Advances in Nursing & Midwifery

Background and aim

With respect to the prevalence and complications of premature rupture of chorionic membranes (PROM) and the importance of correct and on-time detection of the disorder with false positive or negative results, accurate as well as noninvasive diagnostic procedures are always needed.This case-control study was conducted to identify the diagnostic power of qualitative evaluation of beta human chorionic gonadotropins (ßHCG) in cervicovaginal discharge with 1-step test strips (25 IU/ml) for detecting PROM in women referring to Vali-e-Asr Hospital at Zanjan city in 2007.  

Materials and methods

86 singletons between 14 and 41 weeks of gestation were selected. Data collection tools included a form for demographic information as well as gestational history and an observation checklist for speculum examination and tests of Fern, nitrazine and qualitative strip for ßHCG. Of women with amniotic fluid leakage, subjects were examined in 2 43-person groups including those with definite PROM (direct observation with speculum [+], Fern test [+] and nitrazine test [+]) in case group and those with intact membranes (direct observation with speculum [-], Fern test [-] and nitrazine test [-]) in control group. Subjects were matched in terms of gestational weeks in the two groups.

Cervicovaginal discharge samples were taken by rinsing posterior fornix with 5ml saline and aspiration of fluid. ßHCGs were then tested by 1-step gestational strips.    

Findings

It was found that sensitivity, specificity, positive as well as negative predictive values and accuracy of the strips were 97.7%, 88.4%, 89.4%, 97.5% and 93%.

Conclusion

It seems that the diagnostic power of qualitative evaluation of ßHCGs in cervicovaginal discharge to detect PROM is acceptable.

Keywords: Premature rupture of membranes (PROM), Beta human chorionic gonadotropins

                  (ßHCGs), Cervicovaginal discharge, Diagnostic power.

^*Corresponding Author: Kariman, N; Lecturer, Dept. of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Shariati, Tehran, Iran;

Email: n_kariman@yahoo.com

Background and aim

Mammography is a method for screening cancer. Although its results usually show benign conditions, it is associated with known anxiety and depression in women during the procedure. This can affect on their desire to seek for checkups and assistance.This clinical trial was conducted to determine the effects of instruction and preparation on the anxiety of women referring to Izadi Mammography Center in Qom city.

Materials and methods

160 women referring to the center for the first time were selected by convenience sampling method and randomly divided into 2 experimental and control groups. A demographic questionnaire and Beck’s anxiety inventory were used for data collection. Anxiety levels of the 2 groups were measured and compared before and after instruction and preparation phase. Different statistical tests were used for data analysis.

Findings

Mean anxiety scores of the experimental and control groups were 10.9±5.2 and 21.5±8.4 respectively with a significant difference (P<0.001). Anxiety level of the experimental group before mammography decreased than the beginning of the study (P<0.001) but it increased in the control group.

Conclusion

In general, consultation and preparation by different medical staff members can be effective in reducing anxiety levels of women during mammography.

Keywords: Instruction, Preparation, Anxiety, Mammography.                

Background and aim

One of aspects in marital satisfaction is sexual. It has a significant role in mental health of families. With respect to increasing age and life expectancy of Iranian women, studying about sexual aspects of postmenopausal women can promote their health and quality of life. This descriptive study was conducted to determine sexual satisfaction of postmenopausal women referring to healthcare clinics affiliated to Medical Universities in Tehran in 2008.

Materials and methods

270 women were selected by convenience sampling method. A questionnaire completed by interview was used for data collection. It included 2 parts: demographic and sexual satisfaction items. Different statistical tests were used for data analysis.

Findings

Mean age of women was 52.49±4.93. Their sexual satisfaction was desired (58.9%) but their sexual drive was undesired (66.3%). All sexual aspects had a significant relationship with the satisfaction of women from sexual activities (P<0.001). Arousal was significantly related to educational level of husbands (P<0.01), and orgasm as well as resolution to the number of abnormal children (P<0.05), hormone therapy and a specific disease (P<0.01).

Conclusion

Although postmenopausal stage is associated with decreased level of sexual hormones and drive, intimate relationship with spouse, increased educational level leading to increased knowledge, adaptation with menopause, hormone therapy and decreased stress as well as complications of chronic diseases can increase sexual satisfaction.

Keywords: Postmenopausal women, Sexual satisfaction.

*Corresponding Author: Lecturer, Dept. of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences. Tehran, Iran.E-mail: zsheikhan@gmail.com.

Background and aim

Low birth weight (LBW) is the most important indicator of mortality in children. These infants cannot tolerate physiologic stresses; therefore, they are isolated from their mothers to be put in incubators. This isolation put them at numerous risks. This clinical trial was conducted to compare the effects of kangaroo with routine care on physiologic parameters of low-birth-weight infants at NICUs in 2008.

Materials and methods

80 LBW infants were randomly divided into 2 equal experimental and control groups. In kangaroo-care group, the infants were removed from incubator for 1 hour and put on the chest of their mothers. The control group was provided care routinely. Physiologic parameters including pulse rate, oxygenation of arterial blood, temperature and respiratory rate were checked at 30 and 50 minutes after the return of infants to their incubators. Data collection form was validated by content method and validities of instruments were checked by choosing standard and authorized devices. Reliability was achieved by inter-rater method (r=0.87).

