Investigating the degree of self-efficacy perception and role performance of nursery and midwifery college instructors in practical education

چکیده: زمینه و هدف: اگر سلامتی یک جامعه را در گرو خدمات پرستار و ماما بدانیم، شناخت و حل موانع و مشکلات ایفای نقش و خودکارآمدی در آموزش بالینی، می تواند شرایط لازم جهت ایفای نقش بهتر و خودکارآمدتر بودن مربیان را فراهم نماید. از این رو این مطالعه با هدف تعیین احساس خودکارآمدی و ایفای نقش مربیان دانشکده پرستاری و مامایی و ارایه راه‌کارها انجام شده است. روش بررسی: این پژوهش، یک مطالعه توصیفی است که با روش حل مسأله انجام شده است. نظرات کلیه مربیان دانشکده پرستاری و مامایی شهرکرد متمایل به شرکت در پژوهش (29 نفر) با استفاده از ابزارهای بررسی که شامل پرسشنامه ایفای نقش و احساس خودکارآمدی بود مورد بررسی و ارزیابی قرار گرفت. داده ها با استفاده از آزمون آمار توصیفی تجزیه و تحلیل شد. یافته‌ها: در ارتباط با مشکلات مربوط به ایفای نقش، شاخص‌ترین مشکل از دیدگاه این مربیان «فراهم نبودن محیط مناسب برای ایفای نقش مربیان در بالین» با امتیاز 57/127 از 145 بود. در ارتباط با مشکلات مربوط به احساس خودکارآمدی شاخصی که کمترین امتیاز را به خود اختصاص داد و در واقع ضعیف‌ترین احساس خودکارآمدی را در بر داشت، احساس مربوط به «من جهت افزایش اعتماد بنفس خودم، قادر هستم در ارتباط با ایده‌ها و نظریات خودم در صورت لزوم با مسئولین دانشکده در طول ترم تحصیلی بحث علمی نمایم.» بود که با امتیاز 90 از 116 در آخرین رده قرار گرفت. عوامل موثر در ایفای نقش مربیان شامل تاهل، سن، سابقه کار و میزان تحصیلات و عوامل موثر بر خودکارآمدی مربیان شامل سن و نوع استخدام بود. نتیجه‌گیری: با توجه به نتایج حاصل از پژوهش حاضر و دانش، تاهل، سن، سابقه کار و میزان تحصیلات، مهارت و قدرت ایفای نقش یک مربی پرستاری و مامایی را تحت تاثیر قرار داده و توانمندی وی را ارتقاء می بخشد. به هر میزان که این مقوله ها قوی تر باشد، احساس خودکارآمدی مربی پرستاری و مامایی نیز افزایش یافته و تاثیر شگرفی بر کیفیت ایفای نقش وی خواهد گذاشت

The Effect of Empowerment Program Based on the Health Belief Model on the Perceived Satisfaction of People With Acute Coronary Syndrome

Background and Aims Heart disease can affect patients and their families, and society’s biopsychological status. Thus, it is necessary to empower patients to better control the disease and improve their lives. The current study evaluated the effect of empowerment program based on the health belief model on perceived satisfaction in patients with acute coronary syndrome. Methods This clinical trial study was conducted on 70 patients with acute coronary syndrome who were randomly assigned to two intervention and control groups. Initially, perceived satisfaction questionnaires were completed in the two groups; then, the intervention group received a 7-session empowerment program based on the health belief model, and usual care was provided to the controls. Immediately, one month, and three months later, the questionnaire was completed by the two groups. The obtained data were analyzed using the Mann–Whitney U test, Wilcoxon test, and Chi-squared test in SPSS. Results The two groups were matched in terms of demographic variables such as gender, age, and the type and duration of disease (P>0.05). Comparing the level of changes in perceived satisfaction in the two groups revealed that posttest changes were significantly higher in the intervention group, compared to the controls (P<0.001). The mean±SD pretest, immediately after and one month, and three months after the intervention scores of perceived satisfaction changes in the test group were 116.36±33.88, 154.1±29.07, 144.3±27.32, and 127.2±28.58, respectively. Conclusion According to the obtained results, implementing the empowerment program based on the health belief model can increase perceived satisfaction in patients with acute coronary syndrome

