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   2015| March-April  | Volume 20 | Issue 2  
    Online since October 24, 2017

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Effect of a care plan based on Roy adaptation model biological dimension on stroke patients' physiologic adaptation level
Nasrollah Alimohammadi, Bibi Maleki, Mohsen Shahriari, Ahmad Chitsaz
March-April 2015, 20(2):275-281
Background: Stroke is a stressful event with several functional, physical, psychological, social, and economic problems that affect individuals' different living balances. With coping strategies, patients try to control these problems and return to their natural life. The aim of this study is to investigate the effect of a care plan based on Roy adaptation model biological dimension on stroke patients' physiologic adaptation level. Materials and Methods: This study is a clinical trial in which 50 patients, affected by brain stroke and being admitted in the neurology ward of Kashani and Alzahra hospitals, were randomly assigned to control and study groups in Isfahan in 2013. Roy adaptation model care plan was administered in biological dimension in the form of four sessions and phone call follow-ups for 1 month. The forms related to Roy adaptation model were completed before and after intervention in the two groups. Chi-square test and t-test were used to analyze the data through SPSS 18. Results: There was a significant difference in mean score of adaptation in physiological dimension in the study group after intervention ( P < 0.001) compared to before intervention. Comparison of the mean scores of changes of adaptation in the patients affected by brain stroke in the study and control groups showed a significant increase in physiological dimension in the study group by 47.30 after intervention ( P < 0.001). Conclusions: The results of study showed that Roy adaptation model biological dimension care plan can result in an increase in adaptation in patients with stroke in physiological dimension. Nurses can use this model for increasing patients' adaptation.
  1,984 126 -
Pediatric nurses' perception of factors associated with caring self-efficacy: A qualitative content analysis
Azam Alavi, Masoud Bahrami, Ali Zargham-Boroujeni, Alireza Yousefy
March-April 2015, 20(2):232-238
Background: Nurses, who are considered to form the largest group of professional healthcare providers, face the challenge of maintaining, promoting, and providing quality nursing care and to prepare themselves to function confidently and to care effectively. Among the factors affecting nursing performance, self-efficacy has been expected to have the greatest influence. However, the concept of caring self-efficacy was not considered and no research has been done in this field in Iran. This study was conducted to explore and identify the factors described by pediatric nurses as related to caring self-efficacy. Materials and Methods: This is a qualitative study conducted through content analysis in 2013 in Iran. Twenty-four participants were selected through purposive sampling method from pediatric nurses and educators. Data were collected through semi-structured interviews. Data were analyzed using conventional content analysis method. Results: The analysis of the interviews in this study led to the development of four main themes: (1) Professional knowledge of children caring, (2) experience, (3) caring motivation, and (4) efficient educational system as the factors influencing caring self-efficacy perception of pediatric nurses. Conclusions: This article presents the factors associated with the perception of caring self-efficacy in pediatric nurses' perspective. This finding can be used by nursing administrators and instructors, especially in the area of pediatric caring, to enhance nursing professional practice and the quality of pediatric caring.
  1,544 78 -
Effectiveness of three surgical alcohol-based hand rubs on skin flora
Mitra Zandiyeh, Ghodratollah Roshanaei
March-April 2015, 20(2):221-225
Background: It is proved that surgical hand disinfectant contains alcohol, and has favorable properties such as strong and rapid antibacterial effect, ease of application, and suitable effect on skin. Therefore, nowadays use of them has been gradually replacing traditional surgical hand scrub with antibacterial soap. Hence, several domestic and imported products are available to the healthcare facilities in Iran. This study was done in order to determine the antibacterial effect of Decosept, Sterillium, and Septicidine on skin flora. Materials and Methods: This clinical trial was carried out on 20 volunteers. Subjects disinfected their hands with three test products. At first, subjects washed their hands with soap. Then pre-value sample was taken from the finger tips in Tryptic Soy Broth (TSB).1 After that, the hands were disinfected with one of the surgical hand rubs with as much volume as necessary to keep the hands wet, at the recommended application time. Immediate post-value sample was taken from one hand and the other hand was gloved for 3 h. After removing the surgical glove, 3 h post-value sample (sustained effect) was taken from the hand. Results: All products remarkably decreased the colony forming units (CFU) immediately ( P < 0.0001) and 3 h ( P < 0.0001) after disinfection. Analysis of variance (ANOVA) revealed significant differences among immediate post-values ( P < 0.005). Septicidine was significantly the least effective than the others, whereas 3 h effect of the three products was similar ( P = 0.630, ANOVA). Conclusions: Our results confirm the effectiveness of the three alcohol-based hand rubs. Considering the short application time, less volume used, and more antibacterial effect, however, Sterillium seems to be a better choice.
