[Nursing students' perceptions regarding actual and expected Iran university of medical sciences clinical learning environment]

Introduction: Clinical learning environment have an important role in clinical learning of nursing students. Any differences between expected and actual clinical learning environment of nursing student result in reduce the interest of nursing students to clinical environment and decrease their clinical performance. The aim was to comparison the perception of nursing students regarding expected and actual clinical learning environment in medical-surgical wards

Method: This study was a descriptive cross-sectional and conducted in first semester of 2009-2010 educational years. In this study 217 baccalaureate nursing student from Iran nursing and midwifery faculty participated. The researcher appeared in the student's clinical learning placement at last day, and after produce necessary information about purpose of study, both of versions of questionnaire give to students contemporaneously, and collected after completion. For data collection, clinical learning environment inventory was used that contain 42 item in six areas. Data was analyzed by SPSS software using descriptive and inferential statistic

Results: The paired t test showed that there were statistical differences between actual and expected perception on nursing students regarding clinical learning environment

Conclusion: The results of this study showed, nursing students haven't positive perception of the clinical learning environment and their perception of actual clinical learning environment to differ from expected clinical learning environment

[Sleep and health related quality of life in patients with chronic heart failure]

Introduction: Heart failure is one of the most common cardiovascular disorders. In this disease heart is disable to perfusion, insufficient perfusion lead to many symptoms in this patients. Each of these symptoms in some patients is deprived from the suitable sleep. Sleep is a vital and effective element in the health and quality of life in these patients. The purpose of this study is to assess of relationship between sleep quality and quality of life in patients with chronic heart failure

Methods: In this cross-correlation study, 200 patients with chronic heart failure in two teaching university hospital of Tehran university of medical sciences was selected using sampling with proportional allocation. Data were collected using from demographic questioner, Pittsburgh sleep quality index and Kansas City Cardiomyopathy Questionnaire and then were analyzed using the SPSS software and statistical tests

Results: Sleep quality, with some aspects of health related quality of life including physical limitations [P<0.000], symptoms [P<0.001], social functioning [P<0.000], quality of life, [P<0.011] as well as general health related quality of life [P<0.000] has a significant relationship

Conclusion: Considering that sleep quality are associated with health-related quality of life. Community health care providers especially nurses had to more than before attention to sleep quality in these patients

[Clarification of knowledge translation in health system]

Introduction: Knowledge translation is a frequently observed concept in current health science literatures. However, there is no congruence about its definition and properties. Analysis of concept helps researchers to achieve a uniform, clear and understandable description. This study accomplished on 2009 to clarify and reduce ambiguities associated with the meaning of knowledge translation and promote the concept consistency in related literatures

Methods: Walker and Avant's eight-step model was used as the method. After extensive review of all published articles until 2009, we included 29 relevant articles in the analysis. By following the steps of model, definitions, characteristics, applications, antecedents and consequences and empirical referents of the concept were derived

Results: According to the analysis, essential attributes of knowledge translation were emphasize on research knowledge application in practice, ongoing collaboration among knowledge producers and knowledge users, interactional and nonlinear process, and dependency on user and final context. In addition, the consequences of successful knowledge translation were community health promotion; more effective health services, improvement in practice and strengthen of the health care system

Conclusion: Since knowledge translation process in our country is relatively new and unknown, this concept analysis can improve implementation of more extent studies and development of research tools for identification of its barriers and facilitators and its execution

Psychosocial care for breast cancer: physicians' perspective

Many literatures have documented that psychosocial care can improve health outcomes and reduce morbidity in women with breast cancer. The aim of this study was to evaluate the opinion of the breast cancer professional team members on integration of psychosocial care in regular management of breast cancer. A cross sectional sample of 313 physicians involving in diagnosis, treatment and supportive care for breast cancer patients were interviewed using a questionnaire. The majority of participants [52.7%] declared that psychosocial care is necessary for all patients with breast complaints. All except one of the respondents irrespective to their age and job believed that providing the patients with psychosocial supportive care definitively have some positive points for the patients with breast cancer. Of all respondents, 29.6% thought it should be offered as soon as suspicion is raised toward breast cancer, 54.7% preferred to provide such care after the diagnosis of malignancy is confirmed, 11.3% thought it should be prescribed before surgery and 4.4% believed that care should be provided before adjuvant therapy. The necessity of providing psychosocial care for breast cancer patients was mentioned by the majority of respondents; however there are some major differences among the team members of breast cancer care in regard to psychosocial supportive care. The results of this study highlight the insufficient collaboration among medical team members and the necessity of multidisciplinary approach to all aspects of the important disease through programmed sessions and provide the patients with an integrated comprehensive care

