137 1735-7012 Iranian Nursing Scientific Association 12 nursing 1 8 2006 1 1 1 6 27 12 2006 IJNR Iranian Journal of Nursing Research ISSN 1735-7012 Title Page Publisher: Iranian Nursing Scientific Association Chairman: Nikbakht Nasrabadi A. (Ph.D) Editor – in – Chief: Parsa Yekta Z. (Ph.D) Executive coordinator: Mohammadpour A. (Ph.D Student) Editorial Board: Ahmadi F. (Ph.D), Oskouie S.F. (Ph.D), Parsa Yekta Z. (Ph.D), Zamanzadeh V. (Ph.D), Abed Saidi J. (Ph.D), Abbas Zadeh A. (Ph.D), Sharif F. (Ph.D), Fallahi Khoshknab M. (Ph.D), Ghanbari A. (Ph.D), Maddah S.S. (Ph.D), Mohammadi R. (Ph.D), Moattari M. (Ph.D), Nikbakht Nasrabadi A. (Ph.D), Yaghmaie F. (Ph.D). Editorial Advisers: Alhani F. (Ph.D), Basampour Sh. (MSc.), Rahgozar M. (Ph.D), Shaban M. (MSc.), Fakhr Movahedi A. (MSc.), Karimloo M. (Ph.D), Mohammad Pour A. (Ph.D Student), Mohammadi E. (Ph.D), Memarian R. (MSc.), Monjamed Z. (MSc.), Vanaki Z. (Ph.D). Editorial Assistant: Latifi M. (BSN) All rights reserved Series: 500 Prices: 5000 Iranian Rls Address: Iranian Nursing Scientific Association office, Tehran School of Nursing and Midwifery, Tohid sq. Tehran, 141118, Iran. Zip Code: 1419733171 P.O. Box: 14195/398 TEHRAN-IRAN Tel/Fax: + 982166592535 Email: info@ijnr.ir Website: www.ijnr.ir
11 General 1 8 2006 1 1 6 7 27 12 2006 3 nursing 1 8 2006 1 1 7 12 27 12 2006 The effects of breathing [respiratory] exercises teaching on incidence of postoperative (thoracic surgery) atelectasis in hospitalized patients Shaban M (MSc.), Zakerimoghadam M (MSc.), Kordestani P (MSc.). Abstract Introduction: Pulmonary complication due to thoracic surgery changes pulmonary function. Pulmonary atelectasis is the most important complication of postoperative surgery, especially lung surgery, and occurs in the most of thoracic surgery operations. Patient education in preoperative period increases patient's coping with surgery and cooperation in self care. Among teaching of exercises , the nurses must be encourage the patients to do for determining the effects of teaching of breathing exercises on postoperative atelectasis (thoracic surgery) in hospitalized patients in thorax surgery ward. Method and Materials: This study is a clinical trial research. The subject consist of 40 patients (32 female,8male)who were hospitalized in Khorramabad martyrs hospital with age rang 15-65 years old who had eligibility criteria's for this study. Subjects were selected with convenience sampling and then placed in two, 20 persons, experimental and control groups. In experimental group, breathing exercises teaching and how to use incentive spirometry was trained to subjects, and control group received routine cares. Tools of data collection were information checklist and physiological form. Radiography is used for detection of atelectasis. SPSS software descriptive and analytical static's and Qui-square test were used for data analysis in this research. Results: The results of research showed that in 75% of cases of control group, atelctasis is happened. Therefore, in experimental group it was 25%. There was significant difference between two groups for atelectasis. In this research (p) was respected less than significantly 0.005. So that patients in control group were affected with atelectasis more than other group. It means compiled breathing exercises teaching was effective in prevention of atelectasis. Conclusion: This study showed that, for diagnosis of postoperative atelectasis that is due to accumulation of secretions caused by respiratory muscle weakness and decrease in function of respiration center due to drug consumption, we must not be wait for loudly signs of atelectasis because in these patients, atelectasis isn't extensive, but it is moderate to mild. In this research, patients in control group were affected with partial atlectasis, significantly. Between tow groups except in breathing sound, in other signs there was no difference. Basic criterion in diagnosis of atelectasis was chest x ray. Key words: Teaching of breathing exercises, Atelectasis, Thoracic surgery 4 nursing 1 8 2006 1 1 14 19 27 12 2006 The effects of religious film on Secretory Immunoglubulin A levels in school aged children in Hamadan, Iran. Nikbakht Nasrabadi A (Ph.D), Sanei A (DDS), Sheikh N (Ph.D), Tavakol M (MSc.). Abstract Introduction: To investigate the effects of religious content films on secretory immunoglubulin a levels in school aged children in Hamadan primary school students. Material and Methods: This study was a quasi-experimental design with two similar groups of school-aged children. In each group 100 students were examined (girls and boys). They were 9-11 years olds. They were selected purposefully and divided in two case and control groups randomly. Salvia samples were collected for each subject before and after viewing each videotape. Results: The adjusted post mean for the salivary IgA concentration was found to be higher significantly in case in comparison to control group (p<0.04). Conclusion: Although the findings suggest using religious content films in order to increasing the SIgA level in the school aged children, but the researchers recommend replication studies with the same or different methodology especially in hearing aspects of religious sounds and/or films, in order to recommend its practical applications with more validity. Key words: SIgA, religious films, educational films, school aged children 5 nursing 1 8 2006 1 1 21 28 27 12 2006 A Survey on nursing student’s opinions toward nursing and reasons for giving it up Joolaee S (MSc.), Mehrdad N (MSc.), Bohrani N (MSc.). Abstract Introduction: There has been a considerable interest shown recently in student nurse attrition. Despite a long history of researches in this