Developing Basic Educational Standards for Evaluation and Accreditation of Master of Sciences Course in Neonatal Intensive Care Nursing: A Report of a Delphi Study

Background & Objective: Despite the importance of local educational standards for the correct implementation and evaluation of higher education programs, studies show such standards do not exist for the master’s degree in neonatal intensive care nursing. Therefore, the purpose of the present study was to develop basic educational standards for program evaluation and accreditation of the master of sciences course in neonatal intensive care nursing. Methods: This study was a descriptive survey conducted using the Delphi survey method in 2014. A total of 20 experts, including infants and medical education specialists, administrators of the department of education, faculty members of the department of pediatrics, nursing administrators of neonatal intensive care units, and students and graduates of the neonatal intensive care nursing course were selected through purposive sampling. First, items related to basic educational standards were extracted through an extensive review of databases. Subsequently, 3 sessions in 2 rounds were held with the experts and basic educational standards for the evaluation of the master of sciences course in neonatal intensive care nursing were developed on the basis of consensus. Results: This study led to the proposal of 20 items as basic educational standards for the evaluation of the master of sciences course in neonatal intensive care nursing. In the first round, 25 items, of the total 41 items, were agreed upon by experts. Statistical results showed the content validity index in clear expression, importance, and availability in the second round was 0.94, 0.92, 0.87, respectively. Conclusion: Considering that the checklist of basic educational standards was developed by experts, it is hoped it will gain high acceptability and be an efficient model for the evaluation of the master’s program in neonatal intensive care nursing. ------------------------------------------------------------------------

Evaluation of the Effect of Nest Posture on the Sleep-wake State of Premature Infants

Background: Premature birth is a major cause of infant mortality in developed countries. Newborns confined to neonatal intensive care units (NICUs) are in a rapid stage of brain development. As such, sleep plays a pivotal role in the proper brain development of newborns. However, this developmental aspect is often disregarded due to the lack of information. Aim: This study aimed to evaluate the effect of nest posture on the sleep-wake state of premature infants. Method: This cross-over clinical trial was conducted on 60 premature infants admitted in the NICU of Ghaem Hospital in Mashhad, Iran in 2015. Infants were divided into two groups of experimental and control. Data were collected using the Assessment of Premature Infants' Behavior (APIB). Neonates in the control group were placed in an incubator, and neonates in the experimental group were positioned in a nest. Between-group comparison was performed using paired-samples T-test for normal variables and Wilcoxon test for non-normal variables. Results: In this study, no statistically significant differences were observed between the two groups in terms of the scores of deep sleep state before (P=0.50) and after the intervention (P=0.59). However, during the intervention, mean score of deep sleep was higher in the experimental group (P=0.08). Moreover, mean score of slow wake state had no significant difference between the study groups before (P=0.67), after (P=0.86), and during the intervention (P=0.81). Implications for Practice: According to the results of this study, nest posture increased the deep sleep hours of premature infants as the most imperative state of brain development. Therefore, it is recommended that nest posture be used to improve the deep sleep state of premature infants

The effect of teacher′s presence at children′s bedside on the anxiety of mothers with hospitalized children: A randomized clinical trial

Background: The hospitalization of a child is a stressful experience for parents, especially mothers. Not having access to the teacher and not being able to continue school studies within the hospital by hospitalized children is a common reason for anxiety in them and their parents. The current study aimed to determine the effect of teacher′s presence at children′s bedside on the anxiety of mothers with hospitalized children. Materials and Methods: In a randomized clinical trial, a total of 50 mothers with children admitted to pediatric ward of one teaching hospital in Mashhad, Iran, were randomly allocated to two equal groups. In the intervention group, the teacher was present at children′s bedside for daily education and practices, but the control group received standard routine care. The mothers′ level of anxiety was evaluated using the Spielberger State-Trait Anxiety Inventory, which was completed at both admission and prior to child′s discharge. Data were analyzed using SPSS. Results: The results showed that before intervention, the means and standard deviations of the mothers′ trait anxiety scores in the experimental and control groups were not significantly different (P = 0.164). However, after intervention, the mothers′ mean trait anxiety scores decreased significantly in the intervention group compared to the control group (P < 0.001) and compared to the pre-intervention phase (P < 0.001). Conclusions: It seems that the presence of a teacher at children′s bedside is an easy and effective strategy to reduce anxiety in mothers regarding their children hospitalization

The Effect of Creating an Artificial Night On Physiological Changes in Preterm Infants

