Journal of Research Development in Nursing and Midwifery

The Prevalence of Iron Deficiency Anemia in Hemodialysis Patients, Referred to Hemodialysis Ward of Panje Azar Hospital in Gorgan, 2009

alireza shariati

Background and Objective : Anemia is one of the most common complications of end stage renal diseases. Inadequate production of erythropoietin is the main cause of anemia in these patients, and iron deficiency is the other important factor. We designed this study to survey the prevalence of iron deficiency anemia in hemodialysis patients referred to hemodialysis ward of Panje Azar hospital in Gorgan, Iran.

Material and Methods: The subjects of this descriptive and cross-sectional study were all 97 patients undergone permanent hemodialysis. Hemoglobin, Serum Iron, Ferritin, Transferrin saturation and Hemoglobin index were measured to assess iron deficiency anemia. We did data analysis by using chi square, fisher exact test and independent T test in spss 13 environment.

Results: The prevalence of anemia and iron deficiency anemia were 57.6 and 31.1 percent, respectively. Tranferrin saturation in 29.16 percent of the patients is less than 20%. There was no significant correlation between signs of anemia and variables such as, duration of dialysis, causes of the disease and iron- deficiency anemia (p=0.06). But signs of anemia were significantly correlated (p<0.0001) with erythropoietin. In comparison with patients consumed iron orally, those who used injectable iron had higher serum iron, Hemoglobin and Transferrin saturation (p<0.001).

Conclusion: Because of high frequency of iron- deficiency that may results in resistance to erythropoietin therapy and leads to inappropriate treatment of iron deficiency. We recommend first treating of ID to prevent from useless administering of erythropoietin.

Comparison of Coping Strategies between Men and Women Care Givers of Neurologic Patients at Home.

hossein rahmani

Background and Objective : Neurologic patients' care givers are faced with many challenges and stresses, affecting on their health if they cope with an inappropriate style. The awareness of the care givers about coping strategies is necessary to prevent from their psychological problems, therefore the present study was conducted to determine the coping strategies of men and women care givers of Neurologic patients at home.

Material and Methods : This descriptive-Analytical study was conducted on 200 subjects selected by convenience sampling method. The instrument was Jawiloice coping strategy scale having two dimensions of problem-focused part (15 questions) and
emotion-focused (24 questions). The data analysis was performed using estimates of central tendency, Chi-Square, Kruskal-Wallis, Mann-Whitney test and Anova (P<0.05) by spss 16.

Results: The participants were men (N=120) and women (N=80). The problem-focused subscale in men is 51.86 ± 6.3 and in women 52.86 ± 7.63, whereas in emotional-focused the result is 72.86 ± 13.89 in men and 69.68 ± 11.65 in women. In latter dimension, the difference is not statistically significant. In problem-focused between men and women, the difference is significant (p≤0.05). Considering coping levels to low, moderate, and high, there is no meaningful difference between males and females. Duration of involvement with patients is significantly correlated with emotional-focused (p≤ 0.05) and income status with problem-focused (p≤ 0.03).

Conclusion: According to the findings, the care givers must be educated about effective coping strategies skills to decrease stresses due to care of the patients and to improve mental health.

Arteriovenous Fistula Recirculation and its Relationship with Some Factors in Hemodialysis Patients

einollah molaei

Background and Objective : Recirculation rate is essential for the quality of Hemodialysis . Since the treatment of patients is based on the Dialysis Adequacy, the evaluation of recirculation is especially important. This study was performed with the aim of measuring arteriovenous fistula recirculation and its relationship with some factors in Hemodialysis patients.

Material and Methods: In this Descriptive-Analytical study, all Hemodialysis patients (n=100), in Panje Azar Hospital of Gorgan, whose vessels were accessed by arteriovenous Fistula was studied in the summer of 2009. In order to determine recirculation rate ، we used urea based classic method. The cut point of recirculation was considered 10%. The variables studied are Fistula longevity ، direction of needle insertion ، the space between needles and the place of needles fistula and KUF filteration. Data were analyzed by using descriptive statistics and logistic regression test (odds ratio and ci reported) in the SPSS software.

Results: Patients were male (53) and female (47) with the mean age of 50.93± 17.23. The mean year of Dialysis history was 4.04 ± 5.04. Fifteen percent of patients had recirculation. Average access recirculation of all patients was 0.067 ± 0.118. Recirculation rate had significant relationship (P <0.05) with direction of two Arterial-Venous needle and the place of the two needles ، which may have been higher.

