JOURNAL OF NURSING AND MIDWIFERY SCIENCES
Year:2025 | Volume:12 | Issue:4|Papers Count:12

This article has no abstract regards to the type of article

Background :Knee osteoarthritis is a prevalent condition among the elderly, often necessitating total knee replacement surgery, which can impact psychological well-being and resilience during recovery. Understanding the trajectory of these psychological factors is essential for optimizing postoperative care and promoting successful aging. Objectives :This longitudinal study aimed to evaluate trends in self-assessed psychological well-being and resilience among elderly patients following knee replacement surgery. Methods :This research is a longitudinal study. A total of 432 elderly adults (aged 60 - 74 years) undergoing unilateral or bilateral knee replacement surgery at Shafa Yahyaian Hospital, Iran, were assessed at discharge, one month, and three months post-surgery. Psychological well-being was measured using the Reef Psychological Well-being Questionnaire, and resilience was assessed by the Brief Resilience Scale. Data were analyzed using repeated measures ANOVA and other appropriate statistical tests. Results :Psychological well-being significantly improved from discharge to one month and three months post-surgery (P < 0.001), with no significant difference between the one- and three-month assessments. All six dimensions of psychological well-being (autonomy, environmental mastery, personal growth, positive relationships, purpose in life, and self-acceptance) demonstrated significant positive changes over time, except for purpose in life, which showed a different pattern. Resilience scores also increased significantly over time, peaking at three months post-surgery (P < 0.001). No significant associations were found between psychological measures and demographic characteristics such as age, gender, or education. Conclusions :Psychological well-being and resilience improve significantly during the first three months following knee replacement surgery in elderly patients. These findings underscore the importance of integrating psychological assessments and resilience-building strategies into postoperative nursing care and discharge planning to support holistic recovery and healthy aging.

Background :Due to the nature of nurses’ work, they play a crucial role in promoting community health, and job motivation is one of the key factors influencing the quality of their work. The impact of positive psychology on organizational success and job performance has been demonstrated in several studies. This research is significant because it provides crucial insights into actionable strategies for organizations seeking to enhance employee well-being, productivity, and overall competitive advantage. Objectives :The present study aimed to determine the effectiveness of group training in positive psychology on nurses' job motivation. Methods :This non-randomized controlled trial was conducted in 2021 at Imam Reza Hospital Complex in Kermanshah, Iran. The study sample included 64 nurses who met the inclusion criteria; they were selected by simple random sampling and equally divided into control and intervention groups. The intervention group received seven weekly 120-minute online group positive-psychology counseling sessions. The data collection tool was the Herzberg Job Motivation Questionnaire, which was completed by all participants as a self-report before the intervention, immediately after, and one month after the intervention. The collected data were analyzed using SPSS software version 21 and appropriate statistical tests (independent t-test, Pearson correlation, analysis of variance (ANOVA), chi-square test, Mann-Whitney U test, and Kruskal-Wallis test). Results :The assessment and comparison of nurses' job motivation before, immediately after, and one month following the intervention revealed no statistically significant differences in overall job motivation or any of its dimensions within the control group (P > 0.05). In the intervention group, however, job motivation was significantly lower before the intervention compared with both immediately after (P ≤ 0.001) and one month after the intervention (P ≤ 0.001). Moreover, job motivation immediately after the intervention was significantly higher than one month later (P < 0.02). Based on the findings, job motivation and its dimensions did not differ significantly between the intervention and control groups at baseline, but differences were significant both immediately and one month after the intervention. The mean score of job motivation and all its dimensions (except salary and wages) in the intervention group was significantly higher than in the control group (P ≤ 0.001). Conclusions :The results indicate that positive psychology training was effective in increasing nurses' job motivation. Therefore, implementing programs that focus on positivity as a strategy to improve nurses' performance and the quality of care appears useful and necessary.

