Journal of Hayat

The view of patients and patients’ companions regarding patients’ rights: a phenomenological research

S Jolaee

Introduction: Patients&apos rights have been center of attention in recent decades because of patients&apos vulnerability and worldwide sensitivity to human rights.

Materials and Method: The current study is a qualitative, phenomenological research which has been carried out in Emam Khomeini Hospital during 2004-2005. The aim of this research was to identify the meaning of patient&aposs rights from the view point of patients and/or their companions. To achieve this, 16 semi-structured interviews were conducted with 12 informants. They were asked to explain their experience regarding the patient&aposs rights. All interviews were recorded. Data analyzing was simultaneously carried out using thematic analysis method.

Results: The emerging themes included expectation for equality and justice in receiving health care services, human respect and privacy need to be informed regarding their diagnosis and having essential facilities in the hospital.

Conclusion: It appears that whether the participants are aware of patients&apos bill of rights or not, they are able to define some rights for themselves. Attention to theses rights can help policy makers to design unique patients&apos bill of rights according to Iranian sociocultural and economic situation.

Coping with stress

N Salmaani Barough

Introduction: Stress is a complex and physiologic phenomenon that sometimes can be a source of problem. If an individual could not cope with stress, it would be a threat to physical and psychological health. Inclination to cope with stress is a positive way which helps one to improve his/her health.

Materials and Methods: This research is a quasi-experimental study with the aim of determining the effect of education of methods of coping with stress on rate of stress among women working at Tehran University of Medical Sciences. After primary study, 138 cases were chosen through census sampling. The collection tool was Chaudron stress scale. The statistical tests included t test and 2. Data were analyzed by SPSS software.

Results: The result showed that there was no significant difference between level of stress before and after education in domains of job stress (p=0.22), life health stress (p=0.53), personal life stress (p=0.44) and personality stress (p=0.1). Also the statistical result of X2 did not show significant correlation between variables such as type of school, age, duration of work, marital status, number of children, educational level and housing condition with job stress.

Conclusion: The result showed that work environment is an important source of stress for working women. It could have undesirable effects on physical and emotional health of women. It seems that short term education can not decrease the stress of women therefore it is necessary to organize different long-term education programs, consultation and other strategies to reduce stress.

A comparative study of the effect of Benson’s relaxation technique and Zekr (rosary) on the anxiety level of patients awaiting abdominal surgery

A.R Nikbakht Nasrabadi

Introduction: Surgery is a stressful event and patients undergoing surgery experience anxiety. Any effort to reduce anxiety of surgical patients should be of priority in nursing care of preoperative patients. The purpose of this study was to compare the effect of Benson relaxation technique and Zekr (rosary) on anxiety level of patients awaiting abdominal surgery.

Materials and Methods: This research is a quasi-experimental study carried out on patients who were admitted for abdominal surgery in a affiliated hospital to Tehran University of Medical Sciences in the year 2004. A total of 70 patients were chosen and divided randomly into two groups. We used Benson’s relaxation technique in first and Zekr in the second group. The patients were assessed on the day before surgery and on the day of surgery by a questionnaire that included demographic information and Spielberger anxiety tool. Vital signs were also recorded. The data were analyzed by SPSS computer software. The differences between pre and post intervention values were analyzed using paired t test, and between groups using independent t test and 2.

Results: Although there was a significant difference between mean anxiety level before and after intervention in both Zekr (p<0.006) and relaxation group (p<0.02), there was no significant difference between two techniques in reduction of preoperative anxiety (p>0.05). There was also a significant reduction in systolic blood pressure and pulse rate in both groups (p<0.05).

Conclusion: It seems that Zekr is as effective as Benson’s relaxation technique in reducing anxiety level of patients and both can be used to reduce anxiety level of patients awaiting abdominal surgery.

A nationwide study of level of job satisfaction of nursing personnel in Iran

Z Monjamed

Introduction: Level of job satisfaction reflects positive or negative attitude of person toward his/her job and is influenced by many factors. Job satisfaction of nursing personnel directly affects their quality of care. Attention to this issue means attention to community health.

