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   Table of Contents - Current issue
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October-December 2020
Volume 7 | Issue 4
Page Nos. 219-288

Online since Thursday, October 15, 2020

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ORIGINAL ARTICLES  

Effectiveness of smartphone-based medication reminder application on medication adherence of patients with essential hypertension: A clinical trial study Highly accessed article p. 219
Sajede Mohammadi Torkabad, Tayebeh Negahban Bonabi, Shahin Heidari
DOI:10.4103/JNMS.JNMS_16_20  
Context: Failure to adhere to drug therapy in patients with high blood pressure can endanger their lives. Aims: The aim of this study was to determine the effectiveness of smartphone-based medication reminder application on medication adherence of patients with essential hypertension. Settings and Design: This clinical trial study was conducted in Yazd Cardiac Research Center. Material and Methods: Seventy-eight patients with essential hypertension were assigned to intervention (39 patients) and control (39 patients) groups using a random sampling method. In the intervention group, the DaroYab 2.1.0 was installed on the patient's smartphone. The control group received routine care. Data were collected using demographic characteristics form and Morriskey's medication adherence scale (MMAS-8). The MMAS-8 completed prior to and 3 months after the intervention. Statistical Analysis Used: Data were analyzed using IBM SPSS, American multinational technology company, Armonk, New York and nonparametric tests including the Wilcoxon test and Mann–Whitney U-test. Results: The mean age of the 78 patients who completed the study was 46.6 ± 7.98 years. All of the participants had a history of drug forgetfulness and 92.5% of them had poor medication adherence before the intervention. Three months after the intervention, the ratio of good medication adherence and medication adherence scores was significantly improved in the DaroYab software group (P < 0.001). Conclusions: Considering the positive impact of DaroYab as a simple, practical, and inexpensive drug reminder, on medication adherence it is recommended that health-care providers introduce this application to of hypertensive patients and encourage them to use it.
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Characteristics of a supportive clinical instructor in nursing training: A qualitative study p. 226
Mansoureh Ashghali Farahani, Soodabeh Joolaee, Ali Zabihi, Shokoh Varaei, Seyedeh Roghayeh Jafarian_amiri
DOI:10.4103/JNMS.JNMS_4_20  
Context: Support has been one of the most basic needs of students in clinical training and its lack or weakness makes some problems for students' learning. Aims: This study explained nursing students' and instructors' perceptions of the characteristics of a supportive instructor in clinical training. Setting and Design: In this qualitative study, participants were 17 undergraduate nursing students, 3 instructors, and 1 nurse who were selected by purposeful and theoretical sampling in 2017. Participants in this study were selected from nursing students of Babol University of Medical Sciences who had experienced at least one internship course in the hospital, instructors, and one nurse who were in their teaching environment. Materials and Methods: Face-to-face semi-structured interviews were employed to collect the study data. Statistical Analysis Used: Qualitative content analysis method was used. Results: Data analysis led to the extraction of two main themes that included personal and professional competence. Individual competence subthemes include patience and equanimity, courtesy, and capacity and subthemes such as having professional knowledge, having professional skill, effective communication ability, purposeful management of training, role pattern, bound to ethical principles, having positive attitude compared to profession and student and comrade of the student were obtained from the professional competence. Conclusions: The findings of the present study help nursing training managers to select the instructors for selecting instructors who have the necessary competencies to support students.
