health and wellbeing, isfahan, iran, 2014 wellbeing, isfan, iran, 2014 · 2014-12-15 · 6 st...

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NMRC 2014

Orals

NMRC 2014

1st International Nursing & Midwifery Conference on

Health and Wellbeing, Isfahan, Iran, 2014

Wellbeing, Isfan, Iran, 2014

2 st International Nursing & Midwifery Conference on Health and Wellbeing

Poster presentation

1st International Nursing & Midwifery Conference on Health and Wellbeing

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Nursing and Midwifery in the Eastern Mediterranean Region: Challenges,

Opportunities and the Way forward

Al-Darazi Fariba A. Ahmed

Coordinator, Health Workforce Development, Regional Adviser for Nursing, Midwifery and Allied

Health Personnel, Department of Health System Development ,Regional Office for the Eastern

Mediterranean, World Health Organization

Human resources development is a multidisciplinary, intersectorial and an integrated process

within a total system. Developing capable, motivated and supported health workers is

essential for overcoming bottlenecks to achieve national and global health goals.

Transformation of the educational system that prepares health professionals is necessary to

address the quantity, quality and relevance of health care providers to contribute to

population health outcomes.

The Eastern Mediterranean Region continues to invest in the development of nursing and

midwifery resource as a critical component of the health system and health services

development; several gaps remain in the provision of well trained and motivated health

workforce as a whole and in nursing and midwifery in particular.

Nurses and midwives are the main professional component of the “front line” staff in most

health systems, and their contribution is recognized as essential in meeting the development

goals and delivering safe and effective care.

There is a strong correlation between availability of health workforce and health outcomes.

There is evidence from the Region that the density of nurses and midwives is correlated with

infant and maternal mortality.

The situation in the Region requires more educated nurses with expanded skill sets capable

of responding to change, greater demands and new priorities in health care and the social

realities in the places they live and work.

Key issues, challenges and opportunities in developing nursing and midwifery in Member

States will be discussed and the regional strategy for nursing and midwifery development

2012-2020 will be presented. The strategy aims at ensuring that countries provide quality

people-centered nursing and midwifery services where nurses and midwives practice within

the healthcare team or as autonomous practitioners contributing to improved health

outcomes and the well-being of society.

1st International Nursing & Midwifery Conference on Health and Wellbeing 3

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Mobilising Nurses for NCD Prevention, Care and Management: Time for a Paradigm

Shift

Tesfamicael Ghebrehiwet

Independent Consultant, Nursing and Health Policy, ICN Representative

The growing rise of non-communicable diseases (NCDs) is a significant global public health

threat. The determinants of NCDs are embedded in life style, behavioural, political, social,

cultural and structural factors that are causing much preventable premature death and

disability in the form of diabetes, heart disease, cancer and chronic respiratory diseases.

These four NCDs have shared risk factors namely: unhealthy diet, physical inactivity and

tobacco use1.

In the battle plan against the NCD epidemic, all nurses must be mobilised and the Iranian

Nursing Organisation as lead organisation of Iranian nurses is a key partner in tackling this

epidemic. It is estimated that Iran has about 150,000 nursing and midwifery personnel, and

globally there are over 16 million, and nurses have a historic opportunity to roll back NCDs.

In order to tackle the global epidemic of NCDs, the focus of healthcare must shift from

downstream, illness-focussed care to upstream approaches including health promotion and

disease prevention, and nurses are best placed to lead in the shift towards this new paradigm.

The aim of the presentation is to focus on strategies for mobilising nurses for leading the

shift from acute care to a continuum of care encompassing health promotion, disease

prevention, care and cure of NCD. I will argue that nurses - now more than ever-can lead the

shift to chronic disease prevention and management.

1 World Health Organization (2005). Preventing Chronic Diseases: A vital investment. www.who.int/chp/en/.


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Capacity Assessment of ICM South Europe Region Midwifery Associations using the

MACATEnhancing Midwifery Globally

Papadopoulou Maria

ICM Board Member (South Europe Region),Assistant professor Entagmeni, Lead of the Midwifery

Program, Department of Nursing, Cyprus University of Technology, www.cut.ac.cy

Introduction: The first strategic goal of ICM for 2011–2014 is the use of the Global

Standards (Durban 2011), in a global effort to strengthen the midwifery profession. Member

Associations (MAs) of ICM-South Europe Region (SER) used the Member Associations

Capacity Assessment Tool (MACAT) to assess the capacity of their associations.

Methodology: A Cross-sectional study with two cuts was performed. ICM-SER MAs

performed two evaluations of their national midwifery associations using the MACAT. The

first evaluation happened in the first 6 months of 2012 by members of the Boards of each

association. Results were discussed at the regional annual meeting in Nicosia 2012. A

second round of evaluation was decided in the next 4 months involving the whole Board of

each association and data was gathered in October 2012.

Results: Seven from twelve MAs answered the MACAT (58,3%): Cyprus, Greece, FYR

Macedonia, Malta, Portugal, Spain, and UA Emirates. MAs meet all MACAT

criteria,exceptfrom: “monitoring and evaluating the qualityof their work and using the

results to influence service delivery planning” (57,14%), “lack of human resources”

(57,14%), “have mechanisms to identify the needs of their members” (42,5%) and “to

recommend on salaries and working conditions of members” (71,42%), “have mechanisms

to assist members in meeting CPD requirements needed for licensure/renewal of license”

(71,42%), in “human resources planning of their country and quality of health care provision

(85,71%), in“providing advocacy training to association leadership and members (71,42%),

in “monitoring the quality and impact of their work” (85,7%), in “influencing the service

delivery planning” (57,13%), and in having “diversified funding bases capable of sustaining

their programs over the long-term” (57,14%).

Recommendations: MAs make realistic action plans, prioritize gaps and work towards

meeting the standard criteria of MACAT to strengthen their associations for the benefit of

mothers, babies and the profession.

http://www.cut.ac.cy/


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Nurses’ Role in the End-of-Life Care: Current and Future Issues

Bok Yae Chung

College of Nursing, Kyungpook National University, Republic of Korea

Introduction:

Three-quarters of individuals die from chronic illnesses, often after suffering from both

physically and psychologically for months or years. Hospice is an interdisciplinary and

comprehensive care for terminally ill patients with incurable disease. It establishes the

importance to people facing a life-limiting illness and their families coping with advanced

illness of receiving services across multiple domains that address the terminally ill patient's

physical, mental, psycho-social, and spiritual well-being, as well as the families’ well-being.

Hospice also is developed to address the multidimensional needs of people facing a life-

limiting illness and their families, which were not being met by the several reasons.

It is important to determine whether hospice provides to terminally ill patients and families

or how hospice care has changed over time. However, health care delivery system has often

failed to meet the needs of these terminally ill patients and their families, who frequently

experience inadequate pain and symptom management because of conflict with hospice

philosophy, lack of awareness of hospice services, concern about burdening family, health

professionals, economic factors, mistrust of the health care system, limited communication,

and overall dissatisfaction with care regarding end-of-life care.

Conclusion:

Hospice has been a growing area of public interest as well as changeable in hospice in the

subjects, length of hospice stay, scope of hospice, hospice setting because of hospice is a

choice to be made at the end of life. Hospice will advocate on the basis that it was a quality-

oriented alternative to the health care system. It is very clear what we should think about the

implications of expanding hospice care for people who are in the end of life. It will be

supplied home based hospice service if terminally ill patients desire to die at their home. It

will focus later on the reform for functions of hospice.

The future of hospice will be determined by its functional integration into new systems of

care in response to emerging terminal care needs, commitment to standards of quality

hospice care and skilled and knowledgeable hospice professionals and an appropriately

hospice management about hospice stay and settings can offer to patients at the end of their

lives. It is critical to clearly delineate the options, and the implications and challenges of

each option, for improving access to hospice for patients and families.


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The early life origins of non-communicable diseases: time for primordial prevention

Kelishadi Roya

Professor of Pediatrics, Child Growth and Development Research Center, Isfahan University of

Medical Sciences, Isfahan, Iran

Non-communicable diseases (NCDs), which are the leading cause of the burden of disease and

mortality all over the world, originate in early life. Epigenetic factors are proposed as the possible

etiologic factor of early-life programming of adult-onset diseases. According to the Developmental

Origins of Health and Disease hypothesis intrauterine or postnatal adaptations to the environment

causes morphologic, physiologic or metabolic alterations that affect health later in life. The

Developmental Origins of Health and Disease (DOHaD) theory proposes a correlation

between low birth weight ,an indirect clinical marker of inappropriate intrauterine development, and

risk of chronic disorders as hypertension, obesity, diabetes, coronary heart diseases etc in adult life.

However, developmental programming also presents a novel method to prevent cardiovascular and

related diseases through so-called Reprogramming: administration of suitable or inhibition of

harmful perinatal factors in induced or genetic models ameliorated adverse development that

otherwise would unavoidably have resulted in more severe hypertension, cardiovascular and renal

disease. A comprehensive overview of these studies suggests that, in analogy to what has been

previously recognized in programming, many quite different reprogramming interventions all have

similar protective effects. The “Thrifty phenotype hypothesis” expressed that when the fetal

environment is deficient of an essential factor or includes a detrimental factor, the fetus adapts by

favoring growth of crucial organs such as the brain at the expense of other organs that have “reserve”

capacity and are considered less important for survival under these adverse environmental

conditions. The adaptation may cause structural, physiological and metabolic changes that influence

health later in life. This phenomenon is known as Developmental Plasticity or Programming since

the genetic program adapts to existing environmental conditions leading to different phenotypes.

Moreover, it should be considered that lifestyle factors as well as the major risk factors of NCDs are

established from childhood. Pediatric investigations on factors that may affectrisk of adult-onset

diseases have examined a range of biomarkers. The tracking of risk factors from childhood to

adulthood is well documented. Vascular endothelial dysfunction begins in earlylife and is a central

pathological status in the early development of atherosclerosis. Likewise, early-life risk factors,

particularly childhood obesity, are strongly associated with endothelial dysfunction and the

development of atherosclerosis and subsequent diseases. There is also strong evidence that risk

factors in childhood are associated with the precursor conditions or intermediate vascular end points

in adulthood e.g., diabetes, hypertension, and increased carotid intima-media thickness. Clustering of

risk factors, which impart an even greater risk than the sum of the individual risk factors in adult,

also occurs in childhood. More recently, studies have also suggested that epigenetic changes in the

metabolic pathways may not be limited to malnutrition in the prenatal period.“Stunting” refers to

poor height gain due to malnutrition and infection, with height-for-age z-scores more than two

standard deviations below normal. Increasing sources of evidence suggest that poor weight gain in

the first 2 years of life and subsequent stunting in children, and in turn adults are prone to worsened

metabolic findings. These relationships between early stunting and later disease are significant, given

that such stunting influences up to 25% of children in impoverished regions, even as the obesity

epidemic reaches into developing regions around the universe. Given this high prevalence of

stunting, any relationship between stunting and future metabolic risk would be of extreme

importance. The relatively early onset of prompt weight gain is called “adiposity rebound” and is

defined as the time when the physiologic nadir of body mass index reverses and commences to

increase with age. Potential explanations consist of genetic characteristics or, alternatively,

epigenetic changes conferring an increased predilection toward the prompt weight gain.All these

evidences underscore the importance of adult-onset diseases from early life. This justifies the

necessity and importance of primordial and primary prevention of NCDs.


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Quality and Quality improvement in Universites

Labbaf Ghasemi Reza

Interoduction: Undoubtedly we all interested in improving the university quality, but we

dont talk with same language about quality. I believe that quality and the way to reach

higher quality are different for each of us. Having a common language and understanding of

quality is the basis for any effort for improving quality; otherwise all the efforts will be just

rhetoric. The quality of current service is an example of this fact. Everybody talks eagerly

about the quality, but since we don’t know what the quality is and how we can develop

quality we take measures to reach the quality which are not compatible with the concept of

quality.To establish a common ground we have to define clearly what we mean by quality

and quality improvement in education. What follows is the definition of three pillars of

Quality.

Customer

No discussion about quality is possible without thorough addressing the term “customer”.

We will explain the fact that the any discussion about quality begins with “customer”.

Quality

Quality is the next important concept to define. What is quality? Each of us may have our

own definition. Most of the time when managers talk about “quality” they don’t have a clear

picture of what they talk about and how they should proceed.

Process

The third pillar of quality is process. What is process? Any procedure we do is an example

of a process. Giving a lecture, conducting a workshop, registering students, and providing an

educational session are all examples of process.

Three terms of“customer, quality and “process” form three organizational values: Customer

orientation, process orientation and continuous quality improvement. If these three values

are established quality improvement will be the routine task of the organization members

and sections. This means an informed continuous planned effort to respond to needs and

expectation of customers and community. Are the universities established for purposes other

than responding to needs and expectations of a chain of customers including the

community? These values are not conflicting with Academic values but are in full

alignment.


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The role of ethics in health and spiritual growth, nurses and patients

Abbaszadeh Abbas

School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran,

Iran

Introduction: The mission of moral perfection is the issue. True perfection and real growth

in humans is dependent on these institutions. True perfection is defined values are affected.

In many unitary human beings, especially moral values derived from the divine attributes.

Obviously, the physical characteristics of the material and not represent the true values are

divine. Therefore, this value is extracted from the essence of spirituality. The purpose of this

is to claim that the path to spiritual health and promotion of human passes throw ethics.

Method: In this paper we describe the method argument to the spiritual health and growth

theory in the light of personal and professional ethics deals.

Results: In a model of spiritual health, all aspects of the human protect the spiritual values.

If spiritual values in the language and culture, health, spiritual health is presented as the core

of human existence and social well-being support group, we have come together to protect

it. Then layer the outermost layer of the physical and mental health and physiological. All of

these elements protect central values (spirituality) is preserved. If physical health damage

can occur, such as illness or disability, and social support to care for mental health

Spirituality- deals. Ultimately this is a spiritual health and immortality, he will safeguard the

organism. Process of life, disease, aging, accidents…. Whether physical, mental and social

well-being and do not like to hurt but to strengthen the spiritual health and remain until

death seems to bless the world is more.

Conclusion: Ethical practice is the only way to strengthen the spiritual health and moral

factors and the interaction of person he is. Ethical practice nurses proven effectiveness in

improving patients' health, especially the spiritual. But more important is the impact of these

effects on growth and moral health. Based on this logic, it seems that nurses more than any

other group benefit from the performance of their moral and spiritual perfection to achieve

health benefit.

Keywords: Spiritual Health, Nursing ethics, Spirituality, Nurses


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Self-Care: The Foundation of Care Giving in Pediatric Palliative Care

Hasanpour Marzieh

Nursing and Midwifery Care Research Center, Pediatric Department, Faculty of Nursing and

Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran .Email: [email protected]

Introduction and aim: The term self-care has been used in a variety of activities and its

most reductive sense is understood superficially as taking time for ourselves or taking a

vacation. While it is important to balance work-life with other activities, the kind of self-

care that leads to enduring personal resilience and growth requires more than time away

because clinicians can never get away from themselves. Self-care, when stripped of self-

reflection, meaning and paying attention in the present moment, becomes a self-centered

exercise that is about I, Me, and Mine. Self-care activities based solely on distractions, such

as vacations and other means to get away from work can become selfish.

What follows in this article according to Liben, Papadatou and Wolfe 2011, is a focus on the

deep work of caring for the caregivers, which is essential when attending to the suffering of

others. The first part of this article explains the relationship to self for professionals in the

care of the seriously ill, caregivers’ suffering within the work and the possibilities of

personal growth that comes with accepting things as they are. The second will introduce

self-reflective practice with specific exercise in awareness that clinicians may choose to

experience.

Conclusion: From the basic principles of human physiology, such as the heart first pumps

blood to itself, to airline instructions in case of emergency, put your oxygen mask on first

and then assist those around you, emerges the underlying principle of self-care. Without

caring for oneself there can be no caring for others. It is also important to be reminded that

self-awareness ad self-care, although inherently individual processes, are developed and

enriched through relationships with others. Being open to new understanding and

experiences is itself rewarding as we mindfully walk along the path this work offers us.

Take Home Message: The best way to become a better “helper” is to become a better

person. But one necessary aspect of becoming a better person is via helping other people. So

one must and can do both simultaneously. [Maslow AH 1976]

mailto:[email protected]


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Relationship between fixed and rotating shifts with job burnout in nurses working in

critical care areas

Shamali Mahdi *, Shahriari Mohsen**, Yazdannik Ahmadreza**

*Intensive Care Unit, Azahra University Hospital, Isfahan University of Medical Sciences, Isfahan,

Iran

** Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan

University of Medical sciences, Isfahan, Iran

Introduction: While critical care nurses are vulnerable to burnout because of the complex

nature of patients’ health problems, working in critical care areas has become even more

complicated by shift working schedules. Furthermore, studies have reported shift working as

one of the inducing factors of burnout. This study aimed to determine the relationship

between fixed and rotating shifts and burnout in a sample of critical care nurses working in

critical care areas.

Methods: In this retrospective cohort design, 170 critical care nurses from six selected

hospitals were chosen using quota and random sampling and divided into two groups

(exposed and non-exposed). Maslach Burnout Inventory was used for data collection

andindependent t-test and logistic regression was performed to analyze the data.

Results: The mean scores of emotional exhaustion (EE) and depersonalization (DP) were

significantly high in the non-exposed group, but the mean score of personal accomplishment

(PA) had no significant difference in the two groups. Furthermore, the non-exposed group

had 10.1 times the odds to expose to EE and 2.2 times the odds to expose to DP in

comparison with the exposed group. High levels of burnout in the non-exposed group were

60%, 32.9%, and 27.1%, and in the exposed group were 12.9%, 18.8% and 43.5% in EE, DP

and PA, respectively.

Conclusions: The present study has revealed that critical care nurses with fixed shift

schedules display more burnout compared to those working with rotating shift schedules.

Hence, the rotating shift may be useful to reduce job burnout in critical care nurses.

Keywords: Burnout, critical care unit, nursing, shift work


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The relationship between religious beliefs whit spiritual well-being in addict people

referring to Bam addiction treatment centers in 2013

Fuladvandi Masoumeh1, Tirgari Batool

2, AzizZadeh Foroozi Mansoureh

3, Malekian Leila

4*

1. School of Nursing and Midwifery, Bam University of Medical Sciences, Kerman, Iran

2. School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

3. School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran

*4.Faculty of Nursing and Midwifery, Kerman Medical University, Kerman, Iran

Introduction: Addiction is one of the most important challenges of social, political, and

health in the world. Experts believe that spirituality and religion have a significant role in

the treatment of addiction. Since religious belief led to spiritual health, prevention and

reduction of tendency to addiction, Authorities have to will be consider it.

Method: This research is a descriptive correlation study, the sample of this study, based on

a formula sample size n = 287 Cochran. That was selected by cluster sampling. In this study

of religious beliefs and spiritual health questionnaire for the collection of information was

used. Data analysed with SPSS 20 by using the Simonov kolmogrov, Kruskal-Wallis,

Spearman.

Result: The findings of this study showed that the average age of the participants was 33/60

± (3.23), more participants were male; (78.7%) And Mostly "(74/6%) Married, 40/1 per cent

of the participants were cycle education. The total score was spiritual health (95/11.) 61/56

Religious practices total score 4/55 (±1/79) And Score of religiosity and religious 10/42 (±

3/08).A positive significant relationshipwas seen between total score of spiritual health With

Both dimension religious beliefs (p=0/00).

Conclusion: Based on the findings of this research, Spiritual health and religious beliefs can

be Supportive role in front of the substance tends to be, and Can be effective Prevention and

improvement of physical and mental diseases.Educational courses must be provided with an

emphasis on religious patterns And Religious practices to improve mental health patients.

Keyword: Spiritual health, Religious functions, Devotional religiosity, Addiction


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The Effect of Education on Effectiveness of Nurses’ Professional Communication

Related to Clients’ Health

Mohammadi Fariba*, Mansoorian Mohammad Reza, Khosravan Shahla, Alami Ali

*Faculty of nursingand midwifery, gonabad University of Medical Sciences, Gonabad

Introduction: Ability for effective communication isone of the most essential skills for

health workers, especially nurses, as parts of their roles played only by effective

communication with clients. The purpose of this study was to determine Theeffect of

education on effectiveness of nurses’ professional communication related to clients’ health.

Methods: This quasi-experimental study was done on 50 nurses who were selected by

convenience sampling method . The data collation tool was a two-section questionnaire

consisting of demographic and Sussman & Krivonos’s Identify communication

questionnaires. The intervention consisted of a one-day workshop on Effective

Communication Data were analyzed by using SPSS version 20 and descriptive statistics,

paired t- tests and chi-square.

Results: 70 % of participants were female. The mean (±SD) age And work experience of

participants were 30.58± 5.68 years and 10.42± 6.42 years. Findings have shown that the

mean of samples’ communication score increased after intervention in three subgroups

including, subordinates 11.62 (p=0.020), superiors 8.87 (p=0.002) and colleagues 6.04

(p=0.006), which was significant.

Conclusion: Since upgrading Nurses’ Professional Communication is an effective method

to improve the Clients’ Health, it is proposed to this end, educational programs in the field

of communication for the nurses comes into force.

Key words: Education, Effectiveness, Professional communication, Nurse, Health, Client


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An exploration of Lupus erythematosus, suffering, forgotten community health needs

Mazhari Azad Fereshteh1, Abdi Heidar Ali

2, Naji Seyed Ali

3

1. Dept. of Nursing Faculity, Islamic Azad University, Bandar Abbas branch, Hormozgan, Iran

2. Dept. of Nursing Faculity, Islamic Azad University, Khorasgan branch, Isfahan, Iran


Background & Aim: Present research aims to describe the suffering were resulted from

Lupus erythematosus by studying the structure, nature and quality of the patient’s

experiences deeply. Systemic lupus erythematosus (SLE) is an autoimmune chronic disease

so that the immune system attacks the body's cells and tissue, resulting in inflammation and

tissue damage so it involves various body organs and damages grafted blood vessels and

serous membrane tissues. Addition to clinical manifestation, it causes other problems such

as psycho-social, economic, and disability.

Methods & Materials: A qualitative study, using phenomenology approach was used, with

a sample of 10 patients using open interviews. The sample were selected amongst the

patients that affected by SLE referring to Rheumatology clinic of Bandar-Aabbas city.

Results: All interviews were analyzed for the conceptual codes and the original concept of

"mental emotional consequences" which include subcategories concepts such as mood and

suffering resulted from SLE, 9 sub themes were extracted from 223 primary codes, in the

final stage they were grouped into 4 structural components. They formed a new group called

the SLE suffering themes.

Conclusions: Present research result is indicating these patients experienced many problems

in various aspects such as physical, moral, social and economic and moral factor, that are

needed to care by the family and social. The treatment cost is another factor influencing

their economic situation due to disability and losing their jobs. Losing job led them to the

dependency and most of their needs remained unmet. But family member can play a very

important role to support them if they learn how to take care of such patients.

