International Journal of Community Based Nursing and Midwifery
Year:2021 | Volume:9 | Issue:1|Papers Count:9

Background: Adolescence is a time of risks and opportunities. This study aimed to investigate and prioritize the behavioral concerns of male adolescents. Methods: A modified Delphi study (2018-2019) was conducted in two stages. In the first stage, adolescents’ behavioral concerns were extracted based on seven qualitative interviews and a focus group. Then, a questionnaire was designed using the obtained data; also, two-round consensusbuilding approach (rating and ranking) through surveys were conducted among 90students, teachers and parents covered by the Health Departments of Tehran University of Medical Sciences, who had been selected using a stratified cluster random sampling method. Qualitative content analysis was used in the first stage and descriptive statistics in the second stage to analyze the data. Results: In the first stage, eight categories emerged, including relational challenges with parents and other adults; poor interaction with peers; lack of adaptation to conditions; emotional dysregulation; self-esteem and sense of purposefulness issues; materialistic tendencies; cyberspace issues; and nonadherence to religious beliefs. Then 63 behavioral concerns were identified. In each round (rating/ ranking), 29/27, 28/29, and 30/30, responses were received for students, parents and teachers, respectively. According to the specified scores given to different issues, ten top problems according to the viewpoint of different groups were extracted. Conclusion: “ lack of planning and prioritization skill” , “ insufficient skill for controlling crisis” , and “ lack of resilience” are the most important priority for male adolescents, teachers and parents, respectively. These findings can be used for planning programs based on the adolescents’ behavioral concerns.

Background: The first case of Coronavirus Disease (COVID-19) was reported in Iran on February 19, 2020. This study aimed to assess the characteristics and reproduction number (R) of COVID-19 in Markazi province in Iran. Methods: This is a cross-sectional study. Confirmed cases (N=2430) in the regions covered by Arak University of Medical Sciences from Feb 20 to Aug 26, 2020 were enrolled in the study. The included variables were clinical and demographic characteristics of COVID-19 patients. The case fatality rate (CFR), incidence rates, and R were estimated based on the daily reported data. For estimating R, generation time was assumed on multi scenarios. R was estimated by R0-package. Moreover, Chi square test was applied. All the analyses were performed in STATA, Excel, ArcMap and R. A p-value less than 0. 05 was considered as statistically significant. Results: The mean age of the participants was 51. 78± 20. 58 years, and 206(8. 50%) cases were among healthcare workers. Among the patients, 499(20. 50%) had a history of cardiovascular diseases and 337(13. 90%) diabetes type 2. The most prevalent symptoms were cough 1347(55. 40%), fever 1233(50. 70%), and dyspnea 960(39. 50%). The highest incidence rate of COVID-19 in the study area (Delijan) was 575. 35 per 100, 000 persons. CFR was 205(8. 40%). At the end of the study period, R was calculated as 1. 04 (CI 95%: 1. 00, 1. 08) in all districts of Arak University of Medical Sciences. The highest R (1. 08, 95% CI: 1. 06, 1. 10) was observed in Farahan. Conclusion: As R is slightly high, the risk of epidemic has reduced gradually. However, observing social distance and related guidelines are still recommended.

Background: The concept of birth preparedness and complication readiness (BP/CR) has continued to generate interest in the last decade. Unfortunately, there is a paucity of published data regarding this subject in Tanzania and the Lake Zone in particular. This study aimed to determine the factors affecting the level of awareness of BP/CR among Tanzanian women in the Lake Zone. Methods: Between May and June 2016, a cross-sectional study on 737 postnatal or pregnant women was conducted in the Lake Zone Tanzania. A systematic random sampling technique was employed to select the study participants. A structured questionnaire adopted from the Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) questionnaire was used to collect the data. Data analysis was carried out through SPSS (v. 21) using statistical tests including descriptive Statistics, Chi-square tests and Multivariate logistic regression. A significance level of 5% was considered. The odds of the occurrence of events were assessed using Odds Ratios (OR) at a 95% confidence interval (CI). Results: The majority of women were multigravida (512=69. 5%) with up to three living children (409=80%). Awareness of danger signs and BP/CR was low at 40% and 35%, respectively. Predictors of the level of awareness on BP/CR were multi-gravidity (P=0. 04), awareness of at least three danger signs (P<0. 001), and use of public transport (P=0. 01). Conclusion: Low awareness of BP/CR in this study calls for strengthened efforts from policymakers and healthcare providers to design effective programs geared towards educating women on the importance of BP/CR that will reduce the delays of seeking care, hence reducing maternal and neonatal deaths.

