International Journal of Community Based Nursing and Midwifery
Year:2018 | Volume:6 | Issue:3|Papers Count:8

Background: High-risk pregnancy causes worry in not only the pregnant woman, but also her husband. There is no suitable instrument to measure the men’ s worry in high-risk pregnancies. The current study aimed to develop and psychometrically evaluate the instrument used to measure the men’ s worry about their wives’ high-risk pregnancy. Methods: This research is a mixed exploratory study used to develop a questionnaire and conduct psychometric study on it. This research was performed in the spouses of pregnant women who had referred to public health and treatment centers and hospitals in Gorgan in 2016. The items were derived from the results of interviews with 40 men and a review of literature. Then, content validity, face validity, criterion validity, construct validity and reliability were examined. For structure validity, 370 men were included in the study. As to criterion validity, the Symptom Checklist-25 and men’ s worry tool were used. The result of factor analysis was obtained using SPSS software and confirmatory factor analysis was performed by LISREL software. Results: The results of the study revealed that the men were worried about pregnancy and delivery, neonatal health, maternal health, and personal and family data. General correlation of the instrument indicated a Chronbach’ s alpha of 0. 91 and ICC showed an internal consistency of 0. 91. Finally, an instrument with 30 items was developed with an acceptable validity and reliability. Conclusion: The questionnaire developed a psychometric evaluation instrument to measure the men’ s worry in high-risk pregnancies.

Background: Diabetes mellitus is a common metabolic disorder, one of the lesser known of whose consequences is cognitive disorder. This study aimed to evaluate the effects of problem-solving technique in type 2 diabetic patients with cognitive impairment. Methods: This randomized clinical trial was conducted in the south of Iran between December 2014 and April 2015. 96 type 2 diabetic patients with cognitive impairment were randomly divided into two groups. The patients in the intervention group attended classes on problem-solving skills, while the patients in the control group attended the usual classes in the clinic. The quality of life, selfmanagement profile, metabolic indexes of the patients in both groups were measured before and three months after the experiment. Data were analyzed using SPSS version 16. 0. Paired t-test, independent t-test, Wilcoxon, Mann-Whitney and Chi-Square tests were used. Results: The differences between the groups’ levels of HbA1c (P=0. 02) and HDL (P=0. 02) were significant, but the differences between their FBS, cholesterol, triglycerides and LDL were not significant (P>0. 05). The mean difference of the changes in the quality of life (P<0. 001) between the intervention and control groups was significant. The differences between the two groups in the area of self-management were as follows: patient’ s anxiety management (P<0. 001), patient’ s capability in using medicine (P<0. 001), healthy eating (P<0. 001), weight management (P=0. 02), and confidence in one’ s ability to manage his/her diabetes (P<0. 001). Conclusion: Applying problem-solving technique significantly enhanced self-management, quality of life and metabolic indexes in type 2 diabetic patients with cognitive impairment.

Background: Posttraumatic growth resulting from a stressful factor such as the diagnosis and treatment of cancer can positively affect various aspects of a mother’ s life as the child’ s main caregiver. The present study aims to determine the level of posttraumatic growth in the mothers of the children with cancer. Methods: In the present descriptive study, the statistical population consisted of the mothers of the children with cancer referring to oncology clinics or hospitalized in the oncology departments of selected hospitals from June 2016 to October 2016. The samples included 180 eligible mothers selected by convenient sampling. The data were collected using “ Posttraumatic Growth Inventory” (PTGI) that determines the psychological growth following exposure to traumatic events with 21 items in 5 domains of new possibilities, relationship with others, appreciation of life, personal strength, and spiritual changes and scored by 6-point Likert scale, ranging from 0 to 105; the higher scores indicate greater growth. The data were analyzed in SPSS-20 using descriptive and inferential statistical tests. Results: The mean age of the participating mothers was 34± 5. 3, 83. 3% of whom were housewives. The majority of the children suffered from leukemia, and cancer onset age was between 3 and 6 in 33. 9% of the children. The mothers’ mean score of posttraumatic growth was 62. 4± 18. 9, and the highest percentage of scores in various dimensions belonged to “ spiritual change” (3. 59), “ appreciation of life” (3. 04), and “ relating to others” (3. 02). Conclusion: Results showed that the experience of having a child with cancer can lead to posttraumatic growth in mothers.

