Background & Aim: Exclusive breast feeding is highly recommended for children under six months and the best time for starting supplementary food is the end of sixth months. Inadequate feeding can lead to malnutrition. Since infants&apos supplementary feeding pattern is influenced highly by the socio-cultural status it is necessary to study the subject in diverse conditions. This study aimed to investigate supplementary feeding pattern in 6-12 months children referred to Ilam clinics in 2002.

Methods & Materials: In this study, 364 mothers with 6-12 months children were selected using convenient sampling method from 10 health care centers. Data were collected using a four-sectioned questionnaire including mothers and their babies demographic characteristics, feeding pattern (frequency, the type of milk), supplementary food (the age of onset and the type of the first supplementary food, the time of starting mixed foods, and the source of information about supplementary food) and mothers&apos performance about feeding with supplementary food. The questionnaire was filled via interview.

Results: Findings showed that the growth curve in 84.8% of babies was in the health road. About 38% of babies were the first child. In 50.9% of samples, supplementary food was started before 6 months of age and in 49.9% of the cases, it was started after 6 month old. Supplementary feeding accompanied with breast feeding in 83.5% of the infants. The most used supplementary food was rice mucilage (40.8% of the babies). The interval between starting one supplementary food and the other one was 3-4 days in 50.2% of the cases. Also 80.8% of samples started feeding in the amount of one spoon and increased it gradually. The majority of mothers (64%) did not add sugar, salt and spices in order to attract their babies. As well, 75.6% of samples used spoon and cup for feeding and 92.9% knew the safe time for keeping cooked food in the refrigerator. The source of information about supplementary feeding in 65.4% of mothers was health care providers and in 5% were books and booklets.

Conclusion: Findings indicated that more than half of mothers began supplementary feeding for their children before 6 months old without pursuing any accepted pattern. It seems that usual educational programs in Ilam were unable to answer all the problems aroused in this issue. Hence, educating mothers using other methods such as visual teaching material is recommended.

Background & Aim: Family-centered care, which has become the cornerstone for pediatric nursing practice, supports the integrity of child and family health. It brings families a unique care and improves child and family health. Families are recognized as an essential part of a specialized child care during illness. They are expected to be skilful in child care both in and out of health care facilities. This study was carried out to determine health caregivers&apos attitude toward parent participation in the care of their hospitalized children at Madani pediatric hospital- Khoramabad in 2004.

Methods & Materials: This is a descriptive-analytical study. One hundred and sixty nine caregivers were selected through convenient sampling method. Data were gathered using a questionnaire including demographic and parents&apos attitude questions. The questionnaire had 36-item. The data were analyzed via SPSS computer software and using descriptive and analytical methods.

Results: Results indicated that the average of participants&apos attitude score was 92.28±12.55. Most of subjects had neutral attitudes toward parents&apos participation in their children&aposs care. Positive attitude were significantly related with marital status (P<0.04), having children (P<0.04) and being a nursing student (in comparison with medical students) (P=0.04).

Conclusion: The caregivers&apos attitudes toward parents&apos participation in the care of their hospitalized children were neutral. The students&apos and staffs&apos attitudes should be modified by taking part in continuous training programs.

Background & Aim: Today, quality of life measurement is important in health care systems especially for patients with chronic diseases. Heart failure has several complications that affect patients&apos lives. The aim of this study was to investigate the quality of life and its dimensions in patients with heart failure.

Methods & Materials: It is a cross-sectional study. Two hundred and fifty patients with heart failure referred to Tehran medical centers were selected using convenience random sampling method. Data were collected using "Ferrans and Powers quality of life Index". Data were analyzed using descriptive statistics, chi-square, and Pearson correlation coefficients.

Results: The study findings showed that 76/4% of the participants possessed undesirable and less desirable levels of quality of life. There was significant statistical relationship between quality of life with age, gender, education, marriage status, ejection fraction, length of heart disease, co-morbidity, and readmission.

Conclusion: Cardiac heart failure has negative effects on quality of life. So, it seems that if assessing the QOL of these patients becomes one of the nurses&apos duties, it will promote the major caring goals.

