Follow-up Plan as a Necessity for Nursing Care: A Decrease of Stress in Mothers with their Children in Pediatric Surgical Units.

Introduction: Children are vulnerable to damage. Health problems in children, especially if necessitate hospitalization, can cause stress in their parents that may persist even long after discharge. This study aimed to investigate the effect of implementing follow-up care plans on stress in mothers of children discharged from pediatric surgical units. Methods: A quasi-experimental study was conducted on 64 mothers whose children were hospitalized in the surgical wards of two educational hospitals affiliated to Isfahan University of Medical Sciences, Iran. The participants were randomly assigned into two groups of control and experimental. The data collection tools included a demographic data questionnaire and stress response inventory (SRI). The interventions were performed using a four-stage follow-up care plan. The data were analyzed using SPSS software version 13 and descriptive statistics, independent t-test, repeated measures analysis of variance (ANOVA), and least significant difference (LSD) test. Results: The mean (SD) stress scores of the experimental group were 64.1 (28.8), 20.4 (12.4), and 11.6 (7.5) before, one week, and one month after the intervention, respectively. In the control group, these scores were 61.2 (29.2), 59.9 (25.5), and 46.7 (19.1), respectively. The results showed the mean score was significantly lower than that of the control group at one week and one month after the intervention in the experimental group. Conclusion: Our results demonstrated that a follow-up care plan can decrease the stress levels of mothers as a continuity of patient care even after discharge.

The Impact of an Educational Program Regarding Total Parenteral Nutrition on Infection Indicators in Neonates Admitted to the Neonatal Intensive Care Unit.

BACKGROUND: One of the basic care measures for preterm infants is providing nutrition through total parenteral nutrition (TPN) and one of the most important complications of it is infection. Because prevention of nosocomial infections is an important issue for neonate's safety, this study aimed to determine the effects of a continuing medical education (CME) course on TPN for neonatal intensive care unit (NICU) nurses on indicators of infection in newborns. MATERIALS AND METHODS: This quasi-experimental study was conducted on 127 neonates who fulfilled the inclusion criteria. They were selected through simple convenience sampling method at two stages of before and after the CME program. The inclusion criteria were prescription of TPN by the physician and lack of clinical evidences for infection in newborns before the beginning of TPN. Death of the infant during each stage of the study was considered as the exclusion criteria. The data gathering tool was a data record sheet including clinical signs of infection in the infants and their demographic characteristics. Data were analyzed using Chi-square test, Fisher's exact test, and student's t-test in SPSS software. RESULTS: The results showed the frequency of clinical markers for infection in newborns at the pre-intervention stage (n = 41; 65.10%) was significantly less than at the post-intervention stage (n = 30; 46.90%) (p = 0.04). CONCLUSIONS: Nursing educational programs on TPN reduce infection rates among neonates in NICUs.

Comparison of Nurses and Parents' Viewpoints Regarding the Needs of Parents of Premature Infants in Neonatal Intensive Care Units.

BACKGROUND: The birth of a premature infant and her/his hospitalization can cause the parents to experience a variety of needs. Understanding the needs of parents by nurses can lead to provision of high quality care to premature infants. This study aimed to compare the parents' and nurses' viewpoints regarding parents' needs in the neonatal intensive care units (NICU). MATERIALS AND METHODS: In this descriptive cross-sectional study, 63 nurses, 120 mothers, and 120 fathers, who met the inclusion criteria, participated. Nurses were selected through a census method and parents through a simple convenience sampling method. Data were gathered using a researcher-made questionnaire and were analyzed using descriptive-analytic statistical methods in the Statistical Package for the Social Sciences software version 16. RESULTS: From the viewpoint of mothers, the need for assurance with a mean score of 87.4 was the most important and the need for support with a mean score of 71.37 was the least important need. From the perspective of fathers, the need for assurance with a mean score of 78.5 was the most important and the need for support with a mean score of 51.20 was the least important need. From the viewpoint of the nurses, the need for assurance with a mean score of 77.6 was the most important and the need for support with a mean score of 59.77 was the least important need. The mean scores of the needs of mothers in all subscales were higher than that of the fathers' and nurses' (P < 0.001). CONCLUSIONS: From the viewpoint of nurses, the scores of parents' needs were significantly less than that of the parents' for all subscales. It is suggested that appropriate education programs be provided for nurses regarding how they can understand parents' needs to provide high quality care.