  1,525 92 -
Comparing the effect of open and closed endotracheal suctioning on pain and oxygenation in post CABG patients under mechanical ventilation
Ali Mohammadpour, Shahram Amini, Mohammad Taghi Shakeri, Sahereh Mirzaei
March-April 2015, 20(2):195-199
Background: The aim of this study was to compare changes in pain, oxygenation, and ventilation following endotracheal suctioning with open and closed suctioning systems in post coronary artery bypass grafting (CABG) patients. Materials and Methods:130 post CABG mechanically ventilated patients were randomly allocated to undergo either open (n0 = 75) or closed (n = 55) endotracheal suctioning for 15 s. The patients received 100% oxygen for 1 min before and after suctioning. Pain score using critical-care pain objective tool (CPOT) was compared during suctioning between the two groups. Arterial oxygen pressure (PaO 2 ), PaO 2 to fraction of inspired oxygen (FiO 2 ) (PF) ratio, and arterial carbon dioxide pressure (PaCO 2 ) were compared at baseline and 5 min after suctioning. Peripheral oxygen saturation (SpO 2 ) was compared at baseline, during suctioning, and at 1 min interval after suctioning for 5 min between the two groups. Results:The patients were the same with regard to CPOT scores, i.e. 3.21 (1.89) and 2.94 (1.56) in the open and closed suctioning systems, respectively. SpO 2 did not change significantly between the two groups. Changes in PaO 2 and PF ratio was more significant in the open than in the closed system (P = 0.007). Patients in the open group had a higher PaCO 2 than those in the closed group, i.e. 40.54 (6.56) versus 38.02 (6.10), and the P value was 0.027. Conclusions: Our study revealed that patients' pain and SpO 2 changes are similar following endotracheal suctioning in both suctioning systems. However, oxygenation and ventilation are better preserved with closed suctioning system.
  1,496 86 -
The impact of an educational program based on BASNEF model on the selection of a contraceptive method in women
Khadijeh Sarayloo, Zahra Behboodi Moghadam, Jamshidi Manesh Mansoure, Hosseini Mostafa, Saffari Mohsen
March-April 2015, 20(2):171-178
Background: Quality of services, making communications with target groups, and educating them are among the most important success factors in implementation of family planning programs. Provision of public access to contraception and related methods, counseling services, and paying attention to social specification and cultures are important in promotion of service quality. With regard to applicability of health education theories and models, the present study aimed to find the impact of an educational program based on BASNEF model to choose contraceptive methods in women referring to health care centers in Minoodasht in 2012. Materials and Methods: This is a quasi-experimental study. Data were collected using BASNEF questionnaire by the researcher from women referring to health care centers in two groups of study and control ( n = 100 in each group). Educational intervention (in the form of four educational 1-h sessions once a week during 1 month and two additional review sessions) was conducted in the form of group and face-to-face discussions and educational booklets were distributed. Data were analyzed by Chi-square, analysis of covariance (ANCOVA), paired t-test, and t-test through SPSS version 14. Results: After intervention, mean score of knowledge was significantly higher in the study group compared to control ( P < 0.003). Intervention led to a better attitude in the study group ( P < 0.0001). Mean score of subjective norms and enabling factors after intervention was significantly higher in the study group compared to control ( P < 0.0001). The change in practice had a significant increase in the study group (54%) compared to control (9%). Conclusions: BASNEF-based educational intervention was effective in increasing women's knowledge, attitude, and practice. As family and educational facilities are among the influencing factors on contraceptive method selection, interventional planning is hoped to be based on educational model.
  1,459 76 -
Data analysis in oral history: A new approach in historical research
Mohammadreza Firouzkouhi, Ali Zargham-Boroujeni
March-April 2015, 20(2):161-164
Background: Historical research has limitations in applying proper and credit-worthy chronology to clarify the data. In this methodology, the application of oral history is one of the ways in which answers to questions addressed by the research theme are elicited. Oral history, as a clear and transparent tool, needs to be applied with guidelines for qualitative researchers regarding data analysis limitations from oral evidence and face-to-face contact. Therefore, the development of a systematic method for data analysis is needed to obtain accurate answers, based on which a credit-worthy narration can be produced. The aim of this study was to introduce an ethical and objective approach for the analysis of data obtained from oral history. Materials and Methods: This is a methodological article that suggests an analysis method based on qualitative approach and experiences of the authors. Results: A systematic method of data analysis for oral history research, based on common qualitative data analysis methods, has been suggested as the result of this article. Conclusions: This new technique is equipped with measures that would assist qualitative researchers in the nursing field and other disciplines regarding analysis of qualitative data resulting from oral history studies.
