Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501Loving and Humane Care: A Missing Link in Nursing146592110.17795/nmsjournal34297.ENMostafa Rad1Department of Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, IR IranAmir Mirhaghi2Department of Nursing, Mashhad University of Medical Sciences, Mashhad, IR IranNematullah Shomoossi3Department of English Language, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, IR IranJournal Article19700101Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501The Effect of G-ORS Along With Rice Soup in the Treatment of Acute Diarrhea in Children: A Single-Blind Randomized Controlled Trial3106591310.17795/nmsjournal.25852.ENMojtaba Kianmehr1Department of Medical Physics, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, IR IranAshraf Saber2Gonabad University of Medical Sciences, Gonabad, IR IranJalil Moshari3Pediatric Department, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, IR IranReza Ahmadi4Infectious Diseases Department, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, IR IranMahdi Basiri-moghadam5Department of Nursing, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, IR IranJournal Article19700101Background The world health organization guidelines for treatment of diarrhea in children emphasize on continued feeding together with prescription of oral rehydration solution (ORS) and supplementary zinc therapy. However, conflicting viewpoints exist regarding the optimal diet and dietary ingredients for children with diarrhea. Moreover, few studies have investigated the effect of rice soup along with ORS in the treatment of this disease. Objectives This study aimed to explore effects of simultaneous taking of glucose oral rehydration solution (G-ORS) and rice soup in the treatment of acute diarrhea in 8 to 24-month-old children. Patients and Methods This single-blind controlled clinical trial was conducted in the pediatric ward of 22nd of Bahman hospital, Gonabad, Iran between June 2013 and February 2014. Forty children aged 8-24 months with acute diarrhea were randomly assigned into an intervention group (G-ORS plus rice soup group) comprising 20 babies and a control group (G-ORS) of 20 children based on balanced blocking randomization. The variables under investigation were diarrhea duration, patient hospitalization, need for intravenous (IV) fluids and stool output frequency. Data was analyzed using independent samples t and chi-square test. Results At the end of study, the time for treating acute watery diarrhea in the intervention and control groups were 21.10 ± 8.81 and 34.55 ± 5.82 hours (P < 0.001) and hospital stay were 34.05 ± 6.62 and 40.20 ± 6.32 hours (P = 0.005). Moreover, stool output frequency were 4.20 ± 0.95 and 8.00 ± 1.37 (P < 0.001) in the first 24 hours, and 2.18 ± 0.60 and 2.80 ± 0.76 (P = 0.03) in the second 24 hours of treatment in intervention and control groups, respectively. Conclusions Rice soup regimen was highly effective and inexpensive in the treatment of acute diarrhea in children. Thus, in addition to the common treatment by G-ORS, rice soup can be consumed simultaneously with G-ORS.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501The Effects of Pregnancy-Adaptation Training on Maternal-Fetal Attachment and Adaptation in Pregnant Women With a History of Baby Loss11186591510.17795/nmsjournal28949.ENNasrin Baghdari1Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR IranElahe Sadeghi Sahebzad1Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IR IranMasoomeh Kheirkhah2Department of Midwifery, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR IranElham Azmoude3Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, IR IranJournal Article19700101Background Studies have shown that educating mothers can improve their adaptation to pregnancy and motherhood roles. There are also studies that have investigated the effects of certain interventions on maternal-fetal attachment. However, studies on the effects of maternal adaptation training on maternal-fetal attachment in mothers with a history of fetal or baby loss are rare. Objectives The aim of this study was to determine the effects of a pregnancy adaptation training package on maternal-fetal attachment in pregnant women with a history of baby loss. Patients and Methods This quasi-experimental study was conducted on 60 pregnant women with previous fetal or neonatal death in 2014. The women were randomly divided into an experimental group (n = 30) and a control group (n = 30). The pregnant women in the experimental group received routine prenatal education in addition to four sessions of a pregnancy adaption training package. The control group received only routine prenatal education. The data were collected using a demographic questionnaire, Cranley’s maternal-fetal attachment scale, and a prenatal