Background & Aim: The severe pain of labor is the important cause of fear and anxiety in pregnant women. This study has been performed to evaluate effect of education on midwives practice.

Methods & Materials: This is a quasi-experimental study. That was done 59 midwives in the labor wards of non-educational of Guilan University of Medical Sciences Hospital. Data gathered by a questioner, which its validity was done by panel of experts and reliability by test-retest. 59 midwives were chosen by quota sampling and participated in a one-day workshop. Pretest and post-test questioner completed before and after four months of education by all midwives. Data analyzed by descriptive and inferencing statistical methods with SPSS.

Results: The paired t-test results showed that midwives practice about pain relieving methods changed significantly after workshop (p<0.005). Analytical methods demonstrated that there was no significant difference between mean practice scores and demographic characteristics of midwives. Conclusion: This study showed that teaching through workshop can improve the use of pain-relieving methods by midwives in labor wards especially more simple and efficacious methods.

Background & Aim: Socio-economical changes have increased the women&aposs opportunity to take job in recent decades. The increased levels of women in work places, has resulted in a high interest in the potential adverse effects of work on pregnancy outcome. This study was conducted in order to surveying the association between occupational factors and preterm childbirth.

Methods & Materials: It is a cross-sectional study. Samples consisted of nurses and midwives (518 person) who working in Tehran&aposs universities of medical sciences hospitals. Also they delivered newborns in gestational age more than twenty weeks (term or preterm) in years 2001-2006. The subjects were selected using a multi stage sampling method. Data gathered using a self-administered questionnaire. Occupational factors labeled as fatigue score and working hours. The relation between Occupational factors and preterm birth was analyzed using descriptive and inferential statistics (Chi-squared, t-test and Mann-Whitney U test) by SPSS software.

Results: Based on the study findings, the prevalence of preterm labor was 17.2% (95%CI=0.14-0.20). Although the proportions of unfavorable working conditions include: working at acute clinical wards, standing up more than 3h per each working shift, physical exercise, working in cold or hot weather, working in busy environment with continuous noise, being checker of visual and aural monitoring signals, working hours equal or more than 40 hours per week, and working fatigue score equal or more than 3 were higher in preterm group but it didn&apost show any significant relation with preterm birth.

Conclusion: According to the research findings, it seems that occupational factors do not have explicit effect on preterm childbirth. Therefore more investigations are recommended.

Key words: Preterm Labor, Occupational Factors, Fatigue

Background & Aim: Nowadays, mechanical ventilators are being used for some patients in ICUs due to various physiological and clinical causes. Keeping endotracheal tube clean and open is necessary in order to improve the patient&aposs oxygenation. This study aimed to investigate the effects of open and closed system endotracheal suctioning on vital signs of patients in ICU.

Methods & Materials: In this quasi-experimental study, 40 patients from Shariaty Hospital&aposs ICU were selected using convenience sampling method. Data was collected using a record sheet. The sheet consisted of demographic characteristics and vital signs including blood pressure, mean arterial blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation percentage. Endotracheal suctioning was done randomly in 90 minute intervals once using closed method and once using open method. All patients were hyper oxygenated by Ambo bag for 2 minutes before and after the procedures. The patients&apos vital signs were checked and recorded using SIEMENS 680 2xi monitor before, and 2 minutes and 5 minutes after the procedures. Data were analyzed using SPSS software.

Results: Systolic and diastolic blood pressures, and heart rate showed higher increase 2 and 5 minutes after the open method compared to close method (P<0.001). Arterial blood oxygen saturation percentage reduced in the open method more than in the closed one 2 and 5 minutes after the procedure (P<0.001). No significant difference was seen in the patients&apos respiratory rate in two methods (P>0.05).

Conclusion: Closed endotracheal suction system results in lower disturbances in the vital signs than the open system. Therefore, for better results, the closed endotracheal suctioning is suggested.

Background & Aim: Modification of unhealthy life style is a preventive method in cardiovascular diseases. It seems that education which results in enhancing knowledge would improve the life style. For developing effective educational plans, it is required to evaluate the knowledge and performance of the patients. So, this study aimed to determine the relationship between the teachers&apos preventive behaviors and their knowledge on cardiovascular risk factors.  

Methods & Materials: This cross-sectional study was conducted in five zones of Ministry of Education in Tehran. Seven hundred and three teachers participated in the study. Multi-stage sampling was used to gather data using a self-report questionnaire consisted of demographic characteristics, risk factors of CAD, and related modifiable behaviors. Data were analyzed using Pearson coefficient test to determine correlations.

