[Assessment of patient satisfaction from nursing care in hospitals of Iran university of medical sciences]

Patient satisfaction has been recognized as a key indicator of health care quality which is used by accreditation agencies to monitor quality of care in hospitals. A high proportion of health caregivers are nurses. The services provided by nurses are significantly influential in satisfaction of patients. The aim of this study was to assess patients' satisfaction from nursing care in hospitals of Iran University of Medical Sciences in 2010. In this cross-sectional study, we recruited 200 patients from different wards [except for special wards, Emergency department, Pediatric and Psychiatric wards] at the time of discharge from hospital through multistage sampling method. Data were collected using Patient Satisfaction Instrument [PSI]. Data analysis was performed using descriptive statistics, chi-square and regression analysis. Majority of patients [72%] were moderately satisfied. Patient satisfaction had a significant relationship with the type of ward [PG0.001], and type of hospital [PG0.001]. Of demographic variables, only patients' level of education was significantly associated with patient satisfaction [PG0.019]. In this study, patients were moderately satisfied from nursing care services. Educating hospital staff, especially nurses; and encouraging them to actively participate in activities to promote patient satisfaction should be a priority for hospital management. We should also consider that in a competitive market of health and treatment care giving, institutions that put patient satisfaction as their main goal are more successful

[ relationship between self-efficacy and breastfeeding, Tehran, Iran]

Breastfeeding is the most cost-effective, health-promoting, and disease-preventing activity that new mothers can perform. Many researches have focused on identifying factors that influence breastfeeding initiation and duration. An important and modifiable factor is the perceived self-efficacy of mothers for breast feedings. It refers to a mother's perceived ability to breastfeed her newborn; and is a dominant variable in the duration of breastfeeding. The purpose of this study was to assess the relationship between self-efficacy and breastfeeding. A descriptive, longitudinal, analytic approach was used in this study. The three-part questionnaire was administered to the eligible pregnant women [437 pregnant women] who were at least in 37 weeks of gestation and intended to breastfeed. They were then contacted again at one and four months postpartum to determine their infants' feeding level and method. The questionnaire was re-administered to the participants at that time. The results showed that 80.4 percent of participants had exclusive breastfeeding during one month. There was no significant relationship between antenatal breastfeeding self-efficacy and the breastfeeding. The self-efficacy was significantly related to breastfeeding outcomes at one month. Mothers with high self-efficacy were significantly more likely to breastfed their babies exclusively at one and four months postpartum than the mothers with low self-efficacy. Maternal breastfeeding self-efficacy is significantly related to breastfeeding duration and level. Measuring breastfeeding self-efficacy not only identifies high risk mothers, but also provides important information to health care providers in providing support to new mothers

[Study of the susceptible factor in wife abuse among women referred to karaj forensic medicine center in 2005: a case - control study]

Violence against women, which is seen in most societies, is a concealed social disorder. This social issue in itself gives rise to other health and social problems among its victims. This study attempted to identify the contributing factors in violence against women in Iran by evaluating the cases referred to Karaj Forensic Medicine Center. In this case- control study, a questionnaire was fulfilled for 100 married women who suffered violence at home and referred by the judiciary in 2005 to Karaj forensic medicine center, and also 100 married women who referred to Karaj forensic medicine kenter by the judiciary for reasons other than wife abuse and report no history of violence at home. With increasing age of women and men, wife abuse decreased. There was no significant association between education level of men or women and wife abuse [NS]. Crime history [P < 0.001], polygamy [p < 0.001], religious conviction [p < 0.001] and addiction of husband [p < 0.001] had a significant association with wife abuse. Lower age of woman, addiction of man, and low economic welfare of family of man were independent predictors of wife abuse. In addition, our study revealed that incompatibility of partners, guardianship of a person in family of husband, polygamy, religious conviction of man, violence against children, man job, and history of criminal record are the contributing factors in wife abuse

[Evaluation of the quality of life in newly recognized cancer patients]