  1,433 76 -
Relationship between physical activity and quality of life in pregnant women
Parvin Bahadoran, Soheila Mohamadirizi
March-April 2015, 20(2):282-286
Background: Physical activity is one of the important factors in predicting the quality of life, which varies between different cultures and countries. The aim of this study was to determine the relationship between physical activity and the quality of life in pregnant women. Materials and Methods: This cross-sectional study was carried on 380 pregnant women who were admitted to Isfahan healthcare centers and Shahid Beheshti Hospital, by using the two-stage sampling method (cluster convenience) in 2013. Demographic/pregnancy characteristics, physical activity (36Q) and prenatal quality of life questionnaires (26Q) were completed by the participants. The statistical analyses were performed with various statistical tests such as Student's t0-test, one-way analysis of variance (ANOVA), Pearson correlation coefficient, linear regression, and SPSS statistical software version 16. Results: The findings showed that 91.6% of the subjects were 20-35 years old, 69% had a gestational age of 29-37 weeks, 60% had their first pregnancy, 98% had poor physical activities, and 43% had a good quality of life. There was also a negative correlation between physical activity and social support (P = 0.04, r = −0.11). Conclusions: As the results show high percentage of poor physical activity and quality of life, and also the relationship between these variables, more attention should be dedicated to this problem. Furthermore, structured programs and educational approaches are also needed for pregnant women.
  1,407 85 -
The effect of vitamin D on vaginal atrophy in postmenopausal women
Parastou Rad, Mitra Tadayon, Mohammadreza Abbaspour, Seyed Mahmood Latifi, Iran Rashidi, Hamdollah Delaviz
March-April 2015, 20(2):211-215
Background: Most of the women suffer from vaginal atrophy and dryness, and therefore, efficient and safe treatment is needed to improve vaginal lubrication. Vitamin D has several important functions which may be effective in proliferation and repair of the epithelial tissue. This study aimed to evaluate the effect of vitamin D vaginal suppositories on maturation index, pH, and dryness in postmenopausal women. Materials and Methods: Women were enrolled in this double-blind clinical trial, in whom menopause occurred at least one year ago. Those women who had an abnormal Papanicolaou smear, had undergone hormonal treatment, or have had vaginal infection in the previous year were excluded. Forty-four women who found eligible were randomized into two equal groups, the treatment and control groups, which received vitamin D and placebo vaginal suppository daily for 8 weeks, respectively. Vaginal pH and maturation value were measured at the beginning and end of the study. Pain, dryness, and paleness were assessed before treatment and at the end of the 2, 4, and 8 weeks of treatment. Results: In the treatment group, the number (Mean ± SD) of superficial cells increased (69.76 ± 12.4) and vaginal pH decreased (1.42 ± 0.67) significantly compared to the control group after 56 days. The mean pain significantly reduced after 8 weeks in the treatment group (1.23 ± 0.53) compared to the control group 1.95 ± 0.74 (P < 0.001). The mean of dryness and paleness reduced significantly in the treatment group versus control at 56 days. Conclusions: Vitamin D is effective in improving the maturation index and decreased the pH and dryness of the vaginal atrophy due to menopause.
  1,389 56 -
Factors associated with nurses' self-efficacy in clinical setting in Iran, 2013
Simin Soudagar, Masoume Rambod, Noushin Beheshtipour
March-April 2015, 20(2):226-231
Background: In nursing, self-efficacy is quite critical for skill performance. Some factors might influence and predict self-efficacy in nurses. Thus, the present study aimed to investigate self-efficacy and the factors predicting nurses' self-efficacy in clinical setting. Materials and Methods: In this cross-sectional study, 264 nurses were selected from five hospitals affiliated to Shiraz University of Medical Sciences by stratified random sampling. General Self-efficacy Scale (GSE) was used to assess a general sense of perceived self-efficacy. The data were analyzed using one-way analysis of variance (ANOVA) and multiple regression analysis. Results: The mean of self-efficacy in all the nurses was 29.78 [Standard Deviation (SD) = 5.82]. Moreover, the self-efficacy of the nurses with diploma, bachelor's, and master's degrees was 32.22 (SD = 6.21), 29.33 (SD = 5.68), and 32.00 (SD = 6.00), respectively. In addition, a significant difference was found between the nurses with bachelor's and diploma degrees regarding their self-efficacy ( P = 0.01). Also, a significant relationship was found between self-efficacy and willingness to work in the nursing unit (F = 3.31, P = 0.01) and interest in the nursing field (F = 2.43, P = 0.04). The nurses who had more than 16 years of working experience in the field of nursing reported a better self-efficacy score. Overall, self-efficacy was predicted by the years of experience in the field of nursing (β =0.25, P = 0.009) and the interest in the nursing field (β = −0.15, P = 0.02). Conclusions: This study indicated that the nurses with diploma degrees gained higher self-efficacy scores compared to those with bachelor's degrees. Changing the nursing curriculum and increasing the motivation in the nursing context might enhance the interest in the nursing field as well as the nurses' self-efficacy. Of course, other studies are recommended to be conducted to improve the nurses' self-efficacy.
