Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Effect of Developmental Stimulation Program on the Developmental Measures of Toddlers7161049710.22038/ebcj.2018.26127.1601ENElahe GhayebieInstructor, Department of Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-8913-2218Aramesh RezaeianMSc in Nursing, Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-0100-2764Journal Article20170925<strong>Background:</strong> The variability in the developmental skills is reduced after the first three years of life; therefore, it is necessary to identify and manage early developmental delays.<br /> <strong>Aim: </strong>The aim of this study was to investigate the effect of developmental stimulation program on the developmental measures of the toddlers.<br /> <strong>Method: </strong>The present randomized controlled clinical trial was conducted on 31 toddlers aged 1-3 years residing at Ali Asghar Foster Care Center within 2016-2017. Developmental interventions were carried out based on the modified guidelines of West Virginia Early Learning Standards Framework for eight weeks (three 2-hour sessions a week). The interventions included a range of age- and developmental-specific activities described in the given guidelines. Child development age was measured based on motor dimensions (i.e., gross and fine) and language development (i.e., receptive and expressive) before and after the intervention. The data were analyzed in SPSS software (version 11) using independent t-test and Chi-square test.<br /> <strong>Results:</strong> The mean ages of the participants in the control and intervention groups were 19.9±5.5 and 20±6.02, respectively (P=0.62). The mean ages of receptive language development (P=0.003), expressive language development (P<0.001), and gross motor development (P=0.02) were significantly different between the two groups. However, there was no significant difference between the two groups regarding the fine motor development (P=0.96).<br /> <strong>Implications for Practice:</strong> The developmental stimulation program was effective in the receptive language, expressive language, and gross motor development. However, it exerted no significant effect on fine motor development.Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Impact of Group Clinical Supervision on Patient Education Process: A Comprehensive Assessment of Patients, Staff, and Organization Dimensions17261051910.22038/ebcj.2018.30316.1753ENAfsaneh Jafari MoghadamMSc in Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-4153-4004Fatemeh HeshmatiNabaviAssistant Professor, Evidence-based Care Research Center, Department of Mental Health and Management, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-9842-966XAtefeh BehboudifarMSc in Nursing, Internal-surgical Orientation, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-2397-9808Seyed Reza MazloomInstructor, Department of Internal Surgery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, IranFarhad HeydarianPediatrician, Dr. Sheikh Hospital, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20171220<strong>Background:</strong> The most important barriers to patient education are nurses’ poor motivation and training, and poor quality of managerial supervision. Clinical supervision could be a powerful tool for overcoming these barriers. However, the associated patient, staff, and organization-related outcomes still require further research.<br /> <strong>Aim: </strong>The present study aimed to evaluate the patient-, staff-, and organization-related outcomes of group clinical supervision with the goal of improving patient education.<br /> <strong>Method: </strong>This quasi-experimental study was conducted on 35 nurses and mothers of 94 children admitted to the surgery and nephrology wards of Dr. Sheikh Hospital, Mashhad, Iran, in 2016. A 3-month clinical supervision program consisting of support, education, feedback, and facilitation stages was implemented with the assistance of education facilitators. The data were collected using the questionnaire of patient’s satisfaction with nurses’ education, Herzberg’s job motivation questionnaire, and the checklists of nurses’ education performance and quality of education documentation. Data analysis was performed by Mann-Whitney U test, Fisher’s exact test, and independent-t test in SPSS, version 14.<br /> <strong>Results:</strong> The mean ages of the nurses, patients, and mothers were 30.3±6.7, 5.2±3.8, and 32.2±6.2, respectively. Mann-Whitney U test showed a significant improvement in patients’ satisfaction with nurses’ education performance (P<0.001) and the mean score of the quality of patient education documentation (P<0.001) after the intervention. Fisher’s exact test revealed a statistically significant difference in the education performance levels of the nurses between the two stages (P=0.03). The paired t-test showed no significant change in the motivation score of the nurses after the intervention.