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Background and Aim: One of the indicators of recovery in the patients admitted to intensive care units is improvement of the level of consciousness. Various factors, including the type of care are effective in the changes of consciousness level of the patients. This study was conducted to determine the effect of nursing care plan based on "Roy adaptation model" in physiologic aspect on the level of consciousness of the patients in the intensive care unit
Material and Methods: This triple-blind clinical trial included 100 patients in the intensive care unit in 2017. Two ICU units in Sanandaj hospitals were selected randomly as intervention and control groups. Eligible patients in each unit were randomly assigned to intervention and control groups. The intervention group received nursing care plan based on "Roy adaptation model" and the control group received routine care. We measured level of consciousness for every patient based on the GCS for 7 days, twice a day. We used SPSS version 21 for data analysis
Results: The mean level of consciousness in the first three days and nights did not show any significant difference between the intervention and control groups. But there was a significant difference between the mean levels of consciousness from the fourth day and night on, between intervention and control groups [p <0.05]
Conclusion: Roy adaptation model was effective in increasing the level of consciousness after three days in the patients in the intensive care unit. Therefore, we recommend organized nursing care based on standard nursing models for all of the patients in the intensive care units
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Background and Aim: From 2011 to 2013 some efforts had been made in Iran to implement urban family physician program. The aim of this study was to determine the viewpoints of managers, providers, and clients of health care services about the problems in the implementation of urban family physician program in Iran
Materials and Methods: This study was a qualitative study. Data were collected through holding 21 sessions of focus group discussions and 37 individual interviews with managers, providers, and clients of health care services in Alborz, West Azerbaijan, and Kurdistan Provinces in 2014. Data were analyzed by means of content analysis method
Results: According to the results of this study, the problems on the implementation of urban family physician program in Iran can be classified into seven categories including: financial, cultural, educational, motivational, structural, administrative, and contextual problems
Conclusion: We propose definition and stabilization of the financial resources and establishment of appropriate rules for payments to solve financial problems, and also training of general population and staffs and involvement of the mass media in training to solve the cultural problems. In order to solve the educational problems reforms in medical curriculum are recommended. Motivational problems can be solved via encouraging the private sector and experts to take part in the program and also through guaranteeing the continuity of the program. Establishment of appropriate organizations and provision of protocols are recommended to solve the structural problems. Finally, to overcome the contextual problems it is suggested to promote cross-sectoral and inter-sectoral coordination and also attract support from policy-makers
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Introduction: Morbidity and mortality of Thalassemia significantly reduced and nowadays there are more attention to the quality of life and related factors. Considering that thalassemia and its complications impact on quality of life of children, it is still unknown. The aim of this study was investigation of quality of life of Thalassemic children in four domains of physical, social, emotional and school, that compared with the control group
Methods: Thalassemic children [n=40] referred to the special diseases center of Besat hospital selected. Also, healthy children [n=40] that was matched based on age, sex and education selected from their classmate as control group. The standard quality of life questionnaire consisted of two sections used for data collection, the first section included demographic questions [n=9], second section included 23 questions about the quality of life in four dimensions: physical, social, emotional and school. Data analyzed by SPSS v.14 software. Kolmogorov-Smirnov test used for testing normality of the distribution
Results: The mean age of subjects with mean and standard deviation were respectively 13.2 +/- 4.26, level of education of the majority of children [45 percent] were elementary school and 50 percent of their fathers were illiterate and 34.5 percent of mothers in elementary level. The majority [67.5 percent] of residents were without private homes [40 percent] and personal vehicles [70 percent]. Results related to the quality of life showed that children the quality of life in four domains of physical, emotional, social, and school children with specific thalassemia was lower than control group [P<0.05]. Total quality of life in were 1.4 +/- 0.69 in children with thalassemia and 9.6 +/- 0.14 in healthy children, t-test showed a significant statically relationship [P=0.000]