Background & Objective: Osteoporosis is a metabolic disease which results from gradual destruction of bone mass. Prevention of osteoporosis should be started from childhood by getting adequate calcium and doing weight-bearing exercises. Participating of mothers in health education interventions is likely to promote longer-lasting health behaviors in their daughters. The aim of this study was to investigate the effect of simultaneous education of mothers and daughters on osteoporosis preventive behavior among high school female students.

Methods & Materials: In this interventional study, 400 female students were randomly selected via a two-phased sampling method. At first stage, four schools were selected randomly. At the second stage, 400 students were divided randomly into two groups. Their osteoporosis preventive behaviors were measured using a two-sectioned questionnaire: demographic section, and osteoporosis preventive behaviors assessment section. The first group participated in the educational programs with their mothers and the other group participated without their mothers. The educational program had two sessions, each one lasted 45 minutes. The second stage of the study was performed three months later. Data analysis was carried out using t-test and chi squared test.

Results: Results showed that in both groups, osteoporosis preventive behaviors scores increased significantly after intervention. It was higher in case group (P<0.001). Eating behavior was significantly different in two groups (P=0.003).

Conclusion: Results showed that simultaneous educational program for mothers and daughters promotes eating behavior in the girls.

Background & Aim: Anxiety is one of the emotional conditions among patients scheduled for surgery that can result in increasing postoperative pain, increasing analgesic and anesthetic requirements and prolonging hospital stay. The aim of this study was to assess the effectiveness of acupressure (acupuncture without needle) in reducing patients&apos anxiety before abdominal surgeries.

Methods & Materials: In this randomized, blinded, sham controlled trial, 70 patients who were scheduled to undergo abdominal surgery in Tehran University of Medical Sciences&apos hospitals were selected using convenience sampling method. The patients were randomized to an acupressure group (n=35) or a placebo group (n=35), receiving acupressure either at the right points (Yintang and Shen men) in acupressure group or at sham points in the placebo group for 10 min. Anxiety was recorded on a Visual Analog Scale (0-10). Vital signs were measured before and after pressure application in both groups.

Results: The anxiety was decreased in both groups following pressure application for 10 min (P<0.001). The amount of anxiety was significantly different between the groups (P<0.001). The heart rate, respiratory rate, and diastole/systole pressure (P<0.001) were decreased in the case group. Only heart rate (P=0.016) and respiratory rate (P=0.007) were decreased in the placebo group. Changes in respiratory rate and systole pressure following pressure application were statistically significant between two groups.

Conclusion: Acupressure at the right points can decrease anxiety before abdominal surgeries but it has no clinical effect on vital signs.

Background & Aim: Post cesarean ileus is a common complication that induces abdominal distention, delays feeding, and increases hospitalization. Multiple studies showed that false nutrition increases the bowel movement. This study aimed to investigate the effect of gum chewing as false nutrition on the bowel movement and prevention of post cesarean ileus.

Methods & Materials: In this randomized controlled trial, a total of 400 patients who were hospitalized in Mashhad Zeinab hospital were divided into two 200-patient groups. The groups were matched for age, gravity and duration of surgery. In the intervention group, gum chewing was started after surgery, 3 times/day until the regular diet was initiated. In the control group, patients underwent routine care by restricting oral intake until the bowel function was returned. The outcomes were time of the first bowel sound, flatus passage, defecation, ambulation of patients post cesarean, initiation regular diet, and hospitalization. Statistical analysis was performed using unpaired t-test and fisher^&aposs exact probability test.

Results: The mean age, parity and operation time were similar in the two groups. All patients in the intervention group tolerated gum chewing immediately after surgery. The results showed the followings among the intervention group vs. control group, respectively: post operative time intervals to bowel sounds (14.7 hours vs. 16.6 hours P=0.569), time intervals between surgery and abdominal distention (16.59 hours vs. 14.21 hours P=0.01), first post operative defecation (28.16 hours vs. 32.21 hours P=0.000), post operative time interval to onset diet (19.3 hours vs. 16.54 hours P=0.000), post operative time interval to ambulation (20.14 hours vs.17.58 hours P=0.000), post operative lengths of ileus (31.13 hours vs. 30.35 hours P=0.5), hospitalization (1.84 days vs. 1.92 days P=0.02).

