Advances in Nursing & Midwifery

Introduction: Cervical cancer is one of the most common cancers among women, and early detection through a Pap smear test plays an important role in timely diagnosis. This study aims to evaluate the type and degree of success of educational interventions based on health education theories and models in improving women's participation in the Pap smear test in Iran.
Methods: This research comprises a systematic review of studies published between 2010 and 2022 to synthesize existing knowledge on the effectiveness of educational interventions in increasing participation and performance of Pap smear tests. The search was conducted on databases such as Magiran, Science Direct, PubMed, Scopus, and SID, including all interventional studies (experimental and quasi-experimental). The search keywords included terms such as pap smear, screening, cervical cancer, educational models, theories of health education and educational interventions, which were reviewed in both Farsi and English languages.
Results: Among the 3,171 articles initially extracted, 27 relevant interventional studies were included in this review. The intervention methods examined in these studies mostly include lectures, group discussions, questions and answers, educational videos, and multimedia messages in which more than one educational method is used. Times allocated to implement the interventions were different in each study. Approximately 62% of these studies were based on the health belief model, while others explored alternative health behavior models. The measured variables included various components of health education models, and most of these variables demonstrated significant improvement after the implementation of educational interventions among participants in the test group.
Conclusions: This systematic review underscores the beneficial influence of targeted educational interventions in bolstering women's engagement in Papsmear testing and cervical cancer prevention in Iran. The outcomes underscore the potential of health behavior models to guide future evidence-based educational programs aimed at promoting preventive healthcare practices among women.

Introduction: Premature birth (PTB) is a common cause of infant mortality and can lead to long-term complications and disorders. Considering that the prevalence of PTB may vary in the seasons, the changes in preterm birth rates during the seasons were investigated in this study, along with exploring the factors affecting the occurrence of preterm births.
Methods: In this cross-sectional study, data collected from pregnant women at Taleghani Hospital to investigate 140 cases of preterm births, concentrating on seasonal differences, maternal age, gravidity, previous abortion history, newborn gender, weight, umbilical cord pH, and the Apgar score measured at ten minutes birth.
Results: The study found that preterm birth rates vary by season, peaking in autumn at 29.3% and dropping to 19.5% in winter. The gender distribution of preterm infants was nearly equal, with a slight majority of boys. The average gestational age of mothers remained stable across seasons, and there was no significant difference in average baby weight among different maternal age groups. The average umbilical cord artery pH was 7.26, and the mean birth weight was 2,223 grams. Additionally, Spearman's analysis showed a positive correlation between gestational age and both ten-minute Apgar scores and birth weight. However, no significant associations were found between umbilical cord artery pH and gestational age, delivery type, or infant gender.
Conclusions: Preterm birth rates are not significantly affected by seasons, while longer gestational periods lead to heavier newborns and better Apgar scores. Umbilical cord pH remains unaffected by gestational age, delivery method, or baby gender.

Introduction: Vaginismus is a common sexual dysfunction in women that, by negatively affecting mental health, can impact the quality of marital relationships or marital satisfaction. This study aimed to determine the relationship between self-esteem, body image, and marital satisfaction in women with vaginismus.
Methods: This cross-sectional study was conducted on 236 women with vaginismus who were selected with convenience sampling method in sexual health clinics in Tehran, Iran, in 2018. Data were collected through questionnaires including socio-demographic characteristics, ENRICH marital satisfaction, Rosenberg self-esteem, and body image. Pearson correlation analysis was used to determine the relationship between self-esteem, body image, and marital satisfaction as bivariate analysis, and a general linear model with adjustment for socio-demographic characteristics was used for multivariate analysis using SPSS software, Version 24.
Results: The average age of women was 31.48(5.48) and more than 80% had a university education. And 75% of women had a history of vaginismus for more than one year. The mean (SD) scores for marital satisfaction, self-esteem, and body image were 31.55(7.12), 17.42(5.46), and 41.45(13.13), respectively. According to Pearson correlation results, there was a significant positive correlation between self-esteem and marital satisfaction (r= 0.43, p-value <0.001), and a significant negative correlation between body image and marital satisfaction (r=-0.31, p-value < 0.001). The results of the linear model with adjustment for socio-demographic variables indicated that an increase in self-esteem scores (B=0.42; 95% CI: 0.25 to 0.59; P<0.001) led to an increase in marital satisfaction while worsening body image (B= -0.08; 95%CI: -0.15 to -0.20) was associated with a decrease in marital satisfaction.
Conclusions: Increased self-esteem and reduced body image concerns are associated with higher marital satisfaction among women with vaginismus. Therefore, Identifying these people, factors affecting the disease, management and control of the factors involved, and counseling interventions to enhance self-esteem and improve body image are recommended for this group of women.