Conclusion: The results showed that children with thalassemia have problems with the quality of life in four domains of physical, social, emotional and school. Therefore planning to promote mental health, participation in social activities, providing the necessary consultations and adaptive solutions along with clinical and therapeutic services in this patients center patients can increase their quality of life
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Introduction: Asthma is a chronic disease and common that despite advances in treatment has high mortality, currently estimated to be 300 million asthma patients worldwide, more important is increase of prevalence. In the important point in the treatment of asthma in addition control of symptoms is improve quality of life of patients. The impact of asthma and its complications on quality of life in the view of children and people involved with them is unknown yet. To presentation effect of asthma on the life of children with asthma we need assess the quality of life directly, so this study done with purpose of comparison quality of life of children with asthma in the viewpoints of them and their mothers in 2008
Method: In this descriptive-analytical study children with asthma hospitalized in pediatric and emergency wards of Beasat hospital of Sanandaj in 2008, in convince sampling elected and investigate the quality of life in the view of them [38] and their mothers [38]. Demographic information and quality of life questionnaire [PedsqL] children and their mother viewpoint each has 28 question that investigate asthmarelated problem [11 question], treatment-related problem [11 question], problem related concerns [3 question] and problem related to communication [3 question], with five-point Likret scale [never, seldom, sometimes, often, always] from zero to four. Higher scores indicate more problem and lower. Quality of life data collected with structured interview. Information analyzed using statistical [t-test and Chi-square]
Results: Results show mean score of quality of life in the viewpoint of children with asthma was 77.12 +/- 96.59 and in the viewpoint of their mothers was 73.21 +/- 43.81. Comparison mean quality of life score of children and their mothers using the t-test, alpha level of %5 indicates significant statically difference in total score [P=0.000] and in four part of asthma [P=0.003] and part of treatment of disease, concerns and communication [P=0.000]. Chi-square test show statically difference between quality of life in the viewpoint children with location of life [P=0.04] and there we sent significant correlation with other demographic information; age, sex
Conclusion: Result showed that the viewpoint of children and their mothers about quality of life was different in total and in different dimension and mothers view was more undesirable. Therefore in attention to the important role of mother in children care and recommend nurses must consider view of mothers about quality of life and provide background to their participation in care planning to as much as possible promotion of children quality of life
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Job stress is condition in work as part of role playing and need to adaptive responses; job stress is one of attention part of nursing profession and some of most important reasons of job stress are the characteristic of job for example task identity, skill variety, task significance, autonomy and feedback. The purpose of this study was to investigation relationship between job characteristic and job stress in nurses of KUMS educational hospitals. This study was descriptive correlated [cross-sectional], 297 participants in census method recruited from KUMS educational hospitals nurses. Demographic information, job diagnostics surveys [JDS] and job stress [Stimer] were measured by self-report questionnaire. The validity and reliability of these questionnaires approved in the earlier researches. As well as, internal consistency were 0.86 for Job diagnostics surveys and 0.82 for job stress by alpha Cronbach. Then information analyzed by statistical tests such as association linear-by-linear, X[2] and ordinal regression by SPSS 16. 72.7% of participants were female, 59.6% married, 64.6% employed under 5 year, 33.3% work in critical wards and 87.9% were registered nurse. Motivational Potential Score [MPS] of 53.5% was low, job stress 64.6% was middle and the relation between MPS and job characteristics [skill variety [P<0.001], task identity [P<0.001], autonomy [P<0.02] and feedback [P<0.1], age, sex and education level with job stress was statistically significant [P<0.05]. Regression model of relational variables with job stress show that the autonomy was the most effective determinant on the job stress then task identity and feedback. This study showed relation between job characteristic and job stress in nurses so hospital managers must increase autonomy, identifying task identity and give proper feedbacks to redesign job and make nursing more challengeable, motivational and satisfying
Subject(s)
Humans , Female , Male , Workplace , Nurses , Universities , Medical Informatics , Hospitals, UniversityABSTRACT
