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Introduction: Stress is a complex and physiologic phenomenon that sometimes can be a source of problem. If an individual could not cope with stress, it would be a threat to physical and psychological health. Inclination to cope with stress is a positive way which helps one to improve his/her health.

Materials and Methods: This research is a quasi-experimental study with the aim of determining the effect of education of methods of coping with stress on rate of stress among women working at Tehran University of Medical Sciences. After primary study, 138 cases were chosen through census sampling. The collection tool was Chaudron stress scale. The statistical tests included t test and 2. Data were analyzed by SPSS software.         

Results: The result showed that there was no significant difference between level of stress before and after education in domains of job stress (p=0.22), life health stress (p=0.53), personal life stress (p=0.44) and personality stress (p=0.1). Also the statistical result of X2 did not show significant correlation between variables such as type of school, age, duration of work, marital status, number of children, educational level and housing condition with job stress.

Conclusion: The result showed that work environment is an important source of stress for working women. It could have undesirable effects on physical and emotional health of women. It seems that short term education can not decrease the stress of women therefore it is necessary to organize different long-term education programs, consultation and other strategies to reduce stress.

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Introduction: Surgery is a stressful event and patients undergoing surgery experience anxiety. Any effort to reduce anxiety of surgical patients should be of priority in nursing care of preoperative patients. The purpose of this study was to compare the effect of Benson relaxation technique and Zekr (rosary) on anxiety level of patients awaiting abdominal surgery.

Materials and Methods: This research is a quasi-experimental study carried out on patients who were admitted for abdominal surgery in a affiliated hospital to Tehran University of Medical Sciences in the year 2004. A total of 70 patients were chosen and divided randomly into two groups. We used Benson’s relaxation technique in first and Zekr in the second group. The patients were assessed on the day before surgery and on the day of surgery by a questionnaire that included demographic information and Spielberger anxiety tool. Vital signs were also recorded. The data were analyzed by SPSS computer software. The differences between pre and post intervention values were analyzed using paired t test, and between groups using independent t test and 2.

Results: Although there was a significant difference between mean anxiety level before and after intervention in both Zekr (p<0.006) and relaxation group (p<0.02), there was no significant difference between two techniques in reduction of preoperative anxiety (p>0.05). There was also a significant reduction in systolic blood pressure and pulse rate in both groups (p<0.05).

Conclusion: It seems that Zekr is as effective as Benson’s relaxation technique in reducing anxiety level of patients and both can be used to reduce anxiety level of patients awaiting abdominal surgery.

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Introduction: Level of job satisfaction reflects positive or negative attitude of person toward his/her job and is influenced by many factors. Job satisfaction of nursing personnel directly affects their quality of care. Attention to this issue means attention to community health.

Materials and Methods: This study is a descriptive, cross sectional research, conducted to identify the level of job satisfaction of nursing personnel of health, therapeutic and medical education centers of the entire country in the year 2001. Sample size was 4000 and nurses were selected through random stratified sampling method. Data collection tool was questionnaire of Herzberg job satisfaction which was sent by mail. Job satisfaction was classified into three levels: low (0-33.33%), moderate (33.34-66.67%) and high (66.68-100%).

Results: We received back a total of 3029 questionnaires. Results showed that the majority of nurses had moderate level of job satisfaction in domains of working place situation (62.9%), relationship with colleagues (69.6%), professional situation (74.3%), supervision and administration (57.6%), managerial policies (50%) and personnel life in relation to the job (80.6%). Job satisfaction level was low in domains of job security (63.5%) and salary and benefits (77.3%). 2 test showed a significant relationship between age, job position, level of education, job experience, over time working, type of over time working, type of accommodation and participation in continuing education programs and job satisfaction.

Conclusion: As a whole, the level of job satisfaction of majority of nursing personnel was moderate and the majority of subjects were not satisfied with welfare possibilities of their job. According to the research results it is recommended that the authorities try to increase the salary and financial benefits of nursing personnel and also to develop welfare possibilities of this class of community.

