---

To study and determine the educational needs of nurses after graduation in order to make them further capable, aims at promotion of their occupational standards and betterment of this profession. By means of this study we can identify their needs and make necessary planning to reduce the resultant shortcommings and problems. The present research is a descriptive and analytical study conducted to survey the educational needs of nurses regarding non-pharmacological methods of controlling chronic pans in patients at medical surgical wards of the hospitals of Tehran University Medical of Sciences. A total of 119 nurses working at one of these wards participated in this research. The tool for gathering the information was a three-part questionnaire. The first part deal with individual particulars, the second part was about questions regarding the feeling needs of nurses an the third part was about questions regarding the educational needs of nurses. The findings showed: As for the feeling needs, nurses needed training , as for the level of educational needs regarding the concept of pain (69.7%), characteristics of chronic pains (52.9%), guided imagery method (50.4%) of nurses were in need of a high level of training and regarding the progressive muscle relaxation (68.9%) of nurses were in need of a medium level of training. The results revealed the connection between some individual particulars with the level of educational need, to the extent the age, clinical work experience, work experience in medical and surgical ward and the type of ward affected the level of educational need, and by using the Pearson Coefficient a meaningful statistical difference appeared, in other words, as the years of service increases , the level of knowledge decrease and the educational needs rise up.

---

Considering the improvment of technology and development in medical and basic medical science. Continuation of learning in community are necessary. The method is to create a cooperative learning environment for students. Students support in exprience, past information about subject reaction and holistic theory and practice helping notice, problem based learning bridge between theory and practice step intervention strategies P.B.L. which include eight steps: helping problem definition, Data collection, problem formulation, intervention, Assessment of learning needs, independent study, Reporting back review of in dependent study, in this paper, this method was investigated with some examples . Using this method in education of science , particularly medical science will improve the translation of science in education and producing science in research.

---

Today besides the different avilable data there is no unique successfultreatment to cure psoriasis and to prevent its complications and recurrances.This study has been done on 50 psoriatic patients in oder to find out if self -care education can reduce the complications and the severity of the disease(Itching, fissuring, scaling) .Data shows that self - care educations can successfully reduce the fissuringfrom 100% in sever cases to 96% (p< 0/001) , and Itching that is seen in 100%of cases subside to 50% (p< 0/001) . skin scaling that is seen in 100% casesdisapper and the skin become normal in all of them (p<0/001) .In general the 88% of the patients has sever pseriasis and after the education itreduces to 50% in mild form.

---

Introduction: Nowadays continuing education is considered an essential part of nursing education. This study was planned to evaluate the effect of continuing education of neonatal intensive care nursing on knowledge and the practice of nurses who were working in the children’s hospitals.

Materials and Methods: A semi-experimental study was carried out including 42 nurses of the children’s hospitals affiliated to Tehran University of Medical Sciences during 18 months in 1999- 2000. The data were collected by a questionnaire and a checklist. The questionnaire included demographic information and 60 multichoices questions based on the knowledge of the neonatal intensive care nursing. The observation checklist contained 5 parts, how to establish: resuscitation operation, endotracheal suction, management of the patient under mechanical ventilation, nasogastric tube insertion and feeding by gavage. At the end of the training courses the questionnaire and the checklist were completed again individually. The result of the pre and post tests and checklist were compared in the areas of knowledge and practice. The data was analyzed by 2 and paired t Student test.

Results: Statistical analysis showed a meaningful difference in the knowledge and practice after the continuing nursing education (p<00001).               

Conclusion: This research revealed the positive effect of the continuing nursing education on the knowledge and the practice of the nurses who were working in the pediatric wards. It is important to consider the continuing nursing education program to promote the health care system.

---

Introduction: Self-burning is a cruel method of suicide and prevention is the most effective way to decrease its morbidity and mortality.

Material and Methods: This investigation is a descriptive prospective study performed at Shahid Motahari Burn Center, Tehran, Iran from December 2001 to December 2002. Inclusion criteria included being female, married, having no history of medical and mental disorders and admission of self-burning. Data were collected by a questionnaire and interviews and were analyzed with descriptive statistics methods and chi-square test.            

Results: A total of 35 cases entered our study. The mean age of patients was 24.573.94 years and 48.6% of cases were in the 21-25 year age group, 80% had primary school education, 97.1% were housekeeper and 68.8% had low economical status. There were statistically significant differences in all of these variables. In 42.9% self-burning had happened at 12-18 hour period and in 45.7% it had occurred at yard. Kerosene had been used by 91.4% of the women as the burning agent 94.3% of the women had experienced husband’s violence (verbal and physical), 60% of the women stated that their husbands were guilty in their action and 91.4% of the women didn’t know any supportive sources in the society. The mortality rate was 100%.

