Iranian Journal of Nursing and Midwifery Research最新文献

Background: Cancer and associated treatment methods present numerous complications, including anorexia and disturbances in sleep patterns. Consequently, the purpose of this study is to examine the impact of reflexology on the symptoms of anorexia and sleep quality among individuals afflicted with cancer.

Materials and methods: In this double-blinded randomized clinical trial, a total of 60 patients undergoing chemotherapy at Khansari Hospital, Arak, Iran, were selected using convenience sampling and then assigned to two groups of control and experimental using blocked randomization (30 patients in each group). The sample intervention group received reflexology in an exceedingly 4-week amount (two sessions a week), By contrast, the control group was administered a placebo treatment without exerting any pressure on the reflex points during the same time frame. Sleep quality and anorexia in patients were measured using a Pittsburgh questionnaire and visual analog scale before and right after the intervention. Eventually, the data were analyzed, and we used the tests of central tendency, dispersion, independent- and paired-samples t-tests, and Chi-square.

Results: The findings of the study revealed a significant improvement in sleep quality and reduction in anorexia symptoms among patients who received reflexology treatment scores (p < 0.001). Conversely, there was no significant difference in the control group before and after the intervention (without pressure effect on the foot points) (p > 0.05).

Conclusions: According to the positive effects on sleep quality and the reduction of anorexia symptoms, it is recommended to incorporate this therapeutic modality along with conventional medication for the treatment of individuals with cancer.

Background: Midwives are faced with important ethical issues in their professional lives; therefore, becoming a midwife is not only the acquisition of knowledge and skills but also includes acquiring moral values that cause fundamental changes in their attitudes toward their professional responsibilities. The aim of this study was to explore the process of professional ethics development in midwifery students.

Materials and methods: This grounded theory study was conducted from 2020 to 2022 at Mashhad University of Medical Sciences, Mashhad, Iran. The participants included 17 midwifery students and 14 key informants. They were selected through purposeful and theoretical sampling. Data were collected using semi-structured in-depth interviews, field notes, and theoretical notes until theoretical saturation was achieved. Data collection and data analysis were performed simultaneously. Data were analyzed based on the grounded theory presented by Corbin and Strauss (2014) using MAXQDA Analytics Pro 2020.

Results: The core category was "interactive-cognitive learning in a two-way reasoning path" which addressed the participants' main issue of moral numbness. Moral distress, interactive-cognitive learning, moral reasoning, and moral hopelessness were the midwifery students' strategies that led to a spectrum of moral internalization to moral burnout. The improper context of moral development was the context theme of this study.

Conclusions: The theory of "interactive-cognitive learning in the two-way path of reasoning" creates a deep understanding of the process of formation of professional ethics in midwifery students and it can be used in the effective training of students with the aim of promoting professional ethics in midwifery.

Background: One of the coping strategies in stressful situations effectively is resilience skills. Due to the coronavirus disease 2019 (COVID-19) pandemic and its resulting stresses, this study was conducted to determine the relationship between resilience and social and organizational support among nurses working with COVID-19 patients.

Materials and methods: A cross-sectional study was undertaken on 224 nurses working with COVID-19 patients in Iran in 2021. A demographic questionnaire, the Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, and Survey of Perceived Organisational Support were used for data collection. Data analysis was performed using descriptive and interpretive statistics (Pearson correlation coefficient test and linear regression).

Results: The mean [Standard Deviation (SD)] resilience score was 65.86 (14.01). In addition, the mean (SD) scores of organizational support and social support were 21.57 (4.46) and 65.10 (10.93), respectively. The Pearson correlation coefficient test results showed a statistically significant direct relationship between social support and resilience (r = 0.41, p < 0.001). In addition, there was a statistically significant relationship between organizational support and resilience (r = 0.16, p = 0.01). Multivariate linear regression analysis showed that for each unit increase in social support and organizational support scores, resilience scores increased by 0.41 (p = 0.01) and 0.15 (p < 0.001) units, respectively.

Conclusions: The results of the present study showed a direct relationship between resilience and social support and organizational support in nurses. Due to the prolongation of the COVID-19 pandemic and the high prevalence of the disease in our country, nursing managers should seriously consider measures to protect their staff.

Background: Syncope is among the most common paroxysmal disorders in children and adolescents. Vasovagal syncope is the most common syncope in children and adolescents. The aim of this study was to evaluate the impact of self-care recommendations with and without tilt training on the Quality of Life (QoL) of children and adolescents with syncope.