Materials and Methods: This study is a descriptive, cross sectional research, conducted to identify the level of job satisfaction of nursing personnel of health, therapeutic and medical education centers of the entire country in the year 2001. Sample size was 4000 and nurses were selected through random stratified sampling method. Data collection tool was questionnaire of Herzberg job satisfaction which was sent by mail. Job satisfaction was classified into three levels: low (0-33.33%), moderate (33.34-66.67%) and high (66.68-100%).

Results: We received back a total of 3029 questionnaires. Results showed that the majority of nurses had moderate level of job satisfaction in domains of working place situation (62.9%), relationship with colleagues (69.6%), professional situation (74.3%), supervision and administration (57.6%), managerial policies (50%) and personnel life in relation to the job (80.6%). Job satisfaction level was low in domains of job security (63.5%) and salary and benefits (77.3%). 2 test showed a significant relationship between age, job position, level of education, job experience, over time working, type of over time working, type of accommodation and participation in continuing education programs and job satisfaction.

Conclusion: As a whole, the level of job satisfaction of majority of nursing personnel was moderate and the majority of subjects were not satisfied with welfare possibilities of their job. According to the research results it is recommended that the authorities try to increase the salary and financial benefits of nursing personnel and also to develop welfare possibilities of this class of community.

Effect of education of religious values on the rate of depression

F Noghani

Introduction: One of the main aims of religions is to improve psychological health in society and interpersonal relationships. It has been shown that religious education can be used in primary and secondary prevention of psychiatric disorders.

Material and Methods: The samples of study were the teachers of guidance schools of the capital city of Tehran. The samples were 40 depressed female teachers that were chosen randomly among the 30-40 year old teachers who were not using any drugs. Data gathering tool was a questionnaire containing Hamilton test with 24 questions about mood disorders (including depression). Another questionnaire including demographic characteristics and questions regarding change of mood after attending religious education classes was also used.

Results: The results showed that 90% of the subjects were satisfied with religious methods such as prayer, fasting and blessing for decreasing their depression 92.5% were satisfied with regular education of religious values. A total of 80% of the samples believed that training by a particular teacher would influence their interest in the religious values 55% reported calmness after praying. There was a significant differences between the mean score of depression before and after attending religious education classes (p=0.000).

Conclusion: According to the findings of this research, education of the religious values can affect anxiety, sadness, hopelessness, sleeplessness and lack of appetite and depression. Performing religious acts such as prayers causes a type of relaxation and good feeling in the patients.

A study of professional nurses’ perceptions of factors affecting the process of client education

Z Goudarzi

Introduction: Education of patients and helping them to be independent in process of self-care in both health and disease is one of the basic responsibilities of nurses.

Methods and Materials: This descriptive-analytic research was done to study perceptions of 317 nurses working in hospitals of Tehran University of Medical Sciences of factors affecting the process of patient education. Data was gathered by means of a questionnaire containing 30 questions about facilitating factors and 17 about inhibiting factors. We used Likert score to measure questions. Data analysis performed by SPSS software. Statistical test were Chi square, t test, variance analysis and correlation of variance.

Results: The highest percentage of nurses (52.1%) believed that enough attention is not being paid to facilitating factors such as considering patient education as priority in patient care, nurses being responsible for patient education, considering patient education as a criteria in nurses annual evaluation, importance of patient education for nurse administrators, having in-service education about patient teaching and having proper time, place and personnel for patient education. Majority of nurses (57.4%) believed factors such as shortage of nurses, lack of proper place, time and patient motivation for receiving education, nurses and nurse administrators’ inattention to patient education and negative attitude of doctors toward patient education by nurses are inhibiting factors in process of education. Statistical tests showed a meaningful relation between demographic variables such as sex, clinical background, shift work and position and facilitating factors. There was also a meaningful relation between variables like working in more than one shift, having clinical experience of patient education and being evaluated for patient education during study of nursing and inhibiting factors.

