JOURNAL OF MIDWIFERY & REPRODUCTIVE HEALTH
Year:2014 | Volume:2 | Issue:2|Papers Count:8

Background & aim: Grounded theory has taken some different theoretical perspectives since its creation in 1967 by Barney Glaser. Considering that applying grounded theory partly depends on an awareness of its philosophical perspectives, gaining knowledge about these various perspectives is required for health care professionals who are interested in studying the social processes. This review was conducted to provide an understanding of the evolution of philosophical backgrounds of grounded theory.Methods: Relevant literature focused on constructivist or objectivist grounded theory were retrieved from MEDLINE, ISI and Scopus databases, bibliographies of obtained articles as well as related books. The identified data were critically reviewed from the viewpoint of the different types of philosophical backgrounds of grounded theory approach.Results: Grounded theory has two different perspectives. Objectivist grounded theory is rooted in post-positivist epistemology; whereas constructivist grounded theory has its roots in an interpretive tradition and relativism. The Glaserian approach is an objectivist grounded theory and based on etic position, where the researcher is separate from and looks at the social realities. However, the Straussian approach is a constructivist grounded theory and based on emic position, where the researchers co-construct the data through adopting a position of mutuality and partnership between participant and researcher and create the theory of a social process using their own perspectives, values, privileges, interactions and understanding of the social realities.Conclusion: Adopting an appropriate grounded theory approach by health care professionals depends on understanding of the philosophical foundations of the social processes and structures.

Background & aim: Giving improper prescriptions is common among medical practitioners, mostly graduates, in most communities even developed countries. So far, to our knowledge, no study has been conducted on prescription writing of graduate midwifery students. Therefore, this study aimed to detect prescription writing errors of midwifery students in common gynecological problems.Methods: In this descriptive cross-sectional study, 56 bachelor midwifery students, who had passed the theoretical and clinical courses of gynecology, were evaluated by Objective Structured Clinical Examination (OSCE). A demographic questionnaire and a standard checklist for writing the prescriptions and medications were used for data collection. SPSS Version 16 was used to carry out descriptive statistics.Results: Most of the students were single, with the mean age of 23.0±1.7 years. Most errors were related to not recording the patients’ age and sex, diagnosis, chief complaint, and the prescriber’s name (observed in less than 10% of the prescriptions). The complete dosage schedule and drug name were stated only in 1.8±4.8 and 14±18.6 of prescriptions, respectively. In more than 93% of the cases, route of use and treatment duration were not recorded.Conclusion: According to the results, the number of prescription errors of midwifery students was high. Therefore, it is recommended to run educational courses on prescription writing skills (e.g. writing prescriptions based on World Health Organization (WHO) guidelines) for the midwifery students.

Background & aim: The stress resulting from premature delivery and the related neonatal care induces psychological and physical pressure on the mothers, and adversely affects their feeling of comfort. It seems that spiritual care as a sort of communication with a higher power (God) can bring peace to the stressed mothers, and prevent anxiety. Therefore, this study was designed to evaluate the effects of spiritual self-care training on feeling of comfort in mothers of preterm infants, hospitalized in the neonatal intensive care unit (NICU).Methods: In this randomized clinical trial, 60 mothers of preterm infants hospitalized in NICU of Omolbanin and Ghaem hospitals, Mashhad, Iran in 2013, were selected, using convenience sampling, and were randomly assigned to intervention and control groups. In order to familiarize the mothers with their infants’ condition, the mothers in both intervention and control groups were informed and trained for 15 minutes every day, over a 14-day period. The intervention group, in addition to infant-related information, received spiritual self-care training for 45 minutes in 6 sessions, every other day. Before and after each session of self-care training, the mothers filled a self-structured questionnaire related to feeling of comfort resulting from spiritual care. Data were analyzed using SPSS version 16, by repeated measures analysis of variance (ANOVA), t-test, and Chi-square tests.Results: According to the results, the total mean of maternal feeling of comfort was 50.0±4.3 and 55.6±3.3 before and after the intervention, respectively. The results of t-test indicate that comfort significantly increased after the intervention (P=0.000).Conclusion: Based on the results of this study, spiritual self-care training increases the feeling of comfort in mothers with premature infants, hospitalized in NICU.

Background & aim: Postpartum period is often associated with decreased marital satisfaction in couples. The present study aimed to investigate factors contributing to marital satisfaction in primiparous women during postpartum period.Methods: This correlational study was performed on 104 primiparous women who referred to health care centers, Mashhad, Iran in 2013, 8 weeks after delivery, to receive health care services. Convenient sampling was the method of choice, and data collection tools included Nathan H. Azarin marital satisfaction questionnaire, stress, anxiety and depression scales (DASS-21), and demographic and fertility-related questionnaire. Data were analyzed using SPSS version 16, and statistical tests of Kruskal-Wallis and Pearson correlation coefficient.Results: The mean score of women’s marital satisfaction was 65.37±17.4. There was a significant inverse correlation between duration of marriage (r=-0.246, P=0.01), women’s age (r=-0.203, P=0.03) and husband’s age (r=-0.219, P=0.02) with marital satisfaction. Also a significant relationship was seen between the onset of sexual intercourse after childbirth (r=0.268, P=0.006) and frequency of intercourse per week (P=0.001) with marital satisfaction. Additionally, there was a significant inverse correlation between depression (r=-0.414, P=0.001), anxiety (r=-0.27, P =0.004), and stress (r=-0.203, P=0.03) with marital satisfaction.Conclusion: The age of women and their spouses, the duration of marriage, the onset and frequency of sexual intercourse after delivery, stress, depression, and anxiety are factors contributing to females’ marital satisfaction in postpartum period. As marital satisfaction affects the health of couples and families, it is therefore recommended to increase females’ marital satisfaction during the postpartum period through recognizing the related factors and planning appropriate interventions.

