Introduction: Infertility and depression are major problems of today&aposs societies. Although depression is one of the most prevalent diseases in primary care practice, consult for receiving help is carried out much less than true prevalence of the disease. Therefore gathering information about prevalence and risk factors of depression is very valuable. Beck Depression Inventory (BDI) which is a screening tool for depression can be used in Iranian patients because of availability of a validated translation. The objective of this study was to estimate the prevalence of depression in infertile subjects in an infertility center.

Materials and Methods: In this study, 681 infertile women were evaluated in Shariati Hospital, Tehran. Demographic information’s including age, duration, type and cause of infertility, level of education, previous treatments and smoking habits were recorded. BDI was completed by patients and score was estimated. Score of 16 and higher was assumed positive.

Results: There was no relationship between age and prevalence of positive BDI score, but prevalence of positive BDI score was higher in infertilities of longer duration, infertilities caused by both male and female factors and in patients with low level of education and history of previous treatment or surgical therapy.

Conclusion: Infertile patients are at risk of depression. Rate of consulting with psychiatrists and getting help is low in our country due to cultural aspects, so screening of high risk subgroups in infertile patients and referring them to psychiatrist would be very helpful.

Introduction: Evaluation of health care services is an essential step in improving health care quality and without it such an improvement could not be achieved.

Material and Methods: In this descriptive study, parent’s satisfaction of child’s health care in the health and treatment centers affiliated to Tehran University of Medical Sciences was evaluated. Four hundred parents who had attended 25 health and treatment centers were participated in this research. A questionnaire was completed through the interview with parents of 1 to 12 months old children. Analytical and descriptive statistics were used for the analysis of data.

Results: The finding of this study showed that the majority of parents had average levels of satisfaction concerning communication’s skills of health care providers and high levels of satisfaction about availability of these cares. Satisfaction of parents in the section of the vaccination was high and majority of samples had average levels of satisfaction about growth monitoring of children. There was a relationship between infant&aposs age and parent’s satisfaction.

Conclusion: Based on these findings recommendations have been made for future research. The findings of this study can be utilized in public health planning in order to improve the quality of the infant’s health care services.

Introduction: Folic acid is one of the most important vitamins for women of reproductive ages, especially before conception and during pregnancy. Many researches have shown the role of folic acid in prevention of fetal malformations especially neural tube defects, anemia, cardiovascular disease and some cancers.

Material and Methods: This research is a semi-experimental study. A sample of 130 married women at reproductive ages (15-45 year) referring to health centers in Kermanshah was selected randomly. The tool for collecting data was questionnaire. After filling the pretest questionnaire, each woman participated in a face to face 15 minutes educational session. Two weeks later the same questionnaire was filled by the participant. To analyze the data, the descriptive statistics, frequency distribution charts, the mean and central tendency as well as validating statistics (2 test and t test) was used.

Results: The results indicated that there was a statistically significant difference in amount of knowledge (p 0.0001, t=-27.381) and the amount of usage (p=0.0001, 2 = 42.968) of folic acid supplement before and after education. This difference was more prominent in women between 25-29 years of age, self-employed, with diploma degree, housewives, having diploma holding husbands and first time pregnancies.

Conclusion: The amount of information and usage of folic acid supplement increased significantly after education. This finding reveals the importance of health education and the important role of health personnel such as midwives. Therefore, it is suggested that women of reproductive ages be informed of importance of taking folic acid supplement.

Introduction: Documentation of nursing care and procedures is an evidence of performance and quality of these cares. Failure to document could be a sign of inadequate care performance.

Method and Materials: This study was carried out to determine causes of inadequate nursing documentation in wards of Shahid Beheshti Hospital, Zanjan, in 2003. This study was a descriptive survey a checklist was designed according to standard principles of nursing documentation which was validated by 10 academic members. Patients&apos files were assessed based on this checklist. Also, 20 nurses were interviewed (open question) to determine of causes of incorrect nursing documentation.

