[ study of the visual and auditory health of elementary students of abadan villages]

Introduction: Health of vision and audition is very effective in physical health and community health nurse plays an important role in the promotion of students' health. Therefore studying the visual and auditory health of students by a health nurse can play an important role in the promotion of their health

Objective: This study aimed to determine the visual and auditory health condition of elementary students of Abadan villages

Methods: This cross-sectional descriptive and analytic study consisted of all students studying in 50 schools in primary schools of Abadan villages [5,500 students]. Using cluster random sampling method, 26 schools and from each class in every school, 24 students were selected. Finally, 624 students, including 322 girls and 302 boys in age range of 6 to 12 years old in first to sixth grade were enrolled. Data collection tools were Snellen chart and a checklist to record the data. In order to evaluate the auditory health, after training, the student sat against the wall with his/her index finger blocking the ear canal. The researcher stood behind the student and checked right ear, left ear and then both ears by saying two-syllable words. The use of glasses, hearing aids and the eyes and ears were examined and the results were recorded. The validity of the tool was determined by content validity. To determine the reliability, 15 subjects were studied with the tools, twice every other day. The correlation coefficient between the two stages was 1 which showed the reliability of the tool used. Each student was given verbal explanation about the objective and methods of performing the study by the researcher and if content, the students were entered into the study. The data were analyzed by descriptive statistics, measures of central tendency and dispersion, and chi-square with significance level P<0.05

Results: All of students surveyed 20.35 percent [22.98% girls and 17.55% boys] suffered from visual disorder. There was no significant difference between girls and boys [P=0.11]. In the meantime 3.04 percent of them wore glasses. Also, 10.10 percent of students [11.80% girls and 8.28% boys] suffered from auditory disorder and there was no significant difference between girls and boys [P=0.18]

Conclusion: In attention to study findings, more training on study style, TV watch, importance of wearing glasses and ear health observance especially for girls is necessary. Also referring students with disorder to relevant specialist is important. In this regard, the community health nurse can be very effective

qualitative study of the impact of spousal death on changed parenting practices of Iranian single-parent widows

While it is expected, different causes to decision making accept parenting responsibility and parenting style based on the single parenthood occurs as a result death of the spouse, it has not been clearly articulated. Therefore, we explored the parenting experiences of Iranian single-parent widows who keep custody of their children after their spouses die. In this descriptive, exploratory study in-depth interviews were held with 24 Iranian single-parent widows. The data generated were analyzed using the constant comparative method. Preliminary results indicated four main thematic categories: [a] development of a paradoxical identity: a hopeless widow vs. a hopeful mother, [b] submerging self in custody role vs. staying from widow role, [c] sentimental parenting and, [d] paradoxical evaluation: fruitful for children vs. fruitless for self. The results indicate that single-parenting after the death of the spouse is a difficult experience. Sentimental parenting practices, related to maladjustment with spousal death and roles transformation is a risk for the health of widow-single parents, so they need to be supported by health care delivery and social welfare systems to cope with their life after spousal death

[Evaluation of the relationship between global ultraviolet index in different regions of Iran and skin cancer in 1383]

Skin cancer is the most frequent malignancy in Iran. Exposure to the excessive ultraviolet radiation is an important factor in creating skin tumors. The purpose of this study is to determine how the ultraviolet index has been distributed in all townships throughout the country, to determine different kinds of skin cancer and to evaluate a geographical distribution of skin cancers with regard to the UV geographical distribution. This study is ecologic, descriptive and analytical in nature. A total number of 6921 skin cancer cases registered at the Center for Disease Control of Iran in 2004 were thoroughly analyzed and UV data were collected from the world wide web. With the help of ArcGIS software and SPSS, the statistical analysis was done. The incidence rates were 10.13 for the total skin cancer, 7.53 for basal cell carcinoma, 1.79 for squamous cell carcinoma and 0.39 for malignant melanoma per 100000 population of Iran. The mean ultraviolet index differed from 9 in July to 3 in January. The correlation between the skin cancer incidence at the level of districts and ultraviolet index was not significantly observed. Skin cancer is a public health problem in Iran. Further research in this regard would lead to skin cancer registration improvement and more understanding of different climatic, cultural and behavioral factors in developing skin tumors. With this knowledge the possibility of more effective prevention of the most prevalent cancer in Iran can be created