  1,334 78 -
Satisfying patients' rights in Iran: Providing effective strategies
Zohreh Anbari, Mehri Mohammadi, Magid Taheri
March-April 2015, 20(2):184-189
Background: Assessment of patients' views about the observance of their rights and obtaining feedback from them is an integral component of service quality and ensures healthcare ethics. The aim of this study was to assess patients' awareness of their rights and their satisfaction with observance of their rights, and provide effective strategies to improve the management of patients' rights in hospitals of Markazi Province, Iran in 2012. Materials and Methods: This analytical study was conducted on 384 patients at 10 hospitals. Patients' awareness of the relevant hospital legislation was assessed by a structured interview, and then patients' satisfaction with observance of their rights was measured by a standardized questionnaire consisting of 10 principles approved by the Iran Ministry of Health of Iran in 2012. In this study, through Delphi technique, effective strategies have been provided to improve the management of patients' rights in the hospitals of Iran. Analysis of variance (ANOVA), t0-test, and Z test were applied for data analysis. Results: Overall, 89% of the patients were unaware of the relevant hospital legislation and 28% of them were not satisfied with the observance of their rights (1.4 ± 0.6). A significant difference was observed between observance of patients' rights according to hospitals, language, and place of residence of the patients (P < 0.05), but there was no significant difference with respect to patients' rights according to sex, education, job, and duration of hospital stay (P > 0.05). Conclusions: The Patient Bill of Rights of Iran needs further revision and modification. Moreover, extensive education of patients and healthcare processionals as the most structural strategies to promote professional ethics, reduce ethical conflict, and increase implementation of the law to respect patients' rights should be taken into deeper consideration.
  1,337 74 -
Effects of aerobic exercise on blood glucose in continuous ambulatory peritoneal dialysis patients
Nahid Shahgholian, Ozra KarimiFard, Shahrzad Shahidi
March-April 2015, 20(2):165-170
Background: Peritoneal dialysis has a number of complications including increased blood glucose. Although exercise has been suggested to resolve this complication, most patients are not active. The present study aimed at determining the effects of twice-weekly, 40-min sessions of pedaling on a stationary bicycle on mean fasting blood sugar (FBS) and 2-h postprandial blood sugar (PPBS) among continuous ambulatory peritoneal dialysis patients. Materials and Methods: In this clinical trial, convenience sampling was used to select 22 patients [age: 51.4 (12.3) years] undergoing continuous ambulatory peritoneal dialysis [mean duration: 12.5 (8.5) months] from university hospitals in Isfahan, Iran. The subjects were randomly divided into two groups (test and control). The test group participated in an 8-week exercise program in which they pedaled a stationary bicycle with an intensity of four on Borg Scale of Perceived Exertion. FBS and PPBS were measured at baseline and at the end of the 8 th and 16 th sessions of exercise. Data were analyzed with Student's t-test and repeated measures analysis of variance. Results: After the eighth session, the mean FBS and PPBS levels were lower in the test group than in the control group. However, the differences were not statistically significant. After 16 sessions of exercise, the mean FBS and PPBS levels in the intervention group were significantly less than the in control group. Conclusions: Forty minutes of pedaling on a stationary bicycle for two times a week can significantly reduce mean FBS and PPBS levels in continuous ambulatory peritoneal dialysis patients.
