---

In this descriptive research, the application of disinfection and sterilization methods in three hospitals of Malayer was surveyed.The objectives of this study were determining disinfection and sterilization application methods in physical place ,surgical hand scrub, sugical site prepartion and preparing the metal, plastic and linen instruments.For collecting data, an observation checklist was used.The results showed that application of disinfection and sterilization methods evaluated in physical place 30.18%, surgical hand scrub 58.68%, Preparing surgical site 39.93%, metal instruments 77. 96%plastic instruments 40.97%and linen instruments 70.46% respectively. The results also indicated that application of disinfection and sterilization methods evaluated totally in hospital number one 54.75%, hospital number two 48.89%and in hospital number three 55.73%) respectively.Using T-test(a=0.05), the findings revealed that there was not a significant statistical difference among the surveyed hospitals.For further investigation ,it is suggested that the effect of training on the application of disinfection and sterilization methods in operating rooms to be studied.

---

Background & Aim: One of the responsibilities of nurses is to identify of effective factors on sleeping, because identification of these factors prevents from occurrence of sleep disorders, improves sleeping, decreases duration of hospitalization, and reduces use of hypnotic drugs.

Methods & Materials: This research is a comparative descriptive study. The population under research was included 50 nurses who were working in CCU wards and 50 patients who were hospitalized in CCU wards that were selected by interviewing and information gathering tools was a questionnaires which consisted of tow parts and for each group one questionnaire was used. The first part was included demographic specification. Second part is consisted of 56 questions (four rating) related to effective factors on patient&aposs sleeping in the domains such as environmental factors, personal (physical and mental) factors, pre-sleeping habits and an extra question (to explain other factors with the except of factors that mentioned in sleeping). Gathered data is processed by SPSS software, 12&aposTh version, and for achieving to research goals, descriptive and perceptive statistical methods (such as t-test, ANOVA test, and Pearson coefficient of correlation) were used. Then descriptive statistic was used in data analysis and statistical t-tests were used to compare of these two groups opinions.

Results: The results of this research showed that environmental factors such as turned on light, pain, anxiety due to loss of job, fears of outcome of disease, connection to monitoring systems are the important effective factors on sleeping according to the nurses points of view however patients believe that phone ring, pain, anxiety from loss of job, fears of outcomes of disease, connection to monitoring systems are important.

Conclusion: According to the research results, the most important effective factors on sleeping are "turned on light", "phone ring" "pain", "anxiety from loss of job", "fears of outcome of illness", "connection to monitoring systems". The foundation of this schedule is based on identification of effective factors on sleeping according to viewpoint of patients and then eliminating the disturbing factors.

---

Background & Aim: Fatigue is a premature symptom in the patients suffering from chronic obstructive pulmonary disease. This study was conducted to investigate the effect of breathing exercises on fatigue level of COPD patients.

Methods & Materials: This clinical trial is a semi-experimental study. 60 patients suffering COPD which are bedridden at, Tehran university of Medical Sciences hospital wards which have been sampled simply and divided into experience and control group randomly. Data gathering is done by interview and data registration from the files. The data gathering tools are questionnaires, fatigue severity scale (FSS) and respiratory exercise usage checklist. The questionnaire includes to sections of demographic characteristics and patient info. The exercises check list is scaled from 0 to 40 in the way that the maximum amount of usage in 10 days, for 4 daily sessions would be 40 and for the case of usage 0 score is assigned. Fatigue severity scale includes 9 questions with visual diagrams scaled from 0 (Lack of fatigue) to 4 (server fatigue). The gathered data is analysis using SPSS software and the descriptive and deductive statistical methods (Tisuchi, Kai2 and Pearson correlation exam) are used to achieve the research goals. Results: The results show that the average fatigue intensity for the experience group is 40.916 with the standard deviation of 14.4 and for the control group is 52.20 with 8.539 standard deviation after the study and statistical T-exam (p=0.001) indicated that there is a significant difference in fatigue severity between experience and control groups after the study. The findings also showed that the average fatigue severity before (55.766) and after (40.166) using the respiratory exercises in the experience group (p<.001) has enormous difference. While the average fatigue severity in the control group (p=0.002) before (54.166) and after (52.200) the study has a ting difference. Regarding the correlation of using respiratory exercises and the changes in fatigue severity, the Pearson statistical exam showed that there is a significant reverse correlation between using respiratory exercises and fatigue severity (r=-0.593, p=0.001).

