Research Article-Nursing

The Relationship between Psychological Status (Depression and Anxiety) and Social Support and Sexual Function

Nayereh Saberi, Sedigheh Amir Ali Akbari, Zohreh Mahmoodi, Malihe Nasiri

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 1-8


Introduction: Given that large numbers of marital problems arise from lack of proper satisfaction with sexual desire (libido) as well as lack of awareness towards the complicated dimensions of this fundamental motive, the purpose of the present study was to determine correlations between psychological state (depression and anxiety), social support, and sexual function among females of the reproductive age.

Methods: This study was a descriptive-analytic research on 400 females referred to clinics affiliated with Shahid Beheshti University of Medical Sciences in the city of Tehran, during year 2015. The study sample was recruited by cluster and multi-stage random sampling method. The Sexual Function Questionnaire, Demographic Questionnaire, Scale of Perceived Social Support, Spielberger’s Anxiety Inventory, and Beck Depression Inventory were also used to collect the data. The obtained data was analyzed through the SPSS software via descriptive statistics, t test, one way Analysis of Variance (ANOVA), as well as chi-square test.

Results: The findings revealed that 4.5% of females had poor level of sexual functioning. In addition, 24.5% of females benefited from low social support and also 75% and 9% of the given individuals had chronic depression and severe anxiety, respectively. According to the results of this study, sexual functioning was correlated with female’s age, husband’s age, age of first pregnancy, length of marriage, duration of having private rooms, and history of infertility (P ˂ 0.05). Furthermore, there were relationships between sexual functioning and depression as well as anxiety and social support (P ˂ 0.05).

Conclusions: It was concluded that sexual functioning was correlated with psychological state (depression and anxiety) and social support. Thus, it was recommended to conduct screening tests in terms of the variables examined.

Effects of Sex Hormones in Combined oral Contraceptives and Cyclofem on Female Sexual Dysfunction Score: A Study on Iranian Females

Farzaneh Pazandeh, Zohre Sheikhan, Zohreh Keshavarz, Alireza Zahiroddin, Mahrokh Dolatian, Sepideh Hajian, Tahereh Khalighi, Farahnaz Kholosi Badr

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 9-14


Introduction: Unwanted pregnancy can endanger reproductive health, and its complications could adversely affect quality of life in females, families, and the community. A large number of unwanted pregnancies are terminated with abortion or stillbirth. Sex is an important aspect of quality of life. According to reproductive rights, females have the right to experience a safe and enjoyable sexual relationship. This study aimed at comparing sexual function scores between females taking combined oral contraceptives and Cyclofem at health centers affiliated to Shahid Beheshti University of Medical Sciences of Tehran, Iran, During Year 2013.

Methods: This descriptive-comparative study was carried -out on 240 females (each group 120) in Tehran, Iran, by multistage sampling. Data collection tools had 3 parts; General Health Questionnaire (GHQ), demographic variables, and Female Sexual Function Index (FSFI) that were completed by interviews. Descriptive statistics, independent t, Mann-Whitney test, chi-square, and SPPS16 were used for analysis of data. P-values less than 0.05 were considered statistically significant.

Results: The difference in sexual function between combined oral contraceptives and cyclofem was insignificant. Scores of desire and arousal dimensions were better in combined oral contraceptive consumers than cyclofem users.

Conclusions: It is important for females to choose hormonal contraception methods, which are the most effective, yet, cause the least sexual dysfunction.

The Impact of a School-Based Intervention Using the PBSEIM Model on Health Promoting Behaviors and Self-Care in Adolescent Females

Elahe Fahimi Rad, Zohreh Keshavarz, Masoumeh Simbar, Malihe Nasiri, Hasan Mehraliyan

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 15-19


Introduction: Developing effective health habits during adolescence dramatically effects behavior formation during adulthood. Therefore, the current study was conducted with an aim to investigate the impact of school-based intervention using «Integrated Model of Planned Behavior and Self-Efficacy» (PBSEIM) on self-care and health promoting behaviors of female high school students of Abyek city, Qazvin Province (Iran), during year 2016.

Methods: This experimental study was conducted on 100 female public high school students aged 15 to 19 years old in Abyek city, Qazvin Province. Two schools were randomly selected between 6 high schools. One of the high schools was randomly selected as the intervention group and the other one as the control group. Three classrooms in each school were randomly selected and the necessary samples were collected from each class. Overall, 100 samples had the inclusion criteria; 50 were included in the intervention and 50 in the control group. Demographic, “Health Promoting Lifestyle Profile” (HPLP II), and “Adolescent Girl’s Self-Care Questionnaire” was completed by both groups before and after the interventions. Face validity and content validity of the self-care questionnaire were assessed. Also, Cronbach’s alpha coefficient for this questionnaire was obtained as 0.73.The students in the intervention group were trained using the PBSEIM model and the control group received routine training. Data was collected and analyzed using the SPSS software (version 22) and independent and paired t tests. Values lower than 0.05 were considered significant.