<br /> <strong>Implications for Practice:</strong> Group clinical supervision could improve the quality of education documentation, nurses’ education performance, and patients’ satisfaction with provided education.Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Factors Associated with Potential Food-Drug Interaction in Hospitalized Patients: A Cross-Sectional Study in Northeast Iran27341041210.22038/ebcj.2018.24726.1544ENMostafa AbdollahiMSc, Department of Nursing, Khorasgan (Isfahan) Brnach, Islamic Azad University,Isfahan,Iran0000-0001-9623-129XSaeid EslamiAssociate Professor of Information Technology and Pharmacotherapy, Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-3755-1212Zhila TaherzadehAssistant Professor of Clinical Pharmacology and Pharmacology and Toxicology, Targeted Drug Delivery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-7185-970XShayesteh SalehiAssociate Professor of Nursing,Community Health Research Center,Islamic Azad University,Isfahan(Khorasgan)branch. Isfahan,IranMarzieh EbrahimiMSc, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranJournal Article20170712<strong>Background:</strong> The minimization of adverse food-drug interactions will improve patient care by optimizing the therapeutic effects and maintaining proper nutritional status.<br /> <strong>Aim: </strong>The aim of the present study was to find the main factors that may place the hospitalized patients at risk of potential food-drug interactions.<br /> <strong>Method: </strong>This cross-sectional, descriptive study was conducted on 400 inpatients admitted to the Department of Internal Medicine of a teaching hospital in Mashhad, Northeast Iran, within 20 March 2013 to 20 April 2013. The potential food-drug interactions were evaluated for 19 commonly prescribed medications. The main factors (e.g., age, gender, education level, number of medications, and duration of the disease) that may place the patients at risk of potential food-drug interactions were analyzed for each patient.<br /> <strong>Results:</strong> Out of the 19 commonly prescribed medications, 17 drugs (89%) were not properly used with respect to meal. Furthermore, 14 commonly prescribed drugs were found to have a high frequency (≥50%) of potential food-drug interactions. Most of the patients (n=359, 89.8%) consumed their medicines at inappropriate time with respect to meals. The results of a multiple logistic regression after adjustment for confounders revealed that the age [β=0.005, CI: 0.0-0.01; P=033], number of medications [β=0.1, CI: 0.083-0.117; P<0.001], and duration of disease [β=-0.037, CI: -0.05 to -0.023; P<0.001] were significantly associated with higher risk for potential food-drug interactions.<br /> <strong>Implications for Practice:</strong> As the findings of the present study indicated, the number of medications was associated with the higher risk of potential food-drug interactions. Regarding this, it seems necessary to decrease the number of the prescribed medicines to lower the frequency of potential interactions among the inpatients.Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Effect of Self-management Educational Program on Vision-related Quality of Life among Elderly with Visual Impairment35441050410.22038/ebcj.2018.28999.1717ENAhmad GhasemiMSc Student of Geriatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran1363136313631363Hossein Karimi MoonaghiProfessor in Nursing, Evidence-based Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Department of Medical Education, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-0496-2306Samira MohajerPhD Candidate, Instructor in Gerontological Nursing, Evidence-based Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-7118-1783Seyed Reza MazlomInstructor in Medical Surgical Nursing, Evidence-based Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-6722-8411Naser ShoeibiEye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.Journal Article20180117<strong>Background:</strong> Visual impairment is one of the independent risk factors for falling among the elderly. Functional disabilities caused by vision disorders are the most common problems affecting the quality of life in this population. Therefore, vision self-management program (VSM) may be helpful for patients in reducing impairment and improving the quality of life.<br /> <strong>Aim: </strong>The present study aimed to investigate the effect of self-management educational program on the vision-related quality of life among the elderly with visual impairment.<br /> <strong>Method: </strong>This randomized clinical trial was conducted on 57 elderly people in Mashhad, Iran, in 2017. The participants were assigned into two groups of intervention (n=28) and control (n=29). The intervention group received a 6-week VSM as a 60-minute session per week, while the control group underwent the routine education in the clinic. Visual-related quality of life was measured using the 39-item National Eye Institute Visual Function Questionnaire immediately and two months after the intervention to implement home-based intervention. The data were analyzed in SPSS software, version 23.