  1,327 76 -
Efficacy of communication skills training workshop on sexual function in infertile women
Fariba Fahami, Saeid Pahlavanzadeh, Mahboobeh Asadi
March-April 2015, 20(2):179-183
Background: Sexual function is reduced in an infertile woman. This study aimed to determine the effect of a communication skills training program on sexual function in infertile women referring to the medical centers in Isfahan in 2012. Materials and Methods: This study is a field trial study using control groups in which 32 infertile couples were selected by convenience sampling, and then, were randomly divided into control and training groups. Data were collected before (T1), 1 week after (T2), and 1 month after (T3) the training. In the intervention group, education was conducted in the form of five 3-h sessions, sequentially held with 1 week interval. Female Sexual Function Index (FISI) scale and Individual Fertility questionnaire were used to collect the data. Data were analyzed by descriptive statistical tests [ t-test, analysis of variance (ANOVA), and least significant difference (LSD)]. Results: Communication skills training increased the sexual function in infertile women. ANOVA showed that women's sexual function was significantly greater in the intervention group compared to the control group, after training. LSD test showed no significant difference in sexual function in T2 and T3. Conclusions: Communication skills can have a significant impact on the sexual function of infertile couples, and communication skills training can improve the quality of marital life skills through the counseling sessions conducted with infertile couples.
  1,296 82 -
The effect of stretching exercise and walking on changes of blood pressure in nulliparous women
Parvin Bahadoran, Fateme Pouya, Vahid Zolaktaf, Mahboubeh Taebi
March-April 2015, 20(2):205-210
Background: Hypertension in pregnancy is one of the prevalent disorder resulting in maternal death. The aim of this study was to investigate the effect of stretching exercise and walking on changes of blood pressure in nulliparous women during pregnancy.  Materials and Methods: This was a quasi-experimental trial that consisted three groups of women who took part in pre- and post-tests. We used a simple randomized sample, including 118 pregnant females (walking: 29 subjects, stretching exercise: 30 subjects control: 59 subjects). The data were collected using the demographic checklist and blood pressure was measured every week. SPSS 16 was used to analyze the data by one-way analysis of variance (ANOVA) and repeated measure ANOVA. Results: No significant difference was found in the demographic characteristics of the three groups of women. Mean systolic and diastolic blood pressure in the three groups (stretching exercises, walking, and routine care) at three intervals (pre-test, first post-test, and second post-test) were significantly different ( P < 0.05). In this case, Tukey's test showed significant improvement of systolic and diastolic blood pressure in stretching exercise group. Walking and control groups showed no change or significant reduction ( P < 0.05). No significant difference was found between the walking and control groups ( P > 0.05). Conclusions: The results of the study showed that stretching exercise versus walking reduces systolic and diastolic blood pressure in the second trimester of pregnancy and controls it in the third trimester of pregnancy. In contrast, walking has no effect on blood pressure during pregnancy.
  1,254 71 -
Relationship between gender role attitude and fertility rate in women referring to health centers in Mashhad in 2013
Nahid Golmakani, Elham Fazeli, Ali Taghipour, Mohammad Taghi Shakeri
March-April 2015, 20(2):269-274
Background: Fertility rate apparently is a non-interventional behavior, but in practice, it is influenced by social values and norms in which culture and traditional beliefs play a significant role. In this regard, some studies have shown that gender roles can be associated with reproductive behaviors. With regard to the importance of annual reduction of population growth rate and its outcomes, the present study was performed to determine the relationship between gender role attitude and fertility rate in women referring to Mashhad health centers in 2013. Materials and Methods: The present study is an analytical cross-sectional and multistage sampling study performed on 712 women. Data were collected by a questionnaire consisting of two sections: Personal information and gender role attitude questionnaire that contained two dimensions, i.e. gender stereotypes and gender egalitarianism. Its validity was determined by content validity and its reliability by internal consistency (r = 0.77). Data were analyzed by SPSS software version 16. Results: Initial analysis of the data indicated that there was a significant relationship between acceptance of gender stereotypes ( P = 0.008) and gender egalitarianism ( P < 0.001), and fertility. There was also a direct association between acceptance of gender stereotypes and fertility rate (r = 0.13) and an indirect association between egalitarianism and fertility rate (r = −0.15). Conclusions: The results of the present study indicate that there is an association between gender role attitude and fertility. Paying attention to women's attitude is very important for successful planning in the improvement of fertility rate and population policy.
