Prevalence of anxiety and depression in patients with colorectal cancer in Babol - north of Iran [2008-12]

Background and Objective: Colorectal cancer can significantly cause physical, psychological and social problems. This study was done to determine the prevalence of anxiety and depression in patients with colorectal cancer in Babol located in north of Iran

Methods: This cross-sectional, analytical study was done on 120 [75 males, 45 females] patients with colorectal cancer which registered in the Babol cancer registry in north of Iran during 2008-12. A questionnaire containing demographic information, aspects of the disease and HADS questionnaire was completed by interviewing to assess anxiety and depression for each patient

Results: The prevalence rate of depression and anxiety in patients was 23.4% and 30.8%, respectively. Gender, residency of rural area, and having comorbidities are related to depression among which location was identified as an independent predictor. Urban residency had 79% less risk of depression than rural residents [95% CI=0.06-0.67, OR=0.21, P<0.009]. Gender, resident of rural areas, unemployed, having comorbidities, low income and lack of education were associated with anxiety, among which only education was identified as an independent predictor [95% CI=L32-13.81, OR=4.27, P<0.015]

Conclusion: The prevalence of anxiety and depression in colorectal cancer patients was high in this area. Therefore, interventions are recommended to increase awareness and greater attention to rural women and controlling comorbidities

[Attitude of parents towards children's mental disorder]

Introduction: the attitude of parents is an important factor for the prevention, control and treatment of psychological disorders. Despite Western countries, in developing countries, few studies have been done on people knowledge and attitude about mental disorders. The aim of this study was to determine the attitude of parents towards children mental disorder

Methods: This study was a cross-sectional study conducted in child psychiatry clinics of Tehran University of Medical Sciences during 2013. The parents of children [n=400] who referred to the psychiatric clinics were recruited for the study by the convenience sampling method. Data were collected by questionnaire and analyzed using descriptive and analytical statistics

Results: Among the total study sample, 93.7% of parents had a totally appropriate attitude towards children's mental disorder. The results of ANOVA showed that the attitude of parents toward mental disorder had a statistically significant relationship with parent education level [P<0.001] and their familial status [P<0.006]

Conclusion: This study showed that the parents of children referred to the psychiatric clinic have a totally appropriate attitude towards the mental disorder of their children. Logically, having totally appropriate attitude can empower family members to overcome different challenges with the child mental disorder. Such attitude can facilitate the process of disorder management from the step of early diagnosis of any psychological disorder to the treatment adherence

[The study of nursing student's gratification and hilarity as a mental health index]

Introduction: Psychologists and Sociologists believe that happiness affects the psychological, social, educational and cultural dimensions of all individuals. So to pay attention to this issue as an indicator of students' mental health is very important. Therefore, assessment of nursing students' happiness is very important because they are encountered to multiple stresses and tensions. The aim of this study was to investigate the happiness status of Abhar's nursing students and also its correlation with sex, age, marriage, educational course, and the number of family members

Methods: This descriptive-analytical study was conducted between 2007-2008 in Abhar School of nursing. In this study the Iranian version of Oxford Happiness Inventory was used to measure the students' happiness status. After providing written informed consent questionnaires were distributed among 75 samples and finally 64 students [17=male, 47=female] were measured. Then, the collected data were analyzed using descriptive statistics and appropriate tests like independent-t and one-way ANOVA, by SPSS software version 11.5

Results: Data analysis showed that 17.5% of students had low level of happiness, 69.8% reasonable level and 12.7% were very happy. There was no significant association between the level of happiness and gender [P=0.7], marital status [P=0.4] and age [P=0.2]. But, there was significant relationship between happiness and educational terms [P=0.01]

Conclusion: Based on this study only 12.7% of students were very happy and two groups of junior and senior students were less cheerful. So, it is necessary to consider appropriate plans and interventions to improve and retain the happiness of nursing students in the acceptable levels and thus improve their mental health

