JOURNAL OF MIDWIFERY & REPRODUCTIVE HEALTH
Year:2020 | Volume:8 | Issue:2|Papers Count:13

Background & aim: In some situations in quantitative or qualitative research, complementary tools would be of great help in data collection. Vignette is a data collection tool, which has been used for over 50 years in different disciplines including health sciences. Nonetheless, there is a paucity of information regarding this method. With this background in mind, the present study aimed to provide thorough information about the vignette. Methods: This was a narrative review conducted through searching of databases of ISI Web of Science (65), PubMed (27), Science Direct (123), CINAHL (110), ProQuest (23), ERIC (44), Scopus (24) using keywords including “ vignette” , “ qualitative research” , “ quantitative research” , and research” from their inception to September, 2018 to assess those studies regarding different aspects of vignette. Out of 416 documents, a number of 105 books and articles were reviewed regarding the different aspects of the vignette. No language restrictions were imposed. Results: Vignettes are used in different forms including text, illustrations, images, videotape and cartoons, computer-based data, and music as an elicitation tool to provide supplementary and complementary data during a research process. Using this tool, the researcher can gather some data which is not accessible through other sources. At the same time, the researchers should be cautious about its accurate design and validity to get more realistic data. Conclusion: Vignette as an effective tool can be employed in both quantitative and qualitative research to gather more diverse and thorough data even working crossculturally.

Background & aim: Effective preconception care requires childbearing women's knowledge and attitude to improve maternal and neonatal health by the early recognition of risk factors related to pregnancy. The aim of this study was to investigate knowledge and attitude of Iranian women regarding preconception health based on the health belief model. Methods: This cross sectional study was conducted on 110 married women aged 15-49 years in Mashhad, Iran, during 2016. Sampling was carried out through a multi-stage process. Data collected using questionnaires on demographic and obstetric data, knowledge and preconception risk assessment as well as health belief model questionnaire encompassing four constructs of perceived barriers, sensitivity, severity, and benefits, which considered as attitude. Data analysis was performed in SPSS using Pearson’ s correlation, Mann-Whitney U test, and Kruskal-Wallis test. Results: The knowledge of preconception care was poor in 36. 4% of cases and moderate in 63. 6% of participants. The score of attitude were neutral and good among 79. 1% and 20. 9% of participants, respectively. The scores of constructs of sensitivity (80%), severity (77. 3%) and perceived barriers (67. 9%) were neutral, and only the construct of perceived benefit was at a good level among most women (63. 3%). The scores of the all constructs had a significant correlation with scores of knowledge and attitude (P<0. 05). Conclusion: The majority of women had moderate knowledge and neutral attitude regarding preconception care. Therefore, educational intervention based on a health belief model is recommended to improve the knowledge and attitude of women and develop preconception care behaviors in these individuals.

Background & aim: This study aimed to translate and evaluate the psychometric properties of the Farsi version of the childbirth perceptions scale (CPS) to assess women's experiences of their childbirth. Methods: In this validation study, the CPS was translated from English to Farsi using the forward-backward translation method. Subsequently, 150 women who hadrecently given birth and were the residents in Bandar Abbas, Iran were requested to fill out the CPS. The construct validity of the CPS was determined using the exploratory and confirmatory factor analysis. Moreover, Cronbach's alpha coefficient was used to determine its reliability. The reliability of the CPS was determined using the test-retest method with the calculation of the intra-class correlation coefficient. The data were analyzed in SPSS software (version 16) and LISREL 8. 8. Results: A total of 150 individuals participated in this study. The results of the Kaiser-Meyer-Olkin test, the adequacy of the sample size was acceptable (0. 722), and Bartlett's test of sphericity revealed statistically significant results (P<0. 001). The mean± SD of the CPS scores was obtained as 26± 5. Exploratory factor analysis confirmed the two-factor structure of the scale in which factors one and two had seven and five items, respectively. The Cronbach's alpha coefficient and the intraclass correlation coefficient were 0. 975 and 0. 988, respectively. Some of the fit indices of confirmatory factor analysis indicated that the two-factor model best fitted the data. Conclusion: The findings confirmed the validity and reliability of the CPS; therefore, it can be administrated to the Iranian parturient women.