The effect of progressive muscle relaxation program (PMR) on anxiety of patients undergoing coronary heart angiography

زمینه و هدف: یکی از راه های تشخیص بیماری های قلب کاتتریزاسیون می باشد که اغلب به ایجاد استرس و اضطراب برای بیمار منجر می گردد. آرامسازی پیشرونده عضلانی یکی از مداخلات غیر دارویی موثر برای کاهش اضطراب بیماران، می باشد. مطالعه حاضر با هدف بررسی تاثیر برنامه آرامسازی پیشرونده عضلانی بر میزان اضطراب بیماران تحت آنژیوگرافی عروق کرونر انجام شد. روش بررسی: این پژوهش یک مطالعه نیمه تجربی بصورت قبل و بعد بود. 146 بیمار که جهت آنژیوگرافی عروق کرونر در بیمارستان قلب شهید رجایی تهران بستری بودند، انتخاب و برنامه آموزشی آرامسازی پیشرونده عضلانی (PMR) به صورت لوح فشرده 45 دقیقه ای در اختیار آنان قرار گرفت. اضطراب جامعه پژوهش قبل و بعد از اجرای برنامه از طریق پرسشنامه محقق ساخته سنجیده و داده ها به وسیله آزمون های آماری کای دو و تی زوجی مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: بین متغیرهای سن، وضعیت تاهل و تاریخچه تشخیص بیماری با عوامل تنش زا ارتباط معنی داری مشاهده نگردید. بین متغیرهای میزان تحصیلات و وضعیت اشتغال، نحوه پرداخت هزینه ها و سابقه بستری در بیمارستان با عوامل تنش زا ارتباط معنی داری وجود داشت (05/0>P). بین میانگین اضطراب بیماران تحت آنژیوگرافی عروق کرونر قبل و بعد از اجرای برنامه اختلاف معنی داری مشاهده شد (01/0

The effect of implementing self-management plan on selfconcept of family caregivers of multiple sclerosis patients

Background and aims: Caring for patients with multiple sclerosis causes family caregivers many problems and challenges. Self-management interventions can facilitate the caring process and increase the quality of patient care. Therefore, the aim of this study was to investigate the effect of a self-management program on Self-concept of the family caregivers of multiple sclerosis patients. Methods: This quasi-experimental study was conducted in 2018 at the MS Treatment Center of Shahrekord. The samples were selected through convenience sampling method. First, participants were assigned to two groups of men and women by stratified random sampling, and then men and women were assigned randomly to intervention (n=35) and control (n=35) groups. For the intervention group, the self-management program was implemented twice a week in 8 sessions. Data collection was performed using the Coopersmith self-concept Inventory in two groups before, immediately after, and three months after the intervention. Data were analyzed by SPSS version 16.0. Results: The mean scores of self-concept in the intervention and control groups before the intervention were 72.6±9.1 and 72±10.6, respectively. There was no significant difference between the mean score of self-concept between the intervention and control groups before the intervention (P>0.05). The mean scores of self-concept immediately after the intervention in the two groups were 86.4±9.2 and 73±10.6, and three months after the intervention, they were 103±7.4 and 73.9±10.5, respectively. A significant increase in the scores of self-concept in the intervention group (P<0.001) was observed. Moreover, the independent t test showed a significant difference in the two groups immediately after and three months after the intervention (P<0.001). Conclusion: Self-management program increased the self-concept of multiple sclerosis (MS) patients’ caregivers. Therefore, self-management can play a critical role in improving the quality of life of family caregivers and coping with the physical and psychological stress related to their caring role. Keywords: Multiple Sclerosis, Caregivers, Self-Management Plan, Self-Concep

t care intensive the in making-decision clinical’ nurses on gram- pro training safety patient based-SBAR of effect the of Evaluation

