Comparison of adolescents’ Satisfaction with professional Care in Pediatric versus adult wards in Isfahan

AbstractBackground and aim:Adolescence is a unique physical, cognitive, and psychosocial development period. Adolescent hospitalization could lead to many adverse effects on adolescent and causes problems in all areas. Lack of understanding of adolescents needs could impact on providing care. The aim of this study is to assess adolescents’ satisfaction with professional Care and compare it in two groups of adolescents hospitalized in children and adult wards.Material and Methods:In a cross sectional comparative and descriptive study the satisfaction questionnaires were filled out by 200 adolescents 10- 19 year-old hospitalized in Amin and Alzahra hospitals in Isfahan city. They were selected by convenient sampling method. Data were analyzed by SPSS version 11.5 and via t student ,Mann witney tests and person coefficient.Results:Average satisfaction score with nursing services in teens who hospitalized in pediatric wards was significantly higher than those admitted in the adult’s ward, but there was no statistically significant difference between the two groups in terms of medical and other personnel services. 87 percent of adolescents who were hospitalized in adult’s wards and 35.3 percent of teens who were hospitalized in the children wards preferred to be admitted in the adolescent’s ward.Conclusion:In the present study, satisfaction level of adolescents with nursing services in pediatric ward was higher than those in adult’s ward. Most of adolescent want to hospitalize in adolescents’ ward. So it is suggested if it is not possible to prepare adolescent‘s ward for their care, it is better they hospitalized in children ward .Key Words: patient satisfaction, adolescent, hospitalization, nursing care, hospital, medical car

Effect of implementation of continuous care model on mothers' anxiety of the children discharged from the pediatric surgical unit

Introduction: Child's hospitalization for surgery is a source of anxiety for the child and the family that persists for a long time after discharge. Therefore, it is necessary to provide appropriate solutions in this regard. This study aimed to investigate the effect of implementation of continuous care model on anxiety in mothers of children discharged from pediatric units of educational hospitals of Isfahan University of Medical Sciences in 2016. Materials and Methods: In this quasi-experimental study, 64 mothers of children hospitalized in surgical units were categorized in two groups (experimental and control). The intervention was a continuous care model including orientation, sensitization, follow up, and evaluation stages. We used Spielberg's Anxiety Questionnaire to assess mothers' anxiety before, 1 week, and 1 month after the intervention. Data were analyzed using descriptive statistics, (t-test and analysis of variance) using the Statistical Package for the Social Sciences version 16. Results: The results of the study showed that the mean anxiety scores of the experimental group were 58.9, 36, and 31.4, respectively, before, 1 week, and 1 month after the intervention (P < 0.001). These scores were 57.5, 55.8, and 49.7, respectively, for the control group. t-test results showed that the mean anxiety scores of the experimental group were significantly less than that of the control group at 1 week and 1 month after the intervention. Conclusions: Based on the results, use of the continuous care model led to a decrease in mothers' anxiety during their children's discharge from the pediatric surgery units. Therefore, we suggest the implementation of this model in pediatric units

Evaluating the effect of lifestyle education based on health belief model for mothers of obese and overweight school-age children on obesity-related behaviors

Background: Nowadays, childhood obesity is a matter of significant concern because of its negative effects on personal health and harmful socioeconomic consequences. The purpose of the present study was to evaluate the effectiveness of lifestyle education based on the health belief model for mothers of obese and overweight school-age children on obesity-related behaviors. Materials and Methods: In this quasi-experimental study, 64 obese and overweight elementary students and their mothers who met the inclusion criteria participated. The participants were randomly categorized into two groups (experimental and control). The experimental group received the considered interference, which consisted of four educational sessions based on the health belief model. Data collection tool was a standard questionnaire. The questionnaire filled by the participants during interviews conducted before, immediately after, and two months after the intervention. Data were analyzed using Mann–Whitney, Chi-square, student's t-test, repeated-measures analysis of variance, and least significant difference tests. Results: Mean scores of obesity-related behavior before the intervention were not significantly different between the experimental and control group (53.41 (6.78). vs 54.72 (4.63); P= 0.37), however, were different immediately after (58.41 (6.88) vs 54.81 (4.66); P= 0.02) and two months after the intervention (62.34 (8.62) vs 55.84 (7.59); P= 0.002). Conclusions: This study indicated the effectiveness of lifestyle education based on the health belief model for improving obesity-related behaviors. Therefore, the use of this educational program is recommended for mothers

