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Background &Aims: Promoting clinical education quality requires use of effective methods. Outcome-based education (OBE) is an educational reform movement that has influenced many countries in recent years. Despite the global acceptance of outcome-based education, the research documents are fairly rare about its effects on students' competency. The aim of this study was to investigate the effect of outcome-based education program on clinical competency (cognitive skills and behaviors skill) of nursing students on hemodialysis ward. Materials & Methods: In a quasi-experimental study using pre-test and post-test with two group design, 26 nursing students were selected through census sampling method and placed randomly in 2 control and 2 experiment groups, each group containing 6 to 7 people. After taking the cognitive skills pre-tests, control group received traditional education and experiment group went under clinical education using outcome-based education program for 9 days. As the final step, the post-test cognitive skills were held and behaviors skill checklist were observed. The data were analyzed using SPSS software using Wilcoxon and Mann Whitney tests and fisher exact test.  Results: The outcome-based education has been effective in promoting the cognitive and behavioral skills of students. The mean scores significantly differed before and after participating in outcome-based education and the clinical competency of nursing students in outcome-based education groups differed significantly from traditional groups.Conclusion: The effect of outcome-based education program on competency of nursing students was more than the traditional methods. Therefore, it is recommended to use outcome-based education in clinical education.

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  Background & Aims: Expressing pain is common in adolescent, however it needs more attention in children. Regarding that such studies are less, the purpose of this study was pain assessment in children.   Materials & Methods: This descriptive study was done in surgery units of three teaching hospitals - Child Care, Shohada, Imam Reza- in Tabriz, 2007. Data collection tools including children's pain check list that was completed by observation and individual interview with head nurses in all units. Validity of scale with content validity and r eliability of scale were evaluated by Cronbach alpha.   Results: Finding of this study showed the tool face for review was used only in one unit, But in other units, behavioral symptoms such as crying and malaise (75%) were considered. There weren’t any fact review or registration of pain in units. Acetaminophen was the most common drug for pain relief and distraction (%100), toys (%75) and placebo (%25) were the most common non-drug methods. For reducing pain during painful procedures, Lidocaine was used for embedding fully catheter and nasogastric tube in one of the units.   Conclusion: It seems that pain assessment and relieving pain are not well arranged. Therefore, it is necessary to prepare facilities for control of pain in children hospitals.

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INVESTIGATING THE RELATIONSHIP BETWEEN THE AWARENESS OF THE MOTHERS REFERRING TO HEALTH AND TREATMENT CENTERS IN KHOY AND THEIR FUNCTION ABOUT THE NOURISHMENT OF THE CHILDREN UNDER 3 YEARS OLD F Safar Alizadeh , MSc H Parto Azam , MSc R Sodefi , MSc Received: 22 April, 2009 Accepted: 11 July, 2009 Abstract: Background & Aims: The crisis of malnutrition in early childhood is high and according to the statistics of 2008 covers fifty percent of child mortality under five years old. Malnutrition average in Iran is less than 5%. The present study is to evaluate the awareness of mothers referring to health centers of Khoy and their performance on nutritional status of children less than three years old. Materials & Methods: In this descriptive-correlational study, seventy mothers with children under three years old were included. Data collection tool was a questioner for analyzing the data descriptive and inferred statistics were used. Results: Based on research findings, 50% of mothers had moderate awareness, and 81.4% had breastfed their children. In connection with the performance of mothers with their children's nutritional status, 57.2 % had a moderate performance. There are meaningful statistical relations between the variables of awareness and the function in research items. (P=0.01) Conclusion: The findings of this survey are worthy of attention for nurses because of their educational role as they increase mothers’ awareness. Keywords: Awareness, Function, Mothers, Nourishment status in children Address: Islamic Azad university of Khoy, Khoy, West Azarbaijan, Iran Tel: 09143637093 Email: Tsparham@gmail.com