Results: The results showed that the majority of participants (67%) had good knowledge on cardiovascular risk factors with the mean scores of 15.20±2.63 out of 20. Stress was found to be the most recognized risk factor (95.3%). Knowledge about diabetes (61.2%) and gender (17.6%) were in the lowest level. Regarding prevention, just 27.7% of the participants reported healthy nutrition. Some of the patients (35.6%) exercised regularly and majority of them (77.7%) were not active or passive smokers. Pearson coefficient did not find any significant relationship between knowledge level and preventive behaviors among teachers.

Conclusion: According to our findings, teachers&apos knowledge level on cardiovascular risk factors was good but it did not result in healthy practice. Therefore, providing effective educational programs about healthy life style can improve their daily life practices, as well as it can affect the knowledge and practice of their students about prevention of CAD.

Background & Aim: Premenstrual syndrome (PMS) is a common psychosomatic disorder that affects 30-50% of women in reproductive ages. The purpose of this study was to determine the effect of a counseling program on premenstrual syndrome related symptoms.
Methods & Materials: This study was a randomized clinical trial in which the effect of a 3-sessioned counseling program on the PMS symptoms were assessed in 123 adolescent with PMS. The program included information providing, life style alteration, and providing stress management skills on symptoms of PMS. The participants were randomly allocated to intervention (n=67) and control (n=61) groups. Participants completed the demographic questionnaire, the PMS symptoms&apos daily record scale, and the symptom checklist 90-revised (SCL-90-R). Data were analyzed using the SPSS-11.5.
Results: The comparison of baseline data showed no significant difference between two groups regarding demographic characteristic and the PMS related symptoms. There were significant differences in the mean of total PMS severity, somatic symptoms (P<0.001), anxiety, interpersonal sensitivity, and hostility (P<0.05) between two intervention and control groups. There was not any significant difference in depression between intervention and control groups (P=0.11).
Conclusion: Group counseling resulted in a significant reduction in severity of total PMS, somatic symptoms, anxiety, interpersonal sensitivity and hostility in intervention group compared to the control group. There was no statistically significant difference in depression between two groups.

 

Background & Aim: Despite technology development, rate of infants&apos hospitalizations is still high, which endures emotional and economic burden to families. The aim of this study was to investigate the effect of mothers&apos participation in care of preterm infant on readmission rate.

Methods & Materials: In this randomized controlled trial, 100 mothers who had preterm infants (gestational ages: 30-37 weeks) with respiratory distress syndrome were recruited. Samples were selected using continuous random assignment. Collaborative programs for the intervention group were implemented in the form of an information session and presence and participation of mothers in their infants care. One month after discharge, readmission check list was completed. Data were analyzed using Chi-square and paired t tests.

Results: Results showed that readmission rate was lower in the intervention group compared with the control group. The average length of stay in hospital was 6.96 in the intervention group and 12.96 in the control group (P<0.00).

Conclusion: Participation of mothers in care of their infants reduced readmission rate.

Background & Aim: Moral distress, a major issue in nursing, affects nurses in all healthcare sections. The existence of such distress and its consequent job dissatisfaction may pose a threat to nurses&apos physical and mental health, as well as their quality of life and hinder their accomplishment of individual and social goals. The aim of this study was to determine the relationship between the moral distress and job satisfaction In nurses.

Methods & Materials: This cross-sectional correlational study was conducted on 210 nurses employed in the selected healthcare centers of Tehran University of Medical Sciences in 2009. Data were collected using a questionnaire consisting demographic characteristics, the Corley&aposs moral distress scale, and the Minnesota Satisfaction Questionnaire. Data were analyzed using descriptive statistics and independent t-test, analysis of variance, Wilcoxon test and Pearson&aposs correlation coefficient in the SPSS v.14.

Results: According to the findings of the study, the mean of the moral distress was 1.77 out of four and the mean of the job satisfaction score was 3.17 out of 5 indicating a moderate job satisfaction among the nurses. A significant relationship was observed between the moral distress and nurses&apos job satisfaction in the present study, indicating that by decreasing moral distress, job satisfaction increases.

Conclusion: Although numerous factors govern nurses&apos job satisfaction, the observed relationship between moral distress and job satisfaction indicates that identifying and limiting factors influencing these distresses can lead to improved job satisfaction for nurses.

Background & Aim: Oral care and using mouthwash help to prevent stomatitis. The aim of this study was to investigate the effect of two mouth wash protocols on prevention of head and neck radiotherapy induced-stomatitis.