Introduction Preterm infants are exposed to irregular light for several weeks or months in the Neonatal intensive-care unit (NICU). This lack of maternal entrainment, the exposure to irregular extrauterine lighting and care in the nursery may contribute to the disturbances in body temperature, sleep and physiological changes that are commonly experienced by preterm infants. Materials and Methods This is a randomized clinical trial dual group study, 38 preterm infants (gestational age of 30-34 weeks) due to prematurity hospitalized at NICU of Ghaem Hospital, Iran, were evaluated within 10 days. Infants were divided into two groups of 1200-1700 and 1701-2200g based on the weight and the weight of each group were randomized into artificial night (dark period was from 19 to 7 during incubator was covered with linen cloth & light period was from 7 to 19 removed the cover) and control groups (continuous lighting). Mothers & infants through questionnaires, interviews, observation & document completion, changes in physiologic & weight before entering the study & then physiologic changes twice a day, weight & feeding tolerance were collected daily. Data were analyzed using SPSS version16 software. Results The two groups were matched in terms of other variables. Mean gestational age was (31.39+1.39) weeks in both groups, mean weight at study entry in period light of the (1415.8+ 263.46) and (1471.6 + 244.47) was in continuous lighting. The difference in oxygen saturation, respiratory rate, respectively, higher and lower in the intervention group than the control group. Result of the statistical analysis of repeated measures suggests that the difference between the two groups was significant (

Effect of a Supportive Educational Program on Self-Efficacy of Mothers with Epileptic Children

Background: In the aftermath of de-institutionalisation and the move to community management of epilepsia, mothers play an increasing role in the management of the illness. Mothers often complain of being misinformed and ill equipped to aid in the treatment. Aim: The purpose of this study was to investigate the effect of a Supportive Educational Program on self-efficacy of mothers with epileptic children. Method: This randomized controlled clinical trial was conducted on two groups of 50 mothers with epileptic children admitted to Ghaem Hospital in the city of Mashhad in 2014. Maternal self-efficacy was measured before and 6 weeks after intervention through Steffen’s Revised Scale for Caregiving Self-Efficacy as the research instrument. The Supportive Educational Program was implemented for the experimental group during five 60-minute sessions with an interval of 4 days. The control group received the routine care. Data analysis was performed using SPSS software (version 11.5). Results: The mean age of mothers in the experimental and control groups were 32.8±6.9 and 32.8±6.8 years, respectively. The findings of the independent t-test revealed significant differences between the two control (47.4±15.06) and experimental (66.5±11.5) groups following the intervention (

Comparison of Perceptions of Nurses and Premature Infants’ Mothers about Mothers’ Needs in Neonatal Intensive Care Unit

Background & Aim: An important goal of nursing care in the Neonatal Intensive Care Unit (NICU) is to provide holistic care as well as the best possible outcome. Understanding perceived needs of mothers is valuable to achieve these goals. This study aimed to compare perceptions of nurses and premature infants’ mothers about mothers’ needs in the NICUs.   Methods & Materials : This was a cross-sectional study in which 63 nurses and 63 mothers with premature infants were selected from the NICUs of four educational hospitals affiliated to the Mashhad University of Medical Sciences through stratified sampling method in two months. Data were gathered using the NICU Family Needs Inventory of Ward and were analyzed using descriptive-analytical statistical methods in the SPSS v.16.   Results: Among the subscales related to family needs, the following items were reported to be important by mothers: Proximity (95.3%), Assurance (94.1%), Information (91.1%), Support (79.7%) and Comfort (72.8%). On the other hand, nurses believed that the following items were the most important needs of the mothers: Assurance (80.3%), Proximity (75.2%), Information (70.8%), Comfort (66.3%) and Support (64.8%).   Conclusion : According to study findings, nurses should periodically assess needs of the mothers in the NICUs to be aware of the actual needs instead of placing subjective assumptions on mothers needs. This can improve effective communication and interaction with mothers and enhance satisfaction of the mothers with care

The Effect of Facilitated Tucking (FT) During Venipuncture on Duration of Crying in Preterm Infants

Abstract Introduction Humans in the last trimester of gestation are assumed to be in a pain-free environment in the womb, but those neonates who are born preterm often spend weeks in the Neonatal intensive care unit (NICU) and undergo numerous painful procedures as part of their routine care. Materials and Methods In this semi-experimental study, 70 preterm infants born at average 32 to 36 weeks' Gestational age (GA), who needed routine blood collection, were allocated to two intervention (35 neonates) and control (35 neonates) groups. In experimental group a nurse held the infant in the side-lying, flexed fetal-type position during blood collection. The stopwatch was used to determine the duration of crying infants. The control group did not receive additional action for pain relief. Data were analyzed by using SPSS version 16 software. Results The mean age of infants was 34.45 ± 1.22 weeks. The results showed that the duration of crying after sampling in the two groups was statistically significant difference, this duration in control group was higher than the intervention group (

