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Background & Aim: Pulse oximetry is a frequently used and standard non-invasive method for monitoring oxygen (O2)-saturation in blood. Many factors including dark skin and pigmentation may effect on rate of saturation of the blood oxygen absorbed by pulse oximetry. The effect of nail polish and/or henna color on blood oxygen has not been yet identified and the present study has been carried out by aiming at the review on impact of henna and nail polish on results of pulse oximetry.
Methods & Materials: In the current investigation, clinical trial was studied on 60 resident young women at ages 20-40 by means of purposeful sampling method. Initially, 20 g of Iranian original henna was solved in 30 ml water and put on forefinger of non-dominant hand of the subjects. The other fingers of the same hand were stained by red, black, and white nail polish, respectively. The middle finger of the same hand was considered as the control variable. Then, blood O2-saturation was measured by two calibrated pulse oximetry devices simultaneously.
Results: The results indicated that henna (P = 0.020), red nail polish (P ≤ 0.001), and white nail polish (P = 0.020) have increased significantly the rate of O2-saturation absorbed by pulse oximetry. The impact of black nail polish (P = 0.100) on O2-saturation was not significant, but it has changed the mean rate of O2-saturation. Test result of ANOVA with iterative values of f = 10.385 and P ≤ 0.001 showed the significant statistical difference among mean values of O2-saturation (henna, red, black, white, and control nail polish).
Conclusion: Henna and nail polish may effect on percent of O2-saturation that showed by pulse oximetry and this may lead to error in monitoring of the patient. As a result, it is recommended to use other areas of the hand to put pulse oximetry sensor if henna is utilized and nail polish to be removed before installing the given sensor.

Background & Aim: Ventilator associated pneumonia (VAP) is the most common infections in critical care units, which leads to more length of hospital stay, costs, and high mortality. Therefore, prevention is a priority according to clinical guidelines. The aim of this study is determine the effects of passive versus active implementation of VAP guidelines on nurses’ performance in critical care units.
Methods & Materials: In this controlled clinical trial, 110 nurses who working in critical care units in selected hospitals affiliated to Tehran University of Medical Sciences were enrolled to study by convenience sampling at three groups, including active intervention group (n = 40), passive intervention (n = 36), and control (n = 34). First, nurses’ performance in prevention of VAP was evaluated by an observational checklist. In passive intervention group, posters containing recommendations of prevention of VAP was installed over the wall for each bed. In active intervention group, in addition to poster installation, there were training sessions with feedback on nurses’ performance. In control group without any intervention, just nurses’ preventative performance was evaluated before and 1 month later. A month later the nurses’ performance were observed. Data were analyzed by descriptive and inferential tests (Fisher’s exact test, chi-square, ANOVA, and paired t-test) in SPSS version 16.
Results: Results showed that the nurses’ mean percentage score in three groups was 46.80 ± 5.79 and after intervention it changed from 47.76 ± 4.61 to 63.32 ± 6.97 (P < 0.001) in active group, from 45.24 ± 5.72 to 55.03 ± 10.20 (P < 0.001) in passive group and 47.33 ± 6.86 to 47.90 ± 6.06 in control group (P = 0.263). Nurses’ performance in active group improved significantly in comparison to passive group and in passive group, it improved significantly in comparison to control group (P < 0.001).
Conclusion: The results of this study showed that both active and passive methods are effective on nurses’ performance in prevention of VAP. Therefore, considering the existing situation in the country and the high workload of nurses, we can offer VAP guideline as a protocol in critical care units.

Background & Aim: Assisting parents in selection of appropriate method of delivery is one of targets of preparation classes of childbirth. Group training method gives mothers a chance to share their experiences and beliefs with each other and the midwife may provide them with high quality training by
presenting them with correct information. The aim of this study is to investigate the effect group training on pregnant women’s tendency about the method of delivery and pethidine consumption.
Methods & Materials: In this interventional study, initially, after taking written consents, 85 participants attended group training. Moreover, 85 of the participants were provided with ordinary care in the control group. The classes were held for 1.5-2 h, every 2 weeks, with the participation of 10-15 mothers. Data were collected through demographic specifications, optional delivery method after training, and consequence of delivery questionnaires. Pain was measured by visual analog scale and statistical analysis was performed by χ 2 test and t-test using SPSS for Windows 18.0.
Results: The results of the present study indicated that the presence of a significant difference in tendency for cesarean between the two groups after education (0.001). Also, consumption pethidine during labor was significantly lower in the intervention group (0.001).
Conclusion: Group training was one of the appropriate methods for decreasing the number of tendency for cesarean operation and resulted in the reduction of natural labor pain and consumption of sedatives.

