[Facilitating and inhibiting factors in health care personnel participation in in-service education programs]

Introduction: numerous factors play an important role in participation of medical staff in education programs. However, information in this regards is very limited. The purpose of this study was to assess facilitating and inhibiting factors in health care personnel participation in in-service education programs

Method: in this cross sectional study, 740 medical staff from Kerman university of medical science were enrolled into the study using convenience method from April to July 2013. Data collected using three questionnaires [demographic questionnaire, questionnaire that examined barriers of participation in continuing medical education programs and questionnaire that examined facilitating factors of participation in inservice medical education programs. Data were analyzed using SPSS version 16. Descriptive analysis, independent t test, and one way ANOVA were used

Results: "credits earned" was the most important motivational factor with mean score of 4.25 +/- 0.84 and "competitive advantage" was the least significant with mean score of 3.0 +/- 1.12. The main barrier was "lack of enough personnel" with mean score of 4.02 +/- 1.20 and the least significant was "low self-confidence" with mean score of 2.88 +/- 1.38. Results of present study showed significant difference between mean score of personal [3.97 +/- 0.22] and organizational [3.48 +/- 0.27] motivational. But difference between mean score of personal [3.42 +/- 0.36] and organizational [3.49 +/- 0.23] barrier were not significant

Conclusion: "credits earned" was the main motivation factor of participation in continuing education programs. Therefore, methods such as employee suggestion program, determining content of educational, and workshops on program verification for staff nurses may change their attitude towards educational programs

[Effect of blended electronic education on learning and self efficiency in nursing students in the cardiovascular intensive care courses]

Introduction: Applying blended electronic education has benefits of both elearning and face to face courses and can be an excellent option for higher education, including nursing. The aim of this study was to determine the effects of blended education on learning and self-efficiency in nursing students in the cardiovascular intensive care course

Method: This interventional study is a queasy experimental research. Study population was six semester nursing students who were randomly assigned to two case and control groups. We conducted pre and post-test in both groups. In the case group, in addition to routine education we presented an electronic teaching package. After completion of a 16 hours course, we assessed the participants learning changes in the diagnosis of arrhythmia via a questionnaire. Data were analyzed by SPSS version 14 using t-test [independent and paired], Mann-Whitney U and Pearson correlation coefficient

Results: Mean learning score of nursing students through a blended education [electronic and traditional] which were trained in the field of cardiovascular disorders [21.7 +/- 2.59], compared to students with routine learning style showed a significant difference. Students in the blended training group had a higher self-efficiency in the management of these patients

Conclusion: Given the shortcomings of current systems and traditional methods of teaching, a blended learning and education strategies is recommended. It can increase the depth and efficiency of learning

[Hospitalized children's mothers' perceptions of nursing care Behaviors]

Introduction: Nurses must be able to define parameters of their roles based on views of care recipients because awareness of the parents' perception of hospitalized children of caring behaviors is very important and it can produce significant results and provide useful information. This study aimed to explore mothers' perceptions of nurse caring behaviors

Method: This study is a qualitative research with content analysis approach. Fourteen mothers of hospitalized children in pediatric ward of Yazd hospitals selected by purposive sampling and data were collected via semi-structured individual interviews. Data was analyzed by using qualitative content analysis

Results: Data analyses led to emerge of the main theme "confidence building behaviors" that its sub-themes include: calming presence, mother absorption in caring, valuing, constructive communication

Conclusion: Due to the main theme of the study "confidence building behaviors", it seems paying attention to confidence attracting in caring behaviors and planning and implementation of caring plan based on this aim is necessary for pediatric nurses

[Effect of two educational models based on compliance and empowerment on the quality of life of patients with asthma]