Proposing appropriate national standards for nursing and midwifery education derived from international standards: a case study, master of science in nursing and midwifery

Applying foreign standards for accreditation of Master of Science in nursing and midwifery in Iran seems anomalous. Taking advantage of these foreign standards as well as the views of experts in nursing and midwifery, the researcher in this study tried to develop the accreditation standards according to educational circumstances in Iran. This study was performed in the years of 2005-2006 during multiple stages. In the first stage, international standards were gathered through the internet, and in the second stage, using these standards and the views of expert faculty members, proper standards for the context of Iran were set. During the third stage, Delphi technique was employed for taking votes. Whereas 50 persons having the criteria for entering the study were selected through purposeful sampling method and their viewpoints toward appropriateness of suggested standards for the educational circumstances of the country was obtained using the questionnaire designed in the second stage. The results were analyzed using descriptive statistics. After applying experts' views about applicability of these standards to circumstances in the country, 28 standards and 224 indices for nursing and midwifery education were proposed as final standards. Most standards had almost 90% desirability. Issues such as presenting evidences indicating the ability of speaking in English or qualification for education in Master of Science courses had less desirability. It seems that the main cause of their undesir'ability is the educational status in Iran

[Effect of continuous caring and educational intervention [home visit] on quality of life in the congestive heart failure patients]

Quality of life in congestive heart failure [CHF] patient's comrade with declines mortality, psychosocial, physical and social restriction due to inability effect of the disease. So, the aim of this study was the assessment effected continuous caring and educational intervention [home visit] on quality of life in the CHF patients. In a clinical trial study, a total of 110 patients were selected and accidentally were put in two groups [experimental and control]. Each group was equalized based on sex, age, education, living place, heart failure and ejection fraction. Then, experimental group was educated about heart failure disease, drugs being used, self care plan and life style that this educational plan followed by three home visits. In all of the patients, quality of life questionnaire [SF-36] was filled in two steps, in first study and sex months after discharge. Data were analyzed using independent and pair t-tests. Before intervention, the results indicated that there was no difference in two groups base on sex, age, education, living place, cardiac failure degree, ejection fraction and quality of life main score [P<0.05]. But after the intervention, quality of life main score in domains physical function, limitations in usual role activities because of physical health problems, vitality, social function, body pain and general health in intervention group were greater than control group [P<0.05]. Pair t-test was detected quality of life main score after six months was increased in the intervention group and decreased in the control group [P<0.05]. Our results show that, nursing intervention and education in congestive heart failure patient's base on need and life style improve physical status and quality of life of these patients

[Comparison of the effects of lecture and booklet methods on awareness and attention of parents of children with Thalassemia major]

Thalassemia is one of the most important genetic diseases in Iran. Warning of their parents about their children's disease prevents the related problems and reduces its complications. This study was aimed at comparing the influence of lecture and booklet methods on enhancement of awareness and attentions of parents of children with Thalassemia major. In this interventional study, a total of 90 parents of children with Thalassemia who referred to Hajar hospital for medical treatments, were selected using simple sampling and were randomly divided in three groups of 30 parents. The parents in lecture group attended for seasons of lecture for 30 min. each with 3 weeks interval. A booklet with the same contents as the lecture group was given to the booklet group without any intervention. A questionnaire was designed to gather some information about the disease from parents of all three groups. To determine the statistical relationships, student t-test, Spearman's correlation and of ANOVA tests were used. No significant differences were found among the three groups tested in terms of the mean age, gender, level of education, job, number of affected children, and age of the children. The results showed that the mean of knowledge before and after the education in the lecture group was 10.53 +/- 4.37 and 16.5 +/- 4.73 [P<0.05] and in the booklet group was 10.7 +/- 3.06 and 14.6 +/- 2.7 [P<0.05], respectively. There was no significant difference between lecture and booklet groups based education. After the education, the knowledge in the two groups was significantly more than that in control group [P<0.05]. The results showed that lecture and booklet methods have positive effects on increasing of the parent's knowledge about the disease. Thus, providing of the booklet for the parents, particularly in the region with high prevalence of the disease, is recommended

[Myocardial infarction risk factors in the patients referred to Chaharmahal and Bakhtiary province hospitals, 2005]

