1 2676-5748 Hamadan University of Medical Sciences 44 Nursing The impact of educational evidence-based hand washing program on knowledge, attitude, and adherence of intensive care units nurses bikmoradi ali b mardani davod c Soltanian alireza d khatiban mahnaz e b Hamadan University of Medical Sciences & Health Services c Hamadan Universityof Medical Sciences & Health Services d Hamadan University of Medical Sciences & Health Services e Hamadan University of Medical Sciences & Health Services 1 10 2013 21 3 5 13 23 10 2013 26 10 2013   Background: while Hand washing is the simplest strategy to prevent from ventilator-related pneumonias, lots of nurses don’t consider it as an effective measure. This study aimed to determine the effect of educational program on knowledge, attitude, and adherence of critical care unit nurses with respect to hand washing as a preventive strategy against ventilator-related pneumonia.   Methods: This quasi-experimental study was conducted on 52 critical care unit nurses   Selected by convenience sampling from two therapeutic and educational center of Hamadan University of Medical Sciences. knowledge, attitude, and adherence of the subjects in respect to hand washing were evaluated both before and one and three months after the intervention by the use of a questionnaire and a checklist. Data was analyzed by SPSS version16 and analytical statistics such as repeated measurements.   Result : The majority (%80.8) of nurses had not passed any hand washing educational program previously. Both One and three months after the intervention , an increase in the level of knowledge and attitude of the studied subjects was seen (P=0.01).Although the subjects’ adherence to hand washing with alcohol solutions, soap and water was improved, statistical tests were significant only for hand washing with alcohol solutions (P=0.04).     Conclusion: Short-term and continuous educational programs can enhance knowledge, attitude, and adherence of intensive care unit nurses with respect to hand hygiene as a preventive strategy against ventilator-related pneumonia.
55 Nursing Effectiveness of Light Pressure Stroking Massage on the Vital Signs of Patients after Coronary Artery Bypass Graft Surgery Hospitalized in Isfahan Chamran Hospital between 2010-2011 1 10 2013 21 3 14 23 07 11 2013 09 11 2013 مقدمه: جراحی قلب یک جراحی پر استرس می باشد که می تواند باعث تغییرات علائم حیاتی بیماران گردد. از این رو هدف از این مطالعه تعیین تأثیر ماساژ درمانی بر علائم حیاتی بعد از عمل بیماران تحت جراحی پیوند عروق کرونر می باشد. روش کار: مطالعه حاضر یک مطالعه نیمه تجربی است. شرکت کنندگان این مطالعه شامل 72 بیمار واجد معیارهای ورود بستری در بخش های جراحی قلب بیمارستان شهید چمران شهر اصفهان بودند که بطور تصادفی در دو گروه آزمون و شاهد قرار گرفتند. بیماران گروه آزمون ماساژ استروک سطحی در 4 روز بعد از عمل جراحی و بیماران گروه شاهد تنها مراقبت های روتین را دریافت کردند. علائم حیاتی بیماران قبل و بعد از مداخله با استفاده از چک لیست کنترل و ثبت گردید. برای تجزیه و تحلیل اطلاعات از نرم افزار SPSS نسخه 18 و روش های آماری توصیفی و استنباطی استفاده گردید. یافته ها: مقایسه میانگین(انحراف معیار) علائم حیاتی قبل از مداخله در گروه آزمون و شاهد تفاوتی را نشان نمی‌داد (05/0P) بین دو گروه بود. نتیجه نهایی: ماساژ استروک سطحی می تواند باعث تعدیل علائم حیاتی بعد از عمل بیماران تحت جراحی پیوند عروق کرونر شود و با توجه به سادگی و کم هزینه بودن این روش، شاید بتوان بعنوان مکمل مناسبی برای دارودرمانی و مداخلات بعد از عمل در این بیماران مورد استفاده قرار بگیرد. 56 Nursing Effect of EMLA cream on pain of Copper IUD insertion Ahmadi Doulabi mahbobeh k Tavakolian samira l Mortazavi alireza m Akbarzade Baghban alireza n k Shahid Behesht Medical University, Tehran l Fatemiye Hospital, Hamedan m Shahid Behesht Medical University Tehran n Shahid Behesht Medical University Tehran 1 10 2013 21 3 24 30 09 11 2013 09 11 2013   Background: One of the modern contraceptive methods is the insertion of intrauterine devices which contain copper and are effective for 12 years. One of the barriers to the use of IUDs, is fear from feeling pain during its insertion. EMLA cream 5% (25 mg of Lidocaine and 25 mg Prilocaine ) is a local anesthetic. The purpose of this study is to determine the effect of EMLA cream 5% on reducing pain while inserting Copper T 380A IUD.   Methods: The study was conducted on 92 women in one of the health centers of Hamadan. After applying the cream on the cervix, pain level based on visual analog scale, was assessed in three steps after applying Tenaculum, after entering hystrometer and after IUD insertion and removal of insertion tube. Then, recorded pain levels for each step in case and control groups were compared with each other. Independent t test, Mann-Whitney U test and repeated measures analysis of variance were used to determine and compare the pain levels. To determine the homogeneity of the causing variables chi-square test and Fisher’s exact test were used.   