Preventive Care in Nursing and Midwifery Journal
Year:2024 | Volume:14 | Issue:4|Papers Count:8

Background: During the COVID-19 pandemic, nurses faced high levels of anxiety and moral distress. Nurses need moral courage to uphold proper moral performance. Objectives: This study aimed to compare the levels of anxiety, moral distress, and moral courage of nurses working in COVID-19 and non-COVID-19 wards. Methods: This descriptive comparative study was conducted on 107 nurses working in COVID-19 (n=53) and non-COVID-19 (n=54) wards at Zanjan University of Medical Sciences. Participants were selected using a convenience method. Data were collected using the Generalized Anxiety Disorder (GAD), Moral Distress Scale (MDS), and Professional Moral Courage (PMC) questionnaires. Data analysis was performed using descriptive and inferential statistics in SPSS 16 software. Results: The majority of participants in the study were female (66%) and married (54.7%). There was no statistically significant difference in the mean (SD) generalized anxiety score between nurses in COVID-19 and non-COVID-19 wards [5.51 (2.53) vs. 4.83 (2.50), p=0.168]. The comparison of the mean (SD) moral distress score in nurses in COVID-19 and non-COVID-19 wards did not show a statistically significant difference [1.48 (0.71) vs. 1.70 (0.58), p=0.078]. Similarly, no significant difference was found in the mean (SD) score of moral courage between the two groups caring for COVID-19 and non-COVID-19 patients [59.66 (8.28) vs. 60.46 (6.06), p=0.983]. Conclusion: The study reveals elevated generalized anxiety in COVID-19 ward nurses compared to non-COVID-19 counterparts. No significant differences in moral distress severity or moral courage highlight shared resilience and commitment, emphasizing tailored support for nurses in varied environments.

Background: The reopening of occluded arteries in myocardial infarction can be achieved through invasive and non-invasive methods. Objectives: This study aimed to determine treatment factors and outcomes comparison in acute myocardial infarction patients. Methods: This cross-sectional and retrospective study examined the hospitalization data of 252 myocardial infarction patients referred to Ayatollah Mousavi Hospital from April 2021 to March 2022. The patient's demographic and clinical data, factors influencing treatment intervention selection, and clinical outcomes were assessed. Data were analyzed using the Chi-square test/Fisher's exact test, multiple logistic regression analysis, and ANOVA in SPSS v.22 software. Results: Primary percutaneous coronary intervention (PPCI) comprised 45.6% of treatments, with thrombolytic therapy comprising 35.3%. Multiple regression analysis revealed that the availability of a 24/7 operational catheterization lab and immediate access to an on-call interventional cardiologist were significant predictors of treatment selection (P< 0.05). (P<0.05). The success rate of PPCI was 87.2% and thrombolytic therapy was 58.9%. Outcomes such as hospitalization length, analgesia dose, rehospitalization, and mortality rate over a year showed no significant statistical difference between the PPCI and thrombolytic groups (P>0.05). Conclusion: Access to equipment and specialized manpower is essential for PPCI. There were no complications or clinical outcomes that differed between patients treated with PPCI and thrombolytic therapy. Thrombolytic therapy remains a viable alternative to PPCI when timely intervention is not feasible.

Background: Labor is an important experience for women that affects them physically and emotionally. Women and their families need safety and a humanistic approach during labor. Measuring women’s perception of respectful maternity care provided in health facilities is important to provide holistic and humanistic care during labor. Objectives: This study aimed to evaluate the psychometric properties of the Turkish version of the respectful maternity care (RMC) scale. Methods: This methodological study was conducted on 150 postpartum women in Adana, Turkey from January to June 2021. Data were analyzed in SPSS v.22 and AMOS v.22 using suitable analysis methods.  Researchers studied the RMC scale for the reliability of language, content, construct, validity, and internal consistency. The validity analysis of the scale was examined using Confirmatory factor analysis (CFA). The Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Adjusted Goodness of Fit Index (AGFI) were used for confirmatory factor analysis. Results: The Turkish version of RMC has 12 items and three components.  An analysis of the new results indicated a three-factor structure with a Kaiser-Meyer-Olkin (KMO) value of .84 explaining 70.74% of the total variance. The results showed that the data had a good level of fit with the model, χ²/df = 2.148, CFI = .96, GFI = .92, NFI = .92, TLI = .94, RMSEA = .08.  Cronbach’s alpha of the scale was calculated 0.870. Conclusion: The Turkish version of the RMC scale is a valid and reliable scale for Turkish society.

