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   Table of Contents - Current issue
September-October 2022
Volume 27 | Issue 5
Page Nos. 353-473

Online since Wednesday, September 14, 2022

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Factors associated with the involvement of women drug users in risky sexual behaviors: A narrative review p. 353
Hadis Sourinejad, Mahnaz Noroozi, Fariba Taleghani, Gholam Reza Kheirabadi
Background: Drug use is known as an important underlying factor in the occurrence of risky sexual behaviors. The present study was conducted to identify the factors associated with the involvement of women drug users in risky sexual behaviors. Materials and Methods: This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), the Iranian Research Institute for Information Science and Technology (IranDoc), and the Iranian Medical Articles Database (IranMedex) and searching through the Google Scholar engine. All the articles published in English and Persian using the keywords including substance use, drug users, addiction, substance use disorders, substance-related disorders, sexual risks, high-risk sexual behavior, HIV risk behavior, unsafe sex, unprotected sex, and risky sex were searched from January 2000 to December 2020. After reviewing the articles, out of 110 articles, 21 articles were selected for final evaluation. Results: Factors related to the involvement of women drug users in risky sexual behaviors were divided into five categories: individual factors, factors related to drug use, inter-personal relationships, gender discrimination, and socio-economic factors. Conclusions: The results can be used in the field of women's social harms in finding strategies and designing the necessary interventions to prevent risky sexual behaviors in women drug users in different societies and cultural contexts. Also, the results can be used by all researchers who want to study the relationship between these factors and the involvement of women drug users in risky sexual behaviors.
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The relationship between perineal trauma and striae gravidarum: A systematic review and meta-analysis p. 363
Fatemeh Khademol khamseh, Samira Ebrahimzadeh Zagami, Vahid Ghavami
Background: Perineal trauma is a common problem seen after vaginal delivery, which has negative effects on different aspects of women's lives. Poor skin elasticity has been introduced as a predictor of perineal trauma, and the appearance of striae gravidarum is associated with poor skin elasticity. This review aimed to determine the association between perineal trauma and striae gravidarum through a systematic review and meta-analysis. Materials and Methods: We searched with MeSH terms (“Perineum” AND “Lacerations” OR “Rupture” AND “Striae Distensae”) and their equivalents in databases PubMed, Scopus, Science direct, Web of Science, ProQuest, Scientific Information Database (SID), Magiran, and Google Scholar search engine without time and language restrictions from the beginning of May until the beginning of September 2020. After reviewing the inclusion and exclusion criteria, and quality evaluation, ten articles were included in the systematic review, and we analyzed data of 6 articles using Stata ver 11.2. Results: The results indicated that the rate and severity of perineal trauma were directly related to the severity of striae gravidarum (OR = 8.28, 95%CI = 2.49–27.54, I2 = 86.64%). Conclusions: Based on the research results, the probability of perineal trauma was higher in individuals with moderate to severe striae than those with mild or without striae; therefore, we suggest evaluating striae score in the third trimester of pregnancy as a simple and noninvasive method to predict the risk of perineal trauma during childbirth. For reducing perineal injuries in women at risk, some supportive measures such as episiotomy and perineal massage are recommended.
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Communication between parents and preschool-aged children about tuberculosis preventive treatment: A qualitative study p. 370
Windy Rakhmawati, Siti Yuyun Rahayu Fitri, Aat Sriati, Sri Hendrawati
Background: Communication with preschool-aged children about Tuberculosis Preventive Treatment (TPT) is a challenge for parents. Good communication can encourage children to be involved in their treatment and enhance their adherence to the treatment. This study aimed to explore the experience of parents in communicating with their preschool-aged children about TPT. Materials and Methods: This study used a qualitative approach. Participants were 10 parents who were selected using the purposive sampling technique from three community health centers in Bandung City, Indonesia. The inclusion criteria for the study were parents who have a child aged 3–5 years who received or was receiving TPT. Semi-structured interviews were conducted to obtain the data, and when saturation was reached, no further interviews were conducted. Subsequently, the interviews were transcribed and analyzed using thematic analysis. Results: The findings revealed three themes with eight categories. The themes were persuading children, lack of understanding, and supporting communication. Conclusions: The findings are relevant for nurses and other health professionals who need to provide adequate information related to TPT and to develop media for parents and children during their communication. Nurses can collaborate with other physicians and software engineers to develop interesting media such as game applications to educate children about Tuberculosis (TB) prevention.