Materials and methods: This randomized controlled clinical trial was conducted in Isfahan, Iran, from April 2017 to June 2021 and included 120 patients with syncope. Eligible children and adolescents (aged 6-18 years) who met inclusion criteria were recruited by the simple sampling method and then assigned randomly into two groups. The intervention group (n = 60) received routine self-care recommendations such as dietary advice, behaviors to prevent syncope, and counter-pressure maneuvers along with tilt training, while the control group (n = 60) received self-care recommendations without tilt training. The education training included two face-to-face sessions, each of which lasted for 45-60 min. Then, both groups were followed up by telephone (once a month) for six months. A researcher-made self-care questionnaire and Pediatric Quality of Life Inventory (PedsQL™ 4.0) were completed for both groups before and after the intervention. Data were analyzed using descriptive and inferential statistical methods.

Results: The Wilcoxon test results showed a significant difference in the mean scores of physical functioning, emotional functioning, social functioning, school functioning, psychosocial functioning, understanding of health, and total QoL in the intervention and control groups before and after the intervention (p < 0.05). Also, the paired t-test results showed a significant difference in the mean scores of self-care domains and total self-care in the intervention and control groups before and after the intervention (p < 0.05).

Conclusions: Self-care recommendations with and without tilt training can improve QoL in children and adolescents with syncope.

Background: Postpartum Depression (PPD) is a serious depression that develops in the first year, with unknown explained reasons. Many studies evaluated the impact of Vitamin D (VD) levels on depression during pregnancy and postnatal. This narrative review aims to review any association between serum VD levels during pregnancy and the development of PPD.

Materials and methods: PPD data from published trials and research articles (period from 2012 to 2022) were assessed through PubMed, Scopus, Science Direct, and Google Scholar using the following terms: Depression, pregnancy, 25-hydroxyvitamin D (25OH VD), vitamin D deficiency (VDD) and postpartum (PP). Articles were selected manually and with careful tracking to avoid duplication. Articles that investigated any association between VD levels during pregnancy and PPD in the time frame were included in the study, while articles investigating VD levels of PP without depression were excluded.

Results: In this narrative review, five out of seven studies showed an association between PPD and VDD during pregnancy. Danish National Birth Cohort (DNBC), Edinburgh Postnatal Depression Scale (EPDS) and Center for Epidemiologic Studies Depression Scale (CES-D) enrolled among different studies from 3 days to 1 year PP to assess PPD.

Conclusions: Pregnant women with VDD are significantly associated with PPD. Longitudinal follow-up studies are needed to evaluate the association between VDD with PPD. Screening VD levels among pre-postnatal mothers may be essential for awareness programs that can be implemented to promote remission of postnatal depression.

Background: Metabolic syndrome is one of the emerging health issues in developing countries. It includes diabetes, high Blood Pressure (BP), obesity, and elevated blood cholesterol.

Materials and methods: This comparative study was conducted from March 2019 to February 2020 in selected areas of Ernakulam district, Kerala. The study used a quasi-experimental design with a nonequivalent control group. One-way analysis of variance and paired t-tests were used for statistical analysis. Women (aged between 35 and 55 years) with metabolic syndrome were recruited by multistage sampling (N = 220) and randomly assigned into three groups: (a) control, (b) Lifestyle Interventions (LI), and (c) Multi Interventional Therapy (MIT). LI was given to the LI group, and reflexology foot massage along with LI was given to the MIT group for 12 weeks. The control group received routine care. Physiological variables were assessed before and after the intervention.

Results: Women who received MIT and LI had significantly lower values of weight, Body Mass Index (BMI), and waist circumference after the treatment from baseline and compared with control (F = 12.09, 15.58, 22.37, p < 0.001). A remarkable change in systolic and diastolic BP was found in the MIT group (pretest mean of systolic BP and diastolic BP in control: 142.3 and 90.1, LI: 141.7 and 89.7, MIT: 141.8 and 89.8, p = 0.945, posttest means control: 142.6 and 90.4, LI: 131.5 and 85.5, MIT: 118.5 and 78.3, (F = 54.83, 57.87, p < 0.001).

