---

The term: SID syndrome applies to sudden and unexpected death of the infant for which no diagnostic fetal factor has been found. It is also applied to sudden death of a less than one year old baby, the cause is not recognizable after complete post mortem study, and review of disease records. Such a death will be a very bitter and sorrowful experience for the family, therefor the nurses are bound to support the family both mentally and spiritually.

---

This research is a descriptive - analytic study which has been conducted in order to assess the application for prevention of osteoporosis, on menopausal women referred to the health care centers of Tehran University of Medical Sciences in 2001.The research subjects were composed of 336 menopausal women who had been selected by two-stage sampling.The results of the research showed only 4.8% of research subject had adequate calcium intake.Also 5.1% of research subjects have been treated by hormonal drugs, 7.7% of research subjects have taken non hormonal drugs adequately, and (78/3%) had no physical activity.Also the results showed, the application of preventive agents for osteoporosis was influenced by the variables such as: age menopausal characteristic, educational level, marietal status, family income, history of bone fracture, family history of osteoporosis, having employed relatives engaged in medical group, also receiving and having preventive information.

---

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.

---

This is a retrospective research in order to compare the side effect of DMPA with OCP in reproductive women referring to health center in Kalaleh in year 1998. In this assessment the total number of women participated were 198, from this 115 were using Depo medroxy progesterone injection, and 83 women taking OCP. All the research subjects were assessed for having specifice character necessary for this research, and participated willingly. Data collecting was done by the means of questionnaire and checklist, data analysis was performed. The result revealed most users of DMPA were older with higher incidence of pregnancy and more children, lower socio - economical education and using injection for shorter period, comparing to women taking tablets, however the users of injection were taking OCP before, but those taking OCP never used any other method of contraceptive. There was a significant differences in headache, nausea, decreased vaginal discharge and menstrual problems, but no significant differences in acne, backache, leg cramps, mastalgia and hair loss were observed.

---

This research is a descriptive study in order to assess barriers and facilitators of research utilization among nurses working in teaching hospitals in Tabriz, year 2001. The aim is to identify causes of low extent of utilization and also to assess barriers and facilitators of researches. This study was conducted upon 304 nurses working in 12 teaching hospitals of Tabriz, which were selected by random sampling. Instrument used for study was questionnaire. Data were analyzed using SPSS (10). The results of this study showed that three major barriers for research utilization included: 1) inadequate facilities for implementation, 2) Physicians will not cooperate with implementation and 3) the nurses do not have sufficient time to read researches. Facilitators which nurses suggested, emphasized on the role of education in enhancing their knowledge and skills of research evaluation.

---

The present research is a descriptive - analytic study about the rate of use, reasons of use or refusal of Hormone Replacement Therapy in menopausal women referred to gynecology clinics in selected hospitals of Tehran University of Medical Sciences in the year 2001. Samples of research included 400 women age between 40-65 years which selected on accidental basis and collected means was questionnaire which contain demographic characteristics (age, job and education), receiving information, information source, the reasons for use or refusal of Hormon Replacement Therapy. Research findings showed that 8.75% of menopausal women used Hormone Replacement Therapy. Their reasons are as follow: 28.57% due to physician recommendation. 26.37% due to improvement of hot flash. 23.08% for prevention of osteoporosis 16.48% due to hysterectomy. 3.3% due to prevention of cardiovascular diseases. 2.2% because of improvement of sexual activities. The reasons for non-useres are as follows: 46.96% having no information about such a method, 16.4% thinking about menopuae as a natural phenomenon and no need for treatment, 10.53% not-suffering from menopausal effects, 7.08% medical recommendation, 5.6% fear of hazardous effect leading to cancer. In the present research, there is no significant relationship between age, job and the method of Hormone Replacement Therapy but have significant relationship between education rate and receiving information about the method of use.

---

The present study is a descriptive one made for the purpose of quality assessment of family planning counseling in health and treatment centers affiliated to Tehran University of Medical Sciences in year 2000. 410 client of the Family Planning Social Services who had attended 25 health and treatment centers affiliated to Tehran University of Medical Sciences were participated in this research study. A checklist was completed through the observation of family planning counseling sessions. The finding and results of this study showed that personnel&aposs behaviour and the quality of family planning counseling for the majority of samples in the first section have been suitable. In the section of the history taking from clients helping them to select suitable method and to determine next appointment, data for the majority of samples in this study have been in an average level. In the section of need understanding of clients introductory methods providing information the audiovisual training equipments used during family planning counseling, explanation of way of utilizing the selected method, and finally the environment for family planning counseling have not been suitable for majority of the samples. The findings of this study can be beneficial for public health planning in order to improve the quality of the family planning services.