Effect of Environmental and Behavioral Interventions on Pain Intensity in Preterm Infants for Heel Prick Blood Sampling in the Neonatal Intensive Care Unit.

BACKGROUND: Recent researches suggest that preterm infants understand pain and stress. Because of the wide range of effects of pain on infants, the present study was conducted on the effect of environmental and behavioral interventions on pain due to heel-prick blood sampling in preterm infants. MATERIALS AND METHODS: A clinical trial was conducted among 32 infants with gestational age of 32-37 weeks in the intervention and control groups. The effects of noise reduction by earplugs, light reduction by blindfolds, reduction of nursing manipulation, and creation of intrauterine position for neonates, 30 minutes before taking blood samples until 30 minutes after it, were measured during the intervention stage. Data were collected using the Neonatal Infant Pain Scale (NIPS) in 5 stages (before intervention, 2 minutes before sampling, during the sampling, and 5 minutes and 30 minutes after the sampling). The data were analyzed using analysis of variance (ANOVA) and paired t-test in SPSS software. RESULTS: The paired t-test results showed no significant differences between the control and intervention stages in terms of pain scores at base time (P = 0.42) and 2 minutes before sampling (P = 0.12). However, at the sampling time (P = 0.0), and 5 minutes (P = 0.001) and 30 minutes after the sampling (P = 0.001), mean pain score in the intervention stage was significantly less than that in the control stage. CONCLUSIONS: Based on the findings, environmental and behavioral interventions reduced pain and facilitated heel-prick blood sampling in preterm infants.

The Impact of a Neonatal Sleep Care Training Program on Nurses' Knowledge and Performance in Neonatal Intensive Care Units.

BACKGROUND: Sleep is essential for organizing and maturation of the brain in premature infants; it also plays a role in maintaining the natural balance between different nervous centers. Given the role of nurses in neonatal sleep care, this study aimed at assessing the impact of a training program on the nurses' knowledge and performance in a Neonatal Intensive Care Unit (NICU). MATERIALS AND METHODS: In this quasi-experimental study which structured into three stages, 35 nurses working in an NICU in Isfahan, Iran, were included. The neonatal sleep training program was in the form of a lecture with questions and answers and then placing posters and booklets in the NICU. The data were collected by a questionnaire for nurses' knowledge and performance assessment which its validity and reliability were determined through content validity and internal consistency, respectively. The nurses' knowledge was assessed via 40 multiple-choice questions before, immediately after, and 1 month after the training program, and their performance was evaluated before and 1 month after intervention using 15 multiple-choice questions. The data were analyzed by descriptive and inferential statistics using the SPSS software version 16. RESULTS: The results showed that the mean score of nurses' knowledge after training has significantly increased as compared to before training (33.33 (4.4) vs. 19.33 (4.1)) (P < 0.001); however, the score of performance was slightly improved although it did not reveal any significant differences (P = 0.07, 42.6 (7.6) vs. 45.1 (7.8)). CONCLUSIONS: The results indicated that this method of training program could lead to an increase in nurses' knowledge, but it did not significantly improve their performance. It may be due to a low number of training sessions; therefore, it is recommended to implement long-term training programs in this field.

Evaluating the Effect of Lifestyle Education Based on Health Belief Model for Mothers of Obese and Overweight School-age Children on Obesity-Related Behaviors.

