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   Table of Contents - Current issue
Coverpage
January-March 2020
Volume 7 | Issue 1
Page Nos. 1-68

Online since Friday, December 27, 2019

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ORIGINAL ARTICLES  

Effect of changing position and early mobilization on back pain and vascular side effects in patients after coronary angiography p. 1
Masoumeh Neishabouri, Neda Haghighi, Tahereh Gilvari, Sahar Haghighat
DOI:10.4103/JNMS.JNMS_22_18  
Context: Angiography is associated with vascular complications such as bleeding and hematoma. To prevent these complications, patients are restricted to bed rest in the supine position after the procedure. This practice has been associated with back pain. Aims: This research has been carried out to evaluate the effect of changing position and early mobilization on back pain and vascular side effects in patients after coronary angiography. Setting and Design: This study was a randomized controlled clinical trial conducted in 2016 at Taleghani Hospital, Tehran. Materials and Methods: This study was conducted on 120 patients. Each patient was assigned in groups with simple random allocation to either the control group, which remained the supine position 6 h of bed rest after coronary angiography, or intervention group. The intervention group was changed position hourly, varying between supine, elevated to 30°, and semi position (elevated to 45°) during the first 4 h after coronary angiography. Data collected with demographic questionnaire checklist for complications based on Christnson's Guideline, McGill Pain Questionnaire, and Numeric Pain Intensity Scale. Statistical Analysis Used: All data obtained were analyzed using descriptive statistics (frequency, mean, and standard deviation) and inferential statistics (Chi-square and Mann–Whitney U test). Results: The results showed that the mean pain intensity immediately after entering the postangiographic section in the control groups was 0.9 ± 0.34 and in the intervention group was 0.28 ± 1.22. There were significantly less pain intensity and extent back pain in the intervention group than the control group (P < 0.001). Furthermore, the highest severity of back pain in patients undergoing cardiac angiography in the intervention and control group was 2.43 ± 1.32 and 4.88 ± 1.78, respectively (P < 0.001). None of the patients developed bleeding, hematoma, and arterial thrombosis; therefore, there was no significant difference between the two groups. Conclusion: The recent postcardiac angiography changing position and early mobilization on back pain and vascular side effects in patients without any increase in the vascular side effects may results prevention of back pain and decrease in its extent.
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The effect of video-assisted training given to midwifery and nursing students about pain and its management in newborns on students' level of knowledge p. 7
Esra Tural Buyuk
DOI:10.4103/JNMS.JNMS_56_18  
Context: In Turkey, pain and its management in newborns is within the curriculum of midwifery and nursing education. It is important for midwifery and nursing students to have sufficient knowledge and skills for practice about pain and its management in newborns. Aims: The present study aimed to find the effect of video-assisted training given to midwifery and nursing students about pain and its management in newborns on the knowledge level of students. Setting and Design: This study employed a quasi-experimental pretest–posttest design in Ondokuz Mayıs University Health Sciences Faculty between 26 and 27 February 2018. Materials and Methods: Midwifery and Nursing students (n = 182) enrolled by census sampling. In addition to students' sociodemographic data and information about the state of observing and applying a painful procedure on newborns, the data were collected through a questionnaire form prepared by the researcher which included pain characteristics, symptoms of the newborn, scales, and management. The questionnaire form filled in before the training was repeated following the video-assisted training given. Statistical Analysis Used: Data were analyzed using descriptive statistics, Chi-square test, and McNemar's test. Results: It was found that 74.7% of the students who participated in the study observed a painful intervention to newborn and 23.1% performed a painful intervention on newborn. It was found that students' posttraining states of knowing about newborns' pain characteristics, behavioral and physiological symptoms, scales used in the assessment of pain in newborns, and characteristics about nonpharmacological and pharmacological treatments used in pain treatment increased when compared with pretraining (P < 0.05). Conclusion: It was found that students' states of knowing about newborns' pain increased after the training given when compared with before training. It is recommended that the content of the subject of pain and its management in newborn period within the curriculum of midwifery and nursing schools should be reviewed and improved by new educational methods.
