مراقبت های پیشگیرانه در پرستاری و مامایی
سال:1397 | دوره: | شماره: |تعداد مقالات:8

ackground: Postpartum is a significant transition period for women and could be markedly stressful. Objectives: Postpartum stress is a well-established risk factor for poor parenting practices and inadequate mother-infant interaction. The present study aimed to assess adaptation to motherhood and its influential factors in the first year postpartum in Iranian women. Methods: This cross-sectional study was performed in an urban area in the north of Iran. Inclusion criteria were age of more than 18 years, primiparous women, having healthy children in less than one year postpartum, Persian literacy, and willingness to participate in the research. Ill and disabled women, those with a history of depression, and high-risk pregnancies were excluded from the study. Convenience sampling was employed in seven health centers, and 536 subjects were selected. Data were collected using the scale of the experiences of Iranian first-time mothers in maternal role adaptation and demographic questionnaires. Data analysis was performed using descriptive statistics and regression and ordinal logistic regression. Results: None of the women had poor adaptation to motherhood. In addition, 2. 6% of the subjects had average adaptation, 78. 8% had good adaptation, and 18. 6% had excellent adaptation. According to the logistic regression results, favorable economic status increased the possibility of appropriate adaptation by twice (OR=2. 03; CI: 1. 3-3. 004; P<0. 001). Conclusion: Provision of proper counseling services requires the recognition of the influential factors in adaptation to motherhood. According to the results, adaption of women to motherhood in the first year postpartum largely depends on the economic support of the mother and infant.

Background: Empowerment of women is considered to be a critical developmental strategy. Objectives: Today, empowerment of women is not only a priority, but it also is an urgent need of women as a one of the most important populations considering their roles in the family and community. Social support and empowerment of women are regarded as an investment for future generations, which will result in sustainable development. The present study aimed to explore the association between the social support and empowerment of women with their reproductive decisions in the health centers in Sari, Iran. Methods: This descriptive-correlational study was conducted on 400 women referring to the health centers in Sari, Iran in 2017. The subjects who met the inclusion criteria were selected via multistage cluster sampling. Data were collected using a demographic and reproductive characteristics questionnaire, multidimensional scale of perceived social support, and the questionnaire of women empowerment and reproductive behavior. Data analysis was performed in SPSS version 16. Results: The subjects had a moderate level of empowerment in their reproductive decisions. On the other hand, favorable and poor empowerment levels were observed in the dimensions of cultural background and family planning, respectively. Furthermore, social support had a direct, significant correlation with the empowerment of women in reproductive decisions (P=0. 001; r=0. 34). Conclusion: According to the results, the empowerment and social support of women are imperative issues that require special attention and investment considering the key role of women in promoting community health.

Background: Motivation is an abstract, construct and concept regarded important issue in nursing education. The clinical setting complicates the concept of motivation in the clinical education of nursing students. Objectives: The present study aimed to evaluate the concept of motivation in the clinical education of nursing students. Methods: The hybrid model by Rogers was used to develop the concept of motivation. In the theoretical phase, 105 articles were obtained, and 59 articles were selected after accurate assessments. In the fieldwork phase, in-depth, semi-structured, face-to-face interviews were conducted with 14 nursing students and instructors, and the interview data were analyzed. In the final analysis stage, the results of the theoretical and fieldwork phases were integrated and assessed. Results: In the theoretical phase, a definition of motivation was provided based on previous studies. The determined categories based on the interviews in the fieldwork stage included 'spiritual satisfaction', 'attitude of the society toward the nursing profession', 'appropriate educational environments', 'professional knowledge', 'capabilities in clinical practice', 'independence', 'communications', 'values', 'Dignity and respect', 'role models', and 'working conditions of nurses'. In the final analysis stage, the results demonstrated that some of the antecedents and consequences of the theoretical phase overlapped with the fieldwork stage, and some were exclusively related to the field of nursing. Conclusion: According to the results, in addition to interacting with individual psychological conditions, the concept of motivation is correlated with the spiritual beliefs of nursing students, clinical education environment, and professional conditions. Depending on the circumstances, motivation for clinical education in nursing students is within a dynamical range with occasional surges and declines.