Conclusion: This research showed that family violence and marital problems are the most important causes of self-burning in the married women. Because of close relationship to families, community health nurses can prevent self-burning in married women by detecting and eliminating these risk factors.

---

Background & Aim: One of the cause of anxiety for most patients is hospitalization. Once the patients are hospitalized for cardiac catheterization, the anxiety would be augmented. The anxiety raises body physiological and psychological activities such as: heart rate and respiratory rate. This research, as clinical trial study, has the objective to determine the influence of applying two methods of relaxation and premeditation on respiratory rate and pulse rate in hospitalized patients, experiencing coronary angiography, in heart and postangio wards of Shahid Beheshti Hospital in Zanjan, at 2003.

Methods & Materials: 40 patients who were candidates for CA, has been studied, in regard to existing conditions and methods of sampling and random allocation to two groups of relaxation, and premedication. Data collection tool included demographic and disease related information sheet, as well as record sheets for respiratory rate and pulse rate at intervals of 8-12 and ½ hrs before, during and after the angiography. For relaxation group, the researcher would speak individually about the influence of relaxation, the day before angiography then with the aid of client himself/herself, performed relaxation instances in a single bout, and eventually asked client to perform relaxation technique 2-3 times before going for angiography. In premedication group, patients received regular preangiographic medications including diazepam, chlorpheniramine, metoclopramid, and hydrocortisone. Respiratory rate and pulse rate were measured in both groups 8-12 and ½ hrs, before during and after CA. Afterward, resulted data were analyzed statistically by (SPSS) software for windows.

Results: Pulse rate at 8-12 hours before, during and after the angiography showed no significant difference between two groups (p>0.05). Thus our research hypothesis that “alterations of respiratory rate and pulse rate in patients under coronary angiography, who get relaxation, are identical to those in premedicaton group”, would be confirmed

Conclusion: These results show that the premeditation method can be substituted by relaxation before practicing invasive procedures.

---

Background & Aim: Suicide is an intentional death that occurs three time in women to men. Nurses can influence in presentation of educational program and consultation in school, job environment and home as well as detection of person who suspected to suicide. This study has conducted to determine the causes of suicide in married women.

Methods & Materials: This investigation is a descriptive study that has been made among women who admitted to Loghmanoddole-Adham poisoning emergency center in Tehran, Iran (the only poisoning emergency center in Tehran) during one year (from December 2001 to December 2002). Inclusion criteria were female, married, without history of medical, mental disorders and confession to suicide. Data were collected by a questionnaire and interview and were analyzed with descriptive statistics and a chi-square test.

Results: According to the result, there was statistically significant differences between age groups, living areas, educational levels, jobs and financially states. 37.4% of women had forced marry 50.5% had feared of their husband 67.7% had experienced husband’s violence 74.7% didn’t know any supportive sources in the society. 82.8% of women used of medications (tablets) for suicide.

Conclusion: This research showed that family violence and marital conflict are the most important etiology of suicide in the women. Nurses can decrease of acting to suicide in married women with detection of family violence, increasing of clients&apos self-esteem, referring and follow up.

---

Background & Aim: Many of the studies show benefit effects of exercise on mother and fetus during pregnancy. The aims of this research include of assessment of effects aerobic exercise on three factors: pregnancy age, birth weight and apgar score.

Methods & Materials: During an experimental study, 80 pregnant women who referred to prenatal clinics in zone of 17 of Tehran were selected and divided in two equal groups. Inclusion criteria included, 18-35 years old, 18 weeks of pregnancy, second gravidity, without history of medical illness and exercise before pregnancy. In case group samples were under 15-30 minutes aerobic exercises with 50-70% Vo2 max 3 days a week for 8 weeks. Data were analyzed by SPSS version 10.5 soft ware and t test and 2 were used for statistical analysis.

Results: Total 80 pregnant women enrolled in two groups. There were no statistically significant differences between cases and control in demographic factors. The most of cases were in 40 weeks group and more and the most of control were in 38-40 weeks however, there are no statistically significant differences between cases and control. The most of infants of cases and control mothers (60% and 70%, respectively) were in 2500g-3500g group but no statistically significant differences between cases and control. There are statistically significant differences between cases and control in 5 minute apgar score (p=0.01).

Conclusion: In overall, the results show aerobic exercise improve 5 minute apgar score, but do not show significant effects on pregnancy age and birth weight.