Background & aim: Neonatal mortality rate (NMR) is an important health index, which reflects the socio-economic and health status of a community. According to the literature, almost 20% of NMR can be prevented through the implementation of simple resuscitative interventions. This study was conducted to review the neonatal outcomes and resuscitation rate of neonates. Methods: This record review was carried out using records of 4683 birth from March 2016 to March 2017 in Imam Reza Hospital, Mashhad, Iran. The variables reviewed included the birth conditions, neonatal outcomes and resuscitation interventions. The data were collected using a self-structured record form and analyzed using descriptive statistics. Results: The findings showed 179 neonatal deaths out of 4683 births (including those who were born dead or the ones who died shortly after birth in delivery rooms). NMR was 3. 8% in the current study. The rate of cesarean deliveries was 5% higher than normal vaginal delivery rate. Moreover, 18% of births were related to the gestational age lower than 36 weeks. The rate of low and very low birth weight infants was 6. 42% of births. Approximately, 20% of the newly born infants were resuscitated. Conclusion: The results of this study revealed that Imam Reza Hospital of Mashhad, Iran was not in a good condition compared to the developed countries, in terms of the status of births, mortality rate, and resuscitation interventions.

Background & aim: Spread of sexually transmitted infections can be controlled with enhancing the knowledge and correcting the attitudes of students regarding the right and consistent use of contraceptive methods, and being in monogamous sexual relationships. This study aimed to compare the students’ knowledge, attitudes, and safe sex practices between nursing and non-nursing undergraduate students. Methods: A descriptive survey design was employed among 240 students at Niger Delta University in Bayelsa State, Nigeria in 2018-2019 The simple random sampling technique was used to select the sample. A questionnaire designed to elicit information on knowledge, attitudes, and safe sex practices from nursing and nonnursing students. Data were analyzed using SPSS, version 17. 0. Descriptive statistic was employed to describe the data. Results: Nursing students in this study presented with safe sexual practices, compared to non-nursing students. Sexual risky behaviors, such as having a casual partner and not using condoms, were prevalent among the non-nursing students. After summing up the scores of nursing students, they showed a better understanding of knowledge of safe sex (83. 1% for nursing students versus 54. 6% for non-nursing students). Similarly, the nurses’ attitudes and practices seemed better than those of non-nurses. Conclusion: Combination of both correct knowledge and positive attitudes correlates with safe sex practices among students. Safe sex education should be introduced to non-nursing students at the Niger Delta University as a means of promoting safe sex practices among students.

Background & aim: Fatigue is one of the most common complaints among pregnant women. Reflexology can be used to reduce the symptoms of fatigue. The purpose of this study was to measure the impact of foot sole reflexology on the intensity of fatigue in the first half of pregnancy. Methods: This randomized clinical trial was conducted on 73 pregnant women with 8-20 gestational weeks who referred to urban health centers, Mashhad, Iran in 2018. The participants were randomly assigned to two groups of foot sole reflexology (n=36) and control (n=37) using a random number table. In the intervention group, in addition to routine care, foot sole reflexology was daily administered through a 20-minute session for 4 days. The control group only received routine care. The checklist of fatigue symptoms was daily completed by both groups up to seven day. The data were analyzed by SPSS software (version 25) using the Mann-Whitney U test, independent t-test, and analysis of covariance. Results: The results showed that although the mean score of severity of fatigue after the intervention decreased in both groups, compared to those reported before the intervention, there was no significant difference between the two groups (P=0. 87). Conclusion: In this study, foot sole reflexology did not reduce fatigue in the first half of pregnancy. However, as most pregnant women reported more relaxation in the reflexology group than the control group, further research in this topic is recommended in the future.

Background & aim: Government of Ethiopia is promoting institutional delivery despite the fact that there are a high number of home deliveries in the country mainly in hard-to-reach areas. Choice of institutional delivery is vital for the reduction of maternal and neonatal mortalities. The present study aimed to investigate the determinants of institutional delivery in Ethiopia. Methods: This cross-sectional survey was conducted on 11023 women (age range: 15-49 years) who delivered in the preceding five years before the 2016 Ethiopian demographic health survey in Ethiopia from January 18, 2016 to June 27, 2016. The primary outcome variable was institutional delivery. Statistical analysis was performed using SPSS software (version 20). The multivariate logistic regression was used to identify variables that had a significant association with institutional delivery (P<0. 05). Results: Institutional delivery was 4. 36 times higher in women with secondary education (OR: 4. 36; 95% CI: 3. 12-6. 09). In addition, it was threefold higher among the subjects who were the residents of urban areas (OR: 3. 26; 95% CI: 2. 19-4. 35). Institutional delivery was higher among women who had antenatal care (ANC) visits (OR: 1. 81; 95% CI: 1. 58-2. 07) and watched television at least once a week (0R: 1. 90; 95% CI: 1. 35-2. 66). Based on the wealth index, the wealthiest subjects were 2. 61 times more likely to deliver in health institutions (OR: 2. 61; 95% CI: 1. 95-3. 50). Conclusion: Having higher educational levels, being wealthy, residing in urban areas, having ANC visits at least once, and watching television at least once a weak were considered as important determinants for the choice of institutional delivery.