Avicenna the first to describe diseases which may be prevented by exercise

In the modern medical era it has been known as well that physical activity and exercise are important factors to prevent from different chronic diseases. Scientifically, there are numerous evidence based studies about protective role of exercise against chronic diseases such as cardio- respiratory diseases, diabetes, and hyperlipidemia etc, which have been completely explained. Historically, ancient physicians such as Avicenna had described this topic several hundred years ago. However, ancient principles of medicine are too different in comparison with modern medicine and description of diseases which Avicenna has talked about them and their managements are too much different, yet reviewing the protective role of sports and physical activity in his masterpiece, "The Canon of Medicine", reveals that Avicenna has made a significant contribution to the evolution of following knowledge. The present review discusses Avicenna's opinion about protective role of exercise against some diseases through a comparison with modern medical views and also emphasizes aspects that need further investigation for these opinions to be useful in clinic in the future

[Comparison of the effect of clinical evaluation by two methods: Portfolio and popular, on satisfaction of nurse students]

Introduction: Clinical evaluation is one of the important factors in nursing education, and there are some difficulties in evaluation of clinical skills, representing more practical and effective ways in this field is the topic of many researches. So, in this research we designed a lesson plan based on portfolio evaluation method and used it in nurse student's clinical courses. Then we compared their satisfaction from clinical evaluation with popular method

Methods: In this experimental research, students in fifth semester of nursing at Tehran University of Nursing and Midwifery are participated. These students were divided into subgroups of 7 and 8. Each of these subgroups passed the clinical probationary in cardiac unit. After explaining the research goals, these subgroups were put in two research groups randomly. In portfolio group [n=21] students evaluated by using portfolio method and portfolio evaluation tool. And in other group [n=20], popular form of clinical evaluation in university was used. Both groups answered the satisfaction questionnaire in last day. Content validity and reliability of questionnaire was tested. Data analyzed by SPSS software and with Chi square, Fisher Exact, Mann Whitney, Wilcoxon and spearman's rho tests

Results: Findings showed that students had 21.5 +/- 1.36 years of old and most of them was female and married. Satisfaction in portfolio group was meaningfully greater than popular group in three aspects: alignment of subjects in evaluation method and form with clinical course objects [P=0.04], creating interest and motivation for participation of students in learning [P=0.005], motivating students to use books and other scientific references [P=0.01]. Satisfaction of popular group from fairness of evaluation method was greater than portfolio group [P=0.017]. There were no meaningful results in other aspects

Conclusion: More satisfaction in some aspects from portfolio method represents acceptance of new active methods of learning and evaluation by students. so, using portfolio as one of the best method of clinical evaluation in nursing and doing more researches advised

[Nurses perceived worries from error disclosure: a qualitative study]

Declaration of error is an important aspect of ethic and a necessity for care. It has some benefits for client, care givers and health institution. But always, many concerns prevent health care provider to perform this important and necessary intervention. This study was conducted to clarify these concerns from the perspective of the nurses. This was a qualitative study. The study question was what is the experiences and perceptions of nurses about their worries regard to error declaration or what factors affect this concerns? Purposeful sampling was used. The data was gathered by semi-structured focus groups with 115 nurses of two major university of Iran. The data was explored and analyzed according to inductive content analysis. The data was classified in four groups, patient reaction related concerns, immediate manager reaction related concerns, job position related concerns and negative experiences from past error declaration incidences. According to the undeniable effects of [declaration of error to the patient and/or the family] on increase of safe care and reduction of error incidents, health providing system must reduce the concerns of health care providers in this area and provide appropriate context [situation] for this important caring intervention. Along with that, the reasons and benefits of error declaration should be increase by purposeful education of care givers especially health care managers and it is necessary that rules and regulations [Terms] of error declaration impose [pass] and all health care agencies should be informed to run them. [They should be communicate to run]

Fear of being at risk of acquiring HIV, willingness to care, and discrimination in care and treatment of AIDS patients among nurses