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Introduction: One of the main aims of religions is to improve psychological health in society and interpersonal relationships. It has been shown that religious education can be used in primary and secondary prevention of psychiatric disorders.

Material and Methods: The samples of study were the teachers of guidance schools of the capital city of Tehran. The samples were 40 depressed female teachers that were chosen randomly among the 30-40 year old teachers who were not using any drugs. Data gathering tool was a questionnaire containing Hamilton test with 24 questions about mood disorders (including depression). Another questionnaire including demographic characteristics and questions regarding change of mood after attending religious education classes was also used.

Results: The results showed that 90% of the subjects were satisfied with religious methods such as prayer, fasting and blessing for decreasing their depression 92.5% were satisfied with regular education of religious values. A total of 80% of the samples believed that training by a particular teacher would influence their interest in the religious values 55% reported calmness after praying. There was a significant differences between the mean score of depression before and after attending religious education classes (p=0.000).

Conclusion: According to the findings of this research, education of the religious values can affect anxiety, sadness, hopelessness, sleeplessness and lack of appetite and depression. Performing religious acts such as prayers causes a type of relaxation and good feeling in the patients.

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Introduction: Education of patients and helping them to be independent in process of self-care in both health and disease is one of the basic responsibilities of nurses.

Methods and Materials: This descriptive-analytic research was done to study perceptions of 317 nurses working in hospitals of Tehran University of Medical Sciences of factors affecting the process of patient education. Data was gathered by means of a questionnaire containing 30 questions about facilitating factors and 17 about inhibiting factors. We used Likert score to measure questions. Data analysis performed by SPSS software. Statistical test were Chi square, t test, variance analysis and correlation of variance.

Results: The highest percentage of nurses (52.1%) believed that enough attention is not being paid to facilitating factors such as considering patient education as priority in patient care, nurses being responsible for patient education, considering patient education as a criteria in nurses annual evaluation, importance of patient education for nurse administrators, having in-service education about patient teaching and having proper time, place and personnel for patient education. Majority of nurses (57.4%) believed factors such as shortage of nurses, lack of proper place, time and patient motivation for receiving education, nurses and nurse administrators’ inattention to patient education and negative attitude of doctors toward patient education by nurses are inhibiting factors in process of education. Statistical tests showed a meaningful relation between demographic variables such as sex, clinical background, shift work and position and facilitating factors. There was also a meaningful relation between variables like working in more than one shift, having clinical experience of patient education and being evaluated for patient education during study of nursing and inhibiting factors.      

Conclusion: This study shows low level of facilitating factors for patient education in hospitals of Tehran University of Medical Science. To improve patient education in these hospitals it is necessary to improve facilitating factors.

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Introduction: The delivery of placenta and membranes (third stage of labor) is an important stage of delivery. Complications of this stage can increase maternal mortality rate. There is controversy regarding the routine use of oxytocic drugs in this stage of labor. These drugs may shorten duration of third stage but have side effects. Furthermore, management of delivery in physiologic way causes minimum damage to the mother and newborn.

Materials and Methods: The present research is a clinical trial study. A total of 94 subjects were divided into two groups. All subjects in active group received 10 units of Syntocinon in 500 cc serum. The cord was clamped and cut after cessation of pulsation and the placenta was delivered by Brandt–Andrews maneuver. Women in the physiologic group received 1cc of placebo in 500 cc serum, no clamping of the cord was attempted until pulsation had ceased and the placenta was delivered by minimal traction on the cord and with maternal effort without any maneuver.

Results: Two groups were matched in the subjects’ characteristics. The rate of postpartum hemorrhage in physiologic group (14.58%) was higher than active group (10.64%) but the statistical tests showed no significant differences between two groups (p=0.2945). The mean duration of the third stage of labor in the physiologic group (13 minutes) was longer than active group (9 minutes) but the statistical test showed no significant differences between two groups. The statistical tests also showed no significant differences between rate of retained placenta (p=0.5) or piece of the placenta and membranes (0.2428) in two groups.