Background :Type 2 diabetes mellitus (T2DM) imposes a significant psychological burden, with depression and limited social support prevalent among patients, adversely affecting self-care and quality of life. This study evaluated the efficacy of interpersonal therapy (IPT), a structured psychotherapy targeting interpersonal stressors, in improving depressive symptoms and perceived social support in T2DM adults. Objectives :The present randomized controlled trial (RCT) aimed to determine the efficacy of IPT in improving perceived social support and depressive symptoms among adults with type 2 diabetes. By doing so, the study seeks to contribute to a more holistic understanding of diabetes care and offer practical implications for integrating psychotherapeutic approaches into chronic disease management. Methods :In a RCT conducted in Tehran, Iran, in 2025, 110 adults aged 18 - 65 with T2DM and mild-to-severe depressive symptoms [Beck Depression Inventory-II (BDI-II) ≥ 14] were assigned to receive 10 weekly IPT sessions or standard care using simple randomization. Certified therapists delivered IPT, focusing on interpersonal stressors such as role disputes and transitions. Outcomes were measured using the Multidimensional Scale of Perceived Social Support (MSPSS) and BDI-II at baseline (T0), post-intervention (T1), and two-month follow-up (T2). Data were analyzed using repeated-measures analysis of variance (ANOVA) and linear mixed-effects models (LMMs), with intention-to-treat (ITT) analysis addressing a 5.45% attrition rate; gender and marital status were explored as moderators. Results :The intervention group (n = 51) significantly improved MSPSS scores from T0 to T1 (P < 0.001) and T2 (P = 0.002), while BDI-II scores decreased from T0 to T1 (P < 0.001) and T2 (P < 0.001). The control group (n = 53) showed declining MSPSS scores from T0 to T1 (P = 0.017) and T0 to T2 (P = 0.013), with minimal BDI-II change (P = 0.614). Significant time-by-group interactions were observed for MSPSS (P < 0.001) and BDI-II (P < 0.001), with between-group Cohen’s d = 0.63 - 1.08. Females and married participants showed greater improvements in both outcomes (P = 0.031 for MSPSS, P = 0.021 for BDI-II). The LMMs confirmed these findings, and no baseline group differences existed (P > 0.05). Conclusions :The IPT significantly enhanced perceived social support and reduced depressive symptoms in T2DM adults, with sustained effects at T2, particularly for females and married individuals. These findings support integrating IPT into T2DM care to address psychosocial challenges, with future research needed to explore physiological impacts and long-term outcomes.

Background :The onset of natural menopause is a multifactorial biological milestone influenced by a dynamic interplay of genetic predisposition, environmental exposures, and socio-economic conditions. Accurately identifying the average age of menopause and its principal determinants is vital for anticipating age-related health risks and tailoring preventive strategies in women's healthcare. Objectives :This study aimed to determine the mean age at natural menopause and to investigate key environmental, biological, and lifestyle-related predictors influencing menopausal timing among women in Kerman province, Iran. Methods :A descriptive cross-sectional study was conducted in 2023 involving 265 women aged 35 to 70 years residing in Kerman province. Data were collected through systematic random sampling using a comprehensive checklist that included demographic information, reproductive and obstetric history, lifestyle behaviors, and socio-economic status. Statistical analyses were performed to assess associations between menopausal age and potential predictive variables. Results :Participants’ mean age was 40.81 ± 9.09 years with a mean menopause age of 55.4 ± 7.61 years. Multivariable analysis revealed that longer menstrual bleeding (OR = 1.26, P = 0.032), higher maternal menopausal age [odds ratios (OR) = 1.48, P = 0.021], and older participant age (OR = 1.63, P < 0.001) significantly increased the likelihood of menopause, highlighting key predictors of delayed menopausal onset. Conclusions :This study identifies maternal menopausal age and menstrual traits as primary factors influencing menopause timing in southeastern Iranian women, with limited impact from socioeconomic and lifestyle factors. Regional differences stress the importance of localized research. Despite limitations, the findings call for larger, longitudinal studies to improve midlife women's health interventions.