Background: Fear is an important factor that causes pregnant women to opt for cesarean section. Women with the fear of childbirth consider labor pain to be beyond their power. Basically, these women request cesarean section only to avoid normal vaginal delivery, which indicates their low self-efficacy in normal vaginal delivery. Objectives: The present study aimed to investigate the effects of couples counseling based on the problemsolving approach on the fear of delivery, self-efficacy, and choice of delivery mode in the primigravid women requesting elective cesarean section in Zanjan, Iran. Methods: This quasi-experimental study was conducted on 76 pregnant women in the second trimester of pregnancy and their spouses. The women were eligible for elective cesarean section and met the inclusion criteria. The intervention was based on the problem-solving counseling approach with the couples, which was performed in three weekly sessions at the clinic of Shahid Beheshti Hospital in Zanjan, Iran. Data were collected using the questionnaires of knowledge and attitude, Wijma delivery expectancy/experience questionnaire, and Louis’ self-efficacy scale at the baseline and after one month of the final session. Data analysis was performed using independent t-test, Chi-square, and one-way analysis of variance (ANOVA). Results: Significant differences were observed in the mean scores of knowledge and attitude of women and men, and fear of delivery and self-efficacy of women between the intervention and control groups after counseling (P<0. 001). The women in the intervention group were significantly more likely to do normal delivery compared to the control group (P<0. 001). Conclusion: According to the results, couples counseling based on the problem-solving approach could be effective in reducing the fear of delivery and increasing the self-efficacy of primigravid women. Furthermore, it could improve the knowledge and attitude of couples, thereby decreasing the rate of cesarean section and tendency toward this mode of delivery.

Background: The prevalence of low birth weight (LBW) has been estimated at 15. 5%, and approximately 15 million preterm births (PTB) occur across the world. These rates have been reported to be 9% and 9. 2% in Iran, respectively. Objectives: The present study aimed to assess the prevalence of LBW and PTB and compare their influential factors in Zanjan province, Iran during 2014-2016. Methods: This descriptive-analytical study was conducted on 41, 265 neonates (stillbirth and alive) in Zanjan province and suburbs. Data were collected using the registries of the midwives in charge of the maternal and neonatal registry system. Data analysis was performed in Excel and SPSS version 16 using descriptive and analytical tests, including the univariate and multivariate logistic regression models. Results: The prevalence of LBW and PTB was 7. 2% and 8. 2%, respectively. Odds ratio of LBW was lower with increased parity (OR=0. 736; P<0. 001) and gestational age (OR=2. 570; P<0. 001), while it was higher in female neonates (OR=1. 324; P<0. 001) and infants with congenital malformations (OR=2. 570; P=0. 001). Odds ratio of PTB was higher with increased abortions (OR=1. 206; P<0. 001) and in male neonates (OR=1. 440; P<0. 001), while it was lower with increased birth weight (OR=0. 996; P<0. 001). Maternal underlying diseases and diabetes reduced the odds ratio of LBW (OR=0. 633; P=0. 019) and increased the odds ratio of PTB (OR=3. 650; P<0. 001). Moreover, preeclampsia and eclampsia increased the odds ratio of LBW (OR=3. 140; P<0. 001) and PTB (OR=1. 489; P=0. 005). In terms of social factors, maternal education level decreased the odds ratio of LBW (P<0. 05). The prevalence of PTB increased by 22. 8% in 2015 compared to the previous year (P=0. 012). Conclusion: According to the results, congenital malformations, gender, gestational age, birth weight, maternal education level, and maternal underlying diseases were significantly correlated with LBW and PTB. Therefore, improving maternal and neonatal health requires proper planning to control the influential factors in LBW and PTB.

