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This study is a quasi-experimental research with aim of evaluation the effect of respiratory exercise in acute respiratory complication and the length of time patient hospitalization undergoing coronary artery bypass surgery in Kermanshah Emam Ali hospital in year 2000 The study subject consisted of 60 patients (42 male and 18 Femal), with age rang between 30-70 years old, who were eligible for this study. The subjects were selected with convenience sampeling and randomly allocated to two groups (Experimental and control). Experimental group received education in two sessions of videoteaching and control group recived routin cares. Tools of data collection consist of demographic questionnaire, clinical records, check list and respiratory exercise. Results revealed: The incidence rate of atelectasis in experimental group was (26.7%), less than contral group (%56.7), test showed significant difference between incidence rate of atelectasis (P = 0.01). Therefore the length of hospitalization in experimental group was less than control group (P=0.02). Accomplishment of post operative respiratory exercises in all samples were lower than doing exercise pre-operatively, and the highest score for effective exercise and coughing were in two and three days after surgery (P=0.000). The result of this research reveales, videoteaching is effective in promoting nursing care and self care in clients.

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Introduction: Low back pain is a very common complaint in communities as about 80% of people experience it throughout their life. Low back pain has negative effects on different aspects of the patients lives. One of the palliative treatments of low back pain is accupressure.

Materials and Methods: A single blind clinical trial study was conducted to evaluate the effects of accupressure on low back pain in Khorram Abad city Tamin Ejtemaei hospital in 2002. Ninety patients were selected by convenience sampling and then they randomly divided into three groups: Experimental (accupressure was applied in real points), plasebo (sham accupressure was applied in four shampoints) and control (without any intervention). The subjects were 36 males and 54 females, ranging in age from 20-50 years. All three groups used Acetaminophen tablet (325 mg) for pain relief. Data were collected by an structured questionnaire, pain assessment numerical scale and three self reported scale.

Results: The results of study indicated that accupressure and sham accupressure could alleviate low back pain severity, but reduction of pain was statistically significant only in experimental group (p<0.0001). Decline in the amount of medication usage in experimental group was statistically significant (p<0.0001).

Conclusion: In conclusion, the study showed use of accupressure was effective on pain relief and it can be used as a safe treatment.

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Introduction: Bed sore is an important complication of operation. Long immobility, hypotension and hypothermia in perioperative period predispose patients to bed sore. The prevention of bed sore is a priority in caring for immobilized patients and different methods have been used for this purpose. Hydrocolloid dressing is one of these methods.

Materials and Methods: This study is a quasi-experimental research. Subjects consisted of 60 patients aged 40-70 years who had eligibility criteria for this study. Subjects were selected with convenience sampling and randomly allocated to two 30-patient groups (experimental and control). In experimental group, hydrocolloid dressing was used before surgery. No procedure was performed for control group. After surgery sacral area was examined on three occasions to detect bed sore: immediately, 24 and 48 hours after surgery. The data were collected by demographic questionnaire and staging bed sore checklist and analyzed by SPSS statistic program and use of descriptive methods such as Chi square, Fisher exact test, t test, ANOVA and least significant difference (LSD).

Results: Incidence of bed sore was 13.3% in experimental group and %36.7 in control group. Chi square test showed significant difference between incidence of bed sore in two groups (p=0.03). Incidence of bed sore in two groups had no relationship with respect to gender and number of grafts. There was a significant relationship between bed sore and age, body mass index and duration of hypothermia, immobility and cardiopulmonary bypass (p<0.05).

Conclusion: Considering findings of this research, it seems that use of hydrocolloid dressing is effective in preventing perioperative bed sore after coronary artery bypass surgery.

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Background & Aim: Nurses have the major role at care continuity and health promotion. They frequently affect total productivity in a organization. However, the nurses believe that due to several barriers they have not desire productivity, therefore the health care have been left at level of quality. The aim of this research are assessing nurses&apos view about productivity and role of human resource on it.

Methods & Materials: This study has been done based on grounded theory method. Open interviews has been used for gathering of data. Sampling was purposive in beginning study but so that study was proceeding and categories were completed, it changes to theoretic sampling. Constant comparative analysis was method of data analyses.

Results: Essential themes emerged from the data in human resource category. These are: systemic calculating number of staff, accurate staff select and use criteria for them, provide adequate staff from various categories in total year&aposs day, accept patient when as coordinate to in charge nurse and well communication. These make necessary groundwork for productivity. Then accidents that emerged from inappropriate quantity and quality of human resource will be decreased. These enhance nursing productivity the biggest group of health care services. Model of Productivity and human resource effects on it’s, from nurses&apos view, has concluded of this research.

