[ effect of peer-led education on depression of multiple sclerosis patients]

Multiple Sclerosis is a chronic and degenerative disease related to the central nervous system that causes depression in patients. Peer group can better encourage their peers to select the appropriate behavior. This study aimed to determine the impact of peer-led education on depression of multiple sclerosis patients in 2011. This quasi-experimental study was performed by selecting 110 multiple sclerosis patients and allocation of randomized two groups of tests and control groups [each group included55 patients].The MS Society of Iran was the research environment. After preparing the peer group, six training sessions were held during six weeks by peer group for the test group. Data collection tool was a questionnaire named Beck Depression Inventory [BDI] to assess patients' depression; this was completed by both groups before and4months after the program. The data were analyzed using SPSS v.16 software and chi-square test, paired T and independent T. There was no significant difference in depression score between two groups before intervention but the difference was shown significant between two groups after intervention using independent t test [P=0.001]. Pair t test showed a significant difference in the depression reduction in the test group after peer group performance [P=0.000], whereas the same test showed no significant difference in the control group. Peer-led education caused depression reduction in patients with MS. Hence use of this teaching method in multiple sclerosis and patients with chronic diseases is recommended

[Effect of using designed program based on [expectancy theory] by head nurses on nurses' job satisfaction]

Introduction: One of the nursing challenges is nurses' motivation and job satisfaction. Applying motivational theories by nurse managers might be an effective strategy

The aim of this study was to determine the effect of using designed program based on [Expectancy Theory] by head nurses on nurses' job satisfaction

Materials and Methods: This study was a quasi-experimental study that was done in two hospitals in Zanjan providence. Data were gathered by [Nurses' Job Satisfaction Questionnaire]

In this study, internal consistency reliability [Cronbach's alpha] of the questionnaire was measured [alpha=0.9]. Method of sampling was census and nurses were selected in the case group [n=20] and nurses in the control group [n 19]

They were matched in two groups. The applied program was based on [Expectancy Theory] that implemented in case group for 6 months. Data were analysed by Mann-Whitney, Wilcoxon Chi-Square and SPSS/16 used

Findings: The nurses in two groups were matched [P>0.05]

Job satisfaction before and after in two groups did not different significantly, it showed by using Wilcoxon test [P>0.05]

But findings showed that nurses' job satisfaction in case group increased 7%

Conclusion: The program based on "Expectancy Motivational Theory" had clearly implementation steps for applying this theory that it would be practical guide for nurse managers. Use of this theory for improving nurses' job satisfaction is suggested

[ effect of retraining program competency based planning on nurses practice in cardiopulmonary resuscitation in emergency department]

Introduction: According to technology progress towards and growth in medical sciences on cardio-pulmonary resuscitation, nursing human-forces training and education in emergency department seem to be necessary. Therefore, the present study was conducted on of retraining program competency based planning for nurses practice on cardio-pulmonary resuscitation in emergency department

Method: This study is semi-experimental type, sampling non-random, carried out on case [15 nurse] and control [15 nurse] groups in training hospital dependent to Golestan University of Medical Sciences. Data gathered by using of nurse practice observational Questionnaire on cardio-pulmonary resuscitation. Re-training program competency based was planning and implemented based on re-training planning principles as well as competency-based training [CBT] basic steps on cardio-pulmonary resuscitation of case group. Data were gathered from two steps including the previous step and 4-month following experiment on case and control groups separately and analyzed in SPSS16 software using descriptive statistics [Frequency, mean, standard deviation] and inferential statistics [Mann-Whitney, Chi-square, Wilcoxon]

Results: Chi-square statistical test showed that no significant differences were found in terms of demographic variables such as age, sex, job experience, … between two groups [P>0.05]. Mann-Whitney test was revealed that nurses performance dimensions on cardio-pulmonary resuscitation was found to be different between two groups [P<0.05]. Also, Mann-Whitney test, showed significant differences between total nurses performance scores on cardio-pulmonary resuscitation between two groups following 4-months duration [P<0.05]

Conclusion: Findings these study to revealed, applying re-training program competency based is effective on the nurses practice on cardio-pulmonary resuscitation and advancement about 40 percent up to the nurses practice emergency department. So it is suggested that re-training program competency based to be applied as nursing human-forces training in emergency department