Results: There was a significant difference before and after the intervention in the average scores of health-promoting behaviors and self-care of adolescents in the intervention group in comparison to the control group (P < 0.05). Inter-group comparison demonstrated a significantly higher increase of health-promoting behaviors and self-care of adolescents in the intervention group before and after the intervention (P-value < 0.05).

Conclusions: School-based educational intervention using psychosocial models is effective in changing health-promoting behaviors and self-care.

The Association of Prenatal Depression and Body Mass Index (BMI) in Pregnant Women Referred to Health Centers in Qom

Nafiseh Saeidi, Fatemeh Nahidi, Mohammad Rabiee, Malihe Nasiri, Marziyeh Raisi

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 20-26


Introduction: Pregnancy is a period during which women experience physical and psychological changes. The considerable changes can be found in their bodies and weights and they are quickly exposed to being overweight and obesity. On the other hand, few studies have assessed the association of depression with body mass index (BMI). This study explored whether depression and BMI affect each other in pregnancy. It aimed to investigate the correlation between prenatal depression and BMI in pregnant women in Qom.

Methods: This was a descriptive-correlational study conducted on pregnant women referred to health centers in 2016. Participants were selected using multi-stage cluster sampling. Samples of 236 pregnant women were divided into two groups: the second (14-28 weeks) and third (28-40 weeks) trimesters of pregnancy. Height and weight were measured to determine the initial BMI as well as BMI during pregnancy. Demographic information was collected from demographic and obstetric forms. Depression was measured using the Beck Depression Inventory (BDI-II). Data were analyzed using SPSS software and descriptive statistics, t-test, ANOVA, regression analysis and Pearson’s correlation coefficient, significant at P < 0.05.

Results: The results showed BMI in the second trimester to be 48.3% in the normal range, 16.1% overweight, and 30.5% obese. In the third trimester, BMI was 16.9% in the normal range, 34.4% overweight, and 46.6% obese. The rate of depression was 19.5% in the second trimester and 17.8% in the third trimester. Pearson’s correlation test showed that the association between prenatal depression and BMI did not exist in the second trimester (P = 0.499). In the third trimester, there was a significant negative correlation (P = 0.024). Based on regression analysis, among the factors related to BMI (depression, number of family members, gravidity, number of living children, parity, mother’s age, unwanted pregnancy by father, unwanted pregnancy by mother), depression and were are the only predictive factors strongly associated with BMI (P = 0.002 and P = 0.028, respectively).

Conclusions: In our study, there was an inverse correlation between depression and BMI of pregnant women, so that with increase in depression, BMI decreased. According to the different results of the research, further studies should be carried out regarding the effect of depression on BMI in order to be able to provide further assistance to pregnant women.

Factors Related to Functional Independence in Daily Activities of Older People with Osteoarthritis in Mashhad, Iran in 2016

Mahboubeh Ahmadpour, Ali Darvishpoor Kakhki, Mitra Zandi, Ramin Nourbakhsh

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 27-31


Introduction: Osteoarthritis is one of the leading causes of disability and reduction of functional independence in older people. The present study was conducted to investigate the factors related to functional independence in daily activities of older people with osteoarthritis in Mashhad, Iran.

Methods: In this descriptive-correlational study, 300 older people with osteoarthritis who had referred to rheumatology clinics of Mashhad University of Medical Sciences Hospitals in Mashhad in 2016 were selected and entered in the study by available sampling method. Data collection tools in this study included demographic information questionnaire and scale of activities of daily living, the validity and reliability of which were measured. SPSS-21 software was used for data analysis.

Results: The age average of the study subjects was 70.75 (± 7.27). The older people with higher education levels, male gender, married and who lived with a spouse or spouse and children, lower in age, economically independent (higher income and working), lower body mass index, the ones with less duration of osteoarthritis, ones who did not need to use assistive devices, did not suffer from the lack of joint mobility, and did not have hip osteoarthritis, had more independence in activities of daily living (P value < 0.05).

Conclusions: According to the obtained results and related factors from this study, it is necessary that more accurate planning be considered to prevent, control and manage factors leading to the dependence of older people.