  1,247 64 -
Effect of auriculotherapy on menstrual irregularities in single girls with polycystic ovarian syndrome and aged 18-35 years in Isfahan in 2012
Mahboubeh Valiani, Imaneh Khaki, Zahra Shahshahan, Mehri Sirus
March-April 2015, 20(2):190-194
Background: Polycystic ovarian syndrome is one of the most common endocrine disorders with a prevalence of 5-10% in women. This syndrome is one of the major causes for menstrual disorders and is treated by medicational and non-medicational methods. This study aimed to define the effect of auriculotherapy on menstruation disorders in girls with polycystic ovarian syndrome. Materials and Methods: This is a clinical trial conducted on 60 single girls aged 18-35 years with clinical, laboratory, and sonography signs. The subjects were randomly assigned to two groups of auriculotherapy and medication, which underwent treatment for 2 and 3 months, respectively. Clinical signs were investigated in three steps in both groups. Data were collected through observation, laboratory tests, and sonography, and were analyzed by SPSS version 15. Results: In 60 subjects, Chi-square test showed a significant difference in menstruation disorders in both groups 1 month after the start of intervention ( P = 0.001); but 2 months after the start of intervention ( P = 0.11) and immediately after the end of the intervention ( P = 0.16), the difference was not significant. Three months after the end of the intervention, this variable showed a significant difference ( P = 0.02). Conclusions: Medicational treatment and auriculotherapy are both effective on menstruation disorders, but auriculotherapy is more effective on reduction of menstruation disorders, compared to medicational therapy.
  1,217 76 -
Evaluation of the effect of aromatherapy with Rosa damascena Mill. on postoperative pain intensity in hospitalized children in selected hospitals affiliated to Isfahan University of Medical Sciences in 2013: A randomized clinical trial
Maryam Marofi, Motahareh Sirousfard, Mahin Moeini, Alireza Ghanadi
March-April 2015, 20(2):247-254
Background: Pain is the common complication after a surgery. The aim of this study was to evaluate the effect of aromatherapy with Rosa damascena Mill. on the postoperative pain in children. Materials and Methods: In a double-blind, placebo-controlled clinical trial, we selected 64 children of 3-6 years of age through convenient sampling and divided them randomly into two groups. Patients in group A were given inhalation aromatherapy with R. damascena Mill., and in group B, the patients were given almond oil as a placebo. Inhalation aromatherapy was used at the first time of subjects' arrival to the ward and then at 3, 6, 9, and 12 h afterward. Common palliative treatments to relieve pain were used in both groups. Thirty minutes after aromatherapy, the postoperative pain in children was evaluated with the Toddler Preschooler Postoperative Pain Scale (TPPPS). Data were statistically analyzed using Chi-square test, one-way analysis of variance (ANOVA), and repeated measures ANOVA. Results: There was no significant difference in pain scores at the first time of subjects' arrival to the ward (before receiving any aromatherapy or palliative care) between the two groups. After each time of aromatherapy and at the end of treatment, the pain score was significantly reduced in the aromatherapy group with R. damascena Mill. compared to the placebo group. Conclusions: According to our results, aromatherapy with R. damascena Mill. can be used in postoperative pain in children, together with other common treatments without any significant side effects.
  1,218 71 -
Quality of life and related factors among the women undergoing mastectomy
Amir Musarezaie, Ali Zargham-Boroujeni
March-April 2015, 20(2):287-291
Background:Breast cancer is the most common cancer among women and 81% of therapeutic surgery performed for breast cancer in Iran is mastectomy. Following mastectomy, the patients suffer from many problems which lead to several disorders and decrease in their quality of life (QOL). Materials and Methods: This cross-sectional descriptive study was conducted on 105 breast cancer patients who underwent mastectomy, selected with a convenient sampling method. A questionnaire containing three parts was used to collect data. The data were analyzed by SPSS version 14 using descriptive and analytical statistical methods. Results: Spearman test showed that there was a statistically significant relationship between QOL and education level and also fatigue. Moreover, Spearman test indicated a statistically significant correlation between age and the mental dimension of QOL. There was no significant relationship between QOL with marital and employment status. Conclusions: Based on the findings, we can suggest that nurses should be educated about the factors affecting QOL. They can receive the necessary knowledge in various areas such as meeting the patients, optimum management of patients' problems, improvement of their health, and finally help to increase the cancer patients' QOL.
