effect of progressive muscle relaxation on anxiety and stress in nursing students at the beginning of the internship program

Anxiety is a complicated process appearing from low to high which may reduce the learning ability. It is common among nurses as they struggle to cope with increasingly complicated stressors such as examinations, article preparation and practical experiences. The aim of this study was to evaluate the effect of muscle relaxation on reduction of anxiety in nursing students before starting the internship program. In this study, 40 nursing students who were going to start their internship program were randomly divided into two equal groups. Before starting the internship program, all students were asked to fill a questionnaire [Spielberger Test Anxiety] to measure their anxiety. In addition, physiological parameters [blood pressure, pulse, respiration, temperature] were collected before and after the study in both groups. During a 45-min session, muscle relaxation training was given to the test group. Muscle relaxation practice was continued three times per day for two weeks. Two weeks after starting the internship, Spiel Berger Test Anxiety and physiological parameters were collected again in both groups. Data were analyzed using Chi-square and t tests. The average age of the students in both groups was 22.7 +/- 2 [range=21 to 25 years] and the majority of the students were female [75%]. No significant difference was observed between two groups for willingness to the nursing profession, birth rank and the average scores of the students from the previous years. The average anxiety score in control group before and after the study was 27.5 +/- 10.2 and 28.3 +/- 8.8 respectively [P > 0.05]. Average anxiety score in test group before and after the study was 25.4 +/- 19.5 and 29.2 +/- 14.1 respectively [P < 0.05]. To alleviate stressors associated with practical practice and create a healthy work environment for practice, it is recommended that nursing students have some progressive muscle relaxation before entering practical environments

Establishing the standards of control in nursing services management

Perhaps it could be claimed that performing task in organization would not be successful, unless the necessary controls have been provided. Management system needs control to be informed about the methods of goal achievement and performing operations, thereby, gaining the ability for tracking, testing and reforming methods. In any specialty, in order to consider these activities equally and scientifically, the responsible establish professional standards in the form of direction and framework and declare them to enforcers. With due attention to the importance of control, especially in health systems management and with view to the fact that there is no standard in this field, the current study was designed with the aim of compiling standards for control accreditation in nursing management in Iran. This is a triangulation research conducted from 2004 to 2006. The sample size was 15 in Delphi stage and total of 50 nursing management experts [from Iranian medical sciences universities] in stage of survey. The sampling was target based. At first, a pilot study was conducted in Isfahan and Shiraz by an open questionnaire, and then the main research was conducted in three phases. In the first stage, international standards of control for nursing services management were collected. In the second stage, a semi-structured questionnaire was developed from perspectives of 15 professional nurse managers. The suggestions were collected and the researchers reached a consensus of 70% in the third stage. Then, the researchers held a national survey among 50 nursing management experts in Iran. The data were analyzed by descriptive statistics and distribution frequency and eventually control of nursing services management standards in Iran were extracted. Thirty five standards in area of control was established. The results show that these standards had more than 90 percent of acceptability. These standards together with the standard of nursing units can develop quality, so, it is suggested that these standards can be utilized by ministry of health and medical education to control credit rating of nursing units, in order to identify the lacks and shortages

Level of anxiety and its correlation with some individual characteristics in patients with myocardial infarction in hospitals related to Islamic Azad University, Tehran Medical Branch [2005-2006]

The most important factors of anxiety in individuals are diseases and their treatment. Although anxiety is an alerting process, it can affect quality of life or makes the treatment longer. This study was performed to determine the relationship between level of anxiety and some of individual characteristics in patients with myocardial infarction [MI] in hospitals related to Islamic Azad University, Tehran Medical Unit. This study was performed on 200 patients with MI from 3 hospitals related to Islamic Azad University, Tehran Medical Unit. Data were collected with questionnaires, which were filled by interviews. The questionnaire had two parts: 26 questions about some individual characteristics, and the second part comprised Spill Berger standard criteria including 40 questions about anxiety level. "Content validity" method was used for ascertaining validity and "test-retest" method for reliability of tools. The subjects were all in the age range of 22-34 years with a mean of 25.98. Results indicated that 76.5% of study population was married, 64% had a history of hospitalization due to other causes, and 33% knew about their stress and anxiety. On the basis of total anxiety scores [TAS], 8% of individuals had mild [40-79], 47.5% had moderate [80-119], and 44.5% had severe [120-160] anxiety. There were a direct and statistically significant relationship between the level of anxiety and age, gender, marriage status, occupation, job satisfaction, number of children, adequacy of income, site of living, insurance, living conditions, level of liking their visitors, relationship with other family members, anxiety background among the first degree family members, his/her description of personality, description of family environment, present physical health status, and preference to have information about the illness [P < 0.05]. There is a direct and statistically significant relationship between the level of anxiety and individual characteristics of patients with myocardial infarction