Effect of Progressive Muscle Relaxation on Anxiety in Pre-University Students: A Randomized Controlled Clinical Trial

Tahereh Roozbahani, Manijeh Nourian, Kiyarash Saatchi, Azam Moslemi

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 32-37


Introduction: Anxiety experience in adolescents is more intense than other periods of life. The relaxation of muscles leads to the relaxation of the mind, because it prevents the production of negative thoughts. Therefore, this study was done with the purpose of determining the effects of Progressive Muscle Relaxation (PMR) on pre-university students’ anxiety.

Methods: In this randomized controlled clinical trial, 304 pre-university students of public schools in Malayer city that had the inclusion criteria were allocated to 2 groups of PMR and control with simple random sampling . Progressive Muscle Relaxation was taught to the intervention group and the students were asked to do the relaxation once a day for one month. Anxiety score of the entire sample was measured at the beginning, during, and the end of the intervention, using the “Beck Depression Inventory”. Data was analyzed using SPSS version 20, and repeated measures test.

Results: The mean of the control group›s anxiety score was 14.96 ± 8.22, reaching 16.56 ± 8.08 after 2 weeks and 19.45 ± 8.27 at the end of the fourth weeks. The mean of the intervention group›s anxiety scores was 15.71 ± 8.58. It decreased to 13.33 ± 9.06 at the end of the second week and 10.64 ± 9.30 at the end of the fourth week. The repeated measures test showed a significant difference between the 2 groups in mean anxiety scores (P = 0.008),  and was significantly different at the three time points (P < 0.001).

Conclusions: The findings of this study showed that the PMR caused a decrease in anxiety in pre-university students.

A Comparison of Coping Strategies in Iranian Female Victims of Different Types of Intimate Partner Violence

Simin Kasaeinia, Sepideh Hajian, Mahbobeh Ahmadi Doulabi

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 38-44


Introduction: Spouse abuse is defined as physical, sexual, and psychological-emotional violence committed by a spouse against his wife that is a widely variable phenomenon. The present study was conducted to compare coping strategies for stress in Iranian female victims of spouse abuse of different types in the city of Ilam.

Methods: The present cross-sectional descriptive study was conducted on 150 females with an experience of spouse abuse during the one-year leading up to the study, selected through convenience sampling. The study tools included the World Health Organization Violence against Women instrument and the Endler and Parker Coping Inventory for Stressful Situations. Data were analyzed using the SPSS-22 software.

Results: All of the participants had experienced at least one type of psychological violence (100%). Some of them had also experienced physical (94%) and sexual (67.3%) violence in the past year. Emotion-focused strategies were the dominant style used by most of the females (48%) in coping with stress. Certain demographic variables, such as the couple›s low literacy, were associated with emotion-focused and avoidance coping strategies. The use of problem-focused strategies increased significantly with household size (r = 0.17 and P = 0.039). One-way Analysis of Variance (ANOVA) showed that physical violence was associated with an increase in avoidance strategies and sexual and psychological violence with an increase in emotion-focused strategies. The results of the multivariate linear regression showed that only sexual violence could predict emotion-focused strategies (β = 0.216 and P = 0.01).

Conclusions: Given the high prevalence of spouse abuse, teaching certain life skills, such as problem-solving and alternative problem-focused behaviors instead of focusing on emotion and stress could be effective in coping with stressful life situations, help improve interpersonal relationships, and prevent harm caused by violence.

Auditing Palliative Care Provided by Nurses for Chronic Pain Management in the Elderly

Nazli Ebrahimi, Manijeh Naderi, Foroozan Atashzadeh-Shoorideh, Mahnaz Ilkhani, Nezhat Shakeri

Advances in Nursing & Midwifery, Vol. 27 No. 2 (2018), 16 July 2018, Page 45-49


Introduction: Pain is the most common mental pressure in the elderly and its abstract nature makes it a challenging subject to study. Conformity of palliative care management was examined with standards.

Methods: Through a descriptive audit study, 210 elderly patients with chronic pain, who were candidates for palliative and curative care, were examined. A researcher-designed checklist of standard health care for pain management and McGill pain questionnaire were used for data gathering. Data analyses were performed using descriptive statistics and estimating conformity of the pain management measures with standards of SPSS (18).

Results: Checking records of painkillers (60%) and reporting the patient’s pain to the physician (74.8%) were the most efficient palliative and curative measures, respectively. Surveying pain (41.9%) and introducing oneself to the patient (42.4%) were the least efficient healthcare services. In addition, palliative measures (24.73%) and drug-intervention measures (30.93%) had little conformity with the pain management standards.

Conclusions: Pain management care provided for the elderly has a long way to meet standards. This notable difference can be rooted in the abstract nature of pain and lack of knowledge of the medical team about palliative and curative measures for pain management