Background & aim: Factors such as weight, diet, cigarette smoking and unprescribed drug use, and also environmental pollutants affect maternal health and the birth of the healthy neonates. The aim of this study was to investigate women's lifestyle during the preconception period in Kalat, Iran.Methods: This descriptive, cross-sectional study was conducted on 118 married women, who did not use any contraceptive methods in order to get pregnant, from August to March 2012, in Kalat County, Iran. The subjects were covered by Kalat medical and health centers and were selected using quota sampling method. The data were collected using a questionnaire including demographic characteristics and preconception lifestyle. The collected data were analyzed using SPSS and Pearson’s correlation and ANOVA tests. P<0.05 was considered statistically significant.Results: The mean age of the subjects was 25.2± 6.05 years. The most desirable and undesirable aspects of lifestyle were not using of unprescribed drugs and cigarettes (7.38±0.9) as well as lack of physical activity (3.06±1.1), respectively. There was a significant correlation between women’s occupation and drug and cigarette use (P<0.049). In addition, there was a negative correlation between the number of live births and physical activity (r=-0.291, P=0.001). More than half of women (53.4%) had no preconception care, and only 33.9% of females who received preconception care had taken folic acid supplements regularly.Conclusion: Women's lifestyle was not desirable in relation to physical activity, and the majority of women had irregular consumption of folic acid supplements. It is therefore suggested to train women who have decision for pregnancy to do preconception care to take good care of her health before being pregnant.

Background & aim: Menopause refers to the cessation of menstruation due to hormonal changes and ovarian inactivity in women. These changes in hormone levels lead to various health consequences. This period of physiological change usually starts in women with 40-50 years of age, and is characterized by the reduction of estrogen level. The mortality rate of premenopausal women, due to cardiovascular diseases (CVDs), is one fifth of men, though it rapidly increases after the menopause. Therefore, this descriptive study was conducted in order to determine the cardiovascular risk factors for menopausal and non-menopausal women in comparison with men of the same age.Methods: The study sample included patients referring to the cardiology department of Imam Reza Hospital, Mashhad, Iran. The subjects were divided into 4 groups: non-menopausal women (n=35), men of the same age (as the non-menopausal women, n=35), menopausal women (n=50), and men of the same age (as the menopausal women, n=50). All criteria related to major cardiovascular risk factors including systolic and diastolic blood pressure (SBP and DBP), cholesterol, triglyceride (TG), and low and high-density lipoprotein (LDL and HDL) were measured and compared in all four groups. In order to analyze the data, Fisher's exact test was carried out, using SPSS version 16.Results: There was a significant difference between non-menopausal women and men of the same age with regard to high SBP and DBP, hypercholesterolemia, low HDL, and high LDL. However, no significant difference was observed among these groups, regarding high levels of TG. The menopausal women and men of the same age showed significant differences in terms of high SBP and low HDL. However, no differences were observed in DBP, hypercholesterolemia, hypertriglyceridemia, and high LDL.Conclusion: Menopausal women, non-menopausal women, and men had significant differences in terms of high SBP and low HDL. However, regarding high DBP, hypercholesterolemia, and high LDL, there was a significant difference only between non-menopausal women and men of the same age.

Background & aim: Primary dysmenorrhea is defined as painful menstruation in the absence of any confirmed pelvic disease. Its incidence has been estimated between 50-90% in different communities. Non-steroidal anti-inflammatory drugs (NSAIDs) and contraceptives are usually prescribed for the treatment of primary dysmenorrhea; however, they lead to several specific complications. Due to the importance of this issue, some studies have been performed on medications with fewer side effects. This study aimed to compare the therapeutic effects of vitamin E and vitamin B1 on pain severity and duration in primary dysmenorrhea.Methods: This randomized clinical trial was conducted on 90 female students of Ferdowsi University of Mashhad, Iran, who met the inclusion criteria. At first, the participants, whose pain score of Visual Analogue Scale (VAS) was less than 40 during their three last menstrual cycles were excluded from the study; then, the rest of the participants were randomly assigned to two groups. The treatment was started by administrating vitamin B1 100mg/day for the first group (vitamin B1 group) and vitamin E 400unit/day for the second group (vitamin E group). Finally, the two groups were compared in terms of the severity and duration of pain in dysmenorrhea.Results: As to the findings, the mean age of the participants was 22.97±3.23 years. There was a significant difference between the pre- and post-treatment periods in terms of pain severity (P<0.001 & P=0.002, respectively) and pain duration (P=0.001 & P<0.001, respectively) in both groups; however, no significant difference was observed between the two groups regarding the mean of pain severity and duration (P=0.739 & P=0.102, respectively).Conclusion: It is recommended that vitamin E and vitamin B1 be used for the treatment of primary dysmenorrhea.

Horseshoe placenta is a variant of ring-shaped placenta. Ring- shaped placenta is a rare anomaly seen in fewer than 1 in 6000 deliveries, which could be seen as horseshoe shape due to atrophy in a portion of the ring. This report refers to a possible relationship between the horseshoe shape placenta and preterm labor; although it has not been yet validated in the literature. In this case report we present the placenta of a 35 years-old G2L1 woman who was referred to delivery unit of Shohada Hospital in Ghouch, Iran with starting of labor pain at 34 weeks of gestation who gave birth to a live-born female baby with 6/8 APGAR score. The amniotic fluid was meconium-stained. The patient had no evidence of fever, bleeding, infection. It is concluded that due to the risks to the fetus and mother caused by horseshoe placenta, its timely diagnosis during pregnancy using ultrasound is important and leads to early detection and better management of pregnancies complicated with placental abnormalities.