Advances in Nursing & Midwifery

Introduction:
Balance impairment in multiple sclerosis patients was found to be associated with an increased risk of falls. The aim of
this study was to determine the risk of falls among multiple sclerosis patients who have referred to the MS Society of
Tehran 2014.
Materials and Methods:
This was a prospective cohort study. 199 multiple sclerosis patients were selected by convenient method. The data
collection tools were Tinetti performance-oriented mobility assessment (POMA), demographic and self-reported fall
questionnaire. The patients were divided into three groups based on POMA scores. The face and content validity of
tools was determined. The reliability of POMA was obtained by inter-rater method (0.95). The Cronbach's alpha for
researcher-made questionnaire was 0.97. The data were analyzed by using Chi-square test and Mann-Whitney U test.
Results:
There was a negative relationship between the occurrence of falls with the balance and gait scores among MS patients
(p<0.001). The MS patients, who gain a lower balance point, had more fall events. According to the score rating sum of
POMA, most multiple sclerosis patients had high and average score ratings. Also, all three balance motor ability and
gait scores, the total balance and gait score had a significant relationship with MS patients’ fall events (p<0.001).
Conclusion:
In the present study, most of patient with multiple sclerosis had higher and average scores of gait and balance. POMA
is a quick and easy test for identifying, classifying, and predicting the risk of falls among multiple sclerosis patients.
Keywords:
Falls, Imbalance, Multiple Sclerosis.

Background & Aim:
Utilization of nursing theories for finding the factors associated with self-efficacy in the patients
undergoing coronary artery bypass surgery is very important. This study was conducted to
determine the factors associated with self-efficacy based on Orem's theory in these patients after
coronary bypass surgery.
Materials and Methods:
This was a descriptive-correlative study. 150 patients undergoing coronary artery bypass surgery
were selected with convinince sampling. The data was collected by the demographic questionnaire
and the self-efficacy questionnaire. The self-efficacy questionnaire was made based on Orem’s
theory of self care. Instroments validity and relability was determined by content validity and
Cronbach Alpha(0.095). Data were analyzed using SPSS software ver19.
Findings:
Results of this research showed that self-efficacy in patients after coronary artery bypass surgery
was low(2%), medium(49%) and high(49%). Self-efficacy was significantly correlated with some
basic conditioning factors based on Orem’s theory (marital status, employment, level of education,
age, income , health insurance and education about surgery). The highest level of self-efficacy were
in regard of medication use, regular physician consultation, and low fat and low salt diet
consumption at home.
Conclusion:
Patients after coronary artery bypass surgery were more confident in regard to medication use,
regular physician consultation than exercise and stop smoking. This may indicate that Patients have
less attention to non-pharmacological aspects (healthy lifestyle and long-term adherence) and selfcare
behaviors after coronary artery bypass surgery. It seems that nurses and physicians should
emphasize on the effects of non–medical cares more clearly and enhance motivation based on selfefficacy
of the patients.
Key words:
self-efficacy, coronary artery bypass surgery, Orem’s Self Care Model

Background and aim:
Stressful life events during pregnancy are associated with adverse consequences for mother and newborn. The purpose
of this study was to understand the effects of stressful life events during pregnancy on low-birth-weight newborn
according to social determinants of health.
Materials and Methods:
This study was the second part of a large research project. The main study was conducted using case-control design.
Samples were recruited in four stages by selecting 750 mothers with newborns weighing less than 4000 gr using multistage
sampling method. The data about women’s lifestyle during pregnancy was collected using a questionnaire which
was developed using inductive and deductive approaches based on social determinants of health. This study assessed
stressful life events during pregnancy using 18 items
Findings:
The average of stressful life events number and the total score of this domain were different between two groups
(p<0.001). The odds ratio for effect of a one-unit increase in stress score, increased the risk of low- birth-weight by 1.03
times (p=0.001).
Conclusion:
The stressful life events can influence fetal growth independently. Although receiving health care during pregnancy (the
biological dimension), has an important influence, the role of stress, the related factors and the coping methods should
be considered.
Keywords:
Stressful Event; Social Determinant of Health; Newborn, Infant, Low Birth Weight