  1,216 62 -
Iranian Azeri women's perceptions of unintended pregnancy: A qualitative study
Easa Mohammadi, Roghaiyeh Nourizadeh, Masoumeh Simbar
March-April 2015, 20(2):255-262
Background: Many women, throughout their life cycle, experience unintended pregnancy and its subsequent induced abortion. Nonetheless, women's perceptions of this phenomenon - particularly in countries prohibiting elective abortion - are poorly known. The aim of this study was to explore Iranian Azeri women's perceptions of unintended pregnancy. Materials and Methods: This was a conventional content analysis study conducted in Tabriz, Iran. The data were collected through 31 semi-structured interviews with 23 women who had recently experienced an unintended pregnancy. The study participants were recruited using the purposive sampling method. Sampling started in March 2013 and continued until reaching data saturation, i.e. till August 2013. Data analysis was carried out concurrently with data collection. MAXQDA 10.0 software was employed for managing the study data. Results: The study data analysis process yielded the formation of three main themes including negative effects of unintended pregnancy on daily life, fear of being stigmatized with violating social norms, and abortion panic, which in turn constituted the broader overarching theme of "threat supposition." In other words, following an unintended pregnancy, the study participants had experienced different levels of fear and threat depending on their personal, family, and socio-cultural backgrounds. Conclusions: Women perceive unintended pregnancy as a challenging and threatening situation. An unintended pregnancy can threaten women's lives through social deprivations, growing instability, and putting both mother and baby at risk for physical and psychosocial problems. On the other hand, an unsafe illegal abortion could have potentially life-threatening complications. To cope with such a situation, women need strong social support. Healthcare providers can fulfill such women's need for support by developing pre-abortion counseling services and providing them with professional counseling. Also, strengthening women's support system by policy-makers is recommended.
  1,203 53 -
Comparison of the effects of doula supportive care and acupressure at the BL32 point on the mother's anxiety level and delivery outcome
Marzieh Akbarzadeh, Zahra Masoudi, Najaf Zare, Farideh Vaziri
March-April 2015, 20(2):239-246
Background: Natural delivery is distressing and the mother's severe pain and anxiety in this condition can have negative impacts on the fetus, mother, and the delivery process. Yet, pain and anxiety can be reduced by supporting the mother by a doula. Thus, the present study aims to compare the effects of doula supportive care and acupressure at the BL32 point on the mother's anxiety level and delivery outcome. Materials and Methods: The present clinical trial was conducted on 150 pregnant women who had referred to the Shoushtari Hospital, Shiraz, Iran for delivery in 2012. The subjects were randomly divided into two intervention groups (supportive care and acupressure) and a control group (hospital routine care). The mothers' anxiety score was assessed before and after the intervention, using the Spielberger questionnaire. The delivery outcomes were evaluated, as well. Subsequently, the data were entered into the SPSS statistical software (Ver. 16) and analyzed using the analysis of variance (ANOVA), Chi-square test, correlation coefficient, and logistic regression analysis. Results: After the intervention, the highest and lowest mean scores of the state and trait anxieties were  compared with the control and the supportive care groups, respectively, and the difference was statistically significant ( P <</i> 0.001). A significant relationship was found between the labor length and mother's anxiety score after the intervention in the supportive care ( P <</i> 0.001) and the control group ( P = 0.006). However, this relationship was not significant in the acupressure group ( P = 0.425). Also, a significant difference was observed among the three groups regarding the mothers' anxiety level ( P = 0.009). Conclusions: The study results showed that doula supportive care and acupressure at the BL32 point reduced the mother's anxiety as well as the labor length. Therefore, non-pharmacological methods are recommended to be used during labor for improving birth outcomes and creating a positive birth experience.
  1,177 64 -
Comparing the effects of reflexology and relaxation on fatigue in women with multiple sclerosis
Fatemeh Nazari, Mozhgan Soheili Shahreza, Vahid Shaygannejad, Mahboubeh Valiani
March-April 2015, 20(2):200-204
Background: Fatigue is the most common and highly disabling symptom of multiple sclerosis (MS) that has negative effects on employment, the process of socialization, compliance with the disease, and other factors effective on activities of daily living. The usage of complementary and alternative medicine methods in MS patients is higher than in the general population. However, there is no scientific evidence to support their effectiveness. Therefore, this study aimed to compare the effects of reflexology and relaxation on fatigue in women with MS. Materials and Methods: This study is a single-blinded randomized clinical trial that was done on 75 patients with MS who referred to the MS Clinic of Ayatollah Kashani Hospital (Isfahan, Iran). After simple non-random sampling, participants were randomly assigned by minimization method to three groups: Reflexology, relaxation, and control groups (25 patients in each group). In the experimental groups, the interventions foot reflexology and relaxation (Jacobson and Benson) were performed for 4 weeks, twice a week for 40 min in each session, and the control group received care and routine medical treatment as directed by a physician. Data were collected through a questionnaire and the fatigue severity scale before, immediately after, and 2 months after interventions from all three groups. Data analysis was performed by SPSS version 18 using descriptive and inferential statistical methods. Results: Findings obtained from analysis of variance (ANOVA) showed that there was no significant difference in the mean fatigue severity scores in the pre-interventions between the three groups (P0 > 0.05), but there was significant difference immediately after and 2 months after interventions between the three groups ( P < 0.05). Findings obtained from repeated measures (ANOVA) showed that there was significant difference in the mean fatigue severity scores during different times between the three groups ( P < 0.05), while this difference was not significant in the control group ( P > 0.05). Furthermore, least significant difference post-hoc test revealed that the mean scores of fatigue severity immediately after intervention was lower in the reflexology group than in the other two groups and were lower in the relaxation group than in the control group; 2 months after interventions, the mean scores of fatigue severity were lower in the reflexology group than in the other two groups, but there was no significant difference between the two groups of relaxation and control (P > 0.05). Conclusions: It seems that both interventions were effective in reducing fatigue, but the effects of reflexology on reducing fatigue were more than those of relaxation. Hence, as these two methods are effective and affordable techniques, they can be recommended.