Result : Entering hystrometer was recognized as the most painful step (P<0/001). The mean score of feeling pain during this step in EMLA group was (3/11±2/53) and in placebo group was (5/23±2/31). EMLA cream reduced significantly the pain in all three steps of IUD insertion.   Conclusion: Topical application of EMLA cream 5% as a local anesthetic on the cervix before insertion of IUD, reduces pain during this procedure. 64 Nursing Compliance with standard precautions for Blood borne diseases in Hamadan's Maternity Hospitals artimani tayebeh o Khodaveisi masoud p soltani farzaneh o Hamadan University of Medical Sciences & Health Services p Hamadan University of Medical Sciences & Health Services Hamadan University of Medical Sciences & Health Services 1 10 2013 21 3 31 39 26 11 2013 26 11 2013   Background: Blood borne diseases threaten the health and safety of patients and health care workers worldwide. To prevent from these diseases, compliance with standard precautions is essential. The purpose of this study was to determine the level of compliance with standard precautions in midwives, midwifery students & helper staff of 3 birth centers in Hamadan.   Methods: This cross-sectional study was carried out on72 health care workers including 23 midwives, 34 midwifery students and 15 helper staff who worked at three birth centers of Hamadan city by convenience sampling. Data gathering device was a checklist and observation was the method of collecting data.   Result : Findings of the study showed that compliance with standard precautions in 56.5% of midwives was at poor level and in 43.5% of them at good level. It was also demonstrated that 64.7% of midwifery students had poor level of compliance with standard precautions and 35.3% had good level. Based on the study, 100% of helper staff had poor level of compliance with standard precautions   Conclusion: The average level of compliance with standard precautions among the subjects of study dosn’t stand at a good point. So it is recommended to administrators to provide possibilities and give educations to health care workers about blood borne diseases. 28 Nursing Effects of husband’s education on meting supportive care needs of breast cancer patients: A clinical trial 1 10 2013 21 3 40 50 30 09 2013 20 11 2013 Background: Most of breast cancer patients have many supportive care needs during their illness and education may reduce theses needs in these patients. Until now, there is no any related studies investigated the effects of education for husbands of breast cancer patients. So, the aim of present study was to investigate the effects of husbands’ education on meeting supportive care needs of breast cancer patients. Methods: fifty five breast cancer patients participated in this study and divided into control and experiment groups randomly. Education intervention was conducted in 3 sessions. Supportive Care Needs Survey (SCNS) was filling out by all patients before educations intervention for experimental group and one month after it. The data was analyzed by SPSS software. Results: The pretest – posttest mean difference of supportive care needs in experimental and control groups have statistical difference (p = 0.009). In addition, in all subscales of SCNS, except information and health system, patient care and support and additional items, there was a statistical difference between two groups. The pretest –posttest mean difference within experimental group was meaningful (p = 0.001), but this mean difference was not meaningful for control group (p = 0.51) Conclusion: Supportive care needs reduced in breast cancer patients after participation of their husbands in educational intervention. It is suggested that for reducing supportive care needs of breast cancer patients educational intervention to be held for their caregivers. 72 Nursing Comparison of general health Scale in opioid dependent males and females treatment seekers in Hamadan Shokri zolaykh Ahmadpanah mohhamad Torabian sadat Zarei mohhamad Hamadan University of Medical Sciences & Health Services Hamadan University of Medical Sciences & Health Services Hamadan University of Medical Sciences & Health Services 1 10 2013 21 3 51 58 04 12 2013 04 12 2013   Background: According to the world health organization report, mental disorders are major causes of morbidity and disability in the world and can reduce one’s success and progress in his life. The aim of this study was to c o mpare general health in treatment -seeking drug-dependent men and women in Hamadan, Iran.   