[A comparison of data elements of nursing minimum data set]

Introduction: Standard data processing plays an important role in patient care. Nursing data forms the first level of nursing informatics. These are essential tools for documentation of nursing process by methodology of assessment, diagnosis, interventions, outcomes, evaluation and documentation of patient care. Nursing minimum data set [NMDS] is the first action for standardization of gathering unified and essential nursing data for using in multiple sets and patient groups. The objective of this research was comparison of data elements of nursing minimum data set

Methods: This was a descriptive-comparative study and was done at 2009. Nursing minimum data set in the US, Thailand, Belgium, Finland, Canada, Netherlands, Swiss surveyed. Data collection was performed through internet search, books and journals. Results presented in statistical tables

Result: Findings showed that all countries had a national NMDS. In all NMDSs, Nursing data elements divided to three groups: Nursing care, patient and service elements. There is a nursing minimum data set for nursing management in US. There is no NMDS in Iran

Conclusion: Since every countries of this study have a domestic NMDS and also there is no standard in Iran for which data elements must include in Electronic Health Records, then creating an Iranian Nursing Minimum Data Set [IrNMDS] is essential. For identifying Iranian NMDS, we recommend that a professional and legal organization administer to creating of a NMDS

[Clarification of knowledge translation in health system]

Introduction: Knowledge translation is a frequently observed concept in current health science literatures. However, there is no congruence about its definition and properties. Analysis of concept helps researchers to achieve a uniform, clear and understandable description. This study accomplished on 2009 to clarify and reduce ambiguities associated with the meaning of knowledge translation and promote the concept consistency in related literatures

Methods: Walker and Avant's eight-step model was used as the method. After extensive review of all published articles until 2009, we included 29 relevant articles in the analysis. By following the steps of model, definitions, characteristics, applications, antecedents and consequences and empirical referents of the concept were derived

Results: According to the analysis, essential attributes of knowledge translation were emphasize on research knowledge application in practice, ongoing collaboration among knowledge producers and knowledge users, interactional and nonlinear process, and dependency on user and final context. In addition, the consequences of successful knowledge translation were community health promotion; more effective health services, improvement in practice and strengthen of the health care system

Conclusion: Since knowledge translation process in our country is relatively new and unknown, this concept analysis can improve implementation of more extent studies and development of research tools for identification of its barriers and facilitators and its execution

[Burnout and its relationship with the nurses' characteristics]

A number of studies have been done on the topic of nurses' burnout. However social and cultural context of caring institutes and the characteristics of nurses working in these centers would add to the knowledge about this organizational behavior. Accordingly this study aims at identifying the frequency and intensity of nurses' burnout and its relationship with nurses' characteristics in hospitals affiliated to Arak University of Medical Sciences. It was a descriptive correlational study. Two hundred nurses working in hospitals affiliated to Arak University of Medical Sciences were recruited by Stratified probability sampling with proportional allocation. The instruments included Demographic information questionnaire and the Maslach Burnout inventory [MBI]. Data were analyzed by descriptive statistics, independent t-test, chi-square, and ANOVA using SPSS-PC [v.16]. The findings revealed that 39.5% and 37% of nurses have reported high levels of frequency and low levels of severity of emotional exhaustion respectively. the majority of nurses [75%] reported high levels of personal accomplishment frequency and 70% of them reported high levels of personal accomplishment severity. Nurses also reported low levels of frequency [47%] and intensity [45%] of depersonalization. Significant relationship was found between frequency of emotional exhaustion and sex [p=0.05], severity of emotional exhaustion and sex [p=0/05], and severity of depersonalization and age [P=0/04]. Identification of work place stressors in order to prevent emotional exhaustion, and also providing conditions for continuous job promotion and experiencing personal success for nurses working in Arak city is recommended

[Pharmaceutical care: a concept analysis using Rodgers' evolutionary method]

