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Background & Aim: Sleep is an important physiological process that has deep effects on psychological and physical health. This study carried out to investigate the association between quality of sleep and health-related quality of life in nurses.

Methods & Materials: In this cross sectional and descriptive-analytic study, 127 nurses in Imam Hossein Hospital of Shahroud, Iran, during February and March 2006 were chosen enumeration and then their sleep quality and their quality of life in eight dimensions were measured with using Pittsburgh sleep quality index (PSQI) and 12-item short form health survey (SF-12) questionnaire and were compared. The data were analyzed using SPSS 11.5 software.

Results: Upon to the results of this study, 25.2%, 70.9% and 3.9% of cases were working on morning shift, circulator shift and afternoon/night shifts respectively. Mean of time that they spend in bed were estimated 30.2 minute and 2.1% of subjects declare they get to sleep more than 30 minutes after going to bed. Mean of gotten up time in the morning in was at 6 and 58% of them described that they wakeup 1 hour earlier to anticipation time. According to the results, 35.5% of subjects have taken medicine (prescribed or "over the counter") to help them sleep. Spearman correlation coefficient test revealed a significant correlation (p<0.05) between the mean of Sleep Quality score and the mean of quality of life score in all dimensions in subjects.

Conclusion: According to the results, quality of sleep is poor in majority of nurses and significantly has decreased their quality of life in different aspects, especially in general health, mental health and physical pain.

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  Background & Aim: Insertion of chest tubes is a necessary measurement in chest trauma. The trauma patients need specific skills for self-care. This study aimed to determine the effect of using supportive-educative system on self-care skills in trauma patients with chest drainage system .

  Methods & Materials: In this quasi-experimental study, 62 trauma patients with chest-tube were selected from three surgery wards of Besat hospital in Hamadan from December 2012 to May 2013. Two wards were randomly allocated into the experiment group (n=31) and one ward was allocated into the control group (n=31). Participants were selected using convenience sampling. The supportive-educative system was designed based on the patients’ needs and was implemented to the experimental group in three consecutive days. The study instruments included self-care needs assessment form and self-care skills checklist. Measurements were completed once the patients were admitted to the wards and three days later by an external observer. Data were analyzed using t-test, Chi-squared test, Mann-Whitney and Wilcoxon tests with a 95% confidence level in the SPSS-16 . 

  Results: There were no significant differences between the two groups in the study variables at baseline (P>0.05). Although self-care skills in both control (P<0.01) and experiment (P<0.001) groups were improved, using educative-supportive system led to better self-care skills in the intervention group in compare to the control group (P<0.001) .

  Conclusion: In general, self-care skills of patients with chest drainage system could be improved by supportive-educative system. The improvement in the control group can be attributed to self-care trainings conducted routinely by doctors and nurses .

  

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  Background & Aim: Depression is common among nursing and midwifery students. Problem-solving is a short-term intervention that can be used to treat psychological problems. This study was carried out to evaluate the effect of problem-solving skills training on depression scores among nursing and midwifery students .

  Methods & Materials: This was a clinical trial. Nursing and Midwifery st udents (n=900) studying at Tabriz and Urmia universities were recruited in the study during 2 010-2011. The Beck Depression Scale was administered in both schools. Ninety two students who achieved a score above 10 in the Beck Depression Scale were selected. One school was randomly allocated to the intervention group and the other one was allocated to the control group. Students in the intervention group received six sessions of problem-solving skills training within three weeks. T he questionnaire was completed by the participants in both schools after the intervention. Data were analyzed using the independent t-test . 

  Results: After the intervention, the Beck Depression Inventory score in the intervention group decreased from 18.60 to 13.41 (P<0.01). There were no differences in the control group before and after the intervention (P<0.01) .

  Conclusion: The problem-solving skills training program reduced depression scores. Providing information and using the problem-solving skills training are recommended .

  

 

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Background & Aim: Studies have shown that family caregivers’ attitude toward mental illness affects their caring to mental patients and may reduce the quality of caring to them. This study aimed to determine the effect of group psychoeducation on attitude toward mental illness in the family caregivers of patients with bipolar disorder.

Methods & Materials: In this randomized clinical trial study conducted in 2015, 74 family caregivers of the patients with bipolar disorder who had been hospitalized in the psychiatric wards of Razi hospital in Tabriz were selected by random sampling method. Then, they were randomly assigned into the experimental and control groups. The families of experimental group participated in 8 continuous 90-minute 2 times a week psychoeducational sessions. Family caregivers’ attitude toward mental illness was measured using the questionnaire of Opinion about Mental Illnesses (OMI) before and after intervention. Data analysis was conducted using descriptive statistics, Chi-square test, independent t-test, paired t-test and ANCOVA on SPSS software version 13.

Results: The results revealed that there was no significant difference in mean score of attitude toward mental illness between the experimental group and the control group before intervention (92.54±8.51 vs. 90.52±9.43, P>0.05). But the mean score of family caregivers' posttest in the experimental group significantly increased compared to the control group (105.43±14.72 vs. 90.52±7.50, P<0.05).