---

Background & Aim: Healthy behaviors of teenagers are effective on the community development. This study was carried out in order to compare healthy behaviors of female teenagers living with their families and in orphanage centers in Tehran.

Methods & Materials: This was a cross-sectional study. The subjects were consisted of 110 female teenagers that 55 of them dwelled in the orphanage centers and the remaining lived with their families. Both groups were studying at the same schools. Samples were selected using stratified random sampling method. Questionnaire was used to gather data. The data were analyzed by descriptive and analytical statistical methods in SPSS software.

Results: There were statistically significant differences between two groups in nutrition (P<0.0003), sleep & rest (P<0.001), physical exercise (P<0.0013), and individual health (P<0.001). Total score of health behaviors were 112.3, and 87.8 in family group and orphanage group respectively (P<0.001).

Conclusion: The average score of health behaviors in girls that reside in orphanage centers was lower than the score of them who lived with their families. This shows the necessity of planning educational and managerial tools to improve their healthy behaviors.

---

Background & Aim: Communication is one of the basic concepts which nursing students must learn. Nurse instructors&apos behaviors have key role on effective clinical education. The aim of this study was to assess the effect of situational leadership model on nursing students&apos communication competency.

Methods & Materials: In this before-after trial, we recruited the students who had medical & surgical practicum in the second semester and summer of 1385-86 in public hospitals in Arak. They were selected randomly and then allocated to case (n=40) and control (n=35) groups. In the first week of practicum (before), we measured the students&apos communication competency using a self-structured questionnaire. For intervention, we defined behavioral objectives and designed a diagnosis form for identifying level of maturity and a feedback form for the students. After orientation of the students with behavioral objectives, we accompanied with main instructors based on their maturity levels in caring and applied effective leadership style. Along with the practicum period, we supervised the students&apos level of maturity in different nursing care skills. In the end (after), we measured the students&apos competency. We analyzed the data in SPSS, version 13.

Results: The results showed that there was significant difference before and after the intervention (P<0.001). Also, there was significant difference between two groups (P<0.001). Self-evaluation showed no significant differences between students&apos competency in two groups (P=0.335).

Conclusion: The situational leadership model would promote nursing students&apos communication competency.

 

---

Background & Objective: The mortality rate of pneumonia caused by mechanical ventilation is about %25-30. Pneumonia prolongs length of stay in hospital to more than 13 days. There are various approaches to decrease rate of pneumonia in medical wards. The aim of this study was to assess the effect of planned passive respiratory exercise on prevention of pneumonia in coma patients undergo ventilation.

Methods & Materials: In this quasi-experimental study, 76 patients were assigned into two experimental and control groups. The control group (n=38) received usual care in the ICU. The experiment group (n=38) received planned respiratory care within six days. The procedure was done in five minutes/six hours for a three day period and then in 10 minutes/six hours for the next three days. Laboratory tests were done before the intervention and in the third and sixth days of the intervention. The respiratory care planning included respiratory passive exercises along with the common respiratory care.

Results: The results indicated that there were significant differences in the results of lab tests between two groups after the intervention (P<0.0001).

Conclusion: The results of this study showed that planned respiratory care had positive effect on prevention of respiratory infection in coma patients.

 

---

Background & Aim: Diet adherence is a major issue in cardiovascular diseases control. Patient education could be a valuable strategy for promoting diet adherence. The aim of this study was to compare the effects of computer-assisted vs. face to face education on dietary adherence among patients with myocardial infarction.

Methods & Materials: In this experimental study, 117 patients with the first acute myocardial infarction were selected via a convenience sampling. The participants were randomly allocated into three groups. Patients in the face to face group (n=43) received an education about diet in two two-day sessions. The computer-assisted education group (n=33) received the same educational plan provided by computer software containing audio, text, images and animations at home. The control group (n=41) received their usual care. Adherence to dietary regimen was assessed three months after the educations.

Results: There were not significant association between the three groups in terms of demographic characteristics and disease history. There were no significant different in unhealthy diet adherence between the three groups. There were not significant differences in healthy diet between the computer-assisted and face to face education groups. The computer-assisted education group had significantly better adherence with the consumed amount of fats (P=0.01), useful meat substitutes (P=0.01), and other foods (P=0.012) than the control group. In addition, the face to face education group had significantly greater adherence scores with consuming meat substitutes (P=0.04), and fats (P=0.04) than the control group.

Conclusion: Both computer-assisted and face to face educational strategies had positive effects on improving adherence following myocardial infarction.