Conclusion: Statistical tests showed no significant differences between duration and complications of the third stage of labor in two groups. The routine use of Syntocinon in management of third stage of labor can not be recommended.

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Introduction: Caring is the essence of nursing and medication process is an important part of nursing related interventions in the health care systems. Medical and/or nursing errors can lead to severe problems for both patients and nursing system. The purpose of this study was to investigate the ethical practice in medication process among nurses working in selected hospitals related to Tehran University of Medical Sciences.          

Materials and Method: This study is a descriptive–analytic research. Samples of the study were 305 nurses employed in adult units of selected hospitals. The research data gathering tools were a checklist and a questionnaire. Questionnaire included questions about demographic data and errors in medication process. Checklist included 17 questions related to expected behaviors regarded medication process. The researcher first completed the questionnaire and then the checklist was completed on two separate occasions at least 15 days apart. The data were analyzed using descriptive and analytic statistics such as Chi square, Fisher exact test and Pearson correlation coefficients.

Results: The majority of subjects were 26-35 years old, female and single. About half of nurses (49.6%) had undesirable performance in process of medication. Ethical practice had a significant correlation with type of ward (p=0.005), the mean number of occupied beds in a week (p=0.000), number of co-workers in the shift (p=0.001), educating (p=0.037), satisfaction with place of work (p=0.0043) and technical possibilities in the ward (p=0.029).

Conclusion: According to the results, the majority of nurses had an undesirable performance in medication process. It is suggested that managers, program planners and nursing teachers pay more attention to ethical practice in medication process in order to enhance performance of nurses in this field.

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The concept of privacy, which is used in many disciplines, is a basic human need and also is recognized as an important concept in nursing. The concept of privacy has been described in various dimensions including physical, psychological, social and informational privacy. In this article we review these dimensions. Most of the studies related to the privacy have been carried out in the area of physical privacy. One of the basic areas of privacy in hospitals is related to data protection and the prevention of information inaccuracies. Major factors that threaten the privacy include intrusion upon the seclusion or physical boundaries and unnecessary physical touch. In order to decrease these problems, health worker need to find a new approach of working with patients. Review of the literature showed that only a few studies about the privacy of patients have been carried out. To encourage research in this field, accurate instruments should be developed in order to measure different aspects of the privacy, an aim that is difficult to achieve because of the complex nature of the concept. It is also important that necessity of observing patients’ privacy systematically be thought to medical students

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Pregnancy and delivery are special events in women’s and their family’s life. Although pregnancy is a natural phenomenon and not a disease, sometimes it can be associated with several dangers to the mother and her fetus. Maternal death is a global finding and its five most important causes are bleeding, infection, hypertension, prolonged labor and abortion in unsanitary condition. Early diagnosis of abnormal labor progression and prevention of prolonged labor can reduce the risk of postpartum bleeding and infection. The chart of labor called “Partograph” has been introduced and applied since 1970 to help diagnosis of the abnormal labor and cephalopelvic disproportion. Partograph is an early alerting system which can prevent probable difficulties in different stages of labor through recording of all of the observations and examinations on one chart, so that mother can be referred as soon as possible to higher levels of health services.

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Introduction: Continuous professional development is an essential component within many health care 'Learning Organizations'. This paper describes an initiation to develop a professional practice development framework for faculties in Tehran Nursing and Midwifery School.

Materials and Methods: The project was undertaken within an action research methodology with four phases .The goal of the project was to improve research, provide competition, reinforce data management, identify priority of needs in nursing and midwifery, and in so doing, enhance knowledge of the development of health information resources. A multi-method approach to data collection was undertaken to capture the change process from different stakeholders' perceptions. Triangulation of the data was undertaken. Despite organizational constraints, leadership and peer support enabled the co-researchers to identify and initiate high quality research initiatives. The change process for the co-researchers included: enlightening personal journey, exploring the research-practice gap, enhancing personal and professional knowledge, evolving cultural change and collaborative working.