The concept of pharmaceutical care has been used and discussed with multiple definitions in the literature related to health care sciences and especially in pharmacology and pharmacotherapy. However, the use of this concept is not common in the nursing literature and it has not currently been used. This study has been done to analysis the concept of pharmaceutical care in order to clarify areas of agreement of this concept in nursing and pharmacology disciplines and identifying its attributes, antecedents and consequences. Rodgers' evolutionary method of concept analysis was used to clarify the meaning of Pharmaceutical care. Data bases of Sciencedirect, Springer and google scholar were searched to retrieve the related literature. The main criteria for entry were, the literature published in English language in the disciplines of nursing and health care sciences. Literature search was limited to 1990-2011 with the keywords of "Pharmaceutical care" and "Pharmaceutical service" in the title of texts. The initial search resulted in 932 texts, 197 of them deemed relevant to our analysis. Then 40 texts [20 percent of those] were selected and reviewed. In this study, the attributes of pharmaceutical care were identified in two categories of specialized skills and communication skills. Specialized skills included five attributes including the identification of drug problems, resolving the drug problems, treatment and palliative care, monitoring short-term results of treatment and reviewing proportionality of prescription for each patient. The communication skills included four attributes of consultation with the patient, emotional commitment to the welfare of patients, collaboration with the health care team and attention to the patient's medical condition. The antecedents included professional and organizational factors, and the consequences were health care, economic, informational and qualitative outcomes. The findings show that in spite of failure to use the concept of pharmaceutical care in nursing literature independently, it is a significant aspect of clinical practice and overall patient care

[Health-related quality of life in patients with chronic obstructive pulmonary disease]

Complications of chronic obstructive pulmonary disease [COPD] frequently lead to impaired social life, physical Function and daily activities in these patients and finaly the health-related quality of life [HRQL] of these patients will decrease. The aim of this study was to determine HRQL and its relationship with some demographic variables. Using a cross-sectional descriptive design, 331 COPD patients admitted to hospitals affiliated with Tehran University of Medical Sciences were recruited by constant sampling. Data collection tools included demographic information form and HRQL questionnaire [SF-36]. Data was analyzed using SPSS [v.16], descriptive statistics and Pearson correlation coefficient, ANOVA and Independent t- test. The findings showed a reduction in HRQL especially in physical health dimension. Significant relationships were found between HRQL and some demographic characteristics such as gender, education level, duration of disease, type of medication and hospitalizations frequency during the past year [P <0.05]. Regarding the relationship between HRQL and some demographic variables, using appropriate caring approaches such as executing educational programs about adequate activity, breathing exercices, techniques promoting breathing pattern and right ways of using medications in COPD patients is recommended

[Relationship between self-efficacy and quality of life in ostomates]

Physical, psychological and social problem along with significant changes in life style, diminish stoma patients quality of life. At the meanwhile self-efficacy can improve these patients' quality of life. The aim of this study was to assess the relationship between self-efficacy and quality of life in Ostomates. In this descriptive cross-sectional study, 84 Ostomates who referred to selected educational centers of Tehran University of Medical Sciences and Iranian Ostomy Society [IOS] were recruited by census. The data were collected with City of Hope Quality of Life-Ostomy Questionnaire [COH-QOL] and Stoma Self-efficacy Scale [Stoma SE Scale] and then analyzed using independent t-test, analysis of variance and regression analysis by SPSS-PC [v. 15]. The half of patients, achieved 50-75% of overall self-efficacy score [84-112]. The mean score of stoma care-self-efficacy [55.8 +/- 11.6] was more than the mean score of social-self-efficacy [42.1 +/- 13.2]. Moreover, most of patients were scored 7[of 10] and above for overall quality of life and its dimensions. The mean range of quality of life scores in different domains varied from 6 +/- 2 for social dimension to 7 +/- 1.5 for physical dimension. A significant positive association were found between self-efficacy and physical [P=0.00, r=0.485] psychological [P=0.00, r=0.655], social [P=0.000, r=0.694] and spiritual [P=0.00, r=0.393] dimensions and also with overall quality of life [P=0.00, r=0.687]. Also the highest correlation was found between quality of life and social self-efficacy subscale [beta=0.695, P=0.000]. With regard to the significant correlation between self-efficacy and different dimensions of Ostomates' quality of life in this study, it is suggested that nurses design and execute appropriate interventions to promote these patients' self-efficacy, especially in social dimension which had the highest association with their quality of life and in this way help to improve these patients' quality of life

[Comparative study of the effect of dry and moist dressing on burn wound]