self-evaluation questionnaire at the beginning and at the end of the study. The data analysis was conducted using the Mann-Whitney U, Wilcoxon, chi-square, Fisher’s exact, and spearman correlation coefficient tests. Results Before the intervention, there were no statistically significant differences between the study and control groups in terms of maternal-fetal attachment (P = 0.280) and adaptation to pregnancy (P = 0.883). However, following the intervention, the mean score of the maternal-fetal attachment was significantly higher in the experimental group, when compared with the control (77.57 ± 7.23 vs. 61.53 ± 2.62; P = 0.001). In addition, the mean post-intervention adaptation to pregnancy score was significantly lower in the experimental group than in the control group (118.89 ± 8.12 vs. 126.38 ± 4.17; P = 0.001). Conclusions The pregnancy adaptation training package increased the adaptation and maternal-fetal attachment scores in pregnant women with a history of baby loss.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501Evaluation of Mackey Childbirth Satisfaction Rating Scale in Iran: What Are the Psychometric Properties?19276591610.17795/nmsjournal29952.ENZahra Moudi1Pregnancy Health Research Center, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, IR IranMahmoud Tavousi2Health Metrics Research Center, Iranian Institute for Health Sciences Research, Academic Center for Education, Culture and Research, Tehran, IR IranJournal Article19700101Background With the integration of the evaluation of patient satisfaction in the overall assessment of healthcare services, authorities can be assured about the alignment of these services with patient needs and the suitability of care provided at the local level. Objectives This study was conducted in 2013 in Zahedan, Iran, in order to assess the psychometric properties of the Iranian version of the mackey childbirth satisfaction rating scale (MCSRS). Patients and Methods For this study, a methodological design was used. After translating the MCSRS and confirming its initial validity, the questionnaires were distributed among women with uncomplicated pregnancies and no prior history of cesarean section. The participants had given birth to healthy, full-term, singletons (with cephalic presentation) via normal vaginal delivery at hospitals within the past six months. Cronbach’s alpha and test-retest (via the intraclass correlation coefficient) were applied to analyze the internal consistency and reliability of the scale. Moreover, the validity of the scale was tested via exploratory factor analysis, confirmatory factor analysis, and convergent validity. Results The MCSRS consists of six subscales. Through the process of validation, two partner-related items (“partner” subscale) of the scale were excluded due to cultural barriers and hospital policies. Cronbach’s alpha for the total scale was 0.78. It ranged between 0.70 and 0.86 for five subscales, and was 0.31 for the “baby” subscale. Factor analysis confirmed the subscales of “nurse,” “physician,” and “baby,” which were identified in the original scale. However, in the translated version, the “self” subscale was divided into two separate dimensions. The six subscales explained 70.37% of the variance. Confirmatory factor analysis indicated a good fitness for the new model. Convergent validity showed a significant correlation between the MCSRS and the SERVQUAL scale (r = 0.72, P < 0.001). Moreover, the Farsi version of the MCSRS showed excellent repeatability (r = 0.81 - 0.96 for individual subscales and r = 0.96 for the entire scale). Conclusions The study findings indicated the Farsi version of the MCSRS is a reliable and valid instrument. However, according to the reliability assessment and factor analysis, the “baby” and “self” subscales need further revisions.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501Skills Required for Nursing Career Advancement: A Qualitative Study28366591710.17795/nmsjournal30777.ENMohammad Reza Sheikhi1Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR IranMasoud Fallahi-Khoshnab1Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR IranFarahnaz Mohammadi2Social Determinant of Health Research Center and Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, IR IranFatemeh Oskouie3Center for Nursing Care Research and School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR IranJournal Article19700101Background Nurses require certain skills for progression in their field. Identifying these skills can provide the context for nursing career advancement. Objectives This study aimed to identify the skills needed for nurses’ career advancement. Materials and Methods A qualitative approach using content analysis was adopted to study a purposive sample of eighteen nurses working in teaching hospitals affiliated with the Qazvin, Shahid Beheshti, and Iran Universities of Medical Sciences. The data were collected through semi-structured interviews, and analyzed using conventional content analysis. Results The three themes extracted from the data included interpersonal capabilities, competency for career success, and personal capacities. The results showed that acquiring a variety of skills is essential for career advancement. Conclusions The findings showed that personal, interpersonal, and functional skills can facilitate nurses’ career advancement. The effects of these skills on career advancement depend on a variety of conditions that require further studies.