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Showing 11 results for Nursing Care

Reza Abbaschian, Azar Avazeh, Soheyla Rabi Siahkalis,
Volume 1, Issue 1 (9-2011)

  Background and Objectives: Nurses are among the most influential human resources in health systems. Job satisfaction can increase efficiency of systems and commitment of employees to organizations. Identifying the effective factors on job satisfaction can help to increase job satisfaction and motivation of nurses to perform their tasks appropriately. This study was conducted to determine job satisfaction and its related factors among nurses working in the public hospitals of Zanjan.

  Material and Methods: In this cross-sectional study, we recruited 472 nurses from public hospitals at Zanjan University of Medical Sciences using stratified random sampling. Data gathering tools included a researcher–made questionnaire including 25 items in the areas of job security, management style, work environment, facilities, salary and benefits, self-concept and social image of nurses. Data were analyzed using descriptive statistics and chi-square test in the SPSS.

Results: The job satisfaction among nurses was moderate (51.2±1.87). The highest mean score (62.2 ± 2.39) was related to the social prestige of the nursing profession in society. The lowest average scores were related to satisfaction with work and welfare (44.82 ±2.62), and rights and benefits (45.76±2.63), respectively. Conclusion: Facilities, working conditions, and salary and benefits were the most important factors affecting job satisfaction. It seems to be necessary to adjust the work hours, and shifts to enhance the quality of nursing care and nurse satisfaction

Yosof Mortazavi, Asieh Khalilpour Marz, Omleyla Rabiee, Zahra Rohi , Samaneh Ghomi,
Volume 3, Issue 1 (9-2013)

Background and Objectives: Patient satisfaction is an important concept and priority in health system. The aim of this study was to assess patients' satisfaction from nursing care in hospitals of Iran University of Medical Sciences. Materials and Methods: In this cross-sectional study, 450 patients who had undergone surgery during six months were selected to the study. Data were collected using a self-structured questionnaire. Patients' satisfaction was measured in a 5-point Likert scale. Results: The overall satisfaction of patients pre- and post operation was at an optimum level of 83.6% and 89.1%, respectively. The mean overall satisfaction with nursing care was not statistically significant before and after the surgery. Patients' satisfaction after the surgery was significantly related to the education, gender and residential area (p<0.05). Conclusion: Most patients were satisfied with the nursing care before and after the surgery. Patient satisfaction should be measured at the time of discharge as an evaluation index.

Sona Pashaee, Sima Lakdizaji, Azad Rahmani, Vahid Zamanzadeh,
Volume 4, Issue 1 (9-2014)

Background and Objectives: Caring is central to the nature of nursing. Due to the special conditions of patients in the critical care wards, caring behaviors are important to be considered. Despite the important role of nurses in quality of care, viewpoints of nurses on the caring behaviors are unclear. This study investigated the views of critical care nurses toward caring behaviors priorities. Materials and Methods: In this descriptive-correlative study, 200 critical care nurses were selected based on the stratified random sampling. Data were collected using the Caring Questionnaire developed by Larson. Caring behaviors were ranked on a 5-point Likert-type scale with 57 caring behavior items ordered in six subscales. The data were analyzed using the statistical methods in the SPSS-21.0. Results: Results showed that the highest priority was related to the "confident communication with patients" and the lowest priority was related to the "being accessible" and "anticipation". Furthermore, nurses ages had significant relationship with physical relaxation, confident relationship and follow-ups through subgroups (p=0.01). Female nurses ranked "monitors and follow-ups through" higher than male nurses (p=0.01). Conclusion: Most nurses based their work according to the confident communication with patients. The availability and anticipated needs of the patients care were identified as the lowest priorities. Providing long-term and short-term programs by policymakers in order to conduct appropriate trainings are recommended.

Abolfazl Artishedar, Masoumeh Mortaghi Ghasemi, Mohammadhossein Agha Jamaat, Zeinab Ghahremani,
Volume 4, Issue 2 (3-2015)

Background and Objectives: The population of elderly is increasing worldwide. Chronic diseases and disabilities arecommon among elderly. Attitudes of health care providers including nurses on elder people affect the quality and priorities of health and medical care. The aim of this study was to assess the attitudes of nurses working in medical-surgical wards in Zanjan hospitals toward elderly. Materials and Methods: This cross-sectional study was carried out using random sampling to recruit 110 nurses working in medical-surgical wards. Data were collected using the Kogan questionnaire and were analyzed using the T-Test and ANOVA. Results: In this study, 107 nurses (97/3%) had positive attitudes toward the elderly. The attitude scores were not significantly different in subgroups of gender, marital status, age, education, employment, work experience, job location, residency, living with an elderly, having or not having income of the elderly. Conclusion: Interventions to improve attitudes of nurses toward elderly seem to influence the quality of care provided by nurses.

