نشریه پرستاری و مامایی ارومیه
سال دوازدهم شماره 7 (پیاپی 60، مهر 1393)

Pregnancy is one of the most important periods in women who are looking for a great experience. However, all pregnancies are not without complications and, they can be associated with unpleasant outcomes such as being in NICU, low birth weight, IUGR, malformations at birth, abruption and placenta previa. Rate of these disorders in women after InVitro Fertilization (IVF) are higher than the normal pregnancies. The aim of the present study was the comparing of pregnancy outcomes in primigravida women with pregnancies after infertility treatment at spontaneous pregnancy admission to the hospitals in Tehran -1391. The present study is a retrospective comparative analysis to determine and compare the neonatal outcomes such as low birth weight, hospitalization of the infants in Intensive Care Unit, fetal outcomes such as malformations at birth, intrauterine growth restriction, and consequences of placental such as abruptio and placenta previa on the 620 primigravida women have been admitted to the hospitals of Shahid akbrabady (310 samples), Arash (155 samples), and Baharloo (155 samples) with Quota sampling according to desired criteria. The data were collected and analyzed with chi-square, Fisher exact test, t- test and Mann - Whitney U test. The results of this study showed that the mean and standard deviation age of the sample of spontaneous pregnancy is 25/3 ± 4/56, while it was 29/8 ± 5/31in the IVF group. Statistical analysis showed a significant relationship between the variables of neonates in the neonatal unit (NICU) (p<0/0001) and underweight infants (LBW) (p=0/009) in the two groups. Statistically, there wasn’t a significant relationship between the IUGR, malformation at birth, abruptio and placenta previa in both groups. It is notable that after removing the effect of age variable, the correlation between the variables of the NICU was not significant. Infertility treatment with IVF procedures result in a higher incidence of low birth weight. So it is necessary to pay attention to the importance of prenatal care in infertile women.

Nursing belongs to some occupations that a person should work in night shift that encounter nurses with physical and mental disorders that low back pain can be one of them in which moreover than physical damage of this health caring group, cause have exess cost such as break down and early retired. The present research is a descriptive analysis in which the data were gathered by a two part Oswesty questionnaire and demographic characteristics of 380 nurses in Tabriz educational hospitals. To analyze the data, descriptive and inferential statistics were used. It was obvoiuse that there was no relation between night shift and low back pain (Sig=0.98), however prevalence of low back pain in these nursing staffs was high. There was no relationship between demographic characteristics and low back pain except concerning the age variable. The prevalence of low back pain increased by increasing of the age. Nurses in night shifts encounter with variety of physical disorders which needs more envistigation to understand their effects. Interventions such as working in fix shifts and regulating shifts with regard to age, and if possible, applying aged and experienced nurses in areas with less workload, can be helpful in reducing low back pain. Also, systematic review studies on relationship between night work nurses and low back pain are recommended.

Nowadays, application of low cost available methods for minimum treatment of surface waters for drinking in emergency conditions, and in conditions of non-available healthy water was approved by international healthcare organizations. SODIS technology, i.e., the use of solar radiation for disinfection of water, is one of the most important technologies. In this research, the effect of UV-A radiation of solar in disinfection of surface water in Urmia geological conditions was studied. In a cross- sectional study, in June and July of 2013, sampling was done from surface water for 9 days. Then the samples were transferred to laboratory, and the parameters of initial microbial load, turbidity, pH, and water temperature was performed on them. The samples have been exposed to sunlight for 6 hours from 9 to 15 in two types of transparent PET and glass containers. The process was repeated in two 3-hour sessions. The intensity of UV radiation in the UV-A range was measured by UV meter hourly and the average intensity was obtained. By using an statistical analysis, the relationship between reduce of microbial load and contact time, water temperature, turbidity, initial microbial load and pH have been investigated. The results of this study showed a reduction in microbial load of samples after 3 and 6 hours of exposure time which was 1.32 log10 and 0.32 log 10, respectively, when water turbidity is less than 20 NTU. Also by increasing intensity of UV-A radiation, disinfection efficiency was increased and the initial microbial load of water samples didn’t have significant effect on water disinfection. Also results showed that there was a direct relationship between water and environmental temperature with microbial load reduction. SODIS technology can be considered as a method of water disinfection in emergency conditions.