BACKGROUND: Nowadays, childhood obesity is a matter of significant concern because of its negative effects on personal health and harmful socioeconomic consequences. The purpose of the present study was to evaluate the effectiveness of lifestyle education based on the health belief model for mothers of obese and overweight school-age children on obesity-related behaviors. MATERIALS AND METHODS: In this quasi-experimental study, 64 obese and overweight elementary students and their mothers who met the inclusion criteria participated. The participants were randomly categorized into two groups (experimental and control). The experimental group received the considered interference, which consisted of four educational sessions based on the health belief model. Data collection tool was a standard questionnaire. The questionnaire filled by the participants during interviews conducted before, immediately after, and two months after the intervention. Data were analyzed using Mann-Whitney, Chi-square, student's t-test, repeated-measures analysis of variance, and least significant difference tests. RESULTS: Mean scores of obesity-related behavior before the intervention were not significantly different between the experimental and control group (53.41 (6.78). vs 54.72 (4.63); P = 0.37), however, were different immediately after (58.41 (6.88) vs 54.81 (4.66); P = 0.02) and two months after the intervention (62.34 (8.62) vs 55.84 (7.59); P = 0.002). CONCLUSIONS: This study indicated the effectiveness of lifestyle education based on the health belief model for improving obesity-related behaviors. Therefore, the use of this educational program is recommended for mothers.

Comparative Investigation of Indicators of Growth and Behavioral Disorders in Children with Normal, Low, and Very Low Birth Weight at Pre-school Age in Isfahan during 2015.

INTRODUCTION: Birth weight is one of the most important indicators of infant's health and could predict their health condition in future. This study was conducted to determine and compare indicators of growth [weight, height, and body mass index (BMI)] and behavioral disorders in children with normal, low, and very low birth weight at pre-school age. MATERIALS AND METHODS: In this descriptive analytical study, 236 children (126 with normal weight, 100 with low birth weight, and 10 with very low birth weight) at pre-school age were investigated in three groups. Data collection tools were a two-part questionnaire including the Rutter Children Behavior Questionnaire for parents, and parents' and children's demographic characteristics questionnaire, scale, and stadiometer. Data were analyzed using descriptive statistics, variance analysis, Chi square, and Kruskal-Wallis tests. RESULTS: The mean of weight, height, and BMI at pre-school age in three groups had a significant difference (P = 0.009) and it was lower in the group with very low birth weight than the other two groups; however, the difference between the group with normal birth weight and the group with low birth weight was not significant (P = 0.10). The mean score of behavioral disorder had no significant difference between groups (P = 0.49). CONCLUSIONS: Results showed that children with very low birth weight grew less than the other two groups. Therefore, this group needs special attention and long-term follow-up for taking care of them to ensure better growth. It is recommended to conduct more extended studies to evaluate behavioral disorders in these children.

Effect of Implementation of Continuous Care Model on Mothers' Anxiety of the Children Discharged from the Pediatric Surgical Unit.

INTRODUCTION: Child's hospitalization for surgery is a source of anxiety for the child and the family that persists for a long time after discharge. Therefore, it is necessary to provide appropriate solutions in this regard. This study aimed to investigate the effect of implementation of continuous care model on anxiety in mothers of children discharged from pediatric units of educational hospitals of Isfahan University of Medical Sciences in 2016. MATERIALS AND METHODS: In this quasi-experimental study, 64 mothers of children hospitalized in surgical units were categorized in two groups (experimental and control). The intervention was a continuous care model including orientation, sensitization, follow up, and evaluation stages. We used Spielberg's Anxiety Questionnaire to assess mothers' anxiety before, 1 week, and 1 month after the intervention. Data were analyzed using descriptive statistics, (t-test and analysis of variance) using the Statistical Package for the Social Sciences version 16. RESULTS: The results of the study showed that the mean anxiety scores of the experimental group were 58.9, 36, and 31.4, respectively, before, 1 week, and 1 month after the intervention (P < 0.001). These scores were 57.5, 55.8, and 49.7, respectively, for the control group. t-test results showed that the mean anxiety scores of the experimental group were significantly less than that of the control group at 1 week and 1 month after the intervention. CONCLUSIONS: Based on the results, use of the continuous care model led to a decrease in mothers' anxiety during their children's discharge from the pediatric surgery units. Therefore, we suggest the implementation of this model in pediatric units.

Effects of nesting and swaddling on the sleep duration of premature infants hospitalized in neonatal intensive care units.