Key Words: lupus erythematosus systemic, health needs, chronic disease, self-immunity


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Improving Service Quality of maternity care from the perspective of pregnant women

in Tabriz Health Centers and Health Posts based on Customer’s self audit

Tabrizi Jafar Sadegh1, Asghari Jafarabadi Mohammad

2, Farshba Nasrin

3, Rahbar Farzam

Farnaz3, Iezadi Shabnam

4, Gholipour Kamal

5*

1.Tabriz Health Services Management Research Center, Department of Health Services

Management, Faculty of Management and Medical Informatics, Tabriz University of Medical

Sciences, Tabriz, Iran

2. Medical Education Research Center, Faculty of Health, Tabriz University of Medical Sciences,

Tabriz, Iran

3. East Azerbaijan Provincial Health Centre, Tabriz University of Medical Sciences, Tabriz, Iran

4. Tabriz Health Centre, Tabriz University of Medical Sciences, Tabriz, Iran

*5.Faculty of Management and Medical Informatics, Student Research Committee, Tabriz University

of Medical Sciences, Tabriz, Iran .Email: [email protected]

Introduction: This study aimed to improving Service Quality of maternity care from the

perspective of pregnant women based on Customer’s self audit.

Methods: A before-after study was conducted at 2010-2012 using a sample of 185 pregnant

women at the 9th

month of pregnancy from 40 health posts and urban health centers before

intervention and 95 women in intervention group from 11 centers in Tabriz, Iran. About 3 to

8 pregnant women were selected randomly from each health center or health posts.

Intervention includes providing pregnancy book and organizing support group. The

intervention phase began in September 2011 and lasted eight monthslater. Service Quality

(SQ) scores were calculated using: SQ = 10 – (Importance × Performance) based on

importance and performance of non-health aspects from the customer’ perspective. Service

quality scores were reported as mean (SD) and T-test used to comparisons between before

and after scores. Statistical significant level was set at 0.05. Data analyzed using SPSS-17

software.

Results: Overall service quality from the customers’ perspective before the intervention was

7.53 (1.36) and it improve to 8.91 (0.76) after the intervention, this increase was statistically

significant (p<0.001). There was significant improvement in some aspect of SQ such as:

Availability of support group, Safety, Prevention, Communication, Dignity, Basic amenities,

Autonomy and Confidentiality due to intervention. According to this fact implemented

interventions improves Service Quality of maternity care.

Conclusion: Findings revealed conducting support group and educational program is an

effective program to improve pregnant women’s’ satisfaction regard to delivered care and

Service Quality of maternity care.

Key word: Service Quality, Customer’s self audit, Maternity Care, Centered Pregnancy



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Developing a holistic nursing handover process program in pediatric ward: an action

research

Sabet Sarvestani Raheleh1*, Moattari Marzieh

2, Nikbakht Nasrabadi Alireza

3, Momennasab

Mazieh2, Yektatalab Shahrzad

2

1-Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

Email:[email protected]

2-Department of Nursing, College of Nursing and Midwifery, Shiraz University of Medical Sciences,

Iran

3-Department of Nursing, College of Nursing and Midwifery, Tehran University of Medical

Sciences, Iran

Introduction: Nursing handover is a substantial part of nursing care.The content of handover must

contain short and long term goals. It should also be both broad and specific enough to meet the

patients’ needs. Furthermore, it should contain information such as medical and nursing care,

physical, psychosocial, spiritual, and family needs at the same time Although most organizations

have emphasized on nursing handover, existing realities in clinical settings indicates inefficient

practices in this field. One of the obvious reasons is that the content of nursing handover is not

holistic. So, this study aimed at developing a holisticnursing handover process in pediatric wards in

Namazi hospital in Shiraz, Iran.

Method: This study conducted using a cooperative inquiry during 19 month in 2012-2013. The

participants including 12 nurses, 2 diplomas, the head nurse and the academic researcher as a

facilitator working through two cycles of reflection and action for change. In the first phase, the

facilitator and participant discovered the challenges of nursing handover. After that the participants

reflected on their experiences and designed an operational plan and prioritized them. In this phase

they participated in two workshops for empowerment in nursing handover. Third phase resulted in

implementing action plan and immersing in action for change for about four months. At the end of

the first cycle evaluation was done. On the basis of the lessons learned from action and reflection in

the previous cycle, second cycle started as participants reflected in group sessions. After that another

operational plans designed and implemented. Finally the facilitator and participants evaluated the

results. The data were collected and analyzed using the concurrent mixed method. The inductive and

summative content analyses were recruited for analyzing the qualitative data. The quantitative data

were analyzed using Q-square and ANOVA.

Result: Qualitative content analysis revealed two major categories including non-holistic approach

and poor management which resulted in immersing one major theme entitled “ challenges of nursing

handover “. Reflection on actions in two cycles resulted in designing and implementing action plans

for change and learning in both participants and facilitators. The quantitative data showed significant

improvement in frequencies of words toward holistic approach, significant increase in patient and

nurses satisfaction, significant decreased in the time and cost of handover and also effective

allocation of cost to activities (p=0.05).

Conclusion: This study resulted in deep understanding of participant about principles of handover in

real world and applicable knowledge through action for change and reflection on it. Finally nurses

could establish the foundation of sustainable holistic nursing handover successfully.

Key words: Holistic approaches, Nursing handover, Action research, Reflection, Co-operative

inquiry


Poster presentation


NMRC 2014

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The effect method of reflexology massage on the severity of restless leg syndrome

among patients undergoing hemodialysis

Shahgholian Nahid*, Khojandi Gazi Shahrzad, Karimian Jahangir, Valiani Mahboubeh

*Faculty of nursing and midwifery, Isfahan University of Medical Sciences, Isfahan

Introduction: Restless leg syndrome is a sensory and motor neurologic disorder, which

manifests as high tendency to move the legs. Its prevalence is high among the patients

undergoing hemodialysis, and it increases the risk of mortality in these patients. Due to

several side effects of medicational treatments, the patients prefer non-medicational

methods. Therefore, the present study aimed to investigate the effect method of reflexology

massage on the severity of restless leg syndrome among patients undergoing hemodialysis.

Methods: This is a clinical trial. Among the patients undergoing hemodialysis in selected

hospitals in Isfahan, 60 qualified patients, diagnosed with restless leg syndrome through

standard restless leg syndrome questionnaire, were randomly selected by random number

table. They were assigned to reflexology massage and control groups through random

allocation. Reflexology massage was conducted three times a week for 30-40 minutes for

four straight weeks. Data were analyzed by one way ANOVA paired t-test and LSD post

hoc test through SPSS 20.

Results: There was a significant difference in mean scores of restless leg syndrome severity

between reflexology massage, compared to control (p<0.05). Changes mean score of restless

leg syndrome severity was significantly higher in reflexology massage, compared to control

group (p<0.05).

Conclusions: Our obtained results showed that reflexology massage can reduce restless leg

syndrome severity. This method of treatment is recommended to the patients.

Keywords: Restless leg syndrome, reflexology massage, patients undergoing hemodialysis


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Effect of foot reflexology massage on the physiological parameters of patients with

stroke

Dehnoalian Atefeh*, Mohammadpour Ali, Mojtabavi Javad

School of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran

Introduction: In addition to the usual supportive interventions to reduce complications in

patients with stroke (CVA), complementary therapies are used such as foot reflexology

massage, which is part of nursing care. The purpose of this study was to investigate the

effect of foot reflexology massage on the physiological parameters of patients with stroke.

Methods: This study is a randomized clinical trial. They studied on 68 patients with stroke

from Gonabad and Nishabur cities, who were divided randomly into two groups. The data

gathering tools were a demographic questionnaire and physiologic indicators form. In the

test group, foot reflexology message was performed during a session in 30 minutes (15

minutes for each leg) for each patient. The data was analyzed in spss version 20 software

using ANOVA with repeated measures.

Results: Statistical tests show that the changes in systolic blood pressure, diastolic and pulse

rate after intervention in both groups was significant (05/0< P). But these changes were not

significant for the other indices.

Conclusion: The results show the positive effects of foot reflexology on reducing blood

pressure and heart rate in patients with stroke. This method can be recommended as a

supplement in patients with stroke.

Keywords: Foot Reflexology Massage, Stroke, physiologic indicators


Poster presentation


NMRC 2014

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Experiences of the families concerning organ donation of a family member with brain

death

Yousefi Hojatollah 1

, Roshani Asieh, Nazari Fatemeh

1Department of Adult Nursing, School of Nursing and Midwifery, Nursing and Midwifery Care

Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Background: In recent years, the lack of organ for transplantation has resulted in health

planners and authorities in all countries, including Iran, paying serious attention to the issue.

Despite the above-mentioned fact, families with a member affected by brain death are not

interested in organ donation.

Objective: This study is aimed at making an investigation into the decision-making process

of organ donation in families with brain death. Also, the research is aimed at investigating

how the deterrent and facilitating factors in the process of organ donation can be made.

Materials and Methods: The current research is a qualitative study with descriptive

exploratory approach. Data were collected through unstructured interviews with 10 family

members who gave consent to organ donation of their family members in 2012. Purposeful

sampling processes began in March 2012 and lasted up to June 2012. Simultaneously,

thematic approach was used in analyzing the data.

Results: Data analysis led to finding 24 categories and 11 themes, which fell into two

categories: facilitating and deterrent factors. The five main deterrent themes included the

five themes of prohibiting factors that were shock, hope for recovery, unknown process, and

conflict of opinions, and worrying association. The six main facilitating themes included

humanistic desires, immortality, culture making, and satisfaction of the deceased, assurance,

and eternal honor.

Conclusion: The findings indicated that there is ambiguity and different interpretations on

brain death. The research also showed that using the experiences of donator families can

provide practical and applied solutions to facilitate the process of organ donation and solve

the problems faced by the health care system.

Key words: Brain death, family, organ donation


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The effect of intervention based on Pender’s Health Promotion Model on loneliness in

elderly women

Khosravan Shahla1, Alaviani Mehri

2*, Alami Ali

3

1. Faculty of Nursing and Midwifery, Social Determinant Health Research Centre, Gonabad

University of Medical Sciences, Gonabad, Iran

*2. Faculty of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran

Email: [email protected]

3.Department of Health, School of Public Health; Social Determinants of Health, Research Center,

Gonabad University of Medical Sciences, Gonabad, Iran

Introduction: Loneliness is one of the most significant problems during aging. This

research has been done to determine the effect of intervention base on Pender’s Health

Promotion Model on loneliness in older women.

Methods: In this Quazi experimental study which was done in 2013, about 150 person

include elderly people suffering medium loneliness covered by Health and Cure Centers of

Gonabad city (one of Iranian cities) were selected by census methods and blocked by

random assignment and finally divided into two groups of case and control. Data gathered

by using Russell’s UCLA loneliness questionnaire and the other questionnaires set out based

on Pender’s Health Promotion Model about loneliness. The results analyzed by descriptive

statistics and chi-square, T-pair, and independent-T tests through Spss20 software.

Results: Loneliness decreased significantly in case group rather than control group (P<

0/001. In addition, average scores related to variables of Health Promotion Model (received

benefits and barriers, efficacy, interpersonal effectives) in both groups of test and control has

significant differences after and before intervention. Moreover, in comparison with the other

one, test group shows better performance about social behaviors when feeling loneliness.

Conclusion: The intervention based on Health Promotion Model was effective on

improvement of loneliness in older women and can be used as a frame for planning

intervention in order to prevent and promote elderly mental health.

Key words: Loneliness, elder women, Pender’s Health Promotion Model



Poster presentation


NMRC 2014

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Assessment of relationship quality of life and coping skills in spouses of chemical

devotees with pulmonary complications due to sulfur mustard

Akbar Natajbisheh Kolsoun1*

, Shirafkan Amir Hossein2, Safavi Mahboobeh

3, Mahmoudi Mahmoud

4

*1. Department of Nursing& Midwifery, Islamic Azad University of Chalus, Chalus, Iran

email:[email protected]

2. Graduate M.Sc. Social Science, Allameh Tabatabaee University, Tehran, Iran

3. Assistant Professor - Department of Nursing& Midwifery, Islamic Azad University of Tehran,

Tehran, Iran

4. Department of Statistics & Epidemiology School of Health, Tehran University of-Medical

Sciences, Tehran, Iran

Introduction: Agents of chemical war, especially sulfur mustard and their pulmonary

complications in chemical devotees creates worries for their family (spouses) and have

negative impact on wellbeing and quality of life for chemical devotee and their care-givers.

But, coping skills can be implemented for maintaining and improving their QOL. Thus

conductance of studies related to use of coping skills and maintaining and improving of

QOL for this damaged group seems necessary. This study was carried out to determine

relationship between QOL and coping skills in spouses of chemical devotees involved with

pulmonary complications due to sulfur mustard in Tehran.

Method: The study is a descriptive–analytic research on 100 spouses of chemical devotee in

an age range of 20-60 years with a mean age of 36.81 years by random sampling. The

instruments of data collection were Demographic and standard scale of care-giver, s Qol.

(Ferrell and Grant) and scale of coping skills (eight domains of Jallowicequestionnaires) that

carried out for interviewing and self report form in workshop, at their homes and devotees

foundation centers.

Results: The finding of descriptive statistics showed that good scores for Qol in Physical,

Psychological and Social domains are 19%, 0% and 49% respectively. Statistical tests of

Fisher & chi-squared showed a correlation between the educational level (p=2%), devotee

percentage (p=4%) and job (p=0.01) with their score of QOL. Also, 76% of the scores were

moderate for coping methods (whole) in participants and the remaining has the same score

(12%). Statistical tests of Fisher & chi-squared did not show any correlation between the

coping skills and QOL with individual characteristics (p>0.05).

Conclusion: According to thethose findings, there was not a correlation between QOL of

spouses of chemical devotees and their coping skills.

Key words: Quality of life, coping skills, spouse of chemical devotee


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The relevant factors with quality of life among children with cancer

Rahimi Sholeh1, Fadakarsoghe K

2, Tabri R

3, Kazemnejad E

4

1. MSc in Nursing, JavadolAemeh hospital, Kharameh, Fars, Iran. [email protected]

2. Dept .of pediatric nursing ,Guilan University of Medical Sciences ,Rasht ,Iran

3. Dept of Medical &Surgical Nursing, Guilan University of Medical Sciences .Rasht ,Iran

4.Dept of Biostatistic ,Guilan University of Medical Sciences .Rasht ,Iran

Introduction: Nowadays, considering the development in medical sciences and technology,

pediatric cancer has changed from an acute and fatal disease to a chronic one, resulting in a higher

survival rate. On the other hand, an increase in use of aggressive treatment causes children to

experience unpleasant physical, mental, and behavioral complications during the treatment. These

complications, if not controlled, can have negative effects on Quality of Life (QOL). Thus, QOL has

been taken into account in treatment of the children suffering from cancer.The present study aimed

to evaluate the QOL and its relevant factors among children with cancer.

Methods: This descriptive-analytical, cross- sectional study was conducted on 213 children between

2 and 14 years old who suffered from cancer and had referred to Imam Reza clinic and Amir

hospital, shiraz, Iran. The data were collected using a questionnaire including 4 parts as follows: 1)

relevant factors with QOL in children with cancer, 2) mother's general health status form, 3)

TNO_AZL- Health Related QOL including: Pre-school Quality of Life (TAPQOL) and TNO_AZL

Children Quality of Life (TACQOL), and 4) Specialty Quality of Life (PedQLCancer Modules). The

data were gathered through interviewing the mothers and reviewing the children's medical records.

Then, the data were entered into the SPSS software (version 19) and analyzed using descriptive

statistics, and t-test, ANOVA, Pearson correlation coefficients, Kruskal–Wallis, and multiple

regression.

Results: According to the results, mean scores of TAPQOL, TACQOL, and specialty QOL were

62.96±15.78, 75.45±10.05, and 54.73±33.47, respectively. The results of multiple regression analysis

revealed a significant relationship between children’s age (P<0.001,OR=0.38), duration of disease

(P<0.04, OR=2.42), interval between chemotherapy cycles (P<0.006, OR=1.18), and number of

radiotherapy sessions (P<0.01, OR=5.31) and Health-Related QOL (HRQOL). Moreover, cancer-

specific quality of life was associated with children’s age (P<0.04, OR=0.91), number of

radiotherapy sessions (P<0.03, OR=2.95), interval between chemotherapy cycles (P<0.03,

OR=2.81), and mother’s general health status (P<0.04, OR=1.06).

Conclusion: The study results showed that chemotherapy and radiation caused side effects that

could damage the children's QOL. Hence, measures should be taken in order to perform appropriate

treatments to reduce the side effects. This may result in less damage to the QOL of these children

and their mothers, eventually leading to less damage to public health. The findings of this study

suggested that emotional support was as important as financial empowerment. In addition, the QOL

of these patients and their families may be improved by identifying the families who are at risk of

mental problems.

Keywords: Quality of life, Cancer, Child



Poster presentation


NMRC 2014

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The evaluation of stress management Education to improve behavior in people with

Multiple sclerosis based on BASNEF Model

Goldoust Marandy F*, Ebadifard Azar F, Solhi M, Rahmati Najarkolaei F, Ghorchiany F

*Faculty of Health, Tehran university of Medical science, E-mail:[email protected]

Introduction: Multiple sclerosis (MS) is one of the most common diseases of the central

nervous system. MS is the result of damage to myelin. There is the exact relationship

between stresse and the onset or progression of MS so stress management is important in

people whit Multiple sclerosis.

Objective: Investigate The Effect of Educational Program of stress management Based on

BASNEF Model to improve behavior in people with Multiple sclerosis

Materials and Methods: This is a quasi-experimental intervention study.

This study was performed on 100 patients With Multiple sclerosis between the ages of 15-50

years from Sina and Shariati hospitals, and were randomly divided to two groups,

experimental and controls. The instruments for data collecting were a questionnaire

established based on the BASNEF Model. All groups completed the questionnaires before

and one month after intervention, and the patients of the experimental group participated in

3 educational sessions. Eventually, the collected data were analyzed by using statistical tests.

Results: Our findings indicated both groups don’t have any significant difference based on

BASNEF Model variables (attitudes, subjective norm, enabling factors, intention and

behavior). The mean scores of BASNEF Model variables were significantly increased in the

experimental group compared to the controls after intervention. Also behavioral methods of

stress management improved significantly among the experimental group, compared to

control group.

Conclusion: Applying the BASNEF Model is very effective for developing an educational

program for people whit Multiple sclerosis in order to control their stress. In people whit Ms

Stress management is highly recommended.

Key words: Multiple sclerosis, stress management, BASNEF Model


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The Effect of Pain Management Education on the Intensity of Pain and Quality of Life

of Patients with Cancer

Sharif Farkhondeh*1, Ansari Hamideh

2, Mosalaee Ahmad

3, Jafaree Peyman

4, Mohebi Zinat

5

1. Mental Health & Psychiatric Nursing Department, Community Based Nursing &Midwifery

Research Center, Faculty of Nursing, Shiraz University of Medical Sciences-Shiraz Iran

2. Razi Hospital, Shiraz University of Medical Sciences, Shiraz Iran

3. Radiology & Oncology Department, Faculty of Medicine, Shiraz University of Medical Sciences,

Shiraz Iran

4. Biostatistic Department, Faculty of medicine, Shiraz University of Medical Sciences

5. Medical Surgical Nursing Department, Faculty of Nursing, Shiraz University of Medical Sciences,

Shiraz Iran

Introduction: Pain is the most prevalent symptom experienced by patients with cancer. If

left untreated, it can cause complex complications for patients and interfere with their daily

life and function, as well as their general quality of life.

Objectives: We aimed to assess the effect of pain management education on pain intensity

and the quality of life of patients suffering from cancer.

Method: In this semi-experimental study, 60 patients with cancer pain were randomly

selectedand divided into two groups. The case group participated in pain management

education program. Pain intensity was evaluated before intervention, and 2, 4, and 8 weeks

after intervention. Also, the patients' quality of life was evaluated before intervention, and 4

and 8 weeks after intervention.

Results: The case group's mean pain and worst pain indices had a significant decrease four

weeks after intervention. Eight weeks after intervention the mean pain, worst pain, and

current pain indices were significantly reduced in the case group. However, two weeks after

intervention we observed no significant decrease in the pain intensity indices between the

two groups.

Four weeks after intervention, there was a significant increase in the mean quality of life,

emotional function, physical function, and social function scores in the case group p<0.05.

Eight weeks after intervention the case group showed a significant increase in all quality of

life, as well as all functional scales p<0.05.

Conclusion: An organized and consistent pain management education program can

effectively reduce pain and enhance the quality of life of patients with cancer.

Key words: Pain, Pain Management, Quality of life, Cancer, Education


Poster presentation


NMRC 2014

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Perceptions of Iranian mothers on barriers of Normal vaginal Delivery (NVD)-A

Qualitative Study

Sattarzadeh Niloofar *, Mohammadalizade Sakineh, Zargham Ali, Zamanzadeh Vahid

* Midwifery department, Tabriz Medical University, Tabriz, Iran

Introduction: Despite ongoing debate regarding the safety of unnecessary operative

delivery, near the half of Iranian Mothers undergoes cesarean section. The factors

influencing a woman’s decision to choose the mode of delivery remain poorly understood.

This study aim to explore perception of Iranian women who avoid Normal Vaginal Delivery

(NVD) and request for Cesarean section (C.S).

Methods: a qualitative study using semi-structured interviews with 20 urban mothers, who

underwent cesarean section in their current pregnancy without medical indication.

Results: Thematic analysis highlighted three key motivating factors by which women chose

their mode of delivery: Environmental Elements, socio-economical motivators and personal

preferences, which the first one is discussed in this article

Conclusion: Iranian women do make decision under the influence of social, environmental

& personal factors. Unpleasant environment & non supporting behaviors in delivery rooms

persuade mothers to choose cesarean delivery in spite of their will.

Key words: Barriers, NVD, C.S, Iranian women, Qualitative study, Environmental Element


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Evaluation of the Effect of Eye Movement Desensitization and Reprocessing (EMDR)

Intervention on pre-post operative anxiety in patients undergoing surgery

Marofi Maryam1, Marofi Mohsen

2, Zamani Foroushani Shahla

3, Izadikhah Zahra

4

1. Faculty of nursing and midwifery, Paediatric nursing department, Isfahan University of medical

sciences

2. Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan,

Iran

3. Department of Psychology, Islamic Azad University, Science and Research Branch Isfahan,

Isfahan, Iran

4. Department of Psychology, the school of higher education, the Australian Institute of Psychology

Background: Hospitalization, surgery and anesthesia are for some children associated with

anxiety and could be a frightful experience which may result in later problematic behavior.

Different strategies are suggested to reduce the anxiety. EMDR as a non-pharmacological

and inexpensive intervention can be used as a complementary technique. This study aimed

to investigate the effect of EMDR on pre-post operative anxiety in children undergoing

surgery.

Methods: In this semi-experimental study, 56 children aged 12-18 years, were categorized

into the study and control groups. Each girl subject was matched with a boy of the same age.

The study was conducted at Alzahra¸ a Hospital in Isfahan, Iran, in spring and summer,

2013. EMDR was administered for 45 to 60 minutes for the study group. The data gathering

instruments were questionnaires which included demographic information and the State-

Trait Anxiety Inventory for Children (STAIC). The hypothesis was tested with repeated

measurement analysis of variance (ANOVA), t-test, Fisher, Chi-square and Mann-Whitney

test.

Results: Findings of the study indicated that there was a significant reduction in the anxiety

level after intervention in the study group in comparison to the control group (p < 0.001).