Exposure to infectious blood and body fluids increase risk of occupationally acquired HIV among nurses. Discrimination in care and treatment of AIDS patient is one of the challenging ethical issues in nursing. The aim of this study was to determine fear of being at risk of acquiring HIV, willingness to care, and discrimination in care and treatment of AIDS patients among nurses. In this descriptive -cross sectional study, 165 nurses of internal and infectious wards from four selected hospitals of Tehran and Shahid Beheshti University of Medical Sciences participated. Data were collected by self-administered questionnaires. The instruments used included [demographic data form], [risk perception scale], [willingness to care for people living with HIV/AIDS]questionnaire, and [discrimination against AIDS] questionnaire. Data were analyzed by using SPSS 14, t-test, and pearson correlation. Out of 165 nurses, 36.4% had sever fear of being at risk of acquiring HIV, 81.8% were evaluated to be neutral in willingness to care of AIDS patients, and 54.5% agreed with moderately discrimination practice against AIDS patients. There was a significant correlation between fear of being at risk of acquiring HIV with discrimination in care and treatment of AIDS patients [p=0. 003] and willingness to care [p= 0.007]. It seems that education efforts about universal precautions, ethical issues, and patient rights should be made in order to reduce fear of being at risk of acquiring HIV, decrease discrimination in care and treatment of AIDS patients and increase willingness to care

[Spirituality in HIV-infected individuals: a phenomenological study]

HIV/AIDS is a well-recognized global problem in the world, including Iran. It is necessary to comprehend and understand lived experience of HIV positive patients. The present study was designed and conducted to better understand the perspectives and experiences of HIV positive patients about the role of the spirituality and religious beliefs in their lives with HIV/AIDS. This qualitative study was conducted using an interpretative phenomenological approach. In-depth, audio-taped and semistructured interviews with 19 participants were conducted to collect data. Data were transcript. Observations were also recorded in comprehensive field notes. A hermeneutic approach was used to analyze the data, according to the method developed by Diekelmann. According to the findings, participants aged between 21 and 56 years of old at the time of contamination to the HIV. Almost half [47.4%] of the participants had CD4 counts under 200 cells/mm3. Analyzes of the data revealed three main themes: [a] Redefining religious values and communicating with God; [b] Compensation; and [c] Individual development. The themes included some sub-themes. Experiencing difficult conditions in HIV positive individuals provide them with an opportunity to return to religious values, redefine themselves and give meaning to their lives, rather than fear or disappointment. Communicating with other HIV positive patients and religious experts are suggested as additional appropriate strategies

[Assessing nursing performance regarding admittance of preschool children in educational hospitals, Hamedan]

Many Adults remember their hospital admission during childhood. Hospitalization could be terrifying for children. In the other hand, it could be a positive experience, if they get well prepared for hospitalization by nursing plans. First hours of hospitalization are the most important. Therefore, orienting the child to hospitalization process and copying with fears could increase child's self esteem. It would furthermore help the child to adjust with potentially stressful situation in future. The purpose of this study was to identify nursing performances regarding hospital admission of children aged 3-6 years. Using descriptive- analytic study method, 20 nurses who have worked in pediatric wards for at least one year, were selected through census sampling. The data were collected through an observational checklist. Nurses' performance was assessed randomly three times a day during morning and evening shifts when the most hospitalization takes place. To know whether nurses' performance was influenced by availability of facilities, another checklist was used to assess physical environment, facilities and equipments of hospital, three times within different days. All statistics were computed by the SPSS software [version 15]. The results revealed that 95 percent of nurses had weak performance at admission time [461 scores of 960]. Physical environment and equipments of pediatric wards were found appropriate. No significant correlations were found between nursing performance and physical environment or equipments [P=0.21]. There was no significant correlations between demographic of participants and nursing performance as well [.P>0.05]. The study found that physical environment, facilities and equipments of pediatric wards in educational hospitals of Ramadan city is appropriate, eve though nurses' performance weren't good enough in admitting children. It meant physical environment, facilities and equipments didn't had any impact on nursing performance. Therefore, training nurses regarding children admission and how to use the available resources to promote their performance is needed

[Assessing educational needs of nurse managers affiliated to state hospitals]