BACKGROUND: In neonatal intensive care unit (NICU), neonatal sleep is disrupted due to different factors. Due to the critical role of sleep in premature infants' brain development, this study aimed to investigate the effect of nesting and swaddling on the sleep duration of premature infants hospitalized in NICUs. MATERIALS AND METHODS: In a crossover clinical trial, 42 preterm infants who met the inclusion criteria were enrolled. They were randomly assigned to two groups of nest-swaddle and swaddle-nest. Sleep status was evaluated by observation and use of Prechtl's criteria. Then, durations of total sleep time (TST) and quiet sleep time (QST) were recorded. Data were analyzed using repeated measure analysis of variance (ANOVA). RESULTS: Mean values of TST and QST during nesting and also swaddling periods were significantly higher than in the control period in both groups (P < 0.001). Mean values of TST and QST in the swaddling period were higher than in the nesting period in both groups, However, these differences were not significant (P = 0.245). CONCLUSIONS: Both swaddling and nesting could significantly increase the duration of TST and QST, compared to the control. There were no significant differences between the effects of these interventions on TST and QST. Therefore, using any of these methods is suggested to improve infants' quality of sleep in NICU, with respect to the ward policies.

Disturbed eating behavior in Iranian adolescent and young females with type-1 diabetes compared to non diabetic peers: A cross-sectional study.

BACKGROUND: An association of eating disorder with diabetes mellitus may lead to a serious lack of metabolic control, higher mortality and morbidity. There is no recent study conducted in the Iranian population about eating disorder and its variants. The aim of the present study is investigation of frequency of disturbed eating behaviors in adolescent girls with type 1 diabetes mellitus (T1DM) compared to non-diabetics. MATERIALS AND METHODS: In this cross-sectional study, disturbed eating behavior were evaluated and compared in two groups of 12-22 year old adolescent and young females (126 with diabetes and 325 without diabetes). A self-report questionnaire including demographic data, Children's Depression Inventory (CDI), and Eating Attitude Test (EAT-26) was used for data gathering. Independent t-test, Chi-square test, and logistic regression [odds ratio (OR)] were used for data analyses in SPSS 15. RESULTS: Findings revealed that higher percentage of diabetic girls are likely to have eating disturbances (67.9% vs. 53.8%, P = 0.01). Diabetic group obtained higher scores in both dieting (14.95 ± 6.28 vs. 11.79 ± 5.62, P < 0.001) and bulimia scales (4.9 ± 3.13 vs. 4.12 ± 2.89, P = 0.017), which supports a role for T1DM in inducing the symptoms. Diabetic girls were at more than double the risk of developing eating disturbance. CONCLUSIONS: The results indicate that a significantly higher percentage of diabetic girls are likely to have eating disturbances. Also, diabetic subjects had an increased probability of getting higher scores in all three EAT-26 subscales. Therefore, healthcare professionals, especially diabetic nurses, should be aware of the potential effects of the subclinical and clinical eating behaviors on adolescents with T1DM and evaluate them for these disturbances.

The Effect of the Family Empowerment Model on Quality of Life in Children with Chronic Renal Failure: Children's and Parents' Views.

BACKGROUND: Chronic renal failure (CRF) causes a gradual decline in kidney function to the extent that CRF patients need long-term clinical care, which affects the patients' family function and quality of life (QoL). OBJECTIVES: The present study was conducted to study the effects of the family-centered empowerment model on QoL in children with CRF during 2012-2013. PATIENTS AND METHODS: In this quasi-experimental study, 68 children with CRF and their parents were randomly assigned to two groups, intervention and control, via a random numbers table. An empowerment program was then conducted over the course of seven 45-minute sessions, and a questionnaire to ascertain demographic characteristics and the core pediatric QoL Inventory (version 4) were administered to both groups before the sessions and one month after the last training session. The data were analyzed using SPSS 20. RESULTS: The mean age of the children was 10.2 and 10.5 years in the intervention and control groups, respectively. The duration of the disease was five years in both groups. Furthermore, a significant difference was seen in the mean score of the children's QoL from their own perspectives in the physical and psychosocial domains and the total QoL score in the intervention group before and after the training (P < 0.05). CONCLUSIONS: Since family-centered empowerment interventions can determine the training- and treatment-related needs of patients and are low cost and effective, they may help parents promote their children's self-efficacy and QoL.

Prevalence and characteristics of gastroesophageal reflux in children with otitis media in Isfahan, Iran.

