Journal of Hayat

The History of Nursing Research and the Process of Capacity-Building in Nursing Research

Masoud Fallahi Khoshknab

Nearly a century has passed since the establishment of nursing education programs in Iran. The first nursing school was established in 1916 (1294 Solar Hijri) in Urmia and moved to Tabriz after a year due to the World War.

Also, nursing research in Iran has a history of nearly half a century. Nursing research in Iran first began independently in 1970s (1350s SH) with starting admission in master of nursing by nursing schools. Before that, nurses usually participated in studies as an assistant. Most nursing research in this decade included descriptive research performed by master students as their dissertations which were mainly guided by non-nurse supervisors.

In 1980s (1360s SH), nursing research became more analytical and nurses began to analyze the contributing factors in addition to their description and conduct epidemiological studies. The research findings were often presented in medical congresses, however few scientific congresses were held by nursing and midwifery schools in this decade which had significant role in current status of nursing research.

Relationship between Perceptions of Organizational Culture with Patients’ Safety Behavior among Nurses in Babol

Hossein Jafarpour

Background & Aim: Governing organizational culture in hospitals can affect patients’ safety through establishment of behavioral norms among nurses. This study aimed to determine the relationship between nurses’ perception of organizational culture and their performance about patients’ safety .

Methods & Materials: In this cross sectional, descriptive-correlation study, we used stratified sampling method to recruit 250 nurses working in general wards and emergency departments of general hospitals in Babol, 2013. Data were collected through questionnaires and were analyzed using the descriptive and inferential statistic tests including the Pearson test, ANOVA test and T-test in the SPSS .

Results: Nurses' perception of organizational culture was "fairly desirable" (54.5%). Performance of the nurses in the field of patients' safety was "desirable" (88%). The Pearson test showed that there was a positive and statistically significant correlation between nurses’ perception of organizational culture and their performance in the field of patients’ safety (P<0.01) .

Conclusion: It seems that improving organizational culture in hospitals can enhance nurses’ performance in the field of patients' safety .

Nurses' Performance in Prevention of Ventilator associated Pneumonia

Mitra Zolfaghari

Background & Aim: The ventilator associated pneumonia is a common problem in critical care units. It is associated with increased mortality, cost and length of stay. Nurses have great role in preventing the ventilator associated pneumonia. The aim of this study was to assess nurses' performance in prevention of ventilator associated pneumonia .

Methods & Materials: In this descriptive study, 110 nurses working in selected hospitals affiliated to Tehran University of Medical Sciences were selected using convenience sampling method. A 32-item observational checklist was provided based on the ventilator associated pneumonia prevention guideline. The nurses' performance was observed three times. Data were analyzed using descriptive statistics in the SPSS-16 .

Results: This study showed that the mean score of the nurses' prevention was 46.8±5.79. Most of the nurses (66.4%) had poor performance and 36.6% had relatively good performance. There were no nurses with favorable performance in the prevention of ventilator associated pneumonia. The highest score was in contact precaution (72±9.67) and the lowest score was in mouth hygiene (18.78 ± 17.4) .

Conclusion: The majority of nurses had poor performance in prevention of ventilator associated pneumonia. More attention should be paid for planning appropriate training programs for nurses and giving adequate facilities to improve health care quality .

Prevalence, Types of Medication errors and Barriers to Reporting Errors by Nurses in an Educational Hospital in Kermanshah

Alireza Khatony

Background & Aim: The most common types of medical errors are medication errors. Medication errors can cause serious health problems and should be considered a threat to patients' safety. The aim of this study was to investigate the prevalence and types of medication errors and barriers to reporting errors by nurses in an educational hospital in Kermanshah University of Medical Sciences in 2012 .

Methods & Materials: In this cross-sectional study, 96 nurses working in an educational hospital were randomly selected to the study. Review of medication errors and reporting them over the last three months were assessed using a valid and reliable questionnaire. Data were analyzed using the SPSS-20.

Results: The prevalence of medication errors was 79.2%. The most common errors included giving oral drugs by mistake (53.1%) and medication later or earlier than the stipulated time (41.7%), respectively. Reporting the medication errors was 14%. Among the barriers to reporting the errors, barriers related to administrative issues were more highlighted than the staff relating barriers.

Conclusion: The results showed high prevalence of medication errors and low rates of error reporting. Holding periodic courses on safe medication and using management strategies to encourage nurses to report errors are recommended.

Effect of Increased Intravenous Hydration on Duration of Labor and Outcome of Pregnancy among Nulliparous Women: a Randomized Controlled Trial

Ali Delpisheh

Background & Aim: Limitation of fluid intake in parturient can affect uterine contractions. Several studies have been conducted on the effect of hydration in labor progress and reported different results. In the present study, we evaluated the effect of over IV hydration on duration of labor and outcome of pregnancy in parturient women .

Methods & Materials: In this randomized clinical trial, 120 nulliparous women admitted to Ilam Mustafa Hospital were selected from February 2010 to December 2010. All participants had non-complicated singleton pregnancies and were randomly assigned in four groups. The first group received usual care while the second to fourth groups received lactated ringers at 60, 120 and 240 ml per hour (IV fluid groups), respectively throughout active labor phase. All women had unrestrictedly access to oral fluids. The analysis was done using the ANOVA and Chi-squared tests in the SPSS-16. The p-value less than 0.05 were considered to be statistically significant .

