by individual and organizational dimensions. In the individual dimension three themes were emerged: 1) supervisors’ individual competencies; 2) supervisees’ individual competencies; and 3) interaction between the supervisors and the supervisees. The organizational dimension had four themes: 1) high work load; 2) complex nature of clinical supervision; 3) non-effective organization in supervising; and 4) inappropriate fields for monitoring.

According to the findings, several factors influenced clinical supervision including personal characteristics of supervisors and supervisees, complex nature of clinical supervision and environmental factors in hospitals. Understanding the different perceived dimensions of clinical supervision can help nurse managers to implement effective clinical supervision.

The aim of this study was to investigate the prevalence of attention deficit/ hyperactivity disorder among third grade primary school students in Rasht during the academic year of 2007-2008. A total of 200 students studying in third grade of primary school were selected using multi-stage cluster random sampling. The parents and teachers completed the Conner’s Rating Scale. Data were analyzed using appropriate statistical tests. It was shown that 26 children (14.4%), 32 children (17.67%), and 14 children (7.7%) had attention deficit/ hyperactive disorder according to the teachers, parents, or both teachers and parents reports, respectively. The prevalence of attention deficit/ hyperactive disorder that was reported by teachers, parents, or both of them was approximately high in comparison with the previous studies. It might be due our study sample selection in which only third grade primary school students were selected.

Successful managers integrate strong interpersonal skills with technical knowledge to improve their performances. Emotional Intelligence not only provides the basis to further these skills, but also plays an important role in efficiency of group members and solves conflicts using emotions. The aim of this study was to determine relationship between Emotional Intelligence with conflict management strategies among educational and research managers of Shiraz University of Medical Sciences. In this cross-sectional study, 81 educational and research managers from faculties and research centers were selected using random sampling. Three questionnaires including Robin's conflict management, Schering Emotional Intelligence and individual traits were used for data gathering. Data were analyzed using t –test, Chi-square, and Pierson correlation tests. The mean of emotional intelligence was 115.01. About half of the managers (50.6%) used avoidance strategy, and only 47.2% used collaboration strategy. Educational managers (87.6%) and males (59.6%) tend to use avoidance strategy more. Research managers (62.86%) and females (34.5%) used control strategy more. There was no statistically significant correlation between emotional intelligence with the strategies. Among educational managers, there was a statistically significant negative relationship between control strategy and management experiences. Among males, there were significant negative relationships between emotional intelligence and avoidance/collaboration strategies. Emotional Intelligence is an important factor to recognize and solve conflicts. It is necessary to improve top managers´ performances through learning emotional intelligence strategies to them. The continuing education of conflict management strategies would help managers to recognize and manage conflicts timely and properly.

The aim of this study was to assess the effects of a previously conducted needs assessment on West Abouzar neighborhood changes after three years.

This was a cross sectional study in two qualitative and quantitative parts. In the qualitative phase, we conducted semi-structured interviews to determine the types of interventions and selection criteria, and their effects on the approaches of the local headquarters. Based on the qualitative results, a questionnaire was designed in order to use in the quantitative part of the study. A total of 352 individuals selected through random cluster sampling were recruited to the study. Data were gathered by local trained individuals and were analyzed using appropriate methods.

The results revealed that for all identified problems, except for drug abuse and unemployment, at least one intervention was performed. Majority of interventions were constructive, while in social issues limited interventions were conducted. It was shown that 29.5% of the interventions were good in quality, 47% were moderate and 23.5% were weak. More than half of the participants (51%) stated that interventions were effective regarding their quality of life; however, they expected more influential interventions. A total of 21.1% of respondents believed that the interventions were relatively effective; 11.1% reported that the interventions were very effective; and 17% stated that the interventions had no effect on their lives.

Participatory needs assessment and conducting interventions based on the local needs are effective approaches to resolve health-related problems.

Regarding the importance of measurements to reduce neonatal mortality rate, this study aimed to assess the causes of neonatal mortality and its related factors in two hospitals in Qazvin.