Background: Virtual social networks are the most important communication tools in the modern era, which have gained remarkable popularity in various communities. The use of social networks by different age groups has been on the rise, especially among adolescents. Objectives: The present study aimed to assess adaptation to motherhood and its influential factors in the first year postpartum in Iranian women. Methods: This descriptive, cross-sectional study was conducted on 180 students aged 16-18 years during 2016-2017. The research samples were selected by multi-stage method. Data were collected using demographic questionnaires and a researcher-made questionnaire to assess the rate and mode of using social networks. Data analysis was performed in SPSS version 16 using descriptive statistics. Results: In total, 77. 8% of the adolescents were registered in various social networks, and the majority were the users of Telegram (75. 6%). Moreover, 58. 9% of the participants had been using virtual social networks for more than 12 months, and 19. 4% used the networks for more than four hours per day for non-educational purposes. On the other hand, 47. 2% of the students used social networks for educational purposes for less than one hour. Conclusion: According to the results, adolescents frequently used virtual social networks, especially for non-educational purposes. Therefore, it is recommended that various scientific channels and networks with greater magnetism be designed for entertaining adolescents.

Background: Ventilator-associated pneumonia (VAP) is considered a common infectious disease in the intensive care units (ICU) and it is associated with increased morbidity and mortality. Therefore, humidifying the artificial airway is important care for patients under mechanical ventilation in the ICU. Objectives: The present study aimed to compare the effect of using active and passive humidifiers on VAP in ICU patients. Methods: The samples of this clinical trial included patients under mechanical ventilation who were selected by simple sampling method and randomly assigned to two groups of cases. Active and passive humidifiers were applied in the first and second groups, respectively. In addition, data were collected using a demographic questionnaire and clinical pulmonary infection score (CPIS) checklist. Patients were assessed for seven days (days one, three, and seven) in terms of VAP incidence rate. Finally, data were analyzed by the SPSS software, version using independent t-test and Fischer’ s exact test. Results: The heated humidifier standard (HHS) and heat and moisture exchangers (HME) groups were homogeneous with regard to the rate of VAP incidence, indicating no significant difference on days three (P= ) and seven (P= ). Further, the number of patients with VAP was clinically higher in the HHS group ( ) compared to the HME group ( ). Conclusion: Based on the results of the study, no significant difference was found between the research groups regarding VAP incidence. However, humidifiers are suggested to be selected based on the needs of the patents and duration of ventilation.

Background: Worldwide, half of women suffer from nausea and vomiting in early pregnancy which generally continues to the 20th week of pregnancy. Although pathogeneses of nausea and vomiting of pregnancy as well as hyperemesis gravid arum are still unknown, some believe that nausea and vomiting of pregnancy is likely related to maternal serum leptin level. Objectives: This study aimed to examine the relationship between leptin and pregnancy nausea and vomiting. Methods: In this case-control study, 45 pregnant women at first and second trimesters were selected through convenient sampling. Mothers’ blood samples were taken in the 6th, 12th, 15th, and 20th weeks of pregnancy. The participants were devised into healthy, without nausea, (24) and with nausea and vomiting groups (21). The relationship among the variables was analyzed using independent t-test, Pearson correlation, regression tests, and Lambda statistic (P value <0. 05). Results: The mean age of the participants was 27. 47± 5. 55 years, and Body Mass Index (BMI) was found to be 5. 458± 26. 57. There was no significant difference between groups in this regard. Based on results, changes in maternal serum leptin had significant correlation with nausea and vomiting of pregnancy (p<0. 04), meaning that the mean of leptin changes in patients with nausea and vomiting was significantly lower. Moreover, serum leptin at first and second trimesters of pregnancy did not have significant correlation with nausea and vomiting (p=0. 5 and 0. 3, respectively). Conclusion: With regard to leptin peak level at second trimester of pregnancy, leptin changes at first and second trimesters can be a good index to predict the nausea and vomiting of pregnancy. Thus, further domestic studies are required in this respect.