Conclusions: This finding showed that anxiety scores in study group declined after EMDR,

and remained low after surgery, compared to patients who hadn’t receive any intervention.

Keywords: Anxiety, EMDR, Surgery, Children


Poster presentation


NMRC 2014

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Health in holistic nursing theories: a concept analysis

Aghebati Nahid1, Mohammadi Eesa

2, Ahmadi Fazlollah

3

1. Associate professor in nursing, faculty member of Mashhad University of Medical Scinces

2. Associated professor, TarbiatModares University, Tehran, Iran

3. Professor, Tarbiat Modares University, Tehran, Iran

Introduction: Nursing claims to be a discipline dedicated to understanding and relating to

the health of the whole person, not just to the pathology that often brings the person to the

attention of health care professionals. Thus many nurses are looking for holistic theoretical

models with a nursing focus to guide their practice. The aim of this study is to analyze the

concept of health in the context of holistic nursing theories with the simultaneity worldview.

Method: Principle-based method of concept analysis introduced by Morse, Penrod and

Hupcey was used to analyze 5 holistic theories. The theories of "Rogers’ Science of Unitary

Human Beings, Newman’s Health as Expanding consciousness, Watson’s Science of

Human Caring, Erickson’s Modeling and Role-Modeling Theory and Parse’s Human

becoming school of thought" were included in this analysis. The data included 8 theory

books and 16 (selected among 92) articles (1998-2011), which were retrieved through

MedLine and CINAHL.

Results: The concept of health was defined explicitly by all of the theorists. Rogers and

Parse conceptualized health as a value, which is determined by individuals. Watson and

Erickson referred to health as a unity and harmony withbody-mind-spirit. Newman saw

health as the pattern of the whole; she believed that the process of the evolution of

consciousness is the process of health. Although there is no inconsistency between the

definitions, we did not see anequal exploration of health (principle of epistemology). Health

in the context of holistic nursing is applied as an outcome of the human being - environment

relationships. In the caring space the environment can be a nurse and the human being is the

client. Then this concept has an extensive application in complementary nursing care

(principle of Pragmatic). Rogers preferred to use the term human betterment instead of

health, but also she applied the term wellbeing in some parts of her theory. Parse used the

term health at the first version of her theory but over time she replaced health with human

becoming. Watson used interchangeably the terms health and healing, she did not determine

the exact borders of these two concepts. Erickson uses only the term healingand at last

Newman used the term health as expanding consciousness. It is obvious that there is no

consistency between the theorists to use the same term for this concept, (principle of

linguistic). The concept of health was used in two theories as a core concept and in defined

in all of the theories, but there is no evidence to determine the exact borders of the concepts

of health and healing (principle of logic). In this concept analysis, we considered the concept

of health as an outcome of the mutual rhythmic relationships of human being and

environment in the context of holistic nursing. Four themes were extracted as the attributes

of the concept: Considering health byincarnating personal values, Thoughtful evolution and

step on the road of excellence, Cocreating patterns of relating with environment, and

Healing.

Conclusion: A theoretical definition is the study's product, which becomes a foundation for

future concept driven researches to advance health toward delineating the boundaries.

Key words: health/ holistic nursing theories/ principle based concept analysis


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Self-care and Self-neglect among Older Adults

Mardan Homa1, Tengkuaizan Hamid

2, Rahimah Ibrahim

3, Ma’rofredzuan

4

1. Institute of Gerontology, Institute of Gerontology, Universiti Putra Malaysia, Selangor



4. Research Associate, Institute of Gerontology and Faculty of Human Ecology, Universiti Putra

Malaysia

Background: The prevalence of elder self-neglect is expected to rise with the increased in

older population. However, self-neglect in the elderly is not fully understood due to limited

research in the area, lack of consensus in the definition of the concept and limited

instrumentation.

Aims: The purpose of this study is to investigate the relationship between selected socio-

demographic factors on self-care and self-neglect of older persons living in the community.

Material and Methods: A cross-sectional survey design with the cluster sampling was

adopted for the study. Data were gathered from 146 older persons aged 60 years and over in

the state of Selangor, Malaysia through face to face interviews in their homes with a team of

trained enumerators. A new instrument was developed to measure self –neglect.

Findings: The internal consistency of the new instrument showed a reliability of 0.95. A

significant bivariate relationship was noted between self-care and self-neglect. The socio-

demographic factors were also reported between self-care and self- neglect.

Conclusion: The new instrument of ESN could be used to measure self-neglect in a

community-dwelling. The need to self-care in the elderly is crucial in order to reduce self-

neglect and enhance their well-being.

Keywords: Self-care, self-neglect, cross-sectional survey


Poster presentation


NMRC 2014

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Prediction of Self-care behavior based on Hardiness, Hope and Dysfunction Attitude

among patients with Type 2 Diabetes

Ebrahimi Amrollah1, Hoseinikhah Maryam

2, Manshaei Gholam Reza

3

1-Assistant professor, Behavioral Sciences Research Center, Department of psychiatry, Medical

Faculty, Isfahan University of Medical Sciences, Isfahan, Iran 2-Psychologist (MSc), Science and Research Branch Esfahan, Islamic Azad University, Isfahan, Iran

(corresponding Author) 3-Assistant Professor, Science and Research Branch Esfahan, Islamic Azad University, Isfahan, Iran

Background: This study aims to predict self-care behavior based on the characteristics of

Hardiness, hope and dysfunctional attitudes in patients with type 2 diabetes.

Method: Study design was a descriptive correlation method. The targetpopulation was all

patients with diabetes type 2 who referred to Isfahan Endocrine and Metabolism Centers.

The sample consisted of 120 patients. The multi-stage cluster sampling was used for the

sample selection. The instrumentemployed in this research wasSelf – care Scale,

hardinessQuestionnaires, Hope Scale and Dysfunctional Attitudes Scale. The Pearson

correlation and multiple regression analysis with stepwise method were used to analyze the

data.

Results: Analysis of the data showed thatThe only interaction between hope and

dysfunctional attitudes have been able to predict self-care (r=0/191,p<0/05). But separately

there is no relationship between hardiness, hope, dysfunctional attitudes and self-care.

Discussion: Interaction of dysfunctional attitudes and hope are able to predict self-care

behavior. Therefore, the program which modify dysfunctional attitude and enhance Life

Expectancy seems to increase self-care behavior.

Keywords: Self- Care, Hardiness, hope, Dysfunctional Attitude, Type 2 Diabetes


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Ethical Communication in Health care Providers

Shahriari Mohsen

Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan

University of Medical sciences, Isfahan, Iran [email protected]

Communication is a central concept in nursing and other health staff. Human relationship

has been indicated as an ethical value with traits of mutual respect, trust, and reliance which

are accompanied by patients’ confidentiality and privacy. It can be verbal or non-verbal and

defined through having honesty in words and practice, sympathy and mutual understanding,

courtesy, and friendliness. In this regard, giving care is possible only through making

humanistic, efficient, and effective relationship, a relationship based on mutual respect and

understanding.

The therapeutic nature of the nurse-patient relationship is central to nursing practice. Within

this bond, issues such as truth-telling, compassion and communication gain more

importance. In line with other studies; the nurse-patient relationship should be an ethical

obligation for better care. Human relationship based on affectionate understanding,

developing trust, professional behavior, kindness and confidentiality, which in turn results in

the development of a mutual relationship and interaction between the care giver and

receiver.

Common traits such as kindness, patience, and tolerance contribute to high quality nursing

care, while compassionate care is recognized as morally and ethically good care. Kindness

and honesty are important for the development of a therapeutic nurse-patient relationship

and nurse with other health staffs.

Providing optimal nursing care, through constant efforts and commitment to proper

communication, is possible. Man is a social being, and through communicating and sharing

in each other's emotions, it provides correlation and interaction in society.



Poster presentation


NMRC 2014

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Social accountability and reorientation of curriculum of Medical, Nursing,

nutrition,…Schools to societal Needs

Shams Behzad

MD, Faculty of Dept of EDC Isfahan University of medical sciences, Isfahan, Iran

New societal Health needs created a big challenge regarding Educational Institutions to

reorient their curriculum to these needs.To respond practically, schools needs to implement

their Educational plans to fulfill the major four Social Accountability ( SA ) Indicators :"

RELEVENCY,QULITY , EQUITY and COST –EFFECTIVNESS "under the UMBELLA

of JUSTICE .to plan for these changes one should make use of National RGULATIONS

and Ministry AGREEMENTS , In institutional Level all stakeholders should participate

and advocate the issue of changes to reach the objectives and outcomes.The

EDUCATIONAL SPIRAL and EDUCATTIONAL CYCLE demonstrates this planning as

follow :

needs

curriculum

Implement

.

Evalution

Educational Spiral

How Educational institutions can reorient their curriculum components to these competencies of

GP.’s to become Socially Accountable ? (SA)Relevent,High quality ,Equitable ,Costly Effective

• Some components of the curriculumobjectives

contents

Teaching meth

ST assessm

Relevent

High quality

equitable

costly Effective

National Health

Packages NHPofGP.’s

To get to the feasible Action Plan, resources should be directed to this planning .It is

essential that Program should be Evaluated after finishing each Educational cycle and

changes should be implemented.


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The effect of community health nurse home visit on self-care self-efficacy of the elderly

living in selected Falavarjan villages in Iran in 2010

Torkani Sara, Hosseini Habibollah, Tavakol Khosrow

Introduction: Perceived self-efficacy is a strong predictor for behavior. Considering the

importance of health-promoting self-care behaviors in increasing quality of life in the

elderly, this study was aimed at defining the effect of nurse home visits on self-care

self-efficacy of the elderly in rural areas.

Methods: This is a pre and post quasi-experimental study conducted on 33 older adults

randomly selected from five villages in Falavarjan province in Iran. Intervention program

was in the direction of self-care self-efficacy in four domains including nutrition, health

practice, physical activity, and well-being in the form of five home visit programs and one

group session by a nurse during 6 weeks, and included two different sections of education

and nursing interventions administered based on needs assessment and determination of the

tasks for the clients and their families. Theoretical framework of this study was supported by

Bandura’s self-efficacy, Orem’s self-care theory, and Pender’s revised health promotion

model. The data were collected by self-care self-efficacy and demographic information

questionnaire before and after the intervention. Data were analyzed by descriptive statistics

and paired t-test.

Results: The mean elderly score in the four aforementioned domains increased after the

home visit program. A significant difference was seen in the mean total scores of self-care

self-efficacy and its subscales by paired t-test before and after intervention (P < 0.001).

Conclusions:It was observed that home visit program, integrated with the theories, had a

positive influence on improving self-care self-efficacy of the elderly, and was supported by

Bandura’s theory of self-efficacy suggesting four sources of performance accomplishment,

vicarious experience, verbal persuasion, and emotional arousal. With regard to the

importance of self-care behavior in health promotion of the elderly, multifaceted low-cost

interventions with the highest effect seem essential.

Key words: Community health nursing, elderly, home visit, Iran, self-care, self-efficacy


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Comparison of web-delivered and printed reproductive health education on modern

contraceptive beliefs and practices of married women in a public university, Malaysia

Najafi-Sharjabad Fatemeh*, Abdul Rahman Hejar, Hanafiah Muhamad, Sharifah Zainiyah

Syed Yahya

* School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran

Background: In spite of the widely available family planning services in Malaysia during

past three decades, the contraceptive prevalence rate (CPR) has a steady rate, only 34% of

women use modern contraceptive methods. The aim of this study was to evaluate the effect

of web delivered and printed reproductive health educational module on improving

reproductive health knowledge, contraceptive beliefs, and practices for preventing

unintended pregnancy among married female staff in a public university in Malaysia.

Methods: This study wad cluster randomized controlled trial and multi stage random

sampling was used for selection of faculties. Self-administered questionnaire based on

Health Belief Model (HBM) was used for collecting data on women’s contraceptive beliefs

and practices at baseline, three and six months after intervention.Reproductive health

education modules were delivered through website and booklet to the respective intervention

groups. A Family Planning Expert was introduced to the website to answer questions about

women's reproductive health. For the booklet group, question and answer sessions were held

by researcher at the work place. Both intervention groups received weekly reminder emails

and tailored health messages during six months post intervention.

Results: Among website group modern contraceptive use significantly increased over time

(p=0.01). There were significant and consistent increase in the mean knowledge score

(p<0.001), perceived susceptibility (p=0.002), severity (p=0.001), benefits (p=0.02), cue to

action (p= 0.008), contraceptive self-efficacy (p= 0.003), and decreased barriers for using

modern contraception (p= 0.047) over time.

Within booklet from baseline to 6 months there were significant increase in the mean score

of knowledge (p<0.001), perceived susceptibility (p=0.001), severity (p=0.005), benefits

(p=0.015), self-efficacy (p=0.041). In the control group with the exception of reproductive

health knowledge score which significantly changed from baseline to 6 months (p<0.001) no

significant improvement was found in all other aspects.

Conclusion: Web-delivered reproductive health education module which is accompanied by

family planning counseling provide safe environment for discussing about sexual topics

including contraceptive practices that is culturally sensitive among Malaysian women. Web-

delivered health education intervention was more effective in decreasing barriers and

improving contraceptives use, knowledge, and beliefs of educated married women as

compared to printed reproductive health education module.


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Nurses perceptions of ethical climatein hospitals

Borhani Fariba1, Jalali Tayebeh

2, Abbaszadeh Abbas

3

1. Assistant professor, Medical Ethics and Law Research Center, Shahid Beheshti University of

Medical Sciences, Tehran, Iran

2. Lecturer, Medical Faculty in Sirjan, Kerman Medical Sciences University, Kerman, Iran

3. Professor, Nursing and Midwifery Faculty, ShahidBeheshti University of Medical Sciences,

Tehran, Iran

Background: Ethical climate is an important component of organizational culture. Nurses’

perception of hospital ethical climate can influence their performance and attitudes related to

ethical issues.

The aim of this study was to determine the Nurses’ perception of hospital Ethical climate.

Methods: A descriptive design was applied in this study. The sample consisted of 204

nurses who working in privative and Social Security hospitals. The Instruments used in this

study included a demographic questionnaire, Hospital Ethical climate Questionnaire

(HECQ). The reliability and validity of the measures were assessed. Data analysis was

carried out using descriptive statistic through Statistical Package for Social Science (SPSS),

Version 16.

Result: Data analysis identified that the mean of manager (Mean = 3.42±0.66), coworker

dimension (mean = 3.26±1.11). This was followed by patient (mean =3.10±0.79), hospital

(mean =3.32±0.60), and physician (mean = 2.82±0.62).Also the mean of overall ethical

climate was (3.12± 0.6).

Conclusion: Current research indicates moderate to high level of hospital ethical climate

that reported by nurses. This study show that the” manager climate” is dominant climate and

communication between doctor and nurses is the lowest level.Since the ethical climate is an

important factor in job performance and Also affect on quality of patient care, so, this study

suggests that hospital leaders should apply strategy to promote hospital ethical climate. Also

manager of hospitals can promote nurses’ performance by creating environment which

supported nurses.

Key words: Ethical climate, nurses, hospital


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Incongruent Perceptions among Nurses and Patients: A Qualitative Study

Torabizadeh Camellia *, Ebrahimi Hossein, Mohammadi Eesa, Valizadeh Sousan

* Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

Introduction: Maintaining patients’ dignity has been considered an important factor in

improving patients’ health. Patient’s dignity in health care centers is affected by factors such

as the quality and quantity of resources, gender, age, knowledge, skills, attitudes, and culture

of the medical staff. The present study is formed to investigate patients’, companions’, and

nurses’ experiences of patients’ dignity in Iran.

Methods: With the use of purposeful sampling, 35 patients, their companions, and nurses

were interviewed over a 15-month period in five educational hospitals affiliated with the

government. They were questioned about experiences related to respect for patients’ dignity

in health care centers. Data were analyzed using qualitative content analysis and constant

comparison techniques.

Results: Four themes, each comprised of two categories, were obtained through analyzing

the data fromparticipants’ interviews. The four major themes emerged were gap in

resources, communicationbreakdown, distrust, and reciprocal dignity.

Conclusion: Dignity is a fundamental concept in the health care process, which should find

its true place in health-training programs. Patients’ and companions’ views in this regard are

of great importanceand could be used by authorities of health care systems as a basis for

fulfilling patients’ needsand expectations.

The difference between the views of providers and receivers of care in defining the concept

ofdignity might be due to the lack of knowledge about their respective roles. Nurses, as

professionalmembers of a medical team, should believe that work issues must not affect

services they offer topatients or their interactions with patients and their companions.

Keywords: dignity, patient dignity, health care, nursing, qualitative study


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The Relationship between awareness, attitude and tendency totake care of HIV

patients among personnel employed at public hospitals andhealth-care centers in Iran

(Isfahan) in the year 2013

Mohammadirizi Soheila1, Khorvash Farzin

2, Mohaghegh Negar

3 Boroumandfar Zahra

4*

1. Master of midwifery, department of midwifery Nursing and Midwifery school, Isfahan University of

Medical Sciences, Isfahan, Iran.

2. Infectious diseases specialist, assistant professor, department of Infectious diseases, Medical

school, Isfahan University of Medical Sciences, a member of nosocomial Infectious Diseases Research

Center.

3- Medicin student, Medical school, Isfahan University of Medical Sciences

4. Research PhD student (Infectious and Tropical Diseases Research Center) a member of

Nursing&Midwifery Care Research Center, Isfahan University of MedicalSciences ,Instructor,

department of Midwifery, Nursing and Midwifery school, Isfahan University of Medical Sciences E-

mail: [email protected]

Introduction: Aware, attitude and tendency to take care of HIV patientsInfluenced to quality

care of health providers, so the present study aimed to define the association between

awareness, attitude and tendency to take care of HIV patients among personnel employed at

public hospitalsandhealth-care centers in Iran (Isfahan) in the year 2013 was done.

Methods: This is a cross-sectional study conducted on 400 of nurses, midwives and doctors

of public hospitals and health centers in Isfahan, selected through two stage sampling in

2013. Theparticipate completed questionnaires about personal/work characteristics,

awareness, attitude and tendency to take care of AIDS patient’s scales. The data were

analyzed by, Pearson statistical test, T-test, variance analysis through SPSS ver16.

Results: The findings showed that 59.5% of the participantes low aware, 98% negative

attitude about AIDS and 87% had nilled to take care of AIDS patients. Pearson correlation

coefficient showed that there was a linear correlation between the score of aware and

attitude toward to AIDS/HIV (p=0.043, r=-54), attitude toward to AIDS/HIV and tendency

to take care of AIDS patients (p=0.032, r=-0.41).

conclusion: Since personnel’ aware, attitude level and the tendency to take care of the

patients was not good, so In order to change the attitude and willingness to care for AIDS

patients in their Suggested that more accurate planning in hospitals.

Key word: awareness, attitude, tendency, nurse, midwife, doctor



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Development and Evaluation of Indicators of structure, process and outcome in a

"Role Expansion action research": Mixed methods study

Khorasani Parvaneh1, Rassouli Maryam

2, Zagheri Tafreshi Mansoureh

3, Parvizi Soroor

4, Nasre-

Esfahani Mahmood5

1. PhD Candidate in nursing, Nursing and Midwifery School, Shahid Beheshti University of Medical

Sciences, Tehran-Iran. [email protected] 2. Nursing & Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel:

+9821-88655372, [email protected] 3. Nursing & Midwifery School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4. Nursing & Midwifery School, Iran University of Medical Sciences, Tehran, Iran.

5. Official of Health education and clinical supervisor of Al-Zahra educational- therapeutic center,

Medical University of Isfahan, Esfahan. Iran

Introduction and objectives: Expanding educational role of health professionals is one of the

important issues in promoting quality of services in therapeutic centers. Clinical nurses as major

forces in clinical settings must be more accountable in this role. So in an action research for

expanding nurses educational role that has started 2 years ago, simultaneous with the planning and

implementation of the Role expansion programs, development of quality indicators and performance

appraisal considered for evaluating time and place variations. The purpose of this study was to

develop and investigate indicators of educational role expansion of nurse's during an action research

study.

Methods: This study was carried out with a mixed methods design in a big educational therapeutic

center during an action research from 2012 to 2014. After developing a series of 32 plans and7

policies for patient education in the first year, 30 formulas and indices were developedtomonitorthe

structure, process and outcome of the program. And during the second year of the pilot of this

program, five indicators were adopted for comprehensive quality improvement plan in the field.

After creating legal and motivational requirements, weekly reports received continuously and

entered in Excel spreadsheets for collecting raw data required for accounting indices in formulas.

After accounting monthly indices, statistical analysis performed in SPSS18 with T-test, pairedT-test

and Qui square.

Results: Quantity indicators of the structure and process showed a significant increase from (95%

confidence interval) .percentage of nurse educators in wards and nurse-educator to patients ratio, as

well as nurse' participation in programs of empowerment and development of educational pamphlets

increased 2-5 times during program in most wards.Mean score of patient satisfaction from

educational services as an outcome indicator, increased. Although the differences were significant

particularly in the welcome and discharge education, gradual shrinking of Standard Deviations,

indicates on greater coordination of program between wards and nurses.

Discussion: According to role expansion definition, quantitative aspects of the nurse educator role

increased in all wards regarding ethical and legal frameworks, but this rate is different probably

based on the internal and external motivational factors in each ward. Hereinafter, ther is need for

applying more educational, motivational and supervision programs for quality improvement in

patient education services by nurse educators. Also it is necessary to strnghten the infrastructures and

corrective through intra-ward supervisions for comprehensive implementation of mentioned plans

and policies.

Key words: Evaluation study, Instrument development, Nurses, Patient education, Professional role,

Role expansion




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Informal caregivers’ experiences of caring of MS patients: a qualitative study

Ghafari Somayeh, Fallahi Khoshknab Masoud*, Mohammadi Eesa, Nourozi Kian

* Nursing Department, University of Social Welfare and Rehabilitation Sciences (USWR),

Koodakyar St., Daneshjoo Ave., Evin, Tehran, Iran

Introduction: About one quarter of people with Multiple Sclerosis (MS) will need long-

term care by their families. We know little of the experiences of them. Therefore, exploring

of these experiences can be a guideline to improve quality of care for patients with MS. This

study aimed to explore the experiences of informal caregivers of patients with multiple

sclerosis.

Method: A qualitative content analysis method was used to conduct this study. The study

participants were 23 informal caregivers of MS patients, that chosen by purposeful sampling

from MS association of Iran (Isfahan and Tehran). Data analyzed by using content analysis.

Results: The analysis resulted in the emergence of six themes and seventeen subthemes.

The main themes were: Being plagued, mental health damage, Being captive among the

obstacles, Perception of the affected family, Being an emotional supporter, Need to maintain

the functional independence of patient.

Conclusion: The findings highlight several critical issues regarding inpatient MS care that

need improvement such as: support of informal caregivers by healthcare professionals and

government (financial, emotional, instrumental and informational support), attention to

functional independency and emotional needs of patients during care.Therefore, an increase

in awareness of these findings can help healthadministrators and healthcare professionals

like nurses to plan and design a comprehensive care model for MS patients and develop a

support program for theircaregivers.

Key words: content Analysis, informal caregivers, Multiple Sclerosis.


