Communication of nurses and elder patients in hospital wards: a qualitative study

Iranian Journal of Nursing and Midwifery Research1735-906610420100210Communication of nurses and elder patients in hospital wards: a qualitative study134134Abedi, Post Doc of Nursing-Nursing research methodlogy, Associate Professor of Education, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan, Iran, Hezarjereeb Avenue, IsfahanMs of Nursing, Instructor of Fundamental Nursing, School of Nursing and Midwifery, Isfahan university of Medical Sciences, IsfahanMs of Psychiatric Nursing Education, Instructor of Psychiatric Nursing, Psychiatric Nursing Dept, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan20101113  Introduction: There is an increasing aging population in Iran. Most nurses will be involved in caring for older people in the future. Over the past years, many studies showed the benefits of effective nurse-patient relationship. The purpose of this study was to ascertain how nurses and older patients communicate together. Methods: Using phenomenological approach, the researcher drew participants from Al-Zahra hospital in Isfahan. A purposive sample of 8 nurses and 4 geriatric patients were interviewed in-depth. Colaizzi's analysis method guided the essential activities of the researchers. The reliability and validity of the present study were grounded on the four items (factual value, applicability, consistency and neutrality) suggested by Guba and Lincoln. Results: Three major themes were identified. These were as follows: 1) task-oriented communication, 2) incomplete communication, 3) appropriate communication. Conclusion: Despite emphases on nurse-elder patient communication as a basic element of nursing care for older patients, findings showed that this condition continues to be poor. We can improve the relationship between nurses and elder patients through training communication skills and increasing awareness of nurses on aging phenomena.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/134

Iranian Journal of Nursing and Midwifery Research1735-906610420100210The effect of diet education on blood pressure and weight of the patients with hemodialysis in Kashan135135Ms of Nursing-Community Health Nursing, Ms of Medical Education, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan20101113  Introduction: Since urinary system in patients with hemodialysis cannot function to dismiss the unneeded materials from their bodies, these patients should follow an appropriate diet. To define this diet, the current study aimed to define the effect of diet education on blood pressure and weight of patients with hemodialysis, which was carried out in Kashan. Methods: This was a quasi-experimental research. There were 45 selected patients with hemodialysis in hemodialysis unit of Akhavan hospital in Kashan while they had no special education on any special diet. Their weights and blood pressures were measured and recorded before being connected to hemodialysis device. First, educational papers containing necessary nutritional recommendations were prepared with the guide of a nutritionist who investigated the routine diet in Kashan. These papers were distributed among the subjects. All items were rechecked after two weeks post-education and then, second step education was conducted. After two weeks, the above values were measured and recorded again. Results: The findings showed that the mean weight was 59.84 kg before education while it was 58.93 kg after the first step of education and 58.52 kg after the second step. Analysis by t-test showed a significant difference (P=0.041). Mean blood pressure was 151.3 mmHg before education while it decreased to 140.8 mmHg after the first step of education and 140 mmHg after the second step. Further analysis by t-test showed a significant difference between the mean value of blood pressure before education and that one after the first step of education (P=0.036). Conclusion: Providing enough knowledge on special diet and following that is effective in controlling the weights and blood pressures of patients with hemodialysis. So, educating these patients on their diets considering routine foods of each region not only can prevent many possible complications but minimize their present problems.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/135

Iranian Journal of Nursing and Midwifery Research1735-906610420100210Unwanted pregnancy outcomes136136Ms of Midwifery Maternal and child health, School of Nursing and Midwifery, Isfahan university of Medical Sciences, IsfahanPostDoc of Nursing-Nursing research methodology, Associate Professor of Education, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan, Iran, Hezarjereeb Avenue, IsfahanMs of Midwifery, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan20101113  Introduction: Unwanted pregnancy happens when one of the couples or both did not expect pregnancy. Unwanted pregnancy highly affects health of couples and maternal mortality rate. Nowadays, it is one of the major health problems of under-developed countries. Given the high rate of unwanted pregnancy in Iran, this research tried to investigate its outcomes. Then, the health policy makers can precisely look for practical solutions on family planning and decrease the rate of unwanted pregnancies and their outcomes. Methods: This was a qualitative study based on grounded theory. The participants included women with unwanted pregnancies, their husbands and personnel of health centers. Sample size after data saturation through interviews was revealed to be 18 participants. The data were collected by taped semi-organized interviews recorded for 45-80 minutes. The interviews were conducted in participants' houses with unwanted pregnancies, health centers and in one of the nursing and midwifery faculties in Iran. Strawbert method was applied to analyze the data. Results: The findings indulged through qualitative method regarding unwanted pregnancy outcomes were classified in 82 codes and 4 groups of economic, physical, emotional, family problems and deprivation of social activity. Conclusion: Lack of knowledge, motivation and insufficient understanding of couples regarding consequences of unwanted pregnancy caused their ignorance concerning family planning. So, the spouses should equally have family planning counseling to modify their attitudes and functions towards health systems. http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/136