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Comparing the effect of resilience skills training and metacognitive therapy on job stress in nurses: An experimental study p. 377
Halimeh Hasani, Bahare Zarei, Zahra Danaei, Gholamhossein Mahmoudirad
Background: Nursing is one of the stressful professions. The work-related stressful factors have affected the physical and mental health of nurses seriously. This study aimed to compare the effect of resilience skills training and metacognitive therapy on nurses' job stress. Materials and Methods: This experimental study was conducted on 54 nurses working in intensive care units and the emergency department of Valiasr Hospital, Birjand, Iran, in 2018. Selected participants were allocated via permuted block randomization into three groups: resilience skills training, metacognitive therapy, and control (n = 18 for each group). Both resilience and metacognitive therapy programs were held in eight sessions of 45-mintraining classes twice a week. The control group received no intervention. The data were collected using a demographic characteristics form and the Expanded Nursing Stress Scale (ENSS) before, immediately after, and one month after the intervention. The data were analyzed using Chi-square, Fisher's exact test, Analysis of Variance (ANOVA), and repeated measures ANOVA in the Statistical Package for Social Science (SPSS) software. Results: Job stress significantly decreased in both resilience (F2,51 = 123.5, p < 0.001) and metacognitive therapy (F2,51= 29.2, p = 0.002) groups over time. However, this decrease was not significantly different between the two groups (p > 0.05). Also, the control group's job stress mean score increased over time (F2,51 = 9.35, p < 0.001). Conclusions: The findings suggest that both resilience skills training and metacognitive therapy can reduce the job stress of emergency and intensive care nurses. Therefore, it is recommended that both programs be taken into account by managers to reduce nurses' job stress.
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The impact of online learning among adolescents during the COVID-19 pandemic: A qualitative study of mothers' perspectives p. 385
Restuning Widiasih, Suryani Suryani, Windy Rakhmawati, Hidayat Arifin
Background: The COVID-19 pandemic changed the educational system from conventional learning in schools to online learning. The use of the internet as a learning medium can have positive and negative impacts on adolescents and cause concern for mothers. In this study, mothers' perspectives were explored with the phenomenological approach to assess their experience of the effect on line learning during the COVID-19 pandemic among adolescents. Materials and Methods: The qualitative study design: phenomenology was conducted on mothers with children at senior high school education levels. The data were collected using in-depth interviews from June to November 2020 in West Java, Indonesia. A total of 13 mothers were recruited using the purposive sampling technique. Data analysis was performed using the Colaizzi method and NVIVO software for managing the coding process. Results: We obtained four themes, namely (1) formation of adolescent behavior with the internet, (2) prevention of internet addiction, (3) disturbance of cognitive development, and (4) negative effect of online learning. Conclusions: The usage of the internet cannot be avoided. By guiding adolescents, the negative effects of the internet could be prevented. Developing learning programs, media, and online learning strategies according to students' needs should be promoted.
