Journal of Hayat

Evaluation of the mental problems of menopausal women referred to the health care centers of Ilam University of Medical Sciences

F Rasooli

Introduction: Menopause, the permanent cessation of menstruation, is an important event in the long process of climactrium, signaling a change from the years of fertility to infertility. Postmenopausal women have many physical and mental problems.

Materials and Methods: The objective of this study was to determine the mental problems of menopausal women referred to the health care centers of Ilam University of Medical Sciences in 2003. The research tools in this analytical-descriptive study were a questionnaire, record sheet and standard tests composed of Beck and Cattle scales. The data were collected by interview. The samples consisted of 150 menopausal women who had been selected by random sampling method. The data analysis was done by SPSS software.

Results: The results showed that short-term memory disorder (39.3%), mild depression (32%) and mild anxiety (27.7%) were the most common mental problems. There was a significant relationship between depression and marital status (p=0.029) and having knowledge about menopause (p = 0.04). Anxiety had no relationship with any variables (p>0.05) but there was an association between depression and anxiety (p = 0.002).

Conclusion: The findings show that the menopausal women suffer from mental problems, which influence their quality of life and community health. Thus, planning educational and health care programs to help them overcome these obstacles is essential.

Assessment of educational needs of patients and their families after coronary artery bypass graft (CABG) surgery at discharge and one month later

Sh.s Basampour

Introduction: It is necessary to give the essential educations to the patients and their families during hospitalization and after discharge. We conducted this study with objective of determining educational needs of patients undergoing CABG and their families at discharge and one month later.

Materials and Methods: This research is a survey study. 60 patients and 60 members of their family who were selected by simple randomization. Data were collected by questionnaire. The questionnaire was prepared in two parts questions about disease and demographic characteristics and specific educational needs about wound care, activity and rest, drugs, nutrition and other needs of patients and their family. The data were collected in two stages: at discharge and one month later and analyzed with SPSS software. Descriptive and inferential statistical methods (t test,  test and variance analysis) were used to analyze the data. Results: At discharge, most of the patients and their families had respectively moderate and high levels of educational needs. Both groups had moderate educational needs about rest and activity, drugs use (general educational needs), nutrition and other needs. Patients have low but their families have high educational needs about drugs use (special educational needs). At one month after discharge, most of the patients and their families had moderate educational needs in all of the mentioned categories. The t statistical test didn’t show significant correlation between educational needs at discharge and one month later in patients and families. The  test showed significant differences between educational needs of the patients and their families (p=0.036) at discharge but didn’t show such a difference one month after discharge (p= 0.558).

Results: showed a significant relationship between educational needs and level of education.

Conclusion: Since most educational needs of the patients and their families concern the uses of drugs and wound care, and also most patients were unable to count their pulse, we suggest nurses pay more attention to these problems and give the essential training to the patients and their families.

The effect of continuing education of neonatal intensive care nursing on knowledge and the practice of the nurses working in the children’s hospitals

Z Goudarzi

Introduction: Nowadays continuing education is considered an essential part of nursing education. This study was planned to evaluate the effect of continuing education of neonatal intensive care nursing on knowledge and the practice of nurses who were working in the children’s hospitals.

Materials and Methods: A semi-experimental study was carried out including 42 nurses of the children’s hospitals affiliated to Tehran University of Medical Sciences during 18 months in 1999- 2000. The data were collected by a questionnaire and a checklist. The questionnaire included demographic information and 60 multichoices questions based on the knowledge of the neonatal intensive care nursing. The observation checklist contained 5 parts, how to establish: resuscitation operation, endotracheal suction, management of the patient under mechanical ventilation, nasogastric tube insertion and feeding by gavage. At the end of the training courses the questionnaire and the checklist were completed again individually. The result of the pre and post tests and checklist were compared in the areas of knowledge and practice. The data was analyzed by 2 and paired t Student test.

Results: Statistical analysis showed a meaningful difference in the knowledge and practice after the continuing nursing education (p<00001).

Conclusion: This research revealed the positive effect of the continuing nursing education on the knowledge and the practice of the nurses who were working in the pediatric wards. It is important to consider the continuing nursing education program to promote the health care system.

Investigating the effective factors on the duration of breast feeding

F Jamshidi Evanaki

Introduction: A balanced and proper diet is an essential factor in maintaining individual’s health. The improvement of feeding in different age groups, especially children, is considered a significant step in primary health care.

Materials and Methods: This research is a descriptive and analytic study. A sample of 225 mothers whose babies were between 0-24 months and who were referred to selected centers were chosen, using random sampling. The tool was a questionnaire. To analyze the data, the descriptive statistical, frequency distribution charts, the mean and central tendency as well as inferential statistics (2 test and Pearson correlation) were applied.

Results: The findings of the research showed that there is a meaningful relation between variables of age, occupation, the method of the last delivery, inclination of mother to the breast feeding, age of fetus at the time of birth, hospitalization of the neonate, the time of first breast feeding after the childbirth, the quality of baby’s nutrition while he is hospitalized, the quality of the baby’s first nutrition, the time of starting aid-feeding, using the aid-milk and using the pacifier by the baby with the duration of breast feeding. Such a relationship was also found between husband’s idea about the breast feeding, examination of the breast during the pregnancy, teaching the advantages of the breast feeding and its correct method during the pregnancy, the place of the last childbirth, teaching the importance and the correct method of breast feeding after the childbirth, an encouraging and supporting husband concerning breast feeding, presence of the mother and the baby in a same-room after the childbirth, manner of arranging the intervals and times of the breast feeding, breast feeding during the night, renewed pregnancy and the duration of breast feeding in each session with the duration of breast feeding.

