The Necessity of Nursing Prescription from the Perspectives of Nursing Policymakers

Introduction: Presently, in many countries, certain groups of nurses are allowed to prescribe medicine. Despite the increasing attention of the world to nursing prescription and emphasis of the World Health Organization (WHO) on its implementation in regional countries, a review of literature indicated that there is no evidence of nursing prescription in Iran. Thus, this study aimed to assess the necessity of nursing prescription from the perspective of the Iranian nursing policymakers. Method: This descriptive qualitative study was performed through interviews with 14 nursing policymakers. The participants were selected through purposive sampling method. Semi-structured interviews were used to collect data. Interviews were conducted after coordination with participants and in their workplace. All interviews were recorded using a digital voice recorder. Interviews were simultaneously transcribed verbatim and analyzed using conventional content analysis through inductive approach. The coding was performed using MAXQDA software. To achieve the accuracy and reliability of the data, the Lincoln and Guba authenticity criteria were used. Results: Analysis of the recorded interviews resulted in the extraction of the 3 main categories of "the right to health and individual’s requirements", "the current situation of the clinical setting", and "nursing prescription outcomes". Conclusion: The views and perspectives of nursing policymakers indicated that due individuals’ right to health and need for health care services, and also the positive outcomes that may result from nursing prescription, the necessity of its implementation is felt. However, there are challenges to its implementation that require the relevant authorities' efforts to resolve them. Keywords: Drug prescription, Nursing policymakers, Qualitative research

Prognostic Factors for Survival at 6-Month Follow-up of Hospitalized Patients with Decompensated Congestive Heart Failure

Abstract:BACKGROUND: The prevalence of Congestive Heart Failure (CHF) is increasing in recent years. Factors associated with mortality in CHF patients are important to be determined in order to select therapeutic modality by physicians. The purpose of the current study was to declare predictors of 6-months survival in patients hospitalized for decompensated CHF in Isfahan.METHODS: A cohort of 301 hospitalized patients with decompensated CHF were recruited in this study. The diagnosis of CHF was based on previous hospitalizations and Framingham criteria for heart failure (HF). Information regarding past history, accompanying diseases such as cerebrovascular accidents (CVA), chronic obstructive pulmonary diseases (COPD), clinical data, medications and echocardiography were obtained by a cardiologist. Patients were followed for their survival for 6 months by telephone calls. Kaplan-Meier method was used for uni variate survival analysis and Cox proportional hazard model was used for multivariate analysis.RESULTS: Mean age of patients was 71.9 &plusmn; 12.2 years and 59.8% was male. During 6-months follow-up 138 (45.8%) patients died. Mean survival was 119.2 &plusmn; 4.4 days (Mean &plusmn; SEM). Significant prognostic factors for 6 months survival were high education level (HR = 0.74, CI 95% 0.59&mdash;0.93), COPD (HR = 1.91, CI 95% 1.2&mdash;3.04), CVA (HR = 1.69, CI 95% 1.03&mdash;2.78), Angiotensin Converting enzyme (ACE) inhibitors use (HR = 0.44, CI 95% 0.3&mdash;0.66) and Diuretics (HR = 0.63, CI 95% 0.41-0.96).CONCLUSION: Six-month survival of hospitalized decompensated CHF patients in Iran is not favorable. Many factors particularly accompanying diseases and medications affected the patient&rsquo;s 6-months survival.Keywords: Heart failure, Survival,&nbsp; Mortality.</p

Association between R353Q polymorphism for coagulative factor VII and severity of coronary artery disease in Iranian population

Background: Recent research has supported the central role of coagulative factors in advancing atherosclerosis and causing coronary artery disease (CAD). The present study, for the first time, aimed to clarify the relationship between R353Q polymorphism for factor VII and the occurrence and severity of CAD in a large sample of Iranian population.Methods: Nine hundred and nineteen consecutive patients with suspected CAD, who candidated for coronary angiography in the Tehran Heart Center between January 2006 and March 2007, were examined. The number of diseased coronary vessels was determined, and the severity of CAD was assessed by the Gensini score. Genotyping was done via the PCR-RFLP method.Results: The frequency of Q and R alleles was 74.1% and 25.9% in the patients with CADand 75.2% and 24.8% in those without CAD, with an insignificant difference (p = 0.625). The frequency of Q allele in the patients with single-vessel, two-vessel, and three-vessel diseases was 72.8%, 71.5%, and 76.4%, respectively; the difference was also insignificant (p = 0.379). No relationship was observed between the distribution of the genotypes and the number of the involved coronary vessels. The average of the Gensini score was 43.39 ± 46.18 in the patients with QQ genotype, 38.87 ± 42.89 in those with QR genotype, and 55.61 ± 53.80 in the ones with RR genotype, with the difference not constituting any statistical significance (p = 0.084).Conclusions: The results suggest no association between R353Q polymorphism for factor VII and the presence or progression of CAD in the Iranian population