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A SURVEY TO EXAMIN THE EMERGENCY NURSES OPERATION & COMPARING IT WITH INTERNATIONAL STANDARDS IN THE HOSPITAL OF URMIA MEDICAL SCIENCES UNIVERSITY Alizadeh M , Iremlow A , Alizadeh B , Shakibi A , Aliloo L Received: 14 April, 2010 Accepted: 16 Aug, 2010 Abstract Background & Aims: A well-performed cardiopulmonary resuscitation (CPR) remains important in improvement of nurse care efforts during cardiac arrests. Thus, this study sought to determine skills and performance of emergency department’s nurses in university hospitals affiliated to Urmia University of Medical Sciences in accordance to established international guidelines. Materials & Methods: The subjects were nurses working at emergency wards with the minimum of 6 month job experience at any emergency ward. The study was conducted using a standardized questionnaire including demographic characteristics of the subject, emergency department nurse performance (31 questions) in CPR or patients triage (22 questions). The data were analyzed by chi-square, fishers exact and z tests where appropriate. Results: The majority of study subjects (68.5%) showed an excellent and 3.7% had a weak CPR and triage performance. There was no significant statistical difference across the study groups by different university hospitals using fishers exact test (p=0/8). Also, no significant correlation was observed between CPR or patients triage performance and gender of the study subjects (p=0/6). However, the mean performance of male nurses was higher (28/13) as compared to that of females (26/37). Conclusion: According to the findings, it is speculated that management system of hospitals must consider nursing training programs. Due to the risks of emergency wards, skill and performance of the nurses working at emergency departments should be taken into consideration. Keywords: Performance, Nurses, CPR, Standard guidelines Address: Urmia University Medical of Sciences, Urmia, Iran Tel: (+98)9143437642 E-mail: alizadeh@umsu.ac.ir

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  A Survey of tissue oxygenation differences in intensive care patients with blood transfusion     HaghighiMoghadamY [1] *, Valizadeh MA [2] , Feizi A [3]     Received: 26 Dec, 2011 Accepted: 7 Mar, 2012     Abstract   Background & Aims : greater than 75% patient that hospitalized in intensive care units has anemia. Blood transfusion in icu is not recently and about 40-70% patients in intensive cares receive transfusion .blood transfusion is not safety and many of patients that received transfusion have some serious side effects. Therefore to decrease such unwanted events there are some limits in blood transfusion. Because there is no decreased in o2 extraction until hemoglobin above 9 gr/dl. Therefore it seem the o2 extraction is the best categorized to blood transfusion need evaluation .in this study we want to determine the effect of blood transfusion on tissue o2 extraction in intensive care patients.   Materials & Methods : 30 non cardiac and active bleeding intensive care patients that has ordered blood transfusion by physician were selected . before and I hour after transfusion the veinuos and arterial samples obtained to determine Sao2, Svo2 and Hg. And then datas were analysed.   Result : the study showed that hemoglobin level and arterial o2 content (Cao2) has increased in all patients after transfusion. In 66/66% the o2 extraction decreased after transfusion and in 26/66% patient it elevated. There was no significant correlation between hemoglobin level and o2 extraction after transfusion.   Conclusion: although there was significant correlation between Hg and o2 extraction before blood transfusion it was losedafter transfusion that similar studies are needed. It seems that the o2 extraction was decreased after transfusion without related to Hg levels. In order to evalution intensive patients need to blood transfusion, Hg and o2 extraction levels must be insighted together by nurses and physicians.   Key words: o2 extraction, blood transfusion, intensive care patient.     Address: Nursing and Midwifery Faculty, Urmia University of Medical Sciences,   Tel : (+98) ) 0441)2754961   Email: hagigym@yahoo.com   [1] Nursing and Midwifery Faculty, Urmia University of Medical Sciences.(correspond Author)  [2] Flvshyb special car e, Faculty of Medicin Urmia University of Medical Sciences  [3] Assistant Professor, PhDof Nursing, Facultyof Nursingand Midwifery, Urmia University of medical sciences

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  Effect of lidocaine gel on pain from copper IUD insertion: A randomized Dobell blind controlled trial     Mohammad alizadeh S [1] , Kazami F [2] , FarshbafKhalili A [3] , Saidi S [4]     Received: 19 Feb, 2012 Accepted: 20May, 2012     Abstract   Background & Aims : The copper bearing intrauterine device (IUD) is a long-term, reversible contraception method that is as effective as tubal sterilization. Its insertion pain or fear of it may make women hesitate to use an IUD. This study aimed to determine the effect of lidocaine gel on pain from copper IUD insertion.   Materials & Methods : This study was done among 96 women at a health center in Tabriz. The subjects were allocated into three groups using random blocking with 6 and 9 block sizes considering allocation concealment. Inone group, lidocaine 2% gel and in the second, lubricant gel was placed in the cervical canal by a sterile swab one minute before IUD insertion and the third group got no intervention. IUD inserter was blind for the gels used and subjects and the pain assessor were blind for intervention. One expert midwife inserted all the IUDs. Immediately after IUD insertion, pain during the insertion was measured using 0-10 cm visual analogue scale, with the value of 10 meaning ‘‘worst imaginable pain.’’One way ANOVA, Kruskal-Wallis, unpaired t-test, Mann-Whitney and linear regression in SPSS-13 were used to identify effect of lidocaine gel on the pain.   Result : Overall, the mean pain score was 3.5±1.8. In univariate analysis, there was no significant difference in pain scores between three groups. Comparison of frequencies and univariate analysis showed difference in some possible confounding factors between the groups. Results of linear regression model by controlling effect of the possible confounding factors including history of vaginal delivery, interval from the last delivery, situation of lactation, history of IUD insertion and the interval of cervix wash and pain assessment showed no significant effect of lidocaine gel on the insertion pain. The mean pain score in the lidocaine group was 0.39 less than in the control group but it was no significant (CI 95% of the difference: -1.3, 0.57).   Conclusion: Use of 2% lidocaine gel and also use of lubricant gel into the cervical canal, one minute before putting on cervical tenaculum, has no effect on reducing overall pain during IUD insertion.   Key words: Copper IUD, pain, IUD insertion, lidocaine     Address: Nursing and Midwifery Faculty, Tabriz University of Medical Sciences   Tel : (+98)(0411)4772699, fax: (+98)(0411)4796969   Email: seidisimin@yahoo.com   [1] Reproductive Health PhD, Assistant ProfessorFaculty of Nursing and Midwifery, Tabriz University of Medical Sciences (Faculty Research Assistant and Director of Midwifery )  [2] Master of Midwifery, Hospital Fatemie h Hamedan   [3] Master of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Science s  [4] Master of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences (assistant Midwifery Department) (Corresponding Author)