Results: The results showed that 17% of items of checklist had been documented correctly, documentation’s of 35.81% of these items were incomplete and 48% of items had not been documented. The interviews showed that the inadequate nursing documentation was related to inattention to these documentation’s and lack of control of nursing documentation, work overload of nurses, educational problems and unawareness of legal and occupational issues.

Conclusion: Documentation of nursing care was inadequate. The most important causes were inattention and lack of control. Considering importance of nursing documentation, ways to solve these problems must be sought.

Introduction: Pregnancy is a natural phenomena and basis of birth but can induce various dangers to mother and fetus. Since mother is the central part of family, maternal mortality would be an irreparable damage to the community. On average 10100 live births and 12 maternal mortalities occur in Kurdestan province each year the maternal mortality rate is therefore 118/100000 live births which in comparison to similar figure in whole country (37/100000 live births) is three times higher.

Materials and Methods: This research is an analytic case-control study. Cases and controls were matched for place of residence and age at gestation. Cases (n=55) were chosen by census and controls (n=220) were chosen by random sampling. The tool used to collect data was questionnaire, validity and reliability of which was tested by content validity and test-retest method. The statistical testing used in this study were Chi square and odds ratio. Data were analyzed by SPSS .11 software.

Results: Most of maternal mortalities had occurred in women 18-35 years of age, illiterate and living in rural areas. Marivan had the highest maternal mortality compared to other surveyed cities (29.1%). Prenatal care (OR= 22.7), parturition agent (OR= 9.85), use of one of the method of family planning (OR= 2.5) and parturition method (OR= 2.3) had meaningful relationship with maternal mortality.

Conclusion: According to findings of this research, it is possible to decrease the maternal mortality by improving prenatal care and family planning and preventing parturition by uneducated midwives and avoiding unnecessary cesarian sections.

Introduction: Children&aposs health is an important issue in activities of many international organizations. To prepare the children to understand and practice the ways of healthy life, the schools should play their important role by planning and performing effective health education programs.         

Materials and Methods: This research is an analytical-descriptive study. The samples included 330 students who were selected through multistage stratified sampling method. The data was gathered by a questionnaire and were analyzed by using the inferential and descriptive statistics.

Results: The results showed that there was no statistically significant difference between health behaviors of students in schools with and without health educators in the domains of eye and skin health, nutrition, sleep, rest and physical activity, but there was a significant difference between health behaviors related to ear (2=8.58, p=0.014) and tooth (2=9.35, p=0.009) the students with educator had healthier ear and tooth behaviors than students who didn&apost have educator. In the domain of mouth and tooth the girls had healthier behaviors than boys. In the domain of physical activity the boys had better health behaviors than girls, having educator or not.

Conclusion: Overall, there was no significant difference between health behaviors of students in schools with and without health educators. Formation of healthy behaviors is a multifactorial issue and survey of all factors and variables affecting health behaviors can provide clearer measures for planning the health education programs and optimum usage of resources, manpower, budget and time to promote awareness and performance of health behaviors in schools.

Introduction: Hypertension is a major risk factor for coronary heart disease. Truck drivers are more exposed to hypertension due to sedentary life style and consequent obesity, improper food, job stress and high prevalence of cigarette smoking.

Materials and Methods: In this study, after completing a questionnaire by interview, the blood pressures of 122 members of ::::union:::: of truck drivers of Sari, Northern Iran, were measured in two separate occasions. Measurement of blood pressure in all drivers was performed from right arm by using a digital automatic OMRON sphygmomanometer. In order to measure correctly, guidelines of American Heart Association were noted. Analyze of data was performed by SPSS software and descriptive statistics such as mean, standard deviation and Pearson correlation were used.

Results: Analyze of data showed that most of truck drivers (59.1%) were overweight and 14.8% of them were obese. Mean of BMI was 25.5 (standard deviation 4.65). Around 48.3% were smoker, 61.5% didn’t have physical activity and 36.9% had hypertension, which was mostly mild to moderate. Mean systolic blood pressure was 135.08 (standard deviation 17.44) and mean diastolic blood pressure was 82.86 (standard deviation 8.16). Seventy seven percent of hypertensive patients were not aware of their problem. Statistical tests showed that there was a significant correlation between job history, BMI and hypertension.

