Showing papers in "iranian journal of nursing and midwifery research in 2020"
TL;DR: The study suggests that PMR practice is useful during pregnancy to decrease stress, anxiety, and for reducing the occurrence of postpartum complications.
Abstract: Background: Progressive Muscle Relaxation (PMR) helps to improve the emotional state of antenatalmothers with stress and anxiety, which is necessary to keep the fetus healthy inside the womb. This study assesses the efficacy of progressive muscle repose on stress and anxiety among primigravidae. Materials and Methods: Arandomized controlled study was conducted from May 2015 to June 2017 with 250 primigravidae. The women were assigned using a lottery method to interventionand control groups, 125 in each group. Information on background variables, pregnancy outcome,maternal complications, fetal complications, and postpartum depression was collected during the interval following delivery. PMR was the intervention (video) installed on one‑to‑one basis for two consecutive days. Pearson correlation, ANOVA, and regression analysis were used to evaluate the data to determine pregnancy outcome and performance of PMR. Results: There was a significantreduction ((F3 = 24.81, p < 0.001) in all aspects of stress among the intervention and control groupsduring the posttest. The mean gestational age at birth was significantly different (F2 =6.08, p = 0.014)in the control group. There was significant increase in the occurrence of fetal complications such as birth asphyxia (F2 =5.67, p < 0.050), respiratory distress (F2 =8.68, p < 0.050), and jaundice (F2 =3.91,p < 0.050) in the control group. There was a negative correlation between PMR and stress (r= −0.22,p < 0.001), and PMR and state anxiety (r = −0.26, p < 0.001). There was an increased occurrenceof maternal complications among the control group in comparison with the intervention group. Conclusions: The study suggests that PMR practice is useful during pregnancy to decrease stress,anxiety, and for reducing the occurrence of postpartum complications.
30 citations
TL;DR: It can be concluded that senior day care centers have been able to promote perceived social support in the elderly through their participation in daily activities and social activities, and thus were able to reduce depression significantly compared to the other two groups.
Abstract: Background: Social support perceived by the elderly can reduce mental health problems including depression. In Iranian society, some elderly people spend their elderly years in senior day care centers established to promote social protection for the elderly. Therefore, the purpose of this study was to assess perceived social support and depression in the elderly members of senior day care centers and compare the results with that of elderly individuals living at nursing homes and at home. Materials and Methods: This descriptive, cross-sectional study was conducted on 315 elderly people. The participants were selected using stratified random sampling method and a random number table. The data collection tools used consisted of a demographic characteristics questionnaire, the Barthel index for assessing Activities of Daily Living (ADL), Social Support Appraisals (SSS-As) scale, and Geriatric Depression Scale short form (GDS-15). ANOVA, Chi-square, the Pearson correlation coefficient, and linear regression analysis were used to examine the hypotheses. Results: The results showed that with increasing social support, depression decreased in all three groups, which was statistically significant in the two elderly groups living in nursing homes (r = −0.19, p = 0.044) and elderly members of senior day centers (r = −0.18, p = 0.049). Conclusions: According to the results, it can be concluded that senior day care centers have been able to promote perceived social support in the elderly through their participation in daily activities and social activities, and thus were able to reduce depression significantly compared to the other two groups.
24 citations
TL;DR: The concept of professional autonomy is a developmental achievement based on patient-based professional competence along with self-reliance to provide the best care plan for the promotion of patients' health through the professional decision making and professional interactions with other professional team members.
Abstract: Background: Autonomy is the main element of professional practice in nursing. However, despite the many studies conducted on nursing autonomy, this concept is not fully understood and a comprehensive explanation of this concept in nursing is necessary. Meta-synthesis offers a way to increase the understanding of this concept using existing research findings. Thus, the present study aimed to explain the concept of professional nursing autonomy. Materials and Methods: This qualitative meta-synthesis was conducted based on a modified version of Noblit and Hare's meta-ethnography approach and qualitative studies on the concept of nursing autonomy published in databases such as PubMed, Scopus, Web of Science, Cochrane, SID, IranMedex, Magiran, and ScienceDirect in the past 15 years (2003–2018). Results: Thirteen articles that reported the experiences of nurses regarding professional autonomy were included in the research. Based on the meta-synthesis of findings, the final interpretation of the professional autonomy of clinical nurses was presented in the three themes of professional competence, professional decision making, and professional interactions. Conclusions: According to the results, the concept of professional autonomy is a developmental achievement based on patient-based professional competence along with self-reliance to provide the best care plan for the promotion of patients' health through the professional decision making and professional interactions with other professional team members.
18 citations
TL;DR: Nurses' level of empathy in this study was above average with equal scores in different wards, suggesting that increasing the nurses'level of empathy is essential in interventional studies.
Abstract: Background: Empathy is an important component of the nurse-client relationship and nursing care. The current study aimed to compare nurses' level of empathy with patients in critical care units, psychiatric, and emergency wards. Materials and Methods: The present cross-sectional study was conducted on 112 nurses selected by convenience sampling in three educational hospitals affiliated with Isfahan University of Medical Sciences, Iran from June to September 2017. Data collection tool was a two-part questionnaire consisting of sociodemographic data (such as age, gender, and work experience) and Jefferson Scale of Empathy (JSE) containing 20 items, scored according to Likert scale from totally agree (7 points) to totally disagree (1 point). In total, the maximum score was 140 and the minimum score was 20. Data were analyzed using SPSS version 16 as well as descriptive and analytical statistical tests (multiple regression). Results: The mean (SD) empathy score of nurses working in critical care units, emergency, and psychiatric wards was 87.51 (6.65), 87.59 (4.90), and 90.71 (7.12), respectively. Regarding the regression models, it was observed that only the work experience was a significant predictor for empathy (β = 0.19, p = 0.04). This model predicted 3.50% of variances in the nurses' empathy. Conclusions: Nurses' level of empathy in this study was above average with equal scores in different wards. Therefore, increasing the nurses' level of empathy is essential in interventional studies.