Conclusion: Gum chewing after cesarean section is safe and well tolerated and reduces post operative ileus, shortens mean duration of first defecation, decreases the time of returning to regular oral diet, shortens the time of patient ambulation and hospital discharge. Gum chewing is offered as a physiologic and inexpensive method to prevent or reduce post cesarean ileus.

Background & Aim: Modification of unhealthy life style is a preventive method in cardiovascular diseases. It seems that education which results in enhancing knowledge would improve the life style. For developing effective educational plans, it is required to evaluate the knowledge and performance of the patients. So, this study aimed to determine the relationship between the teachers&apos preventive behaviors and their knowledge on cardiovascular risk factors.  

Methods & Materials: This cross-sectional study was conducted in five zones of Ministry of Education in Tehran. Seven hundred and three teachers participated in the study. Multi-stage sampling was used to gather data using a self-report questionnaire consisted of demographic characteristics, risk factors of CAD, and related modifiable behaviors. Data were analyzed using Pearson coefficient test to determine correlations.

Results: The results showed that the majority of participants (67%) had good knowledge on cardiovascular risk factors with the mean scores of 15.20±2.63 out of 20. Stress was found to be the most recognized risk factor (95.3%). Knowledge about diabetes (61.2%) and gender (17.6%) were in the lowest level. Regarding prevention, just 27.7% of the participants reported healthy nutrition. Some of the patients (35.6%) exercised regularly and majority of them (77.7%) were not active or passive smokers. Pearson coefficient did not find any significant relationship between knowledge level and preventive behaviors among teachers.

Conclusion: According to our findings, teachers&apos knowledge level on cardiovascular risk factors was good but it did not result in healthy practice. Therefore, providing effective educational programs about healthy life style can improve their daily life practices, as well as it can affect the knowledge and practice of their students about prevention of CAD.

Background & Aim: Recent studies suggest that patients&apos perceptions might be more important than objective clinical assessments in determining quality of life (QOL) in patients with End Stage Renal Disease (ESRD). The aim of this study was to determine QOL in patients experiencing ESRD and its related factors.

Methods & Materials: In this descriptive-correlational study, we recruited 202 hemodialysis patients from Iran University of medical sciences&apos hemodialysis units using convenience sampling method. Data were collected using "Ferrans and Powers quality of life Index- dialysis version" instrument and analyzed using SPSS-14.

Results: Findings showed that the patients had a high perceived QOL. Lowest satisfaction mean scores were for the items "your health" (M=3.80, SD=1.74), "being able to take care of your financial needs" (M=3.31, SD=1.85), "achieving your personal goals" (M=4.02, SD=1.63), and "your family&aposs happiness" (M=4.96, SD=1.27). It was reported that "probably you will get a kidney transplant" (M=4.22, SD=2.15), "neighborhood" (M=4.32, SD=2.09, "personal appearance" (M=5.67, SD=0.91), and "your spouse"(M=5.84, SD=0.61) also had lowest mean score for importance from patients point of view. Financial status, educational levels, marital status and number of children were all associated with the QOL (P≤0.05). There were no relationship between age, sex, occupational status, with duration of dialysis treatment (P>0.05).

Conclusion: This study denoted financial status, educational levels, marital status and number of children is related to QOL of hemodialysis patients. So, these factors that affect quality of life may promote health and wellbeing and may increase survival in hemodialysis patients. The findings of this study can assist providers in planning and implementing educational and support programs for patients and their family.

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

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

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

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

Background & Aim: Choosing proper method for contraception can help to reduce prevalence of unwanted pregnancy and unsafe abortions. IUD is one of the most trustable effective, and long-term contraceptive methods. The periodical study for recognition of the discontinuation factors is important in family planning and population control. Thus, the study was designed to determine the factors influencing the IUD discontinuation among women referring to Tehran&apos south health care centers.