<br /> <strong>Results:</strong> The mean age of the participants in the intervention and control groups were 66.4±0.7 and 66.1±7.0 years, respectively. The repeated measures ANOVA test showed that the mean score of vision-related quality of life in the intervention group was significantly higher than that in the control group (P<0.05).<br /> <strong>Implications for Practice:</strong> The self-management education can increase vision-related quality of life and its various dimensions in the elderly with visual impairment. Given that the intervention duration in this study was two months, further studies with longer duration are recommended.Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Effects of In-Person and Distance Exercise Training on Outcomes of Knee Injury and Osteoarthritis among Elderly Individuals with Limited Literacy45541056110.22038/ebcj.2018.28332.1685ENForouzan FarzadMSc Student in Community Health Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-4894-0216Hamidreza Behnam VashaniInstructor of Pediatric Nursing, Evidence-based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-9076-2900Amin AzhariAssistant Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran000000024251550XMohammd Hasan JokarAssociate Professor, Rheumatologist, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranZahra Emami MoghadamAssociate Professor of Community Health Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-5142-0329Journal Article20171216<strong>Background:</strong> Osteoarthritis is a common chronic disease of the musculoskeletal system in older adults.<br /> <strong>Aim: </strong>This study aimed to compare the effects of in-person and distance exercise training on the outcomes of knee injury and osteoarthritis among the elderly with limited literacy.<br /> <strong>Method: </strong>In this two-group randomized clinical trial with a pretest-posttest design, 60 elderly patients with knee injuries and osteoarthritis selected from two public parks in Mashhad during 2017-2018 were assigned to two groups of In-person and Distance training. The educational content, which included two stretching and three strength exercises for knee injury and osteoarthritis, was presented to the Distance group using booklets and multimedia. In the In-person group, the exercises were trained in eight 30-minute sessions, two days a week. The Western Ontario and McMaster Universities Osteoarthritis questionnaire was completed before and two months after training the exercises. To analyze the data, Mann-Whitney U test and Wilcoxon signed-rank test were run in SPSS, version 16.<br /> <strong>Results:</strong> The mean ages of the In-person and Distance groups were 68.2±5.6 and 69.2±9.4 years, respectively. We found a significant difference in the outcomes of knee injury and osteoarthritis post-intervention between the In-person and Distance groups (13.8±14.0 vs. 5.0±2.6; P≤0.003).<br /> <strong>Implications for Practice:</strong> Both methods could affect the outcomes of knee osteoarthritis. The <br clear="all" /> in-person method was superior to distance training. These exercises are recommended as safe and cost-effective methods that could be included in health promotion programs targeting older adults.Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Psychometric Properties of Social Support Questionnaire to Measure Empowerment in Elderly Patients with Cardiovascular Disease in Iran55661050510.22038/ebcj.2018.29552.1732ENMaryam MusavinasabMSc in Nursing, Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran0000- 0002-5150-9427Maryam RavanipourAssociate Professor, Department of Nursing, School of Nursing and Midwifery, Persian Gulf Tropical Medicine Research Center, Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran0000-0002-3421-4512Shahnaz PouladiAssistant Professor, Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, IranNiloofar MotamedAssociate Professor, Department of Community Medicine, School of Medicine, Bushehr University of Medical Sciences Bushehr, IranJournal Article20180205<strong>Background:</strong> Chronic diseases and functional decline can affect empowerment among the elderly in the lifestyle management to benefit from social support.<br /> <strong>Aim: </strong>The aim of the present study was to determine the psychometric properties of Social Support Questionnaire to measure empowerment in elderly patients with cardiovascular disease in Iran.<br /> <strong>Method: </strong>This study was conducted on 250 elderly patients with cardiovascular disease referring to the medical centers of Bushehr city, Iran, using the convenience sampling method.<br /> <strong>Results:</strong> Content validity index and content validity ratio were calculated as 0.94 and 0.96 respectively. Based on the exploratory factor analysis, the number of the questionnaire items was reduced to 23 items. Empowerment was classified under seven factors. The internal and external reliabilities of the questionnaire were estimated as 0.85 and 0.83, respectively.