Conclusion: In nurses&apos view that participates in this research, human resource can affect on productivity process and improve it, then it lead to develop quality care- health care vision and goal.

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Background & Objective: Research utilization is a new phenomenon in Iran and the Iranian nurses tend to practice based on evidences. The objective of this research is to investigate nurses&apos attitude toward research utilization.

Methods & Materials: This research is an analytical-descriptive study. The sample included 410 clinical nurses and instructors who were selected through multistage stratified sampling method. Data were gathered using a two-section questionnaire and analyzed using statistical package for social sciences (SPSS).

Results: 91.2% of respondents believed in using research findings in practice. 77.6% of nurses agreed with the following statement: "Research is not applicable in practice". Furthermore 88.3% agreed that" Research helps to build a scientific base for nursing". The majority of respondents had positive attitude toward research utilization. There was a significant difference between attitude and kind of professional activity, setting and research activity.

Conclusion: It seems having positive attitude toward research utilization is not sufficient for applying research results in practice. In order to utilize the research findings, more relevant research in this field of nursing is required.

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Background & Aim: Performance appraisal is one of the most important duties for nursing managers. This will improve the quality of nursing care, and it needs suitable approaches and effective strategies in nursing services. The aim of this study is to determine the impact of performance appraisal using management by objective approach on nursing care quality.

Methods & Materials: This was a quasi-experimental and single-blind study that was carried out in two surgical units of an affiliated hospital of Tehran University of Medical Sciences. 80 patients were selected using a randomized sampling. The quality of nursing care were controlled in both experiment and control units before and after the performance appraisal procedure. The procedure was programmed on the basis of management by objective approach for six months in the experiment unit. In the intervention unit, nursing performance appraisal was done three times and in every time head nurse and supervisors participated in giving feedbacks and recommendations for the nurses. At the end of the intervention, quality of nursing care was assessed in both groups blindly. The results were compared and statistically analyzed.

Results: Significant difference was found between quality of nursing care in the experiment and control units (P<0.001). Quality of nursing care was significantly different before and after intervention in the experiment unit (P=0.009).

Conclusion: Performance appraisal using management by objective approach could increase the quality of nursing care. As a result, using nursing performance appraisal plans according to the basis of MBO could be an effective evaluation way to access the quality of nursing care.

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Background & Objective: Research utilization is an important way to extent the knowledge in nursing practice. It empowers the nursing profession. Research utilization is a new paradigm in Iran&aposs nursing care. This study aimed to assess the extent of research utilization in nursing clinical practice in Tehran, Iran.

Methods & Materials: This is a cross-sectional study. The clinical nurses with at least one year of work experience were selected through a multistage stratified sampling method. They completed a five-sectioned self-report questionnaire. The scores were categorized into high, intermediate, and low. Data were analyzed using descriptive statistics and Chi-Square test in SPSS.

Results: Findings revealed that the research utilization in 66.9% of the nurses was low. There was significant relationships between the extent of research utilization and the level of education, professional condition, clinical setting, research activities, work shift, job satisfaction, and English language skills.

Conclusion: The majority of nurses&apos practice is not according to the research findings. We need to find appropriate strategies to enable us to utilize the research findings.

 

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In the many definitions that are accompanied with nursing, in addition to the scientific aspect, art has always been mentioned. Since Florence Nightingale introduced nursing as an art, several theorists have emphasized the aesthetic aspect of nursing in their literature. However, many experts believe that the word "art" has been accepted in nursing without deep thought and criticism.To judge the statement: "Nursing is an art", it seems that it is necessary to review the similarities and differences of "art" concept in nursing and other fields literature. Art has a complex and multidimensional meaning that is the backbone of many theories presented however, they each have their own strengths and weaknesses. Nursing has artistic properties but this characteristic is referred to as folk art and not to specific features of art. In comparing these theories with the concept of art used in nursing, it is essential to note that art in nursing refers to skills of nursing. In other words, nursing is not a kind of fine art.From the aesthetic perspective, nursing can be easily defined as a form of art however, we must put great importance in the inseparable words of "aesthetic" and "art of nursing". With such a connection, we are able to introduce and capture the true spirit of both art and nursing. In this article, we have reviewed the most important definitions and theories of art as a "specific term", and as "skill", where they have linked nursing to art. Moreover, we have discussed their similarities and differences.