Background & Aim: Mother-infant separation is one of the main causes of sleep-wake states disorders in neonatal intensive care unit (NICU). The current study was conducted to investigate the effect of in-arms-holding by mothers on sleep-wake states disorders of preterm neonates.
Methods & Materials: In a pilot study, through a semi-experimental pretest-posttest method, 35 preterm neonates with gestational age between 32 and 37 weeks and their mothers were selected from NICU of Valiasr Hospital, Tehran, Iran. Data collection process was carried out using the behavioral states scale of Newborn Individualized Developmental Care and Assessment Program. Sleep-wake states data were collected in three phases: 20 min before intervention, 70 min of intervention (mother holding), and 20 min after intervention. The collected data were analyzed using repeated measures analysis of variance (RM ANOVA) and Bonferroni test in the SPSS for Windows 17.0.
Results: About 57% of neonates were male. The results of RM ANOVA showed that there were significant differences between three phases of study in terms of deep sleep (P < 0.001, F = 20.400),light sleep (P < 0.001, F = 167.230), drowsiness (P < 0.001, F = 26.770), quietly awake (P < 0.001, F = 27.380) and crying (P = 0.001, F = 4.370), but there was no significant difference for actively awake.
Conclusion: Holding the preterm neonates by their mothers seems to improve their sleep-wake states. Medical and nursing staff in NICUs and nurseries may be recommended to use this kind of care to prevent sleep and wake disorders of neonates.

Background & Aim: Nurses are exposed to the changing demands in technology as they execute their patient-related duties in the workplace. Integration of information technology (IT) in healthcare systems improves the quality of care provided. Nursing and midwifery students with prior exposure to computers tend to have a positive influence of IT. This study was carried out to determine the attitudes of the students of nursing and midwifery at School of Health to the use of computers in healthcare.
Methods & Materials: The sample was composed of 247 nursing and midwifery students selected by using non-probability sampling method. Survey method and pretest for attitudes toward computers in healthcare scale were used in data collection. Chi-square significance test was conducted in data analysis.
Results: About 94.3% of the students were female, 48.6% were graduates of regular high school, 58.7% were students of nursing and 32.8% were 2nd year students. Moreover, 62.6% of the students had a computer, 80.2% took a computer course, 47.0% used the computer for 1-3 h/day, 96% considered computer use necessary for their profession and 96.8% found it necessary for their profession to possess a computer. It was found that 45.3% of the students were enthusiastic view of the potential of computer use in healthcare.
Conclusion: There was no significant difference between the nursing students and the midwifery students in terms of attitudes to use of computers in healthcare, whereas a significant relationship was found between computer use in healthcare and the daily duration of daily computer use and whether the students possess a computer. This result is significant in terms of planning, applying, and integrating hospital information systems.

Background & Aim: Diabetes with permanent changes in a person’s lifestyle may influence diabetic adolescent quality of life (QOL) negatively. Studies conducted on diabetic patients are increasingly measuring patient-centered outcomes such as functional status and health-related QOL (HRQOL). The development of a HRQOL questionnaire with an optimal measuring performance provides nurses with a standardized assessment tool in order to determine the impact of the disease on diabetic adolescent girl’s activity daily living. This study aimed to develop and assess psychometric properties of “Iranian Diabetic Adolescent Girl’s QOL (IRDAGQOL)” questionnaire.
Methods & Materials: The items and content of “IRDAGQOL” questionnaire were generated from themes and items extracted from a qualitative study using content analysis approach with the participation of 20 adolescent girls with diabetes. Face validity of questionnaire with the participation of 10 adolescent girls and content validity by 15 experts, was approved. Convergent and discriminant validity of questionnaire confirmed. Exploratory factor analyses using principal component extraction method was performed to determine the questionnaire domains. The Cronbach’s coefficient alpha was calculated to determine the instrument internal consistency in 250 samples. In 30 samples, using SPSS statistical package, test re-tests after 2 weeks confirmed questionnaire reliability.
Results: The patient interviews allowed for the identification of 50 items in the final questionnaire. Principal components analysis revealed the presence of five components that jointly accounted for 79.945% of the variance. The face and content validity processes resulted in an approved and valid questionnaire. Reliability analysis showed satisfactory result (Cronbach’sα = 0.870).
Conclusion: The findings showed that the “IRDAGQOL” questionnaire presented in this study is a valid and reliable instrument that can be used for measuring adolescent girl’s QOL.

Background & Aim: Researchers in the nursing science study complex constructs for which valid and reliable instruments are needed. When an instrument is created, psychometric testing is required, and the first-step is to study the content validity of the instrument. This article focuses on the process used to assess the content validity.
Methods & Materials: This article examines the definition, importance, conceptual basis, and functional nature of content validity in instrument development. The conditional and dynamic nature of content validity is discussed, and multiple elements of content validity along with quantitative and qualitative methods of content validation are reviewed.
Results: In content validity process, content representativeness or content relevance of the items of an instrument is determined by the application of a two-stage (development and judgment) process. In this review, we demonstrate how to conduct content validity process, to collect specific
data for items generation and calculation of content validity ratio, content validity index, modified Kappa coefficient, and to guide for interpreting these indices. Face validity through suggestions of expert panel and item impact scores is also discussed in paper.
Conclusion: Understanding content validity is important for nursing researchers because they should realize if the instruments they use for their studies are suitable for the construct, population under study, and sociocultural background in which the study is carried out, or there is a need for new or modified instruments.