18 citations
TL;DR: The combined lemon and peppermint aromatherapy could reduce mild to moderate intensity of nausea and vomiting during pregnancy.
Abstract: Background: Nausea and vomiting are almost inevitable features of pregnancy which have a serious impact on the quality of life of pregnant women. This study aimed to determine the effects of combined inhalation aromatherapy with lemon and peppermint on nausea and vomiting of pregnancy. Materials and Methods: The parallel randomized clinical trial was conducted on 90 pregnant women suffering from nausea and vomiting of pregnancy referred to health centers in Birjand‑Iran‑ from February 2015 to August 2016. Participants were randomly divided into two groups. The combined lemon and peppermint essential oils were used as an inhaler for the intervention and the placebo for the control group. Both groups were trained to place three drops of the solution onto a cotton ball and keep it in a 3‑cm distance of their nose. The intensity of nausea, vomiting and fatigue was assessed through 24‑hour Pregnancy Unique Quantization of Emesis (PUQE‑24) questionnaire and Fatigue Severity Scale (FSS), respectively. Results: Mean (SD) scores of nausea and vomiting intensity before the intervention and on the first day of intervention were not significantly different between the two groups, but became significant on the second, third, and fourth days of intervention. The results showed that the effect of time on the mean intensity of nausea and vomiting was significant in the aromatherapy group (F2,84 = 22.92, p < 0.001) but was not significant in the placebo group (F2,78 = 0.26, p = 0.836). Conclusions: The combined lemon and peppermint aromatherapy could reduce mild to moderate intensity of nausea and vomiting during pregnancy.
15 citations
TL;DR: There are currently gaps in the guidelines in many aspects including maternal and fetal health assessments, mental health care, and also ethical and communication issues.
Abstract: Background: There are standard guidelines for the provision of health care for pregnant women in prisons. There is no single guide to meet all the specific needs of imprisoned women. In this study, the related international guidelines were reviewed to reveal the existing gaps. Materials and Methods: In this narrative review, studies published from May 2010 to January 2019 were reviewed through investigating databases including PubMed, Scopus, the Cochrane Library database as well as Science Direct Google Scholar using keywords: Guideline AND Prison AND Pregnancy AND Prenatal Care. The contents of the guidelines were subjected to analogy comparison. Results: 13 guidelines were included in the study. Of these, 10 guidelines were related to the organizations deployed in the USA, two guidelines to the United Nations and the World Health Organization, and one guideline to the United Kingdom. The most comprehensive care coverage of pregnant women was suggested, at the first level, by Birth Champion and in the second level by the Federal Bureau of Prisons. The care recommended in the guidelines was classified into four general categories of health care, safety and security, education and counseling, as well as miscellaneous issues. Most of the care items mentioned in the guidelines were related to the issue of safety and security of pregnant women. Conclusions: There are currently gaps in the guidelines in many aspects including maternal and fetal health assessments, mental health care, and also ethical and communication issues. It is essential to upgrade the guidelines provided for imprisoned women to promote their health.
14 citations
TL;DR: There is no universal definition for the term “FICUS” in the research literature, so the FICUS is not limited to the occurrence of psychological symptoms, and further research is needed to explore FIC US in the health field.
Abstract: Background: Hospitalization in the Intensive Care Unit (ICU) brings about psychological and physical symptoms in patients' family members. Family Intensive Care Unit Syndrome (FICUS) is a term used to explain the psychological symptoms of the family of a patient in response to the patient's admission to the ICU. The purpose of this study was to define FICUS along with its symptoms and predictors. Materials and Methods: The Web of Science, PubMed, Scopus, Google Scholar, and SID databases were searched for literature published in 2005–2018 with the keywords “FICUS,” “intensive care unit,” “family,” “caregivers,” “anxiety,” “depression,” and “post-traumatic stress disorder” in their title and abstract. The strategy for conducting an integrative review provided by Whittemore and Knafl (2005) was used in this study. Results: Twenty articles were included in the final data analysis. Following the patient's admission to the ICU, family members experience multiple psychological symptoms such as FICUS. The most commonly reported symptoms were anxiety, depression, post-traumatic stress disorder (PTSD), complicated grief, sleep disorder, stress, and fatigue. The low education level, having a critically-ill spouse, adequate support, financial stability, preference for decision-making, understanding of the disease process, anxiety, depression, or previous acute stress were predictors of FICUS. Conclusions: On the basis of the results, families also experience physical symptoms, so the FICUS is not limited to the occurrence of psychological symptoms. This study found that there is no universal definition for the term “FICUS” in the research literature. Thus, further research is needed to explore FICUS in the health field.
12 citations
TL;DR: Peer education can lead to increased level of knowledge, comprehension, and knowledge application of patients in terms of chemotherapy complications, and this effect was significant in the intervention group.
