ABSTRACT
Diabetic neuropathy is one of the more common complications plaguing individuals with type 2 diabetes. The development and progression of such complications are responsible for much of the morbidity and mortality related to this disease. This investigation evaluated accuracy of lily and Semmes-Weinstein monofilaments examination for diabetic peripheral neuropathy screening. Our study population consisted of 150 patients treated for diabetes mellitus at the Diabetes Clinic of the Ahvaz Jundishapur University of Medical Sciences. The samples were chosen on the basis of a non-randomized sampling. All patients were tested for sensory neuropathy using two types of monofilament [Semmes Weinstein monofilament examination 8, and 10-grams]. In the next phase EMG-NCV were examined. Sensitivity and specificity two types of monofilaments were analyzed. The 10-g monofilaments had a sensitivity ranging from 38.5% to 51.3% at sites 1-4, and specificity between 73 to 87.4 the sensitivity and specificity of the 8-g monofilament were 41 to 51.3% and 72.1 to 86.5% respectively. Two types of monofilaments at with 51.3 and 74.8% sensitivity and specificity respectively sites 1 and 4 was the most useful diagnostic test for DPN. These data suggest that the monofilaments may be the optimum methodology for identifying individuals at risk of diabetic peripheral neuropathy. Hence, we recommend screening of patients for neuropathy as soon as they are diagnosed with diabetes
ABSTRACT
Establishing an effective communication with patients is an essential aspect of nursing care. However, most of studies described the nurse-patient relationship as weak. Recognition of barriers in nurse-patient's effective communication from their point of view could facilitate the actions need to be taken for removing such barriers. The study aimed at assessing barriers of nurse-patient's effective communication from nurses and patients' viewpoints and to compare them. This descriptive - analytic study was undertaken in 2008, with a sample of 80 nurses and 80 patients drawn from three educational hospitals in Ahvaz city. They were selected by convenience sampling. Data were gathered through a questionnaire with 30 questions for nurses and 15 questions for patients on a 5-points Likert rating scale. It was found that [nursing works overload] [77.5%], [hardship of nursing tasks][73.75%], [deficiency of welfare facilities for nurses][67.5%], [physical and emotional fatigue] [66.25%] and [not appreciating nurses] [62.5%] were reported by nurses as the main barriers of effective communication. Patients considered [nurses' unfamiliarity with local language] [40%] [Nurses' bad temper] [33.75%], [sex difference with nurses] [32.5%], [Patients' transmitted diseases] [28.75%] and [lack of therapeutic and welfare facilities for patients] [25%] main barriers of effective communication. The study revealed there are some congruency and discrepancy between nurse's and patient's viewpoints in ranking barriers. Thus health manager should put their attempts on eliminating or modifying the most important barriers announced by nurses and patients, especially on factors which both groups reported