Quality of life of patients with asthma is affected by many factors including the lack of knowledge about the disease. Different training methods with different outcomes have been applied to improve the quality of life of these patients. The aim of this study was to design to investigate and compare the effect of two educational models based on compliance and empowerment on the quality of life of patients with asthma. In this s quasi-experimental study, the effect of two educational models on quality of life of 70 patients with asthma was assessed. The samples were randomly assigned into two groups. The training was based on the compliance model [CM] and patient empowerment model [PEM] in each group. Both groups completed the asthma quality of life questionnaire before the intervention and eight weeks after it. Data were analyzed using descriptive and inferential statistics. The mean age of the patients was 47.6 years in the CM group and 44.5 years in PEM group. The mean scores for overall and dimensions of quality of life and self management knowledge were not significantly different between the groups before and after the intervention [P>0.05]. Significant increase in the mean scores of overall and dimensions of quality of life and self management knowledge after the intervention in comparison with the scores before the intervention in both groups was reported [P<0.05]. Both training methods improved quality of life patients with asthma. The role of education in order to improve the quality of life for patients with asthma should be considered by health care team members especially nurses

[Correlation of self- efficacy of nurses to deal with unexpected events with the demographic characteristics of the nurses]

Introduction: Self-efficacy of nurses whom deal with unexpected events is valuable. One of the indexes that have close relationship with performance of nurses in real situation is feeling of self-efficacy. This study aimed to determine the correlation of self- efficacy of nurses to deal with unexpected events with the demographic characteristics of the nurses' city of Kerman

Methods and Materials: In this study, 484 nurses whom are working in public and private hospitals in Kerman participated in the census. The instruments for data collection were Nurses Self-efficacy to deal with Emergencies Questionnaire that was made based on Bandura Social Cognitive Theory by researchers. This questionnaire has 47 items. The validity [content validity index] was 0.92 and internal consistency of this questionnaire was 0.82. Statistical analysis was done using inferential methods of ANOVA with SPSS [v.13]

Findings: The results of this study showed that the nurses have an average self-efficiency in confrontation with unexpected events. Factors such as age, work experience, and the increase in education and experience in previous disasters had a significant correlation with average score self-efficacy [p<0.05]

Conclusion: To deal with possible unexpected events in the future is needed to increase ability of nurses. This study can determine issues and topics to increase nurses' self- efficacy

[Changing care: New challenge in health care process in rural society according to health care providers' experience]

Introduction: Health care delivery systems in rural areas face many challenges in meeting the needs of the community and unfortunately adequate attention have not been paid to resolve this problem. The aim of this study was to explore challenges of health care process in rural society of Iran according to health care providers' experience

Materials and methods: This is a qualitative study using content analysis method. According to purposive sampling17 health care providers were selected. Data were collected via semi-structured individual interviews and were analyzed using qualitative content analysis method

Findings: Analysis of Data, eventually led to formation of one category as challenges of caring process in rural society. This challenge itself consists of different subcategories such as; change in characteristics of rural society, increase in complexity of caring process, decrease in workforce efficiency and reduction in tendency of peoples' taking care

Conclusion: Due to changes in the caring process, health care systems should provide new health care models to face potential challenges in this area

[Effect of mandibular plane angle on image dimensions in linear tomography]

Accurate bone measurements are essential for determining the optimal size and length of proposed implants. The radiologist should be aware of the head position effects on image dimensions in each imaging technique. The purpose of this study was to evaluate the effect of mandibular plane angle on image dimensions in linear tomography. In this in vitro study, the vertical dimensions of linear tomograms taken from 3 dry mandibles in different posteroantenior or mediolateral tilts were compared with actual condition. In order to evaluate the effects of head position in linear tomography, 16 series of images while mandibular plane angle was tilted with 5, 10, 15 and 20 degrees in anterior, posterior, medial, or lateral angulations as well as a series of standard images without any tilt in mandibular position were taken. Vertical distances between the alveolar crest and the superior border of the inferior alveolar canal were measured in posterior mandible and the vertical distances between the alveolar crest and inferior rim were measured in anterior mandible in 12 sites of tomograms. Each bone was then sectioned through the places marked with a radiopaque object. The radiographic values were compared with the real conditions. Repeat measure ANOVA was used to analyze the data. The findings of this study showed that there was significant statistical difference between standard position and 15° posteroanterior tilt [P<0.001]. Also there was significant statistical difference between standard position and 10° lateral tilt [P<0.008], 15° tilt [P<0.001], and 20° upward tilt [P<0.001]. In standard mandibular position with no tilt, the mean exact error was the same in all regions [0.22 +/- 0.19 mm] except the premolar region which the mean exact error was calculated as 0.44 +/- 0.19 mm. The most mean exact error among various postroanterior tilts was seen in 20° lower tilt in the canine region [1 +/- 0.88 mm] and for various mediolateral tilts the most exact error was seen in the canine region in 20° upper tilt [2.9 +/- 2 mm]. The mean exact errors in various regions and various 5° to 20° posteroanterior and mediolateral mandibular tilts were in the range of acceptable values [=1 mm] except for the canine region. However, this effect is more considerable in mediolateral tilt compared with posteroanterior tilt, posterior region compared with anterior region, and upper tilt compared with lower tilt