Methods & Materials: In this single blind clinical trial, 120 individual were recruited. The experiment group (N=40) gurgled with 3cc of Matrices mouthwash and the control group used water mouth wash. The participants were assessed using the WHO grading scale. Data were analyzed using the Fisher exact test and Mann-Whitney U test as appropriate.

Results: There was not significant differences between the experimental and control groups regarding stomatitis intensity in the first day (P=0.371). Tere were significant differences between the two groups regarding stomatitis intensity in days 7 and 14 (P<0.001).

Conclusion: Oral stomatitis is a common condition in patients with head and neck radiotherapy. It makes painful ulcers, dehydration, malnutrition, and potentially life-threatening infection. Matrica mouth wash could prevent and treat induced-radiotherapy ulcer stomatitis.

Background & Aim: Multiple structural factors preside over burn units influence nurses&apos quality of care and their activities. The complexity and multy-dimensional nature of nursing care in these units, creates many challenges. Understanding the perspectives of people&aposs involved is recommended. This study, with a theory-to-research approach, was conducted to assess the frequency of confronting intra and extra organizational factors preside over burn units, the intensity of its related pressure, and correlations among these variables from nurses&apos perspectives.

Methods & Materials: In this cross-sectional, correlational study, 98 nurses working in the Shahid Mottahari burn center were recruited by census. Data was collected using the intra and extra organizational factors instrument, provided based on the previous grounded theory study of the researchers. Intra-organizational factors questionnaire consisted of 58 Likert type statements in eight subscales and two dimensions of frequency (α=0.94) and intensity (α=0.96). Extra-organizational factors questionnaire consisted of eight Likert type statements (α=0.74). Data were analyzed using the SPSS version 14.

Results: The results revealed that the frequency of nurses&apos confrontation with factors related to environment and patients as well as its intensity were more than other factors. Moreover, the intensity of the whole factors was more than its frequency. All the extra- organizational factors were significantly correlated with all intra-organizational factors except for the "absence of employment permission" (P<0.05).

Conclusion: This study explained the importance of intra-organizational factors of a burn center in inducing stress on nurses. In addition to verification of some relationships in the previous mid-range theory, the results of this study also modified some of its aspects. Therefore it added to the existing body of knowledge about organizational factors and job stress in burn units. Moreover, it produced some evidences to use in nursing administration and service, and finally it resulted in some directions to control stress in nurses&apos job.

Background & Aim: Caregivers of elderly with Alzheimer&aposs disease, particularly females, encounter challenges. Their different roles in giving care to the patients could result in physical and mental disorders. The self-efficacy seems to be an essential factor in empowering individuals coping with stressful situations and challenging tasks. The aim of this study was to investigate general self-efficacy among women as family caregivers of elderly with Alzheimer&aposs disease.

Methods & Materials: In this cross-sectional descriptive study, 112 women reffered to the Iran Alzheimer Association, Tehran were selected through convenience sampling method. The General Self-Efficacy Scale (GSE-10) was used to collect data. Data were entered into the SPSS-16 and then processed using descriptive statistics and independent t-test, ANOVA and Scheffe.

Results: The mean score of the general self-efficacy was 28.24±6.34 indicating that considerable percentage of the participants had unsatisfactory level of self-efficacy (65.2%). In addition, there were significant relationships between the women&aposs general self-efficacy with educational and economic statuses (P<0.05). There were no significant relationships between general self-efficacy with age, marital status, occupational status and duration of caring.

Conclusion: According to the findings, a considerable percentage of the participants had unsatisfactory level of self-efficacy. Therefore, it is essential to promote the caregivers self-efficacy in order to give them the ability of better adaptation with the life&aposs challenges. In particular, the self-efficacy promotive programs should be implemented among caregivers with lower educational and economic status.

Background & Objective: Hospitalization of patients in the intensive care unit of open heart surgery (ICUOH) is often stressful for patients&apos family carers. This study aimed to investigate the effectiveness of the informational support on anxiety among families of patients undergone open heart surgery.

Methods & Materials: In this double-group randomized clinical trial, 64 family carers of patients undergone open heart surgery were selected using convenience sampling method and were randomly allocated into two intervention or control groups. The informational support consistedof  holding the ICU orientation tours and educational sessions, and providing educational pamphlets and booklets. The members of the control group received routin information. The anxiety of the family carers was measured using the trait Spielberger anxiety questionnaire before surgery and in the day of discharge from the ICU. Independent and paired t-tests were used to analyze the data.