Conclusion: The study results demonstrate that psychoeducational program improves family caregivers’ attitude toward mental illness. Training methods such as group psychoeducation can be effective in promoting positive attitude in the families of patients with psychiatric disorder.

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Background & Aim: Job satisfaction is of the most fundamental components of mental health in every profession and one of the most important factors in career success. Therefore, identifying factors affecting job satisfaction is necessary. One of these factors is employee empowerment. This study aimed to determine the relationship between structural and psychological empowerment and job satisfaction among nurses.

Methods & Materials: In this cross-sectional correlational study, the study population was all nurses working in public hospitals in Mashhad (N=4300) in 2015. The samples consisted of 340 nurses, were selected by multistage cluster sampling method. Participants were assessed by the Conditions of Work Effectiveness Questionnaire-II (CWEQ-II), Psychological Empowerment Questionnaire and Job Description Index (JDI). In order to analyze the data, Pearson’s correlation coefficient and regression analysis were used through SPSS software v.19, and for validation stage, the confirmatory factor analysis were applied using AMOS software v.21.

Results: Results showed that there is a significant multiple correlation between structural empowerment, psychological empowerment and job satisfaction (P<0.001, R²=0.286). Of the eight variables entered into the regression analysis using stepwise technique, three variables including meaningfulness (β=0.30, P<0.001), impact (β=0.25, P<0.001) and access to support (β=0.13, P<0.001) altogether predict 28.6% of the variance in job satisfaction.

Conclusion: The results show the importance of psychological empowerment, the sense of meaningfulness, impact, and access to support as strong predictors of job satisfaction. So, providing the conditions needed for the empowerment of nurses is recommended to increase their job satisfaction and subsequently their efficiency and life satisfaction.

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Background & Aim: Moral sensitivity has various dimensions including personal sentiments, scientific competency, and reasoning and decision making capabilities. To achieve this, some personal traits and educational preparedness are needed. The aim of this study was to determine nurses’ moral sensitivity and its relationship with demographic and professional characteristics in hospitals affiliated to Tabriz University of Medical Sciences.
Methods & Materials: This descriptive, correlational study was conducted on 198 nurses working in the medical wards of hospitals affiliated to Tabriz University of Medical Sciences in 2016. Census sampling method was implemented. Data were collected through a demographic and professional characteristics form and the Moral Sensitivity Questionnaire (MSQ). The data were analyzed by the SPSS software version 13 using descriptive statistics, T test, Pearson correlation coefficient and ANOVA.
Results: The mean score for nurses’ moral sensitivity was 4.84±0.48 (out of 7). The highest scores were related to the domains of “Interpersonal orientation” and “following the rules”. The lowest scores were related to the domains of “experiencing moral conflict” and “modifying autonomy”. There was a significant and inverse correlation between age and “modifying autonomy” (P=0.008, r=-0.193) and also between age and “following the rules” (P=0.034, r=-0.156). Moreover, there was a significant and inverse correlation between work experience and “following the rules” (P=0.009, r=-0.187).
Conclusion: Given that the nurses gained a low score in the domain of “modifying autonomy”, it is suggested that client centered care and patient’s autonomy be emphasized in developing nursing curriculum and in service training programs.
 

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Background & Aim: Creating and maintaining a safe environment is an important part of care in psychiatric wards. The results of previous studies indicated that some features of the physical environment facilitate the ward’s safety. The experiences of people who are most likely to be present in these environments can be the best source for identifying these features. Therefore, this study was conducted to explain patients’ and employees’ perceptions toward the features of a safe physical environment in psychiatric wards.
Methods & Materials: In this exploratory qualitative descriptive study, seven patients at discharge time and nineteen employees working in psychiatric wards were interviewed about their experiences in psychiatric wards and 84 hours of field observation was done. The data were analyzed using a qualitative content analysis approach according to the method proposed by Graneheim and Lundman.
Results: The results showed a safe physical environment in psychiatric wards meant “having an accident-free environment”. This theme was abstracted from two main categories included “Accidents prevention through design” and “having a natural life environment”, which, according to the experience of the staff, is required to balance the two. The subcategories of “having the design of accidents prevention” were “eliminating or modifying accident-causing objects”, “wards based on the characteristics of the patients” and “conditions for facilitating staff performance” and the subcategories of “having a natural life environment were “meaningful activities", “healthy and pleasant conditions” and “preserved privacy”.
Conclusion: According to the results of the study, it is necessary to create a physical environment free of accidents and at the same time to meet the daily needs of patients in order to prevent physical and psychological damage to patients and staff in psychiatric wards.
 