Results: Descriptive analysis and evaluation method showed that the project was done effectively.

Conclusion: A more flexible time-scale and long term funding are required to enable continuity for trust-wide projects undertaken in dynamic academic settings

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Introduction: It is necessary to understand that psychological reactions after a natural disaster are as complex as disaster itself. Following a catastrophic earthquake like Bam’s, such reactions can be seen in nursing team members as well.

Materials and Methods: This study is a descriptive cross sectional analytic research, conducted with cooperation of Japanese Nursing Association to identify somatic and psychological problems of nursing team members of Bam. A total of 92 members of nursing team affiliated to healthcare centers of Bam were studied. Data collection tools were 2 questionnaires first for evaluating demographic characteristics and general health and second- questionnaire of Goldberg and Williams- for evaluation of four domains of psychosomatic problems, anxiety and insomnia, psychosocial functioning and severe depression. Each domain contained seven questions, each scored from 0 to 3 based on Likert score. Complete score of general health was 0-84. Scores were classified in four groups: 0-20 as optimal, 21-4 as approximately optimal, 41-6 as approximately suboptimal and 61 and higher as suboptimal.

Results: One year after the earthquake, evaluation of general health of nursing team members showed 30.3% of subjects had optimal psychosomatic status, 34.8% had moderate problems of anxiety and insomnia, 40.2% had approximately optimal psychosocial functioning and 44.2% of subjects were not severely depressed. Overall, 38.4% of nursing team members had approximately optimal general health.

Conclusion: This study showed that following a catastrophic earthquake, most of the victims suffer from several psychological and somatic reactions. In addition to on time rescue procedures, other important allaying factors are cultural and religious values and believing in God.

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Introduction: Anemia is a common finding among pregnant women, and it could cause a number of complications for both mother and fetus.             

Materials and Methods: In this case - control study, 302 pregnant women among patients referred to prenatal clinic of Mirza Kochak Khan Hospital were randomly chosen and were divided into anemic and normal groups based on their hemoglobin (Hb) level. Patients with Hb<11g/dl during the first or third trimester as well as those with Hb<10.5g/dl in the second trimester were considered anemic. Anemic patients were treated and pregnancy outcomes of two groups, including birth weight of the newborns, prematurity, stillbirth and abortion, were compared.

Results: Overall prevalence of anemia during pregnancy was 8.6%. The prevalence of anemia in the first, second, and third trimesters of pregnancy were 10.3%, 3.5% and 12.7%, respectively. The frequency of anemia had a positive correlation with maternal age, gravidity and parity however it was less frequent in patients taking iron supplements. There was no significant difference in pregnancy outcome of normal and treated anemic woman. Growth retardation was more frequent in treated anemic patients but only in women who were diagnosed in third trimester.

Discussion: The prevalence of anemia among pregnant women is noticeable, and with the iron deficiency as the most common cause, we recommend administration of iron supplements for prevention of anemia and its maternal and fetal consequences. Treatment of anemia in early stages of pregnancy results in normal pregnancy outcome, a finding emphasizing the importance of treatment.

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Introduction: Pain is a phenomenon with both personal and cultural meanings. As cultural diversity increases around the world, caregivers are more and more likely to care for clients from backgrounds different from their own. Culture affects the assessment and management of pain. The aim of this study was to explore the meaning of pain experiences in 3 subcultures in Iran.

Materials and Methods: A phenomenological approach was used in order to explore the meanings of post operative pain experiences in participants. Data were gathered through series of semi structured interviews as well as goal-oriented observation and collected written narratives. Benner's interpretive method was used for data analysis.

Results: From analysis of viewpoints of 15 patients from Khorram-Abad, 13 patients from Tehran and 8 patients from Gorgan, 4 themes emerged. Considering postoperative pain insignificant compared to primary pain, need for protection, increase in spirituality and insensitivity of healthcare providers were the emerged themes.