Conclusion: Regarding high incidence of hypertension in truck drivers, it seems that similar studies must be done in other long-distance drivers, such as bus drivers, and their blood pressures must be assessed at least once a year.

Introduction: With a dramatic increase in costly mass casualty incidents over the past few decades, disaster planning and preparedness now represent a prominent part of health care policy and practice. Administration of computer technologies, including computerized simulation techniques, in hospitals can improve management of future incidents.

Materials and Methods: In this research, we used SIMAN/ARENA software of disaster management in one of the teaching hospitals of Tehran University of Medical Sciences. Data about the patients&apos need for specific surgeries, possibility of re-operation, length of operations and necessary equipment’s including number of operating rooms and staff, imaging facilities and treatment stations in emergency department were collected. Two teams took part in this program: a simulation team and the hospital staff team. Both teams were trained before taking part in this study.

Results: With the help of simulation system, the simulation team created various preplanned “events” and simulated in and out hospital situations. Hospital staff team reacted to these situations and was able to recognize and solve various problems in different critical points in hospital by using different tactical means.

Conclusion: Simulation technique used in this limited scale drill was useful in evaluating and improving preparedness of hospitals for managing a multi-casualty incident. The current system can be used in all hospitals in Iran to improve preparedness for receiving victims of a multi-casualty incident.

Introduction: According to WHO, prolonged labour is one of the most important causes of maternal and newborn mortality. This study was carried out to assess the impact of education of partogramm on quality of midwifery’s care.

Materials and Methods: This survey was a quasi experimental study with one group pretest-posttest design which was carried out in some of governmental hospitals in Tehran in 2002. Subjects were 53 midwives who were working in different hospitals. The data was collected with an special questionnaire, WHO’s partogramm, and a check list to assess quality of midwifery care in labour. Result were analyzed with SPSS software.

Results: The findings showed that after education of partogramm a statistically significant improvement occurred in recording of twelve of fifteen variables including fetal heart rate, condition of amniotic fluid, vaginal bleeding, vital signs of mother, urine examination, drugs and fluid use, correct plotting of cervical dilatation, correct movement of dilatation graph to alert line, number of vaginal exams, recording time of rupture of membranes and time of amniotomy (p<0.0001).

Conclusion: The findings of this study indicate education of partogramm has a positive effect an quality of midwifery’s care and emphasis important of its education to midwifery’s students

Introduction: Maintenance of the body temperature reduces mortality in low birth weight infants and adequate environmental warmth is essential for maintenance of the body temperature of newborns. However, neonatal hypothermia continues to be a significant issue in the developing countries. This study was performed to describe the incidence and severity of hypothermia after delivery.

Materials and Methods: We measured body temperature of 898 consecutive newborn infants by a low-reading thermometer. Body temperature less than 36.5°C was designated as &aposhypothermia&apos. In such cases, the infants were re-warmed according to the WHO recommendations, their body temperature was recorded every hour and their final outcome was noted.

Results: The overall incidence of hypothermia was 53.2%. A total of 456 (50.2%) infants had mild hypothermia (35°C > T > 36.5° C) while 22 (2.5%) had moderate to sever hypothermia (T < 35°C). The incidence and severity of hypothermia was found to be significantly associated with birth weight (p=0.000) and gestational age (p=0.000). The duration of re-warming was also correlated with birth weight (p=0.000). Logistic regression analysis showed that the mortality rate of hypothermic neonates was 3.64 times that of the normothermic infants. The risk of death was higher in the moderate to severe hypothermic groups than in the mild hypothermic infants.

Conclusion: The incidence of hypothermia was found to be high with both the incidence and severity to be significantly associated with birth weight and gestational age. The risk of death was recognized to be higher in the hypothermic newborns than non-hypothermic ones. These results show the importance of maintenance of the body temperature of newborns.