This was a cross-sectional study in which the medical files of the NICUs of Ghods and Kosar hospitals in Qazvin were assessed during April to September 2010. Data were assessed according to some related factors including gender, gestational age, birth weight, APGAR score, mothers’ age, neonatal age, cause of death, maternal past medical history, and complications of pregnancy and delivery.

From 2 25 admissions, 50 deaths occurred during the study (neonatal mortality rate: 22.2%). The causes of mortality were respiratory distress syndrome (26%), sepsis and its complication (DIC) (40%), asphyxia (16%), congenital heart disease (14%), and other causes (4%). It was also revealed that the causes of death in low birth weight neonates were similar to those of premature neonates. There were significant relationships between death rate and gestational age, birth weight, APGAR score, age at the time of death, and complications of pregnancy.

The most common causes of mortality were respiratory distress syndrome and sepsis. Prevention of preterm labor is recommended to reduce premature births, its related complications and consequently, neonatal mortality rate.

Type 2 diabetes mellitus, a serious chronic disease, is increasing worldwide. Obesity is one of the main independent risk factors in development of the diabetes and its related complications. Weight loss is an important part of disease management. We searched for the studies conducted on obesity treatment of patients with diabetes until the end of September 2010 in the SID and Pub Med databases. We used the economic evaluation methods in order to evaluate the cost of obesity in patients with type 2 diabetes and its treatment methods. We also analyzed the costs and outcome implications of obesity and its management in people with type 2 diabetes. Studies have shown that obesity treatment with Orlistat is cost effectiveness. In Germany and France, surgery is a dominant option in comparison with the other common methods. In England, surgery is reported to be cost effective and in Austria, Italy and Spain, it is approved. All studies have reported that obesity treatments are in the range of what is generally considered as cost-effective. It seems that medication therapy and surgery are cost-effective options for all obese patients.

Most of stroke survivors become dependant to their families for their daily living. However, no attention has been paid to mental and physical status of the caregivers of stroke patients in Iran. The aim of this study was to determine the rate of burn out in caregivers of stroke patients, one and three months after the stroke. This was a cross-sectional study in which 140 caregivers of stroke patients were recruited to the study from a hospital in Arak. The caregivers completed the Zarit Burden Inventory in hospital, and one and three months after discharge. Most of the caregivers were spouses of the patients (70.71%; n= 95). The mean age of the caregivers was 57.1 years old. Of all caregivers, 30.71%, 48.57% and 20.71% suffered from mild, moderate and severe burn out, respectively at three months after the stroke. The caregivers’ burn out was significantly increased at the follow up measurement. The caregivers’ burn out was associated with the level of dependency and age of the patients, and also gender and relativity of the caregiver, and the time spent for daily care (p< 0.05). Care of patients with stroke causes caregivers to experience a sense of burn out. Age, level of patient’s dependency, gender, relativity, and the time spent on care are associated with the burnout. Appropriate interventions should be implemented to reduce such burn outs.

Drug addiction is amongst c urrent crisis of the world including nuclear crisis, environmental degradation, poverty, and social crisis. Drug addiction is a major health problem in many countries worldwide. One of the most common characteristics of addicted individuals is low self-esteem. Self-esteem increases flexibility and reinforces progression of positive attitudes toward self-sufficiency. There are limited studies on non-medical treatment strategies for drug-users. The aim of the present study was to assess the effects of a family-centered problem solving education on self-esteem of drug-users. This study had a pretest-post test experimental design. First, validity and reliability (r=0.85) of the self-esteem Cooper-Smith questionnaire was confirmed. After completing the consent forms by the participant (n=60), they were randomly assigned into two equal experimental and control groups. At baseline, questionnaires were completed. The education was performed using family-centered problem solving teaching method in a two months period within eight 45-minute sessions in the intervention group. The Cooper smith self-esteem questionnaire was completed at the follow up. The paired t-test showed that family-centered problem solving education method led to a significant increase (p=0.001) on the self-esteem scores in the intervention group. Although self-esteem scores of the control group increased significantly either after two months, the increase was 4.5 times more in the intervention group. To sum up, using the family-centered problem solving education method with family centered approach could improve the process of addiction treatment in addiction clinics.