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Background & Objective: One of the most current aggressive methods to access to blood vessels intravenous peripheral catheters that contains excess complications and prevention of it is one of important medical goals. Therefore, this study was done to determining influence dressing with gauze sterile using in complication appearance rate of side effects patients in CCU and having venous catheter. Materials & Methods: This clinical trial accomplished on 64 patient’s hospitalization in CCU and post CCU of Malayer Hospital. 32 of patients in the experimental group (Use of dressing with gaze sterile) and 32 of patients shelled in the control group (Routine) randomly. For data collecting was used checklist and laboratory reports, the method was according to following. Form: In beginning, questionnaire which contained demographic information completed and then venous catheter was enclosed sterility in patient’s hand by one person, after the catheter was replaced, placed the gauze sterile on catheter site for the experimental group (Routine) then every 12 hours considered the place in aspect of phlebitis and infection to 72 hours duration, since phlebitis appearing and or finished 72 hours, the angiocat plastical tip detached from trunck by sterile bisturi and transferred to laboratory tube containing nutritive materials and sent the laboratory during minumm time possible time it was cultured in a culture environment growing 15 colony number on every platelet was considered as positive. Results: 65% of 2 groups are among 61-70 years old 53.1% of both group are illiterate. The majority of both groups (59.4%) had myocardial ischemic heart disease. Catheter situation in the experimental group 53.7% was in the left hand and the control group 63.1% was in the right hand in aspect of type of used drug 44.1% individuals of the 2 groups used 2 drugs heparin and vasodilators. Study’s result about phlebitis with (P<0.05) showed that the gauze sterile dressing has effected in preventing of it’s appearance, therefore statistical fisher test showed that gauze sterile dressing is not effected in preventing of venous catheter’s local infection. Conclusion: The use of the sterile gauze dressing can effect in preventing of phlebitis and colonization.

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Background & Objective: In all of world, a portion of household income expends on health care cost. Amount and distribution of the proportion indicate financial burden of health care in the societies. WHO believes that one of the main determinants in health system efficiency is fairness of financial contribution. This study aimed distribution pattern of urban households’ income, health expenditure by cost types and measuring of equality on health care costs in the Gorgan district. Materials & Methods: In order to establish the population laboratory, this cross-sectional study assessed 1014 household in the Gorgan health posts (No 4 and 8) on January 2003. health insurance status, monthly household income and monthly health care cost gathered through interviewing with the husbandmans. Results: Health insurance coverage was 67% in highest and 44% in lowest income deciles (P<0.05). Median and mean of assessed households’ income and household health care cost were 1200000 Rls, (1669669±187300 Rls) and 80000 Rls, (281530±95124 Rls) respectively. Mean of median of out of pocket proportion health care cost per households’ income was 0.57±0.03 and 0.66 respectively. 13% of total income expended health care cost through out of pocket. This proportion in highest and lowest income decile was 7% and 28% (P<0.05). Gini coefficient of health care cost and out of pocket cost per total household income were 0.22 and 0.18 respectively. Conclusion: Low income households expended almost 40% of their income in order to purchasing of health care, in comparison to richest households, they spent 9% of total income. Instead of, additive development of health insurance systems and complementary insurance mechanisms, a half of health care cost in the population spend by out of pocket. According to WHO standards of health system performance, revising health insurance system and payment mechanisms are mandatory.

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Background&Objective: Hospital infection is one of the important determinants on lengthening hospitalization and increasing the costs and mortality rates in hospitals. Intensive Care Unit (ICU) is one of the wards that are most afflicted with the incidence of this morbidity. This study involves investigating the incidence of infection in one of the Intensive Care Units. Materials&Methods: This study was designed in the form of a prospective cohort which was implemented on patients who were hospitalized in the ICU of Khatamol Anbia Hospital from September 21st 2002 for at least 72 hours and didn’t reveal signs of infection. The status and duration of using tracheal tube, ventilator, urinary catheter, and venous catheter, the duration of hospitalization in ICU and the time infection appeared were all recorded. Results: During the six months spent on this study, 234 patients were hospitalized in ICU, among which 50 patients were investigated. The group of these 50 patients cumulatively spent 528 days in ICU. During their hospitalization, 9 cases of infection occurred in these patients. The incidence of infection was 18% (with a 95% confidence interval of 7.35% to 28.65%). The incidence rate was 17 patients in 1000 person-year of hospitalization in ICU (with a 95% confidence interval of 8.8 to 106.3). Conclusion: Hospital infection is a relatively common complication among patients who have been hospitalized in ICU for at least 3 days. The frequency of infection reported in Iran is equal or more than the results of studies carried out in other parts of the world.