Conclusions: Both LI and MIT should be considered as interventions for reducing the physiological parameters of metabolic syndrome, such as body weight, BMI, and obesity. MIT was found to be more effective in reducing blood pressure.

Background: As an epidemic, COVID-19 has brought a new shock to the world's healthcare system. The crisis caused by this disease and the prolonged involvement of communities and healthcare systems have intensified the duties and psychological burden of nurses. The current study aimed to explain the experience of ICU nurses during the COVID-19 crisis.

Materials and methods: The present study was conducted using conventional content analysis in 2021. Twenty nurses of the COVID-19 ICU of Ahvaz hospitals were selected by purposive sampling. The main method of data collection was semistructured interview. The process of data analysis was done based on Granheim and Lundman's approach using MAXQDA-2020. For the scientific rigor of the findings, Guba and Lincoln's four criteria were abided by. The COREQ (Consolidated Criteria for Reporting Qualitative Research) checklist was used to ensure the study met the recommended standards of qualitative data reporting.

Results: After data analysis, 22 subcategories, eight categories, and one theme (growth under pressure) were extracted. The eight main categories included (psychological crisis, physical exhaustion, family conflicts, complex care, professional development, expertise, life enrichment, and full support).

Conclusions: Despite the pressures that ICU nurses faced during the COVID-19 pandemic, they were able to grow by benefiting from positive experiences. These findings can lead to the development and implementation of effective interventions to improve adaptation strategies of nurses, especially those working in the intensive care unit, during the COVID-19 and other future crises.

Background: Quarantine during COVID-19 disease may be associated with psychological distress and other behavioral problems. This study aimed to investigate depression, anxiety, and stress in self-quarantined pregnant women at home for 14 days during the coronavirus disease outbreak in Iran.

Materials and methods: A cross-sectional web survey was carried out on 874 pregnant women in all governmental health centers of two cities in Iran using the census method in 2020-21. Survey data were collected with the Depression, Anxiety, and Stress Scale-21. Data were analyzed using descriptive statistics and analytical tests (Chi-square, Pearson's correlation coefficient, and logistic regression) at significance level less than 0.05.

Results: Approximately 40.04% (N = 350) of the participants were classified as a self-quarantine group. The mean (SD) of the stress score was higher for the quarantine group compared to nonquarantine (8.12 (4.95) vs. 5.96 (4.51)) (F_2,874 = 25.180, p < 0.001). But there was no significant difference in the depression and anxiety scores between the quarantine group compared to nonquarantine, respectively. Additionally, the adjusted odds ratio for stress score was associated with an unwanted pregnancy (1.993, 95% CI: 1.108-3.587; p = 0.021), younger age (1.707, 95% CI: 1.082-2.692; p = 0.022) and uninsured coverage (2.240, 95% CI: 1.320-3.801; p = 0.003), and complete quarantine (2.027, 95% CI: 1.548-2.654; p < 0.001).

Conclusions: Self-quarantine during the COVID-19 pandemic has been related to high-stress levels, specifically, among women of younger age, uninsured, and unwanted pregnancies. Thus, quarantined pregnant women will need more mental health support and medical supplies.

Background: Comprehensive palliative care for patients with heart failure can be developed by educating cardiac nurses. The current study aimed to design a heart failure palliative care educational program for nurses.

Materials and methods: This study was carried out using the multi-method approach based on two out of four steps of Uys educational program development at Dr. Chamran Hospital, Isfahan, in 2020-2021. In step 1, educational needs were collected through literature review, interviews with 15 patients and 10 nurses, examination of patients' documents and medical records, and observation. Then, in step 2, the importance and necessity of teaching the proposed topics and the teaching and evaluation method of the items were assessed through two rounds of delphi technique (15 expert panel members). Eventually, the educational program was finalized.

Results: In step 1, the educational needs of nurses were identified in 6 general fields and 26 general learning topics. In step 2, educational needs [specialized knowledge (55% necessity and 55% importance) and social support (33% necessity and 33% importance)], teaching methods (role-playing, experiential learning, and journal club), and evaluation method (the information analysis method) were removed due to a lack of consensus (11%). Finally, the main parts of the program, including the program mission and vision, general learning topics, general goals, objectives, teaching strategies, and evaluation strategies, were compiled.

Conclusions: This program provides nurses with up-to-date information on various aspects of the physical, psychological, social, spiritual, and educational needs of heart failure patients and ensures the provision of better services to them.