The best way to reduce myocardial infarction [MI] is to find its risk factors and prevent or modify them in high-risk populations. This leads to decreasing of its complication and mortality and thus maintenance of productive potential in the societies. Therefore, the aim of this study was to identify MI risk factors in patients referred to Chaharmahal and Bakhtiary province hospitals, 2005. This case-control study was performed on a total of 247 patients suffering from MI from Chahrmahal and Bakhtiary province during 2005. These patients were assigned as the case and 240 of the other patients as the control group. The patients were compared in the case of predisposing factors to MI. Data were gathered by a questionnaire consisting of four sets of questions: demographic and physiologic variables, Holmes and Rahe Scale, standard activity and standard annual diet. Data were analyzed using regression, Chi-square, Fischer and Odds ratio tests. Base on the results, there was no significant difference between the two groups in the cases of age, sex, education, job and the place of life. In the case and the control, the frequency of high blood pressure, 40.5%, 29.6% [p<0.001, OR=3.68], total cholesterol level: 42.9% and 19.2% [p<0.001, OR=5.22], Diabetes: 29.1%, 12.1% [p<0.001, OR=3.68], smoking: 60.4%, 39.6% [p<0.01, OR=1.78], stress: 34.4%, 15.4% p<0.01, OR=2.78], and obesity: 15.6%, 5.4% [p<0.001], OR=2.97], respectively. These are recognized as the main risk factors of the disease in this region. The findings showed that the history of high blood pressure, high cholesterol level, diabetes, smoking, stress and obesity were the main MI risk factors in this area

emotional experiences of elderly people regarding the process of residency in nursing homes

There is increasing rate of tendency of leaving elderly people to live in nursing homes in recent years. It is suggested that, the common view of the elderly people towards living in nursing homes is known as "the final sign of failure in the life". It seems that this attitude has a negative influence on adaptation of elders when confronting with a challenge. Therefor, the understanding of the emotional experiences of elderly people to spend their life in nursing homes is important. In this study, the objective was to explore the emotional experiences of elders who living in nursing homes. The research question is "How is structure and meaning of the emotional experiences of elderly people in the Process of Residency in nursing homes?" A qualitative phenomenological approach was used in this study with applied purposive sampling amongst elderly residents in private and public nursing homes in Isfahan. Sampling was continued till data saturation and the resulting sample size consisted 10 participants. The data was collected by in-depth interviews. Field notes was used for completing data collection process and Colaizzi's method was applied for data analysis. The rigor of present study was based on the transferability and credibility. Two themes were extracted from the data [structural components of experience], including: Residents' emotional experiences during nursing home life and Resident's emotional experiences at the entrance in the nursing home. In this study, older people have shown various emotions to relocation and residency in nursing homes. Elders, with different context and different history in their life, had unique experiences. In addition, it is essential to pay attention to social, financial, mental, spiritual and physical needs of elders as components of holistic care. In fact because concerning only physical needs of elderly people can not lead to promote hopeful, meaningful and purposful life for the elderly people

Critical thinking and clinical decision making in nurse

Today, nurses are exposed to everchanging complicated conditions in health care services, they provide. To be able to cope with these conditions effectively, they should be competent decision makers. Besides, as decision making conditions get more complicated, using critical thinking is a need. The current study was carried out to evaluate the relationship between critical thinking and clinical decision making, in nurses of critical and general care units of hospitals in Isfahan. In addition, it is also aimed to compare the nurses of critical and general units in critical thinking and clinical decision making. This is a correlation, descriptive study of cross-sectional type. The participants are 140 nurses; 70 working in critical care unit and 70, working in general units. Sampling method was random stratified sampling and the data was collected using a questionnaire with three sections; containing items on demographic data, clinical decision making and California critical thinking skills test. The validity and reliability of the questionnaire was approved using content validity, test-retest method and internal correlation test. The data was analyzed using variance analysis, Pearson correlation and t-test. The mean score of critical thinking and clinical decision making was 10.61, 63.27 and 10.67, 61.66 for nurses of critical care and general units, respectively. No statistical significant difference between two groups was observed in the area of clinical decision making and critical thinking. In addition, no statistical correlation was observed between the clinical decision making and critical thinking. The findings of the study demonstrated that the mean score of critical thinking was low in nurses. Probably, it originates from the educational system shortages and also, the professional environment problems. Some experts believe that the reason for lack of correlation between critical thinking and clinical decision making goes back to the absence of appropriate tool to measure the correlation