Background: The COVID-19 pandemic significantly impacted educational systems, leading to the rapid adoption of distance education. This shift affected midwifery departments in Turkey, raising items about its appropriateness for such a practical discipline. Objectives: This study aimed to evaluate the attitudes of educators in Turkish university midwifery departments toward distance education during the pandemic. Methods: This cross-sectional study was conducted on 87 academic midwives in midwifery departments of universities in Turkey from June to December 2020. Data was collected online using a structured survey by a researcher. A survey was developed by trainers based on literature to understand the attitudes and opinions of the trainers towards distance education during the COVID-19 pandemic. Results: The mean (SD) age of participants was 36.13 (12.92) years and 12.64 (8.83) years of university teaching experience. A majority strongly disagreed that distance education suits midwifery curricula (36.8%), and 77% strongly disagreed with using distance education for practical courses. However, 27.6% were undecided on its suitability for theoretical classes. Conclusion: Most midwifery educators believe that distance education is not entirely suitable for teaching the midwifery curriculum. To increase the effectiveness of distance education, a hybrid education model should be adopted; theoretical courses should be conducted remotely, and practical courses should be conducted face-to-face. Digital simulations and virtual laboratories should be expanded to support practical training. Academicians should be trained on interactive methods to increase student participation, the infrastructure of universities' distance education systems should be strengthened, and access problems should be resolved.

Background: Currently, a significant number of women are becoming pregnant after the age of 35. Since advanced maternal age is recognized as a risk factor for adverse pregnancy outcomes and fetal complications, there is a heightened potential for increased anxiety and worry among those who become pregnant at older age. Prenatal counseling can play an important role in reducing anxiety and psychological distress, while also promoting the physical and mental well-being of expectant mothers. Objectives: The present study aimed to determine the effect of positive counseling on anxiety concerning giving birth to an infant with anomalies in pregnant women over 35 years of age. Methods: This randomized clinical trial was conducted on 46 pregnant mothers over 35. Participants were conveniently recruited and then randomly assigned to either the experimental or control group using block randomization. The study instrument was the Pregnancy-Related Anxiety Questionnaire (PRAQ; Vanden Berg, 1989). The experimental group received positive counseling in eight 70-90-minute virtual sessions. Data were analyzed using the Chi-square test, independent samples t-test, and covariance (ANCOVA) analysis in SPSS version 22. Results: The mean scores of anxieties concerning giving birth to an infant with anomalies before the intervention were 16.30 (6.47) in the experimental group and 12.13 (6.31) in the control group. An independent samples t-test revealed a statistically significant difference between the mean pretest scores of the two groups (p = 0.032). After the intervention, the mean scores of anxieties concerning giving birth to an infant with anomalies were 8.56 (4.65) in the experimental group and 13.34 (6.47) in the control group. An ANCOVA demonstrated a statistically significant difference between the mean post-test scores of the two groups (p < 0.001). Conclusion: Positive counseling reduces anxiety concerning giving birth to an infant with anomalies in pregnant women over 35 years of age.