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Stigma Hinders Patients with Chronic Hepatitis to Do Self-Care in Public: A

qualitative study

Hassanpour Dehkordi A*, Mohammadi N**, Nikbakhat Nasrabadi A***

*Assistant professor, Nursing and Midwifery Faculty, shre-kord University of Medical Sciences,

[email protected]

** Nursing and Midwifery Faculty, Tehran University of Medical Sciences,iran

*** Nursing and Midwifery Faculty, Tehran University of Medical Sciences,iran

Introduction: Hepatitis is one of health problems throughout the world. It has numerous

consequences on patients’ life and it may appear as a chronic disease inflicting liver. Patient

participation in doing self-care is essential for patients with chronic hepatitis in order to

change their behaviors in the direction of a healthy life style and to rise the own quality of

life. Thus the purpose of this qualitative study was to examine the Impact of Stigma on the

Self-Care Behaviors of chronic hepatitis in Iranian society

Methods: This present study was designed as a qualitative method and this article show up

the results of a qualitative research Study undertaken with patients living with hepatitis in

the Iran. The study uses a content analysis method to determine the Impact of Stigma on the

self-care behaviors in participants. A purposive sample of 18 patients was chosen. Data

collected through a semi-structured interview and field note that the researchers will take

during participants’ observation. Data analysis process performed on the texts which

generate from verbatim transcripts of the participants interviews.

Results: According to the findings, 18 participants were between 18 and 61 years of age;

34%single, 84% male, 63% primary school .In data analysis three themes emerged for this

study: fear of transmission’s, fear of depiction and Burden of care and support

Conclusion: This research indicates that stigma presents major challenges not only for those

with chronic hepatitis, but also for nurses, other healthcare practitioners, family and social

networks, institutions and society. The researcher suggests that interventions to reduce or

eliminate stigma will require individual, structural, cultural thought, society and systemic

changes.

Key words: stigma, chronic hepatitis, self care



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Effect of a family-need-based program on caregiver burden in patients with

leukemia

Pahlavanzadeh S*, Khosravi N**, Moeini M*

*Nursing and midwifery care research center- School of Nursing and Midwifery, Isfahan

University of Medical Sciences, Isfahan, Iran

** Master degree in Nursing

Introduction: Family caregivers are as essential part of health care in patient with

leukemia because care of these patients leaves burden some caregiving burden for their

families. Therefore this study was done with purpose of assessment effect of a family-

need-based program on amount of caregiver burden in leukemia patients.

Methods: This research is a clinical trial which was done on 64 family caregivers’

patients with leukemia had referred to Seyedalshohada hospital for patients with

leukemia in Isfahan city. Caregivers were selected with convenient sampling then

randomized to experimental & control groups. Caregivers of experimental group

participated in family education program but caregivers of control group didn’t

participate in this program. The data were collected by Zarit caregiver burden scale

which completed by caregivers of both groups before, after & one month after executing

family education program. Finally data were analyzed with SPSS (version 20).

Results: Caregiver burdengradually in experimental & control group decreased &

increased respectively. Caregiver burden before, after & one month after executing

family education program respectively, in intervention group were 63/6 &30/4&23/03

respectively in control group were 62/5&67/3&68/8. Also there was significant

difference between caregiver burden of two groups after execution the program

(P<0/001).

Conclusions: Because execution this program could reduce caregivers’ burden of

petient with leukemia, it is recommended to develop & codify other programs for family

caregivers of people with leukemia.


Poster presentation


NMRC 2014

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Effectiveness of a family-centered care program on level of adherence to treatment

regimens in stroke patientsand their family care-givers; a randomized controlled trial

*Mohamadi Sepideh*, Dehghan Nayeri Nahid, Pedram Razi Shadan, Kazemnejad

Anoushirvan

Nursing and midwifery care research center, School of Nursing and Midwifery, Isfahan University of

Medical Sciences, Isfahan

Introduction: By diversity of physical and mental complications associated with stroke and

the chronic nature of the disease, family caregivers are the primary source for ongoing care

and support in stroke patient. While family members accompany patients during their

hospitalisation, they receive little information about how to assist their relatives, and as a

result feel inadequately trained, poorly informed and dissatisfied with the support that is

available after discharge.

Aim: The aim of this study was to investigate the effects of a family-centered care program

on adherence to treatment regimens in 3 area "rehabilitation, diet & medicine" in stroke

patients and their family care-givers.

Methods: This was a posttest-only randomized controlled trial conducted on stroke patients

and their family care-givers in two groups; experimental (N= 30) and the control group (N=

30). The control group received the routine care. The care provided to the experimental

group was routine care plus a family-centered care program consisting of four steps,

including: need assessment, family education based on the patients’ needs, doing follow-up

for the patients’ and care-givers’ conditions, and coordination between families and other

health-care professionals as well as making appropriate referrals. The study was conducted

between July 2012 and March 2013 and lasted two months for each subject. Data were

collected using the researcher-made Adherence to the Treatment Regimen Questionnaire.

We employed the SPSS software and the independent-samples t test, the Kolmogrov-

Smirnov test, the Chi-square test, and the Fisher’s exact test for analyzing the data.

Findings: Study findings showed that the levels of adherence to the different components of

the treatment regimen, including dietary regimen, medications and rehabilitations, are

significantly higher in the experimental group compared to the control group (P value<

0.001).

Conclusion: By empowering the families of patients with stroke and improving their

adherence to the treatment regimens, family-centered care programs would be able to play

an important role in the management of the physical and mental disabilities of the patients

suffering from stroke.

Keywords: Adherence to the treatment regimens, Family-centered care, Stroke


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Considering patients dignity status hospitalize in Isfahan hospitals by nursing staff

Abedi Heidar Ali1, Raee Dehaghi Zahra

2, Shahriari Mohsen

3

1. School of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan,

Iran

2. MSc Student, Young Researchers and Elite Club, Isfahan (Khorasgan) Branch, Islamic Azad

University, Isfahan, Iran

3. Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan

University of Medical sciences, Isfahan, Iran

Introduction: Showing respect to people dignity is one of the fundamental values and

serves as the foundation stone of nursing practices. But unfortunately, gradually, according

to industrial communities, nursing care less attention to the actual value of this issue.

Accordingly, the present study aimed to investigate the compliance status of the patients

who were admitted in hospitals in Isfahan in 1391.

Materials and Methods: This is a descriptive - analytical study that was conducted in 1391

in one of the hospitals in Isfahan. In this study, 401 hospitalized patients were selected by

cluster sampling. Data were collected through a questionnaire with Likret scale with the

degree of compliance in privacy, independency and the relationship of patients by nurses

and were analyzed using descriptive statistics and analytical software spss.

Results: The results showed that most patients (91%) believed the relationship with nurses

to be good and claimed that the communication of nursing and medical staff with patients is

appropriate. Regarding the privacy policy, the results were also observed with the majority

of patients (8/91%) to be moderate and good and the privacy policy of 5/6% of patients was

excellent. Also the majorities of patients (8/84%) were positive after their independency and

were in agreement with being concerned in decision making.

Conclusions: This study showed that the situation of respecting the dignity of patients is

approximately favorable but this situation, particularly in public hospitals and emergency

departments due to lack of time, the stress and workload of nursing is far more difficult and

more unpleasant. On the other hand, insufficient knowledge of nurses in the field of

respecting for the dignity of patients and disregarding the dignity is a major barrier for

respecting the dignity of patients which needs particular attention of nursing supervisor in

the planning and implementation of the measures for the betterment of this matter.

Keywords: Dignity, Nursing Staff, Communication, Privacy, Independency.


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Effect of health promotion plan with collaborative approach on quality of life in

overweight school age girls

Jafarzadeh Saeedeh*, Mohammad khan kermanshahi Sima, Hajizadeh Ebrahime

* Department of Nursing, Faculty of Fasa Medical University, Iran

Background and Aim: The prevalence of overweight and obesity in children and its trend in recent

years has taken a worrying figure. Overweight and obesity in childhood are the most important cause

of adult's obesity and low child's quality of life in now and future. Various studies have shown that

there is a consistent relationship between BMI and quality of life for children, Therefore, the present

study aimed to investigate the impact of health promotion programs with collaborative approach on

the quality of life of overweight Schoolchildren.

Methods: This quasi-experimental study was conducted in 2013, in which 80 overweight students at

Rozbe and Modares elementary school in Firozabad, selected by non-randomized and divided into

case group and control group. The data gathering tool was consisted of demographic information

questionnaire of child and their parents, the general quality of life questionnaire (pedSQl version 4)

in two forms (Child &Parent). Then in case groups, health promotion programs with 3 stages

assessment, Supportive Planning and evaluation was administered for 3 months. Quality of life for

children in both groups before and 3 months after intervention were examined and analyzed by using

the SPSS software version 16 .

Results: There was no significant difference before the intervention between the two cases and

control groups in terms of demographic characteristics and quality of life in children,(P>0/05) .While

after intervention " independent T test" showed a significant different between the two groups in

means of quality of life before and after intervention(P<0/05).

Conclusion: It can be concluded that, by the implementation of health promotion programs as

effective and low cost intervention program in schools with collaboration of child, parents and

teachers can prevent consequence of overweight and obesity like low quality of life and

psychological problem,… in children. Therefore it is proposed with implementation of health

programs by nurses in schools, we can prevent the growing trend of overweight, obesity and low

quality of life in children and adolescents.

Keywords: health promotion program, quality of life, overweight, school-age girls


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Comparative Study of Auriculotherapy and pharmacotherapy on LH, FSH Serum

Changes of 18-35 Year Old Unmarried Females with Polycystic Ovary Syndrome in

Isfahan in 2012

Khaki Imaneh1, Haghighat Dana Zohre

2, Valiani Mahboubeh

3, Azizi Mohammad Reza

4

1. MSc Midwifery Student, School of Nursing and Midwifery, Isfahan University of Medical

Sciences, Isfahan, Iran. Email:[email protected]

2. MSc Midwifery Student, School of Nursing and Midwifery, Isfahan University of Medical


3. Nursing and Midwifery Care research center, school of nursing and midwifery, Isfahan

University of medical sciences, Isfehan, Iran. E-mail: M [email protected]

4. MD, Clinical Laboratory Sciences

Introduction: It is one of the most common endocrine disorders and of the major causes

of hormone changes of polycystic ovary syndrome with 5% - 10% prevalence. The study

was conducted aiming at examining the auriculotherapy and pharmacotherapy on LH,

FSH serum changes of unmarried females with polycystic ovary syndrome.

Methods: The present study is a clinical trial on 60 unmarried female aged 18-35 in two

groups of auriculotherapy and pharmacotherapy with clinical, laboratory and ultrasound

symptoms. The pharmacotherapy group and auriculotherapy group were treated for 3

months and 2 months, respectively. The results were studied within three steps and they

were analyzed using SPSS15.

Results: Abnormal levels of LH in auriculotherapy group decreased from 44.4% before

intervention to 31% immediately after intervention and three months after finishing

intervention. Abnormal levels of LH in pharmacotherapy decreased from 40% before

intervention to 33.3% immediately after intervention and three months after finishing

intervention. It means that auriculotherapy and pharmacotherapy are both effective in

decreasing abnormal level of LH hormone, but the decrease was not significant (P= 0.9

(P= 0.8)(P= 0.8). Relative frequency of abnormal changes of FSH before intervention in

both groups was not significant (P=0.3). However, abnormal changes of FSH

immediately after intervention and three months after finishing intervention showed a

significant decrease in both groups (P=0.006), (P=0.002). Abnormal changes of FSH in

the auriculotherapy group decreased significantly at three periods (P=0.02); however,

such changes did not show a significant decrease in the pharmacotherapy group (P=0.58).

Conclusion: According to the results of the study, auriculotherapy is more effective than

pharmacotherapy in lowering abnormal levels of LH and FSH hormones. Therefore, it is

proposed to replace auriculotherapy with pharmacological methods to treat polycystic

ovary syndrome.

KeyWord: Auricular acupuncture, Polycystic Ovarian Syndrome, Follicle Stimulating

Hormone, Luteinizing Hormone, Iran


http://www.nlm.nih.gov/cgi/mesh/2013/MB_cgi?mode=&term=AURICULAR+ACUPUNCTURE


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NMRC 2014

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Organizations that Make a Difference: The Role of Monitoring & Evaluation

Al-Mohandis Batool

Nurse Consultant, Nursing Policy & Education Development, Kingdom of Bahrain,


Historically, the field of traditional monitoring and evaluation (M&E) strategies shed

insufficient light on developing valued outcome and real impact on society's wellbeing

and prosperity.

A living tragedy in today's political arena is the whole situation of the Middle East crises.

International financial aid organizations such as USAID, UNAID, and the World Bank

Group failed dramatically in their M&E to impact on countries capacity building for a

sustainable development.

In health care industry in general and education in particular, M&E are tools often

utilized for good intentions. It has no doubt lead to significant developments on input,

process, and output parameters of academic institutions, but debates amongst scholars

and interest groups remain on the significance of M&E on sustainable long term impacts.

Following on the footstep of writers and the wealth of information available in literature,

this paper will critique some M&E methodologies and approaches; it will present

strategies and framework that enhances project/ program effectiveness, integrating

principles & values.

The writer will also shed some light on evaluation culture as a growing underlying base

in academic life cycle, examining what some cultures embrace and how does it look like.



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Exploring the consequences of clinical nurses’ creativity for health care

organizations: A grounded theory analysis

Shahsavari Isfahani Sakineh*, Hosseini Mohammad Ali **, Fallahi Khoshknab Masoud ***,

Peyrovi Hamid ****, Khanke Hamid Reza *****

* Nursing Department, University of Social Welfare and Rehabilitation Sciences (USWR),

Tehran, Iran.e-mail: shahsavari_ [email protected]

** Ph.D in Higher Education Administration, USWR, Tehran, Iran

***Associate Professor of Nursing Department, USWR, Tehran, Iran

**** Associate Professor of Nursing, Department of Critical Care Nursing, School of Nursing

and Midwifery, Iran University of Medical Sciences, Tehran, Iran

*****Associate Professor of Nursing Department, USWR, Tehran, Iran

Introduction: To be effective, health care organizations must craft and facilitate creative

responses to increasingly complex health problems. Health care organizations and their

human power should innovate and make changes as patients' needs and demands shift.

Meeting these challenges requires the full use of all available human and mental

resources. Among the most important of those resources is creativity—the capacity to

think of old problems in new ways, to change the perspectives, or to create novel and

useful approaches to make health organizations work better and meet the patients' needs.

The purpose of this study was to understand and explore nurses’ consequences of

creativity in clinical settings.

Methods: Grounded theory methodology was employed to generate a substantive theory

to capture the phenomenon under study. Data were collected from sixteen nurses through

in-depth interviews and analyzed concurrently through constant comparative analysis.

The nurses were recruited by purposive and theoretical sampling. Theoretical saturation

was a criterion to finish data collection. Ten categories were emerged from the initial

analysis. The category "positive and negative consequences of nurses’ creativity are

reported in this paper.



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The impact of nursing spiritual well-being upon patient spiritual care

Zare Azam*, Jahandideh Sepideh*

*Alzahra Heart Charity Hospital, Shiraz University of Medical Sciences Shiraz, Iran

[email protected]

Introduction: Florence Nightingale emphasized the need for nurses to honor the

psychological and spiritual aspects of patients to promote patients' health. Therefore, it

seems very logical that there is a professional requirement for nurses to achieve

competence in the delivery of spiritual care. The purpose of this study was to examine the

impact of nursing spiritual well-being on patient spiritual care.

Method: The cross-sectional descriptive-analytical study had been conducted to

determine the impact of nursing spiritual well-being on patient spiritual care. Two

standard questionnaires were distributed to 210 nurses of special wards, as the study

sample in 2014. One hundred ninety valid questionnaires were returned (response rate,

90.47%). Descriptive and inferential statistics were used to analyze the data.

Results: Most participants were women, ranging in age from 26 to 30 Years. Participants'

clinical experience ranged from 1 year to 5 years, with a mean experience value of 2.5

Years. 59.2 percent of the nurses have Spiritual health in Medium level and 40.8 per cent

were high. In relation to the spiritual health nurses provide 5.8% of spiritual care in poor,

53.4% optimal level and 39.8 % in the highly desirable. There are significant relations

between the average scores of spiritual health and age (p <0/04), history and spiritual

health (p<0/02), education and spiritual health (p <0/03) and education and pastoral care

(p <0/02). Overall, a significant relationship observed between spiritual health and

spiritual care (p<0/01).

Conclusion: This study found that most participants were able to meet the spiritual needs

of patients; however, some of the nurses cannot. Whereas, there is a positive relationship

between spiritual health and spiritual care, providing workshops andtraining in spiritual

care for improving the ability of nurses in catering to the spiritual needs of patients could

be of benefit.

Key words: nursing spiritual well-being, spiritual health, spritual care




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V.I.P. SYNDROME: CHALLENGES OF NURSES WORKING IN PRIVATE

UNITS IN DUBAI, UNITED ARAB EMIRATES

Nematollahi R1, Alblooshi M. E

2.

1.RN, Ph.D, ACNP, CON©, Dubai Health Authority, Medical Education Department, Nursing,

United Arab Emirates, Dubai [email protected]

2. RN, BSN, MSc, Rashid hospital, Dubai Health Authority, United Arab Emirates

Introduction: V.I.P. (very important person) Syndrome occurs in healthcare when a high

authority or well connected person receives a level of care that the average person does

not. The problem with treating a celebrity or high profile patient (Royal family members)

is that all the extra attention can quickly turn into V.I.P. syndrome, a series of bad

judgments, unnecessary tests, second-guessing and, ultimately substandard care.

Results: Healthcare providers often grant this extra access to preferential or special

services. The provider tries to provide a higher quality of care by ordering additional tests

and involving more consultants. From a caring nurse point of view this idea ignores the

fact that we already provide the best care we know how, and money or fame can’t buy

any better. Although doctors feel flattered and privileged to be chosen by a very

important person from the royal family and they like the prestige, the scenario is not the

same for nurses. For nurses working in Dubai coming from over 100 different

nationalities with various cultural backgrounds, caring for V.I.Ps appears to be a big

challenge. No matter how perfect you are as a care provider, when something goes

wrong, all the fingers will be pointed at you as The Nurse.

Conclusion: This presentation elaborates on current nursing challenges which nurses

who work in private units, VIP and/or Royal units in Dubai, United Arab Emirates are

facing. Cultural issues will be discussed and cases will be explained



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Systematic Analysis of Nursing Job Positions in Clinical Setting

Fallahi Khoshknab Masoud Department of Nursing, University of Social Welfare and Rehabilitation Sciences(USWR),

Tehran, Iran There has been a great deal of controversy over the last several years regarding the positions of

nurses in clinical settingthus various methods have been experienced, the evidences suggest

thatdespite the efforts of nursing scientists and managers,the provided solutions were less able to

meet the growing needs of clients / patients of the community.Up to now nurses have been trained

in various styles and with different objectives, but little success has been achieved, once trained

practical nurse of one, two and three years, once technician nursing (Associate degree of nursing

ADN) and currently the undergraduate nurse aid (with 4 months training), graduate program

(BScN) with 4 year training, and post graduate Degree as MScN and doctoral nursing.Sometimes

through resorting to holistic nursing theory we have followed nursing servicesby a discipline and

we weremade to believe that there should only be one type of nurse to offer all types of cares to

the patients andwe had used its managerial fees resulting from this method and due to the creation

of low motivation in nurses other disciplines such as professional nurse, Practical Nurse and

Nurse’s Aides Assistant were used.According to the investigations in the same professions of

physician and non- physician groups the results showed that there is no such a

professioninwhichaservicecarries out by a discipline e.g. physicians have different ranks and

although a physician takes the main responsibility of a patient but gets some advices from other

physicians and non- physicians (nurses, nutrition, etc.) to do his responsibility. In non- physician

groups e.g. radiology and laboratory units educated personnelare working with associates’ to PhD

degreesthustasksare not performed just by a licensed personnel.In non- medical sciences it is also

exactly the same and all the construction works of a building are not performed by a civil

engineer and his subset are the ones such as architect, bricklayer andlaborers.So, having a holistic

approach in nursing is mistakenly interpreted as doing all things by one personand its correct

definition is that the comprehensive care of all dimensions of clients thus does not necessarily

means that one should payattention to all dimensions, but care should be holistic.Cares can be

carried out through several nursingdisciplines with holistic nature by making relationship

between nursing team members throughnursing care plans; systematic and scientific evaluation

and reporting.The second problem is that if you are going to have various types of staff in nursing

what characteristicsshould they have. Once we had the professional Nurse, practical Nurseand

Nurse's Aides and now we have Nurse and Practical nurse and each of them had their own

advantages and problems. To answer this question, it seems that the nursing needs of clients/

patients/ communities should be identified; classified and then adapted to a specific class of job

description. If we simply want to divide the routine nursing care needs of patients into three

groups of Advanced,General and Primary Caresthen we are in need of three types of staff and if

we divide them into two categories: Basic and Advanced cares, we will need two types of

personnel.In either of them, after defining theAdvanced, General and Primary care orBasic and

Advanced first of all this question should be answered that how much of the education and

qualifications is required to perform the above tasks, there is a great diversity in the world but

generally include Professional Nurse, Technical Nurse and Nurse Aid among which Professional

Nurse isresponsible for planning the Nursing Care Plan of patient and performingprofessional or

advanced nursing care;Technical Nurse is in charge of designed General procedure and programs

of health care plan;Nurse Aid is responsible for the Primaryworks, non-expert and non-skilled

(Not Technical) of the patient.What can be the appropriate form based on the current situation in

Iran is the question that present paper deals with, but what is certain is that following the holistic

nursing philosophy does not mean to have one category of nursing personnel to conduct all affairs

in nursing and one type of nursing staffwill not be enough for doing holistic nursing services,

since in this case some cares and some qualities will be ignored that the current system of nursing

faces it.

Keywords: Job positions, Nursing, Clinical Care, nursing staffs


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Nutrition, Physical activity and there's predictors in menopausal women

Sehhati Fahimeh1, Mirghfourvand Moghgan

2, Momeni Fariba

3

1. MSc, Faculty of midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

2. Assistant Professor, Faculty of midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

3. MSc Student of Midwifery Education, Tabriz University of Medical Sciences (Internationals'

Aras), Tabriz, Iran

Introduction: Nutrition and physical activity are health promoting behaviors' dimensions. A

persons' health depends on the type of diet and activity lifestyle.Unhealthy diet and

sedentary lifestyle as one of the important problems of our society. This study aimed to

assess nutritional status, physical activity and predictors have been conducted in menopausal

women.

Methods: In a cross-sectional study, 400 menopausal women that were 45-60 years old

selected using cluster random sampling from Langroud city in Gilan, Iran. Data were

collected using Health Promoting Lifestyle Profile II (HPLP_II) questionnaire.The

demographic data were collected too. Data were analyzed by T- test, one way ANOVA,

correlation and linear regression, using SPSS- 13.

Results: Results indicated that the mean (SD) total score of nutrition in menopausal women

was 2/6 (0/4). Based on linear regression analysis between the total score of feed to body

mass index, marital status and number of children, there were significant relationship. Mean

(SD) total score of physical activity in menopausal womenwas 1/6 (0/3).Based on the results

of the linear regression between physical activity to age at menopause, number of children,

educaion and life satisfaction significant relationship were found.

