The effect of progressive muscle relaxation program on chronic low back pain and living daily activities in patients with intervertebral disc: a randomized clinical trial

زمینه و هدف: عمده‌ترین علت کمردرد، فتق دیسک بین مهره‌ای است. شایع ترین علامت این بیماری درد است که باعث کاهش فعالیت‌های روزمره زندگی در بیماران مبتلا می‌گردد. این پژوهش با هدف بررسی تأثیر برنامه آرامسازی پیشرونده عضلانی بر میزان درد مزمن کمر و فعالیت‌های روزمره زندگی بیماران مبتلا به دیسک بین مهره‌ای انجام شده است. روش بررسی: در این کارآزمایی بالینی که به صورت موازی انجام شد، 56 بیمار مبتلا به فتق دیسک بین مهره‌ای کمر به صورت تصادفی در گروه 28 نفره آزمون و کنترل تقسیم شدند. به بیماران گروه آزمون طی 7 جلسه تئوری و عملی با تأکید بر 14 گروه عضلانی، برنامه آرامسازی پیشرونده عضلانی آموزش داده شد. پرسشنامه مقیاس شدت درد و فعالیت‌های روزمره زندگی، قبل از مداخله، بعد از یک ماه مداخله و بعد از سه ماه مداخله در دو گروه تکمیل گردید. یافته ها: در مجموع 56 بیمار مطالعه را به پایان رساندند. برنامه آرامسازی پیشرونده عضلانی باعث کاهش میانگین شدت درد و افزایش ابعاد فعالیت های روزمره زندگی در گروه آزمون بعد از سه ماه مداخله نسبت به قبل از مداخله شده است (001/0>P). همچنین آزمون آماری آنالیز واریانس با اندازه گیری های مکرر، تفاوت معنی‌داری را در سه بار اندازه گیری میزان درد و امتیاز کل و امتیاز ابعاد فعالیت‌های روزمره زندگی در گروه آزمون نشان می‌دهد (001/0>P). در گروه کنترل این تفاوت ها معنی‌دار نبود. نتیجه گیری: با توجه به یافته‌های این پژوهش، برنامه آرامسازی پیشرونده عضلانی تأثیر به سزایی در کاهش درد مزمن کمر و افزایش فعالیت‌های روزمره زندگی بیماران مبتلا به دیسک بین مهره‌ای دارد. به کارگیری این برنامه برای کاهش درد مزمن کمر و افزایش فعالیت های روزمره زندگی بیماران مبتلا به دیسک بین مهره ای پیشنهاد می گردد

Damaged professional identity as a barrier to Iranian nursing students’ clinical learning: a qualitative study

زمینه و هدف: هویت حرفه ای خدشه دار باعث نارضایتی دانشجویان پرستاری از محیط یادگیری می شود و پیامدهای رفتاری آن عملکرد مراقبتی ضعیف در بالین، کاهش انگیزه، تلاش کمتر برای یادگیری مراقبت پرستاری و شادمانی کم در محیط یادگیری را در پی دارد و بر کیفیت مراقبت از بیمار و اثربخشی نظام آموزشی تأثیرگذار است. این مطالعه با هدف تبیین اثرات هویت حرفه ای بر یادگیری مراقبت های پرستاری در دانشجویان انجام شده است. روش بررسی: در این مطالعه توصیفی- تحلیلی از نوع کیفی، 25 دانشجوی پرستاری در مقطع لیسانس به صورت نمونه گیری مبتنی بر هدف از دانشکده های پرستاری مامایی تهران و شهید بهشتی انتخاب شدند. از مصاحبه های نیمه ساختار یافته برای جمع آوری اطلاعات استفاده شد. روش آنالیز محتوی قراردادی، برای تجزیه و تحلیل داده ها و تعیین الگوهای مرتبط مورد استفاده قرار گرفت. یافته ها: از تحلیل مصاحبه ها یک الگو با عنوان هویت حرفه ای خدشه دار به دست آمد. این الگو شامل دو طبقه پایمال شدن شأن و منزلت فردی- اجتماعی و بی صدایی پرستاران بود. نتیجه گیری: استفاده از الگوی هویت حرفه ای خدشه دار طراحی شده در این مطالعه در فرآیند یادگیری می تواند به مربیان و مدیران آموزشی کمک کند تا استراتژی هایی را برای تقویت هویت حرفه ای مثبت در دانشجویان پرستاری و به دنبال آن ارتقاء یادگیری آن ها به کار گیرند

Effect of applying progressive muscle relaxation technique on fatigue in multiple sclerosis patients