Background: Missed care is a global phenomenon, which can include many clinical conditions that threaten the patients’ safety in all countries and cultures, and also indicates the quality of nursing care. The nursing students’ awareness and understanding of missed nursing care is of great importance. The current study aims to explore the lived experience of postgraduate nursing students in missed care. Methods: The current qualitative study was performed based on the interpretive phenomenological approach in Tehran, Iran, in February to December 2019. A total of 10 master’ s degree nursing students were selected through purposive sampling. A total of 10 semi-structured individual interviews were used to collect the data. The trail version of MAXQDA-10 software was used for coding. All interviews were recorded and codified, and the main themes were extracted from them using Dicklemann et al. ’ s (1989) analytical method. Results: Two main themes, five sub-themes, and 31 meaning units were obtained. The main themes included: “ unfulfilled care” and “ living in limbo” . Conclusion: Missed care, as unfulfilled care, is accompanied with living in limbo for nursing students, and this condition is influenced by organizational and personal factors. It seems that managers can prevent missed nursing care by supervising nursing care, reducing the nurses’ workload, creating a sense of commitment to work, and enforcing ethical issues among nurses.

Background: Despite high number of visited cases, there are no certain therapeutic guidelines for mastalgia. Generally pain is associated with poor quality of life in all dimensions. The present study aimed to investigate the effect of healthy lifestyle promotion intervention on the quality of life in cyclic mastalgia. Methods: This study was a randomized controlled trial (RCT) conducted on women suffering from cyclic mastalgia at the age of 20 and older before menopausal age referred to the health centers of Karaj, Iran from September 2017 to August 2018. The participants were randomly assigned to intervention (N=40) and control groups (N=40). Intervention was carried out in two 46-minute sessions and two 90-minute sessions for the intervention group. The quality of life was assessed before and after the intervention in both groups using the World Health Organization Quality of Life-BREF (WHOQOL-BREF). The data were analyzed through SPSS statistical software(version 21) using independent sample t-test, Chisquare, and Paired t-test. Besides, P<0. 05 was considered as statistically significant. Results: Before the intervention, both groups were matched in terms of marital status, educational level, occupation, history of breastfeeding, and mean scores of quality of life (P>0. 05). After the intervention, the mean score of life quality in physical, social, environmental, and general health dimensions in the intervention group increased significantly compared to the control group (P>0. 001). This difference was not statistically significant in the mental health dimension (P=0. 086). Conclusion: The present study indicated that healthy lifestyle promotion intervention could improve the quality of life of women with cyclic mastalgia. Trial Registration Number: IRCT2017100236513N1.