Conclusion: While pain is a subjective and personal phenomenon and reaction to pain is influenced by cultural and personal values, in this study no difference was found in the pain experiences in 3 under-study subcultures. It seems that Iranian-Islamic culture acts as a conceptual umbrella to encompass the whole experiences and influences all subcultures.

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

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

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

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

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Introduction: In patients who have a chronic disease such as end stage renal disease for which cure is not a realistic goal, maximizing functioning and well-being should be a primary objective of care. However, functioning status in the dialysis patients is often lower than normal.

Materials and Methods: This study is aiming to determine the effect of self–care educational programs on decreasing problems and improving quality of life of dialysis patients. This study was a quasi-experimental research in one group (pretest-posttest) accomplished in the educational hospitals of Iran and Tehran medical sciences universities from 2003 to 2004. A total of 32 patients were chosen on the basis of a non-randomized sampling. Each patient was assessed in two sessions before starting the dialysis treatment by questionnaires about educational requirements and quality of life and a checklist of common problems in dialysis patients. In order to validate the results, the laboratory variables were analyzed as a two months average prior to the education. The authors designed an educational program on the basis of existing problems and then determined the characteristics of each person under study and the required education was presented in two sessions. After the educational period was ended, the laboratory variables (average two months) and quality of life two months after education were analyzed and also the checklist were studied in two stages with a time interval of two weeks (third and fifth weeks).

Results: There was a significant decrease in serum urea, uric acid, serum creatinine, K, weight gain, systolic blood pressure, edema, skin itching and local vascular problems. Also, there was a significant improvement in the patients’ quality of life.

Conclusion: Self-care educational programs have a positive influence on decreasing the problems and improving the quality of life of dialysis patients.

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Introduction: According to some studies, pharmacological concentrations of Mg2+ have anti-thrombotic effects and interfere with platelet aggregation in vitro and in vivo.

Materials and Methods: The study group consisted of 50 pregnant women who required magnesium sulfate for mild pre-eclampsia or preterm labor. In all patients, a platelet count, magnesium level, bleeding time and mean arterial pressure were obtained before and 2 hours after magnesium sulfate infusion. Magnesium sulfate was started with a 6 gr intravenous bolus, followed by 2 gr/hr infusion. Bleeding time was measured by Duke method. Data were analyzed with Mann Whitney U and Wilcoxon rank tests.

Results: Thirty one patients (62%) received magnesium sulfate for preterm labor and 19 (38%) for mild pre-eclampsia. Analysis of the entire study group revealed a rise in the magnesium level (p<0.0001), a lowering of the mean arterial pressure (p<0.0001) and no significant difference of the bleeding time and platelet count. Comparison of platelet count, magnesium level and bleeding time before and 2 hours after magnesium sulfate infusion revealed no significant difference in two groups.

Conclusion: According to this study, magnesium sulfate with usual dosage has no effect on bleeding time in pregnancy.

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Introduction: Evaluation is a systematic process for collecting, analyzing and interpretation of the obtained information for the purpose of investigating how much the objectives in mind can be achieved. Education in an academic educational system means bringing about proper and increasing changes that affect the outcome of this system, that is affecting the students, and the aim of such evaluation was promotion of the quality of an education process.

Materials and Methods: In this study faculty of nursing and midwifery, Tehran University of Medical Sciences, benefiting from opinion poll of university lectures, student and graduates have evaluated their system of educational in the year 2004 and their aim was to remodel and adjust educational system with the society’s needs and promotion of the quality of such education’s. The employed method was cross sectional and descriptive and analytical on the basis of 10 procedural steps and with in 8 sections dealing with evaluated factors. Such as faculty board members, management and organizational capability, students, manpower and logistic affairs, educational environments research work centers, health and therapeutic sections, educational equipment, research equipment, laboratory and diagnosis centers, educational courses and programs, teaching and learning process as well as satisfaction expressed by students.