collaborative care model could be useful. This study aimed to investigate the effect of the collaborative care model on hope in patients with Multiple Sclerosis (MS) and their family caregivers. Methods: This randomized controlled clinical trial was conducted in May to September 2015 on 60 patients with MS referring to the MS Society of Khuzestan province and 60 family caregivers. After block randomization, the intervention groups (patients and caregivers) received 8 intervention sessions based on collaborative care model over 12 weeks. The data were collected using Snyder’ s adult hope scale and a demographic questionnaire at baseline and 12 weeks after the beginning of the intervention. Data analysis was conducted through SPSS, version 19, using frequency, mean, Chisquare, independent, paired t-tests and Fisher’ s exact test (P˂ 0. 05). Results: The results of independent t-test before the intervention showed no significant differences between the patients in the intervention (42. 76± 8. 75) and control groups (43. 13± 7. 20) (P=0. 86) and caregivers in the intervention (50. 26± 5. 79) and control groups (49. 23± 6. 71) (P=0. 52), regarding the score of hope. However, a significant difference was found in this regard 12 weeks after the beginning of the intervention, between the patients in the control (43. 63± 6. 97) and intervention groups (47. 96± 8. 72) (P=0. 03), and caregivers in the control (50. 66± 5. 79) and intervention groups (53. 80± 4. 71) (P=0. 02) Conclusion: The collaborative care model promoted hope in patients with MS and their family caregivers. Hence, this model can be used by healthcare personnel for promoting hope among patients and caregivers.

Background: Child abuse is a kind of domestic violence of children under the age of 18 which potentially or actually damages all aspects of their health. This study was conducted to determine the effect of education based on growth and development with home-visiting follow up on the mothers’ attitude and child abuse with 3-6-year-old children. Methods: This controlled trial study was carried out in two rural community health centers in Khorasan Razavi province in Iran, during April 2016 to Jun 2017 on 64 abusive mothers of 3-6-year-old children. The data collection tools included the 32-item adult adolescent parenting inventory (AAPI) and the questionnaire of child abuse. By using multi-stage random sampling, the mothers referring to two health centers were assigned to the experimental (N=32) and control groups (N=32). The intervention group received parenting educational interventions based on child growth and development and after being followed up for eight weeks through home-visits. The data were analyzed in SPSS-16, using descriptive statistics, analytical tests including the Chi-square, independent t-test, and Mc Nemars test. Results: After the intervention, the overall score of parenting attitudes was found to be significantly increased (P<0. 001), and the prevalence of most abusive behaviors towards children was significantly reduced (P<0. 05) in the intervention group compared to the control group. Conclusion: According to the results, this educational program was found to be significantly more effective in improving parenting attitudes and preventing child abuse compared to routine childcare programs in health centers.