Consistent with recent scientific advances in wound treatment, modern dressing, using technology and knowledge were designed and produced. Such a dressing can provide an appropriate environment for moisturizing wound healing by maintaining and controlling moisture along with other conditions. This study aims to compare the effect of dry and moist dressing on burn wound healing. It was a quasi experimental research. Sampling was done constantly according to inclusion criteria. The final sample consisted of 60 patients hospitalized in Shahid Motahari burn center with second degree burn and a TBSA less than or equal to 10% on both hands or legs. Data collection tools included demographic information form and observation checklist. Part of the burned area was covered with a dry dressing according to hospital routine and the other part covered with the wet dressing of NA ultra. The stage and duration of wound healing was observed and recorded in the third, seventh, thirteenth and twenty-first days. Data was analyzed using descriptive statistics and pair t-test by SPSS-PC [v. 13]. There was a significant difference between the mean scores of the stage [P<0.001] and duration [P=0.004] of burn wound healing. According to the findings, the use of wet dressings in treating burn wounds is advisable

[Informational and structural needs of nursing data classification in computerized systems]

Healthcare classification systems help to gather information and process health data. Nursing management focus on developing computerized records to answer legal, managerial and clinical needs. The Classification systems help organizations to use nursing data. This study investigated informational and structural needs of nursing data classification. This descriptive-comparative study was carried out in 2009. Current classification systems for nursing were investigated and their specifications were gathered in a questionnaire. The items were prioritized by experts in four degrees. Using statistical analysis items with a priority over 80 percent [average 2.4] were selected. Findings about nursing diagnosis, intervention and outcomes showed that diagnosis item [average 2.93 out of 3], intervention item [average 2.52 out of 3], and outcome item [average 2.84 out of 3] should be presented in the system. Structure of nursing data classification was identified as a hierarchical and combinational classification. The computerized terminology [average 1.86 out of 3] had no priority. It is suggested to make decisions for standardizing nursing data to use in computerized systems. Since, nursing system in Iran is moving toward defining tariff for nursing services, coding nursing care components will help this plan to be developed

[Self-efficacy and the related factors in ostomates]

Stoma surgery is one of the events that strongly influences individual life and causes major changes in life style. Self-efficacy as a personal coping resource can facilitate adaptation with these changes. So the aim of this study was to assess self-efficacy and the related factors in ostomates. It was a cross-sectional study. Eighty four patients with ostomy who were referred to selected educational centers of Tehran University of Medical Sciences and Iranian Ostomy Association [IOA] were selected through convenience sampling. The data were collected using personal information form and Stoma Self-Efficacy Scale [Stoma SE Scale]. Data was analyzed by SPSS 15 using descriptive statistics, independent t-test, ANOVA and regression analysis. Half of the participants gained at least half of the overall self-efficacy scores. The mean score of social self-efficacy was lower than the mean score of stoma care self-efficacy. Self-efficacy was associated with marital status, stoma status and stoma duration [P<0.05] but the relationship between self-efficacy and age, gender, educational level, type of stoma and reason of stoma was not statistically significant. The Present study provided useful information about self-efficacy and its related factors in stoma patients. This information can be used for designing and performing appropriate nursing interventions to promote these patients' self-efficacy, especially in the social dimension which is weaker in most ostomates

[Nursing minimum data set: an essential need for Iranian health care system]

Nurses are the largest groups in health care delivery system. Nursing Information systems [NIS] are important for improving nursing performance, increasing nursing knowledge and providing data and information needed for nursing. Identifying Nursing Minimum Data Set [NMDS] is the first step for development of NIS. Considering the absence of NMDS in Iran, this study was conducted with the aim of assessing NMDS needs and giving recommendations for Iran health care system. It was a descriptive developmental study. NMDS was searched in several countries; nursing data elements gathered into a questionnaire and then, were prioritized by experts. Using SPSS-PC [v.16.5], mean scores of priorities were calculated and those with more than 80% of mean score [m=2.9] were selected. Findings showed that most data elements had high priority from within nurses, perspective except "residential status [m=2.34 of 3]", "nurses, employment startup date [m=2.36 of 3]", "number of patients [m=2.32 of 3]", "employment end date [m=2.29 of 3]", "Reimbursement type [m=2.23 of 3]", Nurse Gender [m=2.05 of 3] and Nursing budget [m=1.97 of 3]. Elements for Iranian Nursing Minimum Data Set [IrNMDS] were offered as nursing care data elements [5 Items], Patient data element [14 Items] and service data element [14 Items]. Validity and reliability assessment of data set content, in-service education for nurses and more comprehensive studies regarding the clinical use of this data set is recommended

[ effect of jaw relaxation on pain anxiety of burn dressing: Randomized clinical trial with control group]