Conclusion: Considering the results of this study, we conclude that emphasis should be applied on instructing correct needle insertion in order to decrease recirculation

Comparison of Nurses’ Job Satisfaction and Organizational Commitment in Intensive Care and General Wards of Golestan University of Medical Sciences

GHANBAR rouhi

Background and Objective : Human resources are the most valuable sources of an organization. Nurses, because of special nature of their job, are influenced by various stressors affecting on their job satisfaction and organizational commitment. The aim of this study was to compare Nurses’ job satisfaction and their organizational commitment in intensive care and general wards of Golestan University of medical sciences.

Material and Methods: In this descriptive & analytical study, 389 Nurses were selected via census sampling in 1387. The instrument were job satisfaction questionnaire reliabled by alpha chronbach and meyer organizational commitment scale.To analyze the data, we used Pearson correlation coefficient, independent test, regression and one way anova in spss 16 soft ware environment.

Results: Participants were between 22-55 years. Their mean age was 32.6 ± 7.4 and most of them (72.7%) were female. Intensive care and emergency wards’ Nurses had the lowest organizational commitment and job satisfaction, respectively. There was a significant relationship between job satisfaction and organizational commitment in studied wards (P<0.05).

Conclusion : Whereas job satisfaction can predict organizational commitment of Nurses, it is essential for administrators to consider factors such as salary, participation in decision making, job security, and job enrichment and so on to promote quality of services

Patients’ Satisfaction from Medical and Nursing Services in Khatam Alanbia Hospital in Iranshahr, 2010

tahmineh salehian

Background and Objective : Patients’ satisfaction is an important criterion which can be a good scale to measure and evaluate medical services quality, and can give us some information about fulfillment of patients’ needs expectations and wishes .We conducted this study to investigate the patients’ satisfaction from medical and nursing services.

Material and Methods: In this descriptive and cross- sectional study, the data was collected by a questionnaire including two sections of demographic data and satisfaction level from medical and Nursing services.The subjects are 200 patients selected by easy sampling method, at the time of discharge from hospital. Satisfaction level was measured by likert scale. The data was analyzed using descriptive statistics and chi-square.

Results: The findings show that the patients are satisfied (41%), almost satisfied (21.5%) and unsatisfied (37.5%) from medical services. About satisfaction from nursing services, 57% of the patients were satisfied, 16.5% of them almost and 26.5% rarely satisfied. There was significant relation between variables such as sex, age, education degree and having insurance and satisfaction from medical and nursing services.

Conclusion : The highest percentage of unsatisfied patients was related to lack of giving information by physicians about the disease and Nursing interventions measures. Interaction behavior between medical staff and patient has an effective impact on patients’ recovery and increase patients’ satisfaction therefore, the necessary measures should be taken to improve communication between patient and physician.

Opposite-Sex Classmate: Facilitator and Barrier to Learning

akram sanagoo

Background and Objective: Effective and non-effective communication is the main part of our daily life activities.The purpose of this study was to investigate the male and female students of having opposite gender classmate and its educational impact, based on their perception and experiences.

Material and Methods: In this qualitative study, the nursing students of Golestan University of Medical Sciences were invited to participate in interview.Considering purposeful sampling method and concept saturation, we interviewed with 20 students. The data were collected through individual interactive semi-structured interviews.The interviews were transcribed line by line, coded and categorized through analyzing "content analysis".

Results: Both male and female participants state that having classmates with opposite- sex, due to preparation for future work-life and knowing opposite gender, is essential. Interaction between a male and female classmate is forming gradually during clinical training.Clinical learning environments are effective in better understanding of opposite gender.The experiences and perceptions of the participants in terms of having classmates with opposite gender in educational environment are explained with two main themes "learning facilitator and "learning inhibitor".

Conclusion: Since the academic period is short, it seems that preparation for future work-life is stressful and also being classmate with opposite gender is a major challenge for the students too. Although the students know that having opposite-sex classmate is a necessary issue, due to lack of experiences in their previous school years, this sudden exposure may cause emotional conflict and as a result learning process is inhibited. Having knowledgeable and trustworthy consultants in university may be helpful for the students to deal with their social condition and cultural environment and conduct hidden curriculum

Eleventh Grade Student’s Attitude based on Health Belief Model (HBM) toward Smoking and it’s Complications in Zahedan.

abdolrahman charkazi

Background and Objective: Smoking and drug abuse are among the most important causes of mortality in both developing and developed countries. The aim of this study was to survey of eleventh grade student’s attitude, based on health belief model (HBM), toward smoking and its complications in Zahedan, Iran.

