1 24764132 Iran University of Medical Sciences 51 Special Effect of Educational Program on the “Quality of Life” of Family Caregivers of Patients Undergoing Hemodialysis Ghane Golnar b Ashghali Farahani Mansoureh c Seyed Fatemi Naima d Haghani Hamid e b Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. c Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. d Department of Mental Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. e Department of Biostatistics, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. 1 11 2015 1 4 167 176 12 05 2015 15 09 2015 Background: The family caregivers of patients undergoing hemodialysis have a major role in the care of patients at home. The study results indicate that these caregivers face with multiple problems regarding responsibilities and issues arising from the care and treatment of the patients.These issues decrease their quality of lives. However, these caregivers are mostly neglected andno studies are available on the effectiveness of educational program on their quality of lives. Therefore, this study aimed to examine the effects of educational program on the quality of life of family caregivers of patients undergoing hemodialysis. Methods: This research was a randomized controlled clinical trial, conducted on 76 family caregivers of patients undergoing hemodialysis referred to Shahid Hasheminejad, a medical and educational center in Tehran, Iran. The subjects were equally allocated into 2 groups of 38 patients.The caregivers of the patients who referred in even or odd days of the week were randomly assigned into the intervention and control groups, respectively. The intervention group received 4 training sessions on home care training program during 2 weeks, but the control group just received the routine training at the center. Both groups answered demographic information and “quality of life” (SF-36)questionnaires before and 6 weeks after the intervention. Then, the obtained data were analyzed in SPSS, 21. Descriptive statistics, the Chi-square and Fisher exact tests, as well as independent samples t-test, t-couple, 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. About 68.4% were female and 70% were married. No significant difference was found between the baseline mean scores of “quality of life” of the intervention and the control groups (45.95±14.94 vs. 45.08±11.02, P=0.775). However, the mean scores of quality of life of the intervention group increased at the end of the study and the 2 groups were significantly different in this regard (63.51±11.55 vs. 41.74±10.51, P<0.001). Conclusion: The current study showed that home care training program can be effective in improving the quality of life and compatibility with the responsibilities of caregivers and change their lifestyle. Therefore, we suggest that managers of educational and medical center encourage their staffs to use such programs for improving the caregivers’ health.
63 Special Effect of Kangaroo Mother Care on the Self-esteem of Mothers of Preterm Infants Hospitalized in the Neonatal Intensive Care Unit Dehghan Maryam f Kashaninia Zahra g Sajedi Firoozeh h Soltani Pouria Reza i f Pediatric Nursing, Social Security Organization, Yazd, Iran. g Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. h Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. i Department of Statistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 1 11 2015 1 4 177 182 05 06 2015 02 10 2015 Background: Preterm newborn birth is usually a challenge for the mother and the family. The mother feels inadequate for the care of her newborn and her self-esteem decreases. In this regard, this study aimed to determine the effect of Kangaroo other Care (KMC) on the self-esteem of mothers of preterm newborns. Methods: This quasi-experimental study was conducted on 46 pairs of mothers and newborns admitted to neonatal intensive care unit (NICU) at the Social Security and Shahid Sadoughi hospitals of Yazd City, Iran. We used available sampling; samples were placed in 2 groups of intervention and control. In the intervention group, the mother held the newborn in an upright position at the middle of her chest to establish skin to skin contact. KMC was performed for 30 minutes each day after feeding, for a period of 4 weeks. However, the control group received the regular process of care from NICU. The mothers’ self-esteem in both groups before and after KMC was evaluated and compared by Rosenberg questionnaire. Data analysis was performed by using the Fisher exact test, paired t test, and independent t-test. Results: The mean(SD) self-esteem score of the mothers in the intervention group was 25.826(2.480) after the study. However, in the control group, it was 9.609(2.016) (P˂0.001). The average self-esteem scores of mothers in both groups showed a significant difference prior to intervention (P=0.014); however, in the control group, it was reduced after performing routine nursing cares. Also a significant difference was observed between the self-esteem of mothers in the intervention group before and after intervention (P˂0.001). Conclusion: Kangaroo care increases the self-esteem of preterm infants’ mothers. Therefore, we recommended it to be performed for preterm infants. 