Findings

No significant difference was found between the 2 methods during care in terms of the parameters (P>0.05). However, a significant difference was found between pulse rate as well as oxygenation changes 5 and 50 minutes after care delivery (P=0.01, P=0.02 and P=0.03) with no difference in temperature (P=0.48).

Conclusion

Findings showed that Kangaroo care is as effective as routine care in stability of physiologic parameters. Therefore, developing educational programs for healthcare personnel, nurses and mothers can facilitate the provision of this type of care.

Keywords: Physiologic parameters, Low-birth-weight infants, Kangaroo care, Routine care,

                  Neonatal intensive care units (NICUs).

^*Corresponding Author: Nurian, M; Dept. of Pediatrics, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences . Tehran, Iran. E-mail: Manighea@yahoo.com

Background and aim

Each year, many women in developing countries including Iran die of postpartum hemorrhage. As a result, in 2007, WHO emphasized on instruction of correct principles in delivery attendants.

This quasi-experimental study was conducted to determine and compare the effects of instructing WHO’s guidelines on knowledge and practice of midwives of Fatemiyeh Hospital in Hamedan city.

Materials and methods

All midwifery personnel of the hospital took part in the study. They were instructed theoretically and practically regarding WHO standards in 10 sessions. Data collection tools included a pretest, a posttest and an observation checklist for practice. Content and test-retest methods were used for validity and reliability of the tools respectively.

Findings

A significant difference was found between knowledge (P<0.001) and practice (P<0.004) of the personnel before and after the instruction.

Conclusion   

Instructing the correct principles for controlling postpartum hemorrhage can improve knowledge and practice of personnel. Thus, more extensive educational programs are recommended.

Keywords: Postpartum hemorrhage, Knowledge, Practice, Midwife.

^*Corresponding Author: Dr. Khatiban; Assistant Professor, Faculty of Nursing and Midwifery, Hamedan Medical University, Iran. ^*(Corresponding Author) Email: mkhnurse@yahoo.com

Background and aim

Hormone replacement therapy (HRT) is commonly administered for vasomotor symptoms of menopause. However, its utilization has been under uncertainty because of its carcinogenesis and side effects. Currently, one of the alternative methods in this regard is relaxation techniques.

This quasi-experimental study was conducted to compare the effects of HRT with relaxation techniques on vasomotor symptoms of menopausal women.

Materials and methods

90 women with vasomotor symptoms were first selected by convenience sampling method and then randomly divided into 3 HRT, relaxation technique and control groups. No intervention was performed in the control group. Data were collected with a questionnaire by interviewing the subjects.

Findings

No significant difference was found between the groups in the severity of the symptoms before the interventions. Both relaxation techniques and HRT decreased the symptoms. All symptoms except vertigo, weakness and lack of energy were significantly reduced in the HRT group compared with the control group. The same happened in the relaxation technique group compared with the control group. Although both HRT and relaxation were effective on vasomotor symptoms, the former seems more effective on the frequency of flushing.

Conclusion

HRT and relaxation techniques are both effective on the management of vasomotor symptoms. Therefore, in case of contraindication for hormones or reluctance of clients, relaxation techniques can be replaced.

Keywords: Relaxation techniques, Hormone replacement therapy (HRT), Vasomotor symptoms,

                  Menopause.

Background and aim

Anger rumination is an inevitable, repetitive and cognitive process which occurs during anger experience, continues after it and increases its duration and severity. Anger rumination is associated with a wide range of psychological disorders, especially emotional ones. The main purpose of this study was to examine the validity and reliability of Anger Rumination Scale (ARS) as an important tool in health studies.

Materials and methods

384 students (211 girls and 173 boys) of Tehran University took part in the study by completing Anger Rumination Scale (ARS), Tehran Multidimensional Anger Scale (TMAS), and Mental Health Inventory (MHI). The scale was validated with content, convergent and discriminant validity. Its reliability was measured by test-retest and internal consistency methods.

Findings

Reliability scores of the scale were satisfactory. Its content validity was calculated with a significant result according to Kendall's coefficients of concordance for its subscales including angry afterthoughts, thoughts of revenge, angry memories and understanding of causes as well as its total score after reviewing by 10 psychology specialists. The convergent and discriminant validities of the scale were measured based on an expected pattern of correlations between it and the measures of trait-anger, state-anger, anger-in, anger-out, anger-control in, anger-control out, psychological well-being, and psychological distress with significant results.

Conclusion

It can be concluded that Anger Rumination Scale (ARS) is a valid and reliable scale to measure anger rumination.

Keywords: Anger Rumination Scale, Validity, Reliability.

Background  and aim

Behavior and performance are investigated in different studies, which yields significant information to researchers leading to discovery of weak and strong points of behavior. This plays an important role in reaching to research goals. This review study was carried out to identify methods in the measurement of behaviors and application of them in MS theses of students in faculty of nursing and midwifery of Shahid Beheshti Medical University.

Materials and methods

526 MS theses of students were investigated in terms of the methods for measurement or evaluation of behaviors.

Findings

Of the 526 theses, 22 were related to the measurement of behavior. Behaviors were measured by self-report questionnaires, checklist and no tool in 12, 8 and 2 theses respectively.

Conclusion

Findings showed that behavior is mostly measured by questionnaire and less by observation which yields more complete information.

Keywords: Behaviour measurement, Reasoned Action Theory, Questionnaire, Observation.