[Nurses' readiness in research utilization: moving toward evidence-based practice]

Research utilization is a mechanism for transferring the results of research into practice and improving the quality of care in nursing. The aim of this study was to determine nurses' readiness to utilize research needed for applying evidence-based practice. In this descriptive study, 375 nurses in all teaching hospitals affiliated with Tehran University of Medical Sciences were selected by stratified random sampling method. A 4-part questionnaire with open and close-ended questions including professional profile, research activities, research skills and access to research resources was used for data collection. Content as well as face validities and Cronbach's alpha for reliability [0.82] were identified. 85.9% of nurses had weak readiness in research utilization. Both research activities and skills were also low [71.4% and 82.7% respectively]. 44% of nurses had insufficient access to research resources. A significant relationship was found between nurses' educational level, participation in research activities as well as English language skills and their readiness in research utilization. Lack of skills and inaccessibility to research findings lead to weak readiness for research utilization. With respect to the importance of utilizing research findings, organizational and administrative support, continuing education programs, well-defined processes and pathways to facilitate research utilization need to be provided for nurses

[ extent of research utilization in nursing clinical practice, Tehran, Iran]

Research utilization is an important way to extent the knowledge in nursing practice. It empowers the nursing profession. Research utilization is a new paradigm in Iran's nursing care. This study aimed to assess the extent of research utilization in nursing clinical practice in Tehran, Iran. This is a cross-sectional study. The clinical nurses with at least one year of work experience were selected through a multistage stratified sampling method. They completed a five-sectioned self-report questionnaire. The scores were categorized into high, intermediate, and low. Data were analyzed using descriptive statistics and Chi-Square test in SPSS. Findings revealed that the research utilization in 66.9% of the nurses was low. There was significant relationships between the extent of research utilization and the level of education, professional condition, clinical setting, research activities, work shift, job satisfaction, and English language skills. The majority of nurses' practice is not according to the research findings. We need to find appropriate strategies to enable us to utilize the research findings

[ relationship between self-efficacy and breastfeeding, Tehran, Iran]

Breastfeeding is the most cost-effective, health-promoting, and disease-preventing activity that new mothers can perform. Many researches have focused on identifying factors that influence breastfeeding initiation and duration. An important and modifiable factor is the perceived self-efficacy of mothers for breast feedings. It refers to a mother's perceived ability to breastfeed her newborn; and is a dominant variable in the duration of breastfeeding. The purpose of this study was to assess the relationship between self-efficacy and breastfeeding. A descriptive, longitudinal, analytic approach was used in this study. The three-part questionnaire was administered to the eligible pregnant women [437 pregnant women] who were at least in 37 weeks of gestation and intended to breastfeed. They were then contacted again at one and four months postpartum to determine their infants' feeding level and method. The questionnaire was re-administered to the participants at that time. The results showed that 80.4 percent of participants had exclusive breastfeeding during one month. There was no significant relationship between antenatal breastfeeding self-efficacy and the breastfeeding. The self-efficacy was significantly related to breastfeeding outcomes at one month. Mothers with high self-efficacy were significantly more likely to breastfed their babies exclusively at one and four months postpartum than the mothers with low self-efficacy. Maternal breastfeeding self-efficacy is significantly related to breastfeeding duration and level. Measuring breastfeeding self-efficacy not only identifies high risk mothers, but also provides important information to health care providers in providing support to new mothers

[Strategies in developing research based nursing practice: a review article]