Background :Individual health responsibility is especially important during biological events, as it can lessen their impact and enhance community health. Objectives :The present study explores factors affecting individual health responsibility among non-medical students facing the COVID-19 pandemic. Methods :A qualitative content analysis was conducted based on Graneheim and Lundman’s approach. The study included non-medical students from various fields, including engineering, psychology, economics, management, arts, and agricultural sciences, who experienced the COVID-19 pandemic. Participants were purposively selected based on first-hand experience, willingness to participate, and share insights. Participant withdrawal constituted the exclusion criterion. Semi-structured in-depth interviews (18 participants, 45 - 60 minutes each) were conducted and analyzed selectively. The validity of the findings was ensured following Lincoln and Guba’s criteria. Results :The analysis of interview data from 6 male and 12 female participants with bachelor’s, master’s, and doctoral degrees (mean age = 34.88 years) revealed four primary thematic categories: (1) The debilitating nature of COVID-19; (2) socio-cultural challenges; (3) individual capacity; and (4) community health infrastructure. Conclusions :The results indicate that various factors influence individual health responsibility during biological events, particularly the nature of these events and social dynamics. Understanding these factors can help policymakers enhance positive influences and address barriers. Future research should focus on modifying these influential factors.

Background :Preterm birth (PTB) is a leading cause of perinatal mortality. Identifying women at high risk of PTB and implementing effective prevention strategies are essential for improving neonatal outcomes. Objectives :The present study aimed to evaluate the effectiveness of vaginal progesterone in reducing PTB among pregnant women with an increased uterocervical angle (UCA). Methods :In this randomized clinical trial conducted at Imam-Khomeini Hospital Complex, Tehran, Iran, from January to December 2024, fifty-two pregnant women between 18 and 20 weeks of gestation with cervical length (CL) ≥ 30 mm and a UCA > 105° were enrolled. Participants were randomly assigned to an intervention or control group using a simple randomization method. The intervention group received 400 mg of vaginal progesterone suppositories daily from 18 - 20 weeks until 36 weeks of gestation, while the control group received no progesterone. Statistical analyses included descriptive statistics, independent t-test, chi-square or Fisher’s exact test, and regression analysis. Results :The intervention group had a significantly higher mean gestational age at delivery (269.7 ± 8.6 days) compared to the control group (262.0 ± 15.4 days; P = 0.031). The incidence of PTB was significantly lower in the intervention group (7.7%) versus the control group (34.6%; P = 0.038). Regression analysis indicated that progesterone administration was associated with a significantly reduced risk of PTB (OR 0.14, 95% CI 0.02 - 0.79, P = 0.026). Conclusions :Vaginal progesterone may serve as an effective prophylactic intervention to reduce PTB in women with a normal CL but increased UCA. It is a safe, accessible, and affordable strategy for PTB prevention in this subgroup.

Background :Hope and meaning in life influence medication adherence among the elderly with chronic conditions, including hypertension. The purpose of this study was to examine the association between hope and meaning in life and medication adherence in the elderly with hypertension. Objectives :The aim of this study was to investigate the relationship between hope and meaning in life and medication adherence in older adults with hypertension. Methods :The current study was a cross-sectional descriptive-correlation study on 200 senior adults with hypertension who were referred to health centers in Mahmoudabad city by a multi-stage cluster sampling method. The Morisky Medication Adherence Scale, the Meaning in Life Questionnaire (MLQ), and the Snyder Hope Questionnaire (SHQ) were used to collect data. Results :The average age of the elderly participants was 68.5 ± 7.08 years. Among them, 32.5% demonstrated strong medication adherence, 32% had moderate adherence, and 35.5% showed poor adherence. The mean scores indicated moderate levels of hope and medication adherence, while meaning in life was rated high across all dimensions. After controlling for demographic and socioeconomic factors, hope and meaning in life were found to be directly associated with medication adherence. Specifically, a one-point increase in hope was associated with a 1% higher probability of medication adherence [odds ratio (OR) = 1.01, P = 0.049], and a one-point increase in meaning in life was associated with a 1% increase in adherence probability (OR = 1.01, P < 0.001). Additionally, medication adherence showed a positive and moderate correlation with both hope and meaning in life. Conclusions :The study's findings underscore the necessity of incorporating psychological support into the nursing care of older patients with hypertension. Nurses may improve medication adherence and overall health outcomes for older people with hypertension by instilling hope and meaning in their lives.