problem, attrition rates remain a cause for concern.Material and methods: This article describes a cross-sectional study to identify the nursing students’ opinion toward “nursing “attrition” and “main reasons for attrition” in Iran in 2004. Material and Methods: A 300 sample of students selected by stratified sampling filled a researcher made questionnaire. Data were analyzed by SPSS statistical package. Results: Results showed that only 18% of respondents have positive opinion toward nursing and most of them explained that they have had a decision to change their major (64%) or/and attrition (52%) during their study. The main reasons for attrition from the Iranian nursing students' point of view in this study were: poor social setting, discrepancy between pre-entry perceptions of nursing and the real fact of it, staff and health care team negative attitudes and inappropriate clinical climate, social gap between physicians and nurses, and poor salary of graduates or financial factors. There was no significant statistical difference between the opinions of students of various semesters of education. Conclusion: Then results suggest the need to do a better job of preparing potential students for what they will encounter in nursing prior to admission and to monitor very closely how students are responding program through their study. Nursing needs to receive considerable media attention including interviews with practicing nurses who describe aspects of the profession and the work of nursing that they do. It seems that the students who were disillusioned with nursing and nurses, the majority of whom were in university nursing programs, were not aware of this situation and were not expecting to find this in the profession that they had chosen to pursue. The almost universal recommendation is to provide a very realistic picture of nursing in information sessions for interested potential students confirm this. Additionally health care managers should consider nursing more and apply policies, which make nurses feel more valued in the community. Key words: nursing profession, nursing attrition, nursing student points of view 13 nursing 1 8 2006 1 1 29 34 28 12 2006 Determining the effect of training the continuous quality improvement on knowledge, attitude, performance and the level of occupational satisfaction of the nurses HossainiMA (MSc.), Kakooyi H (Ph.D), Shah zeidiSH (MSc.), Dibaei M (MSc.). Abstract  Introduction: Today, one of the important challenges in nursing management is lack of job satisfaction. Low job satisfaction has some results for example: decreasing quality of care, absenteeism, … Scientists determined many ways to prevent lack of job satisfaction such as training and performance continuous quality improvement (CQI) that can help to promote satisfaction in nursing job and patient. The aim of this study is determining the effect of training the continuous quality improvement of quality on the level of occupational satisfaction and development of knowledge viewpoint and performance of the nurses. Material and Methods: It is a two-group semi- experimental study, in which 15 nurses were chosen as the Trial group and 30 nurses formed the control group from shohadaye Tajrish and Taleqani hospitals in Tehran in a target-based manner. The tools used in this research included the occupation satisfaction questionnaire and knowledge viewpoint and performance assessment questionnaire. Both groups involved were firstly assessed in terms of occupation satisfaction and then their level of knowledge viewpoint and performance were evaluated with respect to continuous quality improvement. After making coordination with the trial group during a 2-day workshop training continuous quality improvement with (FOCUS-P.D.C.A) method was provided for them and right after completion of the training the occupation satisfaction test was carried out only on the trial group. And the level of changes occurred in the knowledge viewpoint and performance was assessed. For about 2 months the processes results were followed up and then once more the occupation satisfaction test was carried out on both groups to get the changes taken place in their level of knowledge viewpoint and performance measured. Then the obtained results from the tests in both groups control and trial before and after Training were compared with each other in both groups and finally after interference and completion of the above-mentioned course the two groups were compared with each other. We used t-test in this research. Result: In control group there was not significant difference in job satisfaction and knowledge, viewpoint and performance variables. Result showed that in these variables there was significant difference in two groups after intervention. The difference in two variables in trial group was significant before and after intervention. Conclusion: The obtained results from this research indicated that training continuous quality improvement has caused changes in the level of knowledge viewpoint and performance of the nurses and making improvements in all concerned areas. Furthermore the findings brought about by this research indicated that the level of occupation satisfaction has increased through training continuous quality improvement. Key words: Continuous quality improvement, occupation satisfaction, knowledge & attitude & practice, nurses  14 nursing 1 8 2006 1 1 36 40 28 12 2006 8 nursing 1 8 2006 1 1 41 46 27 12 2006 Comparison of persica and Chlorhexidine mouthwashes in prevention of stomatitis in patients receiving chemotherapy Abedipour A (MSc.), Abedsaeedi J (Ph.D), Salehi M (Ph.D), Ebrahimi E (Ph.D). Abstract Introduction: Oral mucositis ulcers are well documented side effects