Delegation as experienced by nurse managers

Since it is impossible to carry out organizational activities effectively without trust, managers are recommended to expand trust atmosphere throughout their organizations due to its effect on all human's communication aspects. Delegation of authority leads to the promotion of trust throughout organization and it would be the best tool for managers to prove their trust to their personnel. Therefore, it is the nurse managers' responsibility to have adequate knowledge of delegation and to apply it. Unfortunately, no comprehensive research has been carried out in this field in Iran yet, and there is an informational gap in this field. The goal of this study was to determine the delegation as experienced by nurse mangers. This study was a type of phenomenological qualitative research has been carried out in four selected subordinates of Isfahan University of Medical Sciences in March/June 2001. The sample size of this research consisted of 14 managers as the information sources from three different ranks of superior level [matron], mid level [supervisor] and executive level [head nurse]. All participants underwent unstructured interviews as the data collecting technique for this study. The obtained results analyzed using collizie method. Nurse Managers had three forms of experiences on delegation phenomenon that were as the following: Lack of authority for delegation and frustration experiences, delegation in minor affairs and lack of authority with superior's sporadic unessential interference while neither of them was perfectly acquainted with this phenomenon. Managers' experienced benefits were categorized in four dimensions as benefits concerning superiors, subordinates, hospitals and patients. Experienced barriers were barriers pertaining to superiors, subordinates and situation. In order to apply art and skill of delegation much better in nursing management it is necessary not only for all nurse managers to get acquainted with delegation through educational services but also for nursing students as the future nurse managers. Thus, the attitude of delegation can be inserted in nursing management. Obviously a change in the attitude of matrons and superiors seems to be essential in this regard. It also should be mentioned that more qualitative and quantitative researches in this field are needed

Social health needs in high school female students: phenomenological study

In countries like Iran in that most of the population consists of young people, designing and implementing comprehensive health programs targeted at young people must become a priority in national programs. More than half of high school students in Isfahan are female. Because of their more vulnerability, and their role in health of future generations, it is essential for health community to be aware of what they are experiencing about their health needs, and based on this awareness, designing and implementing accurate programs should be done in order to improve their health. This study was carried out with the aim to describe experienced health needs of female high school students. A phenomenological qualitative approach was used with participants chosen amongst the female high school students from five districts of Ministry of Education - in Isfahan. Purposeful sampling was adopted in the study and sample size was composed of a total of 15 participants selected and went until data saturation. Deep interviews were used through Straubert method. From the findings of the interviews, 77 codes expressing participants' experiences were emerged. At the end these codes were categorized in 3 themes. As 1] school and school performance 2] social security 3] interactions with opposite sex. Social interactions are crucial during adolescence and have great impact on students' health. In fact, female adolescents express and define their health according to their interactions and communications with the environment

Identification of nursing management planning standards in Iran

In recent century, planning is one of the most important care skills for health service development. Nurses should be ready scientifically for managing situations in order to develop and perform appropriate models for patient care. It is necessary for manager to know about the process and standards of planning and how to apply them in real conditions. With regard to importance of health care planning and lack of nursing management planning accreditation in Iran. This triangulating research was carried out between 2004 and 2006. Fifty professional nursing managers in different level of Iran medical universities and central hospitals, having experience in nursing management at least for five years, and an MS or BS degree in nursing management, were included in a study through purposed sampling. At first, a pilot study with an open questionnaire was conducted in Isfahan and Shiraz and then the study went on in 3 phases including searching for international standards in method by 15 professional nursing manager after consensus on 70% and sending the final was used for data analysis. At last standards for nursing management planning were obtained in Iran. 48 standards of nursing management planning were obtained. The findings showed that most of the standards were accepted [90%] and there were not any standards with agreement lower than 70%. These standards, accompanied with the standards of other nursing units, can be used for quality improvement. The researcher suggests the ministry of health to use these findings and other related ones to accredit the nursing system and to identify its deficiencies

[Family experiences of females' high school students: a phenomenological study]

With the aim to recognize the identity of relationship and communication with family as a reality experienced by large amount of young population in country, this research was carried out to describe females high school students on their family experiences. A phenomenological qualitative approach was used in year 2005 in Isfahan. A sample was chosen based on purposeful sampling method amongst females' high school students. Sample size was dependent on the data saturation with a total 15 participants at the end. Data gathering was done using deep interviews, then data were analyzed through Straubert method. From the lived experiences of female adolescents, sixty five codes, three sub concepts and two core concepts were emerged. The two core concepts were emotional support [intimacy] in family and reactions in family. In spite of the vital role of families in adolescents' life, they are not experiencing useful interactions with their families. This study expresses the importance of educating families according to the needs and characteristics of adolescence period