Educational programmes are designed to meet educational needs of learners. Therefore, need identification is the first step in educational planning. Nurses need new skills considering how rapidly the science borders are expanding. Identifying educational needs of nurse managers could be an effective way to empower them. This survey aimed at determining the educational needs of nurse managers of state hospitals, through Delphi method and job analysis. The study utilized mixed method by combing Delphi method and job analysis to determine educational needs of nurse managers. 20 nurse managers drawn from universities of medical sciences were recruited to the study. With reference to nurse managers' task description -approved by Ministry of Health and Medical Education- educational needs were discovered based on ISO 10015 [launched by Ministry of Health for all job categories]. Educational needs of nurse managers were categorized in two groups of personal and organizational needs. Personal needs included skills in lecturing, article writing, English conversation and translation as well as running meetings. Organizational needs consisted of IT, Nursing ethic and law, quality assessment of wards, quality improvement in nursing care, standards of structure, equipments and human resources, crisis management, health education, HIS system, hospital infection control, nursing care procedure, management principles, human resource management, interview technique, research methods, statistics, SPSS software, health economics, teamwork and teambuilding, educational methods, religious practices and adjustments, educational need assessment, comprehensive evaluation, change management, critical thinking, stress management, communication skills, decision making techniques, problem solving and time management. Since the study revealed that significant needs in performing professional tasks of nurse managers have not been met, the results could be applied in developing educational programmes for nurse managers of university hospitals. The mixed method and educational need assessment model used in this study, could be used in assessing educational needs of other managers

[ experience of mothers with newborn jaundice: a qualitative study]

Neonatal jaundice is still a leading cause of preventable brain damage, physical and mental handicap, and early death among newborns in many countries. In spite of this fact, Iranian mothers seem not to approach their newborn jaundice appropriately. Therefore, the present study aimed to explore mother's viewpoints regarding their newborn jaundice. Using qualitative method, in-depth semi-structured interviews were conducted with a purposeful sample of fifteen mothers who their infants were hospitalized in one of the hospitals affiliated to Tehran University of Medical Sciences with a diagnosis of jaundice newborn. The data were analyzed using qualitative content analysis. Two themes and two sub-themes were identified in data analysis. The main themes were challenge between traditional and modern approach to newborn jaundice [with two sub-themes of traditional understanding of disease' nature and challenges in treatment and follow ups] and mothers concerns for their infants' future. In general, mother weren't aware of disease' nature and their traditional approach had caused challenges in treatment of their newborn jaundice. Considering the finding of the study, in order to help mothers to approach their newborn jaundice appropriately and disease follow up, it is recommended that nurses and midwives instruct mothers about their newborn jaundice and plan for perinatal care

identity-based model for adolescent health in the Islamic Republic of Iran: a qualitative study

We conducted this study on 52 adolescents from Tehran to investigate their perspectives on health. We used the grounded theory approach and the constant comparison analysis method. Identity emerged as a core variable along with the concepts of friendship and relationships, education, family, lack of limitation and community. Identity affects adolescents' health regarding the emerged concepts. Participants believed that psychosocial health-related factors were more important than physical and individual health factors. Therefore, social welfare, healthy family/friendship, and caring for adolescents' individuality are important for healthy adolescence

[Effect of open and closed system endotracheal suctioning on vital signs of ICU patients]

Nowadays, mechanical ventilators are being used for some patients in ICUs due to various physiological and clinical causes. Keeping endotracheal tube clean and open is necessary in order to improve the patient's oxygenation. This study aimed to investigate the effects of open and closed system endotracheal suctioning on vital signs of patients in ICU. In this quasi-experimental study, 40 patients from Shariaty Hospital's ICU were selected using convenience sampling method. Data was collected using a record sheet. The sheet consisted of demographic characteristics and vital signs including blood pressure, mean arterial blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation percentage. Endotracheal suctioning was done randomly in 90 minute intervals once using closed method and once using open method. All patients were hyper oxygenated by Ambo bag for 2 minutes before and after the procedures. The patients' vital signs were checked and recorded using SIEMENS 680 2xi monitor before, and 2 minutes and 5 minutes after the procedures. Data were analyzed using SPSS software. Systolic and diastolic blood pressures, and heart rate showed higher increase 2 and 5 minutes after the open method compared to close method [P < 0.001]. Arterial blood oxygen saturation percentage reduced in the open method more than in the closed one 2 and 5 minutes after the procedure [P < 0.001]. No significant difference was seen in the patients' respiratory rate in two methods [P > 0.05]. Closed endotracheal suction system results in lower disturbances in the vital signs than the open system. Therefore, for better results, the closed endotracheal suctioning is suggested