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Background & Objective: Nutritional support is a basic process for survival in trauma patients. The purpose of this study was to evaluate the daily nutritional support practice in head injury patients admitted to Neurosurgery Intensive Care Unit.

 

Materials & Methods: This descriptive cross-sectional study was done on 115 Head injury adults patients who received enteral nutrition for at least 48h in Rasht Poursina hospital during 2005. Nutritional measurements were included the number of patients who received enteral nutrition, the time to initiate nutritional support, amount of initial feeding and clinical outcome were included the duration of mechanical ventilation, ICU and in-hospital length of stay (loss), in-hospital mortality rates .Data was reported as Mean±SD and percent. T-test analysis was used for comparing of calorie and nutrient intakes and requirements.

 

Results: Mean±SD of age patient was 41.22±21.9, 84% of patients received enteral nutrition. The time to feeding and the amount of initial feeding was 4.6±1 day and 52.79±27.83 ml/h respectively. Duration of ventilation was 12±13.4 day and ICU length of stay 18.96±18.3 day, Hospital length of stays 24.47±19.84 day. Mortality rate in six month was 48%. Mean of energy, carbohydrate, fat and protein (P<0.05) intakes had significant differences compared with requirements.

 

Conclusion: The recording process has revealed undesirable feeding practice in head injury patients. Nutritional outcomes would be improved with implementation of standard protocol in neurosurgery intensive care unit.

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Background and Objective: The Acute Physiology and Chronic Health Evaluation II classification system has been extensively used for predicting the patient mortality in various diseases admission in ICU ward. The aim of this study was to assess the predicting mortality rate of patients in critical care unit using APACHE-II index. Materials and Methods: This descriptive analytial study was done on 204 hospitalized patients with multiple diagnostic diseases admitted to ICU ward in Gazvin Kusar hospital during 2007. We used than demographic questionnaire and APACHE-II tool to evaluate the prediction mortality rate. Results: Out of 204 patients admitted, 147 (72.1%) survived. Mean APACHE-II score of the subjects was 11.38 (with arrange of 0 to 41). The predicted death rate was 30.26% and the observed death rate was 27.9%. There was a perfect correlation between APACHE-II score and predicted death rate (r=0.976 and P<0.05). Mean APACHE-II score in survivors and non-survivors subjects was 13.97 and 25.36, respectively (t:9.93 P<0.05). Conclusion: This study showed that APACHE-II score can truly predict mortality rate in patients in ICU ward. In addition, this index is helpful in follow up treatment cycle in critical care patients.

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Background and Objective: Multiple sclerosis (MS) is a chronic, progressive and degenerative myelin sheath of the central nervous system. Manifestation and side effect of this disease drastically impress patient’s body image and destruct self concept. The objective of the implementation of this study was to evaluate the effect of Orem self- care program on multiple sclerosis patients’ self concept. Materials and Methods: This quesi-experimental study was done on 34 MS patients referred to Ayatollah Kashani hospital in Shahrekord – Iran, during 2008. The patients were selected by convenience sampling. 8 sessions educational program based on patients needs and Orem self care frame work during 3 months were carried out and with self reporting sheets program was pursued. After 3 months self concept questionnaire completed and data were analyzed by using SPSS-11.5 software and paired T, will kakson and kruskal wallis tests. Results: Mean of self concept, prior and post intervention was 60.67+-4.20, 118.26+-3.53, respectively (P<0.05). No significant correlation was found between age, gender, educational level, marriage status, number of children, occupation, level of income, duration of outbreak, times of hospitalized with self esteem. Conclusion: This study showed that self care program based on the Orem frame work has positive effects on self esteem in multiple sclerosis patients. Therefore this program is recommended in MS patients.