Results: According to the findings, there were no significant difference between the two groups regarding demographic charachteristics. At the baseline, the mean of anxiety scores were 47.9±11.5 and 49.2±11.5 in the control and intervetion groups, respectively. The anxiety scores diminished in both groups after the surgery, however, the difference was not statistically significant between the two groups (P=0.18).

Conclusion: For effective control of anxiety among family members of patients, both informational support and other supportive techniques such as psychological support and meeting other family needs should be considered.

Background & Aim: Lack of knowledge about coronary angiography may cause anxiety and stress in patients. Implementing appropriate educational methods can be effective in decreasing the level of anxiety among these patients. This study aimed to compare the effects of face-to-face with group education on anxiety and knowledge of patients undergoing coronary angiography.

Methods & Materials: This quasi-experimental study was conducted in Shaheed Rajaie Cardiovascular Center affiliated to Tehran University of Medical Sciences in 2012. Through consecutive sampling method, 84 hospitalized patients who were candidate for coronary angiography were selected and allocated into two educational groups. Data were collected using a demographic data sheet, the knowledge assessment questionnaire, and the Spielberg state-trait anxiety inventory. Patients in both groups received same educational content. The patients&apos knowledge and anxiety were assessed before and after the intervention. Data were analyzed using descriptive statistics and independent t-test and paired t-test.

Results: The finding showed that both face-to-face education and group education were effective in enhancing the knowledge of the patients. However, group education was more effective than the face-to-face education in reducing the patients&apos anxiety (P=0.049).

Conclusion: Health professionals, particularly nurses, can use group education as an effective and appropriate strategy to improve patients&apos knowledge and to reduce the anxiety among patients undergoing coronary angiography.

Background & Objective: Hospitals and healthcare centers, like any other organizations, have some common norms and beliefs called as organizational culture. Organizational culture plays a key role in organization&aposs and staffs&apos performances. Nurses&apos perspectives on the organizational culture affect the way they play their role in. This study aimed to investigate the role of organizational culture from perspectives of nurses working in selected hospitals at Tehran University of Medical Sciences.

Methods & Materials: In this cross-sectional study, 230 nurses working in different wards of selected hospitals of Tehran University of Medical Sciences were recruited to the study. Data were collected using a demographic characteristics checklist as well as the nurse and organizational culture questionnaire extracted from the Robbins criteria. Data were analyzed using descriptive statistical indexes, independent t-test, Pearson correlation coefficient and regression in the SPSS v.17.

Results: Results showed that the existing organizational culture in the selected hospitals was in a moderately good level from nurses&apos perspectives. From the scores obtained for various dimensions of the organizational culture, the highest and lowest scores were for control (44.2%) and conflict tolerance (31.8%), respectively.

Conclusion: The level of the organizational culture from the nurses&apos perspectives might lead them to decrease the quality of their performance. Optimizing the organizational culture can improve nurses&apos performance and motivate them to increase their quality of work.

Background & Aim: Maternal-fetal attachment plays an important role in maternal identity forming. The attachment behavior is different between mothers and most of the reported studies are from Western countries. The aim of this study was to assess maternal-fetal attachment behavior and some related factors among Iranian mothers.

Methods & Materials: This cross-sectional study was carried out in 12 health and medical centers, affiliated to Tehran University of Medical Sciences. Four hundred pregnant women were selected for the study. Data were gathered using two questionnaires. The first one was a self-structured questionnaire and the second one was the maternal-fetal attachment scale. Data were analyzed using the Pearson, Anova and t-test statistical tests. The P<0.05 denoted statistical significance.

Results: Findings showed that the mothers had good attachment toward their fetuses (M=84.72). The race, higher maternal age, higher education, gestational age, planned pregnancy, sex of fetus, and assessing health of fetus had positive effects on prenatal attachment (P<0.05). Tobacco use, multiparity, and high risk pregnancy had negative effects on attachment. There were no relationships between attachment and previous marriage, infertility, abortion, number/type of ultrasound, participation in prenatal classes and healthy baby (P>0.05).

Conclusion: Understanding maternal-fetal attachment behavior could play an important role in quality of prenatal care. Midwives can assess and promote attachment behavior as well as recognize factors influencing maternal-fetal attachment.

  Background & Aim: The effect of perceived stress on students’ health depends on their coping abilities. Resilience is a coping strategy for dealing with the stress. The aim of this study was to determine the relationship between the perceived stress with resilience in undergraduate nursing students .