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The effectiveness of individual interventions on smoking cessation of chronic obstructive pulmonary disease patients p. 13
Ali Sharifpour, Fatemeh Taghizadeh, Mehran Zarghami, Abbas Alipour
DOI:10.4103/JNMS.JNMS_38_19  
Context: Guided self-change (GSC) is theory-driven based on cognitive-behavioral change models such as transtheoreticlal model (TTM) and can be applied with nicotine replacement therapy (NRT) for behavioral change of smoking in chronic obstructive pulmonary disease (COPD) smokers. Aims: This study aimed to investigate the individual GSC, NRT, and GSC-NRT on smoking cessation of COPD patients. Settings and Design: This randomized clinical control trial study was carried out in Imam Khomeini Hospitals in Mazandaran province in 2016–2017. Materials and Methods: Three- group block randomized controlled trial, comparing GSC (n = 20), NRT (n = 20), and GSC-NRT (n = 20) in smoking cessation and other related variables COPD smokers with follow-up to 29-week. Statistical Analysis Used: Descriptive statistics, Chi-square, and repeated measures ANOVA test were used to analyze the data. Results: The GEE model revealed that GSC reduced the odds of quitting smoking rate compared to the NRT group (odds ratio = 0.31, 95% confidence interval: 0.022–0.545, ES = 0.20). Furthermore, the TTM questionnaire, the Fagerstrom test for nicotine dependence, and spirometry variables were evaluated in the three groups. The recovery in nicotine dependency, the exhaled carbon monoxide and spirometry variables was more pronounced in the GSC and GSC-NRT groups than in the NRT over 29 weeks after the treatments. Cons (PV = 0.009, ES = 0.52), pros (PV = 0.04, ES = 0.12), experiential process (PV = 0.005, ES = 0.18), counterconditioning (PV = 0.04, ES = 0.12), stimulus control (PV = 0.004, ES = 0.19), environmental-reevaluation (PV = 0.0001, ES = 0.30), and habitual craving (PV = 0.004, ES = 0.19) were significant across the three groups. Conclusion: The interventions in the GSC and combined GSC-NRT groups were significantly more effective than in the NRT group in TTM variables, and GSC and combined GSC-NRT were equally effective in smoking cessation rate.
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What mothers go through when the unexpected happens: A look at challenges of mothers with preterm babies during hospitalization in a tertiary institution in Nigeria Highly accessed article p. 22
Doreen Asantewa Abeasi, Blessing Emelife
DOI:10.4103/JNMS.JNMS_39_19  
Context: Preterm babies require special care, including immediate hospitalization after delivery. Mothers of preterm babies may be required to stay in a hospital for a longer period and may be anxious about the treatment outcome and health of their babies. These may be stressful for most parents. Aims: The purpose of the study was to explore the challenges of mothers with preterm babies during hospitalization in a tertiary institution in Nigeria. Setting and Design: The qualitative study was carried out at the special care baby unit (SCBU) of the University of Abuja Teaching Hospital using a phenomenological approach. Materials and Methods: Data were collected through semi-structured interviews from 12 mothers with their preterm babies on admission. Only mothers who met the inclusion criteria were interviewed. Statistical Analysis Used: Content analysis was used to analyze the data. Results: Six themes emerged from the challenges the mothers faced, namely limited access to baby, strange SCBU environment, inadequate spousal support, high costs of treatment, lactation problems, and informational challenges. Conclusion: The results of the studies showed that mothers of preterm babies face enormous challenges when caring for their hospitalized preterm babies such as need to emotional and financial supports and educational needs. The health team should help mothers overcome these challenges by strengthening the support structures that exist. Mothers who are able to overcome their challenges can become collaborators in the provision of care, while the babies are on admission.
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Comparison of modular cognitive-behavioral therapy and behavioral activation on the intolerance of uncertainty in students with generalized anxiety disorder p. 30
Elahe Beheshtian, Hasan Toozandehjani, Mohammad Reza Saffarian Tousi
DOI:10.4103/JNMS.JNMS_29_19  
Context: Generalized anxiety disorder (GAD) is one of the most common psychological disorders. The prevalence of GAD among students is higher than the general population. Aims: The purpose of this study was to compare the effect of modular cognitive-behavioral therapy (MCBT) and behavioral activation (BA) on the intolerance of uncertainty of students with GAD. Setting and Design: This research was a semi-experimental design with pre- and post-test design with follow-up conducted for two groups in counseling center of Neyshabur University during the period of January–April 2019.Materials and Methods: The study population included all students of Neyshabur University. The samples recruited from students who referred to the counseling center of Neyshabur University (45 cases) based on the purposive sampling method. The students who diagnosed with GAD based on Spitzer general anxiety questionnaire and met criteria (45 cases) randomly assigned into three groups of MCBT (15 cases), BA (15 cases), and control group (15 cases). Statistical Analysis Used: Data were collected using Spitzer general anxiety questionnaire (2006) and Freeston Intolerance of Uncertainty Scale (1994). Data were analyzed using the SPSS version 24 software through repeated measure analysis. Results: The findings revealed both intervention groups in reduction of the intolerance of uncertainty in comparison to the control group (P > 0.05). Results reported by participants in the MCBT group showed greater mean scores as compared to the BA group. However, no significant difference found between groups (P > 0.05). Conclusion: It can be concluded that MCBT implies decreasing the uncertainty severity of students with general anxiety than BA therapy, although the stability of BA therapy was longer. Therefore, it is suggested to use integrated therapeutic approaches.