---

Iron deficiency is the most common nutritional deficiency in the world. Women at childbearing age are at particular risk of developing iron deficiency due to the iron losses associated with menstruation and childbirth. Therefore, iron supplements are needed in certain groups, while in particular regions increased dietary intake could be provided through food. This descriptive study attempts to identify practice among university students of Tehran University of Medical Sciences in the prevention of iron deficiency anemia due to menstruation in the year 1999. This study includes 257 university students of different majors (such as medicine, dentistry, pharmacy, obstetrics, nursing, nutrition, health (occupational, Public) laboratory sciences) of the Tehran University of Medical Sciences who were selected through a simple random sampling method. The pattern of study was a questionnaire consisting of 37 questions, in addition to a chart to determine food consumption frequency. The questionnaire was divided into three sections: demographic data, the status of nutrition, and iron supplementation. To analyze the data descriptive statistics and (2) test were used. The results showed that the most of the samples were in the age group of 21 to 25 years and 36.5% of them stayed in dormitories. Most of the subjects of study had moderate nutrition and some of them had good nutrition. The majority of them (92.5%) were not using the iron supplements during the menstruation period and the duration between two subsequent menses. The results of the research show that the function of 35.2 % of the subjects of study in relation to the prevention of iron deficiency was weak, 53.9% of them were moderate and only 10.9% of them were good. The statistical test (2) which was used to analyze the results obtained, showed a significant relationship between the practice of the subjects and their living in a dorms (P<0.001). In conclusion, the application of the results for further researches and also for practical use has been proposed.

---

Total fertility rate relates to the number of children that a woman bears in the fertility period of her life. Fertility function is one of the most important health and population indicators. This indicator affects social, health, economic and cultural factors. This study is an ecological or correlative one. Factors affecting total fertility rate in Iran in the year 2000 are studied in this paper. The factors include coverage of women with focus on higher education, infant mortality rate (under 1 year), women’s occupation rate, urbanity ratio, mean age in the first marriage of women in the age group 15 to 49 years as per the last census in Iran in 2000 in 26 provinces. The direct and indirect effects of these factors on total fertility rate, with emphasis on path analysis have been determined. Data analysis shows that women's occupation rate is the most important factor in decreasing total fertility rate. Higher education of women is also an important element in this regard. Therefore increase in the number of women with university education not only decreases the total fertility but also increases the occupation of women.

---

For diagnosing PROM, the need has been acutely felt for special care in obstetrics. Coordinated management for patient care between the clinician and midwives is the custom in several obstetric care centers. Diagnosis and treatment by the physician has greatly facilitated the work of midwives, to the extent that they now play an important role in the special nursing of women in solving obstetrics. This article reviews important topics such as: epidemiology, physiology, pathology and patho-physiology. It also covers preventive measures, objective and subjective evaluation, diagnostic tests and management of PROM, as well as the psychological aspects of hazards for motherhood, fetus and childbirth.

---

One of man's fundamental needs is communication. Nurses within their specialty sense this need in their relationship with their patients, even though in some cases with physical impediments e.g. the placing of bypass tubes, this relationship is endangered. This study is a quasi experimental research, whose main aim is to compare the effects of two types of communication methods on anxiety and satisfaction in patients after cardiac and bypass surgery having intubation, warded at chosen hospitals affiliated to the Tehran University of Medical Sciences. According to the specific criteria, 90 patients were randomly selected by divided into two groups (experimental and control). The researchers met all patients the day before the surgery explained the reason and use of the picture chart for the experimental group and the routine communication methods for the control group. Therefore on the day of surgery communication was established with both groups with their own particular method. Data collection was done through a questionnaire consisting of: 1) demographic specification and clinical history, 2) Spielburger's questionnaire for obvious anxiety and 3) visual analogue scale (10cm) for patient satisfaction evaluation which is undertaken the day after surgery and after extubation. The results of the χ² test and the Fisher's exact test showed significant statistical differences between the two groups concerning the level of the patient's anxiety and satisfaction. The use of the picture chart for the experimental group, decreased patient's anxiety resulting from speech disability and increased their satisfaction with their communication with nurses as compared to the control group. Considering the beneficial results from using picture charts in establishing communication with patients, nurses with the help of devices, must try to create better relationships with intubated patients in the post-surgery period and provide them with more desirable services.