[ effect of implementing clinical supervision model on the patient education outcomes]

Applying proper supervision model is an important factor in promoting the outcomes of the patient education which improves nursing care. The aim of this study was to assess the effect of Clinical Supervision Model on the outcomes of implementing patient education. [Patients' Attitude Toward Education by nurses, patient satisfaction from nurses' education and quality of patient education documentation]. This quasi-experimental study was conducted using static groups' comparison in which the control and experiment groups were compared by a posttest. Study samples included 72 patients who were matched and assigned into two distinct groups. Clinical Supervision Model was implemented through three steps in 3 wards of Samen-al-Aemme hospital in Mashhad for 6 months. The data were gathered by instruments including patient demographic information, patients' Attitude toward Education by Nurses Questionnaire, Patient Satisfaction from Nurses' Education Questionnaire and Quality of Patient Education Documentation check list. Validity of instruments was measured by content validity and reliability by split half and inter-rater. Data was gathered through interview and observation methods and analyzed by SPSS 11.5 software. The results showed significant difference in the quality of patient education documentation before and after implementing Clinical Supervision Model [P=0/0001]. Furthermore, results showed significant difference between patient satisfaction before and after implementing Clinical Supervision Model [P =0/02]. However there were not any significant differences between patients' attitude toward education before and after implementing Clinical Supervision Model Implementation of Clinical Supervision Model can develop nurses' knowledge and skills in patient education through organizing, implementing, and feedback. More studies are required in order to assess the effect of this model on other aspects of nurses' practice

[ effects of rehabilitation techniques on the pulmonary function tests in moderate severity COPD patients]

COPD is a prevalent problem with well-known complications. Rehabilitation techniques have been reported to be effective in pulmonary function tests of these patients. The present study was conducted to determine the effects of rehabilitation techniques on the pulmonary function tests in moderate severity COPD patients in education hospitals in Esfahan city in 2006-2007. This research is a quasi-experimental design. 80 participated Patients in the study with Moderate severity COPD, 50 patients in Case group and 30 patients in control group, were selected randomly. Data collection was done by demographic data and clinical status survey forms. Initially, pulmonary function tests were evaluated on two groups and then pulmonary rehabilitation in case group was carried out during two months in 20 minutes per time. After intervention, pulmonary function tests were evaluated again in each group. Data analysis was done by SPSS software. Pulmonary function tests increased in case group. FEVI/FVC varied from 61.4 to 67.02 in case group. Pulmonary rehabilitation education can improve pulmonary function tests. Therefore, pulmonary rehabilitation education should be a part of physiotherapy programs in COPD patients until improvement in their clinical status

[ effect of employing synectic model in teaching palliative care in children on nursing students' writing creativity and academic performance]

Palliative care in patients with incurable diseases requires creativity in providing services in the best possible way. Therefore, the effect of Synectic model on students' writing creativity and academic performance was investigated in this study. It was a quasi-experimental study performed on 2 groups of nursing students of Tehran University of Medical Sciences in the first semester of 2007-2008 academic year. The control group consisted of 28 and the experiment group included 32 students. After the written pre-test about the concept of children's palliative care, the synectic model was employed for the experiment group and the usual method for the control group. Then, the post-test was held for both groups and they also wrote an essay on palliative care. Data was analyzed by SPSS software using descriptive statistics and inferential tests including Mann Whitney, chi[2], and Fisher exact test. The mean for pre-test scores was 2.8 for the control group and 2.5 for the experiment group which showed no significant difference before the intervention. But after the intervention in post-test, the mean for the control group was 3.8, while it was 4.8 for the experiment group which showed a statistically significant difference. Moreover, investigating students' essay texts showed a significant difference between the two groups concerning creativity in writing. With regard to the results of this study, employing synectic method enhances academic performance and writing creativity of nursing students regarding children's palliative care

[Effect of situational leadership in clinical education on communication competency of nursing students]