Background :Pain and bleeding are common complications among patients undergoing open thyroidectomy. Research suggests that complementary treatments, such as massage therapy, may help reduce postoperative complications. Therefore, this randomized controlled clinical trial aimed to evaluate the effect of massage on pain and bleeding in patients undergoing open thyroidectomy. Objectives :The present study was conducted with the aim of determining the effect of massage on pain and bleeding in patients undergoing open thyroidectomy in the operating room of a selected hospital affiliated with Isfahan University of Medical Sciences during the year 2023 - 2024. Methods :This randomized controlled clinical trial was conducted on 44 patients referred to Al-Zahra Hospital of Isfahan, Iran, between October 2024 and April 2025, all of whom underwent open thyroidectomy. The participants were randomly assigned to either the control or experimental group (22 patients each). In the experimental group, massage therapy was performed by the researcher. In this group, three massage therapy sessions were performed: In the recovery room, on the first postoperative day, and on the third postoperative day. The duration of each massage therapy session was 15 to 20 minutes. Pain was assessed using the Visual Analog Scale (VAS). Bleeding was evaluated based on the volume of drainage and the amount of blood in the hemovac drain in both groups. Hemoglobin and hematocrit levels were recorded from the patient's medical records prior to surgery and again at 24 and 48 hours postoperatively. Data were analyzed using SPSS version 23. Statistical tests, including repeated measures analysis, independent t-test, and chi-square test, were used to compare the results between the groups. Results :The findings indicated that changes in the mean pain score varied over time, with a significant reduction in pain observed in the experimental group (P < 0.001). Prior to the intervention, the mean pain score was 8.75 ± 0.23 in the experimental group and 8.80 ± 0.23 in the control group, with no statistically significant difference between them (P = 0.88). However, at the assessed time points following the intervention, the difference became significant (P < 0.001). Additionally, there was no statistically significant difference in the volume of blood collected in the drain at 24 (P = 0.79) and 48 hours (P = 0.93) post-surgery between the intervention and control groups, suggesting that the intervention had no effect on postoperative bleeding. Conclusions :The present study demonstrated that massage therapy significantly reduced pain in patients undergoing thyroidectomy. However, it did not affect the volume of bleeding, including drain secretions, hemoglobin levels, or hematocrit. Given the limited sample size, further research on a larger population is recommended.

Context :Previous studies have introduced telemedicine as a cost-effective and accessible approach for managing male sexual dysfunction (MSD). However, existing evidence remains fragmented and lacks a systematic synthesis regarding the efficacy of these interventions across different types of dysfunctions. Methods :This study is a systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive literature search was performed using Scopus, Web of Science (WOS), PubMed, ScienceDirect, and Google Scholar for studies published from 2006 to January 30, 2025. A structured, population, intervention, comparison, and outcome (PICO)-based search strategy was used to comprehensively evaluate the relevant literature. Various telemedicine delivery methods, including web-based platforms, phone consultations, video conferencing, and mobile applications, were considered. The primary assessed outcomes included sexual satisfaction and overall sexual function. Studies were selected based on predefined inclusion criteria: Randomized controlled trials (RCTs) assessing sexual satisfaction or overall sexual function in adult men. Exclusion criteria encompassed studies without original data, reviews, protocols, quasi-experimental studies, and those focusing on female sexual dysfunction or non-telemedicine interventions. The quality and risk of bias (RoB) of the included studies were assessed using the Critical Appraisal Skills Programme (CASP) checklist for randomized studies and the RoB tool. Results :A total of 286 studies were initially identified through database searches, of which 10 met the inclusion criteria after screening. These 10 studies were conducted in the USA (n = 1), Iran (n = 2), Australia (n = 2), Italy (n = 1), Germany (n = 1), the Netherlands (n = 1), and Sweden (n = 2). Most studies reported significant improvements in erectile function [in men with erectile dysfunction (ED)], sexual satisfaction, as well as reductions in premature ejaculation (PE, in men with PE) and enhancement of sexual self-confidence. However, the magnitude and specific outcomes varied across studies due to differences in intervention types and study populations. The interventions included therapeutic treatments, self-help programs, and consultative services delivered via various telemedicine platforms. Conclusions :Telemedicine demonstrates significant potential in improving key aspects of MSD, particularly erectile function and sexual satisfaction. Despite variability in outcomes across different intervention approaches, findings consistently support telemedicine as an effective alternative to conventional care. Future research should focus on standardizing intervention protocols and exploring long-term efficacy.