Conclusion: Based on the research findings it can be concluded that using respiratory exercises is effective in reducing the fatigue in the patients with COPD that also confirms the research assumption and the more the respiratory exercises are used the less is the amount of fatigue in the interfered samples.

---

Background & Aim: High frequency of traumatic and non-traumatic brain injuries in one hand and improvement of the health care condition to restore patient&aposs life in the other hand has increased the frequency of comatose patients in ICU. These patients often experience physical, cognitive, behavior or sensory defects, and the sensory input reduction in intensive care units expose them to cognition disorders. It seems that using sensory stimulation programs may be effective in preventing from sensory deprivation and facilitating recovery process.

Methods & Materials: In this quasi-experimental study, 30 comatose patients who were hospitalized in ICU in Shariati and Sina hospitals were sought to be studied. The subjects were selected randomly using matching that was placed in case and control group. In the intervention group, patients received an auditory stimulation for 2 weeks, 6 days of a week, 2 times a day. The auditory stimulator was a recorded tape (5-10 minutes) of a familiar voice for 30 minutes. The Glasgow Coma Scale (GCS) was used for measuring the level of consciousness (LOC). LOC was measured before and after each intervention 4 times a day. The control group LOC was measured in a similar manner to the case group. At the same time, homodynamic symptoms (blood pressure, pulse rate, and mean arterial pressure) were measured. Non-parametric test was used for analyzing data. The data was analyzed through SPSS V.11.5 computer software.

Results: The findings indicated that there was a significant difference in LOC of the intervention group at the first day and after fourteen days of the intervention (P<0.001), but not in the control group (P=0.769). Although 2 groups were similar in LOC of the first day (P=0.605) but there were a significant difference between their LOC at the fourteenth day (P=0.001).

Conclusion: The results showed that the auditory stimulations with familiar voice were effective in increasing LOC in the comatose patients. It is suggested that nurses expose comatose patients with auditory stimulations using a recorded tape of familiar voice in ICU.

 

---

Background & Aim: Diabetes education does not assure adherence to diabetic regimen. The aim of this study was to investigate the effect of nurse-led telephone follow ups (Tele-Nursing) program on adherence to diabetic diet among type 2 diabetic patients.

Methods & Materials: This was a quasi experimental study. Sixty patients who were registered at Iranian Diabetes Society were selected using convenience sampling method. Data gathering instruments included a data sheet to record glycosylated hemoglobin and a questionnaire. Data were gathered at baseline and 12 weeks after the intervention. First, all participants attended in a three-day self-care education and dietary consultation program at Iranian Diabetes Society. Then, they were randomly assigned to the experiment and control groups. Telephone follow ups were applied in experiment group for 3 months, twice a week for the first month and then weekly for the second and third months. Data were analyzed using SPSS version 13.

Results: Results showed that there were significant statistical differences between control and experiment groups in adherence to diabetic diet (P=0.035). There were significant differences in glycosylated hemoglobin between control and experiment groups after the intervention (P<0.000).

Conclusion: According to the results of the study, it is concluded that the nurse-led telephone follow ups can improve HbA_1c and diet adherence in type 2 diabetic patients.

---

Background & Aim: Surgery is a stressful experience. Fear of postoperative pain causes anxiety. The purpose of this study was to investigate the effect of patient education about pain control on patients&apos anxiety before abdominal surgery.
Methods & Materials: In this quasi-experimental study, 89 patients who were planned to undergo elective abdominal surgery in an educational hospital were recruited to the study. Informed consents were obtained. The participants were randomly allocated in two control (n=45) and experimental (n=44) groups. The questionnaire included demographic information, clinical characteristics, and the Spielberger&aposs State Trait Anxiety Inventory (STAI). Patients in the experimental group received education about pain control one day before surgery. The education method was oral explanation for 20-30 minutes. The control group received no intervention. Data were analyzed through descriptive and inferential statistics (chi-square, t-test, Fisher&aposs exact test, Wilcoxon signed ranks and Mann-whitney&aposs tests) in the SPSS.
Results: Findings indicated that there was a significant difference in anxiety level between the experiment and control groups before surgery (P<0.001). There was also a significant difference between anxiety level in the surgery day (P<0.001) between the two study groups. The anxiety level was significantly decreased in the experiment group.
Conclusion: Based on our findings, patient education about pain control led to reduce preoperative anxiety in patients undergoing abdominal surgery. Patient education is a non-medical simple intervention that is recommended for using in surgery wards.