---

Urinary incontinence is a common problem in women. It seems to have negative effects on different aspects of the patients' life. This study was undertaken to determine the quality of life in women with urinary incontinence with referred to hospitals affiliated to Tehran University of Medical Sciences. The samples consisted of 263 women all over the age of 18. None of them were pregnant, had not delivered babies last 3 months, had no chronic diseases, were willing to answer questions posed and were also randomly chosen. The samples of the questionnaire about quality of life were collected using I-QOL and variables of type of urinary incontinence, intensity of urinary incontinence, duration of illness, occupation and education were taken into consideration. Analysis of data has been done by using SPSS Statistical tests 2, Pearson and Mantel - Hanzel. Findings of this research indicated that none of the patients led a comfortable life and (45.2%) of them suffered from a quality of life below standard. 51.3% of the women until the time of the study had not visited a physician and 54.8% of them had the impression that the symptoms seemed to be a normal and common problem and that is why they did not seek professional help. The results also indicated that the effect of urinary incontinence was significantly related to the type of urinary incontinence (p<0/0001), duration of the disease (p<0/02) and level of education (p<0/006). In conclusion despite the negative effects of urinary incontinence on the quality of life of women, most of the patients did not seek professional help. It is suggested that the health care providers pay more attention to this issue and utilizing health care centers, train women in the prevention of urinary incontinence.

---

Nurses play various roles and have various responsibilities in helping patients or other members of the society for example in training, providing support, caring, and in coordinating. The proper performance of these services is dependent on their undertaking of these various responsibilities. Nurses with increased knowledge as to their responsibilities and the proper fulfilling of these in the various fields can be influential in the success of treatment measures. This research is a descriptive study to assess the nursing staff’s perception of their roles and activities at hospitals affiliated to the Tehran University of Medical Sciences, conducted on a random sampling in the years of 2001 -2002. Some 104 male and female members of the nursing staff, randomly chosen, participated in this research. The data was collected by means of some questionnaires of 3 parts containing 8 questions related to demographic characteristics, 41 questions related to the quadric roles namely, teaching, supporting, protecting, coordinating, and 2 open questions regarding obstacles and their suggestions in preventing these obstacles. Analysis of data has been done by using SPSS descriptive and inferential statistics. The results with respect to the roles of nurses in different fields show that most of their roles were in teaching activities in relation to patients, in support relating to stressful and upset patients, in the field of protection during catheterizing and dressing and coordinating daily visits. Results relating to the level of performance of these responsibilities are as follows 31.7% in training activities, 35.6% supporting activities, 38.45% protection and 54.8% coordinating activities, respectively, stood at a favorable level. The greatest percentage of unfavorable performance was noted in the supporting role of the nurses. The results also showed that the level of readiness of the nurses to perform the above mentioned four roles was registered as average to good. In addition some factors such as frustration, lack of on the job training, insufficient number of personnel, lack of proper facilities, and insufficient income…, have a great impact on nurses and the removal of obstacles in the performance of their duties.

---

Menopause is a physiological change for women, which occurs between 40-59 years of age and has a great impact on their life quality and its patterns. This is a descriptive and analytic research, which was carried out to assess the impact of menopause and some socio-demographic and medical variables on quality of life and its patterns in Tehran in 2001. Samples were taken at random from 210 healthy women aged between 40 to 60 years and in four groups: pre-menopausal, about menopausal, menopausal and post-menopausal women with duration of less than or more than 5 years. The data was collected via a special questionnaire through interview. Analysis of data has been done by using SPSS Statistical tests 2, Bonferroni and LSD. The findings show that quality of life and its patterns were related to the menopausal stage with the highest percentage related to pre-menopausal women and the lowest to post-menopausal with a duration of 5 five years (p<0/0001). The results of the study were affected by different factors such as menopausal signs, marital situation and the age of the samples but there was no relationship with duration of the menopause, job, education, financial situation of the women, the age of the woman's first menstruation, and the number of children staying with the family. According to the findings, it is suggested that the health program designers and decision makers develop special plans to enhance women's quality of life and patterns, especially women who are about menopausal age (the first five years).