Communication is one of the basic concepts which nursing students must learn. Nurse instructors' behaviors have key role on effective clinical education. The aim of this study was to assess the effect of situational leadership model on nursing students' communication competency. In this before-after trial, we recruited the students who had medical and surgical practicum in the second semester and summer of 1385-86 in public hospitals in Arak. They were selected randomly and then allocated to case [n=40] and control [n=35] groups. In the first week of practicum [before], we measured the students' communication competency using a self-structured questionnaire. For intervention, we defined behavioral objectives and designed a diagnosis form for identifying level of maturity and a feedback form for the students. After orientation of the students with behavioral objectives, we accompanied with main instructors based on their maturity levels in caring and applied effective leadership style. Along with the practicum period, we supervised the students' level of maturity in different nursing care skills. In the end [after], we measured the students' competency. We analyzed the data in SPSS, version 13. The results showed that there was significant difference before and after the intervention [P<0.001]. Also, there was significant difference between two groups [P<0.001]. Self-evaluation showed no significant differences between students' competency in two groups [P=0.335]. The situational leadership model would promote nursing students' communication competency

[Healthy behaviors of female teenagersliving in orphanage centers and living with their families]

Healthy behaviors of teenagers are effective on the community development. This study was carried out in order to compare healthy behaviors of female teenagers living with their families and in orphanage centers in Tehran. This was a cross-sectional study. The subjects were consisted of 110 female teenagers that 55 of them dwelled in the orphanage centers and the remaining lived with their families. Both groups were studying at the same schools. Samples were selected using stratified random sampling method. Questionnaire was used to gather data. The data were analyzed by descriptive and analytical statistical methods in SPSS software. There were statistically significant differences between two groups in nutrition [P < 0.0003], sleep and rest [P < 0.001], physical exercise [P < 0.0013], and individual health [P < 0.001]. Total score of health behaviors were 112.3, and 87.8 in family group and orphanage group respectively [P < 0.001]. The average score of health behaviors in girls that reside in orphanage centers was lower than the score of them who lived with their families. This shows the necessity of planning educational and managerial tools to improve their healthy behaviors

[Clinical supervision system: a method for improving educational performance of nursing personnel]

Employing supervision methods which focuses on educational aspects may increase the effectiveness of nursing personnel's educational activities, especially patient education. The aim of this study was to investigate the effect of clinical supervision on the effectiveness of nurses' educational performance. This quasi-experimental study was conducted using static groups' comparison in which the control and experiment groups were compared by a post-test. Study samples included 72 patients who were matched and assigned into two distinct groups. Clinical supervision system was implemented through three steps in 3 wards of Samen-al-Aemme hospital in Mashhad for 6 months. The data gathering tool included patient information sheet, patient satisfaction from nurses' educational practice and rating scale of self-care knowledge and practice of patients. Data was gathered through interview and observation methods and analyzed by SPSS software. The mean scores of self-care knowledge and practice of the patients were 30.6 and 57.1 out of 100, in the control and experiment groups, respectively. The mean score of patients' satisfaction from nurses' educational practice was 19.6 in the control group and 20.9 in the experiment group, out of 24. So that, independent t-test showed a significant difference between these two groups. Implementing clinical supervision system through observation, feedback, discussion, and investigation, may develop nurses' knowledge and professional skills in patient education. Therefore, this supervision method could be regarded as an effective model for in-service education. More studies are required in order to investigate the effect of this model on other aspects of nurses' practice

[Organizing "nursing mentors committee": an effective strategy for improving novice nurses' clinical competency]

One of the most significant problems in clinical environment is the unskilled and inexperienced nurses. This is while, most managers are not aware of nurses' proficiency and competency level. Therefore, applying the new strategy of "organizing nursing mentors committee" by managers as well as their orientation in this regard could be considered as a strategy to improve clinical competency. This quasi-experimental study as two group design was performed to assess the clinical competency level of five novice nurses and their performance on 72 patients hospitalized in medical-surgical wards in one of the hospitals in Tehran in 2005. They were divided into two experiment and control groups, and were evaluated before and after the intervention. Data was collected using observational checklists in communicative, cognitive, and psychomotor competency domains as double blinded. Number of patients in the experiment group was 32 and in the control group was 40 which were matched before and after the intervention in each group. The allocation of the novice nurses into groups and wards was done randomly. Data was analyzed by SPSS software. Clinical competency of the novice nurses increased in all three domains in both groups. Paired t-test showed this increase in both groups. Moreover, independent t-test demonstrated that the mean difference in the experiment group was higher than the control group. Novice nurses' clinical competency was in a primary level in both groups before the intervention, but, after 3 months was promoted to the advanced level in the experiment group who were exposed to mentors committee. Organizing "nursing mentors committee" is an effective strategy for nursing managers, in order to help novice nurses who need to acquire clinical competency in different domains in a limited time frame