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Background and Objective: Life saving with a high quality health care programs in the shortest duration is the mainstay of emergency department system. Frequent monitoring and quality control of this process and the satisfaction of patients are among the very important indices in hospital quality. This study was designed to evaluate the clients satisfaction in the hospitals affiliated to Golestan University of medical sciences. Materials and Methods: This descriptive cross-sectional study was done on 2400 referred patients in emergency departments of different hospitals in Golestan province, northern Iran during 2006. Data were gathered by questionnaire included demographic data and questions about satisfaction of outpatients and emergencies. The Data analyzed by SPSS-15 software and chi-square test. Results: Level of satisfaction in emergency department, was reported as follow: physician attention and behaviors (86%), nursing behaviors (85%) responsibility to patients (84.1%) status of the environmental temperature (83.9%) and cleaning (81.9%). The lowest satisfaction was related to behavior of guardsman (33.8%). In emergency ward, levels of patient's satisfaction were as following: Access to telephone (49.7%) quality of the meals (47.4%) quantity of meals (44.1%) and the lowest level of satisfaction of patient was neglecting the patient's right (8.2%). Conclusion: This study indicated that more educational programs, should be arranged for the emergency units employees to observe patients right.

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Background and Objective: Abdominal operations as gynaecological procedures result in gastrointestinal dysmotility. Early feeding and ambulation are nonpharmacologic interventions which can be useful in re-initiation of bowel function. This study was done to evaluate the effect of early oral hydration on the return of bowel function and woman's satisfaction after elective caesarean section in primiparous women.

Materials and Methods: In this randomized clinical trial, 120 primiparous women undergone elective cesarean section were assigned to control and intervention groups in Hajar hospital, Shahrekord, Iran during 2007. In the interventional group, oral hydration with liquids was started 4 hours after surgery regardless of presence of bowel sounds and solid food was started after bowel sounds appeared. The control group recieved liquid diet 12 hours after the operation if it was tolerated, they were given soft diet and regular food at the next meal. The return of bowel activity, time of ambulating, satisfaction, discharge from the hospital and complications were compared in two groups. The data were analyzed using SPSS-15, Chi-Square, T and one way ANOVA tests.

Results: The mean postoperative time interval to first hearing of normal intestinal sounds in interventional versus control groups were (9.5±1.38 and 12.5±2.5 hours) the first passage of flatus (15.7±3.61 vs.22.4±4.1 hours), time to first sensation of bowel movement (10.8±1.99 versus 15.7±3.4 hours) and defecation (18.9±3.65 versus 23.4±4.85 hours). These differences were significant (P<0.05). Also discharge from the hospital (0.96±0.18 versus 1.1±34 days) were significantly shorter in interventional group (P<0.05). The women in the early feeding group got out of bed (patient mobilisation) earlier than their interventional group (14.1 hours versus 18.8 hours (P<0.05). Maternal satisfaction was significantly higher among the early fed women (P<0.05).

Conclusion: Early oral hydration after elective cesarean section associated with rapid resumption of intestinal motility and increased woman’s satisfaction.

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Background and Objective: Unwanted pregnancy can have negative impacts on maternal health. The aim of this study was to compare the health status of women with wanted and unwanted pregnancies in Kerman, Iran.

Materials and Methods: This case – control was performed on women with wanted (100 cases) and unwanted pregnancies (100 cases) whom refered to health centers in Kerman, Iran during 2010. The tool for data collection included a demographic questionnaire, short form 36 health survey (SF36) and a researcher-made pregnancy’s  physical health. Validity and reliability of the questionnaires were assessed initially prior to study procedure. Data was analyzed by using SPSS-16, Chi-Square, T Student and Mann-Whitney tests.