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Effect of aromatherapy with essential oil of Lavandula Angustifolia Mill- Citrus bergamia and mindfulness-based intervention on sexual function, anxiety, and depression in postmenopausal women: A randomized controlled trial with factorial design p. 392
Mandana Mojtehedi, Hanieh Salehi-Pourmehr, Alireza Ostadrahimi, Solmaz Asnaashari, Khalil Esmaeilpour, Azizeh Farshbaf-Khalili
Background: Due to the importance of psychological support for women during menopause as a period with a high prevalence of mental health problems, this study aimed to evaluate the effect of the essential oil of lavender-Bergamot (La-Ber) and Mindfulness-Based Intervention (MBI) on sexual function, anxiety (primary outcome), and depression score (secondary outcome) in postmenopausal women with sexual dysfunction. Materials and Methods: This controlled randomized trial with a factorial design was performed on 132 postmenopausal women. Participants were randomly allocated into four equal groups: Aromatherapy-Routine Care (Aroma-RC), MBI-Placebo (MBI-P), Aromatherapy-MBI (Aroma-MBI), or Routine Care-Placebo (RC-P). Two to three drops of La-Ber or a similar placebo were inhaled three times a day for 8 weeks. Eight sessions of MBI intervention were conducted. At the end of the intervention and eight weeks afterward, the outcomes were assessed. Results: The sexual function score improved significantly in Aroma-MBI (adjusted Mean Difference [aMD]: 2.4, 95% CI: 0.01 to 4.80) and MBI-P (aMD: 2.6, 95% CI: 0.2 to 5.1) groups compared to the RC-P group. The anxiety score was reduced in the Aroma-RC group at the end of the intervention (aMD: -4.12, 95% CI: -7.41 to -0.72; p = 0.020) and eight weeks later as well as in the Aroma-MBI group. In terms of depression, the mean score of depression was significantly lower than the RC-P group in the Aroma-RC group at the end of the intervention (p = 0.011). Conclusions: MBI and aromatherapy seem effective on sexual function and menopausal anxiety. MBI improves sexual function, while aromatherapy ameliorated anxiety and depression.
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Perceived challenges caused by Covid-19 outbreak in students of medical sciences p. 406
Nayereh Baghcheghi, Hamid Reza Koohestani, Mahmood Karimy, Mohammad Hasan Keshavarzi, Ali Asghar Ghorbani
Background: Students of medical sciences are a highly vulnerable group during COVID-19 pandemic who may experience a wide range of challenges and stresses. The aim of this study was to investigate the perceived challenges caused by COVID-19 outbreak in students of medical sciences. Materials and Methods: A qualitative study was carried out based on conventional qualitative content analysis following Graneheim and Lundman from December 2020 to February 2021. The participants were 17 students of medical sciences and data gathering was done through semistructured interviews. Results: Data analyses revealed 5 categories and 12 subcategories. The extracted categories were perceived fear of contracting coronavirus, social limitation, changes in education, neglecting health protocols, and worrying news and information overload. Conclusions: The findings indicated that students of medical sciences had been facing challenges and the COVID-19 had affected the psychological, social, and academic functioning of the health-care students. It is important to take measures to improve their mental health. These measures can prevent medical complications in these students, especially during clinical internship.
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Principal factors affecting couples' childbearing policies: A roadmap for policymaking p. 413
Mozhgan Hashemzadeh, Mohammad Shariati, AliMohammad Nazari, Afsaneh Keramat, Elham Ebrahimi
Background: The concept of negative population growth, population aging, and the need to implement child-encouraging policies is an important concern in many countries. As this issue is completely cultural and country-based, this study is designed to assess and prioritize the perception of newly married couples to the policies that may have a crucial role in the childbearing intention around the world. Materials and Methods: Through a descriptive cross-sectional study, 300 couples were selected by a simple random sampling method. Multilevel binary logistic regression was used for investigating the relationships among dimensions of family policies, socio-demographic variables, and childbearing intention. Results: Childbearing perception positively correlated with education and permanent job in both genders, maternal age range of 25–35, the higher length of marriage, having more children, and living in a government settlement. The most important family policies that couples preferred were contextual requirements (mean rank of 4.50%). Positive childbearing perception negatively correlated with higher age categories in women, the number of children, rental housing status, no insurance access, higher educational attainment, and low employment ranks in both men and women. Conclusions: This study cleared that family policies affect the childbearing intention of young couples. Polices involved contextual requirements, supporting couples to integrate work and home, health promotion plans, child-centered social support, and promoting the level of social and cultural relations.