Effects of Supportive Educational Program on Anxiety of Mothers of Children Undergoing the Lumbar Puncture (LP)

Background: Lumbar Puncture test is one of the most stressful diagnostic procedures in pediatric ward that its prescription put mothers under extreme pressure. There are limited interventions in this regard. Aim: determining the impact of supportive educational program on the anxiety of mothers whose children are undergoing lumbar puncture (LP). Method: the present study is a randomized controlled clinical trial carried out in 2015. Sixty mothers of children undergoing lumbar puncture and hospitalized 3educational hospitals of Mashhad, Iran, were randomly divided to control group (n=30) and intervention group (n=30). The intervention group received supportive program during a session of 60 min. Spielberger State-Trait Anxiety Inventory (STAI) was selected as the research tool. Finally, data were analyzed by Chi-square test, independent t-test using SPSS v.16 software. Results: The mean age of the mothers was 27.3±5.3 and 26.0±3.1, respectively. The mean pre-interventions maternal manifest anxiety was 51.9±6.2 and 53.4±4.3 out of 80, respectively, in the intervention and control groups. The mean post-interventions maternal manifest anxiety was 44.9±5.1 and 52.7±4.2, respectively, in the intervention and control groups. According to the results of independent t-test, significant difference was observed statistically for the mean maternal manifest anxiety between the two groups (p> 0.001). Implications for Practice: Regarding the reduction of maternal anxiety in the intervention group, which is possible because of the attention to the emotional needs of mothers, in addition to proper training; this program can be considered as an effective method to reduce maternal anxiety before the LP test

Effects of Emotion Regulation Training on Attachment Style of Primiparous Pregnant Women with Insecure Attachment

Background: Pregnant women with insecure attachment style are at high risk of psychiatric disorders. Since emotions are the first coordinators of attachment behavior, emotion regulation training can alter maternal attachment style. In this study, we aimed to evaluate the effects of emotion regulation training on the attachment styles of primiparous pregnant women with insecure attachment style. Aim: This study aimed to evaluate the effects of training programs on the headache of patients after spinal anesthesia. Method: This randomized, clinical trial on 40 primiparous pregnant women with age range of 30-34 years, who were referred to healthcare centers of Mashhad, Iran, during 2014. The data collection instrument was Revised Adult Attachment Scale (RAAS). The participants were assigned to intervention and control groups. A training program was implemented on emotion regulation based on dialectical behavior therapy (DBT) for the intervention group. After delivery, RAAS was completed by the mothers again. The control group only received the routine care. To analyze the data, Chi-square and independent t-test were run using SPSS, version 15. Results: Mean ages of the mothers in the intervention and control groups were 26.9±4.04 and 27.5±3.5 years, respectively. According to the results of independent t-test, the difference between the groups was non-significant (P=0.77). The groups were analogous in terms of attachment style pre-intervention. After the intervention, independent t-test did not reflect any significant differences between the groups regarding avoidant (P=0.37) and anxious (P=0.11) attachment styles. However, mean score for secure attachment style was significantly enhanced (P=0.01). Implications for Practice: Our findings revealed that implementation of emotion regulation training increased secure attachment scores. Thus, implementing emotion regulation training program is recommended as part of a program for pre-natal care in healthcare centers

Status of Perceived Social Support and Quality of Life among Hearing-Impaired Adolescents

Background Annual four to five thousand babies are born with hearing loss in the Iran. Hearing impairment is a disability that affects the quality of life of people with this problem. These individuals need to support from family and friends because of their specific conditions that this received support has impact on their quality of life. This study was conducted to assess the status of perceived social support and quality of life of hearing-impaired adolescent. Material and Methods A cross-correlation study was performed with cluster and multi stage random sampling method on 83 students with hearing impairment who met the inclusion criteria of the study in Mashhad. The data collection tools included Pediatric quality of life inventory (adolescent form) and perceived social support inventory (from family and friends).The data obtained from the questionnaires were analyzed through SPSS software version 16. Results The results showed that the majority of the most of adolescents with hearing impairment were reported moderate total quality of life (%51.8). But the majority of them reported perceived social support from family was moderate (%61.5) and from friends was week (%45.8). Also there was a significant relationship between category of total quality of life of adolescent viewpoint with perceived social support from family (P=0.056). Conclusion Based on the obtained results, the majority of the most of adolescents with hearing impairment were reported moderate total quality of life. Disability and condition of these persons affects quality of life of them, so need for adequate support from family, friends and society. Nurses play an important role in identifying and introduce these needs and condition and how to deal with them