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501The Quality of Pre-hospital Circulatory Management in Patients With Multiple Trauma Referred to the Trauma Center of Shahid Beheshti Hospital in Kashan, Iran, in the First Six Months of 201337436592010.17795/nmsjournal32708.ENFarzaneh Maghaminejad1Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR IranMohsen Adib-Hajbaghery1Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran0000-0002-9518-4329Journal Article19700101Background Circulatory management is a critical issue in pre-hospital transportation phase of multiple trauma patients. However, the quality of this important care did not receive enough attention. Objectives The aim of this study was to investigate the quality of pre-hospital circulatory management in patients with multiple trauma. Patients and Methods This was a cross-sectional study conducted in 2013. The study population consisted of all patients with multiple trauma who had been transferred by emergency medical services (EMS) to the central trauma department in Kashan Shahid Beheshti medical center, Kashan, Iran. We recruited a convenience sample of 400 patients with multiple trauma. Data were collected using the circulatory assessment questionnaire and controlling hemorrhage (CAQCH) that were designed by the researchers and were described by using frequency tabulations, central tendency measures, and variability indices. The chi-square test was used to analyze the data. Results The study sample consisted of 263 males (75.2%); 57.75% had lower levels of education and 28.75% were workers. The most common mechanism of trauma was traffic accident (85.4%). We found that the quality of circulatory management was unfavorable in 61% of the cases. A significant relationship was observed between the quality of circulatory management and type of trauma and staff’s employment status. Conclusions The quality of pre-hospital circulatory management provided to patients with multiple trauma was unfavorable. Therefore, establishment of in-service training programs on circulatory management is recommended.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501Effectiveness of Problem-Focused Coping Strategies on the Burden on Caregivers of Hemodialysis Patients43546592210.17795/nmsjournal35594.ENGolnar Ghane1Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR IranMansoureh Ashghali Farahani1Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR IranNaima Seyedfatemi2Department of Mental Health Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR IranHamid Haghani3Department of Biostatistics, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR IranJournal Article19700101Background Studies have shown that family caregivers of hemodialysis patients experience high levels of burden. However, these caregivers are often neglected, and no studies are available on the effectiveness of coping strategies on the burden of care among these caregivers. Objectives This study aimed to examine the effectiveness of problem-focused coping strategies (communication skills, anger management, and deep breathing) on the burden on caregivers of hemodialysis patients. Patients and Methods A randomized controlled clinical trial was conducted on 76 family caregivers of hemodialysis patients referred to Shahid Hasheminejad hemodialysis center in Tehran, Iran. The subjects were equally allocated into two groups of 38. Through a coin-tossing method, caregivers of patients who referred on even or odd days of the week were randomly assigned into the intervention group or the control group, respectively. The intervention group received four training sessions on problem-focused coping strategies, but the control group did not receive any intervention. Both groups answered the caregiver’s burnout inventory at the start and six weeks after the last educational session. Descriptive statistics, chi-square, Fisher’s exact test, independent-samples t-test, and Mann-Whitney U test were used to analyze the data. Results The majority of caregivers (54%) were in the age range of 35 - 55 years, female (68.4%), and married (70%). No significant difference was found between the baseline mean caregivers’ burden scores of the intervention and control groups (88.56 ± 11.74 vs. 84.97 ± 15.13, P = 0.308). However, the mean caregivers’ burden in the intervention group decreased, and the two groups were significantly different at the end of the study (58.77 ± 6.64 vs. 87.84 ± 11.74, P < 0.001). Conclusions The current study showed the effectiveness of problem-focused coping strategies on reducing the burden on caregivers of hemodialysis patients. Authorities and policymakers in the healthcare system are responsible for developing strategies to integrate educational programs, such as the program implemented in the current study, into the country’s healthcare system.