Advances in Nursing & Midwifery

Abstract Introduction: To protect normal birth, admission of pregnant women in labour units is one of the most important decisions. This study developed a protocol for admission of women during labour in order to improve the accuracy of the diagnosis of onset of labour. Methods: First the admission processes of 25 pregnant women were observed in the study hospital. Then the multi-disciplinary team searched and reviewed the Iranian database using related key words. Evidence-based medicine resources and other databases were searched using related key words for the most important symptoms in relation to the onset of active labour as well as early labour assessment programs. Results: The results of observation of the admission process in the study hospital and review of the literature indicated that low-risk pregnant women in labour were admitted using different criteria. The evidence-based protocol for admission of women in labour was developed using these criteria to provide a guide, which lists the necessary measures in dealing with women in various situations during the onset of labour. Presence of regular uterine contractions, cervical dilatation ≥ 4 cm and effacement should be considered as signs of starting labour, which may be accompanied by spontaneous rupture of membranes or bloody show. Conclusions: Protocols are appropriate clinical tools for the design and standardization of clinical processes based on the available evidence. This protocol could be used in a multi-center clinical trial to assess its effectiveness.

Abstract

Introduction: The conflict phenomenon has been always problematic in the health system leading to reduced efficiency of the staff and increased health care costs. Conflicts in the hospital are high due to frequent interactions among nurses, physicians, and other members of the treatment team and their multiple roles. This study expunged upon the correlation between demographic information and the rate of conflict among the nurses in the emergency department (ED). Methods: A total of 147 nurses of teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences participated in this descriptive-analytic study in October, 2015. The nurses were selected using the random cluster sampling method. The data were collected with a researcher-made instrument. The gleaned data were analyzed with descriptive statistics, Pearson product moment correlation coefficient, and one-way ANOVA. Results: Our findings demonstrated that the rate of conflict was higher in the intrapersonal dimension in nurses employed in ED of the hospitals under study compared to the other two dimensions, i.e., intraclass and interclass. There was significant correlation between gender and rate of conflict in intrapersonal and interclass dimensions while the rate of conflict was higher among the males than females. There was also a significant association between the rate of conflict in intraclass dimension and employment status. Conclusions: The results of this study can help managers to remove or diminish conflict-inducer factors. They may further adopt appropriate methods to manage conflict and promote nursing services through cooperative and supportive interaction.

Introduction: Sexual affairs are one of the physiological needs affecting human health. Sexual functioning disorders can reduce individual’s capabilities and creativities. Sexual relations are in the center of women’s quality of life. This study aimed to investigate the correlation   of  sexual  violence, stress perceived, demographic  characteristic  of  women   and  high  risk  behavior  spouse    with  sexual  quality  life of  women  by  using  Path  model  in  Iranian  women   who  referred to health  centers  affiliated  to  Shahid   Beheshti  University  of  Medical  Sciences Tehran, Iran in  2015.

  Methods: This   was   sectional   descriptive-correlative  study conducted on 800 women  who were  selected  through  multistage  sampling method. Data were collected through distinct  questionnaires  demographic  characteristics ,sexual quality life of  female(SQOL-F) , sexual  violence, stress perceived   and  high risk behavior  spouse   that completed  by   interview  .Software  SPPS16   and   LISREL8.80    used  for  analysis  of  data.  

Results: The   results   revealed   that   among   direct   pathways, sexual violence  (β = -0.40)  was the most effective predictor of sexual  quality  of  life  women.  The age (β=-0.03 ) had an inverse association with sexual  quality  of  life  women through direct effect of sexual violence(β=0.33). Moreover, education (β=0.03) had a direct  association  with  sexual  quality  of  life  women   through  inverse  association  0f  sexual  violence (β=-0.10). Stress perceived ( β=-0.24) and  high risk behavior spouse (β=-0.30) indirectly,  effects on  sexual  quality  of  life  women. 

Conclusion:   Women have the rights to experience a safe and enjoyable sexual relationship. Sexual function is very complicated and is affected by many factors, including   the  personal   lifestyle  and  interpersonal relationships. It is essential  that  noticed to sexuality and  increase quality  marital  life  but    avoidance  of  high risk  behaviors    will help  to it.