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Analysis the effect of job strain on nurses' quality of work-life: A mediating and moderating model p. 420
Sara Mohammadi, Belghis Bavarsad, Amin Hendighomashi
Background: One of the most important issues in all organizations is to improve performance of human resources to achieve goals. Therefore, it is necessary plans and solutions to reduce Job Strain (JS) and then increase Organizational Citizenship Behaviors (OCB), and Quality of Work-Life (QWL). The purpose of this study is to investigate the effect of JS on QWL with mediating role of OCB and moderator of employment status. Materials and Methods: This cross-sectional study was conducted on 300 nurses who were non-randomly voluntary selected among nurses working in seven educational hospitals in Ahvaz, Iran. Data were collected using demographic and occupational characteristics questionnaire and JS questionnaire with 12 items, OCB with 16 items & QWL with 26 items in the 5-point Likert scale. Data analysis was performed in SPSS22 using descriptive and inferential statistics, and structural equation modeling with SmartPLS3. Results: The results indicated the mean (SD) score of 49.56 (6.68) for JS (more than normal) and 58.84 (5.94) and 49.88 (7.69) for QWL and OCB, respectively. Spearman correlation coefficients show that JS has a negative relationship with QWL (r = -0.69, p < 0.001) and OCB (r = -0.54, p = 0.008). Also, nurses' employment status (Formal and Contractual) moderates the relationship between JS, QWL, and OCB. Conclusions: According to the results, job stress in nurses of Ahvaz hospitals was high and QWL was moderate (or less). Therefore, increased job stress leads to reduced QWL and OCBs of nurses. Also the employment Status and job security that it provides can modify this impact.
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Exploring the emotional concerns of oncology nurses: A qualitative study p. 425
Mahdieh Poodineh Moghadam, Ahmad Nasiri, Gholamhossein Mahmoudirad
Background: Nursing care for patients with cancer is related to the nurses' ability to manage their emotions and having appropriate behaviors in the clinical setting. Oncology nurses are emotionally influenced by their communication with cancer patients. Thus, this qualitative study was conducted to explore nurses' emotional concerns in oncology wards. Materials and Methods: This qualitative content analysis was performed among 14 oncology nurses in the oncology wards of cancer hospitals in the east and southeast of Iran (South Khorasan and Sistan and Baluchestan Provinces). The study participants were selected through purposeful sampling. Data were collected through face-to-face, semi-structured interviews until data saturation was reached from January to September 2020. The interviews were analyzed after being typed word by word, based on Graneheim and Lundman (2004). Results: The themes and subthemes that emerged from the data were related to the emotional concerns of oncology nurses. The main themes included emotional involvement and attachment (feeling of frustration in nurses, nurses' suffering from painful experiences, and nurses' emotional dependence), emotional ambiguity (nurses' uncertainty emotions, avoidance of expressing real emotions, and having a positive mindset to maintain the patient's positive mood), and emotional exhaustion (persistent chronic stress, excessive worrying about possible harms, and feelings of mental and physical exhaustion).Conclusions: Based on the study results, cancer patient nursing care can be distressing and stressful for nurses. Oncology nurses have many emotional concerns in caring for cancer patients. The experiences of oncology nurses provide new insight into how to manage their emotional concerns.
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Support received and provided by older adults who lost a child: A qualitative content analysis p. 432
Azade Safa, Mohsen Adib-Hajbaghery, Mahboubeh Rezaei
Background: Despite the vulnerability of older adults and the importance of social support following the death of a child, little research has been conducted on the Iranian older population. This study aimed to explore perceived support among older adults after the death of a child. Materials and Methods: This study was carried out in Iran in 2020-2021 using a qualitative content analysis method. Semi-structured interviews with older adults who had experienced child death were used to collect data. To ensure the data's trustworthiness, Guba and Lincoln's criteria were applied. The Graneheim and Lundman method was used to analyze the data. Results: The participants' mean age was 70.41 years. The findings were organized into one theme, two main categories, and five subcategories based on 352 initial codes. Two main categories emerged from the participants' experiences: “supporting networks” and “giving support to others” with the theme of “healing emotional pain.” Following the death of a child, the older parents perceived support as recuperation from their hurt feelings. Conclusions: Receiving support from family, entourages, and society, as well as providing support to the family and parents with the same experience were protective factors against the effects of child death among older parents. To reduce the consequences of child death, older parents' health should be monitored through home care provided by nurses.