Effect of environmental and behavioral interventions on pain intensity in preterm infants for heel prick blood sampling in the neonatal intensive care unit

Background: Recent researches suggest that preterm infants understand pain and stress. Because of the wide range of effects of pain on infants, the present study was conducted on the effect of environmental and behavioral interventions on pain due to heel-prick blood sampling in preterm infants. Materials and Methods: A clinical trial was conducted among 32 infants with gestational age of 32–37 weeks in the intervention and control groups. The effects of noise reduction by earplugs, light reduction by blindfolds, reduction of nursing manipulation, and creation of intrauterine position for neonates, 30 minutes before taking blood samples until 30 minutes after it, were measured during the intervention stage. Data were collected using the Neonatal Infant Pain Scale (NIPS) in 5 stages (before intervention, 2 minutes before sampling, during the sampling, and 5 minutes and 30 minutes after the sampling). The data were analyzed using analysis of variance (ANOVA) and paired t-test in SPSS software. Results: The paired t-test results showed no significant differences between the control and intervention stages in terms of pain scores at base time (P = 0.42) and 2 minutes before sampling (P = 0.12). However, at the sampling time (P = 0.0), and 5 minutes (P = 0.001) and 30 minutes after the sampling (P = 0.001), mean pain score in the intervention stage was significantly less than that in the control stage. Conclusions: Based on the findings, environmental and behavioral interventions reduced pain and facilitated heel-prick blood sampling in preterm infants

Comparative investigation of indicators of growth and behavioral disorders in children with normal, low, and very low birth weight at pre-school age in Isfahan during 2015

Introduction: Birth weight is one of the most important indicators of infant's health and could predict their health condition in future. This study was conducted to determine and compare indicators of growth [weight, height, and body mass index (BMI)] and behavioral disorders in children with normal, low, and very low birth weight at pre-school age. Materials and Methods: In this descriptive analytical study, 236 children (126 with normal weight, 100 with low birth weight, and 10 with very low birth weight) at pre-school age were investigated in three groups. Data collection tools were a two-part questionnaire including the Rutter Children Behavior Questionnaire for parents, and parents' and children's demographic characteristics questionnaire, scale, and stadiometer. Data were analyzed using descriptive statistics, variance analysis, Chi square, and Kruskal–Wallis tests. Results: The mean of weight, height, and BMI at pre-school age in three groups had a significant difference (P = 0.009) and it was lower in the group with very low birth weight than the other two groups; however, the difference between the group with normal birth weight and the group with low birth weight was not significant (P = 0.10). The mean score of behavioral disorder had no significant difference between groups (P = 0.49). Conclusions: Results showed that children with very low birth weight grew less than the other two groups. Therefore, this group needs special attention and long-term follow-up for taking care of them to ensure better growth. It is recommended to conduct more extended studies to evaluate behavioral disorders in these children

Effect of Different Positions on Arterial Oxygen Saturation during Enteral Feeding of Preterm Infants Admitted to Neonatal Intensive Care Units

Background: This study aimed to determine the effects of various positions on the arterial oxygen saturation during enteral feeding of preterm infants admitted to Neonatal Intensive Care Units (NICUs). It is assumed that different body positions influence arterial oxygen saturation during enteral feeding.Methods: This crossover clinical trial included 88 infants. The inclusion criteria were gestation age of fewer than 32 weeks, a weight of 1001-1500 gr, age of fewer than one month, 5-minute Apgar score of at least 5, exclusive breast-feeding, absence of any underlying illness, no oxygen therapy, and a minimum feed volume of 10cc for two h. The subjects were selected from the infants admitted to NICUs at Alzahra, Shahid Beheshti, and Amin hospitals, Isfahan, Iran, using a convenience sampling method. Subsequently, they were randomly assigned to four groups of 22 cases per group. The four groups were A, B, C, and D who were initially positioned on the left side, supine, prone, and right side, respectively. The arterial oxygen saturation was recorded on a minute-by-minute basis 5 min before, during, and 5 min after enteral feeding. Data were analyzed in STATA software (version 14) using a one-way analysis of variance, (ANOVA), linear mixed model, and the Chi-square test.Results: According to the results of the one-way ANOVA and Chi-square test, no significant difference was observed among the four groups regarding the demographic characteristics. Moreover, the linear mixed model revealed no significant difference among the four groups of intervention, the four periods of the study, and carryover effect in terms of the mean oxygen saturation before, during, and after enteral feeding.Conclusion: The results revealed that variations in infant positions during feeding had no effects on the arterial oxygen saturation. Therefore, neonatal nurses are advised to carry out enteral feeding without unnecessary changing of the infant position, which leads to lower manipulation, and improved sleep and awakening cycle of the infants