BACKGROUND: Otitis media (OM) is the most common cause of childhood hearing loss and reason to visit the pediatrician. Furthermore, gastroesophageal reflux (GER) has been associated with a variety of upper aerodigestive tract symptoms or diseases, such as sinusitis, laryngitis, and otits. The objective of the present study was to determine the frequency of GER in children, aged 3 months to 7 years, with OM. MATERIALS AND METHODS: This retrospective case-control study was conducted on 50 children with OM and 50 healthy children. Presence of GER as the main variables was diagnosed by clinical examination in all studied children using the questionnaires with 2 age-stratified versions of the pediatric GER disease symptoms for children 2 years old and younger, and children 3-7 years old. RESULTS: The prevalence of GER in children with OM and controls was 58% and 22% respectively (P = 0.0005). The frequency of irritability, congestion, and feeding complex in children with OM were significantly more than in control groups. Among children with recurrent acute OM (AOM), and chronic serous OM (CSOM) the prevalence of GER was significantly more than controls (61.1%, vs. 22% for AOM, P = 0.004, and 72.7% vs. 22%, P= 0.003). In children with AOM, regurgitation, vomiting, irritability and congestion were significantly higher than controls included. In children with CSOM, regurgitation, vomiting, and congestion were significantly higher than controls. CONCLUSION: Results show a significant association between GER and OM, AOM and CSOM in children with OM compares to healthy children. This shows that looking for GER in children with OM may help improving treatments outcomes.

Effect of peer education on the noise management in Iranian neonatal intensive care unit.

BACKGROUND: Advancements in neonatal intensive care unit (NICU) science and technology have increased the survival rate of preterm infants. Despite these advances, they are still facing with neurobehavioral problems. Noise level in NICU is a potential source of stress for preterm infants. It should be decreased to the standard level as much as possible. The purpose of this study was to evaluate the effect of peer education on the performance of staff in noise management in the NICU. MATERIALS AND METHODS: A pre-post test quasi-experimental design was used. Fifty-eight staff members (nurses and physicians) participated in this study. Sound pressure levels were measured before and after the intervention. Peer education program formed the intervention. The staff performance in noise management was evaluated before and after the intervention by using a questionnaire. Data analysis was done by using t-test. RESULTS: The results of the study showed that the mean sound level in different environments significantly decreased after the intervention. It reached from 86.7 to 74.9 dB in the center of unit and from 68.2 to 48.50 dB in the infants' bedside (P < 0.0001). The mean score of the staff performance in noise management significantly increased after the intervention, compared to the pre-intervention score. It increased from 74.6 to 83.4 (P < 0.0001). CONCLUSIONS: Peer education was found to be successful in noise management because behavioral changes were done to avoid generating unnecessary noise by the staff.

Relationship between parent-infant attachment and parental satisfaction with supportive nursing care.

BACKGROUND: Parent-infant attachment is an important factor in accepting parenting role, accelerating infant survival, and adjusting to the environment outside the uterus. Since family supportive interventions can strengthen the parent-infant caring relationship, this study sought to investigate the relationship between mother-infant attachment and satisfaction of the mothers with the supportive nursing care received in the neonatal intensive care unit (NICU). MATERIALS AND METHODS: In this descriptive-correlational study, 210 mothers with premature infants who were hospitalized in the NICUs affiliated to Isfahan Medical University hospitals took part. The data were collected via Maternal Postnatal Attachment Scale and researcher's self-tailored questionnaire based on Nurse Parent Support Tool. Pearson correlation coefficient and multiple linear regressions were used to analyze the collected data. RESULTS: The results showed that the overall score of mother-infant attachment and the overall score of maternal satisfaction correlated with a correlation coefficient of r = 0.195. Also, the overall score of mother-infant attachment and mothers' satisfaction scores in the emotional, communicative-informative, and self-confidence domains correlated with correlation coefficients of r = 0.182, r = 0.0.189, and r = 0.0.304, respectively. The results of multiple regression analysis revealed that about 15% of changes in the dependent variable (mother-infant attachment) could be explained by different dimensions of mothers' satisfaction. CONCLUSIONS: The results of the study showed that mother-infant attachment improved by increasing mothers' satisfaction of supportive nursing care. Therefore, it seems necessary to increase maternal satisfaction through given nursing care support, in order to promote mother-infant attachment.