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The effect of portfolio training and clinical evaluation method on the clinical competence of nursing students p. 233
Maryam Sadat Katebi, Ali Arab Ahmadi, Hassan Jahani, Fatemeh Mohalli, Masood Rahimi, Fateme Jafari
DOI:10.4103/JNMS.JNMS_2_20  
Context: Nowadays, nurses in addition to acquiring knowledge should have sufficient clinical skills. One of the methods that have recently been taken into consideration in nursing students' clinical education is the method of portfolio. Aims: The purpose of this study was to affect the portfolio training and clinical evaluation method on the clinical competence of nursing students. Settings and Design: This semi-experimental study was carried out at the Faculty of Nursing and Midwifery of Qaen. Material and Methods: The research population was all senior nursing students who were randomly divided into control groups and intervention to available sampling method. Education and clinical evaluation in the field of clinical competency in the internal and surgical departments were conducted in the intervention group of students with portfolio method and in the control group of students with conventional method from the viewpoint of professors and students. Statistical Analysis Used: The data were analyzed by SPSS 24 and paired and independent t-test. Results: According to the students' viewpoint in all aspects of clinical competence (except individual management) and clinical competency, the portfolio group had a higher mean, but there was no significant difference between the two groups (P > 0.05). However, according to the professor's view, there was a significant difference between the two groups in all aspects of clinical competency and total clinical competency. Conclusions: Portfolio training and clinical evaluation can improve students' clinical competence. Therefore method can be used to create either motivation or interest to participate in learning and improve the level of clinical competence. Therefore, those interested and those in charge of educational affairs can benefit from this new educational method for the purpose of training and clinical evaluation of trainee students in the field.
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Intensive care unit nurses' perception of the barriers to effective in-service education: A qualitative study p. 241
Shahrzad Yektatalab, Marzieh Momennasab, Soroor Parvizy, Noushin Mousazadeh
DOI:10.4103/JNMS.JNMS_27_20  
Context: Educating the staff in organizations is one of the most important issues in different countries, so concerning the necessity of nurses' roles and scientific advancements in providing nursing care will not be achieved without in-service education. Aims: The purpose of this study is to investigate intensive care unit nurses' perception of the barriers to effective in-service education. Settings and Design: This qualitative study was conducted at Shiraz University of Medical Sciences (sums). Materials and Methods: The researcher used the conventional content analysis method to evaluate nurses' perception of the barriers to effective in-service education from March 2015 to June 2016. Statistical Analysis Used: Data analysis was done with a conventional content analysis method. Results: Three main themes of nurse's in-service education barriers were extracted from the analysis of the data. The themes are ineffective teaching methods, inappropriate content of educational programs, and inappropriate scheduling of teaching programs. Conclusion: Identifying the barriers to effective in-service education can guide nurses and nursing administrators in improving education in the nursing field and subsequently providing better treatments for patients.
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The effect of progressive muscle relaxation on depressive symptoms in elderly people p. 248
Ahmad Hayati, Laleh Fanisaberi, Tahereh Yaghobi, Mehdi Pourasghar, Nouroeddin Mousavinasab, Zohreh Taraghi
DOI:10.4103/JNMS.JNMS_35_20  
Context: Depression is one of the most common old-age psychiatric disorders. Aims: The present study was conducted to determine the effect of progressive muscle relaxation on depressive symptoms in elders. Setting and Design: This quasi-experimental study was conducted in two seniors daycare centers of Mazandaran in 2019. Materials and Methods: A total of 76 elderly people divided into intervention and control groups (38 each). The intervention group performed relaxation exercises twice a day for 30 days, and the control group received only the routine cares. The two groups' depression was assessed before and a month after relaxation using the Geriatric Depression Scale. Statistical Analysis Used: Data were analyzed in SPSS-22 using Mann–Whitney and Wilcoxon tests. Results: After a month, depression score in the intervention group reduced from 7.13 ± 1.14 to 5.55 ± 0.98 (P < 0.001), but the score change in the control group was not significant (from 7.13 ± 0.96 to 7.18 ± 0.83) (P = 0.655). The intervention significantly changed depression score in elders (P < 0.001). Conclusion: A month of progressive muscle relaxation appears to improve depressive symptoms in elderly people. Implementing of such measures is recommended in the day care centers.