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Background & Aim: Pain during vascular access is an integral part of the life of hemodialysis patients. The aim of this study was to determine the effect of topical ginger on pain following needle insertion into the arteriovenous fistula in hemodialysis patients.
Methods & Materials: In this clinical trial, 100 hemodialysis patients were selected from two hospitals in Shahroud in 2019 and were randomly assigned to intervention or control groups. For the intervention group, ginger ointment was used 20 minutes before needle insertion into the arteriovenous fistula. The control group only received routine care. Patients' pain after needle insertion was assessed using the Numerical Pain Rating Scale. Data was analyzed using the SPSS software version 18 and Chi-square, Fisher, and independent t-tests.
Results: There was a statistically significant difference in the mean and standard deviation of pain scores between the control (8.46±1.26) and intervention (5.08±1.29) groups (P<0.001). While most people in the intervention group experienced moderate pain, most people in the control group had severe pain.
Conclusion: According to the results of the study, the use of topical ginger, which is cheap with almost no side effects, can reduce the severity of pain following needle insertion into the arteriovenous fistula in hemodialysis patients, and its use in hemodialysis wards is recommended.
Clinical trial registry: IRCT20190825044608N1
 

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Background & Aim: The average growth indicators in babies from unwanted pregnancy are lower than other babies. Perceived stress in these mothers can have a double effect on the reduction of milk. Considering the importance of breastfeeding in the health of mother and child, the present study aimed to determine the effect of couples counseling on perceived stress and the improvement of breastfeeding self-efficacy in women with an unwanted pregnancy.
Methods & Materials: In this randomized controlled trial study, 60 women with an unwanted pregnancy referred to comprehensive health centers of Khodabandeh city in 2021 were selected using the convenience sampling method and randomly allocated into two intervention and control groups in blocks of four. The control group received routine care, and the intervention group received six sessions of couples counseling based on spousal support twice a week. The data were collected using the Dennis Breastfeeding Self-efficacy Questionnaire, and the Cohen's Perceived Stress Questionnaire in three stages; before, immediately after the intervention and six weeks after delivery. The data were analyzed using the SPSS software version 16 by descriptive statistics, chi-square test, Fisher’s exact test, independent t-test and repeated measures ANOVA at a 95% confidence level.
Results: In the counseling group, the mean score of breastfeeding self-efficacy increased immediately after the intervention and six weeks after delivery compared to before the intervention, and decreased in the control group (P<0.001). In the counseling group, the mean score of perceived stress decreased immediately after the intervention and six weeks after delivery compared to before the intervention, and increased significantly in the control group (P<0.001).
Conclusion: Couples counseling based on spousal support was effective in improving breastfeeding self-efficacy and reducing perceived postpartum stress in women with an unwanted pregnancy. The presence of spouses in the breastfeeding counseling program appears to be a suitable measure that can be taken into consideration by planners in this field.
Clinical trial registry: IRCT20150731023423N18

 

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Background & Aim: Attempting to improve the quality is an important issue in the nursing service and care system. The COVID-19 pandemic has created great challenges for healthcare systems, especially for the intensive care units, which can affect the quality of nursing care provided to these patients. The aim of this study was to determine the quality of nursing care in nurses working in the intensive care unit of COVID-19.
Methods & Materials: In this descriptive-cross-sectional conducted in 2021-22, 142 nurses from Valiasr, Amir Kabir, Amir al-Momenin and Khansari hospitals affiliated to Arak University of Medical Sciences were selected by the census method. The Martins’ nursing care quality questionnaire (including 25 items in 7 domains) was completed by the participants. The SPSS software version 16 and independent t-tests, analysis of variance and the Pearson's correlation coefficient were used for the data analysis.
Results: The result showed that the mean score of the nursing care quality was 83.83±7.74, which was considered favorable due to being higher than the median score of the tool (62.5). Among the individual characteristics of nurses, the nursing care quality had a statistically significant relationship with the type of employment (P=0.003), age, work experience and work experience in the intensive care unit (P<0.001).
Conclusion: Considering the significant relationship of the nursing care quality with the type of employment, age and work experience, it is recommended that health managers take an effective step in formulating the necessary policies to improve the quality of nursing care by taking into account the experience of skilled nurses in intensive care units.

 

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Background & Aim: Breast cancer is the most common type of cancer in the world, imposing significant physical problems and psychological burdens on sufferers. Education is one of the ways to reduce the psychological problems of these patients. Therefore, the current study was conducted to compare the efficacy of Acceptance and Commitment Training (ACT) and Positive Psychology (PP) in enhancing the mental health and resilience among women with breast cancer.
Methods & Materials: This study employed a two-group quasi-experimental design with a pretest-posttest design, involving 60 women with breast cancer at Khatamolanbia cancer center in Jahrom during 2020-2021. Participants were selected through convenience sampling and randomly assigned to either the Acceptance and Commitment Training group (focused on accepting uncontrollable factors and committing to enriching life) or the Positive Psychology group (emphasizing individual abilities and positive emotions). Prior to and one week following the sessions, participants completed questionnaires evaluating resilience and mental health. Data analysis was performed using MANCOVA with a significance level set at 0.05.
Results: Based on the MANCOVA findings, there was no statistically significant difference in resilience and mental health scores (F=2.318, P=0.110) between the two intervention groups after adjusting for pretest scores. However, clinically significant improvements were observed in mental health and resilience for 75% and 42% of the ACT group, and 65% and 46% of the Positive Psychology group, respectively.
Conclusion: According to the findings, both group therapies, ACT and Positive Psychology, are effective in enhancing resilience and mental health in breast cancer patients. These findings provide more opportunities for healthcare providers to tailor interventions to the characteristics of caregivers and the personality characteristics of the patients.