Patients with burns, experience high levels of anticipatory anxiety during dressing changes. Anxiety tends to increase after each dressing and during time; on the other hand this anxiety cannot be completely managed by anxiolytic drugs. Nurses contribute to pain management by using pharmacological and non-pharmacological interventions. Relaxation techniques are one of the most used approaches in pain anxiety management. However there is not enough information about the effects of these techniques on pain anxiety of these patients. The aim of this study was to determine the effect of jaw relaxation on pain anxiety of burn dressing. This study was a randomized clinical trial with control group. One hundred patients hospitalized in Shahid Motahari Burn Center in Tehran within July to December, 2009 were recruited by convenience sampling and were randomly assigned to either experimental or control groups using minimization. Experimental group practiced jaw relaxation for 20 minutes before entering dressing room. Data were assessed with Burn Specific Pain Anxiety Scale [BSPAS] and analyzed using descriptive statistics, Chi-Square test, dependent and independent t-test and Fisher's exact test by SPSS-PC [17]. Significant statistical difference was seen between the level of pain anxiety before and after intervention in experimental group. Moreover, after intervention there were a significant difference between the level of pain anxiety after dressing in experimental and control groups. There weren't significant difference between pain anxiety after intervention, before and after dressing in experimental group. Nurses can independently decrease the pain anxiety of burned patients and its subsequent physical and psychological burden by teaching the simple and inexpensive technique of jaw relaxation. Further studies are suggested to assess the effect of this technique on pain anxiety of patients with other disease except burns who suffer from painful procedures

[Concept analysis of participation of patient with chronic disease: use of hybrid model]

Approaches to professional health care have changed along with changes in health measures and progression of chronic diseases. Patient participation is an international golden standard in new nursing paradigm. Despite the importance of patient participation and its routine usage in professional care, this concept is not clear, especially in social and cultural context of Iranian nursing. The purpose of this study was to clarify the meaning of patient participation and determine its critical attributes in chronic disease within the nursing context in Iran. Concept analysis of this concept was conducted using hybrid model. Hybrid model has three phases: theoretical, field work and final analytical phase. Literature review in theoretical phase determined the attributes of the concept including; establishing mutual relationship, giving way to control and responsibility, shared information and knowledge, active engagement in activities, and profit from this engagement. Filed work phase determined attributes such as mutual confidence, harmony between patient and nurse, setting the stage, giving responsibility to patient, patient empowerment, and organizational factors. In the final analytical phase, the critical attributes of participation of patient with chronic disease including connection by means of mutual confidence, yielding control and responsibility, sharing information and knowledge, active engagement in self care activities, setting the stage and empowerment of patient to engage in self care was determined. Concept analysis of patient participation revealed the required conditions for participation of patients with chronic diseases in nursing care. In the meantime, this concept is a new and complex one within the context of our nursing, which requires further study of social and cultural context of health care area

[Perspectives of patients and nurses on the reality of learning cardiac heart failure educational content]

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. 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. 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. 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

[Perceived social support in hemodialysis patients]

Physical and psychosocial problems along with the changes in life style, put hemodialysis patients under pressure. It seems that social support decreases psychological stresses and improves quality of life. This study aimed to describe hemodialysis patients' perceptions on their social supports and related factors. This descriptive-correlational study is a part of a larger study. All patients [n=202] referred to the hemodialysis units of Iran University of Medical Sciences were recruited to the study during a four-months period. Data were collected using "Personal Resources Questionnaire" [PRQ 85-PART 2] and analyzed using SPSS v.14. Findings revealed that the most patients [64.9%] had perceived social support at high levels. There were significant relationships between social support with economic status, gender and marital status [P<0.05]. Findings also indicated that the statements of "I enjoy doing little extra things that make another person's life more pleasant" and, "I belong to a group in which I feel important" had the highest and lowest scores respectively. Regarding the variety of perceptions in hemodialysis patients on social support and its related factors, nurses can prevent social isolation of these patients through identification of high risk groups and can also reduce their stresses and help them to improve their quality of life by providing adequate supportive interventions

[Self-efficacy in hemodialysis patients and its related factors]