Introduction: Nurses as the main members of treatment-and-care team play an important role in improvement and promotion of health in society. Job stress is a recognized and integral part of modern nursing which has destructive effects on both nurses and patients.

Materials and Methods: The present descriptive and analytical study aims to determine the level of nurses&apos job stress in Tehran in 2004. It also tries to identify factors affecting job stress from nurses&apos point of view. A total of 111 nurses working in two educational and non-educational hospitals in Tehran were studied. The sampling was simple, i.e. the subjects volunteered to participate in the study. A questionnaire with 2 sections was developed. In the first section we asked about personal and professional characteristics and the second section was designed to evaluate job stress in following 5 categories: management, economy and welfare, mentality and social affairs, occupational health and ergonomics. There was also an open-ended question asking about nurses&apos attitude toward job stress. The questionnaire items were to be answered on a scale ranging from 0 to 4. We used descriptive statistics and Chi square statistical test to analyze the collected data.

Results: The results showed that 44.1% of samples had high levels of job stress while 54.1% suffered from medium and 1.8% from low levels of job stress. There was a significant relationship between hospital type and job stress job stress in the educational hospital was higher compared to the noneducational hospital. There was also an inverse relationship between years of experience and job stress.

Conclusion: Due to high percentage of the subjects with high to medium levels of job stress, employment of preventive and precautionary procedures regarding job stress is recommended.

Introduction: Phenomenological investigation of nursing profession and nurses&apos perspectives in Iran in comparison to a caring-oriented nursing system (Sweden) is the main purpose of this study.

Materials and Methods: Interpretive phenomenology was used to conduct this study. Data gathering methods included observation and semi-structured interviews with 1) Iranian nurses, 2) Swedish nurses, 3) Iranian nurses who graduated from nursing in Iran but work as nurse in Sweden and 4) Iranian nurses who work as nurse in Sweden and studied nursing there. Content Analysis was used for data analysis.

Results: Except humanitarian approach to nursing in a small group of Iranian nurses, the difficulties experienced due to work conditions and environmental factors have lead them to a state of burnout. Although caring is a primacy in nursing, enough attention is not being paid to it in nursing education programs.

Conclusion: Burnout as a main theme which emerged in this study affects all aspects of nursing profession in Iran. The nature of nursing profession, its routine tasks and poor public image as well as sociocultural factors have influenced nursing negatively.

Introduction: A variety of maladies, sometimes disabling, beset many ovulatory women in a recurrent manner during the luteal phase of each ovarian cycle. These problems can deteriorate interpersonal relationships and/or interfere with normal activities of life. Present research was performed to evaluate effects of hypericum perforatum for treatment of physical symptoms of premenstrual syndrome.

Materials and Methods: This study was a randomized, double-blind, placebo-controlled, parallel group compassion study performed over two menstrual cycles on student of Tehran University of Medical Sciences and Tehran University. Volunteers underwent a preliminary screening interview, completed Beck questionnaire as a screening test for depression and attended a medical screening visit before being diagnosed as having premenstrual syndrome. Participants administrated hypericum or placebo, 30 drops BD, for two complete cycles. Premenstrual symptoms were evaluated by a daily symptom report form. Data analysis performed by Chi square, Fisher exact, Wilcoxon and t tests.

Results: Premenstrual daily hypericum caused a significant improvement in mean daily score of severity of premenstrual problems compared to placebo (p<0.05). Premenstrual administration of hypericum, 30 drop BD, showed significant advantage over placebo for physical disorders (%49, p=000).

Conclusion: Daily premenstrual administration of hypericum perforatum treats physical symptoms of premenstrual syndrome. It seems that hypericum perforatum can improve symptoms of premenstrual syndrome.

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.