Methods & Materials: In this descriptive study, 400 women attending to the health care centers in south Tehran in order to discontinue their IUDs were selected randomly. Data were gathered using questionnaires and analyzed using statistical tests such as chi-square and T-test.

Results: The mean IUD duration usage was 29.5±27.88 months. The main complication was bleeding that was reported by 44% of the clients. Infection 36.5% spotting 20.5% pain 12.3% and explosion 11.3% were the other causes of discontinuation, respectively. There was a significant correlation between the discontinuation and complications (P<0.001), husbands&apos education level (P=0.01), and usage duration (P=0.04).

Conclusion: The study showed that the most common reason for IUD removal was its side effects. It seems considering appropriate policies could decrease the complications and increase the usage duration.

Background & Aim: It is important to measure the anxiety level in patients who undergo heart surgery and find out ways to relief it. This study aimed to determine the effect of cardiac rehabilitation program's first phase on the level of anxiety among patients hospitalized for coronary arteries bypass surgery.

Methods & Materials: In this randomized clinical trial, sixty patients were selected using block sampling and randomly allocated into experimental and control groups. Data were gathered using a questionnaire including the spiel burger's standardized questionnaire. The level of anxiety was measured in both groups. Then, the first phase of cardiac rehabilitation program (including physical exercise, and daily living activities) was carried out in the experimental group. Finally, patients in the experimental group discussed their experiences of surgery. Control group Patients received usual care. The level of anxiety was measured in both groups the day before surgery and at the time of discharge. Data were analyzed using t-test, chi-square, and Friedman tests in SPSS.

Results: Findings showed that the level of anxiety had no significant differences between two groups at the time of admission. After implementing the rehabilitation program, the level of anxiety decreased significantly (P<0.001) in the experimental group. Significant differences were observed in the level of anxiety between two groups after intervention (P=0.015) and at the time of discharge (P=0.038).

Conclusion: This procedure should be used in surgery patients

Background & Aim: One of the nurses' roles in patient care is frequent position change in patients undergoing mechanical ventilation. Because of attaching many lines and tubes to these patients, they are in supine or lateral positions most of the time. Nurses prefer these positions due to making care simple. Many studies have shown that prone position has positive effects on oxygenation and ventilation. However, other studies have shown some negative effects. The aim of this study was to determine the effect of prone position on oxygenation in patients undergoing mechanical ventilation.

Methods & Materials: In this quasi-experimental study, 36 patients were selected using simple sampling method. Data were collected using a questionnaire and oxygenation data sheet. First, patients were put in supine position. After 30 and 120 minutes, oxygenation was assessed. Then they were changed to prone position and after 30 and 120 minutes oxygenation was reassessed. Data were analyzed using paired t test, spearman, and fisher exact tests in SPSS.

Results: The results indicated that there was significant differences between prone position and the amount of spo2 and sao2 oxygenation after 30 and 120 minutes (P<0.001).

Conclusion: Prone positioning was effective on oxygenation after 30 and 120 minutes so nurse should use this position in their care.

Background & Objective: High rates of cesarean delivery have worried health policy makers. One of the main reasons for cesarean section in Iran is cesarean election. Health Belief Model (HBM) is one of the most powerful models used in health education programs. The objective of this study was to determine the effect of education designed based on HBM on choosing delivery mode among pregnant women.

Methods & Materials: In this experimental study, 128 nulliparous women were recruited from Shahrood health care centers and private gynecologists' offices. Samples were randomly allocated into two equal groups. Women in the experimental group participated in two 40-minutes educational classes which were designed based on HBM. Data were gathered both before and after the classes, and then were analyzed using SPSS.     

Results: The results indicated that there were no significant differences between two groups in demographic characteristics, infertility history, disease history, perceived susceptibility, and perceived benefits and barriers. After the intervention, significant differences were found between perceived  susceptibility (P<0.001), perceived severity (P<0.001), perceived barriers (P=0.004), with practice (choosing the delivery mode) (P<0.001).

Conclusion: The results showed that using HBM in program designing was effective in the pregnant women's decision-making toward delivery mode.