Developmental skills of 36-60-month-old children in Isfahan daycare centers in 2013.

BACKGROUND: Assessment of developmental skills is one of the most essential components of children's health evaluation. Since several pubertal disorders are caused by parental negligence in diagnosis, prevention, and treatment of childhood problems, failure to make a timely diagnosis of these problems could have adverse effects on the health of children in future. This study was conducted to determine the developmental skills of 36-60-month-old children in Isfahan. MATERIALS AND METHODS: In this cross-sectional study, 196 children, aged 36-60 months, were recruited through random cluster sampling. "Ages and Stages" questionnaire was filled for each subject by their parents (father, mother, or both), and the frequency of developmental delay was determined based on cut-off points. The data were analyzed by descriptive statistics using SPSS 20.0. RESULTS: About 52.6% of the children were male. Mean age of the children was 50.71 (SD = 8.16) months. The abnormal findings were in the five domains of communication (1.5%), gross motor (3.1%), fine motor (7.7%), problem solving (7.7%) and personal-social (2%). CONCLUSIONS: The results suggest that some of the children had scores below or equal to the cut-off points and needed more evaluation by a professional person. The domains in which the children had problems were fine motor, problem solving, and gross motor. Therefore, health staff should pay more attention to assessment of these domains and parents should be trained to develop their children's skills in these domains.

A family support intervention to reduce stress among parents of preterm infants in neonatal intensive care unit.

BACKGROUND: Preterm infants constitute a large proportion of the newborn population in the neonatal intensive care units (NICUs). Parents, as the main members of the care team, are not adequately supported as the focus is chiefly on infant care. The present study aimed to evaluate the effect of a family support intervention on the stress levels among the parents of preterm infants in NICU. MATERIALS AND METHODS: In this quasi-experimental study, convenience sampling method was used to select 50 parents of preterm infants. The subjects were allocated to two groups of intervention and control (n = 25 pairs in each). While the control group received routine care, the intervention group benefitted from a two-stage family support program (including informational and observational phases in the first stage and emotional supportive intervention in the second). The Parental Stressor Scale-NICU (PSS-NICU) was completed by both fathers and mothers of the two groups (before and after intervention). Descriptive and inferential statistics were employed to analyze data in SPSS version 18. RESULTS: Before the intervention, the mean total scores of PSS-NICU and also the mean scores of its three subscales were not significantly different between the two groups. However, after the intervention, significant differences were observed between the two groups. The scores of the intervention group showed significant reduction following the intervention, but such a difference was not detected in the control group. CONCLUSIONS: Apparently, early educational and emotional support for parents of preterm infants decreased their stress. Similar interventions may thus be effective in empowering parents for caring of their infant and playing their parental role.

Effect of family empowerment model on quality of life in children with chronic kidney diseases.

BACKGROUND: Quality of life is a concept, which in recent years is considered as a measure for health in chronic diseases such as kidney diseases. Complications of chronic diseases can affect the quality of life in children and their families over time. Therefore, empowerment programs are necessary to improve their quality of life. This study aimed to investigate the impact of the family empowerment model on the quality of life in children with chronic kidney diseases. MATERIALS AND METHODS: This quasi-experimental study was conducted on 64 children with chronic kidney diseases and their families. The research tools included the questionnaire of demographic characteristics and the quality of life questionnaire 4(th) edition. After data collection in the first phase, the family empowerment model was implemented in the intervention group and the test was repeated after 1 month. For comparison of data between the two groups and within each group, independent t-test and paired t-test were used, respectively. RESULTS: Independent t-test showed that the mean score of quality of life was not significantly different in the two groups before intervention. However, after intervention, the differences were significant. Paired t-test showed a significant difference in the quality of life before and after intervention in the study group. CONCLUSIONS: The findings showed that family empowerment model was effective in increasing the quality of life of children with chronic kidney diseases. Thus, we suggest this model to be used in inpatient and outpatient children's health care.

Evaluation of growth and development pattern in normal, low and very low birth weight neonates at 18 months of age.