Background :Health literacy is a key factor influencing how young people adopt coronavirus disease 2019 (COVID-19) preventive behaviors. Investigating this relationship is essential to protect youth, guide effective public health interventions, and strengthen resilience in future pandemics. Objectives :The study aimed to investigate the relationship between health literacy and preventive behaviors among rural youths in Thailand. Methods :This study employed a descriptive cross-sectional design and was conducted between December 2023 and May 2024. The sample consisted of 373 youths residing in rural areas of Samut Songkhram province, Thailand. Stratified random sampling was used, with educational institutions serving as the sampling units. Two schools were randomly selected from each of the province’s three districts — totaling six schools — using simple random sampling. Data were collected through an online questionnaire (via Google Forms), which consisted of three parts. The data were analyzed using descriptive statistics and Pearson’s correlation coefficient. Results :The results showed that 60.9% of the participants were female, and the majority were 17 years old, accounting for 21.7%. Most participants had previously been infected with COVID-19, representing 70.0%, and the majority had received two full doses of the COVID-19 vaccine, totaling 91.4%. In addition, 50.9% of participants demonstrated a good level of health literacy, while 46.4% exhibited good preventive behaviors against COVID-19. Furthermore, a statistically significant positive correlation was found between health literacy and preventive behaviors (R = 0.783, P < 0.001). Conclusions :The findings of this study can inform planning efforts aimed at enhancing health literacy and promoting preventive behaviors against COVID-19, including the development of targeted programs or activities for rural youths.

Background :Accurate diagnosis of urinary tract infection (UTI) in infants requires a minimally contaminated urine sample. Urine-collection bags are noninvasive but prone to contamination; invasive methods reduce contamination but cause discomfort. Quick-Wee, a stimulation-based clean-catch technique, may offer a faster, cleaner alternative. Objectives :To compare microscopy-defined urine contamination — white blood cells (WBCs), red blood cells (RBCs), epithelial cells, and bacteria as primary outcomes — and collection time and caregiver satisfaction as secondary outcomes, between Quick-Wee and urine-bag collection in infants using a within-subject crossover design. Methods :We conducted a randomized two-period, two-sequence (AB/BA) crossover study. Each infant provided two samples about 6 hours apart within one shift. Sequence (Quick-Wee → bag or bag → Quick-Wee) was assigned via a computer-generated list and sealed, opaque, sequentially numbered envelopes. A single trained pediatric nurse collected all samples per standard operating procedure (SOP); diapers were changed, and the peri-urethral/genital area was washed and dried before each attempt. Laboratory staff were blinded to method/sequence; samples bore anonymized codes. Primary outcomes were quantitative microscopy counts [cells/high-power field (HPF) or semi-quantitative categories]; secondary outcomes were time to collection (minutes) and caregiver satisfaction (5-point Likert). Results :Versus urine-bag collection, Quick-Wee yielded lower counts of WBC (-1.19; P < 0.001), RBC (-0.32; P = 0.007), and epithelial cells (-1.78; P < 0.001); bacterial counts did not differ (P = 0.096). Collection time was markedly shorter with Quick-Wee (10.7 ± 8.9 vs. 52.4 ± 10.3 minutes; difference -41.7; P < 0.001). Caregiver satisfaction was higher with Quick-Wee (median 5 vs. 3; P < 0.001). Conclusions :Quick-Wee is a rapid, noninvasive method that reduces several microscopy-defined contamination indices, substantially shortens collection time, and improves caregiver satisfaction compared with urine-bag collection, with no significant difference in bacterial counts. Findings support Quick-Wee as a pragmatic first-line option for infant urine collection.