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  The effect of postpartum home care on maternal practices in infant care     Mirmolaei ST [1] , AmelValizadeh M [2] , Mahmoodi M [3] , Tavakol Z * [4]     Received: 10 Apr, 2012 Accepted: 30May, 2012     Abstract   Background & Aims: Mothers are the firstattentive for infants, any factor may have impact on mother health, will affect wellbeing of infantandconsequently community health. The aim of this research was to identify the effect of post partum home care on mothers’ practices in infant care.   Materials and methods: This randomized, controlled clinical trial study was conducted at a health center in Tehran city in 2011. The sample study included 200 mothers who had attended to Akbar Abad health care center with the purpose of screening test for their infants. They were equally randomized into two case and control groups (100 in each group).Control group mothers received second and third post partum care in health care center while case group received their post partum cares at their home. Data collection tools were questionnaire, checklist, growthcharts, barometers, babyscales, thermometers and meters . The questionnaire was aboutdemographic information of participantsand the quality of mothers’ practices in infant care. Data were analyzed by descriptive and inferential statistics (Chi-square tests, Mann-WhitneyandWilcoxon) by usingSPSS 18.0and data with p

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  Health according to the experiences of Iranian women with diabetes: A phenomenological study     Valizadeh S [1] *, Agamohamadi M [2] , Mohammadi S [3] , Abrahimi H [4]     Received: 11 Feb, 2012 Accepted: 10May, 2012     Abstract   Background & Aims : To reach a holistic approach for treating patients, being familiar with patients' perception of their own health be an important matter. This study was carried out to determine the meaning of health from the viewpoint of diabetic women.   Materials & Methods : The study was conducted using the qualitative phenomenology method. 22 diabetic women who were suffering from type 2 diabetes for at least one year and were willing to express their experiences were selected employing purposive sampling technique. Data were collected with the use of semi-structured interviews. All interview were tape recorded and transcribed verbatim and were analysed simultaneously with the Van Manen method.   Result : The patients' perspectives of their health introduced health as a multi-dimensional phenomenon which was divided into four groups of physical, psychological, sociological and spiritual dimensions. All the groups were closely connected, however the psychological and spiritual aspects were considered more important. Most of the responses in the physical dimension were related to having independence. Feeling comfort and happiness was one of the main points in the psychological dimension and in the spiritual aspect disease as Gods will had an important role in the answers.   Conclusion: In this study, participants reported health as not just feeling physically healthy. The attention of the patients towards other health dimensions especially psychological and spiritual aspects shown that if patients are not feeling physically healthy, intervention the other dimensions of health could help for improving the physical aspect as well as all the other aspects of health.   Key words: Health, Diabetes, Women, Phenomenology, Iran     Address: Nursing and Midwifery Faculty, Tabriz University ofMedical Sciences   Tel : (+98) 9143098650   Email: Valizadehs @tbzmed.ac.ir   [1] NursingPhD , Assistant Professorof Nursing andMidwifery , Tabriz Universityof Medical Sciences (Corresponding Author)  [2] Master of Nursing, Nursing Ph.D. Student , Instructor Department Tabriz University of Medical Sciencs  [3] Nursing PhD, Associate Professor, TarbiatModares University Tehra n  [4] NursingPhD , Assistant Professorof Nursing andMidwifery , Tabriz Universityof MedicalSciences