Research utilization is the link between research and clinical practice which promotes the quality of care. Research-based practice is the main criteria to demonstrate how nurses implement the findings of research and how provided healthcare is based on research findings. In spite of the increased outputs of research, research implementation hasn't gone so fare compare to growing nursing research quantitatively. Now, it's time to shift the nursing focus to empower the research implementation in care. The present study is a review article aimed at describing the strategies used in developing research based practice in nursing. The published articles and theses reports discussing research utilization and evidence-based practice in nursing during last decade were systematically searched. The review was carried out using the databases of ISI, CINAHL and MEDLINE which cover a wide range of journals and literature. The literature in Persian was searched in SID databases. 51 research studies regarding strategies in research based practice in nursing were chosen to be included in the study. The results revealed the strategies recommended based on research implementation' models and two main concepts of acceptance and preparation. Using these strategies could facilitate research utilization in nursing. Successful research-based practice requires a suitable, supportive for creativity and motivating environment, having resources available and valuing persons' performances. Accessing the valid research outcomes, having competency in conveying and utilizing the results in practice and a supportive context which creates creative atmosphere and research mind is demanded in implementing research-based practice in nursing

[Nurses attitudes toward research utilization in clinical practice]

Research utilization is a new phenomenon in Iran and the Iranian nurses tend to practice based on evidences. The objective of this research is to investigate nurses' attitude toward research utilization. This research is an analytical-descriptive study. The sample included 410 clinical nurses and instructors who were selected through multistage stratified sampling method. Data were gathered using a two-section questionnaire and analyzed using statistical package for social sciences [SPSS]. 91.2% of respondents believed in using research findings in practice. 77.6% of nurses agreed with the following statement: "Research is not applicable in practice". Furthermore 88.3% agreed that" Research helps to build a scientific base for nursing". The majority of respondents had positive attitude toward research utilization. There was a significant difference between attitude and kind of professional activity, setting and research activity. It seems having positive attitude toward research utilization is not sufficient for applying research results in practice. In order to utilize the research findings, more relevant research in this field of nursing is required

[Nurses' information and their view points about patient's rights and practical facilitators in clinics]

Nurses can support the patients' rights advocacy, if they are informed of these rights. Furthermore in order to exercise and protect of these rights, the working environment should be appropriate. The aim of this descriptive analytical study was to explore the nurses' awareness of patients' rights in Tehran teaching hospitals and the facilitators of observing theses rights from their perspective. To achieve this, 517 nurses were selected using multi stage stratified sampling method. Data were gathered utilizing a researcher made questionnaire with 3o statements regarding patients' bill of rights, and an open question about patients' rights facilitators at the end. The findings indicated that overall nurses had a high level of awareness regard patients' rights. In addition nurses mentioned 17 factors as facilitators of patients' rights practice. These were classified to three groups: organization related, personnel related and client/ patient related factors. The most frequent items were in the group of organization related factors. Despite of nurses' high awareness of patients' rights, observing these rights in practice needs many other requirements. These requirements should be recognized and identified. This can be the first step for finding proper solutions by all health care providers and policy makers as well

[ facillative and preventative factors of implementation of research findings in nurses clinical practice]

Research utilization provides quality and cost- effective care, optimizing patient outcomes and enhancing the credibility of nursing. Despite of increase in the amount and quality of nursing research, the conduct of research and use of its results remains poor. In Iran one of the most important barriers of research is related to research utilization. The aim of this study is to identify the barriers and facilitators of research utilization in nursing practice. The study used a descriptive- analytic design. The questionnaire was divided into two sections: The former asked for information on the academic and professional profiles of respondents, the latter was based on the BARRIERS Scale. In addition there was one open -ended question to measure the facilitators of research utilization. Content and face validity was further enhanced by submitting it to nursing researchers. In factor analysis procedure four factors were extracted. The factors were labeled as: organization barriers and limitations, Quality of research, Nurses' values, awareness and skills, Communication of research. Factor loading for barrier item "the nurse is unaware of the research" was not included under factor headings. The top three barriers were The nurses do not have time to read research, the facilities are inadequate for implementation and the nurses do not feel they have enough authority to change patient care procedures. All the participants suggested facilitators to increase research use The most frequently mentioned facilitators were related to human resources, individual and organizational factors. The most dominant findings were related to organizational support. The top three barriers mentioned by the participants reflect a traditional organizational culture which hinders professional autonomy. Organizations need to ensure that facilities are provided and give the authority to the nurses to change the practice based on research

effect of lecture and e-learning methods on learning mother and child health course in nursing students