INTRODUCTION: Growth and development monitoring could lead to general judgment about children's health. With advances in NICUs establishment, the survival rate of very low birth weight (VLBW) neonates has increased in many countries including Iran. Because of the lack of studies about growth and development pattern of low birth weight (LBW) and VLBW neonates in Iran, the present study aimed to compare growth and development of normal, low and very low birth weight neonates at 18 months of age. MATERIALS AND METHODS: In a cross- sectional descriptive study, 214 children with age 18 months were enrolled (90 LBW, 90 LBW and 34 VLBW) and their growth and development were assessed. Data gathering tool was a researcher made questionnaire including anthropometrics measures and developmental key points. Data analyzed by descriptive (mean and SD) and inferential (ANOVA) tests using SPSS version 15. RESULTS: There were significant differences in the mean of anthropometric indexes between three groups. Majority of subjects in three groups had normal weight growth trend. Mean scores of gross motor and fine motor development indexes had significant association with birth weight. Meanwhile, there was no significant association between mean scores of social/cognitive and also language developmental aspects and birth weight. CONCLUSION: Findings revealed that in LBW and VLBW children, growth indexes at the age of 18 months are so far from those of NBW neonates. Further nationwide prospective studies, with a longer period of time is needed to estimate when Iranian LBW children reach at the levels of NBW ones.

The effects of earmuff on physiologic and motor responses in premature infants admitted in neonatal intensive care unit.

BACKGROUND: Continuous high-intensity noise in the Neonatal Intensive Care Unit (NICU) is stressful for premature infants and its reduction is considered as a nursing care. This study aimed to evaluate the effects of earmuffs' use on the physiologic and motor responses of premature infants. MATERIALS AND METHODS: This is a clinical trial conducted on 64 premature infants admitted to the NICU, who met the inclusion criteria, and were randomly assigned to study and control groups. Earmuffs were used for premature infants for 2 h in the morning and 2 h in the afternoon for two consecutive days to reduce the noise intensity in the busiest time of the NICU. The group with earmuff (study group) was compared with the control group receiving only routine care. Infants' physiologic and motor responses were observed before, during, immediately, and 1 h after the intervention. Analysis of covariance and repeated measure analysis of variance (ANOVA) were used to analyze the data. RESULTS: When infants wore the earmuffs, they had significantly higher mean arterial oxygen saturation, the less frequent motor response, and a decrease in their pulse and respiratory rate. CONCLUSION: Paying attention to environmental noise can help the patients, especially the neonates in the NICU, and can be considered as a nursing care. Wearing earmuffs can protect premature infants against noise in the NICU and improve their physiological and motor state.

Comparison of the effects of povidone-iodine and chlorhexidine solutions on skin bacterial flora among hospitalized infants.

BACKGROUND: Infection control is an essential part of caring for hospitalized infants. With regard to the change of bacterial resistance over time and places, as well as the need for periodic studies on the effectiveness of antiseptics, this study aims to compare the effects of both solutions of povidone-iodine and chlorhexidine on skin bacterial flora among hospitalized infants. MATERIALS AND METHODS: This clinical trial recruited 98 hospitalized infants and each of the above-mentioned solutions has been applied to a small area in the left or right side of the infants' bodies. Skin cultures were taken before, immediately after and 2 h after the randomly chosen infants' skin areas that were disinfected by each solution (588 skin cultures in total). Colony count and determination of microorganism types were done by only one person in a single laboratory. The study has been conducted in two teaching hospitals in Isfahan, Iran. RESULTS: Staphylococcus epidermidis was the most common microorganism prior to skin disinfection by either solution. Two hours after disinfection, "Staphylococcus epidermidis" and "Staphylococcus epidermidis and kelebsila" had the highest frequencies of 3.1% and 3.1%, respectively. Before and 2 h after disinfection, distribution of different types of microorganisms had no significant difference between the two groups (P = 0.84 and 0.13, respectively); however, the difference was significant immediately after disinfection, P < 0.01. CONCLUSION: The present study demonstrated that 10% povidone-iodine solution has more significant effect on reduction of skin pathogens promptly after application compared to 2% chlorhexidine. Therefore, prior to any catheterization procedures, it is imperative to use 10% povidone-iodine solutions for skin disinfection.