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The diagnostic value of three fetal movements counting in one hour by mother in the diagnosis of decreased fetal movements Kamalifard M[1], Ghojazadeh M[2], Abbasalizadeh Sh[3], Ghatrehsamani F[4], Rabiei L[5]* Received: 1 Jun, 2012 Accepted: 25 Aug, 2012AbstractBackground & Aims: Fetal movement counting is a method that used by the mother to quantify her baby's movements. Since 1970s a variety of counting techniques with different alarm limits have been developed few of which have been evaluated for predictive values and hence the clinical value of the absolute number of fetal movements has not been established.Materials & Methods: This cross-sectional study was carried out in 2011 in Educational and Medical Center of Alzahra in Tabriz. Three hundred singleton pregnant women at 32-40 weeks’ gestation having inclusion criteria were selected randomly from among women with complaint of decreased fetal movement. To perform the counting of three fetal movements in one hour and their recording in related chart was instructed by the researcher in a face to face manner. After the counting, pregnant woman was referred to ultrasound unit in order to perform the test of biophysical profile, then the two test results were compared with each other.Result: According to the test of fetal movement counting, 99.7% of fetuses were active and 0.3% of them were inactive. On the basis of the test of biophysical profile, 96.3% of fetuses had score of 10 and 3.7% had score less than 10. In this study, a significant relationship was found to exist between the result of maternal fetal movement counting and biophysical profile (p< 0.001). The sensitivity, specificity, positive and negative predictive value of the test of fetal movement counting were 100%, 96%, 9% and 100% respectively.Conclusion:  The result of this study suggests the usefulness of maternal fetal movement counting as an early simple screening and noninvasive method in assessment of fetal well-being.Key words: Diagnostic value, Fetal movement counting, Biophysical profile Address: Student research center, Department of Midwifery, Faculty of Nursing & Midwifery, Tabriz University of  Medical Sciences, Tabriz, Iran. Tel: (+98)9124900711Email: Leilarabii@yahoo.com                                   [1] MSc, Instructor, Department of Midwifery, Faculty of  Nursing & Midwifery, Tabriz University of  Medical Sciences, Tabriz, Iran.[2] Assistant Professor of physiology, Women's health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.[3] Perinatologist, Associate Professor, Faculty of medicine, Tabriz University of Medical Sciences, Tabriz, Iran.[4] Radiologist, Associate Professor, Faculty of medicine, Tabriz University of Medical Sciences, Tabriz, Iran.[5] MSc, Postgraduate Student, Student research center, Department of Midwifery, Faculty of  Nursing & Midwifery, Tabriz University of  Medical Sciences, Tabriz, Iran. (corresponding author)

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  Process of spiritual care learning in Iranian nursing students: A Grounded Theory Study     Tazakori Z [1] ,Valizadeh S [2] *,Mohamadi E [3] , Hasankhani H [4]     Received: 11 Dec , 2012 Accepted: 23 Feb , 2013     Abstract:   Background & Aims: Despite the claim that spiritual care is an integral part and core of holistic care, more than fifty percent of nurses have seldom done it and, they feel that, they need more spiritual care education and practice. Therefore this study was conducted to explore and explain theoretically nursing students' spiritual care learning process.   Materials & Methods: In this qualitative study 18 bachelor students, 4 teachers and 3 hospital supervisors were interviewed using deep and semi-structured interviews. Strauss and Corbin constant comparison was used for data analysis.   Result: Spiritual education, from the participant’s point of view, means the teaching and learning of how to provide comfort, security and connecting to Allah (religious decrees do) which can be achieved via positive motivation, efficient modeling and appropriate educational environment. Clinical and non-formal learning of spiritual care as the main theme comprised 5 sub-themes which include "affected by the master," "effectiveness of friends in clinic," "family influences" and "multimedia, internet, congress and exhibition influences»   Conclusion: This research helped to identify the factors that impact nursing students' spiritual care learning in Iran.   Keywords: nursing students, non-formal learning, Clinical learning, grounded theory, spiritual care     Address: Tabriz Nursing and Midwifery Faculty   Tel: (+98 411)4790365   Email: z.tazakori@arums.ac.ir   [1] Nursing PhD Student, Faculty of Nursing and Midwifery, Tabriz   [2] Assistant Professor, faculty members Nursing and Midwifery, Tabriz (Corresponding Author)*   [3] Associate Professor, Faculty of Nursing and Midwifery, Tarbiat Modares Tehran   [4] Assistant Professor, faculty members Nursing and Midwifery, Tabriz