---

Post-surgery pain is usually controlled by PRN drugs administered by nurses. According to the decision-making theories, this clinical decision-making depends on three factors: nurse-related factors child-related factors and hospital-related factors. This study deals with the first and second factors mentioned. This descriptive-analytic study aims at determining the perspective of nurses on factors which affect their decisions to administer the analgesic PRN to children after surgery in several chosen hospitals of Tehran. The study used a standardized questionnaire to collect data from 57 nurses in pediatric surgery wards. The questionnaire consisted of three parts: 1) nurses demographic data 2) 20 clinical scenario for nurses to make a decision for prescribing either analgesic medication, non-analgesic medication or no medication where necessary and 3) 12 factors which affect clinical decision-making in using analgesics.(in prioritizing among the above mentioned). The results show that factors such as age, nursing experience, pediatric nursing experience and motherhood were significantly related to choosing to use analgesics. Education and personal experience of extreme pain was also related to the type of analgesic chosen. Concerning the specifics of the children there was a significant difference between the choice to use analgesics and the type of analgesic used according to the various ages of the children. There was also a significant relationship between the type of surgery and the time of surgery and with the choice to use analgesics and the type of analgesics used, such that medication and analgesics were administered more frequently for complicated surgeries and in first 24 hours after surgery. Type of surgery, severity of pain, time of surgery and uneasy behaviors were selected respectively as the most effective in the administration of PRN analgesic drugs. Nurse and child related factors strongly influence nurses in making decisions to administer PRN analgesics postoperatively.

---

Consideration of the lifestyles of nursing students, because of the fact that they are at the age where their choice of lifestyle can influence their entire lives, is of vital importance. On the other hand nursing students are conveyors of health information and are responsible for guiding others towards the way of life therefore they themselves need to be appropriate models for those in need of help and the society as a whole. This study is a descriptive research, whose aim is comparing the lifestyle of first and final term female BS nursing students. This investigation was undertaken in Nursing and Midwifery schools of Tehran Medical Science Universities, by sampling 139 students in their first term and 159 students in their final term. The factors of life style under examination were nutrition, exercise, smoking, safety precautions and stress management. The method of data collection was questionnaires that consisted of demographic and life style particularities. Research findings showed that 37.4% of the first term students had moderate nutrition and 49.9% had good nutrition. As concerns physical exercise (37.4%) and (41.1%) of the first and final term students had moderate physical exercise respectively. Research findings also showed that none of the students of either two groups smoked cigarettes. As relates to safety precautions results showed that 37.2% first term students and 35% in final terms students had moderate behavior. In stress management (36.5%) first term students and (32.9) last term students had good behavior. In general (40%) of the samples in their first term had moderate lifestyles while (32.8%) in their last term had very good lifestyles. "t" Statistical test showed no significant difference between the two groups. Research findings showed that nursing education and training in no way influenced life style and that other factors were influential but they require further study.

---

Fear is an undesirable feeling which most of the time results in physiological changes and can affect on the cardiovascular function of the patient. This research is a cross-sectional descriptive study that describes the congruency opinions between 91 patients /nurses about the reasons for patients’ fear related to coronary angiography in two affiliated hospitals of Tehran University of Medical Sciences. The tools which were used included: questionnaire for study and recognition of patient and nurses demographic characteristics, a check list containing thirty probable reasons for patients’ fear which were filled out by patients and nurses, and a scale for analysis of the reasons for fear which were filled out by patients, descriptive statistics indicators, sign test, and t-test were applied in order to analyze the data, by SPSS software. The results showed that patients’ and nurses’ ideas about the reasons for fear before angiography are similar in two cases and only in one case after the operation. Among the thirty probable reasons which were mentioned for patients’ fear, seventeen cases caused less fear after angiography and two cases caused more fear after that. In the comparison between the intensity of fear caused by other reasons no insignificant result was observed. The comparison of intensity of fear showed that the intensity of patients’ fear after angiography is less than before (p= 0.005). According to these cases it may be concluded that because of the different reasons for patients’ fear concerning angiography, nurses need to pay more attention to patients’ fear. It is also suggested that an assessment tool be used in order to assess issues relating to patients, level of care and training related to coronary angiography.