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Background & Objective: Parental participation in pediatric nursing is not ideally done due to several barriers. This qualitative study aimed to explore the barriers of parental participation in pediatric care during 2011-2012.

Methods & Materials: This qualitative study was carried out using content analysis approach. Data were gathered through face to face semi-structured interviews with a sample of pediatric nurses (n=11) who were recruited through purposeful sampling from a pediatric hospital in Tehran. After gaining data saturation, data were analyzed using content analysis method.

Results: Four main themes were emerged as barriers of parental participation in pediatric care including mutual motivation and interest in both parties (motivation and attitudes of nurses and interest in parents), management (lack of support for nurses, nursing shortage, nurses&apos workload, and poor teamwork between nurses and physicians), confidence in the nursing profession, and finally undefined role for mothers.

Conclusion: Findings revealed the barriers of parental participation in caring for their hospitalized children. Managers and nurses can take advantages of these findings to improve and strengthen parental participation in pediatric care units during hospitalization.

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Background & Aim: Nurses are informed from patients needs using effective mutual communications. This study aimed to explore the communication strategies between nurses and patient.

Methods & Materials: This study had a qualitative approach with the content analysis method. Participants included 23 nurses, patients and their families in medical and surgical wards of Imam Khomeini hospital of Tehran University of Medical Sciences. Data were collected using interviews and observations. The first and second interviews were conducted unstructured. The semi-structured interviews were then conducted according to the derived concepts from the first and second interviews. We used observation in order to gain a deeper understanding and verifying data from interviews. The observations focused on the interactions between nurses and patients during mutual communications.

Results: A final theme was emerged through the data analysis: adaptation of nurses&apos attitudes and performances. This theme derived from three main categories: caring according to acute needs of patients, creating a professional realm, and participation. The caring according to acute needs of patients included subcategories such as identifying patients&apos acute needs and nurses&apos communication behavior. Creating the professional realm implicated on the clarifying roles and maintaining of privacy communication. Participation was defined as the audience and content.

Conclusion: The findings showed that nurses, in response to the underlying conditions of nursing care, assimilate their attitudes and performances to be able to meet their professional needs and their patients&apos needs. In fact, the main character of nurse-patient communication is nurses&apos active role and patients&apos passive role.

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  Background & Aim: Nurses’ clinical judgment is an evolving complex concept. In order to understand the concept, clarification is needed. This study aimed to conduct the concept analysis of clinical judgment in nursing .

  Methods & Materials: Based on the Rodgers’s evolutionary method, evolving concept of clinical judgment in nursing was analyzed. Literature was retrieved from scientific databases during 1980 to 2013. Based on the inclusion criteria, 42 articles, three books and one dissertation were analyzed using thematic analysis method . 

  Results: The results showed that clinical judgment in nursing was a complicated process with attributes including intention, observation, data collection and information process, interpretation, prioritization and inference. Antecedents included knowledge, experience, evidences, clinical reasoning, intuition, critical thinking and consequences included nursing diagnosis and clinical decision making .

  Conclusion: Clinical judgment in nursing is a critical thinking process, situational based and beyond observation and assessment. This concept analysis could distinct the transposition concept of clinical judgment and other related concepts. The results of this study would help to develop theories and clinical judgment measurement instruments in practice, research and educational settings .

  

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Background & Aim: Although the number of kidney donors is increasing in the country, few relatives decide to donate. Decision making on kidney donation to a relative faces many challenges, while how to make this decision is still ambiguous. The aim of the present study was to explore the way of decision making about kidney donation to a relative.
Methods & Materials: The present study was a qualitative study conducted in 2015. The thematic analysis approach was used to analyze the data. In this study, 16 relative donors from the kidney transplant centers of all the teaching hospitals affiliated to Tehran University of Medical Sciences (Imam Khomaini, Shariati, Sina) were selected through purposive sampling. Then, 16 face-to-face, in-depth, semi-structured interviews were conducted. Data were analyzed using the thematic analysis approach proposed by Clark & Braun (2006).
Results: Data analysis led to the identification of two themes “being resolute in decision making” and “mulling over the decision”. The first theme was comprised of three subthemes including donation with a heartfelt desire, consistency in decision making, discretion in decision making, and the second theme was consisted of two subthemes including unsteady in decision making and bargaining in decision making.
Conclusion: Decision making on kidney donation to a relative faces a variety of challenges influenced by the donor’s family background, the supportive role of family members, kinship ties and a sense of love for relatives. By providing knowledge and awareness to donors to address ambiguities and subjective questions, they can have an important role in developing the culture of relative’s kidney donation.