Material and Methods : In this cross-sectional study, we selected 380 students through multi
stage clustered sampling. Data gathering was performed by using a valid and reliable researcher- made questionnaire designed on the basis of HBM.

Results: The mean age of the subjects is 15.9 ± 7. The subjects experienced smoking at least once are 23.2% and regular smokers are 2.1% of them. The results of health belief constructs
are perceived susceptibility (74.8%), perceived severity (68.2%), perceived barriers (42.1%) and perceived benefits (72.1%). About cues to action construct, 61(16.1%) have at least one smoker in their family and 260(68.4%) mention that they have studied about smoking and its' disadvantages. The majority of them had high self- efficacy related to smoking temptation situations and its avoidance.

Conclusion: The results show that most of the students have a favorite attitude toward smoking and its complication, based on health belief model. Hence, it is a necessity to maintain and reinforce this condition to prevent from smoking.

Spouse Abuse among Women Referred to a Health Care Centers in Gorgan, 2008

leila jouybari

Background and Objective : Spouse abuse, which has physical and psychological consequences on victims, is one of the most important health problems in many countries. The purpose of the present study was to investigate wife abuse among the women referred to health care centers of Gorgan, 2008.

Material and Methods : The subjects of this descriptive analytical study were 300 married women selected by easy sampling. Data collection was performed by using "Spouse Abuse" questionnaire, consisting of 27 items which are related to emotional, physical and sexual domains. The validity was confirmed by faculty members and reliability by alpha cronbach (=0.86).

Results : The results show that wife Abuse is severe (6.5%), no report of Spouse Abuse (16.5%), sexual abuse (23%), physical punishment (54.5%), and psychological abuse (82.5%). The rate of Spouse Abuse is lower in younger couples. There is significant relationship between wife Abuse and the age of women, smoking and drug abuse of their husbands (P=0.000).

Conclusion : All kind of wife abuse has devastating health effects on women
well-being. Regarding the high rate of psychological abuse in relationships, it is necessary to consider marital counseling as a priority for mental health of families.

Leisure Time of University Students in Golestan Province

akram sanagoo

Background and Objective: Appropriate spending of free time can be considered as an effective means to promote the physical, psychological and moral aspects of life and to avoid of social misconduct. Since it is true for students, we tried to study the leisure time of university students in Golestan province, 2007.

Material and Methods: In this descriptive survey (2007), the subjects were 1080 male and female students, selected by a randomized Multi-Stage sampling, from some universities (Golestan university of Medical sciences, Golestan University of agriculture and natural resources, Gorgan and Aliabad Azad University) in Golestan province.The data were collected using a valid and reliable questionnaire including 63 questions, and described by descriptive statistics.

Results: The students were female (55.8%), male (54.2%) and range of 18-26 years. Their leisure time were more than 3 hours (49.3%), less than 3 hours (31.7%) only one hour in a day (12.5%) and nothing (6.5%). The students spent their time by sending message
(30.1%), surfing the internet (27.2%), and physical activity such as walking and climbing (15.8%), talking on the phone (21%), chatting with friends (9.4%) and sleeping and watching movies (3.8%).

Conclusion: Because text messaging and surfing the internet are the main hobbies of the students , we recommend parents and university officials to have appropriate policy to help young people for using them in a healthy way.

The study of Poisoning in Children Refred to TaleghaniMedical-Educational Centre of Gorgan, 2009

zahra sabzi

Background and Objective: Poisoning is one of the significant causes of mortality and hospitalization in children. This problem occurs mostly under the age of two and is due to accidental ingestion of drug and poisons.Because of the importance of poisoning and its change in cities and time periods, this study was done to evaluate the epidemiology of poisoning in children admitted to Taleghani Medical-Educational centre of Gorgan, 2009 .

Materials and Methods : This cross-sectional study was conducted on 164 hospitalized children due to poisoning. Patient's data such as age, sex and diagnosis were recorded in preplanned questionnaire, then data analyzed by spss 16.

Results: In this survey, 6053 children were admitted in emergency ward of Gorgan's Taleghani hospital during 2009. Of these cases, 164 are related to poisoning including opium intoxication(39.63%),drugs(24.39%),kerosene(9.75%),house hold chemicals(4.87%) methadone intoxication (4.26%), and mouse killer(2.43%).

Conclusion: Toxification should be taken into account seriously in children. Because of high frequency of opium and medicinal poisoning, we recommend public education to prevent from this accident and to improve public health.