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Introduction: Evaluation of health care services is an essential step in improving health care quality and without it such an improvement could not be achieved.

Material and Methods: In this descriptive study, parent’s satisfaction of child’s health care in the health and treatment centers affiliated to Tehran University of Medical Sciences was evaluated. Four hundred parents who had attended 25 health and treatment centers were participated in this research. A questionnaire was completed through the interview with parents of 1 to 12 months old children. Analytical and descriptive statistics were used for the analysis of data.

Results: The finding of this study showed that the majority of parents had average levels of satisfaction concerning communication’s skills of health care providers and high levels of satisfaction about availability of these cares. Satisfaction of parents in the section of the vaccination was high and majority of samples had average levels of satisfaction about growth monitoring of children. There was a relationship between infant&aposs age and parent’s satisfaction.

Conclusion: Based on these findings recommendations have been made for future research. The findings of this study can be utilized in public health planning in order to improve the quality of the infant’s health care services.

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Background & Aim: Although cervical cancer has high prevalence, few qualitative studies have been carried out to reflect the perceptions of women on the influential factors that affect cervical cancer screening in Iran. The aim of this study was to explore a culturally-based experience of Karaji women regarding the barriers to and motivating factors for Pap smear screening test among Karadj women in 2007.

Methods & Materials: In this content analysis, eight focus groups were conducted using semi-structured guide questions (n=86).

Results: Findings revealed that factors such as medical advice, advice from friends and family, knowledge about symptoms and pap smear screening method, free and accessible services, and perceived threats would influence the women to undergo a Pap test. Major barriers were lack of knowledge about cervical cancer and its causative factors, inappropriate beliefs, fear from cancer diagnosis, and pain related to the procedure.  

Conclusion: Regarding the influencing factors on the rate of Pap smear screening test, it seems that designing appropriate educational programs in order to promote knowledge and correct health beliefs using mass media and local communications will result in referring more women to undergo Pap smear screening test.

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Background & Aim: Urinary tract infection is one of the most prevalent complains among elderly in primary care centers. The purpose of this study was to assess urinary tract disorders and prevalence of urinary tract infection in residents of Kahrizak elderly House.

Methods & Materials: In this cross-sectional study, 142 men and 114 women (mean age: 76.03±8.32 years) were randomly selected for the study. Data were gathered using a questionnaire. Weight and height of the participants was measured and urine cultures were ordered. Data were analyzed using c² and Fisher‘s exact test. The P<0.05 denoted statistical significance.

Results: Findings showed that 34% of elderly had urinary tract infection. Of those, 55% (46 cases) were women and 45% (41 cases) were men. Prostate hypertrophy (32.5%) and gyneacologic disorders (16.9%) were the most diagnosed disorders (P<0.05).

Conclusion: The prevalence of urine tract infection in elderly with urinary system disorders is high. Recognizing at risk elderly and referring them to the health care centers can prevent urinary tract infection and its complications.

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  Background & Aim: Patients with end-stage renal disease undergoing hemodialysis are repeatedly exposed to stress and pain from approximately 300 punctures per year to their arteriovenous fistula . Patient comfort with the procedure is therefore of greatest importance for long-term compliance with the treatment and until a successful renal transplant. This study was conducted to determine the effect of rhythmic breathing on pain intensity when the needles are inserted into vascular access for hemodialysis .

  Methods & Materials: This was a quasi -experimental one-group time-series study. Thirty five patients in hemodialysis ward of Hamadan Besat hospital entered into the study via convenient sampling method. In this study, pain intensity during the insertion of hemodialysis vascular needles was measured in six sessions through two methods of routine intervention and rhythmic breathing. The data were collected using visual analog scale. Paired t-test was used to determine pain intensity mean difference between the two conditions . 

  Results: Overall, the results showed that the mean pain intensities were 5.45±1.15 and 2.19±0.92 in two conditions including routine intervention and rhythmic breathing , respectively. Paired t-test showed a significant difference between the routine intervention and rhythmic breathing (P<0.001) .

  Conclusion: These findings showed that rhythmic breathing was effective in reducing pain when the needles were inserted into the vascular access. Therefore, it is recommended to use rhythmic breathing as a simple and non-expensive method to reduce pain in patients before insertion of hemodialysis vascular needles .