Results: Women with unwanted pregnancies had lower scores for physical and mental health, vaccination and supplement consumption, prenatal care and personal health than women with wanted pregnancies (P<0.05). Women with unwanted pregnancies had more complications and high risk behavior compared to unwanted pregnancies (P<0.05).

Conclusion: This study indicated that unwanted pregnancies are accompanied with physical and mental health. Thus, special counseling and extra care measures is recommended during unwanted pregnancies. Pregnancy

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Background and Objective: The child mortality is a index of development and plays an important role in determination of population growth. This study was done to determine the effect of sociol-economical conditions on mortality rate of under 5 years children, Khuzestan- Iran. Materials and Methods: This descriptive study was done on 372 women aged. 20-48 years with at least one child under 5 years whome were admitted to the health centers in urban and rural area of gotvand town in Khuzestan province, Iran during 2004. Individuals questionnaires included variables such as mortality, demographic, economic and social index were completed for each subject. Data were analyzed using SPSS-17, ANOVA, Chi-Square and Pearson’s correlation coefficient tests. Results: Providing maternal health care during pregnancy and up-grading occupational status of parents significantly reduced child mortality rate (P<0.05). Child mortality rate increased in mothers of <18 and >35 years (P<0.05) and parents desire to have male infant (P<0.05). Conclusion: This study showed that up-grading occupational status of parents, maternal health care and maternal age and desire to have male infant play important role on the child mortality rate in Khuzestan province in south west of Iran.

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Background and Objective: The incidence rate of elderly misbehavior increased in the past two decades. This study was conducted to determine the prevalence of elderly misbehavior in northern Iran. Method: This descriptive - analytic study was done on 247 more than 60 years old (137 males, 110 females) in north of Iran during 2012. In order to determine misbehavior, an elderly questionnaire was filled for each subject. Results: The mean age of subjects was 68.8±7.08 years. The prevalence of lack of attention, care, financial, authentic was 34.8%, 33.6%, 29.1% and 22.3%, respectively. The prevalence of psychological, physical, isolation and financial misbehavior were 26.7%, 26.7%, 2.6% and 21.9%, respectively. There was a significant relationship between income and marital status with misbehavior maner (P<0.05). Conclusion: Elderly misbehavior particularly lack of attention and care are more perevlant in northern Iran.

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Background and Objective: Hospitalization of patients in the intensive care units frequently results in anxiety of the family members. This study was performed to investigate the effect of a family-centered clinical intervention on the anxiety of family members of the patients hospitalized in intensive care units.

Methods: In this clinical trail study, eighty family members of the patients hospitalized in the intensive care units were randomly divided into interventional and control groups, respectively. In the interventional group, the family members were allowed to be present at the bedside from the second till the sixth day.The participant's level of anxiety was assessed in the second and the sixth day of patient's hospitalization using hospital anxiety and depression scale. Oral information about the equipment and the regulations and, a daily information card consisting of treatment and care activities, vital signs and patient's level of consciousness was delivered to the participants and their questions were answered.

Results: In the the sixth day, there was a significant difference between the mean anxiety scores in the intervention (11±3.22) and control group (7.05±3.44) (P<0.05). Also, the frequncey of anxiety in the interventional group (56%) was significantly higher than the control group with 15% (P<0.05). The odds ratio for anxiety in sons/daughters was lower than other family members in the sixth day (P<0.05).

Conclusion: Providing information, presence at the bedside and participation in the care of their patient increase the anxiety of family members in the first week of patient hospitalization in the intensive care unit.