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 Perceptions of first and last year nursing bachelor students about their own profession: a qualitative study    Zamanzadeh V [1] , Valizadeh L [2] *, Nasiri KH [3]     Received: 2 Jul , 2013 Accepted: 9 Sep , 2013     Abstract   Background & Aims: Nursing has considerable progresses towards becoming professional in recent decades in comparison with previous decades. It seems that researches on nursing students perceptions about nursing profession at first and at the end of their education in our country(Iran) ins’t enough. So this study was conducted with the aim of describing the nature of first and last year nursing bachelor students about their own profession.   Materials & Methods: This study is a qualitative one, and the participants of this study were 20 nursing students who were in the first and last year of their education in bachelor degree. Sampling method was purposeful. The data were collected and analyzed (content analysis) simultaneously. After explaining the aim of research to the participants, and taking written consent and keeping the record of interviews, unstructured interview was used to gather the data.   Results: In the current study, conceptual domains of bachelor’s degree students about this profession included: “The nature of nursing (knowledge/ job)”, “The profession’s social status” and “Actually/delivering nursing (nursing administering)”. The student were fully aware and close to nursing reality in their last year. Another classification as “effective (positive /negative) factors on nursing student’s perceptions about their own profession” were recognized as well.   Conclusion: According to findings of this study, it seems that some interventions must be conducted in order to assess and inform students about their profession in three dimensions of profession concerning factors which are affecting their perceptions.   Key words: profession, students, nursing, qualitative study     Address: Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran   Tel :(+98)4114796770   Email : valizadehl@tbzmed.ac.ir   [1] Assistant Professor, EDC Research Center for Medical Sciences Education , Department of Pediatric Nursing, School of Nursing and Midwifery Tabriz University of Medical Sciences.  [2] Assistant Professor, EDC Research Center for Medical Sciences Education , Department of Pediatric Nursing, School of Nursing and Midwifery Tabriz University of Medical Sciences. (Corresponding Author)   3 Master science nursing student from Tabriz University of Medical Sciences (medical-surgical nursing department).

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 Evaluation of serum albumin level and its effect on prognosis in patients admitted to intensive care unit    Valizadeh Hasanloei MA [1] , Norozinia H [2] *, SHateri K [3] , Bakhtyari L [4] , Hosseinpour H [5]     Received: 18 Sep , 2013 Accepted: 21 Nov , 2013   Abstract   Background & Aims : Albumin and globulin are the largest components of the body proteins. Albumin is a protein made in the liver and 50-60% of the total protein.   Materials &Methods: In this prospective study, 225 patients who admitted to intensive care unit were enrolled. Serum albumin level on admission to the ICU were recorded and patients were followed. Data analyzed with SPSS.   Result: Mean albumin levels were 3.52±0.87, in 49 trauma patients 3.74±1, in 36 patients with cancerous 3.41± 0.77, in 38 patients with lung disease 3.63±0.7, in 30 patients with CNS disorders 3.61 ±0.77 and in 72 patients with other underlying diseases 3.26±0.92 gr / dl, respectively. According to Chi-square test there were no significant correlation between albumin level and the need for mechanical ventilation in all patients (P = 0.47), trauma (P =0.44), patients with cancerous (P=0.70), lung disease (P =0.42) patients) CNS0(P=0.24) and patients with other underlying conditions (P =0.24). Also according to Chi-square test there were no significant correlation between albumin level and mortality in all patients (P =0.36), trauma (P =0.96), cancerous patients (P =0.16), lung disease (P= 0.78), patients with CNS disorders (P =0.52) and patients with other underlying diseases (P =0.13). Our results showed there is no correlation between albumin levels in patients (trauma, pulmonary, CNS, cancer, and other underlying diseases) and the total patients admitted to the intensive care unit. Conclusion: Although in several studies albumin has known as an indicator of the metabolic status of patients requiring mechanical ventilation, mortality and length of stay, In our study, there is no significant correlation between albumin level and those items. Needed for further studies.Keywords: protein, albumin, APACHE scoring systems, , intensive care unit     Address: Ershad Ave, Imam Khomeini Hospital, Department of Anesthesiology & Intensive Care Medicine , Tel: (+98)0441-33469931   Email : hnoroozinia@yahoo.com   [1] Anesthesiologis t, Fellowship of intensive care medicine, Assistant Professor of Urmia Medical Sciences University.   [2] Anesthesiologist, Associate Professor of Urmia Medical Sciences University (Corresponding Author).  [3] Internist, Gastrointestinal sub Specialist, Assistant Professor of Urmia Medical Sciences University.  [4] General Practitioner, Qom Medical Sciences University.  [5] General Practitioner, Urmia Medical Sciences University.

