پرستاری و مامایی جامع نگر (journal of HOLISTIC NURSING AND MIDWIFERY)
سال:1403 | دوره: | شماره: |تعداد مقالات:10

Introduction: Anxiety after cesarean section can delay the recovery process of mothers after delivery. Auriculotherapy as a complementary medicine may be beneficial in reducing maternal anxiety. Objective: This study assesses auriculotherapy’s effect on women’s anxiety after cesarean section. Materials and Methods: This randomized controlled clinical trial was conducted on 68 women after cesarean section in a teaching hospital in Rasht City, Iran. The mothers were assigned into intervention groups (n=34) and control (n=34). In the intervention group, auriculotherapy was performed by Vaccaria seeds on 1 point in the left ear and 5 points in the right ear. The mothers’ anxiety was measured by the Spielberger state-trait anxiety inventory (STAI) before, 3, and 10 days after the intervention. The collected data were analyzed by using the independent t-test, Fisher exact test, and repeated measures ANOVA. Analysis of covariance (ANCOVA) was also used to compare the STAI score between the two groups after the intervention. The significance level was set at 0.05. Results: The Mean±SD age of the participants was 31.8±7.2 years. In the intervention group, no significant difference was found in the state and trait anxiety scores from baseline to day 3 after the intervention. However, their mean scores were significantly reduced on the 10th day after the intervention compared to the scores at baseline and day 3 (P=0.001). In the control group, the mean state anxiety score on the third day was significantly higher than at baseline and day 10 (P=0.001, η2=0.249). At the same time, there was no significant difference in trait anxiety scores from the baseline to the third day. However, these values increased on day 10 (P=0.001). According to the ANCOVA results, the adjusted means of state and trait anxiety in the intervention group were lower than in the control group on the 3rd and 10th days; these values decreased more from the third to the tenth day (P=0.001, η2=0.829). Conclusion: Auriculotherapy effectively reduces mothers’ anxiety after cesarean section. Therefore, health service providers, especially midwives, can use this complementary medicine to reduce mothers’ anxiety.

Introduction: Childbirth is the most challenging physiological and psychological event in a woman’s life. Despite the recommendations of the Iranian Ministry of Health on having natural childbirth, no favorable statistics have been reported yet. Objective: This study aims to determine the predictors of natural childbirth intention based on the extended theory of planned behavior (TPB) and social support in pregnant women referred to selected hospitals in Rasht, northern Iran. Materials and Methods: This analytic cross-sectional study was conducted on 353 pregnant women aged 15-45 years referred to four hospitals in Rasht city in 2020 who were selected by systematic random sampling method proportional to the size of the study population. A researcher-made self-report questionnaire measuring the demographic information, the TPB constructs, social support, and natural childbirth intention was used. Data was analyzed using t-test, one-way ANOVA, Pearson correlation test, and multiple regression analysis.  Results: Most of the pregnant women had a high school diploma (43.6%) and were housekeepers (83.3%), living in the city (80.5%). Most of them were in the third trimester of pregnancy (37.7%) and had pregnancy for the first time (44.8%). Their mean age was 28.90±5.8, and 58.8% intended to give birth naturally. The mean score of the natural childbirth intention was 6.71±2.50. This intention had a direct correlation with all TPB constructs and social support (r=0.526-0.829; P=0.001). Based on results social support, and participation in childbirth education classes predicted 72% of changes in natural childbirth intention (R2 =0.72). Attitude alone was able to predict natural childbirth intention by 69% (β=0.12, 95% CI; 0.09%, 0.15%, P=0.001) Conclusion: The power of the TPB constructs for predicting the natural childbirth intention in pregnant women in northern Iran is high. The attitude construct is the best predictor of natural childbirth intention. To increase the tendency to choose natural childbirth, educational interventions based on the TPB with an emphasis on attitudes can be useful. In addition, measures should be taken for the active participation of pregnant women in childbirth preparation classes.