Background: The rising prevalence of marital conflict and its detrimental impact on individual and family well-being underscores the urgent need for effective interventions. Objectives: This study aimed to investigate the effectiveness of self-differentiation training on family process and marital intimacy in couples with marital conflict. Methods: A quasi-experimental pre-test, post-test, and follow-up design was utilized. The study population comprised all couples residing in Ahvaz, Iran, aged between 20 and 45, who sought divorce counseling at psychological centers in 2023. A convenience sample of 30 couples was recruited. Participants completed the Family Process Scale and the Marital Intimacy Scale at baseline, post-intervention, and a 45-day follow-up assessment. The intervention consisted of eight weekly 90-minute self-differentiation training sessions. Data were analyzed using repeated-measures analysis of variance. Post-hoc comparisons were conducted employing the LSD test. Results: A significant increase in family process scores was observed between the pre-test and post-test assessments among couples experiencing marital conflict (p<0.001). Similarly, significant improvements in marital intimacy were found between the pre-test and both the post-test and follow-up assessments (P<0.001). These sustained effects at follow-up indicate the long-lasting impact of self-differentiation training. Conclusion: Self-differentiation training significantly improved family processes and marital intimacy in couples experiencing conflict, suggesting its effectiveness in addressing the core issues underlying marital discord. Therefore, mental health professionals and family therapists should consider incorporating self-differentiation training into their practice when working with couples experiencing marital conflict, particularly those considering separation or divorce.

Background: Adherence to treatment and regular physical activity in individuals with asthma will culminate in favorable clinical outcomes, including an effective disease management and an improved quality of life. Objectives: The present study aimed to determine the physical activity level and association with adherence to treatment and quality of life in individuals with asthma. Methods: This cross-sectional study was conducted on 505 individuals referring to the respiratory ward of Vali-e-Asr Hospital in Zanjan, Iran. Participants were selected using a convenience sampling method. Data were collected using the socio-demographic information form, the International Physical Activity Questionnaires (IPAQ), Modanloo Adherence to Treatment Questionnaire (MATQ), and the St. George's Respiratory Questionnaire (SGRQ). Data analysis was performed using descriptive statistics and the Kruskal-Wallis test in SPSS software version 16. Results: The majority of participants were male (57.2%) with a mean (standard deviation [SD]) age of 66.35 (15.33) years. The physical activity level of the majority of participants was vigorous (43.4%). The mean (SD) total scores for adherence to treatment and quality of life were 120.83 (8.92) and 35.42 (5.02), respectively. According to the findings, physical activity had no statistically significant association with adherence to treatment (p=0.535) and quality of life (p=0.173). Conclusion: In the present study, physical activity level was vigorous in asthmatic participants. Adherence to treatment among participants was at a good level, and quality of life was at a moderate level. Therefore, the design of supportive educational interventions is recommended to improve quality of life and promote lifestyle modification in individuals with asthma.

Background: Positive psychology can improve the quality of life of postmenopausal women. Objectives: This study was conducted to determine the effect of telephone counseling with a positive psychological approach on the quality-of-life of postmenopausal women. Methods: This randomized controlled trial was conducted on 70 eligible postmenopausal women (each group=35). The experimental group received eight telephone counseling sessions with a positive psychology approach. Data were collected using questionnaires (demographic characteristics, menopausal women's quality-of-life (MENQOL), and depression anxiety stress scale (DASS-21) on social media platforms (WhatsApp), before, immediately, and 2 months after the intervention. Data were analyzed using chi-square, independent t-test, Friedman, and Mann-Whitney tests in SPSS 16 software. Results: The mean (SD) of quality-of-life score two months after the intervention in the experimental group was 15.50 (7.62) and in the control group was 25.19 (12.19). The mean quality-of-life scores in the experimental group were lower than the scores of the control group. This significant difference remained in the experimental group until follow-up, two months after the intervention (P <0.001). Friedman's test also showed that the quality-of-life variable in the experimental group had a statistically significant change in different phases (P<0.001). According to the median scores, the quality-of-life has improved over time. Conclusion: Telephone counseling with a positive psychology approach can improve quality-of-life in postmenopausal women. Given this, it is recommended that positive interventions be used to promote mental health during menopause, among other methods to improve health.