End-stage-renal-disease [ESRD] patients treated by hemodialysis require major lifestyle changes and self-efficacy in the treatment regimen to comply with their chronic illness. Clients' perception of being self-efficient results in increased self-care activities and adherence to medical regimen. Although client's self-efficiency can affect on outcomes of the disease, few study is available in this regard. This descriptive correlational study was carried out to identify self-efficacy of hemodialysis patients and its related factors. 200 patients referring to health care setting affiliated with Iran Medical University were selected by convenience sampling method. A tool, Guidelines for Health Promotion, was used to assess self-efficacy in the treatment regimen. The tool was made reliable by test-retest method. Findings showed that self-efficacy was correlated with educational level, dialysis duration and weight difference between 2 dialysis sessions. In contrast, no correlation was found between self-efficacy and age as well as sex. The study showed a significant relationship between self-efficacy and some personal characteristics of patients. Thus, it is necessary for nurses to assess self-efficacy of their patients. In addition, nurses are in a key position to influence on self-efficacy of their patients and improve self-care activities of them. To achieve these, they can provide necessary instructions for their clients to control stress and emotional as well as physical stimulations

Quality of life in patients with end stage renal disease

Recent studies suggest that patients' 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. In this descriptive-correlational study, we recruited 202 hemodialysis patients from Iran University of medical sciences' 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. 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's 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]. 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

[Relationship between perceived social support and quality of life in hemodialysis patients]

Quality of life in hemodialysis patient can be affected by Physical, psychosocial and lifestyle disturbances. It seems that perceived social support can improve quality of life in these patients. Therefore, this study aimed at determining the relationship between perceived social support and quality of life in hemodialysis patients. This descriptive- correlational study was conducted with 202 patients with chronic renal failure, recruited through consensus method. They have been under hemodialysis treatment in one of the hemodialysis care units, affiliated to Iran University of Medical Sciences. Data were collected using the [Personal Resources Questionnaire 85] [PRQ-85] part 2 and The [Ferrans and Powers quality of life Index-dialysis version]. All statistics were computed using the SPSS software [version 14]. Finding indicated that patients had a high perceived social support [64.9%], good quality of life [54.0%] and socio-economic condition [P

Relationship between nurse caring behaviors from patients' perspectives and their satisfaction

"Caring" is the central concept of nursing role, but in the current health care systems with huge advances in technology and scarce resourses as well as the issue of nursing personnel shortage, this aspect of nursing role would be questionable. Accordingly, this study was conducted to examine the relationship between nurse caring behaviors from patients' perspectives and patient satisfaction. This study was a descriptive-correlational design, with 250 patients, who where hospitalized in an educational center of Iran University of medical sciences. The subjects were selected by quota sampling method. The data collection instruments were Caring Behaviors Inventory [CBI] and Patient Satisfaction Instrument [PSI]. The study findings showed that, there were significant correlations between caring behaviors including respectfulness to others, assurance of human presence, positive connectedness, professional knowledge and skill, attentiveness to other's experience and patient satisfaction including Trust, Patient education and Technical- Professional care. Moreover, there was a strong, positive correlation between all variables of the nurse caring behaviors and patient satisfaction [r=0.72, P=0.000]. Positive relationship between nurse caring behaviors and patient satisfaction indicates that compassionate nurses with humanistic feelings and art and spending more time for direct caring for patients, play important roles on patient satisfaction. Therefore increasing the time period of direct caring by increasing the number of practice nurses and concerning humanisitic aspects of patient care would reduce the levels of patients dissatisfaction

Ecology of Anopheles dthali Patton in Bandar Abbas District, Hormozgan Province, Southern Iran

Ecology of Anopheles dthali was studied in Bandar Abbas County, where there is indigenous malaria. Anopheles dthali plays as a secondary malaria vector in the region. It is active throughout the year in mountainous area with two peaks of activity, whereas in coastal area it has one peak. There is no report of hibernation or aestivation for this species in the region. Precipitin tests on specimens from different parts showed that 15.6-20.8% were positive for human blood. This species usually rests outdoors. It has different larval habitats. Insecticides susceptibility tests on adult females exhibited susceptibility to all insecticides recommended by WHO. LT[50] for the currently used insecticide, lambda-cyhalothrin, is measured less than one minute. The irritability tests to pyrethroid insecticides, showed that permethrin and lambda-cyhalothrin had more irritancy compared to deltamethrin and cyfluthrin. Larval bioassay using malathion, chlorpyrifos, temephos and fenithrothion did not show any sing of resistance to these larvicides at the diagnostic dose. It is recommended that all the decision makers should consider the results of our study for any vector control measures in the region