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Resuscitation team members ‘experiences of teamwork: A qualitative study p. 439
Mohammad Hosseini, Abbas Heydari, Hamidreza Reihani, Hossein Kareshki
Background: Despite the obvious importance of teamwork in emergency care, the dimensions of teamwork in resuscitation remain a subject of debate among specialists and researchers. The aim of this study was to identify the dimensions of teamwork based on the experiences of members of the resuscitation team. Materials and Methods: This study was conducted between March 2020 and April 2021. By purposive sampling, participants were selected. Sixteen semi-structured interviews were conducted with experienced emergency nurses and emergency medicine residents individually and analysed through deductive content analysis by using the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) model. Interviews were encoded for analysis using MAXQDA software (version 2020). Results: Three main categories were identified around teamwork in resuscitation. These categories were as follows (1) leadership, (2) teamwork, and (3) essential prerequisites for resuscitation. The main leadership category consisted of three sub-categories of time management, resource allocation, and task management. From sub-categories, situation monitoring, communication, and mutual support, the main category of teamwork emerged. Also, the emerging category of essential prerequisites for regeneration included two generic categories: professional requirements and workplace requirements and the teamwork category included situation monitoring, communication, and mutual support. Conclusions: Based on the experiences of the resuscitation team members, leadership, teamwork, and essential prerequisites for resuscitation are the most important dimensions of teamwork in resuscitation. Recognizing the dimensions of teamwork in resuscitation is an initial step and then should be reflected in educational programs and future guidelines.
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Exploring the motivations of pregnant women to seek health information: A qualitative study p. 446
Marzieh Javanmardi, Mahnaz Noroozi, Firouzeh Mostafavi, Hasan Ashrafi-Rizi
Background: Health information-seeking behavior is directed by various factors. Understanding the motivations of pregnant women to obtain health information can facilitate evidence-based policy-making to enhance their health literacy. Therefore, this study was conducted to explore the motivations of pregnant women to seek health information. Materials and Methods: In this qualitative study with a content analysis approach, 39 participants, including pregnant women, midwives, and gynecologists in Isfahan city, Iran, were selected via purposive sampling with maximum variation strategy. Individual interviews, field notes, and daily notes were used to collect data, which was then analyzed using conventional qualitative content analysis. Results: Analysis of data resulted in one main category of “strive to protect the health of mother and fetus.” This main category consisted of four subcategories, including “increasing information related to maternal and fetal health,” “preventing recurring problems or causing complications in pregnancy,” “reducing worry about pregnancy problem,” and “receiving encouragement from the spouse, relatives, and healthcare providers.” Conclusions: According to the findings, pregnant women seek health information for a variety of reasons, including learning more about their own health and that of their fetus, preventing recurring problems or complications, alleviating concerns about pregnancy problems, and receiving encouragement from husbands, relatives, and healthcare providers. Thus, health professionals, midwives, and antenatal care providers should be aware of these issues and provide more evidence-based information to pregnant women at the time they require it.
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A thematic analysis of dimensions of spiritual care p. 452
Mohammad Abbasi, Narges Eskandari, Akram Heidari, Morteza Heidari, Sadegh Yoosefee, Seyed-Hasan Adeli, Abdolhassan Kazemi
Background: An overview of spiritual care studies can help reveal the dimensions of spiritual care and summarize the findings of available studies. Thus, we designed the present study based on existing studies to explain the dimensions of spiritual care. Materials and Methods: In this thematic analysis, we gathered the related articles published in Persian and English in the last 8 years (2013–2021) with the help of the keywords of Care, Support, Spirituality, Religion, Treatment, Hospice, and Palliative, and searching in electronic databases, including PubMed, Scopus, Web Of Sciences, Magiran, Islamic Science Citation (ISC), and Scientific Information Database (SID). We accurately studied 79 articles that met the inclusion criteria, and then the spiritual care components were extracted and coded, and finally, the codes were categorized as themes and sub-theme. Results: Thematic analysis of available studies revealed that the dimensions (theme) of spiritual care include: spiritual and religious assessment, developing a structure for providing spiritual care, establishing effective and supportive communication with the patient, training the patient, answering his questions, encouraging, maintaining, and improving social communications, encouraging the patient to live happily, helping the patient to achieve peace and calmness, supporting for spiritual rituals and activities, supporting and training the patient's family, and supporting the dying patient. Conclusions: Spiritual care includes various and numerous dimensions. Considering the widespread dimensions of spiritual care, it seems necessary to design and plan appropriate studies to reveal other spiritual care dimensions from the perspective of patients and care providers in different cultures.