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  Received: 1 Jan, 2014 Accepted: 4 Mar, 2014  Abstract:   Background & Aims: Clinical judgment is a complex phenomenon which can cause challenges for newly graduated nurses in the decision making process. The aim of this study was to describe the experiences of newly graduated nurses’ challenges on the road to gain competence in clinical judgment.   Materials & Methods : This qualitative study was conducted using the purposive sampling method and was based on the data saturation principle . Data were collected from 30 newly graduated nurses who were working in teaching hospitals in four northwest provinces of Iran during the two past years . Data was collected by means of in-depth semi-structured interviews. Qualitative content analysis was used to analyze the data.  Results: The main challenges for the newly graduated nurses to gain competence in clinical judgment were four categories including: ineffective assessments , weakly interacting , skill related problems and unreliable decisions, and also eight sub-categories including unstructured observations , perfunctory exploration , communication problems , misapprehension , unfamiliarity with the skills , lack of conversance , decision making errors and conflict in the selection.   Conclusion: Achieving to the clinical judgment skills is a professional competence for newly graduated nurses. The familiarity with these challenges can help educational and executive managers to plan new programs for mitigating these challenges and to prevent undesirable consequences.

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   Received: 18 Jan , 2014 Accepted: 19 Mar , 2014  Abstract   Background & aims: It is believed that to be successful in behavior changes and health promotion, individuals need to find themselves efficient to overcome possible barriers of behavior change. Considering the important role of self-efficacy in health promotion and importance of adolescence period in the lifetime, this study aimed to determine the self-efficacy status and its effective factors in adolescents aged 14 to 18 years in Sanandaj.   Materials & Methods: This study was conducted on 1,500 adolescents aged 14-18 years (750 boys and 750 girls) enrolled in public, semi-public and private schools in Sanandaj. The random sampling method was used. We used the Sherer general self-efficacy scale and socio-demographic questionnaire. Multiple linear regression analysis was used to determine socio-demographic predictors of self-efficacy.   Results: The mean (standard deviation) score of self-efficacy was 3.60 (0.59) of the possible range score of 1-5. There was significant correlation between self-efficacy and variables of current suffering from disease, continuous drug use, course of study, field of study, father's job and household income level. This variables accounted for 3% of the variance in adolescents' self-efficacy score.   Conclusion : Based on the findings of this study, the self-efficacy score was average upward. With attention to significant impact of the self-efficacy on health promoting behaviors and reduction of risky behaviors, it is necessary to offer strategies to increase adolescent self-efficacy.  

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  A SURVEY ON THE ACCURACY OF CAPNOGRAPHY COMPARING TO CHEST XRAY IN NASOGASTRIC TUBE PLACEMENT   Hagigi Moghadam Y [1] ,Mohammad Nahal L [2] *,Feizi A [3] ,Valizadeh Hassanloei MA [4]     Received:19 Feb , 2014 Accepted: 23Apr , 2014   Abstract   Background & Aims: P lacement of gastric tubes is a common procedure in patients. Blind placement of the tubes cause inadvertent feeding tube placement into the respiratory tract which can have serious consequences. Despite the prevalence of gastric tube placement, no reliable and definitive method has been determined. The aim of this study was to evaluate the accuracy of capnography to compare with the accuracy of radiography in detecting the location of gastric tubes.   Materials & Methods: In this prospective observational study (process research) 85 eligible patients were randomly selected in a convenience sample. The study was done in 2 parts, first it was done by evaluating the accuracy of capnography in detecting tracheal positioning in a control group of 10 consecutive patients receiving mechanically ventilated patients, then, all placements utilized a two-step radiographic method. Capnography was added to the procedure. Data analysis was performed using statistical software spss 16.   Results: Sensitivity, specificity, positive predictive value and negative predictive value of capnography to distinguish between gastric and respiratory tube placement was 100%.   Conclusion : Capnography accurately identified all intratracheal feeding tube placements. Applying capnography would significantly save time and costs. Capnography should be considered as a routine method in placing feeding tubes to improve patient safety.   Key words : Capnography, intensive cares unit, nasogastric tube placement.  