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Relationship between infants' feeding pattern and mothers' physical and psychological health among the mothers covered by the health centers of Isfahan in 2013
Parvin Bahadoran, Masoome Alijanpoor, Alireza Usefy
March-April 2015, 20(2):216-220
Background: Infants' feeding is one of the critical periods in women's health that can influence their life. The purpose of this study was to investigate the relationship between infants' feeding patterns and mothers' physical and psychological dimensions of quality of life. Materials and Methods: In this cross-sectional study, 189 mothers were selected by convenience sampling ( n = 63 in each group of infant feeding pattern) from Isfahan in 2013. Demographic and World Health Organization's WHOQOL-BREF Quality of Life questionnaires were completed. Data were analyzed by descriptive and inferential statistical methods through SPSS. Results: There was no significant difference in demographic characteristics and the mean total score of quality of life between groups (breastfeeding = 85.7, formula = 83.9, and combination feeding of breast milk and formula = 82.1). Mean scores of physical dimension of quality of life were significantly different between groups (breastfeeding = 24.7, formula = 23.7, and combination feeding of breast milk and formula = 22.7). Mean scores of psychological dimension were not significantly different between groups (breastfeeding = 21.3, formula = 20.6, and combination feeding of breast milk and formula = 20.4). Conclusions: The results of this study showed that mothers in breastfeeding group have higher score in quality of life and physical and psychological dimensions, compared to the other two groups. We can increase mothers' health and quality of life and the rate of breastfeeding with wide planning and supportive intervention by the families and society.
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The relationship between metabolic syndrome criteria and preeclampsia in primigravid women
Maryam Kianpour, Shahla Norozi, Parvin Bahadoran, Leila Azadbakht
March-April 2015, 20(2):263-268
Background: Pregnancy is associated with many physiological changes, which in some cases may cause serious risks such as preeclampsia, and fetal and maternal health threats. Recent research has focused on the relationship between metabolic syndrome and preeclampsia. By identifying appropriate indicators for early diagnosis, maternal-fetal complications can be prevented. The present study aimed to investigate the association between metabolic syndrome indicators and the occurrence of preeclampsia in nulliparous pregnant women. Materials and Methods: This was a prospective cohort study conducted on 220 nulliparous pregnant women (normal metabolic syndrome) from Isfahan health centers, Iran, selected by random quota sampling method. With physical examination and laboratory results, metabolic syndrome and preeclampsia in the second half of pregnancy were identified. Data analysis was performed using SPSS software. Descriptive statistical tests were used for demographic characteristics, and Chi-square test, Student's independent t-test, and Fisher's exact test were used to determine and compare the prevalence of metabolic syndrome indicators and preeclampsia. Results: The relative frequencies of preeclampsia in the group of pregnant women with metabolic syndrome and the healthy group before week 30 ( P < 0.001) and after 30 weeks of pregnancy ( P < 0.001) were significantly different. The results showed a significant difference in the mean triglycerides and fasting plasma glucose between preeclampsia and control groups; however, the mean high density lipoprotein (HDL) in both groups had no significant differences. Conclusions: Based on the results of this study, it was found that in subjects with the metabolic syndrome during pregnancy, the risk for preeclampsia in the second half of pregnancy was higher than in the general population. In this respect, with the design of preventive programs, such as weight management and lowering harmful blood lipids, this complication in pregnancy can be prevented to some extent, or its serious complications can be decreased by early diagnosis. Controlling these indicators before pregnancy as preconception care for individuals at high risk of preeclampsia is recommended.
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The development of a clinical nurse instructor evaluation tool: The need to consult more widely
Kieran Walsh
March-April 2015, 20(2):292-292
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