Abstract: Background: The aim of the present study was to determine the effect of peer education on the level of knowledge, comprehension, and knowledge application of patients regarding chemotherapy complications. Materials and Methods: This study was performed on 80 patients with cancer undergoing chemotherapy in 2018. The participants were selected through convenience sampling and randomly allocated to the two groups of control and intervention (40 participants per group). Before the intervention, the participants in both groups completed a demographic characteristics form and the Educational Needs Assessment Questionnaires. Then, the peer education intervention was designed based on the educational needs of the patients regarding chemotherapy complications for the intervention group. Peer education was performed face-to-face and individually during two chemotherapy sessions. The questionnaires were re-administered to both groups 2 weeks after the end of the second chemotherapy session and data analysis was performed using independent t -test, Chi-square. Results: The means of knowledge (t 78 = 19.74, p < 0.001), comprehension (t 78 = 17.27, p < 0.001), and knowledge application (t 78 = 14.84, p < 0.001) were significantly increased after peer education in the intervention group compared to the control group. The difference in the means of knowledge (t 39 = 17.40, p < 0.001), comprehension (t 39 = -18.53, p < 0.001), and knowledge application (t 39 = -13.94, p < 0.001) after peer education, compared to before the intervention, was significant in the intervention group. Conclusions: Peer education can lead to increased level of knowledge, comprehension, and knowledge application of patients in terms of chemotherapy complications.
11 citations
TL;DR: The application of new approaches like-dignity therapy could benefit patients with cancer in terms of reducing their distress, improving symptom severity, physical and emotional functioning, and total quality of life.
Abstract: Background: Patients with cancer deal with physical, psychosocial, spiritual, and existential problems that impact on their quality of life. This study aimed to assess the effect of dignity therapy on the quality of life of mentioned patients. Materials and Methods: In this quasi‑experimental study, 50 patients with cancer hospitalized in a palliative care center in Tehran, Iran, in 2017‑18 who fulfilled inclusion criteria were selected through convenience sampling. The European Organization for Research and Treatment of Cancer Quality of Life‑C15‑Palliative (EORTC‑QLQ‑C15‑PAl) questionnaire was filled by patients before and 2 weeks after dignity therapy. Data were analyzed using descriptive statistics such as frequency, mean, and standard deviation, as well as inferential statistics, including independent t‑test and Chi‑square test. Results: Results showed that dignity‑therapy led to more improvement in the quality of life of the intervention group (t35,18 = 4.82, p = 0.001). There was also a significant difference between the two groups in terms of the physical functioning scale (t32,96= ‑2.60, p = 0.01) and emotional functioning (t 45,69 = 6.54, p < 0.001). We also found that dignity‑therapy led to more improvement in nausea and vomiting (χ2 = 5.71, p = 0.02), insomnia (χ2 = 15.78, p < 0.001), appetite (χ2 = 5.09, p = 0.02), and constipation (χ2 = 12.50, p < 0.001). Conclusions: The application of new approaches like‑dignity therapy could benefit patients with cancer in terms of reducing their distress, improving symptom severity, physical and emotional functioning, and total quality of life.
10 citations
TL;DR: The results showed that the score of compassion satisfaction was high and fatigue was moderate in the cardiovascular nurses and further research seems necessary to enhance compassion satisfaction and reduce fatigue in nurses.
Abstract: Background: Cardiovascular nurses play a key role in improving the treatment outcomes in patients. Compassion satisfaction and fatigue influence the quality of nursing care. Thus, it is important to examine the levels of compassion satisfaction and fatigue in cardiovascular nurses. This study was performed to determine compassion satisfaction and fatigue in cardiovascular nurses. Materials and Methods: This cross-sectional, descriptive study was conducted with a single-stage design on 200 cardiovascular nurses who were randomly selected from among nurses working in four educational hospitals in Isfahan, Iran, in July–October 2018. Data collection was conducted using the Professional Quality Of Life Scale (version 5) (ProQOL- version 5) with 30 items in the three subscales of compassion satisfaction, burnout, and Secondary Traumatic Stress (STS). The results were analyzed using descriptive and inferential statistics in SPSS software. Results: The results indicated the high mean (SD) score of 41.39 (5.54) for compassion satisfaction and the moderate mean (SD) scores of 26.93 (4.62) and 26.69 (5.90) for burnout and STS, respectively, in more than two-thirds of the nurses. Pearson correlation coefficient showed no significant relationship between the nurses' age, level of education, work experience, and monthly working hours and scores of compassion satisfaction, burnout, and STS, and total compassion fatigue score (p > 0.05). Work experience was directly related to STS score (r = 0.18,p = 0.01). However, it had no significant relationship with compassion satisfaction and burnout (p > 0.05). Conclusions: The results showed that the score of compassion satisfaction was high and fatigue was moderate in the cardiovascular nurses. Further research seems necessary to enhance compassion satisfaction and reduce fatigue in nurses.
10 citations
TL;DR: In this paper, a qualitative study was conducted using a conventional content analysis approach with semi-structured and in-depth interviews and using a purposeful sampling method on 20 nurses, physicians, and endocrinologists.