---

Unintended pregnancy is a world wide problem that affects women, their families, and society. From a total of 175 million pregnancies per year 75 million of them are unintended. This cross-sectional study was undertaken to determine prevalence of unintended pregnancies and pertinent factors and suggests an appropriate solution. A sample of 400 women who were seeking pregnancy tests in laboratories of hospitals affiliated of Tehran University of Medical Sciences, at the obstetric and gynecologic ward, and who had positive tests were selected by the Poisson random sampling method. Women who were found to have diseases such as hydatidiform mole were excluded. A questionnaire was used to collect data. Pregnancy intention was measured using NSFG 2001 questionnaire. Descriptive and analytic tests (chi-square, Fisher exact, t-test) were used to analyze the data. Prevalence of unintended pregnancy was 47.5%, of whom 36.3% hadn’t used contraception methods. Fear of side effects (66.7%) was the most prevalent reason of not using contraception. The main reason for unintended pregnancy was economical problems (42.6%). 63.7% of women with unintended pregnancy had used one of contraceptive method but 86.8% of users had used that method in an incorrect way. Also the results indicated that the age of women, educational status, number of children, husband’s age and education were associated with contraceptive use. The results indicated that prevalence of unintended pregnancy is high and the contraceptive methods weren't used or were used incorrectly by most of them (91.6%). This may show the necessity of training women about contraceptive methods and side effects of unintended pregnancy. Due to the important role of health care providers they should be trained to give such consultation to women.

---

This research is a descriptive-analytical study conducted with the aim of examining and comparing adjusted behaviors of children (brothers and sisters) suffering from a chronic disease, referred to treatment centers with the siblings of the healthy children of the same age, in Tehran. The research sample was a group of 300 children along with a pair of parents. They were divided into groups of 150 siblings suffering from a chronic disease and 150 siblings who were healthy. For sample-taking of the children suffering from chronic disease parents of the children referring to hospitals or hospitalized in wards, who had the required qualifications were also studied through simple random selection. In order to select healthy children and their parents, the parents of the children referring to specified treatment centers for receiving medication and clinical treatment were selected as the control group, through the simple random sampling method. The basis of research comprised of a questionnaire comprising of two parts. The 1st part consisted of demographic particulars and the 2nd part constituted the form of questions put to the child's parents, whose form was prepared on the basis of the standardized child behavior checklist in accordance with Achen Bach's parents’ report. The form consisted of two parts: one concerning social merit (6 questions on activities, social relations and studying performance of the child) while the other related to behavioral problems of the child (102 questions in relation to social problems, anti-social behavior, aggressive behavior, difficulty in concentration, physical complaints, anxiety, depression, isolation disorder in thinking, sexual problems and miscellaneous matters). The results in relation to the research objectives point out that there is by p<0.001 and p< 0.005 and in a sensible manner, the behavioral problems of the siblings suffering from a chronic disease as compared with healthy siblings are more and their social merit is less.

---

Childbirth is one of the most stressful situations in a woman's life. In order for a woman to adjust to the stress of delivery and to make it a happy experience for her, she should be supported with adequate information as well as emotionally and physically. This research was undertaken to analyze the opinion of mothers concerning the importance of and their satisfaction with information, physical and emotional support received in the labor and delivery rooms. In this descriptive-analytic study 400 post-partum mothers from 10 various training hospitals in city of Tehran in the year 2000 were randomly selected and interviewed by questionnaire in the post-delivery ward. Results showed that most of the mothers placed great importance on physical, informational, and emotional support, respectively. They had received inadequate physical and informational support and relatively adequate emotional support. But most of them were satisfied with the informational, emotional and physical support, respectively. There was no significant association between the level of satisfaction of the mothers with these three types of support and their importance but there was a significant association with the way that support was received. (P<0.05). Complete satisfaction with the support offered, despite their inadequacy or limitations, may be due to the fact that mothers are unaware of their rights and have few expectations or may be due to the time of conducting the interview (just before discharge). The lack of any relation between the demographic variables and the value of importance in the different areas of support shows that these are basic needs and all should be equally provided. In order to increase satisfaction, support and care should be provided to mothers in the best possible fashion. Finally, regarding the presence of midwifery students and their teachers in teaching hospitals, they should be made directly responsible for the reformation of the hospital system, preparation of hospital charts and their organization.