Journal of Hayat

Quasi experimental research on anxiety and satisfaction of patients undergoing open cardiac surgery having intubation

Z Parsa-Yekta

One of man's fundamental needs is communication. Nurses within their specialty sense this need in their relationship with their patients, even though in some cases with physical impediments e.g. the placing of bypass tubes, this relationship is endangered. This study is a quasi experimental research, whose main aim is to compare the effects of two types of communication methods on anxiety and satisfaction in patients after cardiac and bypass surgery having intubation, warded at chosen hospitals affiliated to the Tehran University of Medical Sciences. According to the specific criteria, 90 patients were randomly selected by divided into two groups (experimental and control). The researchers met all patients the day before the surgery explained the reason and use of the picture chart for the experimental group and the routine communication methods for the control group. Therefore on the day of surgery communication was established with both groups with their own particular method. Data collection was done through a questionnaire consisting of: 1) demographic specification and clinical history, 2) Spielburger's questionnaire for obvious anxiety and 3) visual analogue scale (10cm) for patient satisfaction evaluation which is undertaken the day after surgery and after extubation. The results of the χ² test and the Fisher's exact test showed significant statistical differences between the two groups concerning the level of the patient's anxiety and satisfaction. The use of the picture chart for the experimental group, decreased patient's anxiety resulting from speech disability and increased their satisfaction with their communication with nurses as compared to the control group. Considering the beneficial results from using picture charts in establishing communication with patients, nurses with the help of devices, must try to create better relationships with intubated patients in the post-surgery period and provide them with more desirable services.

Study in quality of life of women suffering from urinary incontinence

A Rezai-Pour

Urinary incontinence is a common problem in women. It seems to have negative effects on different aspects of the patients' life. This study was undertaken to determine the quality of life in women with urinary incontinence with referred to hospitals affiliated to Tehran University of Medical Sciences. The samples consisted of 263 women all over the age of 18. None of them were pregnant, had not delivered babies last 3 months, had no chronic diseases, were willing to answer questions posed and were also randomly chosen. The samples of the questionnaire about quality of life were collected using I-QOL and variables of type of urinary incontinence, intensity of urinary incontinence, duration of illness, occupation and education were taken into consideration. Analysis of data has been done by using SPSS Statistical tests 2, Pearson and Mantel - Hanzel. Findings of this research indicated that none of the patients led a comfortable life and (45.2%) of them suffered from a quality of life below standard. 51.3% of the women until the time of the study had not visited a physician and 54.8% of them had the impression that the symptoms seemed to be a normal and common problem and that is why they did not seek professional help. The results also indicated that the effect of urinary incontinence was significantly related to the type of urinary incontinence (p<0/0001), duration of the disease (p<0/02) and level of education (p<0/006). In conclusion despite the negative effects of urinary incontinence on the quality of life of women, most of the patients did not seek professional help. It is suggested that the health care providers pay more attention to this issue and utilizing health care centers, train women in the prevention of urinary incontinence.

Perspective of the nursing staff at hospitals affiliated to the Tehran University of Medical Sciences on the roles and activities of the nurses

S Zokaie Yazdi

Nurses play various roles and have various responsibilities in helping patients or other members of the society for example in training, providing support, caring, and in coordinating. The proper performance of these services is dependent on their undertaking of these various responsibilities. Nurses with increased knowledge as to their responsibilities and the proper fulfilling of these in the various fields can be influential in the success of treatment measures. This research is a descriptive study to assess the nursing staff’s perception of their roles and activities at hospitals affiliated to the Tehran University of Medical Sciences, conducted on a random sampling in the years of 2001 -2002. Some 104 male and female members of the nursing staff, randomly chosen, participated in this research. The data was collected by means of some questionnaires of 3 parts containing 8 questions related to demographic characteristics, 41 questions related to the quadric roles namely, teaching, supporting, protecting, coordinating, and 2 open questions regarding obstacles and their suggestions in preventing these obstacles. Analysis of data has been done by using SPSS descriptive and inferential statistics. The results with respect to the roles of nurses in different fields show that most of their roles were in teaching activities in relation to patients, in support relating to stressful and upset patients, in the field of protection during catheterizing and dressing and coordinating daily visits. Results relating to the level of performance of these responsibilities are as follows 31.7% in training activities, 35.6% supporting activities, 38.45% protection and 54.8% coordinating activities, respectively, stood at a favorable level. The greatest percentage of unfavorable performance was noted in the supporting role of the nurses. The results also showed that the level of readiness of the nurses to perform the above mentioned four roles was registered as average to good. In addition some factors such as frustration, lack of on the job training, insufficient number of personnel, lack of proper facilities, and insufficient income…, have a great impact on nurses and the removal of obstacles in the performance of their duties.