[ effect of cardiopulmonary resuscitation workshop on nurses' sustained learning]

The effect of the presence of trained personnel in the team on the outcome of resuscitation has been proved in previous studies. An informative need assessment, in the environment of present study, reveals the role of the nurses' knowledge in Cardiopulmonary Resuscitation [CPR]. Therefore, this study was designed to determine the effect of education through workshop on nurses' sustained learning regarding resuscitation. An interventional study, using pre-test and post-test was carried out. The data gathering tool was a questionnaire consisted of two parts including individual characteristics and 21 multiple choice questions about necessary actions in cardiopulmonary resuscitation. This questionnaire was answered by the participants before, immediately after, and 6 months after the workshop. The results were analyzed using Repeated Measure ANOVA by SPSS software. The highest score, the lowest score and the mean score in pre-test were 17, 6 and 10.12, respectively. These scores for the post-test were 21, 13 and 17.96, respectively. For the test held after 6 month, the highest score was 17, the lowest was 10 and the mean score was 15.02. Comparing the means of these tests showed a significant difference between the pre-test, post-test, and the test after 6 months. Although CPR workshops met the needs felt by nurses to some extent, the repetition of these workshops in regular bases [six months at maximum], seems to be necessary

[Research development in Tehran Nursing and Midwifery School, 2004: an action research report]

Continuous professional development is an essential component within many health care 'Learning Organizations'. This paper describes an initiation to develop a professional practice development framework for faculties in Tehran Nursing and Midwifery School. The project was undertaken within an action research methodology with four phases .The goal of the project was to improve research, provide competition, reinforce data management, identify priority of needs in nursing and midwifery, and in so doing, enhance knowledge of the development of health information resources. A multi-method approach to data collection was undertaken to capture the change process from different stakeholders' perceptions. Triangulation of the data was undertaken. Despite organizational constraints, leadership and peer support enabled the co-researchers to identify and initiate high quality research initiatives. The change process for the co-researchers included: enlightening personal journey, exploring the research-practice gap, enhancing personal and professional knowledge, evolving cultural change and collaborative working. Descriptive analysis and evaluation method showed that the project was done effectively. A more flexible time-scale and long term funding are required to enable continuity for trust-wide projects undertaken in dynamic academic settings

[A phenomenological analysis of post operative pain experiences in three subcultures in Iran]

Pain is a phenomenon with both personal and cultural meanings. As cultural diversity increases around the world, caregivers are more and more likely to care for clients from backgrounds different from their own. Culture affects the assessment and management of pain. The aim of this study was to explore the meaning of pain experiences in 3 subcultures in Iran. A phenomenological approach was used in order to explore the meanings of post-operative pain experiences in participants. Data were gathered through series of semi structured interviews as well as goal-oriented observation and collected written narratives. Benner's interpretive method was used for data analysis. From analysis of viewpoints of 15 patients from Khorram-Abad, 13 patients from Tehran and 8 patients from Gorgan, 4 themes emerged. Considering postoperative pain insignificant compared to primary pain, need for protection, and increase in spirituality and insensitivity of healthcare providers were the emerged themes. While pain is a subjective and personal phenomenon and reaction to pain is influenced by cultural and personal values, in this study no difference was found in the pain experiences in 3 under-study subcultures. It seems that Iranian-Islamic culture acts as a conceptual umbrella to encompass the whole experiences and influences all subcultures