Abstract: Background: Many diabetes educators in Iran do not have the necessary skills and competence for performing a needs assessment, and thus, cannot provide Diabetes Self-Management Education (DSME) to suit individual educational needs and conditions. The purpose of the present study was to explore and analyze needs assessment implementation in DSME and evaluate the barriers and the appropriate strategies from educators' viewpoints. Materials and Methods: The present qualitative study was conducted using a conventional content analysis approach with semi-structured and in-depth interviews and using a purposeful sampling method on 20 nurses, physicians, and endocrinologists. The data of this study were collected from April to October 2018. The interviews were analyzed using the content analysis method of Graneheim and Lundman. Results: Qualitative data analysis resulted in the emergence of two main categories of educational challenges of needs assessment and managerial challenges of needs assessment and four subcategories (lack of structured educational planning, lack of needs assessment practical patterns, managers' insufficient support and supervision, and managers' insufficient attention to motivational factors). Conclusions: Educational strategic planning, managers' obligation and support in designing practical patterns, and supervision tools to evaluate educators' performance in the needs assessment domain can result in the promotion of DSME needs assessment, the efficiency of plans, and the promotion of society's health.
TL;DR: In this paper, a cross-sectional correlational study was conducted on 282 midwives working in labor wards of hospitals in Isfahan (Iran) to assess the correlation between PE and job burnout in midwives.
Abstract: Background: Job Burnout (JB) is a multifactorial psycho-cognitive syndrome that leads to physical and psychological problems and declines the efficiency and productivity. Psychological Empowerment (PE) indicates that an individual feels motivated and competent to fulfill work expectations actively. This study assessed the correlation between PE and JB in midwives. Materials and Methods: This cross-sectional correlational study was conducted on 282 midwives working in labor wards of hospitals in Isfahan (Iran). Convenience sampling was used. Psychological Empowerment Questionnaire (PEQ) with four domains (meaning, competence, autonomy, and impact) and Maslach Burnout Inventory (MBI) with three domains (emotional exhaustion, depersonalization, and personal accomplishment) were used. Partial correlation and regression analysis were used to analyze the data. p
TL;DR: Iranian studies that have investigated midwives' educational needs showed that the educational needs of the midwives can be categorized into the four groups of knowledge and performance, communication skills, occupational rules/regulations, and religious rules.
Abstract: Background: Midwives have a major role in the improvement of health indicators in every country. In order for midwives to be able to play their role well, they must have sufficient updated knowledge. For this purpose, it is necessary to review their educational needs. The aim of the present research was to review Iranian studies that have investigated midwives' educational needs. Materials and Methods: In this narrative review, PubMed, Scopus, Web of Science, Google Scholar, ProQuest, Ovid, SID, and Magiran databases were searched for the full texts of Iranian studies published in Persian and English languages in the period of 2000–2018. Review, descriptive, and interventional articles consistent with the research aim were included in this study. Results: Of the 53 found articles, 23 articles that were relevant to midwives' educational needs in Iran were investigated. The findings of the studies showed that the educational needs of the midwives can be categorized into the four groups of knowledge and performance, communication skills, occupational rules/regulations, and religious rules. Conclusions: The results showed that midwives in Iran have different educational needs. Because the midwifery practice leads to the promotion of public health, it is imperative that midwives have comprehensive knowledge and the skills necessary for providing optimal care. In order to achieve this, short-term and long-term training programs tailored to the needs of midwives are recommended.
TL;DR: Empowering the parents especially mothers through teachers and healthcare providers with the knowledge and skills to maintain the sexual and reproductive health of intellectually disabled adolescent girls would make them emboldened to find the ability to protect themselves in different situations.
Abstract: Background: Intellectually disabled persons, as compared with normal people, experience different changes during the adolescence period including the appearance of secondary sexual characteristics. However, owing to their low intelligence quotient, these changes are usually accompanied by more problems and challenges. The present study was conducted to determine the experiences of parents regarding the sexual and reproductive health of educable intellectually disabled adolescent girls. Materials and Methods: This qualitative study was carried out on 52 participants (adolescent girls, parents, teachers, healthcare providers, and managers) who were selected via purposeful sampling in Isfahan between July 2016 and April 2017. Data were collected through semi-structured interviews, focus group discussions and field notes, and analyzed using conventional content analysis. Results: Five sub-categories were extracted: “unawareness about sexual needs of the adolescent girl and her potential vulnerability,” “inappropriate actions in directing the sexual behaviors of the adolescent,” “insufficient supervision and care over the adolescent's sexual health,” “inappropriate actions toward marrying off the adolescent,” and “inappropriate actions regarding the menstrual and genital health” which formed the main category of “parents' inefficiency in maintaining adolescent girls' sexual and reproductive health.” Conclusions: Based on the results, parents face different challenges about the sexual and reproductive health of intellectually disabled adolescent girls. Hence, empowering the parents especially mothers through teachers and healthcare providers with the knowledge and skills to maintain the sexual and reproductive health of intellectually disabled adolescent girls would make them emboldened to find the ability to protect themselves in different situations.
TL;DR: The basic characteristics and practical definition of maternal role attainment in mothers with term neonate in a new context are shown, providing a good basis for evaluating and applying this concept.
Abstract: Background: A review of the literature shows that there is little consensus on the practical definition of maternal role attainment in the field of neonatal nursing care. The initial interaction between mother and neonate most often begins in the hospital and can be influenced by neonatal nurses, so it is necessary to clarify this concept in nursing. The purpose of this study was to show the basic characteristics and practical definition of maternal role attainment in mothers with term neonate in a new context. Materials and Methods: This study used a hybrid model three-step concept analysis: theoretical, fieldwork, and final analysis phases. At theoretical phase, articles indexed in credential databases were searched using keywords. Totally, 33 articles were analyzed. At fieldwork phase, 12 participants were interviewed. At final phase, the findings of the two earlier phases were analyzed. The study lasted from August to November 2018. After determining the attributes, antecedents, and consequences, a final definition of maternal role attainment was introduced. Results: The concept of maternal role attainment was defined as “a developmentally, interactive, adaptive, and committed multi-dimensional process based on the discovery of pregnancy, characteristics of the mother, receiving social support, which leads to maternal identity, formation of maternal skills, resiliency, development of newborn, improvement of mother-newborn interactions and increased well-being of the mother”. Conclusions: This study identifies the concept of maternal role attainment in nursing, providng a good basis for evaluating and applying this concept.