Background and Aim: ICU is one of the vital departments in the hospital to reduce mortality and morbidity. The department where nurses face complex situations that require decision-making skills. In fact, problem solving is an important and complex issue clinical practice, and decision-making is an important indicator. The purpose of the study was to investigate the effect of SBAR-based patient safety education program on nurseschr('39') clinical decision making in intensive care unit nurses. Methods: The quasi-experimental study was performed on 60 nurses working in intensive care units of Ayatollah Kashani and Hajar hospitals in Shahrekord, Iran in 1398. The subjects were randomly assigned to two experimental and control groups (30 people each). For the experimental group, five SBAR-based training program was held (Situation, Background, Assessment, and Recommendation). Data were collected using Lori et al. (2001) clinical decision making questionnaire before and one month after the intervention respectively. The collected data were analyzed using analysis of covariance in SPSS software (version 22). Results: According to the findings, the clinical decision-making score of the test group nurses before the intervention was 69.1± 5.44 and after the intervention was 80.8 ± 7.22 (P<0.001). In the control group, it was 70.6 ±6.94 before intervention and 71.1 ± 6.72 after intervention (P = 0.214). The rate of changes in the experimental group was 11.7 ± 3.79 and in the control, group was 0.53 ± 2.3. The results of the study showed that the implementation for the patient safety-training program based on SBAR technique had a significant effect on the mean score of clinical decision making of nurses. Conclusion: The program training based on SBAR technique is effective on nurses chr('39')clinical decision-making. Therefore, it is suggested that HEC and planners benefit from this technique. Keywords: Nurses Clinical Decision-making Technique (Status, History, Evaluation, Recommendation), Intensive Care Ward, Clinical Deliver

Identification of Concepts of Spiritual Care in Iranian Peoples with Multiple Sclerosis: A Qualitative Study

Living with multiple sclerosis (MS) often needs attention combined with receiving the holistic care. Attention to spiritual care dimension is one of the most important aspects of care for these patients. This study aims at exploring and explaining dimensions of spiritual care for MS patients in care system of Iran. This study is conducted to explore the concept of spiritual care in care system of Iran during 2015-2016. Purposive sampling is done on 25 participants through unstructured interviews and observation of obtained data through conventional content analysis approach. Four themes of participants' experiences in spiritual care include restoration of identity essence and nature; disease as a factor for nearness to God; giving meaning to life; and disease as a facilitator for self-purification. Clear understanding of spiritual care dimensions and promoting knowledge in MS nurses as the caregivers play important roles in achieving the goals of health among patients in different cultures and religions. Given the results of this study, the themes such as the restoration of identity essence and nature, the disease as a factor for nearness to God, giving meaning to life and the disease as a facilitator for self-purification play important roles in explaining the concept of spiritual care in patients with MS. Therefore, the MS nurses and other health professionals need to effectively and successfully integrate the concept of spiritual care with their professional performance by deep understanding of this concept and try to provide holistic care to respond to MS patients' intertwined needs

Motor neuron diseases caused by a novel VRK1 variant – A genotype/phenotype study

Background: Motor neuron disorders involving upper and lower neurons are a genetically and clinically heterogenous group of rare neuromuscular disorders with overlap among spinal muscular atrophies (SMAs) and amyotrophic lateral sclerosis (ALS). Classical SMA caused by recessive mutations in SMN1 is one of the most common genetic causes of mortality in infants. It is characterized by degeneration of anterior horn cells in the spinal cord, leading to progressive muscle weakness and atrophy. Non-SMN1-related spinal muscular atrophies are caused by variants in a number of genes, including VRK1, encoding the vaccinia- related kinase 1 (VRK1). VRK1 variants have been segregated with motor neuron diseases including SMA phenotypes or hereditary complex motor and sensory axonal neuropathy (HMSN), with or without pontocerebellar hypoplasia or microcephaly. Results: Here, we report an association of a novel homozygous splice variant in VRK1 (c.1159 + 1G>A) with childhood-onset SMA or juvenile lower motor disease with brisk tendon reflexes without pontocerebellar hypoplasia and normal intellectual ability in a family with five affected individuals. We show that the VRK1 splice variant in patients causes decreased splicing efficiency and a mRNA frameshift that escapes the nonsensemediated decay machinery and results in a premature termination codon. Conclusions: Our findings unveil the impact of the variant on the VRK1 transcript and further support the implication of VRK1 in the pathogenesis of lower motor neuron diseases