چکیده: زمینه و هدف: خستگی یکی از شایع ترین و ناتوان کننده ترین علایم در بیماران مبتلا به مولتیپل اسکلروزیس (ام اس) می باشد، که باعث ایجاد اختلالات مشخص و تاثیرات مخرب بر عملکرد روزانه، فعالیت های جسمی، ایفای نقش شغلی و اجتماعی و در کل کاهش سطح کیفیت زندگی در مبتلایان به این بیماری می گردد. شیوع استفاده از درمان های مکمل در میان مبتلایان به ام اس در حال افزایش است این مطالعه با هدف بررسی تاثیر تکنیک آرام سازی پیشرونده عضلانی بر میزان خستگی بیماران مبتلا به مولتیپل اسکلروزیس انجام شد. روش بررسی: در یک مطالعه نیمه تجربی، 66 بیمار مبتلا به مولتیپل اسکلروزیس عضو انجمن ام اس ایران پس از نمونه گیری به روش آسان، به صورت تصادفی در دو گروه شاهد (33 نفر) و آزمون (33 نفر) قرار گرفتند. برای گروه آزمون در مدت دو ماه، 60 جلسه اجرای تکنیک آرام سازی پیشرونده عضلانی و برای گروه شاهد هیچگونه مداخله ای انجام نشد. اطلاعات با استفاده از پرسشنامه اطلاعات دموگرافیک، ابزار سنجش شدت خستــگی (FSS) و چک لیست هـای خود گزارش دهی جمع آوری گردید. برای تجزیه و تحلیل اطلاعات از آزمون های آماری t زوجی، t مستقل، آنالیز واریانس با اندازه گیری های مکرر و تعیین همبستگی متغیرها استفاده گردید. یافته ها: قبل از مداخله تفاوت معنی داری در مشخصات دموگرافیک، طول مدت بیماری و وضعیت گسترش ناتوانی، شاخص توده بدنی و امتیاز خستگی در دو گروه وجود نداشت. امتیاز خستگی در گروه آزمون و شاهد به ترتیب 03/1±69/4 و 96/0±43/5 (01/0

Effects of a self-care program on quality of life of cirrhotic patients referring to Tehran Hepatitis Center

BACKGROUND: Chronic liver disease especially liver cirrhosis is one of the medical problems that substantially reduces the quality of life of its victims. Because of the chronic and irreversible nature of the disease, it needs self-care programs to be developed according to client's needs and to maintain their independence and sense of well-being. The purpose of this study was to determine the effects of a self-care educational program on Quality of Life (QoL) of a sample of Iranian cirrhotic patients. METHODS: A quasi-experimental study was conducted on 44 cirrhotic patients in Tehran Hepatitis Center. Longitudinal case registry and random allocation technique were used to divide the sample into experimental (n = 21) and control (n = 23) groups. Chronic liver disease questionnaire (CLDQ) was used for measuring the quality of life. The experimental group was given a questionnaire to assess their educational needs. A self-care educational program was conducted and the patients were followed for 3 months. Then the quality of life of both groups was compared using descriptive and analytical statistics. RESULTS: The experimental and control groups were the same concerning the effective factors on the quality of life, such as age, sex, etc (P > 0.05). There was no significant difference between QOL mean score of both groups before the intervention, however the QoL significantly improved in the experimental group after the intervention (P= 0.001), while the QoL decreased in control group. CONCLUSION: The result of the present study confirmed the positive effects of the educational and self care programs on the QoL of cirrhotic patients. Extensive educational and self-care programs along with long-term follow up such as the program conducted in this study are suggested

The Effect of Employing Synectic Model in Teaching Palliative Care in Children on Nursing Students\' Writing Creativity and Academic Performance

Introduction: Palliative care in patients with incurable diseases requires creativity in providing services in the best possible way. Therefore, the effect of Synectic model on students' writing creativity and academic performance was investigated in this study. Methods: It was a quasi-experimental study performed on 2 groups of nursing students of Tehran University of Medical Sciences in the first semester of 2007-2008 academic year. The control group consisted of 28 and the experiment group included 32 students. After the written pre-test about the concept of children's pallia-tive care, the synectic model was employed for the experiment group and the usual method for the control group. Then, the post-test was held for both groups and they also wrote an essay on palliative care. Data was analyzed by SPSS software using descriptive statistics and inferential tests including Mann Whitney, chi², and Fisher exact test. Results: The mean for pre-test scores was 2.8 for the control group and 2.5 for the experiment group which showed no significant difference before the intervention. But after the intervention in post-test, the mean for the control group was 3.8, while it was 4.8 for the experiment group which showed a statistically significant difference. Moreover, investigating students' essay texts showed a significant difference between the two groups concerning creativity in writing. Conclusion: With regard to the results of this study, employing synectic method enhances academic perfor-mance and writing creativity of nursing students regarding children's palliative care

Protective disciplinary exchange: A qualitative study into nurse managers' supportive strategies for nursing error management