Often, practitioners avoid investigating sexual symptoms due to concerns of insufficient time or lack of proper and rapid tools to address female sexual dysfunction. The present study aimed to investigate the psychometric properties of the 6-Item Version of the Female Sexual Function Index (FSFI-6) amongst a sample of healthy Iranian women. In this descriptive-correlational study, 650 married women inhabitants of Tehran and 107 women with sexual dysfunctions were selected via a convenient sampling. These participants completed the Persian versions of FSFI-6, Female Sexual Distress Scale Revised (FSDS-R), Depression Anxiety Stress Scales (DASS), Positive and Negative Affect Scales (PANAS) and Locke & Wallace-Marital Adjustment Test (LWMAT).The construct validity and the convergent and divergent validity of the FSFI-6 were examined by using exploratory factor analysis and Pearson correlations, respectively. To examine the discriminant validity of the FSFI-6, data collected from 650 healthy participants, and they were compared with 107 women having sexual problems. The results of the exploratory factor analyses indicated that the FSFI-6 is conceptualized within a one factor model. Results also indicated that the FSDS-R has good internal consistency and test-retest reliability. Significant correlations were seen in the predicted directions between the FSFI-6 scores with the scores of FSDS-R, DASS, PANAS and LWMAT which support both the convergent and divergent validity for the FSFI-6. The results also indicated that the scores of the FSFI-6 significantly differentiated woman with and without sexual problems. In general, these findings support the reliability and validity of the Persian version of FSFI-6, so it can be used as a rapid and accurate tool in screening, research and clinical situations among Iranian women.

Pharmacology education in nursing is a process to teach the students to acquire the necessary skills in the field of patient's pharmaceutical-cares, and the acquisition of these skills is one of the necessary qualifications in the nursing profession. The aim of this study was to evaluate nursing student's perception of their important skills in pharmaceutical-care. This cross-sectional study involved all the nursing students in their second, third and fourth years of study. The data were gathered by a questionnaire consisting of demographic data, the question on presence or absence of weaknesses in pharmacology and table of Self-Assessment Rating Score (SARS), and they were finally analyzed by SPSS statistical software (ver.16). 56/3% of participants were male and 43/7% were female. Except in patient education skills, in other skills over 65% of students had poor assessment of their pharmaceutical care skills. Students estimated themselves highly weak in their ability to detect the common side effects of medicines, and highly capable in patient education. Students evaluated their pharmaceutical care's skills as poor. These findings highlight a flaw in the student's professional competencies that require immediate attention to fix it. We hope to be able to apply appropriate ways to further improve the quality of education of nursing students in an effort to double.

Preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU) are under repeated stress, and they are suffering from sleep deprivation. In this respect, one of recommended strategies is clustered care. On the other hand, direct observation of infant behaviors has been emphasized at time of nursing care. The aim of this study was to compare the behavioral responses in preterm infants in clustered care with three and four noninvasive procedures. This study was a randomized crossover clinical trial performed in NICU of Al-Zahra teaching hospital, Tabriz, Iran in 2013. Thirty one preterm infants were studied at 32 weeks age by clustered care with three and four procedures, and observable behavioral symptoms were assessed. The analysis of data was done with the use of STATA 10 software at 0.05 significant level. The findings showed that mean of behavioral symptoms indicated stability in before, during and after of clustered care with three procedures, and it was 1.48, 2.03, 2.45 respectively, and four procedures 2.68, 4.23, 2.87 and behavioral symptoms indicative stress of three procedures were 2.06, 2.52, 1.97 and four procedures 2.97, 4.03, 3.03. Significant differences were not found in before and after phases between two interventions but it was significant during phase (P=0.035). Although clustered care with three procedures can be assumed more acceptable, clustered care with four procedures is shown acceptable too, both of them could be recommended for preterm infants.

Spirituality is the most important dimension of existence in more than a third of the world population, and it has been at the center of their lives as a strong force, so it may have an influence on a person's quality of life. Infertile women are always at risk of stress and anxiety. The purpose of this study was to investigation the relationship between spiritual well-being and quality of life in infertile women referred to Isfahan infertility centers.

In this cross-sectional study, 190 infertile women, 20 to 45 years old, who referred to Isfahan infertility centers were selected through convenience sampling. To assess the spiritual well-being and the quality of life of the subjects, the spiritual health questionnaire (SWBS) and summarized format of the World Health Organization Quality of Life Questionnaire were used. The data were analyzed by SPSS version 17.

The results of this study showed that the mean total score of quality of life was 87/9, Religious dimension of spiritual well-being 52/8, existence dimension of spiritual well-being 44/8 and total score of spiritual well-being 97/7. There was a direct relationship between the total score quality life with existence dimension (r =. /613 p <. /001), Religious dimension(r= 0/278 و p< 0/001) and total score of spiritual well-being (r= 0/519 و p< 0/001).

As infertility is a multi-dimensional problem which can cause several damage to women and influence the quality of life, and as there is a relationship between spiritual health and quality of life, we can improve the quality of life in infertile women with promotion the spiritual well-being.

Sharp increase in the cesarean rate, has become the major problem in health care system. Wrong believes, wrong attitudes, and lack of awareness are the base of decision making toward delivery method. The aim of this study was to explore the effect of education on knowledge and attitude of pregnant women. In this quasi experimental study, 200 nulliparous women (gestational age 24 to 32 W) in Boukan district, without normal vaginal delivery (NVD) ban, randomly allocated into control and training group with equal size (95). Four weekly educational sessions held for training group. A validated Questionnaire was used for data collection. Paired and independent T test and analysis of covariance at a significance level of 5% were used to compare group mean scores. The increase in scores of knowledge (from 2.79 to 12.29) and attitude (from 47.24 to 54.98) in training group was statistically significant. In the control group, changes in the scores of knowledge (from 3.61 to 4.10) and attitude (45.99 to 46.80) were not significant. The scores of knowledge and attitude changed significantly before and after in both groups(P <0.05). Due to the efficacy of education on increasing the knowledge and attitude of pregnant women to choose the method of delivery, it is recommended that this course of prenatal care should be given to all women to reduce the caesarean section.