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The kangaroo care method in newborn is a way of protecting the baby through skin to skin contact between newborn and their parents. This review study was done by using the keywords including kangaroo mothre care, neonatal, skin to skin contact and preterm. All related articles were published in Pubmed, Sience direct, Google scholar, SID, and Magiran were studied during 2000 to 2016. Finally, 36 articles were reviewed which were similar according to objectives, method of work, sample size, analysis method, and conclusion. Reviewing the selected articles showed that skin to skin contact among newborn and their parents regulated the body temperature of the neonate, increased the newborn's immune system, reduced infection and mortality rate, regulated heart and respiratory rate, increased the growth and weight gain in low birth weight neonates, reduced the stress and crying, increased prolong and stable periods of sleep, and also creates an emotional bond between the parents and the neonates. Kangaroo care method not only helps to care for the early stages of growth of premature neonate, but also increases the general health of the newborn and mother. This care can be used as an inexpensive and highly beneficial method for neonate's growth and health in human.

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Background and Objective: Managed health care is one of the main components of universal health care systems, which recently has drawn more attentions. Therefore, based on the high costs of health system, poor quality of services, reduce efficiency, it is necessary to study and design a model to distinguish managed form unmanaged systems in Iran. This study was done to evaluate the managed health care in contagious and non-contagious diseases in Golestan province, northern Iran during 2016.

Methods: This descriptive-analytic study was done based on data collected from all urban and rural health centers of Golestan province, north of Iran during 2016 using standard checklists. Data were analyzed according to rural and urban area and type of diseses.

Results: Managed health care of tuberculosis was considerd in first rank following by hypothyroidism, leishmaniasis, hypertension, brucellosis and finally diabetes in a respective manner. In addition, managed cares in rural centers significantly had better condition than those of urban centers (P<0.05).

Conclusion: This study showed that managed care in rural areas is better than urbans and the tuberculosis has well condition according to managed health care.

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Background and Objective: Cancer can cause many problems in all aspects of the physical, mental, social, economic and family life of the elderly patients. This study was done to determine the supportive care needs of the elderly people with cancer in north of Iran.
Methods: This descriptive- analytical study was carried out on 248 elderly patients with cancer whom referred to governmental and private medical centers in Gorgan, Northern Iran during 2018. Data were collected by a valid and reliable questionnaire "Supportive Care Needs Survey-SCNS" consisted of five domains of physical needs and daily functioning, health system and information, supportive and care, mental, and sexual chracteristics.
Results: There was a significant relationship between physical activity and daily functioning, sexual domain, support and care, health and information system with gender (P<0.05). Female seniors were more in need of assistance in the areas of physical and daily functioning, and male seniors in the areas of sex, support and care, health systems, and information.
Conclusion: This study showed that unmet needs in the elderly with cancer are particularly high in physical and functional areas.

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Background and Objective: Diabetes is one of the most common chronic diseases and also the biggest health problem in all countries. The world health organization has called it a silent epidemic. Self-care is one of the most important factors in controlling blood sugar in diabetics’ patients. This study was done to determine the relationship between self-care and glycosylated hemoglobin level diabetic patients in rural area in Golestan Province, northern Iran.
Methods: This descriptive-analytical study was done on 239 male and female patients with type 2 diabetes (56.92±10.70 years) in rural area in Golestan Province, northern Iran during 2016. Data collection tool were a standard diabetes self-care questionnaire with demographic variables and HbA1C test. Completion of data and sampling was done by referring to the health center and calling patients.
Results: There was no significant relationship between glycemic controls with any of the self-care items studied. Mean of HbA1c was 8.23±1.85%. 97 patients (40.6%) had good blood sugar control (less than 7.5%). Patient's self-care had a mean of 3.58, of which the highest score was related to the dietary regimen (6.60) and the lowest was related to self-monitoring of blood glucose (0.88) and regular physical activity (2.3).
Conclusion: Self-care of the patients was moderate. Interventions to increase self-care of patients are recommended in this area.