[Effect of applying progressive muscle relaxation technique on fatigue in multiple sclerosis patients]

Fatigue is the most frequent and disabling symptom in 92% of multiple sclerosis [MS] patients. Fatigue interferes with daily functioning and prevents sustained physical exertion, limits work and social role performance, and is related to lower quality of their life. Complementary therapies are widely used in treatment of people with MS and Progressive Muscle Relaxation Technique [PMRT] is a form of complementary therapies. The aim of this study was to assess the effects of applying PMRT on fatigue in MS patients. In this Quasi-experimental study, a total of 66 MS patients were selected with convenient sampling according to specific criteria and then were divided randomly into two groups of experimental and control [33 patients in each group]. PMR performed for 63 sessions on experimental group during two months but no intervention was done for control group. Data were collected using demographic questionnaire, Fatigue Severity Scale [FSS], and Self report checklists. Statistical analysis was done by SPSS software and use of paired-t test, student-t test, analysis of variance [ANOVA] and correlation between variables. Student t-test showed that there was no significant difference between two groups in mean scores of fatigue before the study but this test showed significant difference between the two groups, one month [4.69 +/- 1.03 and 5.43 +/- 0.96, P<0.01] and two months [4.09 +/- 1.06 and 5.43 +/- 1.08, P<0.001] after intervention, respectively. ANOVA test with repeated measurements showed that there is a significant difference in mean score fatigue between two groups in 3 times [P<0.01]. The results of this study showed that PMR is practically feasible and could decrease fatigue of MS patients, so that applying this technique offered to these patients

[ effect of self-care education on quality of life in patients with esophageal cancer following esophagectomy]

Physical complications following esophageal cancer are known as factors that affect the patrent's quality of life. These symptoms affect the mental, social and emotional aspects of patient's life adversely. This study was carried out to investigate the effect of self-care education on life quality of patients suffering from esophageal cancer following esophagectomy in selected hospitals of Tehran University of medical sciences. In this quasi-experimental study 77 patients treatment and control groups with esophageal cancer were selected non-randomly regarding their characteristics [35 years old and over, and transhiatal esophagectomy]. Three half-hour face-to-face education sessions were held for 40 patients and their families, while 37 patients were regarded as control group. Quality of life of patients undergoing esophagectomy and the number of problems in both groups were measured through SF36 checklist in two stages: before education and esophagectomy and one month after education and esophagectomy. Finally, life quality and the number of complications were compared in both groups. Independent t-test revealed that total life quality score before intervention in two groups was not significantly different [p=0.53]. Moreover, the same test showed no significant difference in two groups after intervention [P=46]. However, paired t-test revealed that total life quality score in treatment group differed significantly before and after intervention [p=0.035]. In addition the same test showed a significant difference in control group before and after intervention [p=0.009]. Pearson correlation coefficient indicated that there was no significant difference between demographic variables and total life quality score [p>0.05]. Paired t-test showed that the number of patient's complications decreased following the education. Self-care education following esophagectomy improves the life quality of patients and reduces the complications. Thus, regarding the follow-up period [one month] sample volume, and efficacy of the intervention more comprehensive studies using laryer sample volumes with longer follow-ups are recommended

[ effect of implementing therapeutic communication plan on burned patients' pain]