Conclusion: The results showed that the nutrition status in menopausal Women is average,

and poor physical activity level was low.Therefore, strategies to promote dietary behavior

and lifestyle changes on mobility must be designed and implemented in this segment of the

population to the status of life style to the optimal level of reach.

Keyword: Nutrition, physical activity, Menopausal women.


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Violence in the Hospital from the Viewpoint of Support–Administrative Staff: a

Qualitative Study

Keyvanara Mahmoud1, Bahmanziari Najmeh

2, Maracy Mohammad Reza

3

1. Associate Professor, Department ofHealth Care Management, School of Management and

Medical Information, Isfahan University of Medical Sciences, Isfahan, Iran

2. M.Sc. student of Health Care Management, Isfahan University of Medical Science, Isfahan, Iran.

(Corresponding author) [email protected]

3. Associate Professor,Department of Epidemiology and Biostatistics, School of Public Health,

Isfahan University of Medical Sciences, Isfahan, Iran

Introduction: Today, violenceis considered as one of the topics related to health and

occupational safety of individualsand for many jobs, workplace violence represents a serious

occupational hazard. Therefore this study aimed to investigate and identify how violence

occurs and its risk factors from the viewpoint of support-administrative staff of hospital,

then by using data, the necessary steps should be taken to eliminate or reduce it.

Method: The study was conducted qualitatively with semi-structured interview and

opinions of 10 authorities and staff of support-administrative units in AlzahraUniversity

Hospital about violence and risk factors were collected. Thus, the contents were transcribed

after each interview and then the interview data was reduced and structured using thematic

analysis.

Results: Subjects’ views about causes and risk factors of violence in the hospital were

classified into 40 sub-themes and 7 themes including economic factors, social factors,

structural factors, and problems of the hospital, problems related to the patients and their

companions, problems arising from the interaction of individual and problems with staff.

Conclusion: According to the high prevalence of violence in hospitals and its risk factors

associated with society, organization and individuals are propose measures such as excess

insurance coverage, changes in the physical structure of the hospital to increase security and

limit the passage of persons, transparency of administrative processes, culture making about

terms of visiting and patient companionship, holding workshops about violence and proper

and respectful relationship with patients and families, increase the number of staff,

involvement them based on skill and ability and using experienced staff to interact with

clients.

Keywords: Violence, Hospital, Support-Administrative Staff, Qualitative Study


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Postpartum depression and it’srelationship to child caring behavior of mothers and

developmental milestones of children

Kheirabadi Gholamreza1*, Sadri S

2

*1. Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2. MS, Psychologist, Payamenoor University of Tehran

Introduction: Depression is 2-3 times more common in women, particularly among

women of childbearing age and especially in the postpartum period. A tremendous of

studies showed adverse impactsof depression in women after childbirth on children's

psychological development in developed countries but somatic development is ignored in

most studies. This study aimed to evaluate the adverse effect of postpartum depression on

somatic development of children.

Methods: We assessed 6627 women, two to 12 months after delivery in rural area of

Isfahan province (Iran), for depression and their children somatic developmental

milestones. Beck Depression inventory-II IS completed to assess depression in mothers

and children developmental milestones assed by trained heath workers.

Collected data analyzed with correlation tests using SPSS-19 software.

Results: 38.1 % of mothers had clinical depression ( score of above 21 on the BDI)

.Unemployment, low education, mothers' young age, undesired gender of the child,

unplanned pregnancy, and history of depression were the main risk factors of postpartum

depression. Depression score of women showed significant negative correlation with their

child caring behavior and thereby with their children head circumference.

Conclusion: Maternal child caring behavior and some developmental milestones of

children may be negatively affected by post partum depression.

Keywords: Postpartum depression, child caring behavior, developmental milestones


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The importance of a strength-based perspective when assessing people with mental

disorders: A qualitative study

Magsoudi Jahangir

Nursing PhD candidate, School of Nursing and Midwifery, Isfahan University of Medical

Sciences, Isfahan, Iran

Introduction: Traditionally, the clinical assessment has focused on examining the

symptoms, problem behaviors, emotional impairments, deficits, and functional difficulties.It

seemsthat theimportance of investigating the psychiatric patients’capabilitiesis stillnot clear;

therefore, the present study was conducted to describethe perceptions and experiences of

these patients and nurses about the benefits and impacts of assessing mentally ill patients’

strengths.

Methods: This is a descriptive and exploratory study. The main purpose was to uncover the

benefits and impacts of assessing mentally ill patients’ strengths.Data collection methods

included interviews with psychiatric patients and focus group with nurses. The clinical

context was the psychiatric setting including mentally ill patients, and mental health nurses.

We used purposive sampling. In total four focus groups and thirteen individual interviews

were carried out. Permission was attained; all the interviews were taped, transcribed and

analyzed by using qualitative content analysis.

Results: Two main themes emerged. The first theme was “feeling of worth”, with the

subthemes of “promoting self- esteem”, and “increasing self- awareness”.The second theme

was “facilitating factors forimprovementor development”, withthe subthemes of “therapeutic

effect on patients’ outcome”, “completeness of patients’ care planning”, and “identification

of patients strengths”.

Discussion and conclusion: Findings showed that strengths are valuable factors in recovery

process of clients. Assessing the strength can induce feeling of worth that itself may promote

self-esteem, and to provide facilitating factors forimprovementor development. Examining

the strengths, also, may increases a holistic view of patients, enhance clinical clarity,

increase the information, and provide a more complete image of clients and their

circumstances.So, nursing assessment, as much as possible, should be a hybrid endeavor:

exploring strengths along with weaknesses.

Key words: strength, assessment, mental disorders, Iran


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Exploring the Meditation Role of Self-efficacy on the Relationship between

“Fear of Falls”and Falls among Iranian Elderly Community Dwellers

Dadgari Ali

Introduction: Fear of falls is a known risk factor for many health problems including falls

among senior community dwellers. However, there is insufficient data to explain the

relationship between fear of falls and falls incidence. This study conducted to identify

mediation role of self-efficacy between fear of falls and falls among elderly people living in

community.

Methods: In this cross-sectional study, 1312 male and female senior citizens living in both

rural and urban areas were randomly selected to assess their fear of falls (FoF), falls self-

efficacy (ABCS) and history of falls during last 12 months. Selected subjects of the study

were from faller and non-fallers elderly people according to inclusion criteria of the study.

To analyse the data, SPSS software version 21 was applied. Moreover, SPSS-AMOS version

21 was used to analyse the mediation role of self-efficacy on the relationship between FoF

and falls.

Results: The mean age of the elderly person who participated in this study was 71 years

(M= 71.3±9.1). Slightly less than half of the respondents lived in the rural areas (n=651,

.49%) and the rest was living in the rural areas (n=661, .51%). About 34% of the

respondents had experienced fall within the last 12 months prior to the research. The mean

FoF score among the subjects was 73.5 which was slightly higher than the cutoff point of 70

for fear of falls among elderly people. This study indicated that high levels of fear of falling

were significantly related to low “falls self-efficacy” (p<.00). In addition, findings of this

study supports the mediation role of self-efficacy between relationship of fear of falls and

incidence of falls as in default model RMSEA= .000 which is well below recommended

value of .06 for accepting the best model fit.

Discussion: Results of this study supports the hypothesis indicating the mediational role of

falls self-efficacy on relationship between fear of falls and falls. So it is recommended that

any falls prevention programme for community elderly people should consider

psychological covariates of falls especially subjects’ self-efficacy to reduce falls, alongside

other risk factors and covariates of falls.


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Culture of Collaboration in health team from Islamic perspective

Ghaljaei Fereshteh1, Irajpour Alireza

2, Alavi Mousa

3

1. PhD Candidate of nursing education. Nursing and midwifery, Zahedan University of medical

sciences

2. Nursing& Midwifery Care Research Centre, Social Determinant of Health Research Centre,

Isfahan School of Nursing & Midwifery, Isfahan, I ran

3.) Nursing& Midwifery Care Research Centre, School of Nursing & Midwifery, Isfahan, I ran

Objective: Collaboration involves direct and open communication, respect for different

perspectivesand mutual responsibility for problem solving. In particular, religious literature

has many references to collaboration. This article is a report ofasystematic review that

surveys concept of collaboration fromthe Islamic point of view and intends to answer the

question, “Does the Quran deal with the use of collaboration in human activities?”

Methodology: This study is conducted using electronic documents at related websites to

Islamic and Quran sciences: Howzah.net, Nashriat.ir, Tebyan.net and Google scholar from

1950 until 2013 by focusing on the following key words: collaboration and Islamand then

retrieving the Islamic document (Quran and Hadith). The language in which the search was

conducted was English and Persian.

Findings: Nearly 28 articles and 72 books related to this topic were found and after

applying the search criteria and methodologyonly 13% of thereferences found to be

applicable. In this reviewfour themes were found:"Equality", "Helping each other”,

“Moving toward Improvement", "Devote".

Conclusion: The results show that in the Quran the concept of collaboration is equivalent to

Taavon1and Muslims are requested to collaborate in their affairs and never

collaboratewitheach other for illegal affairs. Islam asserts that nobody is needless from

others in his life. All people require social relationship in their life. God has enacted mutual

rights for people and meeting these requirements is possible only through collaboration and

meeting mutual rights.

Key word: Collaboration, Islam, Quran


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Effectofself-management program onlung function status and exercise tolerance in

patients withchronic obstructive pulmonary disease

Heidari Maryam 1

, Fayazi Sadighe 1*

, Borsi Hamid2, Latifi Mahmood

3

1. Department of Nursing, School of Nursing, Abadan faculty of medicine, Abadan, Iran.

2. Department of Pulmonologist, School of Medicine, Ahvaz Jundishapur University of Medical

Science, Ahvaz, Iran.

3. Department of Statistics, School of Health, Ahvaz Jundishapur University of Medical Sciences,

Ahvaz, Iran. *correspondence author: School of Nursing and Midwifery, Ahvaz jundishapur university of medical

sciences, Ahvaz, Iran Telephone: e-mail: [email protected]

Introduction: The major increasing in chronic illnesses such as chronic obstructive

pulmonary disease, can lead to caring systems challenges.The exacerbation of symptoms in

this patient lead to progressive decrease in lung function, a lot use of health care service and

death. So this patients suffer from low pulmonary function.Thus, the present study have

been performed with the aim of investigating the effect of self-management program onlung

function status and exercise tolerance in patients withchronic obstructive pulmonary disease.

Materials and Methods: In thisclinical trial study, 50chronic obstructive pulmonary disease

patients with moderate and severe grade which having the inclusion criteria were randomly

assigned to control and intervention groups.The control group received usual care and

intervention group received usual care plus the self-management program based onthe 5

Amodel. Patients were assessed by spirometric test and6-minute walking testfor lung

function status and exercise tolerance at baseline and after 12 weeks. SPSS software, chi-

squere and independent t-test were used for data analysis.

Results: There was not seen the significant statically difference in spirometric indexes

difference mean in two groups (P>0/05). Also, this difference between groups in exercise

tolerance at baseline was not significant. But, the difference between two groups was

significant at theend of 12 weeks (P=0/007).

Conclusion: Using the self-management program in short term can lead to increased

exercise tolerance in patients with chronic obstructive pulmonary disease, thus this program

is recommended as an effective wayto improve the functional statusof these patients.

Keywords: chronic obstructive pulmonary disease, self-management, pulmonary functional

test, exercise tolerance.



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Health in Islamic Thought: A philosophical inquiry

Alimohamadi Nasrollah1, Taleghani Fariba

2

1. Department of Critical Nursing Nursing, School of Nursing & Midwifery, Isfahan University of


2.Department of Adult Health Nursing, Nursing & Midwifery Care Research Center, School of

Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

INTRODUCTION: Nursing as a profession has its own knowledge basics and specific concepts

such as, Health. These concepts play key roles in nursing profession and have various definitions

based on the philosophies dominant in nursing theories. Concepts form the foundation of a discipline

and the essence of the philosophical underpinning that guide a profession. Therefore, they must be

interpreted according to the philosophies dominant in the societies, based on which the nursing

practices are theorizing.

Nursing system needs to adopt new theories to satisfy the needs of this social and religious culture:

like Islam. So this article amid to clarify" health" and "healthy human being" in different paradigms,

particularly Islamic thought.

METHOD: To achieve the objective of the study, we conducted a philosophical inquiry. In this

study, Mors's (2000) method, critical analysis of the literature, was employed to analyses the concept

of health and healthy human being. Mors's method has scientific rigor, intellectual reasoning and

ability in expanding the core concepts in the nursing discipline .

To assess state of concept and select an appropriate approach for analysis, Mors et al. (1996) suggest

"determining the level of maturity of concepts “as a first step. Ideally, concepts used in a discipline

should be "mature" That is, they should be relatively stable, clearly defined, with well described

characteristics, and demarcated boundaries .

There are four broad philosophical principles – epistemological, pragmatic, linguistic and logical –

for assessing, determine and evaluate the state of the science surrounding the concept. According to

these principles, the literature of nursing was reviewed to assess the state of maturity the concept of

health and healthy human being base on Islamic thought. Health and health human being based on

Islamic thought was used as a key word or subject heading in several data base, such as: MEDLINE-

CINAHL and ISI index, and found that it was not well defined . Therefore, we conclude that this

concept is immature.

FINDING: A clear definition and description of the characteristics of the concepts facilitates

ultimately of them. Based on the findings are presented according to the criteria (definition,

attributes /characters and boundaries) of the structural concept suggested by Morse and et al (1996).

Definition of Health: In the Islamic thought health is interpreted as to be faultless, cleanness and

redemption from any type of fault, as well as to be far from plagues and superficial and inwardly

faults. It consists of equilibrium in the entire existential dimensions of human being. Besides, lack of

existence of such state is considered as illness and impairment. In the body of a living entity, the

organs are in interaction and harmony with one another and not in struggle; i.e. upon the entire

existence of a living entity (human being), a unique life is dominant and all the organs follow one

single life. Therefore, when this equilibrium is disturbed, effort is made for the return to the state of

equilibrium. Now, if this impairment and deviation is severe, it leads to death, and if the impairment

is not too severe, its state returns to equilibrium.Finally, As such obtained data were analyzed. For

more clear presentation of the concept of health and healthy human being in the Islamic worldview,

we expressed different paradigm, specialty holism paradigm, in the nursing and their differences and

similarities with the Islamic thought.


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Exploration the process of confrontation with nursing errors in critical care units:

model development

Valiee Sina

Introduction: Nurses are in the first frontier for confronting with clinical errors and nursing

errors are common and sensitive in critical care units. Therefore, understanding the process

of confrontation with nursing errors and exploration different dimensions of them is

necessary. The aim of this study was to explore the process of confronting with nursing

errors in critical care units.

Methods: A qualitative grounded theory study was conducted. The sampling method was

purposive and then changed to theoretical sampling. The data were collected through in-

depth interviews with 19 critical care nurses and one focus group. The data analyzed

according to Strauss and Corbin (1998).

Findings: Three main categories emerged out of the confrontation with nursing errors. The

main categories were active cognitive scrutinywith subcategories of evaluation of error,

evaluation of consequences and situation monitoring, error resolve with subcategories of

self-action, group-action, declaring the change, and cover up and reporting. The findings

revealed that participants confront with nursing error based on the result of active cognitive

scrutiny by resolving error or reporting.

Conclusion: Active cognitive scrutiny was basic social process of the study. The findings of

the present study revealed that the process of confrontations with nursing error in critical

care units need to special attention from policy makers, managers and also nurses.

Considering the perception of nurses and for removing predisposing factors of informal

behavior among them, it is suggested to have planning to meet the needs of nurses and

implementing the various strategies so that the management of this process can be more

favorable. Also, making a change in perspectives and establishing the culture of patient

safety is essential. Moreover, it's appropriate that necessary information about errors and

correct confrontation with them be considered in nursing education programs. Investigation

of the scientific and practical various strategies with research for directing confrontation in

correct path are also necessary. Altogether replacement of personal approach with systems

approach is recommended.

Keywords: Nursing errors, Error confrontation, Critical care nurse, Process, Grounded

theory.


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Investigation the effect of an educational plan based on the health belief model on food

consumption of women who are at risk for hypertension

Maleki Fatemeh, Hosseini H, Moeini M, SharifiRad G.

Ms. Nursing Student, Isfahan University of Medical Sciences

Background & Aims: Hypertension is the main risk factor of many diseases and main

reason of death all over the world. Because signs of hypertension aren’t clear, people don’t

feel its dangers and don’t believe they are at risk. This problem turns preventing

hypertension to a great defiance of health system. One lifestyle factor that is effective in

preventing hypertension is healthy diet. The aim of this study is investigate the effect of an

education plan based on the health belief model on diet of women who are at risk for

hypertension.

Materials & Methods: A randomized interventional study was conducted on 92 women in

2013 in 2 centers of health care systems of Esfahan city. Subjects were selected through

systematic sampling. The three-day dietary questionnaire is used to evaluate food intake in

both experimental and control group before and 2 month after intervention. Intervention plan

was 3 education sections based on health belief model that took place once a week. The data

were analyzed by SPSS.

Results: Findings showed that there was significant differences between the average of

consumption of fruit, vegetable and Dairy in the intervention and control groups after

intervention (p>0.05) that was not significant before it.

Conclusion: The finding of this study confirmed the effectiveness of education plan based

on the health belief model on improve Food intake in women in some aspects.

Key words: Health education, prevention, hypertension, diet, Women


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A family oriented model for health management: a qualitative study

Keshvari Mahrokh

Assistant Professor of Community Health Nursing- Management and Aging, Nursing and Midwifery

Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences,

Isfahan, Iran

Background & objective: Former studies show that despite existence of different health

programs and services, yet, there are numerous health threatening problems clients and their

families. Therefore, a better understanding of family health provision phenomenon and

presentation of appropriate related models is essential. This study aimed to present an

appropriate family health management model for clients based on socio-cultural condition of

Iran in order to empower clients’ families concerning the care given to them.

Methods:

This is a qualitative grounded theory study. The data were collected through unstructured

deep personal interviews obtained from a group of participants (47 of health care providers,

clients and their families) by purposive sampling up to data saturation. The data were

analyzed through constant comparative approach and Strauss and Corbin method. Finally, an

efficient health monitoring model for clients’ families was designed based on elicited theory

and other related theories through Walker and Avant theory construction.

Results & Conclusion:

In family oriented health care approach, the families are the best sources of information

about situations, process and appropriate outcomes.

In this approach, the emphasis is on the existing potentialities and resources of clients’

families. Nurses share their proficiency with the clients’ families through discussion and

conducting the care. They act as counselors and help families detect their needs and

priorities, and provide them with their needed support and knowledge. In this model, nurses

act as a manager in family oriented care provision, and the clients’ families monitor the

trend and development of the care plans.

Nowadays, designing and selection of an appropriate model in provision and giving health

care services is essential, and family, with a functional position, can play a crucial and key

role in health promotion of the clients and their families.


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Dynamic redefinition of profession: A grounded theory about humanistic nursing

Khademi Mojgan1, Mohammadi Easa

2, Vanaki Zohreh

3

1. Graduated from Tarbiat Modares University, Assistant Professor, Faculty of nursing and

midwifery, Lorestan University of Medical Sciences

2. Associate professor Tarbiat Modares University, Tehran, Iran

3. Associate professor Tarbiat Modares University, Tehran, Iran

Introduction: Revitalization and promotion of humanistic nursing are among main missions

and of the major challenges of contemporary nursing. Theory is an essential tool for guiding

nursing practice and passing these challenges. The aim of this study is development a theory

about humanistic nursing in acute care setting in Iran.

Method: The theory was developed using Glaserian grounded theory approach. 52 nurses,

patients and families from two teaching hospitals in Tehran were selected for the study. Data

were collected from interviews and observations. Data were analyzed using constant

comparative analysis .Memos were written during analysis, and once theoretical saturation

occurred, memos were sorted until theoretical completeness was evident.

Result: The main concern of nurses and patients/families in the substantive area of

humanistic nursing is “rights violation in the context of suffering and need”. The study on

how to deal with this concern, revealed fluctuating between two opposite basic social

processes. “Rights violation” of nurses causes activation of “Unsuccessful rights claim and

self compensation” process by them. This process leads to the “Rights violation” of

patients/families and subsequently, the activation of the same process by them. This, in turn,

violates the rights of nurses. With the emergence of “Synergy of situation –

education/learning, that is simultaneous presence of “education and learning of values” and

“sensitivity of situation” or “ existence of care promotion elements”, the nurse’s way of

confrontation with this problem will be changed and “unsparing response to situation” will

be activated. The consequence of this process is “prosperity” of nurse/manager and

patient/family.

Conclusion: According to this theory, violation of nurses’ rights is a pivotal obstacle in

promotion of humanistic approaches in nursing. So, nurses’ rights should be seen as a light

for the guidance of current thinks and activities of the health system and the nursing

profession.

Keyword: Grounded theory, Humanistic nursing theory, Nurses’ rights


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Women’s Domestic Decision-making Power and contraceptive use in Iran

Talebeian Ferdous1, Kohan Shahnaz

2

1-M.Sc. student of reproductive Health, Isfahan University of Medical Science, Isfahan, Iran

2-Assisstant Professor, Nursing &Midwifery Care Research Center, Isfahan University of Medical

Sciences, Isfahan, Iran

Introduction: Women’s Domestic decision-making autonomy is a potentially important for

fertility planning. The purpose of this study was to examine association between women’s

autonomy and contraceptive use.

Materials and Methods: In this cross-sectional study, two hundred and seventy women of

childbearing age, eligible for family planning and residing in Isfahan, were selected through

random cluster sampling in 2012 and they filled a researcher-made questionnaire. Data

about Women’s decision- making and their contraception were gathered and analyzed.

Results: The results of this study revealed that the Mean of women’s household decision-

making autonomy was 50.Their mean age was 31 years, 65% had education ≥high school

diploma, and 14% were employed.Pearson correlation coefficient showed a poor direct

significant association between length of usage of present contraception method and

women’s household decision-making autonomy(r= 0.2,P=0.01). However, analysis of data,

revealed no significant correlation of household decision-making autonomy (P=0.15) with

the type of contraception method.

Conclusions: findings of this study show that women expressed half of the possible

autonomy. Also women with higher household decision-making autonomy used their

present contraception method longer. Moreover, this study suggests that women’s

empowerment in reproductive health cannot be separately addressed from that of domestic

issues. Thus, an empowerment program should prioritize improving women’s control over

fertility.

Key words: Autonomy, contraception, decision making, Iran


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Living in a foggy lagoon: the experiences of self-care suffering in Iranian thalassemic

patients; a qualitative study

Pouraboli Batool*, Abedi Heidar Ali**, Abaszadeh Abbas***, Kazemi Majid ****

* Department of Nursing, School of Nursing and Midwifery, Khorasgan Branch, Islamic Azad

University, Isfahan, Iran **

School of Nursing and Midwifery, Kerman University of Medical Sciences,Department of Nursing,

School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.

*** School of Nursing and Midwifery, Shahid beheshti University of Medical Sciences, Tehran, Iran.

**** School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, rafsanjan, Iran

Introduction: Thalassemia major is the most prevalent hereditary anemia in Iran.

Thalassemic patients need life-long care and experience self care suffering. Awareness of

the nature, meaning and effect of suffering from patient’s perspective is necessary to

determine helping interventions to reduce their suffering. This study aimed to realize of self

care suffering experiences of thalassemic patients.