  Methods & Materials: In this cross-sectional study, 309 undergraduate nursing students of Tehran University of Medical Sciences were selected during the first semester of 2012-2013 using the stratified sampling method. Data were collected using the Perceived stress scale and the Connor-Davidson Resilience Scale (CD-RISC). The data were analyzed using descriptive and inferential statistics in the SPSS-14 . 

  Results: Findings revealed that most of the students (99.3%) had a moderate or high perceived stress. There was a statistically significant relationship between the perceived stress with the resilience (P £ 0.001, r=-0.38) .

  Conclusion: The school of nursing should provide facilities and opportunities for students in their 4-year educational program to learn stress management strategies including increasing resilience ability.

  Background & Aim: An important goal of nursing care in the Neonatal Intensive Care Unit (NICU) is to provide holistic care as well as the best possible outcome. Understanding perceived needs of mothers is valuable to achieve these goals. This study aimed to compare perceptions of nurses and premature infants’ mothers about mothers’ needs in the NICUs.

  Methods & Materials : This was a cross-sectional study in which 63 nurses and 63 mothers with premature infants were selected from the NICUs of four educational hospitals affiliated to the Mashhad University of Medical Sciences through stratified sampling method in two months. Data were gathered using the NICU Family Needs Inventory of Ward and were analyzed using descriptive-analytical statistical methods in the SPSS v.16.

  Results: Among the subscales related to family needs, the following items were reported to be important by mothers: Proximity (95.3%), Assurance (94.1%), Information (91.1%), Support (79.7%) and Comfort (72.8%). On the other hand, nurses believed that the following items were the most important needs of the mothers: Assurance (80.3%), Proximity (75.2%), Information (70.8%), Comfort (66.3%) and Support (64.8%).

  Conclusion : According to study findings, nurses should periodically assess needs of the mothers in the NICUs to be aware of the actual needs instead of placing subjective assumptions on mothers needs. This can improve effective communication and interaction with mothers and enhance satisfaction of the mothers with care.

  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 .

  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 .

  Background & Aim: Cancer is the most common childhood chronic medical illnesses that can affect quality of life of the children and their families. The aim of this study was to determine the effect of coping skills training on quality of life among parents of children with leukemia.

  Methods & Materials: This non-randomized clinical trial was conducted from March to June 2013. Ninety eight parents of children with leukemia who were referred to two selected hospitals affiliated to Tehran University of Medical Sciences were enrolled to study using convenience sampling method. The participants were allocated to two experimental (n=48) and control (n=50) groups. Data were collected through two questionnaires including demographic characteristics of the parents and children, and the Persian version of the Caregivers Quality Of Life index Cancer. Coping skills training including social communication skills was performed through small group discussion (5-8 members) in four 2-hours sessions for the experimental group. The questionnaires were completed four weeks after the intervention by the parents. Data were analyzed using the independent t-test, paired t-test, Fisher's exact test and Chi-squared test in the SPSS-16. 

  Results: The results showed significant increase in the overall quality of life after the intervention (P<0.001). The quality of life of parents in the experimental group was improved significantly in comparison with the control group (P=0.045). Mental/emotional burden (P<0.001) and lifestyle disruption (P<0.001) decreased significantly after the intervention.

  Conclusion: The coping skills training affected the quality of life among parents of children with leukemia . Effective educational interventions may help to increase the quality of life of parents who have children with Leukemia.

  Background & Aim: Several studies have indicated that hospitalizing infants causes disruption on mother-infant attachment. The aim of this study was to assess the effect of infant massage by mothers on maternal attachment behavior in infants hospitalized in the neonatal care units .

  Methods & Materials: In this clinical trial, 42 mothers and their neonates were recruited and randomly allocated to the intervention and control groups. Mothers in the intervention group received training by means of educational movies about practical exercises on how to massage the infants. The trained mothers used massage techniques on their infants for five days. The process lasted 15 minutes. The attachment of the mothers on their infants was assessed before and on the day 5 after the massage. Data were collected using the scale of mother-to-infant attachment. Data were analyzed using the Chi-squared test, Fisher’s exact test and the t-test in the SPSS-19 . 

  Results: There were no differences between the two groups in terms of demographic variables and the mean of maternal attachment at baseline (P>0.05). Five days after the massage, there were statistically significant differences between the two groups in the mean maternal attachment (P<0.001) .

  Conclusion: According to the role of massage in attachment behavior, this traditional care is recommended to be used in neonatal units .