Introduction: Cesarean section (CS) is more dangerous than normal delivery for mothers and neonates. Rates of CS in our country are very high, especially in Guilan province (57.6% in urban areas). The claim that a major reason for these high rates is maternal request, hidden behind of the routine medical diagnoses, was the basis of present study.

Materials and Methods: A total of 210 pregnant women in Rasht who were at 36-40 weeks of pregnancy and had chosen CS as their delivery method without previous history of CS or any medical reason were included in this study. Cluster sampling was performed at health-treatment centers of Rasht. Data were collected by interview and a questionnaire was completed by the investigators. Statistical analyzing was performed by descriptive and analytic methods (Chi square and Fisher exact test).

Results: The majority of participants (68.6%) had moderate knowledge about benefits and harms of CS and most had taken their information from relatives and friends. The majority of women (71.4%) had moderate attitude toward CS. More than 50% of the mothers had chosen CS for following reasons, in decreasing order of frequency: child&aposs health, fear of pain, stress and anxiety, prevention of genital tears, fear of vaginal exams, prevention of deformity and relaxation of genitalia and shortening of delivery time. There was a significant relation between some of the demographic factors or obstetrical history, level of knowledge and kind of attitude with some of the reasons of choosing CS for example, age, level of knowledge (both p<0.05) and kind of attitude (p=0) with fear of pain.

Conclusion: Reasons for choosing CS by the medically low risk mothers are not medically acceptable and midwives and the other health workers can successfully explain this to mothers. They can also support pregnant women informationally, emotionally and socially in different ways such as holding childbirth preparation classes. In this way they can influence women&aposs decision about method of delivery and promote mothers&apos and neonates&apos health by decreasing CS rates.

Introduction: It has been estimated that 335 million elderly, about 13 percent of general population, live in developing countries. It has been predicted that in 2040, this percentage will rise to 20 percent. Psychophysical complains are common in elderly and investigation of quality of life (QOL) in these samples of population is very important.

Materials and Methods: This research is a descriptive analytical study carried out to investigate the QOL of elderly residents of Zahedan city. In this study a short form questionnaire (SE 36) of QOL was used. Estimated required number of the samples was 200 that were selected with random cluster sampling.

Results: Average age of studied population was 72.3 years and their mean number of children was 6.7. Mean scores of the general health perception, physical activity, physical role function, bodily pain, social function, emotional role function, vitality and mental health were 38.6, 42.7, 36.8, 37.8, 43.9, 45,46.7 and 42.7, respectively.

Conclusion: Since currently there are no sound data for elderly QOL in Iran, considering mean QOL score of 50 and standard deviation of 10, all observed QOL scores (in eight dimensions) were low. These findings show importance of attention to QOL in elderly clients.

Introduction: Midwifery practice is involved with clinical judgments which have direct effect on mother&aposs and embryo&aposs health. A midwife should be able to make vital decisions based on her knowledge and skills in emergency situations. A midwife can reach correct decisions by using critical thinking.

Materials and Methods: In this cross-sectional, descriptive-comparative study we compared critical thinking of the first and last trimester baccalaureate and post graduate midwifery students of Medical Sciences Universities of Tehran. A total of 259 qualified students of 2002-2003 educational year were selected by census method. After description the goals and methods of study, we applied California critical thinking skills test (form B) in order to measure level of student&aposs critical thinking. This test is a valid tool for measuring critical thinking and skills, including analysis, inference, deductive reasoning, inductive reasoning and evaluation. Scores were analyzed by statistical tests (ANOVA, t test and Pearson correlation coefficient).

Results: No significant difference between total critical thinking scores of first and last trimester students was found but the scores of critical thinking of the last trimester students showed a significant decrease in Tehran University (p=0.009) and a significant increase in Iran University (p=0.007). No significant difference was found in skills of critical thinking among students. In last trimester students, scores of inductive reasoning showed a significant decrease in Tehran University (p=0.001) and a significant increase in Iran University. There was a significant decrease in evaluation ability scores in Tehran and Azad (open) Universities (p=0.002) a significant increase in these scores was found at Iran University (p=0.008).