Methods: This qualitative study was conducted with 21 participants who were selected

purposefully and theoretically using content analysis method. The study setting was a

specialty clinic affiliated to Kerman University of Medical Sciences. Data were collected

using semi-structured interviews.

Results: The analysis of data led to emergence of 5 main categories of physical burnout,

spiritual discomfort, behaviors and thoughts of society and passing a hard life, which were

included in patient’s suffering theme.

Conclusion: The results show that thalassemia is stressing and painful for patients in all

physical, spiritual, social and economical aspects and culture has an important role in

patients’ experience of suffering. It can assist healthcare authorities especially nurses to

improve nursing care to reduce suffering based on this experience.

Keywords: self-care suffering, thalassemic patients, qualitative study


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Advanced Practice Nursing in the Eastern Mediterranean Region:

Challenges &Future Strategies

Al-Mohandis Batool

Nurse Consultant, Nursing Policy & Education Development, Kingdom of Bahrain,

[email protected]

Hovering with a bird eye view on the Eastern Mediterranean countries, the reaffirmation of

the definition of health as a state of complete physical, mental, and social wellbeing, and

not merely the absence of disease stated in Alma-Ata declarationmust be challenged. The

political turmoil including the reformed economic and social order has kept one hundred

million people in undesirable living conditions and widened the gap in health standards in

this part of the world. Countries such as Yemen, Mauritania, and Djibouti, parts of Sudan,

Somalia, Iraq, Afghanistan (post war), Palestine, and more recently Syria suffer profound ill

health, mass causalities, and poverty. The future prosperity is grim and uncertain.

Responding to these challenges, governments resorted to PHC to address the health of its

citizens, but with only a small percentage of medical graduates selecting residencies in what

they believe is “less attractive” rehabilitative, palliative, and preventive primary care

specialties, a significant gap remained in the health care delivery system. The situation is

further compounded by the fact that the roles of many family physicians are mostly curative.

Advanced Nurse Practitioners (APN) and specialist nurses began to emerge in this region,

they were uniquely qualified with advanced practice competencies and skills to fill the gaps

and respond to the unmet needs of the underserved groups within the society, but issues such

as legal status, liabilities and protection, regulation, scope of practice, prescriptive authority,

education, titling, and recognition of APNs by the health community are still not resolved.

This paper will focus on tracing the historical initiatives and evolution of APN in Eastern

Mediterranean Region, scan current status, interpret evidences on the relationship between

APN and improved health indicators, highlight critical challenges, and provide forward

thinking strategies to support development of family nursing and advanced practice nursing

to ensure nurses’ contribution to high standard primary health care.


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Empowering mothers about breastfeeding based on BASNEF model and its effect on

exclusively breast feeding in their infants

Abdeyazdan Zahra1, Elahi Tahereh

2, Golshiri Parastoo

3

1. Nursing and midwifery care Research Center, Faculty of Nursing and midwifery, Isfahan


2. Faculty of Nursing and midwifery, Azad University of Khorasgan Isfahan, Iran

3. Department of community Medicine, Medical School, Isfahan University of Medical Sciences,

Isfahan, Iran

Introduction: Although breast feedingis one of the most important ways to improve

children's health in each community, nowadays many mothers stop breast feeding due to

multiple factors. Therefore, using appropriate method for training mothers in this area and in

appropriate time is very important.

Aims: This study compared the effectiveness of empowering mothers based on BAZNEF

model for breast feeding intwo periods, before and after delivery on duration of exclusive

breast feeding.

Methods: In a quasi-experimental study 99 cases of nulliparous women attending Shariati

Hospital were enrolled in a simple method, after obtaining written informed consent .Then

they placed in three groups, two intervention groups and one control. The empowerment

program which was based on BAZNEF model components and behavioral objectives were

accomplished within one or more sessions. Duration of exclusive breast feeding in their

infants was determined by telephone interview at 2 and 4 months after birth. Data were

analyzes in SPSS soft ware.

Results: The mean duration of exclusive breast feeding in infants whom their mothers

received the curriculum prior to delivery, was significantly more than those in the group that

received after delivery and the control group (p<0/05). Also, the mean duration of exclusive

breast feeding in infants who their mothers received the curriculum after delivery was more

than the control group, but this difference was not significant (p>0/05).

Conclusion: Empowering mothers for breast feeding prior to delivery is more effective in

promotion of exclusively breast feeding than the postpartum period, so it is suggested that

health officers use educational program for training mothers prior to delivery.

Key words: Breast feeding, exclusively, empowerment, BASNEF


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Relationship between spiritual intelligence, personality components and mood among

nurses

Nazemi Fatemeh

Payam-e-Noor university of Tehran

Introduction: In recent years a new concept has been of interest to psychologists in

religious psychology is spiritual intelligence. At the basis of important role of spirituality in

the areas of working specifically critical jobs in treatment rejoin, the aim of this study is to

survey the relationship of spiritual intelligence, personality and mood among nurses

Method: This descriptive-correlational study carried out between the years 1390-91. The

study population was including of four hospitals in Tehran and among nurses 101 persons

selected randomly. Data were collected of integrative spiritual intelligence scale, the Big

Five Personality Inventory and Beck depression inventory. For analyzing the data Pearson

correlation and multiple regression analysis were used.

Results: Between the 5 dimensions of personality and spiritual intelligence was a significant

relationship. So that the relationship between extroversion, openness, conscientiousness, and

agreeableness, was significantly positive and between Neuroticism and spiritual intelligence,

the relationship was negative. Results of the analysis as showed that the three dimensions of

extraversion, openness to experience and agreeableness explain and predict 35% of spiritual

intelligence changes significantly (p<0/001).the relationship between depression and

spiritual intelligence was negative. The spiritual intelligence can predict 17% of the change

in mood significantly.

Discussion: Among nurses having a spiritual mood is very helpful at work and job

satisfaction. It is suggested by introduction of this variable and with efforts to improve of

that in the recovery of room care be leading.

Keywords: Spirituality, spiritual intelligence, depression, extroversion, openness,

agreeableness, Neuroticism, consciousness.


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Understanding Religiosity in patients with Multiple Sclerosis

Jaberi Azita *, Vizeshfar Fatemeh**

*Faculty of nursing midwifery, Shiraz University of Medical Sciences, Shiraz, Iran; Faculty Member

of Islamic Azad University-Kazerun Branch

**Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Faculty

Member of nursing midwifery colledge Shiraz University of Medical Sciences,Iran

Introduction: Among healthy adults, religion and spirituality have shown strong

associations with improved life satisfaction and other adaptive outcomes through

mechanisms that include increased social support and improved coping skills. Multiple

sclerosis (MS) is a chronic neurological disease with considerable effect on patients’ QoL.

Little is known on the influence of religious life on QoL, though this relationship became a

subject of recent interest in MS. Little is known on the influence of religious life on QoL,

though this relationship became a subject of recent interest in MS. The purpose of the

present study was to describe the extent to which religious confer unique benefits and have

unique predictive value in MS patients.

Methods: In this cross-sectional study, 102 patients with MS were selected using sequential

convenience sampling method. Data were collected using a three-part questionnaire.

Descriptive analysis, Pearson correlation and multivariate regression analysis were used to

analyses the data.

Results: Factors predicting quality of life (MCS and PCS) were intrinsic religious beliefs;

Organizational religiousness and Unorganizational religiousness in sequence but There were

not significant correlations between the intrinsic religious and QoL (p<0.05).

Conclusion: Religious involvement, with regular prayer, seems to represent a general

protective factor that promote psychological health and improves QOL in patients with

chronic diseases, including patients with MS. The results of this study emphasized on the

importance of the religion as variable affecting on QoL in patients with MS. This would

help nurses and clinical specialists to focus on religion in order to increase QoL in the

patients.

Keyword: Religiosity, Multiple Sclerosis


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Nurses and other health professionals’ readiness to approaching towards

interprofessional collaboration: a qualitative cross-cultural investigation

Alavi Mousa *, Irajpour Alireza

*Assistant professor, Nursing and Midwifery Care Research Center, School of Nursing and

Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Background: inter-professional collaboration (IPC) is well-known strategy to pursue a holistic

approach to provision and delivery of health care services. Literature shows that such IPC is affected

by various factors mainly exist in socio-cultural context nurses play their roles.

Aims: this study aims to explore and describe nurses and other health professionals’ readiness to

approaching towards IPC.

Material and Methods: this was a qualitative descriptive study. Data were collected through

conducting one to one and group in face and written interviews (narratives) with purposeful samples

of health professionals from various disciplines including nurses, medical doctors (MDs) from

variety of specialities, social workers and psychologists from health system in Iran and Germany.

Other methods of data collection were taking field notes, and reviewing of related literature. The

qualitative content analyses method was employed to emerge common categories and themes.

Findings: totally 22 participants took part in the study. Moreover researchers had a 10 day

period of field observation in Germany (health systems affiliated with Albert lodwigs

University of Freiburg) and a one year field observation in Iran. Qualitative data analysis

revealed 6 sub-themes under the main theme“nurses and other health professionals’

readiness to approaching towards IPC”. The sub-themes were 1) knowledge/attitudes about

collaboration, 2) person centered versus profession centered, 3) collaboration versus

conflict, 4) interpersonal skills, 5) training background, and 6) professional power.

Conclusions: the results of the study emphasized that in both eastern and western context,

the same factors constitute nurses and other health professionals’ readiness to approaching

towards IPC. Nevertheless these factors work in different way in these different contexts.

Keywords: Inter-professional collaboration (IPC), Socio-cultural, Nursing profession, Iran,

Germany.


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Placental alterations during pregnancy in diabetic mothers

Rafah Hady Lateef, Al-Mamori, Ahlam Jaber

Dept. of Biology, College of Science for Women, University Of Babylon-Iraq

Back ground: The placenta is a unique organ of limited life span interposed between two

separate individuals. Placental examination is of critical value in neonat-perinatal care.

Gestational diabetes specifically causes more distraction to placental structure and altering

its function that have a role in disturbance of fetal growth and development.

Aim: To find out the morphological and histological changes of placenta in the mothers with

gestational diabetes.

Methods: This is an observationl cross section study. A25 pregnant women with gestational

diabetes were selected from Gynecology and Obstetrics Department of (Al-Hilla Teaching

hospital-Iraq).The full term placenta with its umbilical cords were collected immediately

after delivery. The weight of placenta, the site of attachment of umbilical cord, vascular

pattern of the chorionic blood vessels, the cord coiling index(CCI),were calculated

according .For light microscopy, two centimeter of tissue was taken from the center of each

placenta and fixed for one week. The tissue sections were stained with hematoxylene and

eosin.

Results : In case of Gestational diabetes (GDM) group,weight,diameter, central thickness

greater as compared to normal , marginal insertion .The fibriniod necrosis was seen more in

diabetic group as compared to normal, Also hyalinization ,villous edema, syncytial knots

and villous fibrosis were observed in GDM group more than group.

Conclusion: On the basis of results of present study, it is concluded that diabetic placentae

showed increase in weight, central thickness and diameter.

Key words: Placenta, Pregnancy induced hypertension, Gestational diabetes


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Prediction of Self-care behavior based on Hardiness, Hope and Dysfunction Attitude

among patients with Type 2 Diabetes

Ebrahimi Amrollah1, Hoseinikhah Maryam

2, Manshaei Gholam Reza

3

1-Assistant professor,Behavioral Sciences Research Center, Department of psychiatry, Medical

Faculty,Isfahan University of Medical Sciences, Isfahan, Iran 2-Psychologist (MSc), Science and Research Branch Esfahan, Islamic Azad University, Isfahan, Iran

3-Assistant Professor, Science and Research Branch Esfahan, Islamic Azad University, Isfahan, Iran

Background: This study aims to predict self-care behavior based on the characteristics of

Hardiness, hope and dysfunctional attitudes in patients with type 2 diabetes.

Method: Studydesign was a descriptive correlation method. The targetpopulation was all

patients with diabetes type 2 who referred to Isfahan Endocrine and Metabolism Centers.

The sample consisted of 120 patients. The multi-stage cluster sampling was used for the

sample selection. The instrumentemployed in this research wasSelf – care Scale,

hardinessQuestionnaires, Hope Scale and Dysfunctional Attitudes Scale. The Pearson

correlation and multiple regression analysis with stepwise method were used to analyze the

data.

Results: Analysis of the data showed thatThe only interaction between hope and

dysfunctional attitudes have been able to predict self-care (r=0/191,p<0/05). But separately

there is no relationship between hardiness, hope, dysfunctional attitudes and self-care.

Discussion: Interaction of dysfunctional attitudes and hope are able to predict self-care

behavior. Therefore, the program which modify dysfunctional attitude and enhance Life

Expectancy seems to increase self-care behavior.

Keywords: Self- Care, Hardiness, hope, Dysfunctional Attitude, Type 2 Diabetes


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Nurses' perceptions of cancer patients' Quality of Life (QoL) and its relationship with

patients' demographic and clinical variables

Bahrami Masoud

Department of Adult Health Nursing, Nursing & Midwifery Care Research Center, School of

Nursing & Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Introduction: This study sought to address the following specific aims: (a) to investigate

the level of agreement between patients’ and nurses’ QoL scores and (b) to investigate the

influence of patients’ demographic and clinical variables on the level of agreement.

Methods: This descriptive correlational study was part of a bigger study which was

conducted in a selected oncology hospital in Isfahan. Each patient and nurse was invited to

complete the WHO QoL-BREF questionnaire. This questionnaire considers QoL across four

domains or dimensions: physical, psychological, social relationship and environmental.

Patients’ characteristic form was also created to collect demographic and clinical variables

of patients.

Results: The majority of nurses (54precent) stated that knew their patients at a moderate

level. Pearson Correlation revealed a low to moderate agreement between nurses’ and

patients’ scores in different domains. Patient performance status was the only variable that

influenced the agreement between patients and nurses.

Conclusion: These findings confirm that nurses need to enhance their understanding of

patients’ QoL. Nurses have an important supportive role toward cancer patients which

includes physio-psycho-social concerns and needs. Using QoL tools to directly assess

patients' QoL might also be useful. Improving patient performance status may improve

nurses understanding of cancer patients QoL.

Keywords: Nursing; Quality of Life; Oncology, WHO QoL-BREF questionnaire, patients'

demographic variables


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The Effect of Nurse-Led Telephone Follow up (Telenursing) On Quality Of Life for

Patients with MS

Parsayee Manesh Esmail1, Moghaddam Sara

1, Mahdavi Maryam

2

1Msc of nursing, Faculty of Nursing, Jahrom University of Medical Sciences

2 Msc of management, Jahrom University &JahromPayam-e- Noor University

Introduction: Multiple sclerosis (MS) is one of disability diseases of central nervous

system (CNS) and in recent years many attempts have done to present new strategies for

controlling and treating MS. The purpose of this study was to determine the influence of

nurse-led telephone follow up (telenursing) on quality of life in MS patients referring to

Jahrom MS society.

Materials and Methods: the current study done on 50 patient's MS. The subjects selected

from patients with MS who referred totoJahrom MS society randomly. Demographics data

include age, gender, educational level, marital status, family history of depression, substance

abuse, were recorded .then they divided to case and control groups (n = 26 case group and

n = 24 control group) randomly that nurse-led telephone follow upprogram done for case

group for 6 weeks and fourth in each week. The patients were guided by the home telecare

units in following their individualized needs. Questionnaire (MSQOL-54)completed before

and after this program in both groups. Data were analyzed by using independent t-test and

paired t-test with SPSS software version 18.

Results the patients that used the nurse-led telephone follow up program for 6weeks, a

statistically significant improvement was shown in aquality of life. Statistical independent

T- test showed that total score and quality of life score didn’t have significant difference in

two groups before intervention (P=0/63), while total score and quality of life score had

significant difference in two groups after nurse-led telephone follow upprogram(P<0.001).

Paired T- test also showed significant difference in total score and quality of life score

before and after intervention (P<0.001).

Conclusions: Designing and applying the nurse-led telephone follow upprogrambased on

the educational needs of MS patients it will prevent frequent hospitalizations, reduce

frustration, increase confidence and improve quality of life in MS patients.

Key words: Multiple sclerosis, nurse-led telephone follow up, quality of life.


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The role of nurses in health promotion and cancer prevention

Taleghani Fariba

Associate professor in Nursing, Nursing & Midwifery Care Research Center, School of Nursing &

Midwifery, Isfahan University of medical sciences, Isfahan, Iran

Cancer is the third top reason for deaths in Iran - as every day about 105 people and 41,000

annually die due to cancer in Iran. Number of cancer patients is about 90,000

fatalities.Breast cancer is the most common one among women, while prostate cancer is the

most common among men The cancer treatment costs $804 million and annual for the

treatment of cancer, while indirect costs reach to $2.41 billion, annually.

There is considerable evidence that life style behavior is responsible for approximately 70%

of cancer in the United States.Understandably, efforts by the research community to

investigate the effects of nutrition, physical activity, tobacco use and weight control on

cancer incidence have flourished over the past several decades.

Nurses may represent the largest group of health care workers worldwide and, if promotion

and prevention practices are incorporated in to their daily practice, there is potential for

enormous impact in reducing cancer incidence and prevalence.

Nurses perform traditional cancer prevention function such as identifying unhealthy

behaviors (eg, tobacco use, obesity) and providing education and counseling related to

healthier lifestyle choices and cancer screening

Cancer risk assessment has become a large part of the prevention nurses repertoire.Risk

assessment includes an evaluation for increased cancer risk due to behavioral, physiological,

environmental and family history and genetic factors. After assessment nurse should then

provide advice as appropriate and refer for additional screening tests if indicated

Health promotion and cancer prevention should not be perceived as tasks only for the nurse

working in primary care setting, but for all nurses and at every client contact.However there

are barriers to maximizing nurses' impact:

1. Nursing education does not prioritize heath promotion topics

2. Nurses often feel that they lack skills and knowledge to conduct assessment and provide

counseling

3. The behavior of nurses themselves has an impact on their willingness and ability to

discuss health promotion topics

4. Cancer related policymaking tends to emphasize diagnostic testing and treatment

5. Low priority given to prevention in the training and practice of health care professionals

Nurses should be aware that their role in health promotion and cancer prevention is not

limited to healthy or asymptomatic patients.

Patients, who have a cancer diagnosis, are currently under treatment or are cancer survivors

should also receive counseling related to minimizing of risk factors including smoking

cessation. Nurses can practicing in a new era where making appreciable changes in the lives

of many individuals through cancer prevention is a reality.


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Family Adaptation to Stroke: A Meta-Synthesis of Qualitative Research

Hesamzadeh Ali, Dalvandi Asghar*, Bagher Maddah Sadat, Fallahi Khoshknab Masoud,

Ahmadi Fazlollah

* Nursing Department, The University of Social Welfare and Rehabilitation Sciences, Tehran,

Iran.Email: [email protected]

Introduction: Qualitative meta-synthesis is a valuable method to synthesis of qualitative

studies. Disability in stroke is common often leaving stroke survivors dependent on the

family. This study reports an interpretive review of research into subjective experience of

families with stroke survivor based on the components of double ABCX model including

stressors, resources, perception, coping strategies, and adaptation of these families.

Methods: Meta-synthesis was applied to review qualitative research looking at stroke

family members experience and responses to having a stroke survivor as a family member.

Electronic data base from 1990 to 2013 were searched and eighteen separate studies were

identified. Each study was evaluated using methodological criteria to provide a context for

interpretation of substantive findings. Principal findings were extracted and synthesized

under the double ABCX model elements.

Results: Loss and uncertainty(as stressors), struggling with new phase of life(as perception),

refocusing time and energy on elements of recovery process (as coping strategy), combined

resources including personal, internal and external family support (as resources), and

striking a balance (as adaptation) were identified as main categories. Family members of

stroke survivor respond cognitively and practically and attempt to keep a balance between

survivor’s and their own everyday lives.

Conclusion: The results of the study are in conformity with the tenets of the double ABCX

model. Family adaptation is a dynamic process and the present study findings provide rich

information on proper assessment and intervention to the practitioners working with families

of stroke survivors.

Keywords: cerebrovascular accident, family, adjustment, meta-synthesis,


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The prevalence and related factors to unmet need for family planning in Khuzestan

Province, Iran, an epidemiologic study

Abedi Parvin1, Botyar Malihe

2*, Afshari Poorandokht

3, Haghighizadeh Mohammad

Hossein4

1.PhD in Community Nutrition, Assistant Professor in Midwifery Department, Reproductive Health

Research Center, Ahvaz, Jundishapur University of Medical Sciences, Ahvaz, Iran

2.*MSc in Midwifery, Jundishapur University of Medical Sciences, Ahvaz, Iran E-mail:

[email protected]

3.MSc in Midwifery, Lecturer in Midwifery Department, Reproductive Health Research Center,

Ahvaz, Jundishapur University of Medical Sciences, Ahvaz, Iran

4.MSc in Statistics, Lecturer in Biostatistics Department, Health Faculty, Ahvaz, Jundishapur

University of Medical Sciences, Ahvaz, Iran

Introduction: Unmet need for family planning is a reason to increase unwanted pregnancies

and induced abortion and it in turn could increase the maternal morbidity and mortality. This

study aimed to evaluate the prevalence and related factors to unmet need in Khuzestan

province, Iran.

Methods: In this cross-sectional study 3000 reproductive aged women in Khuzestan

province were recruited randomly. Eight cities according to the geographical region in the

province and five health centers in capital city (Ahvaz) have chosen. A questionnaire

consisting of 42 questions were designed to collect data. Descriptive statistics, chi-square,

Independent t-test and Logistic Regression were utilized for analyzing data.

Results: Unmet need for limiting was 80 (3.42) and for spacing was 288 (9.59), therefore

the prevalence of unmet need in Khuzestan province was 13%. The unmet need group had

more pregnancies and more live children compared to the met need group (p<0.05). Men

who had primary education compared to those were illiterate (OR= 0.37, p=0.001, CI= 0.20-

0.65); women who had university education compared to those who were illiterate (OR=

0.68, p= 0.04, CI= 0.47-0.98), women who had good knowledge about contraceptive

methods compared to those with poor knowledge (OR= 1.16, p= 0.001, CI= 1.086- 1.245)

were more likely to have less unmet need.

Conclusion: Unmet need for family planning in the Khuzestan province is rather high

compare to some statistics from other cities as well as in the whole country. Improving

awareness about family planning can help women to decide about safer and reliable

contraceptive methods.

Key words: Unmet need, Met need, Family planning, Prevalence, Iran


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Development and validation of sleep disturbance questionnaire in patients with acute

coronary syndrome

Jalali Rostam

Faculty of nursing and midwifery Kermanshah University of Medical Sciences, Kermanshah, Iran

Introduction: Severe sleep disturbances and poor-quality sleep are common problems

among the patients hospitalized in cardiac care units (CCUs). There are various devices to

measure the sleep quality and provide better understanding on the relationship between sleep

disturbances and their adverse consequences. Therefore, the present study was aimed to

design a valid and reliable device to assess sleep disturbance in patients with acute coronary

syndrome (ACS) hospitalized in CCUs.

Methods: In the present methodological research, items of the questionnaire were initially

extracted through a systematic review and translation of the existing questionnaires. The

validity and reliability of the initial questionnaires was assessed by face validity, content

validity, construct validity, concurrent validity, Cronbach’s Alpha Coefficient and test-retest

methods.