Methods: This comparative cross-sectional study was done on 119 participants (59 women and 60 men) selected by available sampling. Data collection instrument was Goldberg's 28-item general health questionnaire. Data was analyzed by descriptive and inferential statistics.   Results: Results of the study showed that 53.33% of subjects had some problems in general health Indexes. Assessing the results of the groups separately, demonstrated that 66.87% of males and 59.73% of females were not in good general health. Comparing the results showed a statistically meaningful difference between two groups (P<0.05).   Conclusion: Findings of this study showed that disorders related to general health is prevalent among treatment -seeking drug-dependents. To prevent from spreading the idea that addiction treatment centers are not efficient and also to prevent from drug-dependents’ disappointment from referring to these centers, it is needed to pay attention to their general health along with the treatments they receive for addiction. 1141 Nursing The relationship between perceived social support and self- efficacy with diet adherence among hemodialysis patient Esmaeil ravanbakhsh ahmadi hamidreza . Jannati yadollah Khalilian Alireza Espabodi fatemeh Mazandaran University of Medical Sciences Mazandaran University of Medical Sciences Mazandaran University of Medical Sciences Mazandaran University of Medical Sciences Mazandaran University of Medical Sciences 1 10 2013 21 3 59 67 17 12 2013 17 12 2013   Background: Adherences to diet is essential for the treatment of hemodialysis patients. Nonadherence to treatment is directly associated with worse clinical outcomes.This study was designed to determine the association between Adherences to diet with perceived social support and self-efficacy among hemodialysis patients .   Methods: In this cross-sectional study, 203 hemodialysis patients were selected by census sampling. Data were gathered by demographic questionnaire, multidimensional scale of perceived social support (MSPSS), strategies used by patients to promote health (SUPPH) questionnaire, and the renal adherence behavior questionnaire (RABQ). The data were analyzed using descriptive and correlation statistics.   Result : Our findings showed that there was significant relationship between perceived social support and self-efficacy with adherence to diet (p=0.001). In addition, a relationship was found between perceived social support with serum phosphate and potassium levels (p=0.023, p=0.043), moreover, there was a correlation between self-efficacy and between dialysis weight gain (p=0.004).   Conclusion: The findings indicated that patients with greater perceived social support and self-efficacy had higher levels of adherences to diet. Based on these findings, to enhance adherence with therapeutics regimen it is necessary increasing the perceived social support and self-efficacy in patients with renal failure. 1147 Nursing Investigating causes of the infants’ growth disorder (6-12 months) in Hamadan health centers based on Health Belief Model Hazavehi mohhamad Taheri maliheh Moeini babak Roshanaei godrat Hamadan University of Medical Sciences & Health Services Hamadan University of Medical Sciences & Health Services Hamadan University of Medical Sciences & Health Services Hamadan University of Medical Sciences & Health Services 1 10 2013 21 3 68 76 24 12 2013 24 12 2013 Background: Due to rapid transition from breast feeding to other food groups, failure to thrive is common among infants. The aim of this study was to determine the factors that cause failure to thrive in infants from 6 to 12 months based on Health Belief Model (HBM) in Hamadan. Methods: In this cross sectional case-control study, 100 mothers of infants with growth disorders as case group members and 100 mothers of healthy infants as control group members were selected randomly from Hamadan health centers. The subjects’ performance was measured by a questionnaire, HBM's constructs and a check list. Data was analyzed by SPSS software 16. Result: This study showed that birth rank (p =0.04) and family income (p=0.004) had direct relationships with growth disorder. The mean score of awareness about infants’ growth disorder in case group mothers was lower than control group members’ (P= 0.01). The study also demonstrated significant relationships between growth disorder and perceived severity (p=0.01), perceived benefits (p= 0.022) and self-efficacy (p= 0.01) Conclusion: Based on this study, Family size, family income, mother's awareness about growth disorder, perceived severity, perceived benefits and self-efficacy are associated with growth disorder in infants. So, family planning intervention to control family size and educational intervention to increase mothers’ self-efficacy and awareness about preparing supplementary food for their infants are recommended.