Abstract:
Background and aim:
Professional self-concept is an individual’s perception of self as a professional person and it affects his/her thinking,
role development and professional functions. Among the various professions, some needs to have higher self-concept
the nursing profession has a special status in this regard. This issue is more important in nurses working in intensive
care units because in addition to high experience and sufficient knowledge, they should have special clinical skills and
personality. Therefore, the present study was conducted to determine the nurses’ professional self-concept and its’
dimensions scores in nurses working in intensive care units in hospitals affiliated to medical sciences universities of
Tehran in 2014.
Materials and methods:
The present cross-sectional study was conducted on 205 qualified nurses working in Intensive care units in hospitals
affiliated to medical sciences universities of Tehran. Data was collected using a questionnaire which consisted of
demographic information and “Nurse Self-Concept Questionnaire” (cowin, 2001), after confirming their validity and
reliability. The range of total score was 36-288. The SPSS software version 22 was used to analyze the data.
Results:
The mean score of professional self-concept was 197/20±23/67. The highest and the lowest score were respectively
related to dimensions of communication and nurse general self-concept (self-esteem) with the mean of 41/34±4/93 and
16/23±6/96.
Conclusion:
however intensive care unit nurses gained relatively high professional self-concept score, but it seems that it was far
from ideal. Also nurses working in intensive care unit gained the lowest score from nurse general self-concept
dimension that it represented the weakness of nurses in this context. Therefor the necessity of education and preparation
of nurses, in order to have higher professional self-concept and self-esteem was felt.
Key words:
Self-Concept- Nursing- Intensive Cares Unit

Abstract
Background and aim:
Nowadays, infertility and attitudes toward it, cause issues like depression, helplessness and anxiety. The present study
aimed to investigate the relationship between general health with happiness, inferiority feeling, and marital conflict in
infertile women.
Methods and Materials:
In this cross-sectional analytical study, 100 infertile women selected by convenience sampling. General Health
Questionnaire (GHQ), the oxford happiness scale, inferiority feeling and Kansas Marital Conflict Scale (KMCS) were
used as data gathering tools. The Validity of the questionnaires were determined by the content and face validity. The
reliability of the questionnaires was determined using the internal consistency method. The calculated Cronbach’s alpha
for general health questionnaire, happiness, inferiority feeling and the marital conflicts scale were 88%, 93%, 76%, and
95% respectively. Data was analyzed using SPSS-16 software by a Pearson correlation coefficient and linear regression
Results:
100 infertile women 18 - 43 years old with an average age of 29.3 were studied. 55% of women had moderate levels of
economic conditions and only 6% of them were referred to a psychologist or psychiatrist. The general health of the
women with a minimum of 32 and maximum of 87 and a mean (56/14) was at moderate level. The results showed that
there were significant relationship between general health, happiness and inferiority feeling (p <0.01), while there was
no significant relationship between marital conflict and general health. Regression analysis showed that happiness and
inferiority feeling with respect to the beta coefficient (-0.56, 0.21) can vary significantly predict their general health.
Conclusion:
General health of infertile women could be affected by the happiness and inferiority feeling. According to the results, it
seems that professional assistance from psychologists and clinical psychiatrists is useful in helping infertile patients to
cope better with problems caused by infertility.
Keywords:
Health; Happiness; Inferiority Feeling; Marital Conflict; Infertility