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Background and Objective: Writing about emotions and emotional disturbances, improve the performance of an autonomous system, immune system and physical and mental health. The aim of this study was to determine the effect of narrative writing on stress intensity of attendants’ patients hospitalized in intensive care units (ICUs).
Methods: This single blind clinical study was done on 106 attendants’ of adult patients hospitalized in ICUs of Babol city in northern Iran. The patients' attendants were divided into two groups of 53 controls and intervention. Data were collected using stress (DASS21) questionnaire. Intervention was writing narration about feelings, thoughts and experiences related to the hospitalized patient and ICU in a notebook as daily for seven days in the intervention group.
Results: The mean and standard deviation of overall stress intensity following intervention were significantly reduced in the intervention group in comparison with controls (P<0.05) (22.64±7.89 versus 17.15± 8.2). There was significant relationship between intervention and control groups in three areas of stress, anxiety and depression (P<0.05).
Conclusion: Narrative writing reduces the severity of stress in attendants’ patients in ICUs.

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Background and Objective: Coronary disease is the most common life-threatening among chronic diseases. Coronary angiography is one of the most important diagnostic procedures that have complications similar to other invasive procedures. This study was performed to determine the effect of changing sandbag weight on complications of femoral artery catheterization and patient comfort.
Methods: This single-blind clinical trial was performed on 140 patients who were referred to Amir Al-Mo'menin Kordkoy hospital in northern Iran. Patients were randomly assigned into four groups consisting 35 patients. After angiography, sandbags with different weights (control group, first intervention, and second intervention, third intervention with weights of 4, 3.5, 3 and 2.3 kg) were placed on the angiography site for 6 hours. Bleeding, hematoma, pain and comfort of patients were recorded and compared immediately, 2, 4, 6, 8 and 24 hours after angiography.
Results: Bleeding and hematoma were not observed in any of the patients. There was a significant difference in pain and patients comfort between groups (P<0.05). The third intervention group had the lowest pain and highest comfort at 6 and 8 hours after angiography. Also, the control group had the highest pain and the lowest comfort.
Conclusion: Reducing sandbag weight leads to decrease back pain and improves patient comfort without increasing vascular complications.

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Background and Objective: Today, the role of family members in caring for cancer patients is becoming more important. Numerous cancer-associated problems affect both the patients and their caregivers. Little information is available about the social support and spiritual health of caregivers of cancer patients; therefore, this study was conducted to investigate the spiritual health and social support status of family caregivers of cancer patients in northeastern Iran.
Methods: This descriptive-analytical study was performed on 265 family caregivers of cancer patients. The subjects were selected by convenience sampling from inpatient wards and outpatient clinics of Babol University of Medical Sciences in 2019. Data were collected using the Social Support Questionnaire (by Vaux), the Spiritual Well-Being Scale (by Paloutzian and Ellison), and a socio-demographic questionnaire.
Results: The mean scores of social support and spiritual health of family caregivers of cancer patients were 98.86±14.58 and 91.32±11.97, respectively, which are at a desirable level. The age of caregivers and the duration of cancer had no significant relationship with the score of spiritual health and social support.
Conclusion: According to our findings, family caregivers of cancer patients have a desirable level of social support and spiritual health.
 

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Various sciences such as medicine, psychology, sociology, history, ethics, etc., each of them look at humans from a specific angle and study them. Therefore, in any science, including medicine, what constitutes the subject of that science and forms the basis of the problems of that science depends on the definition of that science of the nature and essence of man. Therefore; it is very important to look at human nature in the recognition of disease and its prevention and treatment. The present research, with descriptive analytical method and referring to library sources, aims to investigate the impact of non-material factors such as disobeying divine orders and moral vices in depriving mental health from the point of view of Islam. The findings of this research show; there are two general views about human nature: material and divine. Now; in medical sciences, in all three areas of disease recognition, prevention and treatment, depending on the acceptance of one of the two mentioned points of view, the data and, accordingly, the results will vary. It is obvious that, rejecting metaphysical dualism, the materialist view in medical studies defines its scope of research only on the axis of material and experimental factors and in opposite; the divine perspective considers the scope of the mentioned studies beyond material factors and includes non-material and spiritual factors as well. As a result: by assuming the divine perspective, it is shown that the causes of disease go beyond material factors and include non-material factors as well, and sin and disobedience to divine orders and moral vices have a direct effect on causing some diseases And on the contrary, observing religious and moral principles has an effect on maintaining and sustaining the health of the body as a cage of the soul.