TL;DR: BAE has to be taught to the patients with DM in improving the level of LEP and can be encouraged to practice in the hospital and home care setup.
Abstract: Background: Buerger‑Allen Exercise (BAE) promote Lower Extremity Perfusion (LEP) via the wound healing process and reduce Peripheral Neuropathy Symptoms (PNS) among Diabetes Mellitus (DM) patients We study the efficacy of BAE on LEP and PNS among patients with DM Materials and Methods: This quasi‑experimental study was conducted prospectively from July to October 2017 Fifty DM patients between the ages of 30 and 75 from both genders were selected using a purposive sampling technique and were assessed for LEP with a manual Ankle‑Brachial Index (ABI) scale and assessed for PNS with Michigan Neuropathy Screening Instrument (MNSI) The BAE was demonstrated for 4 consecutive days The intervention was repeated five times per day for each patient and the posttest was conducted 5th day using the same tools Results: The majority ( n = 75, 75%) were 60–69 age group and 98% had education till primary school 62% had diabetes and 20% of them had a history of peripheral arterial disease 50% of participants had mildly impaired perfusion during pretest whereas abnormal neuropathy was seen in more than 70% cases which decreased posttest A significant difference in PNS was seen after the implementation of BAE in both right LEP (t48 = 681, p < 0001) and left LEP t48 = 521, p < 0001) Conclusions: BAE has to be taught to the patients with DM in improving the level of LEP and can be encouraged to practice in the hospital and home care setup
TL;DR: It is suggested that the women at risk for preterm birth are trained for prenatal self-care based on Orem's theory, which suggests that educational interventions could reduce the incidence ofPreterm birth.
Abstract: Background: Preterm birth is increasing as a major cause of perinatal complications and mortality in Iran. The present study aimed to investigate the effect of prenatal self-care based on Orem's theory on preterm birth occurrence in women at risk for preterm birth. Materials and Methods: The present clinical trial was conducted on 176 pregnant women at 24–26 weeks at risk for preterm birth in Mashhad, Iran, from December 2015 to October 2016. A multistage sampling method was used in this study. The intervention group (88 pregnant women) received individual self-care education but the control group (88 pregnant women) received only common prenatal care. Results: There was a statistically significant difference between intervention and control groups in terms of preterm birth occurrence (6.80% vs 20.50%) (χ2 = 6.90, df = 1,p = 0.008). The incidence of preterm birth in the intervention group was approximately three times higher than that in the control group. Conclusions: Given that educational interventions could reduce the incidence of preterm birth, it is suggested that the women at risk for preterm birth are trained for prenatal self-care.
TL;DR: It is revealed that perineal massage with Ostrich oil could be recommended as an effective, safe, and inexpensive method to improve the rate of episiotomy in vaginal delivery.
Abstract: Background: Perineal lacerations resulting from vaginal delivery may cause short and long complications, which lead to some problems in women after the delivery. Ostrich oil is safe for use in skincare and beauty products. The aim of this study was to examine the effect of perineal massage with Ostrich oil on the episiotomy and lacerations in nulliparous women. Materials and Methods: This single‑blind randomized controlled trial was conducted on 77 nulliparous women referred to Razi Hospital in Qazvin (Iran) from May to December 2018. After screening of potential participants, 80 out of 105 pregnant women were selected by convenience sampling and were assigned into the intervention and control groups by block randomization technique. In the intervention group, participants received a perineal massage with Ostrich oil in the active phase and the second stage of labor. The rates of episiotomy and perineal laceration were compared between the two groups. Data were analyzed using Chi-square, t -test and Mann-Whitney. Results: Perineal massage with Ostrich oil in the intervention group significantly decreased the rate of episiotomy compared to the control group ( x 2 = 18.32, df = 1, p < 0.001). However, there was no statistically significant difference in perineal lacerations between the two groups. Conclusions: The results revealed that perineal massage with Ostrich oil could be recommended as an effective, safe, and inexpensive method to improve the rate of episiotomy in vaginal delivery. Perineal massage can be performed by midwives in the first and second stages of labor.
TL;DR: The consequence of reciprocal endeavors of pregnant women along with their husbands as well as their work environment expectations tends to selection, management, and adjustment of feminine roles.
Abstract: Background: The role of women and men is changing across the world, and women, including pregnant women, are adopting newer roles in traditional societies like Iran. This study aimed to explore the meaning of pregnant women's experiences regarding their social roles in the sociocultural context of Iran. Materials and Methods: This study was carried out using an ethnophenomenological approach. Participants included 16 pregnant women who attended health centers, hospitals, and private obstetric clinics in Mashhad, Iran, between 2016 and 2017 and were selected based on purposive sampling. In-depth semistructured interviews, vignette interviews, participant observations, and field notes were used to collect data. To analyze data, six-step van Manen's (1997) descriptive-interpretive phenomenological approach was used. Results: Through data analysis, the overarching theme of “selection, management, and adjustment of various roles to play social roles” was emerged. This was consisted of four themes: “Mother's perspective regarding out-of-home employment, incompatibility between pregnancy and social roles, mother's management strategies to play different roles, and husband's authority regarding mother's employment.” Conclusions: The consequence of reciprocal endeavors of pregnant women along with their husbands as well as their work environment expectations tends to selection, management, and adjustment of feminine roles. Since the employment of pregnant women leads to their more physical and psychological involvement, not only the problems of working women but also the expectations and rules of the workplaces as well as the requests of their husbands should be taken into account.
