Advances in Nursing & Midwifery

Abstract:
Background and aim
Infertility is a major reproductive health problem that affect 10%-15% of couples. According to the World
Health Organization, there are currently 50-80 million infertile couples in the world. Physical activity is a
life style factor with possible positive or negative effects on reproductive. The aim of this study was to
compare the physical activity of fertile and infertile couples in Kermanshah, Iran during 2013.
Materials and Methods
This was a descriptive comparative study. The case group consisted of 118 infertile couples attending
Motazedi Infertility Center. One hundred and eight fertile couple attending to six public health centers in
Kermanshah, Iran, were the controls. The sampling method was convenience sampling. Data were collected
by a questionnaire. The questionnaire was consisted of two section. The first section was demographic and
fertility characteristics and the second section was international physical activity questionnaire. The data is
presented by descriptive statistics and analyzed with logistic regression, independent t-test, chi-square, and
gamma tests using SPSS v16.
Results
The result of this study showed that the majority of fertile women(86.1%), infertile women(73.1%), fertile
men(87%) and infertile men(96.3%) had moderate level of physical activity. There was a significant
difference between fertile and infertile men and women in terms of physical activity. The fertile and infertile
couples, also, have significant difference in physical activity(P<0/05).
Conclusions
Given the importance of physical activity on reproductive health and significant difference of physical
activity between fertile and infertile couples in this study, it seems that more attention should be paid to
lifestyle behaviors, especially in infertile couples.
Keywords
Life Style; Physical Activity; Fertility, Iran

Background and Aim
Developmental care along with medical care controls premature infant's potential stress. Improving the
quality of developmental care as well as other healthcare services is very important. In this paper, the
existing quality care improvement models have been reviewed and followed by analysis of their applications
to the Iranian NICU. Consequently, an appropriate model is proposed.
Materials and Methods
In this review article, Iran Medex، Science direct، Google Scholar، SID, PubMed, Scopus, and EBSCOCINAHL
databases have been searched by keywords including quality improvement, quality, developmental
care, health care, NICU, premature infants. The content of articles were analyzed and compared.
Results
The review of the literature indicates that there are many health care improvement models. Some of macro
and micro related models are applicable in NICUs. However, there are some limitations in this regards. With
considering the characteristics of developmental care and the attributes of an ideal health care improvement
model a number of models chose to promote developmental care in Iranian's NICU. The models are "Quality
Improvement Collaborative", Clinical Pathways, Plan- DO- Study- Act Cycle, Six Sigma, EFQM and ISO.
Keywords
Developmental care; Neonatal Intensive Care Units; Healthcare; Quality Improvement

Abstract:
Background and Aim
Decision making process about Do- Not-Resusciate (DNR) order is unique, since, it is the only treatment
decision that should be taken in advance. Most physicians and nurses are not sure whether and when to make
a decision about DNR order and its moral aspects. The current study is performed to compare and investigate
nurses and physicians attitude about DNR order for patients in their final phases of life.
Materials and Methods
In this descriptive–comparative study, 152 physicians and 152 nurses have been studied. The sampling
method was stratified sampling. The data gathering tools were a demographical questionnaire and a attitude
questionnaire about DNR order.
Results
The nurses and physicians in this research with averages of 3.25 for nurses and 3.22 for physicians, had a
positive attitude about DNR order. But there was no significant difference between the attitude average score
of the physicians and nurses about DNR order (p>0.5). Nurses and physicians with experience of
participating in implementation of cardiopulmonary resuscitation and DNR order, had more positive attitude
toward DNR order
Conclusions
The findings suggest that there is no difference between the physician’s and nurse’s view about DNR order.
Although there is a significant relationship between former experience of participating in implementation of
cardiopulmonary resuscitation and DNR order with positive attitude about DNR order.
Keywords
Cardiopulmonary resuscitation; Physician; Nurse, Attitude

Abstract:
Background and Aim
Increasing life expectancy and improving the quality of life of patients with cancer is one of the health
priorities. The attitude towards life is one of the most important effective factors. The objective of present
study was psychometric evaluation of revised life attitude scale in cancer patients undergoing chemotherapy.
Materials and Methods
This was a methodological study. 138 patients with cancer patients undergoing chemotherapy have been
selected by simple random sampling. First, the scale was translated to Persian. Internal consistency was
estimated using Cronbach's coefficient alpha. The validity was determined by constructed validity using
exploratory factor analysis exploratory, content validity (by calculating content validity index and content
validity ratio) and also face validity.
Results
Results of factor analysis showed six essential factors as the basis of Persian life attitude profile-revised
scale. The first factor (goals) explained the main portion of variance of scale’s questions. The index of
Kaiser-Meyer-Olkin showed the adequacy of sample size. (0.601). Content validity index was 0.79-0.85. The
content validity ratio for the above choices of scale was equal to +0.99 (p<0. 05).
Conclusions
According to the results of this study the Persian version of life attitude in patients scale in cancer patients
had appropriate validity and reliability. The mentioned tool is also suitable for researches and useful as a
screening tool in clinical environments.
Keywords:
Attitude; Reliability and Validity; Cancer; Scales