The impact of a neonatal sleep care training program on nurses' knowledge and performance in neonatal intensive care units

Background: Sleep is essential for organizing and maturation of the brain in premature infants; it also plays a role in maintaining the natural balance between different nervous centers. Given the role of nurses in neonatal sleep care, this study aimed at assessing the impact of a training program on the nurses' knowledge and performance in a Neonatal Intensive Care Unit (NICU). Materials and Methods: In this quasi-experimental study which structured into three stages, 35 nurses working in an NICU in Isfahan, Iran, were included. The neonatal sleep training program was in the form of a lecture with questions and answers and then placing posters and booklets in the NICU. The data were collected by a questionnaire for nurses' knowledge and performance assessment which its validity and reliability were determined through content validity and internal consistency, respectively. The nurses' knowledge was assessed via 40 multiple-choice questions before, immediately after, and 1 month after the training program, and their performance was evaluated before and 1 month after intervention using 15 multiple-choice questions. The data were analyzed by descriptive and inferential statistics using the SPSS software version 16. Results: The results showed that the mean score of nurses' knowledge after training has significantly increased as compared to before training (33.33 (4.4) vs. 19.33 (4.1)) (P < 0.001); however, the score of performance was slightly improved although it did not reveal any significant differences (P = 0.07, 42.6 (7.6) vs. 45.1 (7.8)). Conclusions: The results indicated that this method of training program could lead to an increase in nurses' knowledge, but it did not significantly improve their performance. It may be due to a low number of training sessions; therefore, it is recommended to implement long-term training programs in this field

Effect of peer education on the noise management in Iranian neonatal intensive care unit

Background: Advancements in neonatal intensive care unit (NICU) science and technology have increased the survival rate of preterm infants. Despite these advances, they are still facing with neurobehavioral problems. Noise level in NICU is a potential source of stress for preterm infants. It should be decreased to the standard level as much as possible. The purpose of this study was to evaluate the effect of peer education on the performance of staff in noise management in the NICU. Materials and Methods: A pre-post test quasi-experimental design was used. Fifty-eight staff members (nurses and physicians) participated in this study. Sound pressure levels were measured before and after the intervention. Peer education program formed the intervention. The staff performance in noise management was evaluated before and after the intervention by using a questionnaire. Data analysis was done by using t-test. Results: The results of the study showed that the mean sound level in different environments significantly decreased after the intervention. It reached from 86.7 to 74.9 dB in the center of unit and from 68.2 to 48.50 dB in the infants' bedside (P < 0.0001). The mean score of the staff performance in noise management significantly increased after the intervention, compared to the pre-intervention score. It increased from 74.6 to 83.4 (P < 0.0001). Conclusions: Peer education was found to be successful in noise management because behavioral changes were done to avoid generating unnecessary noise by the staff

Developmental skills of 36-60-month-old children in Isfahan daycare centers in 2013

Background: Assessment of developmental skills is one of the most essential components of children's health evaluation. Since several pubertal disorders are caused by parental negligence in diagnosis, prevention, and treatment of childhood problems, failure to make a timely diagnosis of these problems could have adverse effects on the health of children in future. This study was conducted to determine the developmental skills of 36-60-month-old children in Isfahan. Materials and Methods: In this cross-sectional study, 196 children, aged 36-60 months, were recruited through random cluster sampling. “Ages and Stages” questionnaire was filled for each subject by their parents (father, mother, or both), and the frequency of developmental delay was determined based on cut-off points. The data were analyzed by descriptive statistics using SPSS 20.0. Results: About 52.6% of the children were male. Mean age of the children was 50.71 (SD = 8.16) months. The abnormal findings were in the five domains of communication (1.5%), gross motor (3.1%), fine motor (7.7%), problem solving (7.7%) and personal-social (2%). Conclusions: The results suggest that some of the children had scores below or equal to the cut-off points and needed more evaluation by a professional person. The domains in which the children had problems were fine motor, problem solving, and gross motor. Therefore, health staff should pay more attention to assessment of these domains and parents should be trained to develop their children's skills in these domains