Iranian Journal of Nursing and Midwifery Research1735-906610420100210Comparison of premarital educational needs among would-be spouses in Molahady center137137Instructor of Midwifery, School of Nursing and Midwifery, Isfahan university of Medical Sciences, IsfahanPediatriacian, Beheshti Hospital Felezy Brij Motahary St Isfahan IRAN, Isfahan university of Medical Sciences, IsfahanMs of Medical Edducation, Instructor of Fundamental Nursing, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan20101113  Introduction: One of the most important events in life is marriage. Premarital counseling can help would-be spouses first to get knowledge and then, get married. Since, educational need assessment studies are essential to design every educational program, this study tried to evaluate the educational needs of would-be spouses and to compare them between men and women. Methods: This research was a descriptive-comparative study with the goal of assessing educational needs of would-be spouses in 4 fields (reproductive health, family planning, diseases and prevention of common cancers) in 300 women and men carried out in Molahady center in Isfahan in 2004. Data were collected by a questionnaire with 57 questions in 2 sections (demographic and educational subjects). Descriptive statistical methods and t-test were used to analyze the data. Results: Findings of this study indicated significant differences between men and women's educational needs in all fields (P<0.05) with the exception of cancer prevention. Also, all samples in both groups needed education in all four fields. Conclusion: Premarital counselors must be aware of premarital educational needs of would-be spouses and then, design educational programs according to these needs. Inclusion of above-mentioned four fields, investigated by this study, in designing educational programs is suggested.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/137

Iranian Journal of Nursing and Midwifery Research1735-906610420100210Occurrence and predisposing factors of phlebitis in patients with IV therapy13813820101113Introduction: Catheterization is the most common invasive and stressful treatment for inpatients. In addition to pain, it may complicate the patient's life. One of these complications is phlebitis. Phlebitis is a serious complication that causes an unexpected increase in hospitalization period and treatment costs. It may cause sepsis and emboli. The accepted rate of phlebitis is 5% or less, while some studies reported the rates of 25-70 percent. The main objective of this study was to determine phlebitis rate and its predisposing factors in surgical wards of Ardabil hospitals. Methods: This study was a descriptive cross-sectional one. In this study, 400 cases with catheters in surgical wards of hospitals were randomly selected and studied. In this study, the peripheral catheter of patients over 12 years was studied and parameters such as demographic data, diagnosis, catheter type, drugs, solutions, catheterization period, vein, dressing type and rate of phlebitis were studied and then, the data were analyzed with SPSS. Results: Results showed that about one-third of patients (31.9%) had catheter for 4 days. Most catheters (37%) were inserted in cephalic veins. The occurrence of phlebitis rate was 19.6 percent in 72 hr while post-infusion phlebitis rate was 16.5 percent. In most cases (85%), catheters were covered with no sterile dressing. Conclusion: Given the high rate of phlebitis in this study, it seems necessary to conduct education on more appropriate application of catheters in patients in order to diminish phlebitis rate.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/138

Iranian Journal of Nursing and Midwifery Research1735-906610420100210The effect of postpartum exercise on mothers' quality of life139139Ms of Midwifery, School of Nursing and Midwifery, Isfahan university of Medical Sciences, IsfahanAssociate Professor of Medical Education, Isfahan University of Medical Sciences- Hezar Jerib Ave, Medical Education Research Center20101113  Introduction: In postpartum period, mothers are exposed to some potential complications that harm their health. Therefore, extra cares for promoting their health are necessary. Encouragement of mother to exercise and support her in this regard is one of the efficient health care interventions, but its effect on postpartum health status of mother has not been assessed yet. Methods: This was a prospective quasi-experimental study that covered 62 women divided into two groups. Intervention group included mothers exercising in postpartum period while control group included those not. The subjects were selected by convenience sampling method. The data were collected through questionnaires. The data were analyzed with SPSS. Results: In six weeks after childbirth, the mean scores of general, social and psychological health status of intervention group were significantly higher than those in control group. There were significant differences between the two groups (P<0.001, P=0.01 and P=0.005, respectively). But, there was no significant difference in physical health status between the two groups (P=0.082). Subscales were significantly higher in intervention group. Two groups were matched in demographic variables. Conclusion: The health status of intervention group was better than that in control group.  Therefore, instruction and encouragement of mothers to do postpartum exercise and support them in this track is beneficial to mothers' health and their qualities of life. http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/139

Iranian Journal of Nursing and Midwifery Research1735-906610420100210Nurses' clinical thinking and decision making140140Assistant Professor of Nursing Education, Nursing & Midwifery School, Isfahan University of Medical Sciences, IsfahaPhD of Nursing-Oncology Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, IsfahanInstructor of Fundamental Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan20101113  Introduction: Nowadays in health care arena, the nurses are increasingly confronting constantly changing complicated situations. These unreliable and unstable situations require nurses with the ability of decision making. Since decision making became more complex, critical thinking is necessary. Because of the importance of critical thinking and clinical decision making in modern nursing, this study aimed to estimate capacities of nurses and to evaluate the relationship of critical thinking and clinical decision making. Methods: This research was a cross-sectional descriptive analytic study. The study was planned with the purpose of detection of relationship between critical thinking and clinical decision making of nurses in general and intensive care wards. Furthermore, it was to compare nurses of general wards with nurses of intensive care units. This study was conducted on 140 nurses in two groups (70 nurses from the general wards and 70 nurses from the intensive care units). The samples were selected based on stratified random sampling and the data were collected by a questionnaire. This questionnaire consisted of three parts including 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. Results: Mean scores of critical thinking and clinical decision making for nurses of intensive care units were 10.61 and 63.27, respectively. For nurses of general wards, they were 10.67 and 61.66, respectively. The results didn't show any difference between mean scores of critical thinking in nurses of intensive care units and those of general wards. Also, there was no difference between mean scores of clinical decision making in nurses of intensive care units and those of general wards. The result didn't show any relationship between critical thinking and clinical decision making in nurses. Conclusion: The findings showed that mean score of critical thinking in nurses is low. The reason can be due to the defects either during university training or professional ones during working period. Some experts claim that the 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.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/140