Results: the results of the research showed that general average of 8 investigating sections, based on SWOTs model were respectively 80.4% (nursing department), 81.5% (Midwifery department) and 82.1% (Ph.D nursing) that may well be interpreted as a desirable research work.                        

Conclusion: Educational evaluation is the best indicator showing how much we should go to achieve certain aims, analyzes quality of the activity if such a system and by which we achieve logical and routine results.

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Introduction: Attention to psychological abuse of old women as a vulnerable group and its complications are important issues. We performed this study to determine the effect of family counseling program on prevention of psychological abuse of elderly women.

Methods and Materials: This is a semi-experimental study. We selected 30 old women referring to clinics of an educational hospital in Tehran by simple randomization. Data collecting instruments included demographic sheets about old person and family members and a questionnaire about psychological abuse, which were completed by interview. An observational checklist about behavioral symptoms was completed at 3 interview sessions by family and old person at home. Then 6 counseling sessions were established. Duration of every session was 1:30 up to 2 hours. After two months and in the last three sessions, final evaluation was conducted by again completing data collecting instruments.

Results: study results showed that 90% of abusers were woman and family dysfunction was the reason of abuse in 43.3% of cases. Mean score of psychological abuse showed a significant decrease after counseling, using dependent t-test and Wilcoxon test (p<0.001). Also, mean score of behavioral symptoms of abuse showed a statistically significant decrease after counseling, using dependent t-test and Wilcoxon (p<0.001). Pearson correlation coefficient (r=0.90) showed that there was a significant correlation between psychological abuse and behavioral symptoms.

Conclusion: Regarding positive effect of family counselling programs on reduction of psychological abuse of old women, it is suggested that effect of family counseling programs in reduction of other types of abuse be determined.

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Introduction: Job satisfaction of midwives, as key members of healthcare system, has special importance in the quality of midwifery care to the vulnerable groups of the society i.e. mothers and children.

Materials and Methods: This is a survey and cross sectional study. Sampling size was 251 midwives, which were chosen through cluster sampling. Data were gathered by questionnaire in one stage and were analyzed by SPSS software, using descriptive and analytic (2, Pearson correlation) statistical methods. Results:

Results of this research demonstrated that satisfaction level of midwives in two aspects of job position (62.9%) and relationship with colleagues (48.2%) was moderate. It was low in the aspects of salary and benefits (92.8%), job security (69.7%), managerial policies and work condition (64.9%), supervisory (48.6%) and relationship with personal life (49.8%). There was a significant relationship and correlation between job satisfaction and all of its aspects, strongest with the aspect of managerial policies (r=0.87) and weakest with the relationship with colleagues (r=0.547). There was no significant relationship between job satisfaction and demographic characteristics such as age, academic degree, marital status, the number of children and monthly salary but there was a significant relationship between job satisfaction and the condition of house ownership, the years of job experience, the condition of employment, the place of work, work shift and whether they liked midwifery when they chose it (p<0.05).

Conclusion: Half of midwives (49.4%) had moderate job satisfaction, 49% had low and only 1.6% had high job satisfaction. Considering the results of this research, it can be concluded that the authorities must take efficient measures to omit the most important causes of low job satisfaction through increasing salaries and benefits, promoting job security, improving work condition, reformation of managerial and supervisory systems and using midwives’ professional ability in areas of their skill’s.

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Background & Aim: This paper investigate the application of some management’s new theories in nursing care in order to determine the similarities between management and nursing. The need of Health Services to be effectively managed was a prominent features of developed countries health policy in the 1980 s and early 1990. In the recent years, four management’s new theories has identified: organizational excellence, total quality management, organizational culture and empowerment. Each of these new theories has key role in nursing care. This paper identifies similarities and convergence’s between management profession with nursing care, using application of management’s new theories.

Conclusion: The comparison between nursing care and management’s new theories has been provided the collaboration and cooperation between nurses and management professions to deliver health care services to patients effectively.