<br /> <strong>Implications for Practice:</strong> The final questionnaire had appropriate psychometric properties and strength of factor structure. Therefore, this tool can be used by the healthcare providers in the health care systems of Iran.Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Comparing the Effects of Continuous Care Model and Psychological Support Training Package on Self-Care in Patients with Bipolar I Disorder67751052110.22038/ebcj.2018.28528.1704ENAzam MohammadiMSc Student in Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-5143-5096Saeed VagheeInstructor of Psychiatric Nursing, Evidence-based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-4477-1371Shahrokh MaghsoudiInstructor of Nursing Management, Evidence Based Care Research Centre, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-2818-2128Hamidreza Behnam VashaniInstructor of Pediatric Nursing, Evidence-based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-9076-2900Azam SalarhajiPhD Student in Nursing, Student Research Committee, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran0000-0001-5857-956XJournal Article20171227<strong>Background:</strong> Despite the growing prevalence of bipolar I disorder (BD-I), implementation of continuous care after hospital discharge in these patients is limited.<br /> <strong>Aim: </strong>To compare the effects of continuous care model (CCM) and psychological support training package (PSTP) on self-care in patients with BD-I.<br /> <strong>Method: </strong>This clinical trial was conducted during 2017-2018 on 90 BD-I patients admitted to Ibn-Sina Psychiatric Hospital in Mashhad, Iran. CCM and PSTP designed in the form of a CD and a manual were implemented (within 12 weeks) to intervention groups. A control group received the routine care. The research instrument was Roldan-Merino Self-Care Requisites Scale completed before and two months following the intervention. To analyze the data, one-way analysis of variance (ANOVA) was run in SPSS, version 16.<br /> <strong>Results:</strong> The two study groups were homogeneous in terms of demographic characteristics. The results of one-way ANOVA before the intervention revealed no significant difference among the three groups considering self-care mean scores (P=0.52); however, this variable was significantly different among the groups following the intervention (P<0.001). According to the post-hoc Dunnett’s test results, a significant difference was observed in self-care mean scores between the CCM and control groups (P<0.001) and between the CCM and PSTP groups (P=0.04). Nonetheless, there was no significant difference between the CCM and control groups in this regard (P=0.13).<br /> <strong>Implications for Practice:</strong> CCM can improve self-care in patients with BD-I. Therefore, it could be used to empower these patients and their families.Mashhad University of Medical SciencesEvidence Based Care2008-24878120180401Effect of Preconception Care Education by Health Volunteers on Knowledge and Attitudes of Women: Application of the Health Belief Model76811051810.22038/ebcj.2018.28654.1709ENNasrin FazeliMSc Student in Counseling in Midwifery, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.IRCT2016101430297N1Maryam MoradiAssistant Professor in Reproductive Health, Evidence-Based Caring Research Center, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0002-9084-8907Talat KhadivzadehAssistant Professor in Reproductive Health, Evidence-Based Caring Research Center, Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0001-9872-3933Habibollah EsmailyProfessor in Biostatistics, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.0000-0003-4139-564XJournal Article20180102Preconception care identifies and modifies the risk factors for pregnancy and childbirth. The present study aimed to determine the effects a preconception care education program, which was based on the Health Belief Model (HBM) and implemented by health volunteers, on knowledge and attitudes of women. A semi-experimental study was conducted using 22 health volunteers and 110 women aged 15-49 years selected from two comprehensive health centers of Mashhad, Iran, in 2016. The convenience sampling method was employed for selecting the volunteers and the regular random sampling method for choosing the women. For data collection, we applied a researcher-made tool with verified validity and reliability. HBM-based education was implemented by the volunteers during three sessions. Data analysis was performed in SPSS using Mann-Whitney test, Friedman, and Spearman's rank correlation coefficient; repeated measures data analysis was carried out at the significance level of 0.05. The mean age of the women was 30.6±6.6 years in the intervention group and 31.6±6.5 years in the control group. The mean levels of knowledge and attitude increased significantly after the intervention (P<0.001). We suggest using the current educational intervention based on the HBM to promote women's knowledge and attitudes towards preconception care.