Introduction: Conflicts arise when a person or group perceives that another person or group opposes their interests, beliefs, and values. Although conflict usually carries a negative sense, it may be productive for nurses, their colleagues, or patients in clinical settings. Objective: This study aims to determine the prevalence of workplace conflict and the coping strategies used by nurses working in teaching hospitals in Qom City, Iran. Materials and Methods: This is a descriptive-analytical study with a cross-sectional design. Study participants comprised 373 nurses in teaching hospitals affiliated with Qom University of Medical Sciences. They were selected using simple random sampling. Data collection tools were a demographic form, DuBrin workplace conflict questionnaire, and Putnam and Wilson’s organizational communication conflict instrument (OCCI). The obtained data were analyzed by descriptive statistics, the chi-square test, Fisher’s exact test, and a one-way analysis of variance (ANOVA) and multivariate linear regression model. Results: Most participants were female (63.8%) with a bachelor’s degree (88.3%). Their mean age was 34.78±5.96 years. The mean score of workplace conflicts was 10.04±3.93 and the mean score of the control strategy was significantly higher in nurses with a high level of workplace conflict (24.90±3.75). The multivariate regression results revealed that age, sex, marital status, educational level, type of employment, department of service, work experience, and three conflict resolution strategies could predict 32% of workplace conflict (adjusted R2=0.32, P=0.001). Conclusion: Workplace conflict among nurses of hospitals in Qom is high. They mostly use the solution-orientated strategy followed by non-confrontation and control strategies.

Introduction: Dysmenorrhoea is one of the leading causes of school absenteeism among adolescent girls. Many women have menstrual cramps before and during their menstrual periods. For some women, the discomfort is merely annoying. Methods used to relieve dysmenorrhea include; exercise, a healthy diet, and yoga. Objective: This study aims to evaluate the effect of a gym ball exercise program on dysmenorrhea in nursing students from a selected college in Mangaluru, India. Materials and Methods: This is a quasi-experimental study on 52 eligible nursing students (26 in the exercise group and 26 in the control group). A pre-test assessment was done in both groups to assess the level of dysmenorrhea by using the numerical pain rating scale. The gym ball exercise was performed in the exercise group for 3 weeks prior to their predicted menstrual date, three times a week, each for 45 minutes. The post-test assessment was done on the first day of their menstruation and followed up one month later to assess the sustainability of the effect of the exercise. To analyze the data, inferential statistics, including chi-square test, Fisher’s exact test, Wilcoxon signed rank test, and Mann-Whitney U test were used. Results: The participants had moderate to severe pain. They had regular menstrual cycles lasting for 28-30 days, with a menstrual duration of 3-6 days, and moderate bleeding. The level of dysmenorrhea in the exercise group was lower (2.69±1.15) than in the control group (4.77±1.75) in the post-test phase. The mean level of dysmenorrhoea in the follow-up phase was 3.08±1.74 and 4.35±1.79 in the exercise and control groups, respectively. A significant difference was found between pre-test and follow-up pain scores (P=0.001) and between post-test and follow-up pain scores (P=0.001). Mann-Whitney U test results showed a significant difference between the two groups in the post-test (P=0.001) and follow-up phases (P=0.001). Conclusion: The four-week gym ball exercise program is effective in reducing the intensity of dysmenorrhea in nursing students.

Introduction: Pain is the most common symptom among patients with cancer; the pain also affects their caregivers. Objective: This study aimed to explore the pain characteristics and caregiver burden in patients with cancer-related pain and their associated factors. Materials and Methods: This cross-sectional study was conducted on 240 patients and their caregivers (120 patients and 120 caregivers), who were chosen using the convenience sampling method. They completed face-to-face surveys, including information about sociodemographic and disease characteristics, the brief pain inventory, the pain beliefs questionnaire, and the Zarit burden interview scale. The descriptive statistics, frequency distributions, and multiple linear regression model were used to analyze the obtained data according to the two-tailed P<0.05. Results: The mean age of the patients was 58.79±13.46 years, and 50.8% were females. The mean age of the caregivers was 47.84±13.24 years, and 83.3% were females. The linear regression analyses showed demographic and clinical factors of patients were associated with pain severity (R2=0.326, P<0.001). In addition, these factors were associated with all sub-dimension of pain interference and pain beliefs (P<0.001). Furthermore, the linear regression model showed that patients' pain severity, pain interference and pain beliefs were predictive factors of caregiver burden (R2=0.266, P<0.001).  Conclusion: These results will help health professionals understand the pain characteristics of patients and caregiver burden to improve cancer-related pain and caregiver burden.