64 Special Needle-Stick, Sharp Injuries, and Its Related Factors among Nurses of Imam Reza Hospital, Kermanshah, Iran Abdifard Edris j Sepahvand Elham k Aghaei Abbas l Hosseini Saman m Khachian Alice j Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. k Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. l Department of Statistics and Epidemiology, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. m Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. 1 11 2015 1 4 183 188 17 04 2015 30 08 2015 Background: Nurses are at risk of injuries caused by sharp instruments in hospitals. The objective of this study was to investigate the frequency of injuries due to sharp instruments and its relevant factors among nurses of Imam Reza Hospital, Kermanshah, Iran. Methods: This descriptive-analytic study was conducted on 258 nurses working at Imam Reza Hospital of Kermanshah, Iran, in 2013. The data collection measure was a researcher-made questionnaire, which its validity and reliability were verified. The obtained data were entered into SPSS, version 16 and were analyzed using the Chi-squared and ANOVA test at the significance level of P<0.05. Results: According to the findings, 73.3%(n=191) of nurses were exposed to sharp injuries at workplace. About 41.8% of cases occurred during the first year of nursing. Major injuries were caused by needle-sticks (73.3%) and then IV catheter (42.4%). About 43.5% of the observed injuries occurred while trying to recap the needle-sticks. Also, 38.52% of injured nurses performed the tests after injury screening, while 48.7% did nothing after being injured. Conclusion: With regard to the findings of this study, human and environmental factors are effective on these exposures and environmental factors are much effective than human factors. It seems necessary to train the personnel, observe general precautions, and change wrong behaviors namely needle re-capping. 65 Special Consequences of Stigma in the Life of People with Mental Disorders: A Qualitative Research Momeni Alireza o Parvizy Soroor p o Razi Educational Treatment Psychotherapy Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. p Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. 1 11 2015 1 4 189 196 16 05 2015 12 09 2015 Background: The stigma of mental disorder has destructive impacts on emotions, feelings, personal relationships, parenting, education, occupation, and house management of people with mental disorders. Understanding and awareness of the stigma consequences are important for the establishment and development of constructive relationships with people suffering from mental disorders as well as their care and treatment. This qualitative research aimed to explain the attitudes of people with mental disorder, the treatment team, and the patients’ families towards the consequences of stigma in the life of people with mental disorder. Methods: This study was conducted using a qualitative approach and content analysis method. Sixteen people (patients with mental disorder, their family members, psychiatrist, psychiatric nurse, social worker, legal expert) were selected from 3 psychiatric centers in Tehran by using targeted sampling method and were interviewed using semi-structured interviews until the data were saturated. Results: Content analysis of the interviews showed that people with mental disorder experience the consequences of stigma as fear of stigma, self-blame, searching for a cause for the disorder, denial, avoiding psychiatric treatment, rejection, discrimination, and relapse. Conclusion: The findings of this research can help the psychiatric team to make effective and targeted treatment decisions. Performing interventions to reduce stigma of mental disorder in society seems to be necessary. 66 Special The Effect of Teaching Critical Thinking Skills on the Decision Making Style of Nursing Managers Kashaninia Zahra Yusliani Fateme Hosseini Mohammad Ali Soltani Pouria Reza Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Rehabmanagment, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Statistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 1 11 2015 1 4 197 204 01 06 2015 15 09 2015 Background: One of the main goals of nursing education is training them to provide proper medical services to patients as well as healthy people in the community and health centers using their knowledge and specific skills. This service requires nurses’ critical thinking and effective learning. The purpose of this study was to determine the impact of critical thinking skills on decision making styles of nursing management. Methods: This interventional study is of semi-experimental kind and conducted on 60 nursing managers (30 in each group of the samples). In the beginning of the study, California questionnaire of critical thinking scale was completed by the participants. The intervention group received critical thinking skills training for 8 sessions (4 theoretical sessions and 4 practical sessions). A week after the end of the last training session, the same questionnaires were completed by the participants. Results: Prior to conducting the study, 2 groups were not significantly different regarding demographic variables. The mean score of critical thinking and decision making style of the control group was the same before and after intervention, but in the intervention group, the mean score increased. Conclusion: Teaching critical thinking skills increases the level of critical thinking and the use of rational decision making style by nurses. Nurses’ cognitive ability, especially their ability to process information and make decisions, is a major component of their performance and requires possession of critical thinking. Thus, universities of medical sciences are suggested to provide necessary support to allow the development of professional competencies, decision making, problem-solving, and selfsufficiency skills, which are influenced by the ability for critical thinking. 