Pain in burned patients is not only caused by damage to joints and tissues but it is also affected by a variety of reasons that can not be ignored. A number of studies indicate that implementing different supportive approaches could affect pain severity through reduction of fear and anxiety of the patients. Hence, the present study was conducted in order to study the effect of therapeutic communication plan on pain severity in burned patients in Mashhad during 2004. In this quasi-experimental study 60 female burned patients were investigated in two groups of treatment and control. The control and case patients were identical in terms of age, burning agent, and burn surface area. Data collecting tools were patient's demographic information and linear pain scale. For each group pain measurement was carried out once at the beginning of study [48 to 72 hours following the burn] and then once a week for a month [average five times] immediately after dressing. Type, time and amount of sedative and analgesic drugs were recorded each time. For treatment group 7 to 12 therapeutic communication sessions [20 to 45 minutes] were held within four stages. The amount of pain was measured and compared in each group before intervention [the first week], within intervention [during three weeks] and after intervention [the fourth week]. Data analysis was performed through Mann- Whitney and chi[2] tests. The results showed that there was significant difference between pain severity in two groups after intervention [P=0.005] so that before intervention 36.7% of the patients suffered from severe pain, whereas after intervention none of the patients had this type of pain. Moreover, the number of patients suffering from extremely severe pain [36.7%] declined to 16.7% after intervention. The study results indicate that implementation of therapeutic communication plan affects pain severity of burned patients. Hence, we recommend the application of the plan in burned patient care. More research is also suggested

[ effect of self-care program on relief of skin complications of psoriasis]

Psoriasis is an unpredictable, chronic, cutaneous disease with recurrence period that could lead to disability and psychosis. Evidence shows that in addition to routine therapeutic procedures implementing self-care program can contribute to reduction of complications as an inexpensive method. Hence, this study was conducted with the aim of investigating the effect of self-care program on relief of the disease complications in Tehran in 2002. This quasi-experimental study [before and after] was carried out on 50 patients. Self-care program was performed in different fields [food, medicine, bathing, washing, type of clothing, temperature, …] through face to face education and role playing and the cases were investigated in terms of symptom severity [skin dryness including splitting and flaking itching and existence of new plaque] every two weeks for three months. To collect data questionnaire, self-reporting check list, observational check list with Likert scale and correlation of 92.5% were used whose validity had been confirmed through content validity. The data analysis was performed using t-test and Wilcoxon. The results showed that 64% of the studied patients were male, 54% employed, 72% married and 42% had university degrees. 34% were 11-20 years old with the mean age of 11.9. The results indicated that the mean skin splitting severity decreased from 2.34 to 0.04%, flaking from 4.48 to 0.5, itching from 2.5 to 0.54 and area of lesion from 81.77 to 27.33 after intervention [P=0.0001]. The comparison of behavior before and after intervention showed that the extent of all self-care behaviors increased significantly [P=0.001]. The research results show that implementation of self-care program reduces the severity of skin symptoms. Thus, administration of this inexpensive, accessible program in care plans of patients to lower the physical, mental, familial, and social problems of patients is recommended

[Factors affecting the process of obtaining clinical competency]

Nurses form the most significant sector of the health care provision and play a fundamental role in providing on-going quality care for patients. To attain clinical competency, it is essential to understand the factors influencing it. Due to the fact that clinical competency is directly affected by specific features of the educational and health care system and the medical training within each country, it is necessary to assess the factors influencing clinical competency. This study was based on the Grounded Theory method. The sample of 36 comprised of clinical nurses, as well as trainers and managers within the Ministry of Health and Medical Training, Nursing and Midwifery faculties, hospitals and members of the Nursing Council in Tehran. Data was obtained through semi-structured interviews, which were recorded and subsequently transcribed. The analysis was carried out by the Straus and Corbin method. In this study, personal factors were identified as one of the contextual factors affecting clinical competency. The respondents branded this category as "the internal and personal factors". This included a significant number of sub-categories such as education and skill, moral values, consciousness responsibility and accountability. Another category was identified as "the external and organizational factors" which included categories such as educational and clinical environments, work license, control and supervision and effective educational system. The clinical competency process resulted from the interaction between three factors; ethics, effective experience and environmental factors

[Comparative study on two methods, Benson relaxation Vs premeditation, and their effect on respiratory rate and pulse rate of patients experiencing coronary angiography]