Traditional teaching methods used in medical education are not able to respond to the rapid changes and growth of information as well as continuous change in educational needs of societies. This study was performed to compare the effect of two teaching approaches, lecture and e-learning on learning outcomes of mother and child health course in nursing students of Tehran Medical University. This quasi-experimental study was performed on all third semester nursing students who had passed mother and child health course in 2006 [N = 32].It was a one group two-shot study. During the first four weeks, the students received traditional education and during the second four weeks they studied the rest of the subject matter using an on-line learning method. At the end of the course, the students' opinion toward the educational methods was asked using a questionnaire. An exam that covered the content of the 4-week block was also administered. Analysis of data was done by SPSS software using mean, standard deviation, and t-test. The learning outcomes in both groups were similar. Based on the students' opinion about two teaching methods, e-learning was more effective on "their capability to use the method" and "independence in using the method", and lecture was better than e-learning in "the effect on learning" and "motivation". E-learning can be used for teaching some nursing courses. It is recommended to use e-learning method with considering appropriate interactive and more attractive virtual environments to motivate students

[Screening and vaccination in prevention of cervical cancer]

Cancer of cervix is the second most common cancer among women worldwide, with a frequency of more than 500000 cases every year. The mean age for cervical cancer is 51/4 years and the most common type is squamous cell carcinoma. HPV can be found in a growing proportion of patients with cervical cancer,approaching 100%. HPV 16 is the most prevalent in cervical cancer, followed by HPV 18 and 33. As half of cervical cancer cases are diagnosed as an advanced at the time of stage and with the techniques available, remain untreatable. During the past 20 years, vast research has been focused to unveil definite diagnostic techniques production of vaccines and new management modalities. Cultural status, habits and social behavior of women have an important bearing in the occurence and morbidity and mortality due to this disease. Minority class and woman with low income and women with low income undergo less screening. In America and Northern Europe, the Major cause for a reduction in the morbidity and mortality of cervical cancer has been the execution of screening at a large scale resulting in a 70% reduction in morbidity and mortality due to cervical cancer. On the other hand, in Iran according to the available statistics, the leading cause of a delayed diagnosis of cervical cancer has been the absence of the performance of Pap smear test. A high rate of false negative smears and atypical squamous cells [ASC] diagnoses have led to the development of new diagnostic techniques. More recently, the use of liquid-based technologies such as Thin Prep and AutoCyte Prep have gained popularity; It has been held till today that pap smear might increase the sensitivity of detecting cervical dysplasia. In reviewing the published literature about the efficacy of this technique and the endorsement of the results of screening, information is lacking HPVDNA typing can be used concurrently with pap smear in cases where pap smear is abnormal. A negative combination test [Pap smear HPVDA typing] in contrast three-repeated Pap smear tests shall provide more reliability as regards the absence of neoplasia in future. In the year 2003, FDA approved the use of Hybrid capture 2 Assay for HPVDVA typing along with Pap smear in women above 30 years of age, so that high risk in faction in these woman is subjected to screening

[ comparative investigation on health behaviors of students in primary schools with and with out health educator]

Introduction: children's health is an important issue in activities of many international organizations. To prepare the children to understand and practice the ways of healthy life, the schools should play their important role by planning and performing effective health education programs

Materials and Methods: this research is an analytical-descriptive study. The samples included 330 students who were selected through multistage stratified sampling method. The data was gathered by a questionnaire and were analyzed by using the inferential and descriptive statistics

Results: the results showed that there was no statistically significant difference between health behaviors of students in schools with and without health educators in the domains of eye and skin health, nutrition, sleep, rest and physical activity, but there was a significant difference between health behaviors related to ear [2=8.58, p=0.014] and tooth [2=9.35, p=0.009] the students with educator had healthier ear and tooth behaviors than students who didn't have educator. In the domain of mouth and tooth the girls had healthier behaviors than boys. In the domain of physical activity the boys had better health behaviors than girls, having educator or not

Conclusion: overall, there was no significant difference between health behaviors of students in schools with and without health educators. Formation of healthy behaviors is a multifactorial issue and survey of all factors and variables affecting health behaviors can provide clearer measures for planning the health education programs and optimum usage of resources, manpower, budget and time to promote awareness and performance of health behaviors in schools