  

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  Background & Aim: Exacerbation of the symptoms among patients with chronic obstructive pulmonary disease is a part of the disease's cycle . Despite having medical treatments, most patients experience severe degrees of dyspnea. Self-management programs can help relieving the symptoms. T his study aimed to assess the effect of a self-management program on dyspnea and fatigue severity in patients with chronic obstructive pulmonary disease (COPD) .

  Methods & Materials: In this randomized clinical trial, 50 patients with COPD referred to Apadana clinic in Ahvaz were recruited into the study. Patients were randomly allocated to control and intervention groups. The intervention group received a self-management program designed based on the 5A model the control group did not receive any intervention. Patients were assessed using the Fatigue Severity Scale and the Borg Dyspnea Scale at baseline and three month later. The Chi-squared test and t-test were used to analyze the data . 

  Results: There was no significant difference between the two groups in fatigue severity at baseline. At the end of the three months, the fatigue severity score differed significantly between the two groups (P=0.004). There was also significant reduction in the patients' dyspnea in the intervention group than the control group after 12 weeks (P<0.001) .

  Conclusion: Our program was effective in reducing the COPD symptoms among patients. This simple and non-expensive program can be applied as a beneficial intervention to decline major difficulties of the disease among patients with COPD .

  

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Background & Aim: Given the importance of mothers’ health and considering that developmental delay in children affects their mothers’ mental health this study aimed to compare stress and perceived social support in mothers of 6-18 month old children with and without developmental delay.

Methods & Materials: This cross-sectional, analytical study was performed on 610 mothers and their 6-18 month-old infants in health centers affiliated to Shahid Beheshti University of Medical Sciences. The participants were selected through the multi-stage random sampling. To collect data, the following questionnaires were used: obstetric and demographic characteristics, socio-economic status, infants’ characteristics, the Cohen perceived stress scale, perceived social support, and Ages and Stages questionnaire to determine the children’s development status. The data were analyzed by SPSS v.19 software and using descriptive statistics, Pearson correlation, chi-square, independent t-test and Man-Whitney statistical tests.

Results: The mean age of infants were 10.68±4.5 months. Independent t-test revealed a significant difference between mothers’ perceived stress (P=0.004) and social support (P=0.01) in the two groups. In addition, a relationship was observed between the mother’s social support and stress (P<0.04).

Conclusion: The results showed that mothers of children with developmental delays have more stress and lower perceived social support than mothers of normal children. Therefore, it is recommended to perform developmental screening for further examination and the reduction of mothers’ stress, as well as to provide appropriate social support.

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Background & Aim: Besides medical treatment, self-care education is necessary for patients with heart failure. The aim of this study is to compare the effect of telenursing and education without follow-up in the caregivers of heart failure patients on the self-care behavior and clinical status of heart failure patients.

Methods & Materials: This clinical trial (IRCT2016080829184N2) was performed on 66 heart failure patients referred to the clinic of Taleghani hospital in Abadan in 2015-2016. The patients were randomly divided into three groups: control, intervention-1 and intervention-2 groups. Control group did not receive any intervention. Patients and caregivers in the intervention-1 group received verbal education, and caregivers in the intervention-2 group received continuous phone follow-up plus verbal education. Self-care behavior, fatigue severity and exercise tolerance were assessed in the patients by the self-care behavior questionnaire, fatigue severity scale and six minutes walking test at baseline and the end of 3 months. Descriptive statistics, chi-square, paired t-test, ANOVA, ANCOVA and Scheffe post hoc test were used to analyze the data using the SPSS software v.18.

Results: At baseline, three groups were consistent in terms of demographic variables and three variables. At the post-test, there was a significant difference between the intervention-2 group with the control group and intervention-1 group in self-care behavior (P<0.001) and the patients’ fatigue score mean (P<0.004). But, no significant difference was observed between three groups in the patients’ exercise tolerance score mean.

Conclusion: Telenursing for the caregivers of heart failure patients can lead to the improvement of self-care behavior and decrease in fatigue among the patients.