Introduction: Considering the rapid growth in the number of aged people and their oral & dental health problems, there is a need for effective community-based interventions to improve their oral health.  Objective: This study aims to investigate the effectiveness of community-based interventions in improving the oral & dental health of elderly people. Materials and Methods: This is a systematic review and meta-analysis. The related studies published from January 2000 to March 2023 were searched in PubMed, Scopus, Cochrane Oral Health’s Trials Register, and Web of Science databases. The risk of bias in the included studies was assessed using the Cochrane tool. Results: Nineteen articles were included in the review. Interventions were divided into four groups: educational interventions, oral & dental health care interventions, chewing gum, and combined interventions. A total of 95 indicators were examined in the studies, 53 of which were not statistically significant. Regarding the overall effectiveness of the interventions, 10 studies reported them as completely effective, 5 studies as relatively effective, and 4 as ineffective. Chewing gum had the highest effectiveness. The results of the meta-analysis showed that the mean difference in the dental plaque index between the intervention and control groups was -0.65 (95% CI; -2.03%, 0.74%, Q=59.6, df=5, P=0.001, I2=97.8%) the mean difference in the denture plaque index was -0.20 (95% CI; -0.38%, -0.02%, Q=3.22, df=3, P=0.36, I2=21.3%), and the mean difference in the gingival index was -0.36 (95% CI; -0.99%, 0.27%; Q=5.2, df=1, P=0.02, I2=80.9%). Conclusion: There are no clear advantages or evidence about the effectiveness of community-based interventions in improving the oral & dental health of elderly people.

Introduction: The goal of clinical practice is to provide students with practical training experience and the ability to work as a team. Objective: This study aims to analyze the effectiveness of a phantom-based mannequin in improving midwifery students’ performance in vaginal toucher (VT) examinations Materials and Methods: This is a quasi-experimental study with a pre-test/post-test design. Participants were 70 final-year midwifery students in two groups of factory mannequin (n=35) and modified mannequin (n=35). The instrument used for assessing performance was a validated 10-item scale. Data analysis was done using paired t-test, Kolmogorov-Smirnov test, and ANCOVA. Results: Participants had a mean age of 21.6±2.2 years in the modified mannequin group and 21.3±2.4 years in the factory mannequin group. There was no significant improvement in students’ performance after using the factory mannequin, but the modified mannequin improved their skills, since there was a significant difference in VT examination performance before and after using the modified mannequin (mean difference=3.97, P=0.001). The ANCOVA results showed a significant difference in the mean post-test scores between the factory and modified mannequin groups (mean difference=1.59,η2=0.299, P<0.05). Conclusion: The modified mannequin is more effective than the common factory mannequins in improving the VT examination performance of midwifery students. For this reason, these devices are highly recommended for practical learning of VT examinations.