Keywords: Sexual  Quality, Sexual  violence, Stress perceived , High risk behavior, Women, Iran

Abstract Introduction: In Iran the growing concern over low reproductive rates has led to alterations in demographic policies over recent years. The literature is indicated of different effects of women’s employed and religiosity on their reproductive performance. Present study aimed to Comprise religious orientation and reproductive performance of employed and non-employed women. Methods: This cross sectional study was conducted on 360 unemployed and employed women in healthcare centers affiliated to Shahid Beheshti University of Medical Sciences and in schools of selected districts of Ministry of Education in Tehran, 2015. Three questionnaires including: demographic characteristics, religious orientation and reproductive performance were utilized for data collection. Results: The Mean ± SD number of children for unemployed women was 1.29±0.75, for women working at schools 1.68±0.71 and those working in healthcare centers was 1.08± 0.84 (P=0.001). The mean ideal number of children for women working at schools was significantly higher than that of unemployed women and employed women in healthcare centers and hospitals (P=0.001). The level of gender preference for a male child in the housewife group 21.7% (39) was higher than that of the employed groups and the majority of employed women in Ministry of Health 61.1%(55) and Ministry of Education 70%(63) had no gender preferences. Intention for childbearing in unemployed women 43.3% (78) was higher than in the employed ones. Religious orientation had significant and positive correlation with the number of children (P = 0.01, r = 0.13). Conclusions: Women’s employed is associated with their religious orientation and reproductive performance. This research took steps to identify the factors affecting the success of demographic policies.

Introduction: Nurses' Competence is a critical factor for providing safe and quality care and self- assessment is a key issue in maintenance of competence. This study was conducted to identify the level of competence and its associations with some job related factors.

Methods: A cross sectional and descriptive design was conducted at seven university hospitals in Rasht during September 2015. This study included 230 nurses working in university hospitals who were selected using stratified sampling method. The majority of nurses was female and had a bachelor's degree. Nurses' competence was measured using self reported competency inventory for registered nurses (Persian version). Data was analyzed with Spearman correlation, Mann-Whitney-U SPSS /21 software.

Results: The average score of competence was 173.59±26.72 and was considered in high level. The highest and the lowest competence were in dimensions of 'ethical-legal performance' (M=3.23±.52) and 'Critical thinking/research aptitude' (M=3.11±.51) respectively. There were significant associations between nurses' competence and some job related factors consisting work experience (p = 0.001), monthly salary (p = 0.001), working hours per month (p = 0.004), Nurses' shift work (p = 0.021), and employment type (p = 0.003).

Conclusions: Nurses assessed their competence at a desirable level, which may be due to self-assessment tool. Some job related factors associated with nurses' competence. Exploring the competence level and its relationship with these factors could be helpful in managerial interventions for professional competency.

Introduction: Chronic pain which is a pain that remains or repeats for more than 3 to 6 months affects one in every 10 people in the world. Rising direct and indirect costs of chronic pain show the importance of researches which help to find better ways of pain management. Testing the validity and reliability of pain measurement tools in different populations can help this kind of researches. The chronic pain grade questionnaire is devised by Vonkorff and his colleagues. This seven-item instrument gives a score which empowers chronic pain patients to be characterized into one of four hierarchical categories according to pain severity or interference. The goal of this research was to test the validity and reliability of the Persian version of the chronic pain grade questionnaire. Methods: As a cross-sectional study after downloading the questionnaire from the internet and translating from English to Persian by researchers and backward translation by a native researcher, it was answered by 204 patients with musculoskeletal pain. These patients were referred to the physical medicine and rehabilitation clinic in Modarres Hospital and were registered using convenience sampling method. Patients were aged between 18 and 87; suffering from musculoskeletal pain (including primary and secondary pains) for at least the last 6 months. Fifty patients were reevaluated after two weeks. Results: As a result of testing reliability, Cronbach’s alpha was 0.89 and the Guttman split-half coefficient was around 0.82 and Test re-test coefficient using Spearman’s correlation coefficient was 0.89. Only a single component was extracted for the questionnaire, as a result of factor analysis. This component defines 59.8% of the variance. Conclusions: In summary, construct validity and reliability of the Persian version of the chronic pain grade questionnaire are approved, therefore it would be applicable to people with musculoskeletal pain in the Iranian population.