Leili Yekefalah, Tahere Ashktorab, Homan Manouchehri, ,
Volume 4, Issue 2 (3-2015)

Background and Objectives: The concept and meaning of futile care depends on the existing culture, values, religion, beliefs, medical achievements and emotional status of a country. We aimed to elaborate the concept of futile care from view points of nurses working in critical care units in Iran. Materials and Methods: The participants of this phenomenological study included 25 nurses working in the ICUs. Face-to-face interviews and observations were used to collect data. All interviews were recorded and codes and themes were extracted using the Van Manen's analysis method. Results: Initially, 191 codes were extracted. During data analysis and comparisons, the codes were reduced to 178 ones. Ultimately, nine sub-themes and four themes were emerged. The participants defined the futile care as: “useless and ineffective care that wastes resources and irritates and annoys the patients and nurse and includes Nursing and medical aspects”. Conclusion: Regarding key role of nurses in managing futile care, being aware of their experiences in this regard could be the initial step for providing useful care and delivering educational programs in ICUs.

Fatemeh Mahdavisaeb, Mahin Ruhani, Nasrin Hanifi, Kurosh Kamali,
Volume 6, Issue 1 (6-2016)

Background and Objectives: The high clinical competency of Critical Care Nurses (CCNs) is required, as the quality of nursing care in critical care units (CCUs) with critically ill patients is extremely important. This study was conducted to compare CCNs' clinical competency using self-assessment method and assessment by their Head nurses.

Materials and Methods: This cross-sectional study was conducted on 148 CCNs who were included in the study in a period of six months (June -November 2014), in the hospitals of the Zanjan university of medical sciences. Data was collected using Nurse Competency Scale (NCS) which assesses 63 skills in seven different domains. The Cohen's kappa coefficient was used to compare the agreement between the clinical competency and the use of skills in CCNs and their head nurses.

Results: The inter-rater agreement was poor between the nurses and their Head nurses in the evaluation of the clinical competency, and in two aspects was very poor. The "Quality assurance" (0.098) and the" Helping Role" (0.373) domains had the lowest and the highest level of agreement, respectively. The inter-rater agreement of the use of skills by nurses was reported very poor in all domains.

Conclusion: The current study revealed that there is no agreement between the evaluation of CCNs' clinical competency by own nurses and their head nurses indicating these two methods are not interchangeable.

Masoumeh Masoumi, Nasrin Hanifi, Mohammadreza Jamshidi, Soghrat Faghihzadeh,
Volume 6, Issue 1 (6-2016)

Background and Objectives: Oral care is a fundamental activity in nursing care. Providing oral care for ill patients, who are not able to keep their oral care, would provide comfort for patients and prevented them from oral lesions. This study was conducted to compare of the effect of Ozone water with Chlorhexidine in prevention of oral lesions in patients in critical care units.

Materials and Methods: This randomized controlled trial was carried out on 74 patients under mechanical ventilation in intensive care unit of Mousavi hospital in Zanjan. The participants were selected preliminary using convenience sampling, and then allocated randomly to two groups of intervention (n=39) and control (n=35) groups. Data was collected using the Beck Oral Assessment Scale (BOAS) scale. The data were analyzed using univariate statistical analysis (independent t statistical tests, Fisher's exact test, and Cochran Q (in SPSS16.

Results: The results of the study showed that the mean score of oral lesions according to BOAS in intervention group was almost the same as control groups by the third day of intervention. However, the mean score of oral lesions in the intervention group was reduced statistically compared to control group (P=0/013) on the fourth day.

Conclusion: The results of the current study revealed that Ozone water is more effective than chlorhexodone in prevention of oral lesions.

Maryam Zaeimi, Farhad Ramazani-Badr, Mohsen Bahrami,
Volume 6, Issue 4 (3-2017)

Background: Underlying diseases and aggressive procedures, such as different types of surgery and care, for patients with critical conditions in intensive care units (ICU) may be associated with physiological disorders.

Objectives: This study intended to determine the effect of therapeutic touch on physiological variables of patients undergoing mechanical ventilation in ICU.

Methods: This randomized clinical trial with a control group was conducted on 60 mechanically ventilated patients hospitalized in internal and adult intensive care units of educational hospitals of Zanjan University of Medical Sciences from 22 November 2014 to 22 June 2015. Patients were randomly divided into the intervention and placebo groups. Therapeutic touch was administered in four sessions. Physiological variables, such as Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial

Pressure (MAP), and Heart Rate (HR) were recorded in both groups before and after each therapeutic touch session. Data was analyzed using SPSS 21.

Results: The results from comparison of physiological variables in the intervention group before each session showed a significant reduction only in heart rate (p<0.001). Moreover, results from comparison of physiological variables in the intervention group after therapeutic sessions showed significant differences in SBP (p=0.025), MBP (p=0.033), and HR (p=0.002).

Conclusion: It seems that therapeutic touch can result in a greater stability of some physiological variables of mechanically ventilated patients, if it is administered frequently for long term.