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Background & Aim: Patient monitoring in cardiac intensive care unit (CICU) is considered to be non-invasive and safe, but it can cause unintentional catastrophic consequences due to the alarm fatigue. The aim of the study was to determine the status of monitoring system alarms and nurses’ alarm fatigue.
Methods & Materials: This descriptive, cross-sectional study was carried out in cardiac intensive care units of a hospital in Fars province from January to March 2019. The alarm status of 24 monitoring devices was observed for 100 hours in 100 patients under the physiological monitoring. Patients under monitoring were included in the study using a continuous and convenience sampling. Also, 62 nurses working in five CICUs of this hospital completed the alarm fatigue questionnaire (through census). The data obtained from the observation and the questionnaires were analyzed by the SPSS software version 16 using descriptive statistics.
Results: The auditory alarms of monitoring devices were turned off and only visual alarms could be recorded. In the visual alarms recorded during 100 hours, 131 alarms (53.47%) were technical, followed by the false, nuisance, and ultimately real or actual alarms with rates of 40 (16.33%), 38 (15.51%) and 36 (14.69%), respectively. The mean (and standard deviation) score of alarm fatigue among nurses was 21.04 (7.52), and the alarm fatigue score for %50 of nurses was higher than the average score.
Conclusion: Turning off the auditory alarms can lead to serious risks to patients. Also, a high proportion of technical, nuisance, and false alarms can cause alarm fatigue in nurses. Adopting solutions in accordance with standard guidelines and checking physiological monitoring devices in hospitals are necessary in order to reduce false, nuisance, and technical alarms. Failure to pay attention to these issues leads to the alarm fatigue among nurses, which itself results in numerous consequences such as compromising the patients’ safety.
 

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Background & Aim: Caring for children with congenital heart disease is very challenging for their parents, and the mothers of these children have a low quality of life. The aim of this study was to evaluate the effect of discharge planning on quality of life among mothers of children with congenital heart disease undergoing surgery.
Methods & Materials: In this quasi-experimental study, 72 mothers of children with congenital heart disease referred to Shahid Rajaie Cardiovascular center in Tehran in 2019 were included in the study using the continuous sampling method and non-randomly allocated to experimental or control groups (36 in each group). Data collection tool included demographic questions and the SF-36 questionnaire, which was completed before and two months after the intervention. The intervention was performed in six thirty-minute training sessions at the time of admission, during hospitalization and discharge. The training follow-up continued for two months after discharge. Data was analyzed by the SPSS software version 20 using Chi-Square test, independent t-test and Fisher's exact test.
Results: The mean score of quality of life before the intervention was 58.93±19.35 in the experimental group and 64.93±16.78 in the control group, and there was no significant difference between groups (P=0.165). Two months after the intervention, the mean score of quality of life was 73.44±17.81 in the experimental group and 73.67±16.49 in the control group, and there was no statistically significant difference between groups (P=0.956).
Conclusion: The discharge planning did not improve the mothers’ quality of life. It is suggested that in addition to educating about proper care of the child, psychological support be provided for mothers while implementing discharge planning.
Clinical trial registry: IRCT20180501039489N3
 

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Background & Aim: Anxiety and hemodynamic changes are common complications of surgeries. The aim of this study is to investigate the effect of foot reflexology massage on overt anxiety and physiological parameters of patients undergoing tibia plaque surgery.
Methods & Materials: In this clinical trial study, 96 eligible patients who were candidates for Tibia plaque surgery, referred to Imam Ali (AS) Teaching Hospital in Bojnourd in the spring of 2016, were selected by the convenience sampling method. Then, they were randomly divided into two groups of 48 people: experiment and control. For the experiment group, one hour before the operation, the foot reflexology massage was performed for 10 minutes. For the control group, the foot was touched for 2 minutes. Patients’ anxiety was measured using the Spielberger Manifest Anxiety Questionnaire before and one hour after the intervention, and patients’ physiological parameters were measured before and after the intervention and at 2, 4, 6, 12 and 24 hours after the surgery. To compare and analyze the data, chi-square tests for qualitative variables and t-test, Mann-Whitney test and Repeated Measure ANOVA for quantitative variables were used on the SPSS software version 21.
Results: This study showed that the average score of anxiety after the intervention was significantly different in both the control and experiment groups (P=0.038). Also, Foot reflexology massage significantly reduced systolic blood pressure after the intervention (P=0.039) and 4 hours after the surgery (P=0.007), and also reduced diastolic blood pressure immediately after the intervention (P=0.001). Heart rate decreased significantly at all measured times after the intervention (P<0.05).
Conclusion: Foot reflexology massage can reduce overt anxiety and improve physiological parameters of patients undergoing tibia plaque surgery. Therefore, this method can be used for reducing anxiety in the patients candidate for orthopedic surgery.
Clinical trial registry: IRCT20200502047265N1