Conclusion: According to the findings of the research, different factors affect duration of the breast feeding. Necessity of the midwife’s attempt to instruct mothers during pregnancy and after childbirth was affirmed. The necessity of instruction of the medical groups about breast feeding is also made clear more than before.

Investigation of the teacher evaluation process with in Iranian medical education system

Z Parsa Yekta

Introduction: There are different methods of teacher evaluation .The aim of this study was to investigate process of teacher evaluation in selected Iranian Medical of Sciences Universities.
Materials and Methods: In this descriptive-analytic study, we investigate the existing documents and performed serial semi-structured interviews with evaluation staff in the universities. The implementation of the whole process of staff evaluation at universities were also observed. The data were analyzed considering both qualitative and quantitative approaches. The descriptive analytic method as well as content analysis was applied for data analysis.
Results: Review of the teachers by students was the dominant method for teacher evaluation in the selected universities. This method have some important advantages and disadvantages which are discussed in this article according to the findings.
Conclusion: According to the results of this study, it is highly recommended to use a combination of different methods for evaluation of the university teachers as well as decision making purposes.

Assessment of Expanded program on immunization for mothers and children under 2 years old in Shahriar

A Rezaipour

Introduction: Immunization is the most effective means of improving health. In the absence of a proper and regular immunization program, people and especially children will be left at high risk of many infectious diseases. This study was designed to assess Expanded Program on Immunization (EPI) for mothers and children under 2 years old in Shahriar, South west of Tehran.

Materials and Methods: This research was a cross-sectional study. standard cluster sampling was applied to select 210 children in the age group 18-24 months old and 240 women with a child less than 1 year of age who were resident in Shahriar city. Standard formats were used for collection of the data. Descriptive and analytic tests (chi squares, Fisher exact-test, t test, ANOVA, bivariate and logistic regression module) were applied to analyze the data.

Results: The results showed that vaccination coverage in children was over 90 percent. 17.6 percent of the children were partially vaccinated and 41.4 percent were vaccinated completely but with more than one-month delay. The important character which was strongly associated with more than one month delay in immunization was center of childhood immunization. Although 83.8% of women with a child under 1 year age had received twice tetanus immunizations, only 13.3% of women had obtained the complete series of five immunization. The character which was associated significantly with dT immunization status was the length of time that mother had been living in Shahriar.

Conclusion: There are some barriers in vaccination delivery, including unefficient recall and follow up systems and scattered records of dT vaccination. These factors were statistically associated with immunization status and therefore some proper solutions against these barriers should be introduced. It is now time for a boost to be given to both quality and sustainability of appropriate immunization programs.

Relationship between milk-feeding patterns in infancy and obesity among 5-6 year-old children of kindergarten and pre-elementary schools in Qazvin

Introduction: Obesity is a problem to individual’s health and determintion of its causative factors is essential for prevention of obesity and maintenance of health.
Materials and Methods: This research is a case-control analytic study (prospective) which has been conducted in kindergartens and pre-elementary schools affiliated to health organization in Qazvin city. After a preliminary study on twenty 5-6 year-old children, 35 obese (case) and 70 normal (control) children were chosen. The kindergartens and pre-elementary schools were selected based on random cluster case-picking method. The tools were a questionnaire, tape meter and spring scale. The obesity was defined as a weight/ height ratio more that two standard deviation above average for sex. The statistical tests were 2, t test and Mann-Whitney test.
Results: The findings showed that the individual characteristics of the child, except weight birth and playing hours, were congruous in case and control groups. Also there was no significant difference between milk-feeding patterns in case and control groups, 77.1% and 85.7% dominant feeding on mother's milk, 20% and 8.6% feeding on formula and 2.9% and 5.7% feeding jointly on mothers milk and formula, respectively. In case of length of each feeding pattern group, no meaningful difference in two groups was found. Therefore all the survey hypotheses were rejected.
Conclusion: According to the research findings, no meaningful relationship between feeding patterns in infancy and obesity in 5-6 year-old children was found and hence probably other factors are playing a role in predisposing to obesity. It is recommended that more extensive researches being carried out in this field.

Evaluation of immediate effect of foot massage on patient’s vital signs in a general intensive care unit

M Shaban

Introduction: Massage of the limbs is a safe procedure that could have therapeutic effects and cause physical and psychological relaxation of patients in intensive care unit (ICU).

Materials and Methods: This survey is a quaziexperimental study that assessas immediate effects of foot massage on patient’s vital signs in a general ICU. After a pilot study, a sample size of 50 patients was chosen. A questionnaire about demographic data and a 3-table checklist for recording vital signs (heart rate, peripheral O2 saturation and mean arterial pressure) was used. The data gathered by interview and physiologic measurement. For every patient, vital signs were recorded every 1 minute interval for 5 minutes (after completing the demographic data). Then foot massage was applied for five minutes and during the massage patients’ vital signs recorded every minute. Immediately the patients’ vital sings were recorded every minute for five minutes. The mean of each parameter was calculated and compared the values at baseline, during massage, and after massage.

Results: The findings showed that there was a significant difference between mean heart rate, mean arterial pressure and mean spO2 before and during foot massage (p<0.0001). Difference between mean heart rate, mean spO2 and mean arterial pressure during and after foot massage was not significant but, deference of mean heart rate and mean arterial pressure before and after massage was significant (p< 0.0001). Difference of mean spO2 before and after massage was also significant (p<0.003).

Conclusion: According to the findings of this study, foot massage has a potential beneficial effect on patients vital signs and last at least for 5 minutes. This effect could be due to increasing relaxation which moderates the changes of vital signs, caused by stress.