of cytotoxic chemotherapy of cancer. Such complications are not only painful for the patients, but may lead to premature discontinuation of effective chemotherapy due to decreased food uptake or risk of severe infection. The purpose of this controlled randomized clinical trial was to assess the effects of Persica mouthrinse in comparison with Chlorhexidine mouth rinse in the prevention of chemotherapy-induced stomatitis. Methods and Materials: By sequential sampling, 30 patients were seleced and were assigned to a treatment or control group (each 15 patients). Subjects were seleced from oncology units of medical sciences hospitals in Tehran, and all of them received similar chemotherapy regimen for AML and ALL. The patients of the treatment group performed 3 times daily rinsing with persica, the control patients with chlorhexidine. Clinical examination of the oral mucosa was performed before starting chemotherapy and every other day during chemotherapy until 3 weeks. Results: Stomatitis was observed in 5 patients (33.3%) of the treatment group (mean grading: 0/67) and 8 patients (53.3%) of the control group (mean grading: 0/87) furthermore 13 patients (86.7%) were satisfied with persica While 11 patients (73.3%) were satisfied with chlorhexidine. Conclusion: All findings were not significantly different between the two groups. It is conducted that rinsing with persica reduces the onset and severity of stomatitis during chemotherapy as well as chlorhexidine. Also the acceptability of both, persica and chlorhexidine, was similar. With regard to the side effects of chlorhexidine we can suggest persica as a safety mouthwash in the prevention of chemotherapy - induced stomatitis. Key words: Stomatitis, persica, chemotherapy, mouthwash 9 nursing 1 8 2006 1 1 47 57 27 12 2006 A Content Analysis of Concerns of Cancer Clients Rahemi Sh (MSc.). Abstract Introduction: The prevalence rate of cancer as a non infectious disease is on the rise in developing countries. There are lots of information about diagnosis of cancer, its treatment and nursing care, but this qualitative study reveals the concerns and needs of the cancer patients besides the need for treatment regimen. Material and Methods: This study collected information from 30 patients with cancer in the age group of 40 and above, through observation and semi structured taped interviews. Each client was visited for 5 times, all verbal and nonverbal behavior was recorded. Demographic as well as concerns of clients' based on Roper's living model were recorded. The validity of the interview form was checked with reviewing books, articles (Roper's model and Laschinger Empowerment theory) and checked with the experts. For reliability and credibility a deep observation and spending sufficient time for interview in each visit was done. A pilot study was also performed with four clients to provide feed back to the participant regarding the security of interpretations. Results: Using content analysis, interviews and all notes were coded and categorized, concepts and concerns were identified. The findings were compared with roper model of living to asses its application. Findings indicated that one of the main problem of these clients is to talk about their needs and concern .The findings revealed that clients had fleeing of uncertainty to plan and make long term decisions. They also had identity conflicts by expressing having less energy and are not empower enough to do things that they want. Conclusion: They mentioned that they isolate themselves at home due to the low self confidence and low self image and not having control over their life activities. The feeling of having no power resulted in missing the opportunities and their positive abilities to enhance their quality of life. This study should continue with a large group of clients in order to make a proposal for client care in oncology units. Key words: Cancer, content analysis, client’s concern, uncertainty, identity conflict, isolation 10 nursing 1 8 2006 1 1 59 64 27 12 2006 Investigation of the rate and type of medication errors of nurses in Sanandaj Hospitals Penjvini S (MSc.). Abstract Introduction: Medication administration is one of the fundamental nursing practice that requires skill, technique and take care of patients. Mediation errors can induce serious problems in nurse’s profession and put patients in Potential dangers. The purpose of the study was to determine the rate and type of medication errors in nursing staffs, in Sanandaj Hospital 2002. Materials and Methods: In this cross – sectional, descriptive analytical study, 104 nurses personnel in two educational hospitals in Sanandaj city based on census sampling method were studied. A questionnaire with three sections was developed and during the medication were filled by research team. Data analysis performed by Chi-square and Fisher exact test. Results: The findings showed that medication errors in general were 16.7% and the majority of them were related to drug omission and wrong dose in intravenous (IV), intramuscular (IM) and oral (P.O) routes. There was a meaningful relationship between medication errors in IV route and gender (p=0.001), IV route with staff organizational position (p=0.000) P.O with staff organizational position (p=0.003), P.O with the number of Patients (p=0.0001), IV with critically ill patients (p=0.007) and P.O with critically ill patients (p=0.01). Conclusion: According to the results of this study, the work overload (the number of critically ill patients) has an important role in rising the medication errors. Attention must be paid to this problem in order to get balance between patients and nursing staffs. Key words: Medical error, nursing, caring, management