Arezoo Monfared, Mostafa Soodmand, Golshan Ghasemzadeh,
Volume 7, Issue 1 (6-2017)

Background: Delirium is a common problem in patients hospitalized in Intensive Care Unit. Despite the importance, only less than 13% of cases are diagnosed by physicians and medical personnel.

Objectives: The present research aimed to study knowledge and attitude of critical care nurses towards delirium.

Methods: This cross-sectional study was conducted in Iran. Convenience sampling was used to enroll nurses (186 persons) working in intensive care units of Rasht educational hospitals affiliated to Guilan University of Medical Sciences in 2015. Data collection instruments included a three part questionnaire: demographic data, 15- item questionnaire formerly used by Guthrie and Sendelbach (2009) on nurses’ knowledge about delirium, and 10-item questionnaire adopted from Herrero et al on attitude of the nurses towards delirium. The obtained data were statistically analyzed using descriptive statistics, Pearson's correlation coefficient and t- test in SPSS-20.

Results: The majority of nurses (68.3%) have intermediate knowledge about delirium and only 24.6 percent reported good knowledge and 76 percent had positive attitude about delirium.

Conclusion: Nursing knowledge and awareness have a significant role in improvement of the quality of healthcare and preventive measures, as well as the attitude of nurses towards dealing with delirium patients. Hence, it is recommended to give greater importance to academic courses and ongoing post-graduation professional development programs in the workplace, as a globally practiced healthcare quality improvement strategy.

Fatemeh Teymouri, Fatemeh Alhani, Anoshiravan Kazemnejad,
Volume 7, Issue 1 (6-2017)

Background: Asthma is considered as the most common chronic disease of childhood that can cause missing school and daily limits. It can also have effects on physical, psychological, and social well-being in children. Therefore, improving two indicators of self-efficacy and self-esteem seem of utmost importance in this domain.
Objectives: The purpose of this study was to determine the effect of family-centered empowerment model (FCEM) on self-efficacy and self-esteem in children with asthma.
Methods: In this quasi-experimental study, 60 children along with their parents were randomly divided into two experimental and control groups. Then, family-centered empowerment model was implemented for the experimental group lasting seven 30-minute sessions. After that, self-efficacy and self-esteem were similarly evaluated by distributing questionnaires in both groups before and after the intervention. Moreover, the data were analyzed using the SPSS Software as well as descriptive statistics (frequency, mean, and standard deviation) and inferential statistics (Chi-square test, Fisher’s exact test, independent t-test, and paired t-test).
Results: The self-efficacy scores of all children in the experimental group before (2.95±0.33) and after (3.97±0.49) the intervention showed a significant difference (P=0.0001). Meanwhile, a significant difference was observed in the self-esteem scores of all children in the experimental group before (0.62±0.13) and after (0.77±0.08) the intervention (P=0.0001), while self-efficacy scores of the individuals in the control group before (2.86±0.49) and after (2.88±0.40) the intervention suggested no significant difference (P=0.607) in this respect. Furthermore, there was no significant difference in self-efficacy scores of the control group before (0.67±0.17) and after (0.67±0.13) the intervention (P=0.845).
Conclusion: It seems that empowerment (FCEM) of children suffering from asthma can lead to increased self-efficacy and self-esteem and help them to have an efficient care, and also may result in improvements in their roles. Therefore, further studies are recommended in this domain.

Khalil Yosefi, Mohammadreza Dinmohammadi, Mahdi Moosaeifard, Soghrat Faghihzadeh,
Volume 7, Issue 2 (10-2017)

Background: Dialysis adequacy is one of the most important factors in determining the survival rate and mortality of dialysis patients.
Objectives: The aim of this study was to determine the dialysis adequacy of patients undergoing chronic hemodialysis at dialysis centers located in the province of Zanjan, located in northwest Iran.
Methods: This descriptive cross-sectional study was performed on 257 patients undergoing chronic hemodialysis with an available sampling method in 6 dialysis centers in the province of Zanjan. The hemodialysis sessions were performed for 3 to 4 hours using via synthetic filters and bicarbonate dialysate. To determine the adequacy of dialysis, serum BUN levels were assessed before and after dialysis. The standard software provided by the Ministry of Health was used to calculate the adequacy of dialysis and Kt/V was considered to be at least 1.2.
Results: The most common underlying causes of chronic dialysis were hypertension (41.2%) and diabetes mellitus (35.8%), respectively. Mean Kt/V and URR were 1.26±0.34 and 63.55±9.5%, respectively. The difference among these indexes was significant between men and women (p<0.05). Also, dialysis adequacy was significantly associated with increased dialysis frequency, blood flow rate, interdialytic weight gain, vascular access and dialysis shift (p<0.05).
Conclusion: Despite the relatively favorable dialysis adequacy among patients, this index is highly variable based on patient gender, the dialysis center, location, frequency of dialysis, blood flow rate, interdialytic weight gain, type of vascular access and dialysis shift. Therefore, serious attention and greater caution are recommended among the dialysis centers of the province

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