Results: Factor analysis provided a questionnaire of 23 items on 5 dimensions of sleep

disturbance in coronary patients: "sleep onset and continuity disorder", "disorder in daytime

functioning", "sleep disturbance because of environmental factors," "sleep disturbance as a

result of cardiac diseases” and "respiratory disorders during sleep". Concurrent validity

showed a high correlation with the Pittsburgh Sleep Quality index (r=0.901). Furthermore,

test-retest analysis showed a reliability correlation coefficient of r=0.766 and α cronbach

reliability (α=0.855) (p<0.001).

Conclusion: Sleep disturbance questionnaire for patients with ACS hospitalized in

Coronary Care Unit (CCU) was identified in 5 dimensions and assessed for validity and

reliability. Findings of this study show that to control and improve the sleep quality of CCU

hospitalized patients, predisposing we need to identify and remove causing factors.

Keywords: sleep disturbance, acute coronary syndrome, psychometric, instrument

development, validity, reliability, validation.


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Effect of end-of-life care education on the attitudes of nurses in infants’ and children’s

wards

Sayed Bagheri Sayed Hamid1*, Zargham-Boroujeni Ali

2, Kalantari Mehrdad

3, Talakoob

Sadigheh4, Samooai Farangis

5

1.*School of Nursing and Midwifery, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. E-

mail: Shamid_siba@yahoo

2. Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan


3. PhD, Department of Educational Sciences, School of Educational Sciences and Psychology,

Isfahan University of Medical Sciences, Isfahan, Iran

4. Department of Pediatrics Nursing, School of Nursing and Midwifery, Isfahan University of


5. Researcher &Children's Nurse

Introductions: Infants palliative care becomes an important aspect of nursing when

providing welfare and promoting children's life quality are the objectives of care. The

number of children with life threatening diseases has increased along side the developments

in technology and medical treatment in medicine. It is a pure fact that our attitudes are

related to our behaviors and performances. This research was conducted with the aim of

assessing the effect of intensive course of children's palliative care on the attitudes of

children and infants' nurses in Isfahan University of Medical Sciences.

Methods: This was a quasi-experimental, two-group and two-stage study in which 56 nurses

working at Infants’ andchildren’s wards who met inclusion criteria were divided into

experiment and control groups. The participants of experiment group attended in the infants'

palliative care training course which lasted for 3 weeks. A reliable and already

validatedquestionnaire of Infants and Children Wards Nurses' Attitudes Regarding the

Dying Children was used before and after training.

Results: There was no significant difference between the two groups regarding demographic

characteristics, except formarital status which was found the study findings were not

confounded by it. There was a significant difference between mean test and re-test scores in

the experiment group and also between the mean scores of control and experiment

groupsafter training. There was no significant difference between mean scores before and

after training in the control group.

Conclusion: End-of-life children care is one of the issues in modern medicine which has not

gained a definite status in Iran. It is hoped that nurses would be for erunners of this modern

science in Iran.

Keywords: Education, child care, children, nurses, attitude.


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An Iranian model of home visit

Nikbakht Alireza, Sachiko Hosoya*, Veisi Parastoo

*Assistant Professor, School of Nursing, Faculty of Medicine, Toho University, Japan

[email protected]

1) Context of the project

Due to development of medical technologies and aging of population, the number of people

with chronic diseases orpermanent impairments has been increasing. Long-term medical

follow-ups, nursing care and rehabilitation at home are necessary for the patients with

chronic situations, especially when inpatient treatments are expensive.

Spinal cord injuries (SCI) are one of the most frequently seen permanent impairments in

Iran. Apart from their motor and sensory paralysis, SCI patients also suffer from

accompanying symptoms and complications during their lifetime. Most of the PSCI in Iran

go home and stay with their family members after the acute stage. A systematic and

longtime holistic support for PSCI at home by professionals is necessary, but there is no

home care service provision system in national or provincial level.

2) Purpose and method of the project

This project is aimed at developing an Iranian model of home visit, especially for SCI

patients. In order to find an applicable home visit model for Iranian patients with SCI, their

living situations at home are assessed, and a home visit team provides services to the

patients (now still ongoing).

3) Findings and discussion

The first home visit must be conducted by an experienced nurse, in order to assess the needs

of the patients in their own living environments at home. In the panel discussion, home visit

models in other countries will be introduced for comparison, and with case studies, the

difficulties of implementation of home visit in Iran will be presented. Possible solutions for

the problems and recommendations for roles of the nurses will be discussed with the

audience.Key words: Home visit / Spinal Cord Injuries / Nursing assessment



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Palliative Care: “A Nursing Perspective”

Roxanne Nematollahi

RN, Ph.D, ACNP, CON©, Dubai Health Authority, Medical Education Department, Nursing, United

Arab Emirates,Dubai [email protected]

Palliative Care has traditionally been thought to begin at the time when active treatment

aimed at curing the disease or prolonging life has ceased to be effective. More recent

definitions see palliative care as extending across the illness continuum. People with chronic

illness often experience both periods of stability and periods of decline over the course of an

illness. They may have a variety of treatments, surgeries and hospitalizations over months

and years. However, a time may come for some when they may either say to themselves or

hear from a health care professional, "there is nothing else we can do." Whether it is during

the time of treatment or when there are no options for further treatment, relief or palliation

of symptoms can be very important to preserving one’s quality of life. Depending on the

definition of ‘palliative care’ one may wonder when and where acute care ceases and

palliative care commences. Is there merit/benefit in knowing? Is there a grey zone where the

concepts of care blend/blur?

Historically, Medicine and education has been based on the traditional model of curative

care. In the old model, the curative care focus suddenly ends, substituted by a palliative

approach to care, too often only in the last hours of life. Patient goals and wishes may never

be clearly established, leaving family and care providers to guess at what the patient's wishes

were if at respected. If we are to provide quality palliative care, we must equate it with

health care providers establishing, acknowledging, and honoring patient and family goals. A

major facilitator in accomplishing palliative care goals can arise from the nursing discipline

with an impeccable assessment skill. This presentation elaborates on the concept of

palliative care from a nursing perspective and the vital role of nurses in this rewarding

specialty.



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Spiritual care in palliative care: Exploring the concept of ‘’Roqya’’ programme.

Albalooshi Manal1, Ibrahim Fatima

1

1. RN, BSN, MSc, Rashid hospital, Dubai Health Authority, United Arab Emirates

Spiritual care is one of the corner stones of palliative care. In the moment of illness and

dying, people tend to seek another type of care to relieve or comfort intangible suffering that

no one can define it accept the suffers .Therefore, the definition and act of spirituality is

uniquely defined within the context of religions in different cultures. Islam teaches its

followers to seek healing ‘’Sheefa’’ from the holy book of Quran. The instruction was

cleared by the Prophet Mohammed‘s act of ‘’Roqya’’ which is using certain verses of Quran

to cure illnesses ranged from mild psychological illness to active physical illness like cancer.

Accordingly ’’Roqya’’ programme has taken its name. The programme was initiated in

Saudi Arabia to find its way to United Arab Emirates’ hospitals, including Dubai health

Authority hospitals. The vast advantages of the programme were revealed from stories told

among Muslims and even non Muslim patients or relatives as well as health care providers

who experienced and viewed the secrets of ‘‘Roqya’’. This presentation will explore the

implemented spiritual programme of ‘’Roqya’’ in Dubai hospitals elaborating through real

stories of people experienced the programme as part of end of life care.


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Palliative care The Missing ring in the health system of Iran

Nejatian Ahmad

Bachelor of Nursing and Master of Science in Health Education, Member of the Supreme Council of

Iranian Nursing organization- cardiac Nurse specialist, Farabi Hospital affiliated to social security

organization of Iran

The subject of death and dying have been an important concern and challenges for human

being from the creation.in this long way different people have told different views about it.

The long history of medicine with brilliant achievements in improving the quality and length

of life has been involved in this issue for short course.

In dominant medical view in the health system the death is treated as unnatural phenomenon

that should be postponed with any action so lifetime boosted. This kind of view, with rapid

prevalence of chronic non-communicable diseases has increased the painful deaths under the

advanced life supporting devices away from family and regardless of the patient's wills.

These kinds of deaths are contrary to morality and dignity of death principles.

But in the recent half of century there have been great emphasize in providing palliative

and end of life care in world and many countries started the introducing this approach in

their health systems in education ,research and practice.in definition of nursing by ICN the

issue of care of dying people has important situation.

In Iran as an Islamic country despite of great emphasis of religion of Islam on the

importance of the stage of death as a transition stage from the physical world to the other

world , still palliative care in different aspects like education , competence, legal and policy

issues requiring immediate attention and intervention .

In this article the situation of palliative care in Iran will assessed and some suggestions for

implementation of palliative care with emphasize of nursing contribution will provid.


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Roles of Midwives, Physicians and Other Providers in Selection of Delivery Method

and Satisfaction with Delivery Outcomes in couples

Haghighat Dana Zohreh1, Khaki Imaneh

2, Valiani Mahboubeh

3, Forghani Mohammad

Saad4, Ghoncheh Mahshid

5, Badrei Sadat Zavarei

6

1. MSc, Midwifery, Health Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Email:[email protected]

2. MSc, MSc Midwifery Student, School of Nursing and Midwifery, Isfahan University of Medical


3. Nursing and Midwifery Care Research Center, School of Nursing and Midwifery,Isfahan


4. Department of Nephrology, Kurdistan University of MedicalSciences, sanandaj, Iran

5. Deputy of health, ShahidBeheshti University of Medical Sciences, Tehran, Iran

6. BSc Midwifery, Health Center, ShahidBeheshti University of Medical Sciences, Tehran, Iran

Background and Objectives: The World Health Organization has declared the acceptable

rate of 10-15% for cesarean section (CS); however, it has prevailed uncontrollably in recent

years. Providers have a special role in selection of delivery method. This study aimed to

evaluate the role of delivery providersin selection of delivery method and satisfaction with

delivery outcomes.

Methodology: This study was a randomized clinical trial with 90 couples referring to health

centers ofIsfahan. They were divided into three groups including mothers (alone), couples

(mothers and theirspouses), and ontrol group. The study was performed in four stages. After

sampling, the pre-test wasconducted then educational interventions were administered. Post-

test was carried out immediately, onemonth after the intervention, and after delivery in three

groups. The data was analyzed using SPSS-16.

Findings: The rate of cesarean section with medical reasons was 75%, 69.2%, and 63.6% in

themothers, couples, and control groups, respectively, and 68.1% in total. There was no

significantdifference between the three groups (p=0.497). The opinion of physician was the

most important factorin delivery method selection; so that before intervention, 74.43% of

women and 82.2% of men, and afterintervention 66.7% women in mothers group, 83.3% of

couples group, and 86.7% of control, and 73.3%of men in mothers group, 73.3% of couples

group, and 80% of control group, preferred the opinion ofphysician as their first priority.

There was no significant difference between women (p=0.433) and men (p=0.101) in the

three groups concerning satisfaction with the selection of delivery method by physician.

Discussion and Conclusion: Since the opinion of the most important person in delivery

methodselection by couples was the Physicians’ suggestion; therefore, it seems necessary to

design a programin order to make cultural changes in delivery providers and prevent from

CS without indication.

Keywords: Delivery, Personal Satisfaction, Midwife, Physicians, Iran


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The evaluation of factors affecting the quality of life of women in puerperium

Kamrava Manesh Mastaneh*, Bakhteh Azam*, Abdifard Edris**

* Department of Midwifery, School of Nursing and Midwifery, Kermanshah University of Medical

Sciences, Kermanshah, Iran. E-mail:[email protected]

**Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran

Introduction: Pregnancy and postpartum period have dramatic changes in physical and

mental health of women that it can be associated with a reduced quality of life in this critical

period. Type of delivery is one of the effective factors on postpartum quality of life.

Therefore this study carried out with aim of determining effective factors on women’s

quality of life specially type of delivery during puerperiumperiods in Kermanshah city in

2012.

Materials & Methods: Present research was carried out as a descriptive – analytical study

on 270 primiparous women that referred to Motazedi hospital in Kermanshah city. Based on

type of delivery these women divided in two groups of normal delivery and cesarean

section.The toolused for collecting data was a two-part questionnaire. The first part of

questionnairecompleted immediately postpartum that includedobstetric and demographic

characteristics of individuals. The second part of its was included quality of life (SF-36) that

completed via interview during 6-8 weeks after postpartum. Data were analyzed by SPSS

software (version 13) and ANOVA and Kruskal- Wallis test was used in this research.

Results: Average age was 24.06± 4.6 years. Statistical results showed that the quality of life

score was higher 50 in all of the groups. Although the highest quality of life score was

reported in the physiologic delivery group butthere was not a significant difference. Mean

quality scores for the aspects such as physical functioning P<0/0001, vibrancy and vitality

P<0/03, playing the role of affective P<0/02 in the normal delivery were higherthan

thecesarean section group. There were a significance relation between some of demographic

variables such as place of living, postpartum hemorrhage, pregnancy acceptance and quality

of life.

Conclusion: Since different aspects of quality of life of women in puerperium after normal

delivery is better than cesarean section, it can be concluded that one of the effective factors

on quality of life is the type of delivery specially physiologic delivery .Therefore it is

suggested that in order to improve maternal health, creating positive attitude in women

,physiologic birth and finallycesarean section reduction, normal childbirth preparation

classes should be held in public and private institutions regularly.

Keywords: Type of delivery, quality of life, puerperium


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The Effect of Educational Program to Caregivers of Children with Cancer Undergoing

Chemotherapyon the Prevention Chemotherapy Side Effects

Elahi Asgarabad Hamideh1, Behnam Vashani Hamidereza

2, Badiei Zahra

3, Heshmati Nabavi

Fateme4

1. MSc in Nursing Education Children orientation, Mashhad University of Medical Sciences,

Mashhad, Iran.

2. Instructor of Nursing, Child and Infant, Child and Infant Nursing and Midwifery Faculty of

Medical Sciences, Mashhad, Iran.

3. Associate Professor of Pediatric Hematology and Oncology, Faculty of Medicine, Mashhad

University of Medical Sciences, Mashhad, Iran.

4. Assistant Professor of Health Psychology, School of Nursing and Midwifery, Mashhad University

of Medical Sciences, Mashhad, Iran.

Correspond author: Behnam Hamidereza, Nursing and Midwifery Faculty of Medical Sciences,

Mashhad, Iran, Email: [email protected]

Introduction: Chemotherapy as a treatment method for the prolongation of life and survival of

children as the main treatment of chemotherapy is many side effects and on quality of life and level

of patient acceptance and compliance from the patient influence. Therefore recognizing these

complications and their prevention, in the improvement of treatment and prevention of recurrent of

survival of the patient's admission is very helpful.

Methods: This study is a clinical trial with two groups’ control and intervention in Dr Sheikh

hospital in Mashhad in 2013. 30 Careers of children with cancer undergoing chemotherapy in the

intervention group and 30 Carers patients in the control group were. Protocol and Training Guide

care of cancer patients in three educational sessions with focus on complications: infectious, nausea,

diarrhea, constipation, loss of appetite, mouth moucosit were trained on experimental group. Data

using standard questionnaire chemotherapy side effects in three stages before, during and after the

intervention in both groups were collected. Data Using Spss Version 11/5 and Spearman's correlation

test and Friedman test one-way analysis were analyzed.

Results: In terms of the proportion of cancer patients, acute lymphoblastic leukemia, acute

Myloblastic leukemia, lymphoma, Sarcoma and Rhebdomysarcoma, respectively 56/7, 13/3, 10, 6/7,

3/3, 20% of patients had. %61/7 of males and %38/3 were female. The mean age of the patients

studied 5/6±3/23 years and the average age caregiver for the 32/1±8/08 was.Average side effects in

intervention group after the intervention lower than the control group and in intervention group

between incidence rate side effect before and after the intervention, significant differences

seen)p<0/001).

Conclusion: Educational programs to reduce side effects of chemotherapy in children with cancer

undergoing chemotherapy have been.

Key words: side effect, Chemotherapy, Child, Educational, Caregivers


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Effect of sexual psychotherapy in vaginismus in fertility years in shiraz/iran 1392

Karbasi Marjan*, Hassani Fatemeh**

*Clinical Psychology Phd. Afifabad Aveniu Lg building, Shiraz, Iran

**Instructor and Faculty member of department of nursing, Islamic Azad University Jahrom, Iran

Introduction: Female sexual problems are very extensive.Thirtyfive to fortyfive percent of

female suffer from sexual disturbances.%8 have dysparonia and %5 have vaginal

spam.Causes of vaginismus are psychological factors such as sexual fear,history of sexual

trauma and etc.

Aim: Effect of sexual psychotherapy in vaginismus in fertility years in shiraz/iran1392

Method: This is a quasi experimental research. Samples were 42 female with diagnosed

Vaginismus by obstetrix specialist.30 female divided in experimental group and 12 female

in control group. Cognitive behavioral therapy based on diagnostic and statistical manual of

mental disorder 4th version text revise was done. Data collected by validated questionare

that provided by literature review, consist of demographic data and signs of sexual

disturbances. Data analyzed by describtive statistic and Pearson correlation coefficient and t

test.

Results: This study showed that in all cases mean of vaginismus before sexual

psychotherapy was 23/83 and after that was %3/8. Differesnce of sexual desire before

intervention in control and experimental group wasn’t significant ( p = 0/646).The results

also showed that two groups were similar. But after psychotherapy it was meaningful in

experimental group. Therefore sexual psychotherapy caused to increase sexual desire (p =

/019). In control group difference of Sexual desire in first measurement and second

measurement wasn’t meaningful (p= /754).S exual desire in this group wasn’t changed in

duration of research.

Conclusion: Sexual psychotherapy had positive effect in treatment of vaginismus. Rate of

sexual desire after treatment was increased. Therefore all females in fertility years must are

encouraged to interview about their sexual problems with health care team.

Key words: sexual psychotherapy, vaginismus, fertility years


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The comparative study of Coping Skills in Addicted and Non-addicted Individuals

Taziki SA1, Modanloo M

2*, Abdollahi H

3, Moosavi S.

1- MD, Associate Professor, Department of Psychiatry, Golesan University of Medical Sciences,

Gorgan, Iran

2- PhD, Assistant Professor, Department of Community and Mental Health Nursing, Faculty of

Nursing and Midwifery, Golesan University of Medical Sciences, Gorgan, Iran, E-mail:

[email protected] (Corresponding Author)*

3- BSc, Faculty of Nursing and Midwifery, Golesan University of Medical Sciences, Gorgan, Iran

Background & Objective: Addiction is one of the major problems of today’s world

population. The first step on combating a social issue or disease is the proper reorganization.

This study was designed to compare coping skills in addicted and non-addicted group in

Polyclinic Center of 5 Azar Treatment and Educational Center in Gorgan.

Materials & Methods: This case-control study was carried out in self-introduced addicts

who seek for detoxification and normal population who refer for treatment in polyclinic of 5

Azar treatment and educational center. Data were collected by questionnaire to assess

demographic data and coping skills. Coping skills was measured by the Jalowiec Coping

Scale (JCS); it consists of 39 coping behaviors, which are rated on a 1- to 5-point scale to

indicate degree of use. The sample consisted of 150 self-introduced addict men who

volunteer for seeking detoxification (case group) and 225 non-addict men (control group)

who were matched on some demographic characteristics in Polyclinic of 5 Azar Treatment

and Educational Center in Gorgan. Data were analyzed by using Kruskal-Wallis and chi-

square tests. P-value < 0.05 was considered significant.

Results: The finding showed that the range of age was 15-65 years, with mean age of 33.62

years. Academic degrees were more in control group in comparison with case group (17%

versus 7.3%). Comparing the ranks of two groups was showed that there was no significant

difference between emotional-based coping skills (p<0.126) and problem-based ones

(p<0.457). The coping skills had more tendencies to emotional based methods in case group

(mean rank of 195.3) and problem-based methods in control group (mean rank of 189.91).

The frequency distribution of age in both groups showed that addict men with >46 years old

and non-addict men with 15-20 years old preferred emotional-based to problem-based

coping skills.

Conclusion: The result of this study can help the governments to design a preventing plan

by recognizing the common characters of substance users. We suggest further research for

recognizing risk factors of substance abuse.

Key words: Addiction, Coping Skills, Jalowiec Coping Scale, Gorgan, 5Azar Treatment

and Educational Center

http://www.google.com/url?sa=t&rct=j&q=%D8%A2%D8%B2%D9%85%D9%88%D9%86+%DA%A9%D8%B1%D9%88%D8%B3%DA%A9%D8%A7%D9%84-%D9%88%D8%A7%D9%84%D9%8A%D8%B3&source=web&cd=2&cad=rja&ved=0CDcQFjAB&url=http%3A%2F%2Fwww.tahlil-amari.com%2F%25D8%25B9%25D8%25B6%25D9%2588%25DB%258C%25D8%25AA-2%2F%25D8%25B3%25D9%2581%25D8%25A7%25D8%25B1%25D8%25B4%25D8%25A7%25D8%25AA-%25D8%25AA%25D8%25AD%25D9%2584%25DB%258C%25D9%2584-%25D8%25A2%25D9%2585%25D8%25A7%25D8%25B1%25DB%258C%2F%25D8%25A2%25D8%25B2%25D9%2585%25D9%2588%25D9%2586-%25DA%25A9%25D8%25B1%25D9%2588%25D8%25B3%25DA%25A9%25D8%25A7%25D9%2584-%25D9%2588%25D8%25A7%25D9%2584%25DB%258C%25D8%25B3-kruskal-wallis%2F&ei=EzrcUMncCYXdtAbA-YCoCA&usg=AFQjCNEpz018uAg2YOGJvrHFLajdlZirgQ&bvm=bv.1355534169,d.Yms


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Inter-professional collaboration and multidisciplinary efforts help develop public

health policy to reduce environmental noise and improve the quality of life

Fooladi Marjaneh M.

Professor RN, WHNP-bc, FNP-bc, Ph.D, World Wide Nursing Service Network (WWNSN), PLLC,

El Paso, Texas, USA. [email protected]

Objectives: This inter-professional effort among Nursing, Medicine and Engineering

faculty was aimed to investigate the influence of involuntary and persistent environmental

noise on health and hearing of adult Lebanese in Beirut, Lebanon. Participants shared their

experiences with persistent noise from construction sites, power generators, honking cars,

and motorcycles.

Methods: Using a descriptive and exploratory design with mixed methods helped survey,

interview and test participant’s hearing while street noise levels near the participant’s

residents and work place were measured and compared to the WHO standards.

Results: Self reports from 83 Lebanese adults ages 18-38 who lived and worked in Beirut,

identified daily experiences with irritability, anger, headaches, and sleep disturbances due to

noise annoyance. Of those tested for hearing, 30% suffered from high-frequency hearing

impairment. We found that environmental sound decibel (dB) has increased by 12% and

sound intensity by 400% above the maximum standards when compared with the WHO

report of 1999.

Conclusion: Our inter-professional public health research helped to identify local health

concerns. Public policy update and health education on noise related health risks were

suggested, “HUSH” program was enforced in hospitals and presented to the public school

system. Authorities were encouraged to include noise safety at urban development projects

to improve the quality of life and reduce premature hearing loss, especially for the iPod

generation exposed to voluntary and involuntary noise.