Conclusion: This study shows low level of facilitating factors for patient education in hospitals of Tehran University of Medical Science. To improve patient education in these hospitals it is necessary to improve facilitating factors.

Comparison of active and physiologic management of third stage of labor

F Vasegh Rahimparvar

Introduction: The delivery of placenta and membranes (third stage of labor) is an important stage of delivery. Complications of this stage can increase maternal mortality rate. There is controversy regarding the routine use of oxytocic drugs in this stage of labor. These drugs may shorten duration of third stage but have side effects. Furthermore, management of delivery in physiologic way causes minimum damage to the mother and newborn.

Materials and Methods: The present research is a clinical trial study. A total of 94 subjects were divided into two groups. All subjects in active group received 10 units of Syntocinon in 500 cc serum. The cord was clamped and cut after cessation of pulsation and the placenta was delivered by Brandt–Andrews maneuver. Women in the physiologic group received 1cc of placebo in 500 cc serum, no clamping of the cord was attempted until pulsation had ceased and the placenta was delivered by minimal traction on the cord and with maternal effort without any maneuver.

Results: Two groups were matched in the subjects’ characteristics. The rate of postpartum hemorrhage in physiologic group (14.58%) was higher than active group (10.64%) but the statistical tests showed no significant differences between two groups (p=0.2945). The mean duration of the third stage of labor in the physiologic group (13 minutes) was longer than active group (9 minutes) but the statistical test showed no significant differences between two groups. The statistical tests also showed no significant differences between rate of retained placenta (p=0.5) or piece of the placenta and membranes (0.2428) in two groups.

Conclusion: Statistical tests showed no significant differences between duration and complications of the third stage of labor in two groups. The routine use of Syntocinon in management of third stage of labor can not be recommended.

Investigation of the ethical practice in medication process among nurses

M.R Tefag

Introduction: Caring is the essence of nursing and medication process is an important part of nursing related interventions in the health care systems. Medical and/or nursing errors can lead to severe problems for both patients and nursing system. The purpose of this study was to investigate the ethical practice in medication process among nurses working in selected hospitals related to Tehran University of Medical Sciences.

Materials and Method: This study is a descriptive–analytic research. Samples of the study were 305 nurses employed in adult units of selected hospitals. The research data gathering tools were a checklist and a questionnaire. Questionnaire included questions about demographic data and errors in medication process. Checklist included 17 questions related to expected behaviors regarded medication process. The researcher first completed the questionnaire and then the checklist was completed on two separate occasions at least 15 days apart. The data were analyzed using descriptive and analytic statistics such as Chi square, Fisher exact test and Pearson correlation coefficients.

Results: The majority of subjects were 26-35 years old, female and single. About half of nurses (49.6%) had undesirable performance in process of medication. Ethical practice had a significant correlation with type of ward (p=0.005), the mean number of occupied beds in a week (p=0.000), number of co-workers in the shift (p=0.001), educating (p=0.037), satisfaction with place of work (p=0.0043) and technical possibilities in the ward (p=0.029).

Conclusion: According to the results, the majority of nurses had an undesirable performance in medication process. It is suggested that managers, program planners and nursing teachers pay more attention to ethical practice in medication process in order to enhance performance of nurses in this field.

Patients’ privacy: a literature review

N Mehrdad

The concept of privacy, which is used in many disciplines, is a basic human need and also is recognized as an important concept in nursing. The concept of privacy has been described in various dimensions including physical, psychological, social and informational privacy. In this article we review these dimensions. Most of the studies related to the privacy have been carried out in the area of physical privacy. One of the basic areas of privacy in hospitals is related to data protection and the prevention of information inaccuracies. Major factors that threaten the privacy include intrusion upon the seclusion or physical boundaries and unnecessary physical touch. In order to decrease these problems, health worker need to find a new approach of working with patients. Review of the literature showed that only a few studies about the privacy of patients have been carried out. To encourage research in this field, accurate instruments should be developed in order to measure different aspects of the privacy, an aim that is difficult to achieve because of the complex nature of the concept. It is also important that necessity of observing patients’ privacy systematically be thought to medical students