Conclusion: According to the results of this study, despite importance of critical thinking, enough attention is not being paid to it during the educational course. The current midwifery education strategies are unable to increase level of critical thinking in students. It is essential to utilize new teaching strategies and active learning methods.

Introduction: Gathering information about quality of life is an essential step in designing more effective treatments and also helps developing better supportive and rehabilitation programs.

Materials and Methods: In this cross-sectional to investigate the relation between cancer characteristics and quality of life in patients under chemotherapy, 200 patients with different types of cancers were selected by simple sampling method. The data were collected through interview, reviewing patients’ files and patients’ self-reports. The data were collected by a questionnaire consisted of three parts: part one, demographic characteristics part two, questions about cancer type, stage and duration, pain, acceptance or refusal of cancer by patient, decrease or loss of organs’ function and degree of fatigue, and part three, designed to investigate different aspects of quality of life, including questions about general appearance, physical activity, occupational status, social function and sleep. Descriptive and analytic statistics were used.

Results: The results showed that quality of life in majority of the subjects (66%) was moderate. There was a meaningful relationship between some of cancer characteristics like type of cancer (p=0.007), intensity of pain (p=0.007), decrease or loss of organs’ function (p=0.001) and degree of fatigue (p=0.0) with quality of life, but there was no meaningful correlation between acceptance or refusal of disease, duration of disease from diagnosis time and stage of cancer with quality of life.

Conclusion: It seems that there is a relationship between some cancer characteristics and quality of life. Attention must be paid to these aspects to improve quality of life in cancer patients.

The idea of the technology of molecular engineering or nanotechnology was first proposed by Richard Fieman in 1959. Nanotechnology is, in essence, the technology of breaking down the molecular structures with an atomic precision. The strategic significance of this technology and its relations with minute particles in medical and environmental sciences are discussed in this paper. We first surveyed the potential capabilities of American National Sanitation Institutes and Scientific Foundation, as the leading country in the field of nanotechnology in areas such as health care, medicine and environment in the years 2000 and 2001. Bio-substances (common mediators of living tissues and inanimate substances and adaptable environmental substances), tools (bio-sensors and experimental tools) and diagnostic procedures (medical and genetic injection systems) related to nanotechnology are among the topics discussed in this article. Molecular building blocks of life (lipids, proteins, nucleic acids, carbohydrates and non-biological substitutes of them) are all substances with unique dimensions, repeatability and nonic scales. Using nanoic layers and instruments such as infrared Lasers within 1000 nanometric frequencies and He-Ne gas Lasers with 632.8 nanometric wavelength and with a power of about a few milli-Watts, the current difficult processes of setting the genome and decoding of genes can be revolutionized dramatically and their efficiencies can be increased. Increasing our ability in identifying genetic framework of individuals will entail a revolutionary development in medical diagnosis and treatment. In addition to facilitating optimal consumption of medicine, nanotechnology will also introduce new methods of delivering medicine to body, which in turn, will dramatically expand and improve medical treatment capabilities.

Introduction: Patients&apos rights have been center of attention in recent decades because of patients&apos vulnerability and worldwide sensitivity to human rights.

 Materials and Method: The current study is a qualitative, phenomenological research which has been carried out in Emam Khomeini Hospital during 2004-2005. The aim of this research was to identify the meaning of patient&aposs rights from the view point of patients and/or their companions. To achieve this, 16 semi-structured interviews were conducted with 12 informants. They were asked to explain their experience regarding the patient&aposs rights. All interviews were recorded. Data analyzing was simultaneously carried out using thematic analysis method.

Results: The emerging themes included expectation for equality and justice in receiving health care services, human respect and privacy need to be informed regarding their diagnosis and having essential facilities in the hospital.

Conclusion: It appears that whether the participants are aware of patients&apos bill of rights or not, they are able to define some rights for themselves. Attention to theses rights can help policy makers to design unique patients&apos bill of rights according to Iranian sociocultural and economic situation.