The chronic diseases such as cancer could seriously affect health and consequently quality of life of individuals. The purpose of this study is to evaluate the quality of life in the patients who have been recently diagnosed with caner. This research is a descriptive - analytical study aims to determine quality of life in newly diagnosed cancer patients in selected oncology clinics of Tehran University of Medical Sciences. In this research, 196 newly diagnosed cancer patients were selected by simple sampling method and based on aim. The data were collected by a questionnaire including demographic data, disease characteristic and questions about quality of life in physical, physiological and socioeconomic aspects. The socioeconomic questionnaire presented to the patients after his/ her permission and giving necessary descriptions to him/ her about the objectives of the research. The questions were read for illiterate patients by researcher. The SPSS program was used for data analysis. Descriptive statistics such as absolute/ relative and average sufficiency and deductive statistics such as kappa2 test were used as well. The research results show that the quality of life in physical aspect is desirable in majority [67/9%] of patients. The quality of life in physiological aspect is desirable in majority [63.3%] of patients and as well the quality of life in socioeconomic aspect is desirable in majority [76.5%] of patients. The research conclusion shows that there is a meaningful relationship between number of children and economic status [P<0.001] and quality of life in physical aspect. There is a meaningful relationship between economic status with quality of life in psychological aspect and with quality of life in socioeconomic aspect [P<0.05]. There is a meaningful relationship between type of cancer, disease stage at the time of diagnosis [P<0.001], and quality of life in physical aspect. There is a meaningful relationship between disease stage [P=0.002], and quality of life in psychological aspect and quality of life in socioeconomic aspect [P<0.05]. The research result shows that the quality of life in physical, psychological and socioeconomic aspects is desirable in the society. Thus the nurses can play an important role in increasing the quality of life of such patients

[Evaluation of infection control methods using by hemodialysis Units' Staff]

Hemodialysis centers are highly susceptible to nasocomial infections due to application of hemodialysis machines, medical equipment, and invasive techniques and devices. This research was carried out in order to evaluate methods of infection control using by staff of hemodialysis centers. In this descriptive study, all hemodialysis units in hospitals of Tehran University of Medical Sciences [n=4] were studied. Data were gathered using a 3-section questionnaire as well as five series of check-lists that were designed to evaluate physical characteristics of the units, methods of disinfection processes of the units, hemodialysis machines, and common equipment, and finally precaution measurements using by the staff. Data were described using SPSS statistical software. Research findings showed that just one of the study units was appropriate regarding physical characteristics of the units. Method of disinfection of hemodialysis centers was appropriate in 50 per cent of the study units and it was relatively appropriate in the rest. Disinfection of hemodialysis machines was appropriate in all units. Regarding disinfection of the shared equipment, all units were relatively appropriate. In 25 per cent of the units, staff had relatively appropriate precaution measurements and the rest [75 per cent] had inappropriate measurements. Results showed that the methods of infection control using by the staff of hemodialysis centers in hospitals of Tehran University of Medical Sciences were not appropriate

effect of lecture and e-learning methods on learning mother and child health course in nursing students

Traditional teaching methods used in medical education are not able to respond to the rapid changes and growth of information as well as continuous change in educational needs of societies. This study was performed to compare the effect of two teaching approaches, lecture and e-learning on learning outcomes of mother and child health course in nursing students of Tehran Medical University. This quasi-experimental study was performed on all third semester nursing students who had passed mother and child health course in 2006 [N = 32].It was a one group two-shot study. During the first four weeks, the students received traditional education and during the second four weeks they studied the rest of the subject matter using an on-line learning method. At the end of the course, the students' opinion toward the educational methods was asked using a questionnaire. An exam that covered the content of the 4-week block was also administered. Analysis of data was done by SPSS software using mean, standard deviation, and t-test. The learning outcomes in both groups were similar. Based on the students' opinion about two teaching methods, e-learning was more effective on "their capability to use the method" and "independence in using the method", and lecture was better than e-learning in "the effect on learning" and "motivation". E-learning can be used for teaching some nursing courses. It is recommended to use e-learning method with considering appropriate interactive and more attractive virtual environments to motivate students

[Nurses' information and their view points about patient's rights and practical facilitators in clinics]