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Self-evaluation of conflict management skills: A cross-sectional study among vietnamese nurses in 2021 p. 461
Nguyen Hoang Long, Ngo Xuan Long
Background: Effective conflict management requires various skills. However, evidence suggests that nurses are unprepared to deal with conflicts at work. Accordingly, this study aimed to examine nurses' evaluations of their conflict management skills. Materials and Methods: This cross-sectional descriptive study involved 202 nurses who were enrolled in short professional training courses at the Faculty of Nursing, Thai Nguyen University of Medicine and Pharmacy (TUMP). From March to June 2021, they completed self-administered questionnaires which included evaluations of ten common conflict management skills. The four-point rating scale ranged from very bad (0 points) to very good (3 points). Descriptive statistics, Mann–Whitney U, Kruskal–Wallis, and Spearman's rho tests were used for data analysis. Results: The nurses ranked their ability to identify their and others' emotions and feelings as the highest [mean (SD): 1.99 (0.42)]. Their ability to self-manage conflict-induced stress was rated as the lowest [1.86 (0.56)], with managing own feelings and emotions [1.88 (0.56)], and negotiation [1.90 (0.53)] rated as second and third lowest, respectively. There were no differences in skills between nurses based on gender (Mann–Whitney U = 2814.50, p = 0.720), department (Kruskal–Wallis = 5.89, df = 3, p = 0.117), job position (Mann–Whitney U = 1502.50, p = 0.522), and education (Mann–Whitney U = 3304.00, p = 0.394). Additionally, nurses who demonstrated better skills reported higher effectiveness in previous conflict management (r = 0.45, p < 0.001). Conclusions: Conflict management skills varied and seemed suboptimal. Important areas that require proper attention include emotional intelligence and negotiations.
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The neonatal mortality and hospitalization rate among high-risk neonates who underwent home care services p. 466
Reza Khadivi, Shadi Mirzaeian, Raheleh Toghyani
Background: Low birth weight neonates often require intensive care. However, in the absence of resources, Home Care (HC) could replace theoretically the essential health care. HC was presented for high-risk neonates who were born in 2016 in Isfahan city as a national pilot study. The aims of this study were to evaluate the Neonatal Mortality Rate (NMR) and hospitalization rates in the HRNs who received HC during the neonatal period. Materials and Methods: In a cohort study without a control group that was performed during 2016–2017, 130 HRNs who received HC in the neonatal period in Isfahan city were evaluated during 1 year. Data about the neonates' gender, age, birth weight, gestational age, congenital anomalies, cause of death (in terms of prematurity and related problems), and age at death were gathered and analyzed using the Chi-square test, independent t-test, Mann–Whitney U test, and multiple linear regression tests. Results: Out of the 129 HRNs who had received HC and completed a 1-year follow-up period, one neonatal death occurred due to multiple anomalies. In this way, the NMR was estimated as 7.75 per 1000 live neonates. In addition, 86 cases (66.66%) were hospitalized for one time in the neonatal period, 10 (6.14%) cases for the second time, and one HRN for the third time for 10 days. Conclusion: About one-third of the HRNs who had previously received HC in the neonatal period did not require inpatient care. In addition, the neonatal and infant mortality rates were low.
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Keeping women informed following pregnancy termination for fetal abnormality p. 472
Yusrita Zolkefli
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Performance of healthcare providers in informing and educating women with experience of termination of pregnancy due to fetal abnormalities p. 473
Bahareh Kamranpour, Mahnaz Noroozi, Masoud Bahrami
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