incidence rate of chronic brucellosis following one-year antibiotic therapy in Koohrang district of Chaharmahal and Bakhtyari province

Brucellosis is a common zoonotic disease with different clinical pictures such as chronic brucellosis. The aim of this study was to determine the incidence rate of chronic brucellosis after one-year of antibiotic therapy in tribal patients of Koohrang district of Chaharmahal and Bakhtyari province from 2003 to 2004. The patients with acute brucellosis were recognized using both standard tube agglutination [STA] [Wright] and 2-mercaptoethanol [2ME] tests. Also a questionnaire about demographic variables of the patients, their signs and symptoms and how they were infected was filled in by the patients. Subsequently, they were treated using conventional regimen. After one year, the patients were reviewed for the signs and symptoms of the disease and their sample sera were tested for related antibodies. The patients with specific antibody [>1/160 for both tests] regarded as positive. The data was analyzed by t, Chi square, and regression tests. During the peak of brucellosis in 2003. 119 persons were infected, 63.9% male and 36.1% female. Arthritis [88.7%] and fever [78.54%] were the most common signs and symptoms. In the second visit 97 new patients were recognized, rifampin with cotrimoxazole [57.7%] and doxycycline with rifampin [15.5%] were used for treatment of the patients. 17.5% of the patients had final titer of STA test titer and 15.5% of them had a 2ME titer higher than 1.160. 16.5% of the patients had recurrence signs and symptoms and 11.3% of them had mild symptoms. There was significant statistical relationship between antimicrobial drugs regimen and final titer of STA and 2ME tests and clinical course in the following year [p<0.001], Using both rifampin and cotrimoxazole resulted in a higher chance of chronic brucellosis [p<0.001]. The incidence rate of chronic brucellosis in this area was higher than that in the other regions of Iran and other countries. This was mainly due to lack of standard antimicrobial regimen, using single drug regimen, short-course antimicrobial therapy, low level of training of the patients and low access to health facilities in the region

Nurses' clinical thinking and decision making

Nowadays in health care arena, the nurses are confronting with increasingly complicated situation constantly changing. This unreliable and unstable situation requires nurses with ability of decision making. Since decision making became more complex, critical thinking is necessary to use. Regarding the importance of critical thinking and clinical decision making in modern nursing, this study aims to estimate capacities of nurses and to evaluate their relationship. This is why most of the authors believe that critical thinking improves clinical decision making. This research was a cross sectional descriptive correlation study. The study was planed with the purpose of detection of relationship between critical thinking and clinical decision making of nurses in general and intensive care wards. Furthermore, it is to compare nurses of general wards with nurses of intensive ones. This study was conducted on 140 nurses in two groups [70 nurses from general and 70 nurses from intensive wards]. The samples were selected based on stratified random sampling and the data were collected by a questionnaire. This questionnaire was consisted of three parts, demographic characteristics, clinical decision making inventory and California critical thinking skills test. Validity and reliability of the tool were confirmed with content validity, test retest and internal correlation. Data were analyzed with SPSS and descriptive and inferential statistics. Mean score of critical thinking and clinical decision making for intensive care nurses were 10.61 and 63.27 respectively. For general care nurses, they were 10.67 and 61.66 respectively. The results didn't show a difference between mean score of critical thinking in intensive and general ward nurses. Also there was not any difference between mean score of clinical decision making in intensive and general ward nurses. The result didn't show any relationship between critical thinking and clinical decision making of nurses. The findings showed that mean score of nurses' critical thinking is low. The reason can be either due to the defects during training or professional ones during working period. Also, this study didn't show any relationship between critical thinking and clinical decision making. Some experts claim that lack of relationship between critical thinking and clinical decision making is due to lack of an appropriate tool or project to measure them rather than the lack of their relationship