Results: Key variables known to affect labor outcomes were statistically similar in all groups. The mean duration of active phase of labor was lower in the intervention groups in comparison with the control group. All groups had significant differences in the duration of second stage of labor, Oxytocin augmentation, and prolonged labor. There was a trend toward a lower frequency of the Cesarean deliveries in the 240 ml group however it was not significant. There was no significant difference in the Apgar scores between groups .

Conclusion: Over IV hydration reduced duration of labor. There were no reports of poor outcomes for mother and infants .

Effectiveness of Education based on Orem’s Self-Care Model in Self-Care Activity of Patients with Implantable Cardioverter Defibrillators

Mohsen Salavati

Background & Aim: Several studies have shown that the self-care activity of patients with implantable cardioverter defibrillator is inadequate. This study was conducted to assess the effect of an educational program based on the Orem’s self-care model in self-care ability of the patients .

Methods & Materials: This clinical trial was conducted among 66 patients with implantable cardioverter defibrillator. Four educational sessions were held based on the patient's needs and Orem’s self-care model. Data was collected using a self-report questionnaire at baseline and one month after the intervention. Data were analyzed using statistical tests (x², t-test, paired t-test) in the SPSS-18 .

Results: There were no significant differences in the self-care awareness, tendency to self-care, self-care skills, and self-care ability between the control and intervention groups. After the intervention, the self-care awareness score remained 22.06 ± 3.26 in the control group and increased (28.69 ± 1.51) in the intervention group (P<0.000). There was also significant difference in the tendency to self-care between the control (25 ± 3.31) and intervention (28.9 ± 1.33) groups (P<0.000). The self-care skills differed significantly between the control (14.9±3.06) and intervention (29.03±1.15) groups after the intervention (P<0.000). After the intervention, the self-care ability was also significantly different among the control (61.96±8.06) and intervention (86.63±2.93) groups (P<0.000) .

Conclusion: The results of this study showed that implementing educational programs based on the Orem’s self-care model can improve self-care ability in patients with implantable cardioverter defibrillator. Applying this method is recommended in nursing interventions to promote health status of the patients .

Psychometric Analysis of Persian Version of Body Image flexibility Questionnaire (BI-AAQ) among University students

Javad Karimi

Background & Aim: Body image flexibility is defined as the capacity to experience the ongoing perceptions, sensations, feelings, thoughts, and beliefs associated with one's body fully and intentionally while pursuing chosen values. This study was aimed to translate Body Image flexibility Questionnaire (BI-AAQ ) into Persian language and assess the validity and reliability of the translated version as an instrument to measure body image resilience .

Methods & Materials: In this cross-sectional study, 354 students (130 males and 224 females) studying in an academic year (2012-2013) at Tehran University of Medical Sciences were selected through convenience sampling method . Students filled out demographic questionnaires, "body image flexibility questionnaires", "acceptance and action questionnaire edition 2", and "depression, anxiety and stress scale". For data analysis, IBM SPSS 21 and IBM SPSS Amos 21 software were used .

Results: The test-retest coefficient was 0.72. The correlation of the scale with the weight consent, psychological flexibility, stress, depression and anxiety was -0.54, 0.33, 0.33, 0.45, and 0.37, respectively which represented the concurrent validity of the scale. Confirmatory factor analysis results also showed that single-factor model of body image flexibility questionnaire has good fitting the Iran' community. Internal consistency reliability was estimated with Cronbach ’s alpha (α=0.87) .

Conclusion: Psychometric characteristics of the body image flexibility questionnaires showed that the questionnaire seems to be acceptable in Iranian society. It is a useful tool for research in the psychological and psychiatric clinics .

Relationship between Problem Solving and Assertiveness Skills among Nursing Students

Zeinab Moshirabadi

Background & Aim: The nature of clinical practice has altered in recent years. It has been affected by different kinds of problem-solving models' so, the problem-solving skill is necessary in practice for nurse practitioners. Besides assertiveness is a critical element which persuades nurses and nursing students to establish good relationships and use their knowledge and professional skills effectively. The aim of this study was to assess the relationship between problem solving and assertiveness skills among undergraduate nursing students .

Methods & Materials: This was a descriptive correlational study. The study was carried out in the School of Nursing and Midwifery at Iran University of Medical Sciences. The study population included all students enrolled in the four-year nursing program in 2009-2010. Data were collected using the Heppner and Petersen’s problem solving inventory and Rathus assertiveness schedule. Data were analyzed using the ANOVA, independent sample t-test and Pearson Correlation Coefficient tests in the SPSS .

Results: Three hundred and twenty two students participated in this study. The students' problem-solving skill (mean=89.5) and assertiveness (mean=12.1) were moderate. The study showed that last year students reported higher assertiveness skill than the freshmen (F=2.85 P≤0.037). The level of assertiveness was correlated with the level of problem-solving skill .

Conclusion: Educational programs should provide opportunities for nursing students to enhance life skills such as problem solving and assertiveness skills. Nursing schools should improve students' skills in clinical approaches to be better care professional .