Background: Parents of insulin-dependent children and adolescents need resilience to continue their lives. The aim of this study was to determine the psychological predictors of resilience in parents of insulin-dependent children and adolescents. Methods: This was a descriptive correlational study performed in 2016. One hundred and thirteen parents of children and adolescents with diabetes who referred to a diabetes clinic in Shiraz participated in this study. Convenience sampling was used. Depression Anxiety Stress Scales (DASS-21) and Connor-Davidson Resilience Scale (CD-RISC) (25 items) were also used. The data were analyzed by SPSS software version 20 using t-test, ANOVA, Pearson correlation coefficients, and linear regression analysis. P<0. 05 was considered as significant. Results: The findings showed that the mean± SD score of resilience was 65. 33± 23. 81 in parents of children and adolescents with diabetes. Indeed, 45. 1% of the parents had mild to extremely severe levels of stress. Besides, 58. 4% and 71. 4% of them reported mild to extremely severe depression and anxiety, respectively. The lowest mean± SD scores of resilience were reported in parents with extremely severe levels of depression (37. 57± 16. 26), anxiety (44. 89± 23. 53), and stress (37. 84± 17. 90). Moreover, 49% of changes in resilience was explained by such factors as stress, anxiety, depression, and life and health satisfaction. Among these variables, the association between resilience and depression (t=-6. 97, P<0. 001) and life satisfaction (t=-3. 18, P=0. 002) were statistically significant. Conclusion: Since nearly half of the parents experienced stress, depression, and anxiety, and there was an association between resilience and these psychological variables, parents’ psychological problems, especially depression, might be reduced by improving their resilience.

Background: Grief involves a set of emotions, thoughts and behaviors that people experience when faced with a lack or threat of loss. This study was conducted to evaluate the suicidal ideation among women with experience of the death of a young person and assessed the predictive role of individualismcollectivism, social support, and resilience in suicidal ideation. Methods: This cross-sectional study was conducted from March to August 2016 through recruitment of 146 breaved women from Gilan-e gharb (the west part of Iran). Data gathering instruments included Individualism-Collectivism Questionnaire, Multidimensional Scale of Perceived Social Support (MSPSS), Connor-Davidson Resilience scale (CD-RISC), and Beck Scale for Suicidal Ideation. Collected data were analyzed using SPSS-22. Results: The findings showed that among women, 48 percent had suicidal ideation (scores above 6). The results of Pearson correlation showed that there were significant negative relationships between suicidal ideation (P<0. 05) and factors such as collectivism (r=-0. 286), family support (r=-0. 558), support from friends (r=-0. 307), support from significant others (r=-0. 617), social support (r=-0. 561), and resilience (r=-0. 457). The results showed that individualism-collectivism, social support, and resilience correctly predicted 73. 5% of women with suicidal ideation and 83. 3% of women without suicidal ideation. Conclusion: We concluded that higher collectivism, social support, and resilience in the bereaved women can lead to a reduction in suicidal ideation. Therefore, psychologists and counselors can provide the necessary background to strengthen supportive issues and the use of resilience-based interventions among bereaved women.

Background: Exclusive breastfeeding (EBF) in the first six months of the life can significantly improve maternal and children health, and it is especially important in low-and middle-income countries. We aimed to determine the factors affecting EBF duration in a sample of Iranian infants. Methods: This prospective study was conducted between April 2012 and October 2014 in Fars, Iran. Women (N=2640), who had given birth to healthy term infants were categorized into EBF versus non-EBF groups. Demographic information from mothers and infants, medical and drug history, and pregnancy related factors were compared between the two groups. Multivariable analysis was performed using Adaptive Lasso regression. P<0. 05 was considered significant. Results: The mean duration of EBF was 4. 63± 1. 99 months. There was an inverse association between the mother’ s educational level and duration of EBF (P<0. 001). Also, we found that mothers who were housewives had a significantly longer duration of EBF (4. 68± 1. 97) compared to mothers with either part-time (4. 21± 2. 01) or full-time jobs (4. 02± 2. 12) (P<0. 001). By eliminating the redundant factors, the proposed multivariable model showed the infant’ s weight gain during EBF, singleton/multiple pregnancies, maternal perception of quantity of breast milk, post-partum infection, use of pacifier, neonate’ s irritability, birth place and mother’ s full-time job as the most important factors affecting the duration of EBF. Twin pregnancies, post-partum infection, cesarean section by maternal request, use of a pacifier and irritability in the neonatal period significantly reduced the duration of EBF. Conclusion: Health policy-makers should promote EBF programs among the educated as well as working mothers in order to positively affect the community’ s health status.