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 Comparison of clustered care with three and four procedures on behavioral responses of preterm infants: Randomized crossover clinical trial  Valizadeh L[1], Avazeh M [2]*, Hosseini MB[3], Asghari Jafarabadi M[4], Conneman N[5], Babaei N[6]  Received: 13 Jul , 2014 Accepted: 15 Sep , 2014  Abstract  Background & Aims: Preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU) are under repeated stress, and they are suffering from sleep deprivation. In this respect, one of recommended strategies is clustered care. On the other hand, direct observation of infant behaviors has been emphasized at time of nursing care. The aim of this study was to compare the behavioral responses in preterm infants in clustered care with three and four noninvasive procedures.  Materials & Methods: This study was a randomized crossover clinical trial performed in NICU of Al-Zahra teaching hospital, Tabriz, Iran in 2013. Thirty one preterm infants were studied at 32 weeks age by clustered care with three and four procedures, and observable behavioral symptoms were assessed. The analysis of data was done with the use of STATA 10 software at 0.05 significant level.  Results: The findings showed that mean of behavioral symptoms indicated stability in before, during and after of clustered care with three procedures, and it was 1.48, 2.03, 2.45 respectively, and four procedures 2.68, 4.23, 2.87 and behavioral symptoms indicative stress of three procedures were 2.06, 2.52, 1.97 and four procedures 2.97, 4.03, 3.03. Significant differences were not found in before and after phases between two interventions but it was significant during phase (P=0.035).  Conclusion: Although clustered care with three procedures can be assumed more acceptable, clustered care with four procedures is shown acceptable too, both of them could be recommended for preterm infants.  Key words: Preterm infants, clustering, caring, behavioral symptoms   Address: Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran.  Tel: (+98)4114796770,Fax:(+98)4114796969  Email: M.avazeh@yahoo.com    [1]Associate professor, academic member, Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran.    [2] MS students, Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran. (Corresponding Author)  [3]Associate professor of Neonatology, academic member, Tabriz University of Medical Sciences, Tabriz, Iran.    [4] PhD, Assistant Professor of Road Traffic Injury Prevention Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.  [5] Neonatologist and Senior NIDCAP trainer at ErasmusMC_Sophia Childrens Hospital, Rotterdam, Netherlands.  [6] MS students, Nursing & Midwifery faculty of Tabriz University of Medical Sciences, Tabriz, Iran.

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  Nurse’s perception from barriers to empowerment: A Qualitative research   Valizadeh S [1] , Fallahi Khoshknab M [2] , Mohammadi E [3] , Ebrahimi H [4] , Arshadi Bostanabad M [5] *      Received: 4 Nov , 201 4 Accepted: 8 Jun , 201 5      Abstract   Background & Aim: Development of a successful career in the field of organization is an important factor. L ack of it has implications for health policy, organizational structure and its performance . This study aimed to describe nurses' experiences of barriers to organizational empowerment.   Materials & Method: A qualitative design using a conventional content analysis approach was applied for data gathering and analysis. In this study, 18 nurses , and nurse directors in North-west of Iran were recruited through purposive sampling. Semi-structured interviews were conducted to collect the data.   Results: The data analysis result s are catogorized in 2 main categories (personal factors and organizational structure) and six subcategories: Dignity and value, non-client focused tasks, insufficient self-confidence, inadequate organizational support, lack of up-to-date knowledge, and professional motivation.   Conclusion: The study showed barriers affecting the ability of nurses who are often hidden in the quantitative studies. It seems that by dispel ling these barriers, the quality of nursing abilities can be improve d .   Keywords: Power, Nurses, Barriers     Address: Nursing & Midwifery Faculty, South Sharyati Ave, Tabriz, IRAN   Tel: (+98)41-34796770   Email: arshadi@tbzmed.ac.ir   [1] PhD in Nursing, Associate professor,Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran   [2] PhD in Nursing, Associate professor, Department of Nursing, University of social welfare and rehabilitation sciences, Tehran, Iran   [3] PhD in Nursing, Associate professor, Tarbiat Modares University , Tehran, Iran   [4] PhD in Nursing, Associate professor, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran   [5] PhD Student, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran-(Corresponding Author)

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 The individual factors influencing knowledge transfer activities in nursing research    Valizadeh L [1] , Zamanzadeh V [2] , LakDizaji S [3] , Nasiri KH [4] , MohammadianRoshan S [5] *, Maddah S [6] , Behshid M [7] , PalmehT [8]     Received: 21 Jan, 2015 Accepted: 14 Apr , 2015  Abstract Background & Aim: Transferring and applying the knowledge is a critical and complex method. Production of research-based knowledge in nursing is increasing but the trend of its practical usage is slow. This study tries to determine the factors affecting the individual research transfer among educators and faculty members in medical science universities, Iran.   Materials & Methods: This descriptive correlation study was conducted using a clustered sampling of 279 nurses working in Medical Sciences Universities, Iran. The data were gathered using tools developed by Knott & Wildavsky (1980), and Landry et al (2003), and they were analyzed using SPSS, v13.  Results : The results showed that at the individual level , the highest activity was presenting and participating at the conference, the lowest participation was in " commercial activities". Factors as "the research based on consumer needs" and "the years served as nursing instructor" had statistically significant relationship with personal research transfer performance ) P< 0/05 .(  Conclusion: Findings indicate that the instructor’s individual performance in research transfer was statistically significant correlation with some factors. So it is necessary to promote and encourage the performances but also considering determinants and intervening factors. Keywords: Knowledge transfer, Knowledge, Nursing, Nursing research, Nurse Educator     Address: University of Medical Sciences, Aras international campus, Department of Medical-Surgical Nursing.   Tel: (+98)9372681253   Email: mohamadian63@gmail.com   [1] Associate Professor in Department of Pediatric Nursing, School of Nursing and Midwifery Tabriz University of Medical Sciences.   [2] Associate Professor in Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences.   [3] MSN in nursing education, Faculty member at Tabriz University of Medical Sciences , medical-surgical nursing department.   [4] MSN in nursing education, Ardebil University of Medical Sciences, Department of Medical-Surgical Nursing.  [5] Master of science in nursing, University of Medical Sciences, Aras international compus, Department of Medical-Surgical Nursing. (Corresponding author)   [6] PhD in nursing, School of Nursing and Midwifery Tehran University of Medical Sciences.   [7] PhD student, Faculty member at Tabriz University of Medical Sciences , Department of Medical-Surgical nursing.   [8] Master of science in nursing, University of Medical Sciences, Aras international compus, Department of Medical-Surgical Nursing.