TL;DR: Use of honey, yarrow, and breast milk can be recommended to women in breastfeeding counseling and pharmaceutical companies can be advised to use honey and yarrow in the preparation of anti-fissure creams.
Abstract: Background: Nipple fissure is a common problem among breastfeeding women, which can lead to early cessation of breastfeeding Because of the lack of effective treatment and given the approved efficacy of honey and yarrow on sore healing, this study was conducted to evaluate and compare the effects of yarrow, honey, and breast milk on the treatment of nipple fissure Materials and Methods: This study was a three-group clinical trial, and sampling was conducted at Sina breastfeeding counseling center from September 2016 to March 2018 in Sirjan, Iran, using a target-based method The sample size consisted of 150 individuals who were randomly assigned into three groups as topical use of yarrow, the mountain honey, and breast milk after obtaining the written informed consent The correct method of breastfeeding and using materials were instructed to these three groups on the 1st, 3rd, and 7th days, where the Storr scale was completed by the researcher Results: Friedman test showed that, in these three groups of yarrow (χ2 = 9219, df = 2, p 005) Conclusions: Use of honey, yarrow, and breast milk can be recommended to women in breastfeeding counseling and pharmaceutical companies can be advised to use honey and yarrow in the preparation of anti-fissure creams
TL;DR: Nurses play an important role in the care process of brain dead patients; therefore, recognizing their challenges can be the first step in increasing holistic care and maintaining organ vitality for transplantation.
Abstract: Background: Caring for brain dead patient is one of the most troublous duties of an Intensive Care Unit (ICU) nurse This study aimed to determine nursing challenges based on recent literature and identify the strategies to overcome these challenges Materials and Methods: In this systematic review, the standard systematic review guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used with articles published in PubMed, Science Direct, Scientific Information Database (SID), and Google Scholar databases during 2000–2018 on the keywords “brain dead OR brain death” and “nurses OR nursing” After the primary search, 212 articles were found Eventually, 21 articles were selected for the final evaluation Results: According to the results, the challenges included the concept and diagnosis of brain death, religious, and cultural beliefs opposing organ donation, lack of knowledge about the care process, interactions with the families The proposed strategies were providing medical and nursing interventions to maintain a brain dead patient for organ donation, providing working conditions that maintain nurses' health, and increase the quality of care Conclusions: Nurses play an important role in the care process of brain dead patients; therefore, recognizing their challenges can be the first step in increasing holistic care and maintaining organ vitality for transplantation It is suggested that nursing authorities commence special educational programs with the aim to increase the knowledge of nurses about the care process of brain dead patients
TL;DR: Fertility expectations are affected by several factors and are compatible with a variety of conditions, and according to the results of the qualitative studies, some of the most important effective factors were women's decision-making power and financial issues.
Abstract: Background: Childbearing is an important phenomenon among adolescents. Studies that have evaluated teenagers' reproductive patterns have found that many adolescents are ambivalent regarding sexual activity and childbearing. In order to assess the patterns of adolescents' reproductive health and pregnancy to conduct interventions, every country needs to collect specific data about childbearing intentions. This study was conducted to determine the factors that may affect the childbearing intentions of adolescents. Materials and Methods: This article was a narrative review. Articles derived from PubMed, Scopus, and Web of Science from January of 2000 to February 2015 were assessed. Moreover, gray literature, such as conference abstracts, theses, and the result of technical reports were also used. Results: In total, 15 studies were included in the review. The findings of this study showed that childbearing motives are affected by several factors. According to the results of the qualitative studies, some of the most important effective factors were women's decision-making power and financial issues. In this regard, the quantitative studies noted that the cultural and economic factors were more effective than other factors in determining the childbearing motives of adolescents. Conclusions: Fertility expectations are affected by several factors and are compatible with a variety of conditions. Moreover, access to precise information on the effects of each factor (positive or negative) is necessary and useful for demographers, policymakers, and other planners in any community.
TL;DR: Most patients were satisfied with the self-care training held by the nurses, and nurses' performance and their training methods were directly associated with a high satisfaction level in stroke patients.
Abstract: Background: Stroke is a major cause of disability around the world. Different studies have shown the inadequate knowledge and skills of nurses to educate and manage stroke patients. Therefore, stroke patients are facing many challenges in their lifetime. In this study, we investigated the effects of nursing empowerment on stroke patients' satisfaction. Materials and Methods: This cross-sectional study is the fifth stage (evaluation phase) of action research study that was conducted on 29 stroke patients from Alzahra hospital, Isfahan, Iran, during 2013-2014. Workshops, pamphlets, and booklets were used for nursing empowerment. The stroke patients have been trained by empowered nurses. The data gathering tool that was the researcher-made survey questionnaire included the characteristics of patients, participants' satisfaction with self-care training and nurses' performances. T-test was used for the analysis of the obtained data. Results: Twenty-seven (93.10%) cases mentioned that “they would try to follow all the received trainings”. Twenty-three (73.10%) cases were satisfied with self-care training. Majority of patients, 25 (85%) participants were satisfied with the training performances by the empowered nurses and 24 (82.80%) cases were highly satisfied with the nurses' training method. Conclusions: Most patients were satisfied with the self-care training held by the nurses. Based on the obtained data by questionnaires, the nurses' performance and their training methods were directly associated with a high satisfaction level in stroke patients. Therefore, improving the skills and knowledge of nurses could be a potential approach for increasing the satisfaction levels among stroke patients.