Abstract
Background and aim
Professional socialization is a critical aspect of nursing students’ development. This process begins with
entering into the nursing program and continues after graduation and beginning of professional practice. This
paper aimed to introduce the professional metamorphosis theory of BSN students and its application in the
nursing education.
Materials and methods
This study was conducted with the aim of the introduction of the professional metamorphosis theory of BSN
students. For this purpose, a search was performed on scientific databases (Pub Med, CINAHL, SID &
IranMedex) using the key terms “professional socialization”, “professionalization”, “nursing education”, and
“ metamorphosis”. Ultimately 27 scientific articles and 2 Textbooks selected and reviewed. The results were
compared with the present theory.
Findings
In this study, the professional metamorphosis nursing students as a grounded theory was introduced. The
theory was compared with related models and theories in the nursing literature. The applications and
practical suggestions were provided in the nursing education.
Conclusions
This study introduced "professional metamorphosis of nursing students" as a grounded theory in the sociocultural
context of the health system of Iran. The nursing students' experiences during these stages
(dependence, disintegration, and integration) and surrounding professional and extra- professional contexts
help the nurse educators and administrators to develop effective educational interventions.
Keywords:
Socialization; Professionalization; Metamorphosis; Nursing Education; Iran

Background and Aim:
Dysmenorrhea, defined as pain associated with menstruation that affects millions of women in the reproductive age
worldwide. Considering the high prevalence of dysmenorrhea and its adverse consequences on quality of life, the
present study examined the effects of Rosaceous on the severity of primary dysmenorrhea and its systemic
manifestations.
Materials and Methods:
This double blind clinical trial was performed on 110 students of Hamadan University of Medical Sciences. Students
randomly assigned into intervention and control groups. Both groups were matched before intervention for age,
education level, BMI, income, education wife, age of menarche and marital status. In the intervention group in the first
3 days of menstruation, 10 drops of Rosaceous extract were given to the subjects two times daily for two consecutive
menstrual cycles. The controls take placebo. Severity of primary dysmenorrhea is compared in the two groups using the
paired t test and between groups using the independent t test.
Findings:
The severity of primary dysmenorrhea and systemic manifestations decreased in both groups, this reduction was more
significant in the Rosaceous group (p <0.001).
Conclusions:
The results of this study results showed a positive impact of Rosaceous in reduction of severity of primary
dysmenorrhea and systemic manifestations. It seems that can be used to reduce the severity of primary dysmenorrhea
and systemic manifestations.
Keywords:
Dysmenorrhea; Rosaceous; Traditional Medicine.

Abstract:
Background and aim:
One of the basic principle of patient protection is the patient's right to make decisions for their health. Over two
decades, results of the studies have showed the positive effects of patient participation in decisions about their treatment
and application of "patient decision aid". But so far, the impact of implementing of these interventions in routine
practice in clinical settings, is not clear. The aim of this study was to analyze the findings of published studies that
investigated the effectiveness of strategies, methods or approaches to implement IDES into routine clinical settings.
Materials and methods:
This is a review article. Electronic resources and databases such as CINAHL, Embase, Medline, Scopus, Science
Direct, MD Consult, OVID and Google Scholar were searched to find all studies that have investigated various aspects
of the subject of "patient decision aids".
Findings:
There are significant challenges to the implementation of patient decision support. The study results showed
indifference and noncooperation between health professionals. The noncooperation was stemmed in lack of confidence
in the content of IDEs and concerns about disruption of workflows.
Conclusion:
It is too soon to make firm recommendations about the best way of implementation of patient decision support methods
into routine practice. Because teams that use this model consistently report difficulties. It seems that the major problems
against the use of these interventions are their limit implementation and they need further and special investigation.
Keywords:
Decision-Making; Decision Support Techniques; Patient Outcome Assessment

Abstract:
Unquestionably, data analysis is the most complex and mysterious of all of the phases of a qualitative
research, and the one that receives the least thoughtful discussion in the literature. The aim of this review
paper that adapted from methodology section of doctoral dissertation was outlines the descriptive
phenomenological psychological method of research and explain of data analysis based on Giorgi approach
with objective examples to cause further insight and reflection by later researchers who may this choose as
most appropriate method to analyze their data. Data analysis based on Giorgi framework follows Husserl
tradition. Description and clarification of the phenomenon being studied is cornerstones of this
phenomenological method. The stages of analysis method based on Giorgi are: 1) assuming phenomenology
attitude, 2) read of interview to attain of Sense of the whole, 3) determination of primary meaning unites, 4)
transforming of meaning unites to psychological statements , and 5) synthesize of psychological General or
Essential structure of experience based on constituents.
Among the analysis approaches of qualitative data, analytical method of Giorgi has been as least preferred
method by local researchers. However, the review of literature suggests that many foreign studies have used
this approach to analyze data, describing the data analysis with comprehensive details has not been
mentioned. Providing more details on the method of data analysis, allowing researchers access to necessary
information and will be useful as a guide for future research. therefore, The data analysis procedures are
described in detail in the paper and this matter has been resolved.
Keywords:
Qualitative Researches, Phenomenology, Descriptive phenomenology, Giorgi analytic approach