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Comparative effectiveness of cognitive-behavioral group therapy and reality therapy on the quality of life of patients with seborrheic dermatitis p. 36
Ahmad Alipour, Mohammad Oraki, Mehran Zarghami, Gholam abbas Mollazadeh Mahally
DOI:10.4103/JNMS.JNMS_36_19  
Context: Skin diseases contribute to considerable psychological consequences and low quality of life (QOL) in these patients; it is believed that psychological status can be effective in the improvement of the disease. Aims: Therefore, this study aimed to compare the effect of cognitive-behavioral therapy (CBT) with reality therapy (RT) on QOL in patients with seborrheic dermatitis. Setting and Design: This semi-experimental study with pre- and posttest conducted in the private clinics of Sari and Ghayemshahr. Materials and Methods: Forty-eight cases selected by purposive method and randomized in three groups of control, cognitive-behavioral, and RT. Participants in three groups' evaluated pre-posttest and follow-up (3 months after intervention) by skin QOL index Wang (1994). Intervention groups received 10 weeks intervention, whereas the control group did not receive any intervention during this study. Statistical Analysis Used: The data were analyzed using SPSS-20 software through mixed covariance analysis. Results: There was no significant difference found between the two intervention groups (P > 0.05). The comparison of the effect size of two groups showed higher effect size for CBT group 0.81 versus 0.51. Conclusion: According to the findings of the research, it can be concluded that CBT and RT are effective on QOL and severity of skin disease.
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Nursing students' knowledge and practice of infection control in burns and medical-surgical units at the University of Benin teaching hospital, Nigeria, 2019 p. 42
Olaolorunpo Olorunfemi, Oluwatosin Mary Oyewole, Rachael Olufunmilayo Oduyemi
DOI:10.4103/JNMS.JNMS_40_19  
Context: Nursing students form a larger percentage among the health-care team. Therefore, for any infection control policies in the hospital to be effective; they must be put into consideration. Aims: This study sought to find out the level of knowledge and practice of infection control (KPIC) among student nurses posted to Medical-Surgical and Burns Unit, and also determine if knowledge level will statistically predict the practice of infection control. Settings and Design: This cross-sectional study was conducted on student nurses posted to Burns and Medical-Surgical Unit of University of Benin Teaching Hospital, Nigeria, 2019. Materials and Methods: This study was conducted among 100 student nurses who were posted to Medical-Surgical and Burn Units through census method and KPIC questionnaires were administered. Statistical Analysis Used: Data collected were analyzed using descriptive statistics and Spearman's correlation coefficient at 0.05 significant levels. Results: The nursing students had low knowledge and do not practice infection prevention with mean score of 15.38 (3.32) and 14.17 (2.80), respectively. The result also revealed that there is a significant relationship between KPIC among nursing students using Spearman's correlation coefficient, which showed P < 0.001. Conclusion: The level of KPIC measures was poor among nursing students, and those who are knowledgeable about infection control also have high compliance to infection control; we, therefore, recommend laborious training on infection control measures of nursing students prior to clinical posting.