TL;DR: If planners and policymakers have a positive attitude toward the presence of forensic nurses, they can anticipate better forensic services for clients through the development of systematic educational programs, the formation of forensic teams, and the expertise of this profession can provide many benefits.
Abstract: Background: Nursing is a vital element in providing safe and effective care. Forensic nursing is one of the specialties in this discipline which, in addition to creating more satisfaction in nurses, is considered essential in holistic, quality, and safe care. This study aimed to describe the consequences of the presence of forensic nurses in the health system. Materials and Methods: This qualitative study was conducted between 2017 and 2018 in Iran. Semi-structured interviews were performed with 18 participant experts in the field of health and law. The interviews were analyzed using the inductive content analysis approach proposed by Graneheim and Lundman. Results: The consequences of the presence of nurses in the health system were summarized into two categories: positive and negative consequences. The positive consequences consisted of improved performance, better legality of nurses, the calmness of nurses, prevention of patients' rights violations, advancement comparable with developed countries, reduced costs, increased accuracy and speed in dealing with forensic cases, improved performance of Iranian Legal Medicine Organization and increased employment. On the other hand, the negative consequences were role conflict with other involved professionals and nursing shortage. Participants included nurses (with different specialties), nurse lawyers, forensic medicines, forensic midwives, a judge, and a medical lawyer. Conclusions: If planners and policymakers have a positive attitude toward the presence of forensic nurses, we can anticipate better forensic services for clients through the development of systematic educational programs, the formation of forensic teams, and the expertise of this profession can provide many benefits.
TL;DR: Family-oriented educational intervention resulted in reducing the intensity of pain and the use of narcotic drugs after orthopedic surgery.
Abstract: Background: Non-pharmacological methods including the improvement of knowledge of patients and his/her family members in the management and control of pain can reduce patients' experiences of pain. The present study aimed to investigate the effects of family-oriented educational intervention on postoperative pain after orthopedic surgery. Materials and Methods: This study is a non-randomized controlled trial with the control group, which was carried out on 46 patients in orthopedic surgery units of Mousavi Hospital in Zanjan in 2017. Patients were selected based on convenience sampling and categorized into two groups of experimental (n = 23) and control (n = 23) groups. In the experimental group, educational intervention was performed with the attendance of the patient and his/her family members in two sessions of the preoperative and postoperative period. The control group received routine care. The pain intensity was measured by Visual Analog Scale (VAS) for 3 days in both control and experimental group. Data were analyzed by using Chi-square, Fisher exact test, independent t-test, and Analysis Of Variance (ANOVA) with repeated measures and Greenhouse–Geisser. Results: Mean (SD) of pain intensity in the experimental and control groups was 5.21 (1.47) vs 6.74 (1.30) on the first day, 2.91 (1.20) vs 4.81 (1.32) on the second day, and 1.75 (0.67) vs 3.38 (1.53) on the third day, respectively. Pain severity reduction was significant in the experimental group compared to control group in every 3 days after surgery (F = 152.30, df = 1.62, p = 0.005). Conclusions: Family-oriented educational intervention resulted in reducing the intensity of pain and the use of narcotic drugs after orthopedic surgery.
TL;DR: To remove barriers of V BAC in health care system, appropriate strategies including establishment of specialized VBAC counseling centers, performance-based incentive policies, cultural development and promotion of natural childbirth, promoting of teamwork culture, shared decision making, improvement of knowledge and skills of maternal care providers and implementation of clinical guidelines, should be considered.
Abstract: Background: Approximately half of mothers give birth by cesarean section in Iran and two-thirds of them are repeated cesareans. Repeated cesarean is threatening for the mothers and newborns and not compatible with fertility policies in Iran. Vaginal Birth After Cesarean (VBAC) is a reasonable strategy but its prevalence is very low due to some barriers. The aim of this study was to explore barriers to VBAC in health care system. Materials and Methods: In this qualitative study, 26 semi-structured individual interviews with maternity care providers and mothers with prior cesarean section as well as one focus group discussion with maternity care providers were conducted. Interviews and focus group discussions were tape-recorded, transcribed verbatim and analyzed with conventional content analysis developed by Graneheim and Lundman using MXQDA10 software. Results: Barriers to VBAC in health care system identified in the main category of “the climate of restriction, fear and discourage” and eight subcategories including: “defective access to specialized services,” “insufficient encouragement system,” “modeling in cesarean section,” “physician-centeredness in VBAC,” “fear of legal responsibilities,” “imposed policies,” “marginalization of midwives,” and “unsupportive birth team.” Conclusions: To remove barriers of VBAC in health care system, appropriate strategies including establishment of specialized VBAC counseling centers, performance-based incentive policies, cultural development and promotion of natural childbirth, promoting of teamwork culture, shared decision making, improvement of knowledge and skills of maternal care providers and implementation of clinical guidelines, should be considered. Future research could be focused on the effect of implementing these strategies to decrease repeat cesarean section rate.
TL;DR: The findings of this study revealed that the training program based on the HPM has a positive effect on improving physical activity in women with type 2 DM.