67 Special The Effect of Swedish Massage on Relieving Fatigue of Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy Kashaninia Zahra Zamanian Jahromi Hamideh Norouzi Tabrizi Kian Bakhshi Enayatollah Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. 1 11 2015 1 4 205 210 18 04 2015 14 08 2015 Background: Fatigue is the most annoying side effect of cancer treatment in children who experience it from the time of diagnosis till conclusion of therapy. About 75% to 90% of children undergoing chemotherapy suffer from this complication. To relieve this problem, massage therapy is recommended which is the most widely applied adjuvant therapy. The purpose of this study was to determine the effect of Swedish massage on fatigue relieve in children aged 7-12 years suffering from acute lymphoblastic leukemia (ALL) who are undergoing chemotherapy at the Children’s Medical Center of Tehran, Iran. Methods: In this clinical trial, 50 children with ALL undergoing chemotherapy were assigned into 2 groups of intervention and control. First, the severity of fatigue in both groups was measured employing a child fatigue scale questionnaire. Then, in the intervention group, the Swedish massage with the effleurage technique was applied by the child’s mother daily for 4 weeks. The fatigue in both groups was measured at the end of each week. The obtained data were analyzed, using descriptive and inferential statistics (repeated measures analysis). Results: Indicated a significant difference in total score of quality of life and the mean score of fatigue between two groups after intervention (P<0.001). The mean score of fatigue intensity and total score of quality of life, had significant decrease in experimental group than control group after intervention. Conclusion: Considering the results of this study, applying the Swedish massage by the mother as a supplemental and non-invasive intervention can be effective in reducing fatigue in children suffering from ALL who are undergoing chemotherapy. 68 Special Effect of Benson Relaxation on Fatigue of Nurses Working in Intensive Care Units Najafi Ghezeljeh Tahereh Sedghian Hojatollah Mohaddes Ardabili Fatemeh Rezaei Loieh Habibollah Department of Intensive Care Unit, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Department of Intensive Care Unit, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. Shahid Rajaei Cardiovascular, Medical and Research Center, Tehran, Iran. 1 11 2015 1 4 211 217 21 06 2015 08 10 2015 Background: Fatigue is one of the important factors in nursing performance because it affects the quality of care provided to the patients. In this regard, some complementary interventions such as Benson relaxation techniques may relieve fatigue. This study aimed to evaluate the effect of Benson relaxation on fatigue of nurses working in intensive care units. Methods: This is an experimental study (pretest-posttest randomized with control group) conducted on 63 nurses working in intensive care units of Shahid Rajai Cardiovascular, Medical and Research Center in Tehran, Iran. Participants were selected by stratified sampling based on wards and were randomly allocated in the intervention and control groups. Benson relaxation method was performed by nurses in the intervention group for 20 minutes twice a day with at least 6 hours interval between 2 sessions. The relaxation therapy was scheduled for 2 weeks. The data were collected via demographic and fatigue questionnaires. After data collection, the Chi-square test, independent t-test, Fisher exact test, and analysis of variance with repeated measures were performed by SPSS, version 21. Results: The results showed that the mean(SD) of fatigue score in the intervention group before, 1, and 2 weeks after intervention were 4.73(0.97), 4.58(0.94), and 4.38(0.85), respectively. Two groups had significant differences in terms of fatigue as the mean fatigue score of the control group increased over time compared to that of the intervention group (P=0.002). Also, there was a significant difference (it decreased) between the mean fatigue score of the nurses before the intervention and 2 weeks after the intervention. However, the mean of fatigue in the control group increased over time. Conclusion: Implementation of Benson relaxation was associated with decreased fatigue of nurses in intensive care units. Therefore, we suggest that managers and authorities of health centers consider Benson relaxation method a part of fatigue reduction plans for nurses.