[ effects of video education on comfort and tolerability of patients undergoing coronary angiography]

Coronary angiography is a definite diagnostic evaluation for coronary artery disease and valvular heart disease. It is necessary to provide information to such patients in order to maximize their comfort and tolerability to the invasive procedure. The study aimed at assessing the effect of patients' education by video on comfort and tolerability of patients undergoing coronary angiography. Using quasi- experimental method with a pretest-posttest design, 128 patients with coronary artery diseases randomly assigned to two groups of control and experiment. The sample hadn't any experience of the procedure before. Control group received routine oral education by nurses and experimental group received an informative video on coronary angiography procedure as well as pre and post angiography interventions. Data were gathered through a 10-point rating visual analog scale [VAS] for comfort level and a 4-point rating scale to measure tolerability. No significant difference was found between the two groups, concerning demographic variables. It was revealed that the comfort level [P<0.001] and tolerability of the patient [P<0.05] in experimental group was higher than control group two, four and six hours after angiography [P<0.05]. The study indicated providing information on angiography through video could enhance patients' comfort and tolerability to the invasive procedure. It could result in shortened stay at hospital and increased satisfaction of patients

[Preoperative worries and its association with sleep disturbances in children admitted for surgery to Kerman medical university hospitals]

Preoperative worries can have adverse impacts in children. It has associations with a number of behavioral disturbances after the surgery. Considering the rate of 65% of children candidates for surgery, suffering from preoperative worries, recognition of worries relationship with behavioral disturbances has great impotence. It could help nurses to diagnose such complications better in order to have a proper plan for reducing preoperative worries and disturbances after surgery. The study aimed at determining the association of preoperative worries and sleep disturbances in children undergo surgery in hospitals affiliated to Kerman Medical University. A correlational descriptive - analytic study was conducted cross-sectionally. A total of 309 children, aged 8-14 years old were who had undergone general anesthesia and surgery, participated in the study. Data were collected through standard preoperative worries questionnaire in four dimensions of disease, surgery, hospitalization and injection procedures, and sleep disturbances questionnaire [researcher-made] in 4 domains of general sleep disturbances, disturbances prior to sleep, disturbances during sleep and disturbances after sleep. All statistics were computed using the SPSS software [version 13]. ANOVA and Pearson correlation coefficients were used as statistical tests for analysis. Among 309 participants, 118 were female and 191 males. Their mean age was 10.64 years old. 14 years old participants had the minimum scores of worries and 12 years old ones, the maximum. The results showed a significant correlation between preoperative worried and sleep disturbances after surgery [r=0.31]. The children who underwent respiratory surgery had the highest levels of worries and the children with mass resection surgery showed the lowest levels of worries. Also, the children who had come from other provinces expressed more worries. A negative correlation was found between worries scores and age [P<0.05] but no significant correlation between worries scores hospitalized care units and residential place [P<0.05]. Worried related factors had significantly positive correlation with age, gender and kind of surgery [P<0.05]. The study revealed that children experience fear and worries in surgery which is directly associated with their sleep disturbances. The study calls for more investigation on different aspects of issue. Nurses should provide plans for decreasing levels of children and their parents' worries in collaboration with other health team members and make it as an acting plan for taking care of such children