Todays, role of health and it’s maintaining is very important in development of economic, cultural, social and political matter in all countries. Therefore, experts believe that to achieve educational goals, and scientific development in the field of health, managers and coaches must have the necessary competence and efficiency. Hence, the goal of this research is study of the relationship between the individual characteristics, including age, work experience, management experience, and triple skills of managers (human, technical, perceptional parameters) and efficiency. This study is a descriptive survey. The statistical population included 103 managers of university, and the sample included 52 managers that were selected using random sampling. Two questionnaires were used to collect the data. One of the them is to collect personal information from them, and the other one is used to measure the efficiency of managers by staff. The main results showed that there is no significant relationship between age and performance (r =0.250, P =0.740) and between job experience and efficiency (r =-0.188, P=0.182), however, there is direct positive relationship between experience of management and efficiency (r =0.127, P =0.04). There are relationships between triple skills of managers (technical, human and conceptual) and efficiency, so by increasing the efficiency, the skills will be better as well. Identity of factors, the three skills, and their relationships with the efficiency are the factors that can be useful for managers to achieve efficiency.

Peripheral Vascular Disease (PVD) constitutes an important part of Chronic Renal Failure (CRF) complications leading to amputation and similar surgical operations; it also precipitates some disabilities for patients, despite the presence of cardiovascular risk factors such as hypertension, diabetes mellitus, aging, smoking and hyperlipidemia in CRF patients. Even with the removal of these factors, there is an independent and definite association between PVD and CRF. Measurement of Ankle-Brachial Index (ABI) is a simple and noninvasive method which can be used for diagnosing PVD in outpatient centers. In such centers, by detecting the renal failure, the subclinical cases can be diagnosed effectively; later on these groups would have more benefits from treatment and educational interventions. All of the patients referred to Urmia Taleghani university hospital and the equal number of them from cardiac and medical wards of the same hospital were chosen as case and control groups which totally formed the study population, and then the researcher has made the subjects to fill the questionnaires. For this reason the ABI of each patient were measured and included in questionnaires. A German made Richter mercury manometer used for blood pressure measurement. Then the completed questionnaires were collected and the abundance and relative abundance indices are presented in tables and graphs. The total study population were 386 people (193 hemodialysis and 193 control patients), the collected data were processed and analyzed by SPSS software version 18, and after determination of central and dispersion indices, the comparison of Means by independent T, comparison of proportions by chi-square and determination of relationship by Pearson Correlation Coefficient tests were carried out. The following results were obtained: Mean age of the samples was 55.27±17.17 which minimum 3 and maximum 88 years old, %54 male and %46 females, %19.2 had a history of diabetes, %35.5 were hypertensive, %6.2 had hypercholesterolemia and %23.8 had hypertriglyceridemia, %3 had a history of CVA, %26.7 had CAD and %23.1 of them were smokers. The obtained results also showed that %15 of the study population had PVD. According to the results of this study we suggest that ABI measurement must consider as an important indicator in routine examinations of the doctors. Paying more attention to the blood pressure, lipid profiles in monthly visits of the patients, and if there is any distribution in the above mentioned indicators, appropriate medical decision making must be done to avoid complications of PVD in these patients.

Gestational diabetes is carbohydrate intolerance in a medical situation because it can lead to adverse outcomes of pregnancy. The childbirth can be risky, and because of adverse effects on mother and fetus more attention and training should be considered. Since one of the best ways to reduce complications, and to improve the quality of life in people with diabetes is education that does not cost a lot and is applicable to all patients; therefore, the aim of this study was to compare two methods of discharge education on pregnancy outcomes in women with gestational diabetes. This study is a clinical trial which includes 126 patients with gestational diabetes with gestational age of 28-36 weeks that were divided into 2 test groups and 1 control group. The first experimental group received 2 sessions of 40 minutes of training. The second experimental group received an instructional booklet, while the comparison group received routine hospital services. The data were collected by means of questionnaires. To complete the questionnaires, a telephone call was done one month after delivery. To analyze the data Fisher's exact test, Chi-square, ANOVA, and Kruskal Wallis tests were used. The groups were homogeneous in terms of demographic, obstetric and laboratory variables. A statistically meaningful difference was observed in the number of maternal readmission (P =0/002) and fifth minute Apgar infants (P=0/049). There was no statistically significant difference on the other variables. Discharge education, especially in patients with gestational diabetes can affect the knowledge of mothers, which it can in turn increase the mother's understanding of disease to control and hence to reduce hospital costs.