Introduction: Medication errors (MEs) are common among nursing staff due to the fear or lack of knowledge and time in reporting MEs. Objective: This study aims to identify the barriers and facilitators of voluntary ME reporting according to the nursing staff in India. Materials and Methods: This cross-sectional study was conducted on 398 nurses of a hospital in India, working in three different shifts with various specialties, who were selected by a convenience sampling method. A validated questionnaire was used to collect data which was prepared in Google Forms. The chi-square test was used to determine whether there was any statistical difference among the responses. Results: Results showed that 87% of nurses were female and 13% were male. The majority were at an age range of 31–40 years (44.9%) and had good knowledge of MEs and the reporting system in the hospital (96.2%). Regarding the barriers, 29.9% (P<0.001) were a beginner in using the reporting system, while 70% had prior experience with the system; 85.4% (P=0.024) reported the lack of a relaxing working environment, 54.7% (P=0.031) reported burnout, 27.6% (P=0.0001) reported personnel problems, 21.6% (P<0.001) reported peer pressure and so on. Receiving support and encouragement from the multi-disciplinary team (91.7%), receiving feedback for the reported MEs that focuses on the system and not on the individuals (90.7%), professional encouragement for the reported MEs (90.4%), and developing a “no-blame” culture (86.9%) were the facilitators of the voluntary ME reporting by the nursing staffs (none of them were statistically significant).  Conclusion: Although it is impractical to eliminate all MEs, the engagement of nursing staff is essential in ME reduction and prevention.

Introduction: For patients with epilepsy and their family caregivers, epilepsy risk awareness (ERA) can affect various aspects of health. They need effective education to improve their quality of life. Objective: This study aims to compare the effect of self-care education on ERA in patients with epilepsy and their family caregivers using the face-to-face method and pamphlets. Materials and Methods: In this quasi-experimental study, participants were patients with epilepsy referred to a neurological outpatient clinic in Tabriz, Iran and their family caregivers. They were randomly assigned to the intervention (60 patients and 60 caregivers) and control (60 patients and 60 caregivers) groups. The ERA scales for patients and family caregivers were completed before and one month after the education. The intervention group received ERA-based self-care education in a 60-minute session using the face-to-face method. The pamphlet group received the same education using pamphlets. Data were analyzed using descriptive statistics, paired t-test, independent t-test, Fisher’s exact test, chi-square test, and ANCOVA. Results: Most of the patients (70%) and caregivers (53.3%) in the intervention group were female, and their mean age was 28.07 and 40.75 years, respectively. In the pamphlet group, most of the patients (68.67%) and caregivers (63.3%) were female, with a mean age of 30.28 and 42.32 years, respectively. After education, mean ERA scores increased significantly in both intervention and pamphlet groups (P=0.001). Except for the two domains of physical and mental health, the mean scores of ERA domains were higher in the intervention group than in the pamphlet group (P=0.01). These results were confirmed by ANCOVA results (P<0.01). Conclusion: Self-care education with the face-to-face method or pamphlets both can increase the ERA of patients with epilepsy and their family caregivers. Depending on the conditions and available facilities, nurses can use these methods to facilitate patient education and the learning process.

Introduction: Professionalism in nursing is a fundamental concept for providing effective and high-quality nursing care. Due to the complexity and multiple sides of this concept, it lacks a clear and precise definition. This ambiguity has created different and even poor interpretations of meanings and characteristics, making its accurate measurement difficult. Objective: This study aims to review the literature to provide the definition and attributes of “professionalism in nursing” and formulate a conceptual model for it. Materials and Methods: In the present study, the integrated review method was used in five stages: Specifying the problem, searching the literature, evaluating and extracting data, analyzing data, and presenting the results. The studies published in English or Persian were searched in international databases, such as CINAHL, EBSCO, PubMed, ProQuest, The Cochrane Library, EMBASE, SAGE, Science Direct, and Google Scholar search engine, as well as national databases, including SID, MagIran, IranDoc, and the medical sciences theses search engine. Results: After reviewing and analyzing 54 studies (17 qualitative studies, 27 quantitative studies, 4 mixed-method studies, 4 review studies, and 2 guidelines), the definition, attributes, antecedents, and consequences of “professionalism in nursing” were stipulated. The attributes included academic specialized knowledge, continuous pursuit of competence, autonomy, professional commitment, professional interaction, accountability, adherence to ethical principles and values, and advocacy. The antecedents were personal/occupational, organizational, and social factors. The consequences were individual and social outcomes. Conclusion: The results of integrative review of the literatures showed professionalism in nursing has evolved and encompassed new attributes and dimensions. Due to the comprehensiveness of the provided conceptual model, it can be used to design a tool to evaluate the professional qualities of nurses in their jobs.