Nurses can support the patients' rights advocacy, if they are informed of these rights. Furthermore in order to exercise and protect of these rights, the working environment should be appropriate. The aim of this descriptive analytical study was to explore the nurses' awareness of patients' rights in Tehran teaching hospitals and the facilitators of observing theses rights from their perspective. To achieve this, 517 nurses were selected using multi stage stratified sampling method. Data were gathered utilizing a researcher made questionnaire with 3o statements regarding patients' bill of rights, and an open question about patients' rights facilitators at the end. The findings indicated that overall nurses had a high level of awareness regard patients' rights. In addition nurses mentioned 17 factors as facilitators of patients' rights practice. These were classified to three groups: organization related, personnel related and client/ patient related factors. The most frequent items were in the group of organization related factors. Despite of nurses' high awareness of patients' rights, observing these rights in practice needs many other requirements. These requirements should be recognized and identified. This can be the first step for finding proper solutions by all health care providers and policy makers as well

[Preoperative variables associated with extubation time in patients undergoing coronary artery bypass graft surgery]

Decreasing mechanical ventilation and early extubation after cardiac surgery are the important scientific subjects that their clinical and financial benefits had been demonstrated. There are some variables that are associated with extubation time so, determination of them will help nurses to plan appropriate care aimed at doing an early and safe extubation. The purpose of this descriptive-analytic study was to determine whether any preoperative variable had a significant effect on extubation time after CABG. The research was conducted in one of hospitals in Tehran city. In this retrospective study, data were collected by reviewing of files of eligible patients who were undergoing CABG from December 2003 to March 2005. 93 files reviewed by convenience sampling method. Collecting data tool was a checklist consists of three parts: 1] demographic characteristics 2] health and disease history 3] physiologic status. Samples divided into two groups: early and delayed extubation [>6h]. Data analysis was performed by descriptive methods, chi square, fisher exact test and regression analysis. Mean and standard deviation of duration time of intubation was 7.19 +/- 3.00 with range of 3-18.25 hours in all samples. Totally 43% of subjects extubated in 6h. Age was the only preoperative variable that was found to be statistically significant to extubation time [p=0.01]. According to our findings age is associated with postoperative intubation time after CABG. It means older patients need to be under long mechanical ventilation. So, nurses should make a decision on extubation in older patients, carefully

[ comparison of self-esteem between male and female cancer patients]

Chronic illnesses, such as cancer, can cause changing in self-esteem. This study has been perform to compare the self-esteem between male and female cancer patients. In this research 101 patients [51 women and 50 men] with different types of cancer [solid tumors and leukemia] have selected by simple sampling method. The tool for gathering data was a questionnaire, with three parts: demographic characteristics, disease characteristics, and Cooper smith self-esteem inventory. Data collection was done through interview, patient's charts and patients self-report. The descriptive and analytic statistics have been used and the exams were "chi-2" and "Fisher", through SPSS software. This study showed that the majority of cancer patients in male and female group have moderate level of self-esteem. There is no significant difference in self-esteem of men and women with cancer and the majority of them [84.3% women] and [%76 men] have moderate self-esteem, but noticeable difference between men and women is connected to the variables that are related to self-esteem, whereas, men's self-esteem has not any significant meaningful relationship with demographic variables, meanwhile, variables of being under support of somebody [p=0.005] and having caregivers at home [p=0.039] have a meaningful relationship with women's' self-esteem. Among the diseases' characters change or decrease in function of different parts of body has a meaningful relationship with men's [p=0.014] and women's [p=0.005] self-esteem. Constipation is the only other variable related to men's' self-esteem [p=0.071], but about women there are some variables related to the self-esteem of them consist of duration of amputation [p=0.018], anorexia [p=0.001], alopecia [p=0.027] and fatigue [p=0.021]. It seems that, in comparison between tow genders with cancer although the women's self- esteem is related to more variables than men, but, recognition and specify these variables can help nurses to design an effective care-plan to meet the gender-specific needs

[ comparative investigation on health behaviors of students in primary schools with and with out health educator]

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

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

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

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