 

---

Background & Aim: Anxiety is a common experience which is felt as uneasiness, non-specific threat, and activation of autonomic nervous system. The aim of this study was to assess the effect of muscular relaxation on anxiety level of patients underwent cardiac catheterization.

Methods & Materials: In this clinical trial, 118 patients who were expected to have a cardiac catheterization were recruited from an educational hospital at Tehran University of Medical Science. The participants were allocated to two groups, including muscular relaxation group (50 patients), and control group (68 patients). Data were collected using a questionnaire, and a self-report paper for recording anxiety level. Anxiety level was recorded one hour before cardiac catheterization in two groups. Then, the intervention group was asked to listen to the Benson muscle relaxation guide direction tape for 20 minutes through headphone. After using muscle relaxation in the intervention group and immediately before cardiac catheterization, the anxiety level of the respondents was recorded once more. Control group received standard nursing cares. Data were analyzed using χ², Fisher&aposs exact test, Kruscalwallis, Man-Whitney and Wilcoxon statistical tests in the SPSS.

Results: There were no significant difference between two groups in demographic characteristics and anxiety level before the intervention and one hour before cardiac catheterization. After the intervention, the anxiety level was significantly reduced in the intervention group (P<0.001) while it increased in the control group.

Conclusion: Based on the results of this study, Benson muscle relaxation significantly decreased anxiety level in patients who were expected to go for cardiac catheterization.

 

---

Background & Aim: The aim of this study was to investigate the relationship between nurses&apos knowledge about pain and satisfaction from pain relieving procedures among postoperative CABG patients in selected Tehran medical university hospitals.

Methods & Materials: In this cross-sectional study, 100 nurses were recruited from the ICU Open heart. Also, 200 patients were selected from whom underwent CABG in 24 hours after surgery and were extubated using a simple random sampling method. Data were gathered using two questionnaires including 17 question about demographic characteristics of patients and their satisfaction, and 36 questions about demographic characteristics and nurses&apos knowledge about pain and pain control after the CABG. Data were analyzed using descriptive and inferential methods using SPSS-11.5.

Results: There was not significant relationship between the nurses&apos pain knowledge and the patients&apos satisfaction. However, there were a significant relationship between the knowledge of the nurses about pain control after the CABG and the patients satisfactions (r=0.209, P=0.037).

Conclusion: According to the findings of the study, there were some significant relationships between the nurses demographic and pain knowledge with the pain control after the CABG. There was also significant relationship between patients&apos satisfaction and some of them demographic characteristics.

---

Background & Aim: With the increasing phenomenon of elder abuse in today's societies, understanding the facilitating and inhibiting factors related to abuse seems necessary. The purpose of this study was to explain the facilitators of elder abuse in Iranian society.
Methods & Materials: This is a qualitative study that used a thematic analysis approach to collect and analyze data in order to explain the elderly’s perceptions of the facilitators of abuse. In this study, 20 elderly people in the community were selected by purposeful sampling. The data were collected by in-depth, semi-structured and face-to-face individual interviews. The Braun and Clark’s thematic analysis was used to analyze the data.
Results: The results of data analysis led to the identification of three themes including role modeling, evacuation of failures, and cultural-familial context of the society. The third theme had three sub-themes intergenerational gap, parenting style and society’s indifference.
Conclusion: Abuse is the result of a combination of causes and factors. The elderly’ experiences suggest that abuse goes beyond a personal matter and is rooted in cultural, social, and economic practices. Today, it is not acceptance of each other and disregard for the expectations of the other party that gives rise many contradictions and abuses at the family and community level.