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  Life experience with burn injuries: A qualitative study     Zamanzadeh V [1] ,Valizadeh L [2] , Lotfi M [3] *, Salehi F [4]     Received: 23 Jan , 2015 Accepted: 7 Apr , 2015   Abstract  Background & Aim: Due to multifunctional and wide range of burning diverse effects on burned patients, life experience after burn is considered as an individual experience, and it has a close relationship with their cultural and religious context. This study was done to assess burn patient’s experiences during accident till returning back to the society in order to improve rehabilitation-caring plan to match with the existing context and Iranian social needs. Materials & Methods: This is a qualitative study which is done using qualitative content analysis and unstructured deep interviews with 15 participants who had burn experience. Results: Based on the existing elements in the context, three categories is extracted: (A) Threat. (B) Disturbance. (C) External, internal and interpersonal factors as the essence of participants’ experiences. ‘Threat’ was formed based on the risk of death, life procedures disorder, spiritual conflict, mental disorder, feeling loneliness and isolation, and changing of the self-image. ‘Disturbance’ was formed based on pain, suffering and enduring violent behaviors and changes in self-confidence. ‘External, internal and inter personal factors’ was formed based on beliefs and values, wishes and tendencies, motivation, attitudes, demographic characteristics, personal properties, personal beliefs, affection and emotion, interactions , awareness, culture and finally being in a time and place frame. Conclusion: Deep conception of these two concepts will help to health care providers to undertake mental and social problems beside physical problems in considering rehabilitation and caring plans. Key words: Burn-survivors-live experience-qualitative research   Address: Tabriz University of Medical sciences, Nursing and Midwifery faculty  Tel: (+98):0413-4799946  Email: Mojgan.lotfi@yahoo.com  [1] Associated Professor, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences  [2] Associated Professor, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences   [3] Assisstant Professor, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences (Corresponding author)  [4] Associated Professor, Nursing & Midwifery Faculty, Tabriz University of Medical Sciences

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Background & Aims: Antenatally detected of congenital abnormalities can prevent the bearing of abnormal newborns that can create big problems for family and society. The aim of this study was comparing the results of amniocentesis and triple marker tests. Materials & Methods: This is a descriptive study which carried out in 2013. The participants in this study consisted of 205 pregnant women at 15–20 weeks of pregnancy. The result of Down syndrome and other Aneuploidy screening were high in these patients who referred to Alzahra hospital of Tabriz for amniocentesis. A questionnaire including demographic, Down syndrome and triple marker test information was used for data collection. Independent-Samples T-Test, Pearson test and One- Way ANOVA were used for data analysis by applying SPSS /ver 13. Results: The findings indicated that the mean (SD) age of participants was 33.9 ±4. AFP in 139 (68.5%) was lower than 1 MOM, Total &betahcg in 68 (33.4%) was higher than 2 MOM, UE3 in 133 (65.5%) was lower than 1 MOM and Inhibin in 29 (31.2%) was higher than 2 MOM. Aneuploidy was detected in 11 newborns (10 down syndrome, 1 Klinefelter's syndrome).There were significant relationship between risk of Down syndrome and amniocentesis result (P= 0.0001). There weren't significant relationship between NTD and trisomy 18 to amniocentesis result (P&ge 0.05). There were significant relationship between age (P= 0.03), number of delivery (P= 0.04), number of children (P= 0.03) and prior abnormal child (P= 0.001) and amniocentesis results. Conclusion: The results showed that the screening in first trimester can detected 11 newborns of aneuploidies and it can prevent the stress of family, and invasive techniques (amniocentesis).So we can use this way as a routine screening method.