Hemiballismus, Hyperphagia, and Behavioral Changes following Subthalamic Infarct

The function of subthalamic nucleus (STN) which is a part of the basal ganglia system is not clear, but it is hypothesized that this component might be involved in action selection. Unilateral damage to STN, which can commonly occur due to the small vessel stroke mainly, causes hemiballismus and sometimes hemichorea-hemiballismus. This paper deals with a 60-year-old patient with sudden onset of abnormal movements in his right limbs. He had increased appetite and hyperphagia and also developed mood and behavioral changes (aggressiveness, irritability, anxiety, and sometimes obscene speech). The magnetic resonance imaging revealed infarct area in left subthalamus. In our case, hemiballismus is caused by infarction in left subthalamic area. Occurrence of irritability, anxiety, and some behavioral changes such as aggressiveness and obscene speech can be explained by impairment of STN role in nonmotor behavior and cognitive function as a result of infarct

Effects of a Designed Discharge Plan on Anxiety and Length of Hospital Stay in Patients Undergoing Heart Valve Replacement

Background & Objective: Anxiety is the most common issue in the candidates of surgical heart valve replacement. The length of hospital stay in these patients is economically and organizationally important as a predictor of their recovery from acute physical conditions. The present study aimed to assess the effects of a designed discharge plan on anxiety and length of hospital stay in patients undergoing heart valve replacement. Materials and Methods: This clinical trial was conducted on 65 candidates of heart valve replacement in Chamran Hospital in Isfahan, Iran, who were randomly divided into the intervention and control groups. In the intervention group, the designed discharge plan was implemented and continued one month after discharge via phone follow-up. Length of hospital stay and anxiety were analyzed before the intervention and one and three months after discharge in both groups in SPSS. Results: ANOVA indicated that the mean anxiety in the study groups was significantly different at different times (P0.05). Conclusion: The designed discharge plan reduced anxiety in the patients, while its effect on the length of hospital stay requires further investigation. Therefore, it is recommended that the discharge program be used as an effective approach to maintaining care in patients undergoing heart valve replacement. Keywords: Discharge Plan, Anxiety, Hospitalization, Heart Valve Replacemen

The Effect of Empowerment Program Based on the Health Belief Model on the Perceived Satisfaction of People With Acute Coronary Syndrome

Background and Aims Heart disease can affect patients and their families, and society’s  biopsychological status.  Thus, it is necessary to empower patients to better control the disease and improve their lives. The current study evaluated the effect of empowerment program based on the health belief model on perceived satisfaction in patients with acute coronary syndrome. Methods This clinical trial study was conducted on 70 patients with acute coronary syndrome who were randomly assigned to two intervention and control groups. Initially, perceived satisfaction questionnaires were completed in the two groups; then, the intervention group received a 7-session empowerment program based on the health belief model, and usual care was provided to the controls. Immediately, one month, and three months later, the questionnaire was completed by the two groups. The obtained data were analyzed using the Mann–Whitney U test, Wilcoxon test, and Chi-squared test in SPSS. Results The two groups were matched in terms of demographic variables such as gender, age, and the type and duration of disease (P>0.05). Comparing the level of changes in perceived satisfaction in the two groups revealed that posttest changes were significantly higher in the intervention group, compared to the controls (P<0.001). The mean±SD pretest, immediately after and one month, and three months after the intervention scores of perceived satisfaction changes in the test group were 116.36±33.88, 154.1±29.07, 144.3±27.32, and 127.2±28.58, respectively. Conclusion According to the obtained results, implementing the empowerment program based on the health belief model can increase perceived satisfaction in patients with acute coronary syndrome