Caring for People at the End of Life: Iranian Oncology Nurses' Experiences

Aim: To explore the meaning of Iranian oncology nurses′ experiences of caring for people at the end of life. Materials and Methods: A phenomenological hermeneutic approach was applied. Fifteen nurses working in oncology units were interviewed in 2007 regarding their experiences of caring for people at the end of life. Results: Participants experienced caring for people at the end of life as sharing space and time to be lost within an organizational context. This main theme was divided into three subthemes including being attentive to the dying persons and their families, being cared for by the dying persons and their families, and being faced with barriers. Conclusion: The study suggests that the nurses′ success in caring for people at the end of life is reliant on their interpersonal caring relationship. Facilitating such relationship requires the establishment of palliative care unit, incorporation of palliative care into undergraduate nursing studies, and cultural preparation through public education

Exploring the Challenges of Adolescent Mothers From Their Life Experiences in the Transition to Motherhood: A Qualitative Study

Objective: Early motherhood and its impact on mothers, children, families and communities is a prevalent health challenge in developing countries that needs to be urgently explored. The aim of this study was exploring the challenges encountered by Iranian adolescent mothers during the transition to motherhood. Materials and methods: Inductive conventional content analysis approach was used in this qualitative study. Face to face in-depth semi-structured interviews were conducted with 16 Iranian teenage mothers in the Kerman province of Iran from March to December2016. Data collection continued until the point of data saturation and MAXQDA software was utilized in the analysis of the data. Results: Six main categories increasing burden of responsibility, experiencing physical problems, receiving insufficient support, inefficiency in maternal role, emotional and mental distress; and role conflict and 18 sub-categories were extracted from the data analysis. Conclusion: The findings of this study showed that adolescent mothers experience many physical, psychological, mental and social challenges. Therefore, it is expedient that special attention and care support is made available to them by health care providers. A comprehensive understanding of the challenges encountered by adolescent mothers, will aid the development of culturally appropriate health promotion guidelines and strategie

Exploring the experiences of Iranian adolescent mothers about the maternal role: a qualitative study

Background: Early motherhood is one of the most important issues in developing countries. Adolescent mothers are not sufficiently prepared to accept the maternal role. How to achieve success in the maternal role should be studied. Objective: To explore the experiences of Iranian adolescent mothers about the maternal role. Methods: This qualitative study was conducted through a conventional content analysis approach from March to December 2016. Face to face in-depth semi-structured interviews were conducted with 18 Iranian teenage mothers in Kerman province, Iran. Participants were selected purposefully and with maximum variation of the age of the first birth, child's age, place of residence and financial status. Data collection continued until data saturation and MAXQDA software was utilized to analyze the collected data. Results: Data analysis resulted in the extraction of the two main categories including optimizing the process of the maternal experience (use of maximum individual capabilities, planning and management of conditions, efforts to acquire maternal competency, and reliance on spirituality) and supporters for the acceptance of the maternal role (social support, professional services of health care providers, time lapse, care history). Conclusion: Early motherhood is not merely an unpleasant experience; if appropriate strategies and facilitators are used, it can have positive consequences. Health care providers should provide satisfactory services in care, education and support with adequate knowledge of adolescent characteristics. Opportunities in the community should also be directed to support this vulnerable group

Evaluation and Estimation of Water Balance Components in Arid Zone Catchments Using RS and GIS Case Study: Manshad Catchment, Yazd Province

Today, water scarcity is one of the main problems around the world, especially in arid and semi arid regions. Iran is a country that is now faced with water scarcity. One of the effective solutions for water management in arid catchments is determination and analysis of water balance components. So this study has focused on determination of water balance components in arid-mountainous catchment of Manshad in Yazd province, during 2006-2007 cropping season. To estimate actual daily evapotranspiration (ETa) of the region, time series of MODIS images were acquired and used via the surface energy balance algorithm for land (SEBAL)methodology. Annual ETa then was calculated in the form of a pixel by pixel basis map. Also annual precipitation (P) and runoff (R) were calculated using rain gauge and hydrometric station records, respectively. Inaddition soil water storage of the catchment was estimated using double ring installation and infiltration rate measures. After determination of annual P and R, the ET component was calculated as the residual of water balance equation. Then the calculated ET was compared with the estimated ET of SEBAL methodology. Comparisons show the adequacy of SEBAL in estimation of actual ET at the studied condition. Finally, the results of the study show that a large portion of catchment available water wastes through evapotranspiration, nearly540 mm. The runoff and soil storage amounts of the studied year are about 117 and125 mm, respectively