[ relationship between religious beliefs and locus of control with mental health]

Prevention of mental disorders is considered to be the major aim of mental health. Preventive attempts to strengthen religious beliefs and ideas are among the approaches to help reducing mental disorders. To study the relationship between religious beliefs and locus of control with mental health in female students. This was a descriptive-analytic study performed on 80 female students of Bandar Abbas University of Medical Sciences in 2000. Random clustering method was used for selection of samples. The data were collected using 3 different questionnaires named as Julian Rater Locus of Control, Symptom-Check List-90-Revised questionnaire, and Islamic Act Screening Scale. The data analysis showed a direct and positive effect of religion on mental health and locus of control, although the relationship between religious beliefs and symptom-check list-90-revised scale was significantly reserved. Regarding the positive effects of religious beliefs and practices on mental health, the use of this potential in community health planning specially when dealing with young adults is recommended

Medical ethics in disasters and emergencies

According to statistical reports, natural and man-made disasters are increasing in world and also in our country. In response to disaster the first and the most important subject is human damages and their effects on human health. It is expected that health managers in such cases can perform maximum services in minimum time to all injured and patients. Today, because of knowledge development and use of equipments in response to disaster survivors are increased, and also disaster cases are increasing, mortality decreased. Human rights and dignity must be regarded in all situations. But there is one basic question that, what is the position of ethics in response to disaster and relief activities? This paper is not develop to response to this question, but attempts to remark important of subject for legal and ethical scientists. Among complex subjects in medical ethics is regarding medical moralities in serious and disastrous situations that need for rapid decision making and interventions. In disasters and mass casualty events there are injured and disastrous overcrowd and must be considered to many people in limited time. There is no reduction of importance of medical ethics in disasters, so we need rapidly and correct decisions. It is no doubt that medical relief must be according to medical ethics. This decision making must be directed with medical ethics principles. The Bam earthquake and some similar events show that patients rights and moralities are among most important worries of physicians, nurses and other health workers in relief actions. In emergencies and disasters in addition to routine and public moralities that in Iran are under direction of Islamic ethics, we need some specific principles of disaster ethics. Literatures are not more topics about disaster ethics. Regarding shortage in literatures, this paper is attempted to present some theoretical bases of disaster ethics and discuss some questions. 1] Can develop special model for medical ethics in disasters and emergencies? 2] Is any differentiation between medical ethics as a whole and medical ethics in disasters and emergencies? 3] Are medical ethics principles can guide medical ethics in disaster and emergencies? 4] Can develop special principles for medical ethics in disasters and emergencies? 5] What ethical principles can guide morality in disaster and emergencies?

Prevalence of postpartum thyroid dysfunction in Shiraz

Postpartum thyroiditis [PPT] is an autoimmune disease that usually occurs in the first year after parturition and presents with periods of transient thyrotoxicosis and/or hypothyroidism, and in some cases results in permanent hypothyridism. To determine the prevalence of PPT in healthy postpartum women in Shiraz, southern Iran. Of 460 postpartum women from Shiraz 385 cases who had no history of any medical problem or signs of other autoimmune disorders were selected during 1-8 months of postpartum period, to fill a questionnaire about signs and symptoms of their possible thyroid dysfunction. TSH and Anti-Tpo Ab were measured and FT4 assay was done on samples with abnormal TSH. 100 women at reproductive age were randomly selected as control group. Result: The clinical and biochemical prevalence of PPT were 33% and 11.4%, respectively [p<0.01]. Hyperthyroidism was more frequent in early months of postpartum period and hypothyroidism was more frequent in later months. Thyrotoxicosis and hypothyroidism occurred in 34 [8.8%] and 10 [2.6%] mothers, respectively. Positive Anti-Tpo Ab was found in 80% of patients and in 38% of the control group [p<0.0001]. Our results showed a high prevalence of PPT in women in Shiraz. This may be due to the transition from low to adequate iodine intake and participation of women in earlier postpartum period. The major difference compared to other studies is the high frequency of thyrotoxicosis