Abstract: Background: Physical activity among women with type 2 Diabetes Mellitus (DM) is an undesirable level. This study aimed to determine the effect of a training program based on the Health Promotion Model (HPM) on physical activity in women with type 2 DM. Materials and Methods: This randomized clinical trial was performed on 128 women with type 2 DM, who were randomly assigned to control and intervention groups. Data were collected using the Baecke Physical Activity Questionnaire (BPAQ) and a researcher-made questionnaire designed based on the HPM constructs before and 2 months after the intervention. The training was carried out in four sessions in the intervention group and the control group received regular education at the clinic. Data were analyzed using Chi-square, Fisher's exact test, paired t-test, independent t-test, and Mann–Whitney and Wilcoxon tests in Statistical Package for the Social Sciences (SPSS) software. Results: The findings showed that the mean [Standard Deviation (SD)] of physical activity in the intervention and control groups before the intervention was 6.52 (0.86) and 6.56 (1.07), respectively, and there was no significant difference between the groups (p = 0.95). However, after the intervention, the mean (SD) of physical activity in the intervention and control groups was 8.04 (0.92) and 6.33 (1.60), respectively, which showed a significant difference (t126 =9.71,p
TL;DR: The tracheal tube cuff pressure has been significantly reduced during manual intermittent measuring and it is suggested that continuous cuff pressure monitoring and regulation should be used.
Abstract: Background: Usually, the endotracheal tube cuff pressure is controlled by cuff pressure monitoring. However, the intermittent pilot-manometer connection and disconnection may cause a change in the adjusted pressure. This study aimed to investigate changes in the endotracheal tube cuff pressure using both manual and intermittent controls. Materials and Methods: A semi-experimental within-subject design was conducted. Fifty-nine intubated patients in the Mazandaran Intensive Care Units (ICUs) participated through convenience sampling in 2018. In the control condition, first, the cuff pressure was adjusted in 25 cm H 2 O then it was measured without manometer-pilot disconnection at 1 and 5 min intervals. In the intervention condition, cuff pressure was immediately adjusted in 25 cm H 2 O then it was measured with manometer-pilot disconnection in the 1 st and 5 th minutes. Data analysis was performed using Independent t -test, Chi-square test, and Phi coefficient. Results: The mean and Standard Deviation (SD) change of cuff pressure after 1 minute, from 25 cm H 2 O, in the intervention condition was 20.22 (3.53) cm H 2 O. The mean (SD) of this change in the control condition was 25.22 (3.39) cm H 2 O. This difference was significant ( t 116 = 7.83, p < 0.001, d = 1.44). The mean (SD) change of cuff pressure after 5 minutes, from 25 cm H 2 O, in the intervention condition was 19.11 (2.98) cm H 2 O. The mean (SD) of this change in the control condition was 25.47 (4.53) cm H 2 O. This difference was significant ( t 116 = 9.24, p < 0.001, d = 1.70). Conclusions: The tracheal tube cuff pressure has been significantly reduced during manual intermittent measuring. Therefore, it is suggested that continuous cuff pressure monitoring and regulation should be used.
TL;DR: Encouraging healthcare managers and administrators is considered as crucial for developing supportive structures and highly sensitive management which promotes moral courage while reducing moral distress in nurses' work setting.
Abstract: Background: Moral distress and moral courage among healthcare professionals have received considerable attention in recent years. However, there is a paucity of studies investigating these topics among nurses. Thus, the present study aimed to evaluate the association between moral distress and moral courage among nurses in an Iranian sample population. Materials and Methods: The present cross-sectional study was conducted during February–December 2018. Corley's Moral Distress (MDS-R) and Sekerka's moral courage scales were used to collect the data. MDS-R is a 21-items scale which includes frequency and intensity ranges from 0 (never) to 4 (very frequently) and 0 (none) to 4 (great extent), respectively. In addition, the moral courage scale contains 15 items ranging from “never true” (1 point) to “always true” (7 points). In total, 225 eligible nurses were entered into this study. Finally, SPSS-16 was used for statistical analysis at the α = 0.05 level. Results: The mean scores of the frequency and intensity of moral distress and moral courage were 45.41 (95% CI = 43.37-47.45), 44.24 (95% CI = 42.98-45.42), and 59.63 (95% CI = 58.50-60.87), respectively. Eventually, a significant relationship was found between the moral courage and frequency of moral distress (r = 0.46, p
TL;DR: Asynchronous hybrid/blended learning as a type of e-learning, simple, relatively inexpensive, and new educational strategy can improve nurses' performance and reduce medication errors.
Abstract: Background: Medication error is one of the most important and most common events threatening patient safety. This study was conducted with the aim to determine the effect of asynchronous hybrid/blended learning on the rate of medication administration errors of nurses in medical wards. Materials and Methods: This quasi-experimental study was conducted with a pretest-posttest design in 2019. The participants of this study included 57 clinical nurses working in the medical wards of a selected educational hospital affiliated to Lorestan University of Medical Sciences, Khorramabad, Iran. The study participants were selected through census method. An asynchronous hybrid/blended learning program was used in this study. Data collection was performed using a two-section researcher-made checklist. The collected data were analyzed using descriptive [Mean (SD)] and inferential (paired sample t-test) statistics in SPSS software. A p value of less than 0.05 was considered statistically significant. Results: The results showed that the mean score of total errors in medication administration in the medical wards after the intervention was significantly lower than before the intervention; the mean score of errors before and after the study was 61.67 and 50.09, respectively (t56= 11.41, p