Background & aim: Pregnancy involves physiological, psychological, and social changes, in which women are expected to adapt to the biopsychosocial changes. Failure to make such an adaptation would be accompanied by an increased risk of prenatal depression in pregnant women. This study was conducted to determine the relationship between psychosocial health status and the risk of depression in pregnant women. Methods: This descriptive-analytic study was carried out on 792 pregnant women (i. e., 73, 369, and 350 cases in the first, second, and third trimesters, respectively) referring to the Outpatient Clinic of the Meram Medical Faculty Hospital, Necmettin Erbakan University, Turkey, from 22 March to 30 June 2016. The pregnant women who attended the outpatient clinic and met the inclusion criteria were selected using haphazard sampling, as a non-probability sampling method. The data were collected through a researcher-made questionnaire, the Pregnancy Psychosocial Health Assessment Scale (PPHAS), and the Edinburgh Postnatal Depression Scale (EPDS). Data analysis was performed in SPSS software (version 22) using descriptive statistics, Mann-Whitney U test, and Kruskal Wallis test. Results: The pregnant women had the depression risk of 28. 2% and mean depression score of 9. 41± 4. 8. The total mean score of PPHAS was obtained as 4. 05± 0. 45. The risk of depression showed a statistically negative relationship with the total and sub-dimension mean scores of PPHAS, as well as the mean EPDS score (P˂ 0. 001). Conclusion: Pregnant women with lower psychosocial health status were more likely to have the risk of depression. In other words, the risk of depression in pregnant women was influenced by factors that determine their psychosocial health.

Background & aim: The caesarean rate is on the rise in Cameroon; nonetheless, there is a paucity of data regarding its associated risk factors and outcomes. This study aimed to determine the associated risk factors, as well as maternal and fetal outcomes of caesarean delivery in four hospitals in Cameroon. Methods: This cross-sectional study was conducted on 1322 parturient women who gave birth in one tertiary, two secondary, and one primary healthcare facility in Cameroon within March 2015-February 2016. Maternal and fetal data were obtained by interviewer-administered pretested questionnaires. Univariate and multivariate analyses with Chi-square and Fischer's exact tests compared outcomes between caesarean and vaginal births. Results: Referral from one hospital to another (AOR 2. 83; 95% CI: 2. 09-3. 84) and antimicrobial use during labor and delivery (AOR 11. 0; 95% CI: 7. 6-17) were maternal factors independently associated with caesarean delivery. Postpartum hemorrhage of 1000-1500 mL (AOR 9. 7; 95% CI: 1. 7-55), maternal fever (AOR 3. 5; 95% CI: 1. 4-9. 2), and prolonged hospital stay (AOR 3. 8; 95% CI: 3. 2-4. 4) were maternal complications independently associated with caesarean delivery. Furthermore, birth asphyxia (AOR 2. 1; 95% CI: 1. 3-3. 6), respiratory distress (AOR 4. 7; 95% CI: 1. 6-12. 4), and neonatal sepsis (AOR 3. 2; 95% CI: 1. 5-6. 9) were fetal complications independently associated with caesarean delivery. Conclusion: There were more referrals from another facility, intrapartum antimicrobial use, hemorrhage, maternal fever, prolonged hospital stay including birth asphyxia, neonatal sepsis, and respiratory distress among caesarean delivery.

Background & aim: Preconception care (PCC) is the provision of biomedical, behavioral, and social health interventions for women and couples before conception occurs. Although it serves to close the gap of poor maternal health through promoting good behavior, risk assessment and management of chronic medical conditions, treatment of infections, and vaccinations, but it is still a challenge to most women of the childbearing age worldwide. The present study was performed to investigate the perceptions of women of the childbearing age regarding PCC. Methods: A descriptive qualitative design was used on a purposive sample of eight pregnant women within the age range of 15-49 years attending Masvingo general hospital, Zimbabwe for antenatal care. The sample size was determined by data saturation. The data were collected within March 2018 to April 2018 through indepth interviews, which were conducted in private rooms while detailed notes were taken. Thematic analysis was manually performed to analyse the data. Issues of trustworthiness was considered. Results: Major themes identified were inadequate knowledge of PCC, recognition of the importance of PCC, barriers to PCC, and facilitators of PCC. Conclusion: Women acknowledged the importance of PCC. However, there was a number of barriers to the full utilization of PCC, and it was a neglected aspect of maternal-child health. There is a need to promote the awareness of PCC to enable informed decision-making regarding the issues of fertility and pregnancy planning.