Abstract:
Background and Aim:
Menopause is an important issue in the field of reproductive and women's health. Social support can help to reduce
post-menopausal women' problems and improve their quality of life. The aim of this study was to investigate the
relationship between social support and the experiences of menopause.
Materials and Methods:
This was a descriptive correlative study that was conducted in 2013 in Mashhad, Iran. 220 postmenopausal women aged
40 to 65 years were recruited through quota and community-based sampling. Data collection tools included
demographic questionnaire, multidimensional social support MSPSS, and assessing the experiences of women in
menopause. Validity and reliability of the questionnaires was reviewed and approved before use. Data was analyzed by
SPSS 21 software using variance analysis, Spearman correlation coefficient and regression analysis at significant level
of 0.05.
Results:
The average score of MSPSS was 59.73±15.74 and 60% of women perceived high social support. The average score of
"physical and psychological experiences of women" was 33.5±18.1. There was a significant negative correlation
between social support and the importance people of life(Family, neighbor, doctor,….)with women's experiences of
menopause (r= - 0/19, p= 0/006 and r=- 0/16, p= 0/01). Also, the “important people” dimension of perceived social
support was a better predictor for women's experiences in menopause.
Conclusions:
Perceived social support has a positive impact on menopausal experiences. "Important people" dimension was a better
predictor for the women' experiences in menopause.
Key words:
Health, Menopause, Social Support, Women's Experience.

Background and Aim:
In all over the world, sexual activities are increasing among single youth. Personality as a determining factor can
influence all human personal and social behaviors. Studies show that some Personality traits may contribute to high-risk
sexual behaviors. The aim of the current study was the assessment of correlation between high risk sexual behaviors and
emotional intelligence.
Materials and Methods:
This is a descriptive study with non-probability and convenience sampling method. The samples of research were girls
and women 65 years-old with high-risk sexual behaviors that were referred to a female forensic unit in Tehran in 2014.
The research instruments included a researcher-made questionnaire to assess high risk sexual behaviors and Bar-on
emotional intelligence questionnaire. The validity of high risk sexual behavior questionnaire was determined using the
content validity index and content validity ratio. The test-retest method was selected to determine the reliability and
stability of high-risk sexual behavior questionnaires. Then, Interrater reliability was determined by the kappa
coefficient. The questioner had a suitable level of reliability. Data analysis was performed using Pearson and Spearman
correlation coefficients, logistic regression and independent T test.
Results:
The most frequent sexual behavior was vaginal sex. Regression analysis showed that there were negative
correlations between vaginal intercourse with happiness and self‐actualization as some emotional
intelligence components. there were also negative correlations between oral sex with problem solving,
self‐actualization, realism, stress tolerance and independence as other emotional intelligence
components (p<0/05). There is only a significant positive correlation between empathy component
of emotional intelligence and vaginal intercourse (p<0/05).
Discussion and conclusions:
The results support of the impact of emotional intelligence and its components on high-risk sexual behaviors among
girls and women.
Key words:
Emotional Intelligence; Sexual Behavior; Forensic Medicine

Abstract
Background and aim:
Researchers, in qualitative researches, both influences on and take effect from the research process. One of the main
issues in qualitative research is validity of the researcher as an instrument of data collection. If the researcher does
not have enough validity in the data collection, the results of the study will also not be cited. The researcher as
instrument provides an opportunity for researchers to enter into the unknown world of individual about the
phenomena in question and sometimes faced many challenges in reaching this goal. This study has been reviewing
the opportunities and challenges of researchers as an instrument in the qualitative research.
Materials and methods:
This was a review study on the methodology of qualitative research. Using keywords including qualitative research,
instrument, challenges, and opportunities, articles and available books were investigated in PubMed, Scopus,
Science Direct, Proquest, Magiran ¡SCI ¡IranDoc, SID, Medlib, IranMedex databases with no time limit. The
Quality of the articles was assessed by using the McMaster Critical Review Form for Qualitative studies.
Findings:
Studies over 12 books and 18 articles showed that the role of the researcher can be varied in different qualitative
research designs such as phenomenology researches, grounded theory, ethnography, and content analysis researches.
Also previous experience and skills in the process of observation and interview, having effective communication
and asking the appropriate questions have an important impact on the role of researchers as a key factor in
qualitative research.
Conclusions:
Researchers have the main role, especially in data gathering of different types of qualitative researches. Actually
they are factors that validate the data. Experience and skills, ability to communicate, asking the right questions are
the most important factors that have an influence on doing qualitative research in an appropriate ways.
Key words:
Qualitative Research, Instrument, Challenge, Opportunity

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