Background: Premature birth is a crisis for mothers and affects resilience. Premature babies are at risk for developmental disorders. The Kangaroo Mother Care (KMC) can reduce maternal stress and improve the growth of the baby. This study aimed at assessing the effect of home visit based on the continued KMC on maternal resiliency and development of premature infant. Methods: This randomized controlled trial conducted on 50 pairs of mothers and premature babies with gestational age of 26-32 weeks who were admitted to Neonatal Intensive Care Unit of Om-alBanin Hospital, Mashhad, Iran in 2019. The KMC is practiced routinely for all eligible newborns in this hospital. The experimental group continued the KMC one month after discharge at home and received two home visits. Resiliency of the mothers was assessed in admission, discharge, and one month after discharge with the Connor and Davison questionnaire and the development of the newborns was assessed in two months of adjusted age with Ages and Stages Questionnaire (ASQ). Data analysis was performed using SPSS software version 16 and t-test, Mann-Whitney, ANOVA, Friedman, Chi-square, Fishers exact. The significance level was set at P<0. 05. Results: The resiliency score of the mothers one month after discharge was112. 50± 5. 50 and 76. 40± 5. 60 in the experimental and control groups, which was significantly different (P<0. 001). The ASQ development score of the newborns in two months of adjusted age was also significantly higher in the experimental than the control group (280. 40± 15. 60vs223. 80± 22. 00) (P<0. 001). Conclusion: The results showed that the home visit program based on the continued KMC was effective in increasing maternal resilience and the development of premature infants. Trial Registration Number: IRCT20181121041718N1.

Background: Patients with multiple sclerosis (MS) require health literacy to manage the symptoms and problems of the disease, which improves their quality of life. Health literacy is recognized as a critical indicator of health care outcomes. This study aimed to compare the effect of peer-led and lecture-based education on health literacy in MS patients. Methods: This quasi-experimental study was conducted on MS patients in Jahrom from December 2018 to November 2019. 90 patients were selected using convenience sampling and then assigned into control (n=45) and intervention groups (n=45). While routine education was presented to patients in the control group, peer education intervention was held for the intervention group. The number of sessions held for both groups was six sessions (one session per week). For data collection, MS health literacy questionnaire (MSHLQ) was used before and one month after the intervention in both groups. Data were analyzed through SPSS version 21 using Chi-square, Fisher’ s exact test and t-test. The significance level was considered P<0. 05. Results: Paired t-test showed that there was a significant difference between the mean of health literacy in the intervention group before and after the intervention (P=0. 001), while this difference was not observed in the control group (P=0. 39). Independent t-test showed a significant difference in the mean of health literacy between the intervention and control groups after the intervention (P=0. 001). Conclusion: The results showed that peer group experiences were more effective than lecture-based education in improving health literacy. It can be beneficial to employ as an educative-supportive approach in MS patients.

The coronavirus disease 2019 (COVID-19) outbreak has brought to people all over the world, in particular to patients, not only the risk of death, but also too much psychological pressure. Individuals who are quarantined at hospitals or homes might experience various adverse feelings. The potential lethality of the illness, some clinical symptoms of patients including shortness of breath and hypoxia, and devastating and sensational news, especially on social networks could lead to anxiety and fear in patients. Patients may also have feelings of guilt about potentially exposing their family members to infection. “ Medical mistrust” which refers to lack of trust in medical treatments may also increase the patients’ overall sense of worry and despair. Inadequate information about the disease and insufficient transparency from authorities about the disease status could also make the patients feel anger as we can see in previous studies on outbreaks such as Ebola. 1 Reduced contact with others, especially loved ones, leads to boredom, frustration, and a sense of loneliness and isolation, which is distressing to patients. Based on clinical observations and patients’ reports, worry about the health of self and that of significant others, loneliness, and lack of entertainment are the most concerns of patients quarantined at hospitals or homes. Therefore, mental health services should provide mental health care for individuals who are quarantined...

Health promotion is the process of enabling people to increase control over their health and its determinants, and thereby improve their health. Through the Ottawa Charter, World Health Organization (WHO) defi ned health promotion as “ the process of empowering individuals to increase their control and improve their health” . 1 WHO and the United Nations Educational, Scientific and Cultural Organization (UNESCO) have launched a new initiative called “ Making Every School a Health Promotion School” through the development and promotion of global standards for health promotion in schools. The initiative will help more than 2. 3 billion students and the WHO to achieve the motto of “ one billion healthy lives” by the end of 2023...