Abstract

premenstrual dysphoric disorder and severe premenstrual syndrome are from prevalent problems in women that cause impairment in many aspects of their life. This research aimed to study personality characteristics of female students with premenstrual syndrome and severe premenstrual dysphoric disorder. The sample of the study consisted of 210 female students of Shahed University in Tehran, Iran. They completed NEO-FFI, Premenstrual Symptoms Screening Tool (PSST) and demographic form. Data were analyzed using MANOVA. 10.2 % of participants suffered from PMDD, 32.1% of participants have PMS and 57.2% were free of symptoms. There were significant differences in neuroticism between students with moderate to severe PMS and PMDD, and students who are free of symptoms or have mild PMS. There was also significant difference in agreeableness between individuals with PMDD and those who are free of symptoms/ have mild PMS. In conclusion, personality characteristics (including Neuroticism and Agreeableness) should be considered as the psychological factors that effect on incident and severity of PMS and PMDD.

Abstract Introduction: Induced abortion is a major threat to women’s fertility health. In particular, in developing countries and the societies where abortion is illegal, abortions are commonly carried out under unsanitary conditions, causing maternal complications, dangers to maternal health, and women’s future infertility. These consequences are especially evident in Iran where at least 80,000 illegal abortions are done annually. The current study aimed to examine the reasons for abortion, methods of abortion, and its short-term and long-term complications. Methods: This study, which adopted a descriptive design, was conducted among the women who had already carried out abortion and referred to one of the health, therapeutic, and educational centers affiliated with Shahid Beheshti University of Medical Sciences. The participants (N = 360) were selected the data were gleaned through a self-designed questionnaire and statistically analyzed using SPSS version 17. Results: The results of analyzing the data collected through the 369 questionnaires revealed that the mean age of participants was 26 years (SD = 7.2 years). The main reason for abortion was financial problems. With regard to marital status, 91.3% of the participants were married. Also, considering their job, 74.2% of the respondents were housewives, while 15.5% were employed in office jobs. Further, in 55.3% of the cases, abortion had been carried out as a result of the husband’s encouragement. The most common method of abortion was prescribing chemical medications, while the least popular method was intrauterine manipulations (with only 197 women reporting this abortion method). Moreover, 114 participants reported that they had accomplished curettage in a specialist physician’s office without anesthesia. The short-term complications of abortion included abdominal pain after abortion and incomplete abortion. On the other hand, long-term complications entailed visceral injury (1%), complications in the next pregnancy, bleeding in early pregnancy (10.7%), preterm delivery (7.9%), and ectopic pregnancy (7.4%). Conclusions: Scientific and religious education through appropriate procedures along with preventing unwanted pregnancy is a decisive factor in abortion.

Introduction: Chronic pain is common in the elderly. Distraction is one of the important uses of cognitive-behavioral techniques and humor is one of the distraction techniques used in pain control. The aim of the present study was to determine the impact of humor therapy (HT) on quality and fear of pain in nursing homes. Methods: We conducted a randomized clinical trial study on 55 elderly who had experienced chronic pain for at least 3 months and residing in nursing homes in Mashhad, Iran, 2016. The sampling was of convenience type as well as random allocation of nursing homes to two groups; the one receiving HT (n = 28) and a control group (n = 27) living in two similar nursing homes. The experimental group received 6 sessions of humor therapy over 6 weeks and the control group received the routine care. To this end, pain quality and fear of pain were assessed at the first, after the 3rd and 6th sessions in both groups respectively using the McGill Pain Questionnaire and Fear of Pain Questionnaire. The main data were also compared using the Mann-Whitney U test. Results: Total pain quality and fear of pain before the study was homogeneous in both groups (P > 0.05); but after 6th sessions in humor therapy the score of total pain quality decrease from 3.5 ± 1.1 to 2.4±0.7 (P < 0.001) and the score of fear of pain decrease from 36.0 ± 1.4 to 30.6 ± 0.8 (P < 0.05). These results were not significant in control group (P > 0.05). Conclusions: HT as a low-cost method can be an effective way to reduce the quality and fear of pain in elderly pain.