Background & aim: Lack of objective expression of emotions leads to the experience of unpleasant thoughts and evocations, followed by the non-recognition of one’ s emotions and feelings. This is identified as one of the most important factors accounting for marital conflicts. The purpose of this study was to predict marital burnout based on negative automatic thoughts and alexithymia among couples in Shiraz, Iran. Methods: This correlational study was conducted on 150 couples referring to four counseling centers located in districts 1 and 2 of Shiraz in 2018-2019. The study population was selected using a multistage cluster sampling method. The data were collected using the burnout measure developed by Pines, automatic negative thoughts questionnaire, and twenty-item Toronto alexithymia scale on a selfreport basis. Data analysis was performed in SPSS software (version 21) using regression analysis and Pearson correlation coefficient at a significance level of ≤ 0. 05. Results: The results showed that the dimensions of an automatic negative thoughts could predict marital burnout positively and significantly (P≤ 0. 05). The coefficient was obtained as 0. 27, meaning that automatic negative thoughts, alexithymia, age, and education could predict marital burnout at 27%. Conclusion: Alexithymia and automatic negative thoughts could eventually lead to the elevation of dissatisfaction with marriage due to exerting a negative effect on maintaining a strong emotional relationship between partners.

Background & aim: The present study aimed to investigate the effects of a threemonth aerobic exercised training course on inflammatory markers in women with polycystic ovary syndrome (PCOS). Methods: This quasi-experimental study was conducted on a total of 24 women with diagnosed PCOS in Isfahan, Iran, within May 22nd to September 21st 2018. Participants were randomly assigned into two groups of experimental (n=12) and control groups (n=12). The experimental group underwent 12-week aerobic exercise training, and the control group was only followed in the study. Biochemical markers, including fasting blood glucose, insulin, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α ) were measured in the two groups. Insulin resistance index was also determined by the calculation of the homeostasis model assessment of insulin resistance (HOMA-IR). All the variables were assessed and compared after 12 weeks. The independent t-test was used for comparing the two groups (P<0. 05). Results: There was a significant difference between the experimental and control groups in terms of IL-6 (P=0. 003), CRP (P=0. 001), insulin (P=0. 008), and HOMA-IR (P=0. 04) and all were at lower level in intervention than control group. No significant difference was observed regarding TNF-α (P=0. 48) and glucose (P=0. 09) levels between the two groups. Conclusion: The findings of the current study showed that aerobic exercise is useful in the management of PCOS. Therefore, it is recommended to perform aerobic exercise as an appropriate modality to control PCOS and reduce its adverse effects.

Background: Cervical ectopic pregnancy is a rare condition with an incidence of less than 0. 1% in all ectopic pregnancies. This life-threatening condition is associated with a high morbidity and mortality rates. Recently, the recommended protocol for the treatment of cervical ectopic pregnancy is fertility preservation rather than invasive surgery and hysterectomy. The aim of this report was to introduce a case of successful management of cervical ectopic pregnancy. Case report: A 31-year-old woman was presented with her third pregnancy with a history of one cesarean section and spontaneous abortion. She was admitted to an academic hospital with vaginal bleeding following 10 weeks of amenorrhea. Based on transvaginal ultrasound, a live fetus of about nine weeks was reported, located in the cervical canal. The β-subunit of human chorionic gonadotropin (β hCG) titer was reported as 108000 mIU/m. Cervical pregnancy diagnosis was consistent. In order to preserve fertility based on the patient’ s hemodynamic status, medical treatment and surgical intervention, including methotrexate and then intravaginal ligation of cervical branches of uterine arteries, and subsequently cervical tampon was successfully performed. Conclusion: The early detection and accurate diagnosis of cervical ectopic pregnancy using ultrasound and serial β hCG titer can be a valuable approach. Appropriate and conservative management has decreased the morbidity rate and preserved the ongoing fertility in the affected patients.