Study of quality of life and its patterns in different stages of menopause for women in Tehran

Sh Golyan Tehrani

Menopause is a physiological change for women, which occurs between 40-59 years of age and has a great impact on their life quality and its patterns. This is a descriptive and analytic research, which was carried out to assess the impact of menopause and some socio-demographic and medical variables on quality of life and its patterns in Tehran in 2001. Samples were taken at random from 210 healthy women aged between 40 to 60 years and in four groups: pre-menopausal, about menopausal, menopausal and post-menopausal women with duration of less than or more than 5 years. The data was collected via a special questionnaire through interview. Analysis of data has been done by using SPSS Statistical tests 2, Bonferroni and LSD. The findings show that quality of life and its patterns were related to the menopausal stage with the highest percentage related to pre-menopausal women and the lowest to post-menopausal with a duration of 5 five years (p<0/0001). The results of the study were affected by different factors such as menopausal signs, marital situation and the age of the samples but there was no relationship with duration of the menopause, job, education, financial situation of the women, the age of the woman's first menstruation, and the number of children staying with the family. According to the findings, it is suggested that the health program designers and decision makers develop special plans to enhance women's quality of life and patterns, especially women who are about menopausal age (the first five years).

Perspective of nurses on effective factors on their decisions to administer PRN analgesics to children after surgery

R Karimi

Post-surgery pain is usually controlled by PRN drugs administered by nurses. According to the decision-making theories, this clinical decision-making depends on three factors: nurse-related factors child-related factors and hospital-related factors. This study deals with the first and second factors mentioned. This descriptive-analytic study aims at determining the perspective of nurses on factors which affect their decisions to administer the analgesic PRN to children after surgery in several chosen hospitals of Tehran. The study used a standardized questionnaire to collect data from 57 nurses in pediatric surgery wards. The questionnaire consisted of three parts: 1) nurses demographic data 2) 20 clinical scenario for nurses to make a decision for prescribing either analgesic medication, non-analgesic medication or no medication where necessary and 3) 12 factors which affect clinical decision-making in using analgesics.(in prioritizing among the above mentioned). The results show that factors such as age, nursing experience, pediatric nursing experience and motherhood were significantly related to choosing to use analgesics. Education and personal experience of extreme pain was also related to the type of analgesic chosen. Concerning the specifics of the children there was a significant difference between the choice to use analgesics and the type of analgesic used according to the various ages of the children. There was also a significant relationship between the type of surgery and the time of surgery and with the choice to use analgesics and the type of analgesics used, such that medication and analgesics were administered more frequently for complicated surgeries and in first 24 hours after surgery. Type of surgery, severity of pain, time of surgery and uneasy behaviors were selected respectively as the most effective in the administration of PRN analgesic drugs. Nurse and child related factors strongly influence nurses in making decisions to administer PRN analgesics postoperatively.

Study of the practice of female medical students in the prevention of iron deficiency anemia due to menstruation

Iron deficiency is the most common nutritional deficiency in the world. Women at childbearing age are at particular risk of developing iron deficiency due to the iron losses associated with menstruation and childbirth. Therefore, iron supplements are needed in certain groups, while in particular regions increased dietary intake could be provided through food. This descriptive study attempts to identify practice among university students of Tehran University of Medical Sciences in the prevention of iron deficiency anemia due to menstruation in the year 1999. This study includes 257 university students of different majors (such as medicine, dentistry, pharmacy, obstetrics, nursing, nutrition, health (occupational, Public) laboratory sciences) of the Tehran University of Medical Sciences who were selected through a simple random sampling method. The pattern of study was a questionnaire consisting of 37 questions, in addition to a chart to determine food consumption frequency. The questionnaire was divided into three sections: demographic data, the status of nutrition, and iron supplementation. To analyze the data descriptive statistics and (2) test were used. The results showed that the most of the samples were in the age group of 21 to 25 years and 36.5% of them stayed in dormitories. Most of the subjects of study had moderate nutrition and some of them had good nutrition. The majority of them (92.5%) were not using the iron supplements during the menstruation period and the duration between two subsequent menses. The results of the research show that the function of 35.2 % of the subjects of study in relation to the prevention of iron deficiency was weak, 53.9% of them were moderate and only 10.9% of them were good. The statistical test (2) which was used to analyze the results obtained, showed a significant relationship between the practice of the subjects and their living in a dorms (P<0.001). In conclusion, the application of the results for further researches and also for practical use has been proposed.

Effect of path analysis factors on total fertility rate in Iran in 2000

Total fertility rate relates to the number of children that a woman bears in the fertility period of her life. Fertility function is one of the most important health and population indicators. This indicator affects social, health, economic and cultural factors. This study is an ecological or correlative one. Factors affecting total fertility rate in Iran in the year 2000 are studied in this paper. The factors include coverage of women with focus on higher education, infant mortality rate (under 1 year), women’s occupation rate, urbanity ratio, mean age in the first marriage of women in the age group 15 to 49 years as per the last census in Iran in 2000 in 26 provinces. The direct and indirect effects of these factors on total fertility rate, with emphasis on path analysis have been determined. Data analysis shows that women's occupation rate is the most important factor in decreasing total fertility rate. Higher education of women is also an important element in this regard. Therefore increase in the number of women with university education not only decreases the total fertility but also increases the occupation of women.

Premature rupture of membrane (PROM)

For diagnosing PROM, the need has been acutely felt for special care in obstetrics. Coordinated management for patient care between the clinician and midwives is the custom in several obstetric care centers. Diagnosis and treatment by the physician has greatly facilitated the work of midwives, to the extent that they now play an important role in the special nursing of women in solving obstetrics. This article reviews important topics such as: epidemiology, physiology, pathology and patho-physiology. It also covers preventive measures, objective and subjective evaluation, diagnostic tests and management of PROM, as well as the psychological aspects of hazards for motherhood, fetus and childbirth.