Students' experience with the hidden curriculum in the faculty of Nursing and midwifery of Isfahan University of medical sciences

The hidden curriculum has great impact on students 'learning. The present study was conducted on Nursing and Midwifery students to determine their experience with the hidden curriculum. It was a combined survey achieved in two stages on Nursing and Midwifery students. During the first stage, a free interview was carried out to determine their attitudes towards, experiences with, and references of the hidden curriculum. These interviews were analyzed using Streubert technique. During the second stage, a questionnaire was completed and finally analyzed. All students have experienced the hidden curriculum and usually found it to be more effective than their routine learning program. This learning modality was associated with more stable behaviors among them. Meanwhile, most of their learning objectives, including positive and negative or group and individual learning were achieved through the hidden curriculum. They have pointed out that faculty professor, nursing and midwifery staff, other students, patients and mass media were their main source of reference, however, nursing and midwifery staff augmented the training impact. Students believed that the hidden curriculum is an effective modality for learning

prevalence and types of domestic violence against pregnant women referred to maternity clinics in Shahrekord, 2003

Domestic violence during pregnancy causes significant mental and physical impairment in both mother and fetus and is an important threat to social health. The aim of this study was to determine the prevalence and types of domestic violence against pregnant women referred to maternity clinics in Shahrekord, 2003. This descriptive and analytical study was performed on 1600 pregnant women referred to maternity clinics in Shahrekord during year 2003. Using a questionnaire, the demographic characteristics were collected and the data was analyzed using x[2] test. The prevalence of domestic violence was% 67.5 including physical [%39.5], psychological [%51.7] and sexual [%13.8] violence. The detrimental effects on the women due to the violence were physical [% 17.44], psychological [%12.56] and sexual [%0.4]. There was no correlation between the domestic violence and residence place, education and age of marriage. However, the rate of violence in the women with less than five years of marriage life, with poor economical condition, with first pregnancy, with unemployed and drug addicted husbands was statistically higher [p<0.05]. Our results showed that the prevalence of domestic violence in this city is high and it is significantly related to poor economical condition, unemployment, addiction, first pregnancy and duration of marriage life

Serum homocysteine level in patients with multiple sclerosis

The etiology of multiple sclerosis [MS], a chronic demyelinative disease-is unknown. The damage of blood-brain barrier [BBB] vasculature is a characteristic of MS and Homocystein [Hcy] can damage BBB, then increase in total Hcy may be important in MS pathogenesis. The aim of this study was to compare the serum level of total Hcy in MS patients with control group. In a case control study, serum level of total Hcy measured in 35 MS patient and compared with 30 healthy matched controls. All patients had definitive MS according to Poser criteria, without history of myocardial infarction, stroke, neuropathy, transient ischemic attack, homocystinuria or renal failure. The serum concentration of total homocystein was significantly higher in multiple sclerosis patients than healthy controls. The mean total Hcy level was 17.92 +/- 6.9 mmol/lit in cases and 14.6 +/- 2.92 mmol/lit in controls [P=0.013]. Serum total Homocystein may have a role in MS pathogenesis and reduction of it should be studied moreover

Students' experience with the hidden curriculum in Faculty of Nursing and Midwifery of Isfahan University of Medical Sciences

The hidden curriculum has great impact on students' learning. The present study was conducted on Nursing and Midwifery students to determine their experience with the hidden curriculum. It was a combined survey achieved in two stages on Nursing and Midwifery students. During the first stage, a free interview was carried out to determine their attitudes towards, experiences with, and references of the hidden curriculum. These interviews were analyzed using Streubert technique. During the second stage, a questionnaire was completed and finally analyzed.All students have experienced the hidden curriculum and usually found it to be more effective than their routine learning program. This learning modality was associated with more stabilized behaviors among them. Meanwhile, most of their learning objectives, including positive and negative or group and individual learning were achieved through the hidden curriculum. They have pointed out that faculty professor, nursing and midwifery staff, other students, patients and mass media were their main source of reference, however, nursing and midwifery staff augmented the training impact.Students believed that the hidden curriculum is an effective modality for learning