Background & Aim: Spiritual well-being harmonizes several dimensions of human's life and is essential for coping with diseases. Chronic illnesses such as cancer cause crisis in physical, psychological, and spiritual dimensions of ones life. This study aimed to measure the spiritual well-being in cancer patients who undergo chemotherapy.

Methods & Materials: In this cross-sectional, descriptive-correlational study, Paloutzian & Ellison's Spiritual Well-being Self-report questionnaire was completed by 360 cancer patients. Patients were recruited using sequential sampling method. The inclusion criteria were being more than 20 years old, and being able to read and write. Data were analyzed using chi-square and Pearson tests in SPSS (version 11).

Results: The study findings revealed that the mean scores for spiritual well-being, religious well-being, and existential well-being were (98.35±14.36), (54.67±5.92), (43.67±10.01), respectively. Also, statistically significant relations were found between age, marital status, and educational levels with spiritual well-being (P<0.001).

Conclusion: Findings showed that the level of spiritual well-being was high in cancer patients. Moreover, as it is expected in Iranian culture, the level of religious well-being was more than existential well-being. There were significant relationships between spiritual well-being and personal characteristics. Hence, nurses should consider personal characteristics in their caring programs and choose a comprehensive and holistic approach toward their patients' care.

Background & Aim: While patient education promotes compliance to treatment and self-care ability, short hospital length of stay, anxiety, illness, and sleep disorders can interfere with this approach. It is not clear how realistic is to learn during the short hospitalization period, from nurses' and patients' perspectives. This study aimed to compare perspectives of patients and nurses on the reality of learning cardiac heart failure educational content in Shahid Rajaee heart hospital.

Methods & Materials: In this cross-sectional study, two hundred and fifty one patients and 181 nurses were selected using convenience sampling. Data were collected using the reality part of CHFPLNI and were analyzed in SPSS-11.

Results: Most of the patients were male (82.4%) most of the nurses were female (85.6%). The mean ages of patients and nurses were 55.18 and 35.15, respectively. The mean hospitalization period was 4.26 days and the mean duration of heart failure was 10.70 years. The majority of nurses had not participated in advanced preparation courses. Patients and nurses had agreement on the reality of medication learning. Patients rated medication (P<0.001), diet information (P<0.001), other information (P<0.001) and the total scale (P<0.001) as more realistic than the nurses did. Female nurses (P=0.012) and nurses with advanced preparation (P<0.001) perceived learning needs as more realistic than the other nurses.

Conclusion: Regarding discordance between patients' and nurses' perspectives on the reality of learning, nurses may postpone to implement educational program. Patients' perspectives should be considered in the establishment of heart failure educational programs.

Background & Aim: The issue of children's mental health has been attracting widespread attention in recent years and the issue of parent-child mental health is particularly important. To investigate the effect of maternal anxiety on pregnancy outcome and also infants' mental health were the main purposes of this article.

Methods & Materials: In this comparative study, a total of 40 pregnant women were selected using random sampling method from Imam Khomeini hospital. First, The women completed the Ketel anxiety questionnaire during the third trimester of their pregnancies. Based on the results, 20 women were allocated in the anxious mothers' group and the other 20 women were allocated in the calm mothers' group. Then, birth indicators were measured in both groups at the time of birth. Finally, infants' mental health indicators were measured using infants mental health measurement scale three months later. Data were analyzed using descriptive- inferential statistics (Chi-square and t-test) in SPSS.

Results: The results showed that there were significant differences in anthropometric indexes between two groups (P<0.001). The rate of vaginal delivery was more in calm mothers than in the vexatious ones. Most of the calm mothers stated that they had wanted pregnancies. Mental health of the calm mothers' newborns were significantly higher than the mental health of the other group's newborns (P<0.001).

Conclusion: These findings illustrated that maternal mental status could affect pregnancy outcomes at birth and infants' mental health third months after birth.

Background & Aim: Using illicit drugs such as Ecstasy is a deviant behavior in adolescents. Attitude toward using illicit drugs can predict its usage. This study was carried out in order to determine the adolescents' attitude toward using Ecstasy in 2006.