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Effect of spouse’s prenatal education classes on quality of life and pregnancy outcomes

in primiparous women referred to Hajar hospital gynecology clinic

Safdari Dehcheshmeh Faranak 1

, Parvin Neda2, Salehian Tahmine

3

1. MSc, Nursing and Midwifery Department, Shahrekord Medical University of Sciences,

Shahrekord, Iran

2. MSc, Nursing and Midwifery Department, Shahrekord Medical University of Sciences,

Shahrekord, Iran (Corresponding Author) [email protected]

3. MSc, Nursing and Midwifery Department, Iranshahr Medical University of Sciences, Iranshahr,

Iran

Introduction: According to partner support importance in the pregnancy, the present study

aimed to determine the impact of spouse’s education classes on quality of life and pregnancy

outcomes in primiparous women.

Methods: This clinical trial study was done during 2011-2012 in Hajar gynecology clinic,

Shahrekord, Iran. Eligible primiparous pregnant women who participated in physiologic

childbirth education classes were selected and allocated randomly in intervention (n=31) and

control (n=27) groups. Physiological childbirth education classes include 8 sessions was

established for both intervention and control groups In addition, in intervention group

spouses was conducted in two sessions (sessions 3 and 8). Women Quality of life was

evaluated before and after intervention by SF36 questionnaire and pregnancy’s Outcomes

after delivery were studied. Data were analyzed by Chi-square and t-test.

Results: There was no significant difference between two groups in quality of life score and

demographic characteristic at the beginning of study. At the end of study, intervention group

had only significantly better score in mental health dimension of quality of life (P=0.049).

Furthermore, the time of hugging, kissing, and beginning of breast feeding had significant

difference between two groups and intervention group had better condition(P<0.05). There

were no significant differences in gestational age, gravid, abortion, pregnancy outcomes, age

of mother and spouse in two groups(P>0.05).

Conclusion: Spouses’ classes during pregnancy could be effective in enhancing quality of

life in pregnant women and the mother-infant relationship.

Key words: Education classes, Pregnancy outcome, quality of life, Spouse


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NMRC 2014

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Integrated Program for Children Developmental Services

Barekati Seyed Hamed, Eslami Mohammad

Introduction: Early childhood years experiences are important infrastructure for the human

life. By providing appropriate responses to early childhood needs, children health situation

and their abilities will improve more. Child development is a priority of children health

program in the Islamic Republic of Iran. In case of problems and disorders in children

development, there will be a lot of problems during childhood and thereafter which limits

her/his social opportunities’ in the adulthood period and will affect her/his social and

economic situation.

Situation analysis: Developmental disorders are one of the most important health issues in

the Islamic Republic of Iran. Developmental disorders make a lot of problems in childhood

period, limit her/his opportunities in the adulthood and will affect her/his social and

economic situation. Based on IrMIDHS 1389, addressing the children development issues,

some of the indicators were as below: verbal-counting: 68.98%, physical development:

70.84% and educational/ training development: 95.39%.

Practical interventions: The integrated children development program is one of the

projects of National Comprehensive Document for Early Childhood Growth and

Development. Having an appropriate screening program for early detection of children who

has abnormal developmental process is the main objective to implement an on time

intervention to solve the problems or decrease its severity and finally prevent any --- among

them. This program will be started by modified primary screening PEDS test at the health

houses, health posts and urban rural health centers level. The standard developmental

screening test of ASQ will be done for the children who will refer from the previous level

and all 12 months children. The children, whose tests will be below 2SD, will be referred to

the medical doctor in charge. In case of approval of developmental disorder, the child will

refer to the 1st Integrated Center for Developmental Disorders. Rehabilitation and curative

programs will be started after final diagnosis under supervision of related specialists.


Self care,

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Patients' perception of Postoperative Pain Management

Rajha Abdulhassan Hamza

Nursing PhD, Department of Adult Health Nursing, Faculty of Nursing, University of Kufa/ Najaf

/Iraq, [email protected]

Background: postoperative pain management is a very serious matter to deal with. The

patient may be afraid from taking the decision of doing an operation may save his /her life

because of pain that not handled with attention by medical team. Little researches done in

Iraq those deal with the problem.

Aims and objectives: To explore patient's perception about quality of postoperative pain

management.

Methods: A purposive "non- probability" sample of a descriptive study postoperative

patients (n=50) interviewed about their perception of pain were asked to rate the quality of

pain in a scale of 3 (low, moderate, high). Data was collected in 2012

Results: Most of the patients reported they have moderate postoperative pain

Conclusion: The patients' perceptions have a significant relation between pain quality and

educational level, and number of admission. Pain consider as one of the reasons discourage

patient to agree on operation. Therefore, Attention should be directed toward educational

program to nurses about pain management and then they can increases patient awareness

about pain management to reduce feeling of pain.

Keywords: Patients' perception, Postoperative Pain Management


Poster presentation


NMRC 2014

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Analyzing the Effect of Spiritual Care on General Health of Patients with Cancer in

Palliative Care Center at the Seyedoalshohada Hospital of Isfahan in 1392

Laa’li Maryam1, Abedi Heidar Ali

2, Ziaeirad Marzieh

3, Hazini Abdolrahim

4

1. MSc Nursing student, Dept. of Nursing Faculity, Islamic Azad University, Khorasgan branch,

Isfahan, Iran [email protected]



4. Dept. of Hematology, School of Medicine, I sfahan University of Medical Sciences

Background and objective: For patients to get rid of cancer treatment efficacy and

compliance with medical problems, they are frequently in search of interventions, including

spiritual intervention (Spiritual Care). For these patients because of the particular

circumstances of disease and its chronic nature, offering spiritual care matters. The aim of

this study was to determine the effect of spiritual care on general health of patients with

cancer in palliative care center of Seyedoshohada Hospital.

Method: This is a quasi-experimental research conducted in two groups, with a two-step

pre-test and post-test. 60 patients with cancer referring to clinic of Imam Reza and the center

of palliative medicine in there, with the census method divided in two experimental and

control group for 3 months and the general health questionnaire before and after the spiritual

care was completed in both groups. All data obtained from the questionnaires were coded

and with the help of SPSS-18 and were analyzed with descriptive and inferential statistics

(chi-square, dependent and independent t). Results: The mean scores of the general health pre-test in experimental and control groups

are not significantly different (p=0.685). But mean scores of public health in experimental

group before and after spiritual intervention is significantly difference. (p=0.001). Conclusions: These findings suggest that spiritual care in patients with cancer reduces the

problems of somatic symptoms, anxiety and impaired sleep, depression, and impaired social

function and can also improve the level of health in patients and nurses can use health

improvement program to improve patients' health.

Keywords: Spiritual care, Cancer, General health, nursing care


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Evaluation of team performance Ganaveh city school health promotion in public

health and health awareness among primary students in academic year 91-92

Farvardin Mina*, Farvardin Marjan**

*Midwife Health Network, Bushehr University of Medical Sciences, Ganaveh city

** Bushehr University of Medical Sciences - [email protected]

Introduction: More than half of all illnesses and deaths are caused by germs that enter

through food and water are the child's mouth. Health education as the cornerstone of the first

case considered in the light of Islamic teachings has been undoubtedly successful and

dynamic society, a society that is healthy humans, is mighty happy. In order to promote

health in schools program, school "health promoters "in a country songwriter has been the

main target of the surveillance system , updating health information to students , parents and

staff of health care . Therefore, familiarity with health care for their children, as members of

the family and parents is crucial to the future

Methods: A cross-sectional study of primary health care, school health team Ganaveh city

during the 91-92 academic year at primary school level is done.is completed by the students.

Methods of data collection forms and education activities by educating the students on the

basis of the three good (score above 80), moderate (score 50 to 80) and low (below 50)

division basis in three months. Research by collecting, monitoring, and analysis are

discussed.

Results: The results obtained in this study indicate that in the first quarter of academic

knowledge students 26/5 % well, 49 % moderate and 15 % were poor in the third quarter of

the academic year after program activities in the school " health promoters " 41 % well, 59

% were moderate .

Conclusion: Results of this study showed that the performance of the health team to

promote health in schools is significant and is consistent with other research programs,

school " health promoters " a clear message that the interests of all students and it is a

healthy body, self-confidence and self-esteem along with the main objective of this program

is to develop positive attitudes about health issues that will stay with them after leaving

school.

Keywords: health education, primary school, school health


Poster presentation


NMRC 2014

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Maternal affectivity and the pattern of breast feeding

Ansari Ali1, Negahban T

2, kazemi M

3

1. MSc psychiatric & Mental health nurse, Rafsanjan University of medical sciences, Rafsanjan Iran

2. MSc community health nurse, Rafsanjan University of medical sciences, Rafsanjan Iran

3. School of Nursinh & Midwifery, Rafsanjan University of medical sciences, Rafsanjan Iran

Background: Although breastfeeding is a natural behavior, but for some mothers its

continuity up to 6 month may be associated with difficulties and challenges. As the

maternal personal characteristics affect the way of their thinking, feeling and behavior in

different situations and times its seem that negative affectivity such as the negative

emotions, anxiety, depression, irritability and negativity influence breastfeeding patterns.

The aim of this study was to determine maternal affectivity and the pattern of breast feeding

in Rafsanjan in 2011.

Materials & Methods: In this Cross-Sectional study, affectivity and breast feeding

patterns of 412 mothers with 6 months infants, who referred to health care centers in

Rafsanjan for infants health care monitoring and vaccination was surveyed . Sampling was

randomly by considering of the inclusion criteria and data gathering was done by Watson's

PANAS-X questionnaire through face to face interviews. Data was analyzed using SPSS

software version 14, and considering the significant level of p>0.05, descriptive statistics,

chi-square tests, t-tests, ANOVA and Fisher's exact test.

Results: about 14.3% of mothers had been unsuccessful breastfeeding experience and

69.5% had exclusive breast feeding for 6 months. Mothers who had preterm infants had

higher mean score of negative affectivity (P = 0/04) and those who had exclusively breast

feeding for their infants had lower mean score of negative affectivity (P = 0/01). The mean

scores for positive affectivity in mothers who started the first breast feeding during the first

hour after birth, was higher (P = 0/04).

Conclusion: Mothers negative affectivity can be as a predictive factor for her breast

feeding performance so mothers who experience negative affects during pregnancy and

breast feeding should be consider specially.

Key words: Maternal personality, breast feeding pattern, 6 months infants, maternal

affectivity


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Neglect in Providing Medical Care services for the Elderly Admitted to the Bahman 22

Didactic Hospital of Gonabad: Action Research

Abedi Heidarali1, Amiri Delui Masumeh

2

1. PhD, Associate Professor, the Faculty of Nursing and Midwifery (Khorasgan Branch of Isfahan),

Islamic Azad University, BLV-Arghavanie, Isfahan-Iran. Email: [email protected].

2. Corresponding Author, Master Student, the Faculty of Nursing and Midwifery (Khorasgan Branch

of Isfahan), Islamic Azad University, BLV-Arghavanie Isfahan-Iran.


Introduction: With the increasing prevalence of chronic diseases, demographic changes in the

health care systems are challenges for the elderly. It is necessary to improve the quality of care for

the elderly and the relationship between the elderly patient and care provider. This study aimed to

understand the factors influencing the neglect in providing medical care services for the elderly

admitted to the Bahman 22 Didactic Hospital of Gonabad.

Methods: This is a qualitative action research study. In the first step after obtaining the consent of

the 11 elderly people with the ages between 65 to 89 years who were admitted to the different wards

of the hospital, the data was collected, recorded and rewritten purposefully by unstructured

interviews for 30 minutes. In order to analyze data, a qualitative content analysis was used. Then, the

focus group was formed which included 12 members of treatment team; the group's attitudes towards

providing the optimal care and its obstacles and the problems that the elderly faced were proposed

and suggested. At the end, didactic workshops were held for the care group and evaluation was

performed in different stages.

Results: Interviews obtained from the elderly patients were analyzed and categorized into the

following concepts: a) The quality of nursing care,b) Participation in decision making, c) facilities,

d) Medical expenses, e) Nutrition and f) The following problems was also proposed in the focus

group by the care team. The crowding of wards, the shortage of nursing staff, hearing disorders and

forgetfulness in the elderly, reduction of learning and dialect.

Discussion: The results show that improving the quality of care for the elderly and training of the

nurses and care team regarding the aging process and the physical and emotional needs of this

vulnerable group is essential. Therefore the action research is effective way for improving the

Providing Medical Care services for the Elderly.

Keywords: Neglect of the Elderly, Medical Care Services, Hospital, Action Research


Poster presentation


NMRC 2014

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The relationship between stress adaptation strategies and hypertension

Fakoori Elham1, Ghaderi Musab

2*

1. Master Student of Consultations in Midwifery, Student Research Committee, Jiroft University of

medical science, jiroft, Iran

*2. BSc in Nursing, Jiroft University of Medical Sciences, Jiroft, Iran. [email protected]

Introduction: Stress is inevitable problem in everyday life has a great impact on a person's

mental and physical disorders. One of these disorders is hypertension. Purpose of this study

was to investigate the relationship between stress adaptation strategies and hypertension in

healthy individuals and people with hypertension diseases in Jiroft city in year 2013.

Materials and Methods: In this study, 636 patients were studied by using the random-

clustering method. Instruments included the demographic checklist and questionnaire stress

adaptation strategies made by Researcher. After completing the questionnaire, blood

pressure was measured and recorded (after 10 minutes at rest, in two steps). People who two

times consecutively with an interval of at least 5 minutes, had a systolic blood pressure

equal or greater than 14 mm Hg, or their diastolic blood pressure were equal or greater than

9 mm Hg were considered as hypertension. Also people because of hypertension under

medical supervision were considered as hypertension. For analysis of data Spss18 statistical

software and descriptive and inferential statistical tests were used. p<0.05 was considered as

statistically significant.

Results: Average age of the samples was 43.7 ± 9.2. In this study 330 individuals (51.9%)

were diagnosed as hypertension. The mean score of stress adaptation strategies was 14.24 ±

3.75. T-test showed a significant inverse relationship between hypertension and stress

adaptation strategies (p <0.05).

Conclusion: The results of this study indicate importance of stress adaptation strategies in

prevention of hypertension. Therefore recommended in order to prevent diseases such as

high blood pressures towards improving this method in Individuals perform the necessary

actions.

Keywords: Stress, Hypertension, Adaptation




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Evidence-base for Peer-led Services: Behavioral Changes Using the Wellness Recovery

Action Plan® (WRAP®)

Mutazammil Wali

Chief Executive Officer, Wellness Recovery, LLC, Baltimore, Maryland, USA

Aim: To share two research studies (Cook et. al. 2009; Cook et. al. 2010) which examined peer-led,

self-management interventions for mental health recovery and other psychosocial behaviors using

the Wellness Recovery Action Plan® (WRAP®). In 2009, 108 individuals were enrolled in a study

from traditional treatment organizations.

Methods: The study included measuring symptoms of recovery, hopefulness, self-advocacy,

empowerment, support system, and self-perceived physical health. Methods: WRAP® was

delivered in eight weeks with 2.5 hours each week by two Certified WRAP® Facilitators. The first

session was introducing the key concepts of WRAP® and the lived mental challenges of the

WRAP® Facilitators, participants, and group exercises. The second and third sessions were to

develop learning around an individualized wellness toolbox to maintain recovery, and functional

strategies, which are inexpensive to address life challenges. Also, increase “how-to” individualized

self-esteem, skills and abilities, and benefits of peer support. The fourth session was developing a

daily maintenance plan that is used every day, which helps with staying emotionally and physically

healthy, including a triggers management plan to identify and an action plan to symptom triggers to

prevent things getting worse/crisis. The fifth session facilitated learning about early warning signs

and how these signal a need for additional supports and/or services. The sixth and seventh sessions

created a crisis plan that listed signs of impending crisis, named individuals willing to help,

described types of assistance preferred and other desires. The final session covered how to ensure

adequate post-crisis support to avoid relapse. A follow-up two States study in 2012 of 347

participants’ pre and post-test qualitative survey questionnaire supported Cook’s study.

Findings: Statistically significant decrease was found – psychoticism, depression, phobic anxiety,

obsessive-compulsive, interpersonal sensitivity, paranoid ideation, and general anxiety. Significantly,

indicating improvement. Significant increases were observed – personal confidence, willingness to

ask for help, goal orientation, reliance on others, and freedom from symptom domination.

Significant increases were found – feelings of hopefulness, self-advocacy, and self-perceived

physical health. Conclusion: WRAP® is now being offered in all of the 50 United States (U.S.) and

U.S. territories, and growing rapidly internationally. The field of psychiatry, psychology, and

psychiatric nursing stands to benefit from such research, and individuals who participate in WRAP®

will have an opportunity to experience enhanced autonomy and greater self-determination. Clearly,

WRAP® has the potential in having positive effects on mental health wellness and multiple

behavioral changes.

Keywords: Self-determination, Self-management, Self-advocacy, Hopefulness, Recovery,

Depression


Poster presentation


NMRC 2014

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Depression and anxiety in association between clinical blood characteristics and

quality of life in Armanian Mediterrane fever disease patients

Elya Pepoyan1, 2

, Natalya Harutyunyan1, 2

, Marine Balayan1, 2

, Maria Karagyozyan2,

Laura Hakobyan2, Susanna Mirzabekyan

1, 2, Vardan Tsaturyan

2, Astghik Pepoyan

1, 2*

*Head of Food Safety and Biotechnology Department, Armenian National Agrarian University,

Yerevan, Armenia [email protected] 1Armenian National Agrarian University, Teryan, Yerevan, RA

2 International Associations for Human and Animals Health Improvement, RA

Background: During our preliminary investigations the significant levels for depression and anxiety

in Armenian Crohn’s disease (CD) patients was registered and link between the psychoemotional

status of CD patients and the effect of placebo was described [1, 2].

The aim of current investigations was to evaluate depression and anxiety in association between

clinical blood characteristics and quality of life (QOL) in Armenian Familial Mediterranean fever

(FMF) disease patients.

Methods: The Zung self-depression scale, Beck Anxiety Inventory and QOL scale were used to

study the depression, anxiety levels and QOL of Armenian FMF disease patients.

ESR measurements were performed by the Westergren method. Rheumatoid factor, C-reactive

protein and erythrocyte sedimentation rate in blood were measured according to standard procedures

using Stat Fax 3300 (Awareness technologies).

Result & Conclusion: The investigations on depression and anxiety levels of FMF patients,

compared with healthy controls revealed significant levels of depression of Armenian patients in

remission. We didn't found any association between QOL and clinical characteristics or depression

and anxiety levels of these patients.

Keywords: depression, anxiety, quality of life, questionnaires, FMF, blood, patients

1. Pepoyan A.Z., Pepoyan E.S. Depression and anxiety levels in Armenian Crohn’s disease patients

// Proceedings of World Academy of Science, Engineering and Technology. 2007, (24):131-134.

2. Pepoyan A.Z., Pepoyan E.S. Placebo effect on psychoemotional status and clinical analyses of

Armenian Crohn’s disease patients // International Journal of Biological and Medical Sciences. 2008,

1(2):171-175.



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The effective factors on comatose patient’s caring: A hermeneutic phenomenology

approach

Shokati Ahmadabad M

1, Hasani P

2, Manoochehri H

3

1- Corresponding author: Assistant Professor of Nursing of Qazvin University of Medical Sciences,

Qazvin, Iran e-mail: [email protected]

2- Assistant Professor of Nursing of Shahid Beheshti University of Medical Sciences, Tehran, Iran

3- Assistant Professor of Nursing of Shahid Beheshti University of Medical Sciences, Tehran, Iran

Introduction: During of caring of comatose patients, caregivers involve in a lot of factors

which effect on caring. This caring is a holistic care undergoing caregiver’s preferences. Our

purpose was to examine the effective factors on comatose patient’s caring.

Methods: Van Manen’s conception of hermeneutic phenomenology with purposeful

sampling of caregivers of comatose patients was used in Tehran in 2012. The data were

collected through 10 semi-structured interviews and were analyzed using Van Manen’s

phenomenology.

Results: The participants were 5 males and 5 females, 8 nurses and 2 family members and

working in critical care units between 6 and 23 years and working as a teacher. 7 essential

sub themes were elicited: effective communication, mutual satisfaction, Depression and

disappointment of caregiver, Hopefulness of caregiver, Guilty feeling of caregiver, Belief of

death in caregiver and Compassion and sympathy then were classified into 1 theme:

caregiver’s preferences. This caring means that the caregivers have to realize, percept,

understand and evaluate of the caring because the comatose patients are unable to do them.

The trustworthiness of sub themes and themes were achieved in our study.

Conclusion: The caring in coma is a holistic care and the caregiver is instead of comatose

patient. To enhance caring process and to achieve our goals, we created an assessment tool

based on the findings of our study; it seems that the results can be used in this regard.

Key words: Coma, caring, hermeneutic phenomenology



Poster presentation


NMRC 2014

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Decision making for vaginal delivery in the North of Iran: a focused ethnography

Zakerihamidi Maryam1 *, Latifnejad Roudsari Robab

2, Merghati Khoei Effat

3, Kazemnejad

Anoshirvan4

*1. PhD student in Reproductive Health, School of Nursing and Midwifery, Mashhad University of

Medical Sciences, Mashhad, Iran. corresponding author: [email protected]

2.Associate Professor in Reproductive Health, Evidence-Based Care Research Center, Department

of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad,

Iran

3.Assistant Professor in Sexual Health Promotion, Iranian National Center of Addiction

Studies(INCAS), Tehran university of Medical Sciences, Tehran, Iran

4. Professor in Biostatistics, Tarbiat Modares University, Tehran, Iran

Introduction: Many factors have been stated on decision making for different kinds of

delivery. Decision making for vaginal delivery is done under the influence of culture,

perceptions, beliefs, values, attitudes, personalities and knowledge. The current study aims

at exploring the determinants of decision making for vaginal delivery in the north of Iran

from women’s perspective. Methods: A focused ethnographic method with purposeful sampling method has been used.

Semi-structured interviews and observation were conducted with 12 pregnant women and 10

delivered women, 7 midwives, 7 gynecologist and 9 non-pregnant women in Tonekabon

clinics Interviews and observations were recorded and transcribed. The accuracy of extract

codes and theme by restoration of arranged and coded texts to the participants (member

check) and by an expert person from outside the study context were confirmed. Data were

analysed using thematic analysis and MAXqda software. Results: Five themes were extracted from the data: economic determinants, cultural values

and norms, Positive attitudes about vaginal delivery, social networks and normal delivery

facilitators. Several sub-themes and sub-sub themes also emerged from the data (e.g. safe

delivery, forming maternal feelings, painful but tolerable, maternal role facilitator,

inexpensive delivery, a process with good conclusion and low complications, relief

messenger).

Conclusion: giving enough information about vaginal delivery for pregnant women and

their family members, training pregnant women to increase tolerance during labor pain, and

modifying expenses can increase economic affordability, positive cultural norms and

attitudes about vaginal delivery, proper social support, using of normal delivery facilitators

and direct them toward vaginal delivery. Keywords: Vaginal delivery, qualitative study, focused ethnography, decision making,

culture

health and wellbeing, isfahan, iran, 2014 wellbeing, isfan, iran, 2014 · 2014-12-15 · 6 st...

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