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Clinical differentiation: Achievment of planned peer-assistant education for nursing students p. 255
Roghieh Nazari, Fatemeh Hajihosseini, Zohreh Vanaki, Hamid Sharif Nia
DOI:10.4103/JNMS.JNMS_19_20  
Context: Different types of peer education have been used in nursing. There is not a formal peer education in Iranian nursing curriculum. Aim: The present study was conducted to identify and contextualize nursing students' perception of clinical training by planned peer assistant education. Setting and Design: This study was conducted using conventional qualitative content analysis by a descriptive explorative method in Mazandaran University of Medical Sciences. Materials and Methods: Participants included 24 trainees who received intensive care unit training by eight peer assistant. Data saturation was achieved through semi-structured in-depth individual interviews with 14 students and three focus group sessions. Statistical Analysis Used: Data were analyzed using conventional qualitative content analysis with MaxQData. Results: Participants' experiences were categorized into two main themes including (1) “Clinical differentiation” with three subthemes of clinical independence, courage, and sincere clinical experience, and (2) “facilitating interactive directed clinical learning” with two subthemes of facilitating clinical learning, and interactive directed learning were extracted from the qualitative content analysis of data. Conclusions: Students participating in planned peer-assistant education had a positive perception of the program and considered “clinical differentiation” as its most important achievement.
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Frequency of violence against nurses and its related factors during cardiopulmonary resuscitation in emergency wards p. 262
Majid Khorram Margavi, Masoumeh Bagheri-Nesami, Nouraddin Mousavinasab, Hamideh Azimi Lolaty
DOI:10.4103/JNMS.JNMS_59_19  
Context: Workplace violence in the healthcare setting is an important issue in recent years. Aims: The aim of this study was to evaluate the frequency of violence against emergency and cardiopulmonary resuscitation (CPR) nurses and its related factors in teaching hospitals in 2019. Setting and Design: In this cross sectional study, 140 emergency and CPR nurses who worked in hospitals of the Mazandaran University of Medical Sciences randomly selected. Materials and Methods: The workplace violence in the health sector questionnaire was used. Statistical Analysis Used: Data were analyzed using the SPSS software version 20.0. Results: The mean age of the nurses was 34.48 ± 6.07 years with work experience of 10.49 ± 5.93 years. Most of them were female (n = 86; 61.4%) and married (n = 115; 82.1%). A total of 302 different types of harassment were reported during 12 months before the study including physical 55.7%, verbal/bullying 38.6%, sexual 5%, and racial 29.3%. Relatives of the patients were the main perpetrators of the violence. Association between gender and physical and sexual harassments was significant (P = 0.0001 and P = 0.043, respectively). Physical harassment was significantly associated with marital status (P = 0.044), education level (P = 0.034) and worry about workplace violence (P = 0.020). The association between racial violence with the working situation was significant (P = 0.008). Conclusion: Based on results the prevalence of workplace violence against emergency and CPR nurses is a serious problem. Future research must move from descriptive to intervention studies to provide a guideline in clinical settings.
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A descriptive study of menstrual hygiene practices among women at the rural area of Haryana p. 269
Poonam Sheoran, Simarjeet Kaur, Hem Lata, Jyoti Sarin
DOI:10.4103/JNMS.JNMS_18_20  
Context: Menstruation is physiological phenomenon for women demonstrating her ability for reproduction. In developing country, such as India, menstrual hygiene management (MHM) is a significant issue for women because of poor water supply and sanitation, privacy and security, and inappropriate puberty education. Lack of hygienic MHM items (absorbents) also cause women to perceive menstruation as a burden. Aims: This study aimed to assess the practices of women regarding menstrual hygiene. Setting and Design: The present, descriptive analytical study was conducted in three rural provinces of Ambala district in Haryana, India (from October 2017 to October 2018). Materials and Methods: The quantitative research approach with descriptive survey design was used to assess the practices of 800 women residing in the rural areas of Ambala District, Haryana by using the convenience sampling technique. Women under the reproductive age group of 14–49 years who attained the menarche were included in the study. Statistical Analysis Used: The data were collected by using the structured practices questionnaire. Descriptive analysis was done using percentage and frequency. Results: Majority (56%) of women was in the age group of 14–25 years and most (92%) of them were eager to know more about menstrual hygiene. Majority (79.87%) of women assumed menstruation as a biological process, whereas only 11.09% assumed the menstruation blood as a normal blood. Nearly two-third (70.50%) preferred to use cloth as absorbent and most (88.37%) of women dispose used absorbent in dustbin. About 34.72% were facing religious limitations as a problem during menstruation. Conclusion: Practices regarding menstrual hygiene is still not adequate, whereas many of the socio-cultural restriction persist among women. There is a need of appropriate education to abolishing the myths related to menstruation.