Introduction: Because the COVID-19 pandemic necessitated the use of e-learning, this study aims to investigate medical students' perspectives about quality and Satisfaction of the e-learning services provided by the Learning Management System (LMS) during COVID-19 Pandemic in Iran.
Methods: This descriptive cross-sectional research study conducted in 2022 in Iran. The statistical population consisted of 455 medical students. For this purpose, the convenience sampling method was used. Required data were collected using a demographic survey and SERVQUAL questionnaire in two parts importance and performance of learning services. Data were analyzed by using descriptive and non-parametric statistical tests in SPSS version 18 with a 5% confidence level.
Results: The results showed a negative gap in all dimensions of e-learning service quality. The highest and lowest mean quality gaps were related to responsiveness (-8.22 ± 1.8) and tangibility (-5.86 ± 0.7), respectively. Among the demographic variables, a significant relationship was observed only between education level and assurance dimension of e-learning service quality importance-performance (P<0.05).
Conclusions: Based on the findings of the present study, the LMS system has major challenges for the education of medical students. Therefore, to be used in the medical group, fundamental reforms are needed to improve the quality or to be used together with other appropriate methods and technologies in order to gain more satisfaction.

Introduction: This study investigates the academic satisfaction of master’s level operating room students, who are potential future faculty members. This exploration aids in monitoring the educational system of medical sciences universities in Iran.
Methods: This 2022 cross-sectional survey research included all 131 master’s students in operating room technology across Iran for the academic year 2022-2023. Students in Tehran completed the questionnaires in person, while those from other provinces responded electronically. Data were collected using a demographic profile form and a researcher-developed academic satisfaction questionnaire. The validity and reliability of the questionnaire were confirmed. Data analysis was performed using SPSS26 software.
Results: Of the 131 students participating in the study, 72% were female, 65% were employed, 61% were married, and 26% were local residents. The overall academic satisfaction was average (with a mean score of 66 in a range of 23 to 115). Factors such as the host university, undergraduate GPA, academic semester, employment status, marital status, gender, and parents’ education significantly influenced academic satisfaction (P<0.05).
Conclusions: The academic satisfaction of master’s level operating room students was moderate. To enhance student satisfaction, steps such as creating favorable conditions to advance the operating room field at the master’s level and providing specialized training for postgraduate specialists are necessary. Enhancing specialized skills can foster a more positive attitude among students towards their field of study, thereby increasing their academic satisfaction.

Introduction: The majority of ICU patients require holistic care, neglecting which can lead to various issues, including eye-related problems. This research aimed to assess the impact of a designed educational program focusing on eye care for patients on the knowledge and practice of ICU nurses in selected hospitals affiliated with Iran University of Medical Sciences.
Methods: A semi-experimental study investigated the impact of a designed educational program on the knowledge and performance of 126 nurses working in the ICU departments in Tehran during the year 1402. The intervention consisted of three 2-hour educational sessions. The control group received standard hospital training. Data analysis utilized descriptive and analytical statistics, chi-square, independent t-tests, and paired t-tests with SPSS version 19 software. To adhere to research ethics, educational booklets were also provided to the nurses in the control group after the sessions.
Results: Initially, there were no statistically significant demographic differences between the groups. Pre-intervention, both control and intervention groups exhibited similar average scores in knowledge and practice. However, following the training sessions, the intervention group's scores notably improved, leading to a statistically significant difference between the two groups (knowledge P= 0.000 and practice = P= 0.02).
Conclusions: Training on eye care proves effective in enhancing nurses' knowledge and skills. It appears essential to incorporate workshops and ongoing training sessions for sustained improvement and optimal outcomes. In this way, it is possible to prevent eye problems in patients hospitalized in ICUs, and if they occur, timely care can achieve favorable results.