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501Barriers to Practical Learning in the Field: A Qualitative Study of Iranian Nursing Students’ Experiences54566591410.17795/nmsjournal26920.ENFaezeh Jahanpour1Pediatric Nursing Department, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, IR IranParviz Azodi2Department of Anesthesia, Paramedical Faculty, Bushehr University of Medical Sciences, Bushehr, IR IranFarzan Azodi3Students’ Research Committee, Bushehr University of Medical Sciences, Bushehr, IR IranAli Akbar Khansir4Foreign Languages Department, Bushehr University of Medical Sciences, Bushehr, IR IranJournal Article19700101Background Clinical training is an integral part of nursing education; however, some studies have shown that it is not always efficient. Objectives This study aimed to find out the factors that can impede nursing students’ clinical learning. Materials and Methods In this qualitative study, data were collected via reflective journal writing. Purposeful sampling was used, and 12 senior nursing students were recruited to the study. The data were analyzed using a content analysis method. Results Three main categories were derived, including inappropriate communication, ineffective role models, and theory-practice gaps. Students perceived that inappropriate communication between instructors, staff members, and students had the greatest impact on student learning. The competence of clinical instructors and staff is an important factor affecting students’ training. The clinical learning environment does not always integrate theory and practice together. Conclusions Nursing students did not experience effective clinical learning. Having expert instructors and supportive communication are important factors in creating a clinical learning environment.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501The Association Between Obstructive Sleep Apnea and Depression in Older Adults56606591910.17795/nmsjournal32585.ENMohammad Farajzadeh1Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR IranJamileh Mohtashami4Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR IranSamira Chaibakhsh5Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, IR IranMansoureh Zagheri Tafreshi6Management Department, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IR IranReza Ghanei Gheshlagh7Kurdistan University of Medical Sciences, Sanandaj, IR IranJournal Article19700101Background Depression is the most frequent psychiatric disorder among the elderly. Obstructive sleep apnea (OSA) is a chronic and prevalent disease that has an ambiguous role in triggering depression. Several researches with contradictory findings have been performed about the association between OSA and depression. Objectives This study aimed to investigate the association between OSA and depression among elderly. Patients and Methods A total of 350 home residing elderly took part in this case-control study. The participants were selected using clustering method. All cases were divided into two groups of depressed and non-depressed using the geriatric depression scale (GDS). Then they were matched in age, gender, education and body mass index (BMI). Berlin questionnaire (BQ) was used to diagnose OSA. Data analysis was performed using Mann-Whitney U test, t-test, Chi-square and Fisher’s exact tests and odds ratio. Results Totally, 60.6 % of depressed group and 18.9 % of non-depressed group were in high risk for OSA. A significant association was found between OSA and depression (P < 0.001, OR = 6.61, CI 95 % = 4.1 - 10.7). In addition, a significant association was found between gender and OSA (P = 0.008). Conclusions OSA was associated with depression among the elderly patients. Given the high prevalence of OSA in older adults, implementation of screening methods is necessary to identify people at high risk of OSA.Kashan University of Medical SciencesNursing and Midwifery Studies2322-14885220160501Self-Concept in Mothers of Educable Mentally Retarded Children61626591810.17795/nmsjournal31919.ENZahra Aliakbarzadeh-Arani1Department of Operating Room, Faculty of Paramedical, Qom University of Medical Sciences, Qom, IR IranJournal Article19700101