Methods & Materials: In this cross-sectional study, eight hundred adolescents aged 16-18 years who lived in the west of Tehran recruited from public regions of municipality. Data was gathered using authors-structured questionnaire. After filling in informed consents, the questionnaires were completed by the respondents.

Results: Findings revealed that 78.9 % of the adolescents had negative attitudes and 17.5% had positive attitudes toward using Ecstasy. Boys and girls attitudes were not significantly different.

Conclusion: Regarding relatively high negative attitudes among the adolescents toward Ecstasy using, it seems that investments in health promoting programs were appropriate. Nevertheless, along with these programs, parents and teachers should pay more attention to the issue.

Background & Aim: Effect of women's psychological status on delivery processes is proven. Studies showed that women who experience severe anxiety were more vulnerable for getting emergency cesarean, and physical and psychological complications. Cesarean section is a surgery in which a lot of complications may occur. As primiparous women experience more fear than the other women and also delivery outcomes in first delivery affect later deliveries this study aimed to study the relationship between fears from vaginal delivery with the occurrence of emergency cesarean in primiparous women.

Methods & Materials: In this cross-sectional study, 243 primiparous women were recruited randomly from Nicknafs hospital during a six months period in 2004. Data were gathered through face-to-face interviewing with the respondents using a structured questionnaire. This questionnaire was included demographic information, reasons for fear from vaginal delivery, and method of delivery. Data were analyzed using χ2 test in SPSS.

Results: Seven percent of the respondents stated that they did not fear from Normal Vaginal Delivery (NVD). Most of the respondents (44.4%) reported that they slightly fear from NVD and 26.3% said that they fear much from vaginal delivery. A relatively high percent of women (22.3%) stated that they extremely fear from NVD. The most mentioned reasons by the women for fear were pain (%68/3), and fetal injury (30%). There was a significant relationship between fear and method of delivery (P<0.001).

Conclusion: It is essential that midwives consider the fear from NVD in their routine cares.

Background & Aim: Although cervical cancer has high prevalence, few qualitative studies have been carried out to reflect the perceptions of women on the influential factors that affect cervical cancer screening in Iran. The aim of this study was to explore a culturally-based experience of Karaji women regarding the barriers to and motivating factors for Pap smear screening test among Karadj women in 2007.

Methods & Materials: In this content analysis, eight focus groups were conducted using semi-structured guide questions (n=86).

Results: Findings revealed that factors such as medical advice, advice from friends and family, knowledge about symptoms and pap smear screening method, free and accessible services, and perceived threats would influence the women to undergo a Pap test. Major barriers were lack of knowledge about cervical cancer and its causative factors, inappropriate beliefs, fear from cancer diagnosis, and pain related to the procedure.  

Conclusion: Regarding the influencing factors on the rate of Pap smear screening test, it seems that designing appropriate educational programs in order to promote knowledge and correct health beliefs using mass media and local communications will result in referring more women to undergo Pap smear screening test.

Background & Aim: Social support is known as a factor in buffering negative effects of occupational stress. There are several stressful situations in nursing which could cause job dissatisfaction, low work performance, quit or turnover among nurses. These situations cause physical and mental problems which mostly lead to irreparable damages in nursing care. The purpose of this study is to determine the rate of social support among nurses.

Methods & Materials: In this cross-sectional study, 373 nurses who worked in Iran university of medical sciences affiliated hospitals were selected randomly. The inclusion criteria were nurses who had no management experiences and at least had a six-month nursing experience. Data were gathered using a demographic form and the McCain and Marklin Social Integration Scale. Data were analyzed using SPSS 13.

Results: Eighty five percent of nurses mentioned that the support they receive from their coworkers, head nurses, and supervisors were moderate, high (10.7%), and low (4.3%), respectively. A significant association was found between social support and shifts. Perceived support from coworkers (mean=24.83) were more than perceived support from head nurses and the supervisors (mean=19.37).

Conclusion: Most of the nurses received moderate level of support whilst, they desired to have more relationship with their coworkers and nurses managers. Head nurses and supervisors can arrange excursions and traveling tours to establish more relationship with their staff.