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Breakfast consumption as a test anxiety predictor among paramedical students p. 47
Valiollah Akbari, Hamid Asayesh, Fatemeh Sharififard, Mostafa Qorbani, Asghar Elahi, Azam Heidarpour
DOI:10.4103/JNMS.JNMS_37_19  
Context: Having breakfast is an important part of healthy eating behaviors. Based on evidence, it is effective in improving cognitive and psychological performance of individuals. Aims: The purpose of this study is the examination of having breakfast association with test anxiety of paramedical students. Settings and Design: This cross-sectional study was conducted in Qom University of Medical Sciences (QUMS), Qom, Iran. Materials and Methods: Two hundred and twenty-three university students were selected from paramedical faculty of QUMS through random sampling. A self-administered questionnaire (demographic information and test anxiety inventory) was used for data gathering. Statistical Analysis Used: Data were analyzed using logistic regression to examine the association between breakfast consumption and test anxiety. Results: The prevalence of skipping breakfast was 40.1%. In the multivariate logistic regression model, it was found that being male (odds ratio [OR]: 0.53, 95% confidence interval [CI]: 0.30–0.94) and breakfast consumption (OR: 0.54, 95% CI: 0.30–0.95) had a significant relationship with lower test anxiety. Conclusion: It was found that the considerable number of students skip breakfast. Therefore, based on the significant relationship between breakfast skipping and higher level of test anxiety, it is important to identify the causes of breakfast skipping.
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Effective factors on management of nurses organizational learning: A qualitative study p. 52
Seyedh Khadijeh Moafimadani, Esmaeil Kazempour, Ali Khalkhali, Flora Rahimaghaee
DOI:10.4103/JNMS.JNMS_35_19  
Context: Organizational learning management is the implementation of knowledge policies and the mission of improving work with the help of knowledge and better understanding in the organization and helps employees to continually apply their capabilities to recognize the complexities and develop common mental models. Aims: The purpose of this study was to identify a variety of variables, including attitudes, beliefs, and facts about nurses' organizational learning management in the field of health. Setting and Design: This study was conducted to determine a more accurate plan for improving the activities in the field of health, considering the importance of managing nurses' organizational learning. Materials and Methods: This qualitative study was carried out by thematic analysis method in 2019. The research population consisted of experts from medical universities of Iran. Semi-structured. Sample size in this study was 15 people, including 8 executives and 7 nurses. Statistical Analysis Used: In this study, the “latent content” analysis approach was used to analyze the data, which has four steps (coding, classification, finding themes or themes, data integration) Results: The findings of the present study showed that the realization of nurses' organizational learning management in hospitals in Iran can be conceptualized in three categories: individual, contextual and organizational factors. Conclusion: Although the health system makes considerable efforts to learn nurses, it is not responsive to the needs of nurses in the current situation. Therefore, considering the importance of organizational learning for nurses, identifying the effective factors of learning management for achieving these goals seems necessary.
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REVIEW ARTICLE Top

Educational intervention for improving self-care behaviors in patients with heart failure: A narrative review p. 60
Maryam Karami Salahodinkolah, Jila Ganji, Sedigheh Hasani Moghadam, Vida Shafipour, Hedayat Jafari, Susan Salari
DOI:10.4103/JNMS.JNMS_19_19  
Heart failure is one of the most common cardiovascular disorders, and as a chronic and progressive disorder, it can disrupt with interpersonal and social relationships, reduce physical activity, and in fact, impair self-care. Therefore, it is necessary to improve the self-care behavior of the patients with heart failure with effective interventions. There are several ways to improve self-care behavior, and educational interventions are one of these methods. Review of educational interventions causes promotion in self-care behaviors of patients with heart failure. The aim of this study was reviewing the educational intervention for improving self-care behaviors in patients with heart failure. The present study is a narrative review study that uses a search in databases such as Google Scholar, Cochrane, Science Direct, ProQuest, Springer, SID, Magiran, IranMedex, Web of science, Scopus, and PubMed from 2000 to 2018. Search for articles using Keywords: heart failure, self care, education and training. All articles with educational intervention and clinical trial in Persian and English and articles with full-text of individual or group training in the database of internal and library were included in the study, and unrelated articles with just abstract were excluded from the study. Seventy-one articles were finally included, after removing repetitive and nonrelated items. Initially 340 articles were obtained and after reviewing the articles for inclusion criteria, finally 71 articles were included in the study. Educational interventions were divided into four groups: face-to-face teach-back training and home visitation by follow-up phone call, group training, and e-learning. The results of this study showed that four abovementioned educational methods significantly improved self-care behaviors in patients with heart failure. According to the findings of this study, it is recommended to improve self-care behaviors in patients with heart failure Based on the findings of the study, it is recommended to use one-to-one face-to-face, teach back, home visits with telephone follow-up, group training, and e-learning to improve self-care behaviors in patients with heart failure.
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