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Association between quality of life and palliative care at the cancer patients p. 274
Ghasem Abedi, Jalil Shojaee, Mohammad Javad Kabir, Jamshid Yazdani charati, Peivand Bastani, Abdolrahim Hazini, Habib Jalilian, Pouyan Asadi
DOI:10.4103/JNMS.JNMS_55_20  
Context: Patients with cancer experience great pain and stress. Many studies show that palliative care has a positive effect on many clinical outcomes involving symptom distress, quality of life, satisfaction, and survival. Aims: This study aimed to survey the association between quality of life and palliative care in cancer patients. Setting and Design: This was a descriptive correlational study conducted from February 2019 to August 2019 on 399 patients diagnosed with cancer recruited from seven universities of medical sciences. Materials and Methods: The sample size consisted of 97 cancer patients who had received palliative care and 302 cancer patients who did not receive palliative care. The convenience sampling method was used. The World Health Organization quality of life (QOL)-BREF questionnaire was used for data collection. Statistical Analysis Used: Data were analyzed using SPSS software version 22. Data were described with mean, standard deviation, and frequency and analyzed using Mann–Whitney, K-S test. A generalized linear regression model was used in this study. Results: The mean score of total QoL in patients who did not receive palliative care was higher than those who received (51.038 ± 23.771 vs. 48.195 ± 27.361), and this difference was not statistically significant (P > 0.05). A statistically significant association was observed between palliative care and psychological and environmental health, total QoL, education, employment and income status (P < 0.05). Conclusion: The utilization of palliative care was associated with improved psychological health and environmental health.
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REVIEW ARTICLE Top

Non-pharmacological interventions to promote sexual function in women with Type 2 diabetes p. 281
Somayeh Karimi-Valoujaei, Zahra Kashi, Seyede-Sedigheh Yousefi, Hamid Sharif Nia, Soghra Khani
DOI:10.4103/JNMS.JNMS_51_19  
Sexual dysfunction is known as one of the chronic complications of Type 2 diabetes, having its own negative effects on marital relationships as well as quality of life. Thus, the main objective of the present study is to review nonpharmacological interventions to promote sexual function in women affected with Type 2 diabetes. This review was conducted on the studies published within early 1990–2019. The search was performed using the available databases including Scopus, Science Direct, PubMed, Google Scholar, Magiran, Barakat, and SID. The keywords used include Diabetes, Lifestyle, and Sexual function. A total of 675 articles were obtained based on the inclusion criteria; however, eight articles were found to be completely relevant to the topic of interest. The main results were divided into two main categories: Category I: lifestyle modifications (two articles) and Category II: training/counseling intervention programs (six articles). Moreover, the research instrument utilized in all studies was the Female Sexual Function Index. The results of the selected articles further revealed that lifestyle modifications and training/counseling intervention programs were effective in promoting sexual function among women with Type 2 diabetes. However, the retrieved documents were not adequate to reach a definitive conclusion. Therefore, further interventional studies using different types of counseling methods and lifestyle modifications are suggested to promote sexual function in women with Type 2 diabetes.
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LETTER TO THE EDITOR Top

Application of chaos theory in the patient's safety p. 288
Ali Asghar Jesmi, Leila Mahasti Jouybari, Akram Sanagoo
DOI:10.4103/JNMS.JNMS_34_19  
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