Feeling of health is subjective and unique and health criterion varies in different age, cultural and socioeconomic groups. Illness can have a great effect on individual's feeling and definition of health and well being. The aim of this study was to explore the meaning of health concept in the view of diabetic patients. This study was qualitative, semi structured interviews were conducted with 20 diabetic patients who attended to the diabetes clinic of Sanandaj Tohid Hospital. Interviews were transcribed and analyzed using conventional content analysis, and codes and themes were derived from participant's responses. Based on the findings of study five major themes about health emerged: intact body and happiness, life without any limits, peace of mind, spirituality and absence of complications. Health definition based on specific conditions of any culture and group that affect health behavioral. Based on emerged themes, health care providers must consider these themes and seek ways to achieve health in diabetic patients and use them in care plans
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Death is a phenomenon even thinking about which can produce anxiety. Death anxiety in staff nurses can be influential on their communication with and quality care delivery for dying patients and also affects nurses' job satisfaction and mental health. The aim of this study was to determine death anxiety in nurses working in critical care and general wards and related factors. This was a cross-sectional study in which 387 nurses [155 nurses working in critical care wards and 232 nurses working in general wards] from a teaching hospital affiliated to Tehran University of Medical Sciences were recruited by census sampling. Demographic information sheet and Templer's Death Anxiety Scale were used to collect data. Then the data were analyzed using Chi-square, T-test and regression. The results showed a statistically significant difference between mean score of death anxiety of nurses working in critical care [8.30 +/- 2.4] and those working in general wards [8.26 +/- 2.1]. Death anxiety was correlated with some variables such as marital status [p=0.046], organizational situation [p=0.001] and the ward which nurses now worked [p=0.02], but it was not significantly correlated with age, sex, shift, care of end stage patients, and partnership in patient resuscitation. Death anxiety affects physical and emotional aspects of nurse's life, thereby affecting process of caring. Results showed that death anxiety was higher in critical care nurses and they faced more dying and death than general ward nurses. So, they need special attention about death anxiety and its causes, and require institutional support to enable them for providing quality care for patients
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To assess the effectiveness of acupressure [acupuncture without needle] and synergism of acupoints in reducing and maintaining patient's anxiety before abdominal surgeries. Participants in this randomized controlled trial were 70 patients who were scheduled to undergo abdominal surgery. Patients were randomized to an acupressure group or a placebo group, received acupressure either at the right points or at sham points for 10 mins. Anxiety [recorded on a Visual Analog Scale [0-10]] measured before, following pressure application and 30 minutes after intervention in both groups. The anxiety decreased in both group following pressure application for 10 min [P<0.001], but these effect sustained 30 mins after intervention only in acupressure group [P<0.001] not in placebo group. Comparison anxiety in following pressure application and 30 mins after intervention between groups was significant. Acupressure at the Yintang and Shen men points can decrease the anxiety level in patients before abdominal surgeries and sustained lower for 30 mins
Subject(s)
Humans , Acupressure , Preoperative Care , Acupuncture PointsABSTRACT
Anxiety is one of the emotional conditions among patients scheduled for surgery that can result in increasing postoperative pain, increasing analgesic and anesthetic requirements and prolonging hospital stay. The aim of this study was to assess the effectiveness of acupressure [acupuncture without needle] in reducing patients' anxiety before abdominal surgeries. In this randomized, blinded, sham controlled trial, 70 patients who were scheduled to undergo abdominal surgery in Tehran University of Medical Sciences' hospitals were selected using convenience sampling method. The patients were randomized to an acupressure group [n=35] or a placebo group [n=35], receiving acupressure either at the right points [Yintang and Shen men] in acupressure group or at sham points in the placebo group for 10 min. Anxiety was recorded on a Visual Analog Scale [0-10]. Vital signs were measured before and after pressure application in both groups. The anxiety was decreased in both groups following pressure application for 10 min [P<0.001]. The amount of anxiety was significantly different between the groups [P<0.001]. The heart rate, respiratory rate, and diastole/systole pressure [P<0.001] were decreased in the case group. Only heart rate [P=0.016] and respiratory rate [P=0.007] were decreased in the placebo group. Changes in respiratory rate and systole pressure following pressure application were statistically significant between two groups. Acupressure at the right points can decrease anxiety before abdominal surgeries but it has no clinical effect on vital signs