Background: Understanding nurse managers' supportive strategies for managing nursing errors can facilitate the improvement of nursing care quality and patient safety. Objectives: This study aimed to explore nurse managers' supportive strategies for nursing error management (NEM). Methods: This descriptive qualitative study was conducted on twenty nurse managers and two nurses purposively recruited from teaching hospitals affiliated to Urmia University of Medical Sciences, Urmia, Iran. The data were collected via in-depth semistructured interviews and concurrently analyzed via conventional content analysis. Results: Nurse managers' supportive strategies for NEM were overlooking nurses' errors to promote their obedience, prioritizing nursing care measures to reduce errors, error prevention training rounds during shift handover instead of error reporting, and alternative disciplinary measures instead of error reporting. These strategies were conceptualized as protective disciplinary exchange. Conclusion: Protective disciplinary exchange denotes that nurse managers prefer to manage nursing errors with flexibility. This situational communicative strategy helps nurse managers protect their staff resources and maintain their positions

Effect of a dietary program on school boy's vitamin A and iron intake

Introduction: Nutrition is the most important aspect for healthy and disease in children andadolescents. This pre-experimental study was performed to evaluate the efficacy of developed dietaryintervention programmed package in vitamin A and iron received in school children.Materials and Methods: This study was performed on 120; 11-14 years old children along withtheir families were randomly recruited and divided in two experimental and control groups fromAjabshir Junior high Schools. Families' dietary history and dietary data from students by means ofthree consecutive 24-hour diet records and recalls before and after intervention were collected. Datacollection has done by nutritional table and quaderprounch. Factors such as age, education level, job,income, type of home matched. Dietary intervention programmed package contained on role ofvitamin A and iron received in growth and healthy, introducing sources of vitamin A and iron innutrition and take 7 nutritional plans based on socio-economical level for families (21 plans for 3levels). This plan flowed up for 30 days and the 2 questionnaires measured again in 2 groups.Results: The baseline data indicated that intake of most micronutrients were below theRecommended Dietary Allowance after the intervention period. Vitamin A and iron intakes of theexperimental subjects were significantly higher than those of the control group (P< 0.001).Conclusion: These results indicate that encouraging the consumption of rich but cheap and locallyavailable dietary sources of vitamin A and iron can prevent vitamin A and iron deficiencies in schoolchildren. Thus to prevent micronutrients deficiencies, were commend establishing dietary interventionprograms availability of foods and communities according to their cultural and socioeconomic status

The Effect of Using “Applied In-Service Education Model” on Quality of Nursing Care in Surgery Unit

Introduction. One of the important duties of nursing managers is staff development for improving the quality of nursing care. If staff development is designed and implemented based on proper principles and nurses’ needs, it can lead to the improvement of nursing care. In this study, we have tried to present an applied model for nurses’ in-service education and determine its effect on the quality of nursing care. Methods. A quasi-experimental research with two groups, using pre and post-tests was performed. A sample of 60 patients were selected randomly and divided to two experiment and control groups. The quality of nursing care in surgery unit was assessed by a separate checklist. Educational model was designed based on the educational needs of nurses and presented to the experiment group by the nurses for three months. The control group received the routine in-service education. Then, the quality of nursing care was assessed one month after education in each group. The data was analyzed by SPSS software using independent and paired t-test. Results. The quality of patient care and patient education increased significantly after the intervention in the experiment group. Also, a significant difference was observed between the control and experiment groups in the quality of patient care and patient education. Conclusion. Considering the effectiveness of the designed model on the quality of nursing care and patient education, it is recommended to use this model as an effective educational model for in-service nursing education in order to achieve high quality nursing care

‍Clinical Supervision System: A Method for Improving Educational Performance of Nursing Personnel

Introduction: Employing supervision methods which focuses on educational aspects may increase the effectiveness of nursing personnel's educational activities, especially patient education. The aim of this study was to investigate the effect of clinical supervision on the effectiveness of nurses' educational performance. Methods: This quasi-experimental study was conducted using static groups' comparison in which the control and experiment groups were compared by a post-test. Study samples included 72 patients who were matched and assigned into two distinct groups. Clinical supervision system was implemented through three steps in 3 wards of Samen-al-Aemme hospital in Mashhad for 6 months. The data gathering tool included patient information sheet, patient satisfaction from nurses' educational practice and rating scale of self-care knowledge and practice of patients. Data was gathered through interview and observation methods and analyzed by SPSS software. Results: The mean scores of self-care knowledge and practice of the patients were 30.6 and 57.1 out of 100, in the control and experiment groups, respectively. The mean score of patients' satisfaction from nurses' educational practice was 19.6 in the control group and 20.9 in the experiment group, out of 24. So that, independent t-test showed a significant difference between these two groups. Conclusion: Implementing clinical supervision system through observation, feedback, discussion, and investigation, may develop nurses' knowledge and professional skills in patient education. Therefore, this supervision method could be regarded as an effective model for in-service education. More studies are required in order to investigate the effect of this model on other aspects of nurses' practice