One of the cause of anxiety for most patients is hospitalization. Once the patients are hospitalized for cardiac catheterization, the anxiety would be augmented. The anxiety raises body physiological and psychological activities such as: heart rate and respiratory rate. This research, as clinical trial study, has the objective to determine the influence of applying two methods of relaxation and premeditation on respiratory rate and pulse rate in hospitalized patients, experiencing coronary angiography, in heart and postangio wards of Shahid Beheshti Hospital in Zanjan, at 2003. 40 patients who were candidates for CA, has been studied, in regard to existing conditions and methods of sampling and random allocation to two groups of relaxation, and premedication. Data collection tool included demographic and disease related information sheet, as well as record sheets for respiratory rate and pulse rate at intervals of 8-12 and 1/2 hrs before, during and after the angiography. For relaxation group, the researcher would speak individually about the influence of relaxation, the day before angiography; then with the aid of client himself/herself, performed relaxation instances in a single bout, and eventually asked client to perform relaxation technique 2-3 times before going for angiography. In premedication group, patients received regular preangiographic medications including diazepam, chlorpheniramine, metoclopramid, and hydrocortisone. Respiratory rate and pulse rate were measured in both groups 8-12 and 1/2 hrs, before during and after CA. Afterward, resulted data were analyzed statistically by [SPSS] software for windows. Pulse rate at 8-12 hours before, during and after the angiography showed no significant difference between two groups [p>0.05]. Thus our research hypothesis that "alterations of respiratory rate and pulse rate in patients under coronary angiography, who get relaxation, are identical to those in premedicaton group", would be confirmed These results show that the premeditation method can be substituted by relaxation before practicing invasive procedures

[ effect of pain management by nurses on the satisfaction rate of patients after abdominal surgery]

Annually more than hundreds of million people undergo surgical operations and experience postoperative pain. Pain is one of the most common problems in postoperative nursing cares. This study was aimed to determine the effect of pain management by nurses on the satisfaction rate of patients undergone abdominal surgery.In this quasi experimental study, data gathering was done by using demographic and pain questionnaire, a questionnaire for patients satisfaction of nursing care and pain control visual scale [0-10]. Study samples included hospitalized patients of Sabzevar Emdad Shahid Beheshti hospital who were candidates of surgery. They were selected according to Poisson distribution and the sample qualifications [aged 15-65 years']. First control group sampling was done and patients [65 patients] were asked to fill out the demographic questionnaire. Then three training sessions of 45-60 minutes about systematic management of pain were conducted for the personnel and the care process was performed on 60 experimental cases for one month. Then the satisfaction rates of patients in both groups were obtained within the first 24 hours and 72 hours after admission. The two groups were matched in regard to age, sex and surgery type [P>0.05]. According to the obtained results, 98% of the control group were not satisfied of the first systematic pain management and 2% were relatively satisfied. While in the second pain management, 71% were not and 29% were satisfied of the pain management. In the experimental group, 94% were relatively satisfied and 6% were satisfied of the first pain management, while 65% were relatively satisfied and 35% were satisfied of the second pain management. Independent t-test revealed a significant difference between the two groups in regard to their satisfaction rate of systematic pain management in the first 24 hours and 72 hours after admission [P<0.05]. According to the findings, it seems that pain management by nurse increases the satisfaction rate of the patients undergoing abdominal surgeries and by increasing their satisfaction rate, they will be able to participate in their treatment process and consequently more comfort for the patients and higher levels of health will be provided for the community

[ effect of premedication on hemodynamic state of patientsexperiencing coronary angiography]

Invasive diagnostic procedures such as coronary angiography, in most cases, are accompanied by stress and anxiety in patients which in turn may affect the hemodynamic, signs. To determine the effect of premedication on hemodynamic parameters in patients under coronary angiography, who were hospitalized in heart and post-angio unit at shahid Beheshti heart center in Zanjan during the year 2003.This was a quasi-exprimental study in which 40 patients under angiography were selected and marked as premedication and control groups for the purpose of this research. Data collection tools were two forms used to record hemodynamic parameters during 8-12hours and half an hour pre-, during and post- angiography and also a questionnaire to record demographic data. In premedication group, patients were taken drugs including Diazepam, Chlorpheniramine, Metoclopramide and Hydrocortisone. In control group, patients were taken only routine nursing cares. In both groups, hemodynamic parameters were measured during 8-12 hours and half an hour pre-, during and post- angiography. The data were analyzed statistically usingSPSS.Therewasnosignificantdifferencebetweencontrolandpremedicationhemodynamic parameters [systolic and diastolic blood pressure, pulse rate, respiratory rate, L.V.P pressure, end diastolic pressure, systolic and diastolic aorta pressure][p>0.05].There were no significant changes in hemodynamic signs between control and premedication groups