Journal of Holistic Nursing and Midwifery
Volume:26 Issue: 4, 2016

Drug abuse is among the main problems at present time which seriously puts people's physical and mental health at risk. And since mental stress plays an important role in the trend to addiction and disability, it is necessary to recognize people's methods of resistance to stress.
This study was performed to determine the effect of hardiness training on self-esteem and adjustment among addicted male.
This research is a pre-post test and control group. Study sample included 200 addicted men referring to Payam addiction center in Rudsar in 2012 who agreed to participate in the study. Upon getting permission from the technical in-charge of the clinic and presenting the required description to the referred persons about the study process and its objectives, the samples responded to a three-part questionnaire consisting of personal data (age, marital status and education), Cooper Smith Self-Esteem Scale and Bell Adjustment Inventory.
Cooper Smith Self-Esteem Scale includes 58 items and the subjects chose between "Yes and No" options. The grading method of this test was as 0 and 1; positive response was 1 and negative was zero. The minimum grade a subject may take was zero and maximum was 50. In case the subject took more than 4 from eight items of the Polygraph; it means that the test validity was low and the subject attempted to show himself better than what he is.So, the subjects get the grade more than mean score, have high self-esteem and the ones get lower have less self-esteem.
Bell Adjustment Inventory (BAI) included 160 questions and 5 subscales of 32 questions that the subject responded the questions with Yes, No or I dont know; the five subscales included: adjustment at home, health, emotional, job and social. In order to obtain the grades of each adjustment field, based on the determined key 9 – 21: good adjustment; 22 – 47: average adjustment; and finally 48 – 60: weak adjustment.
In order to do the study, the justifying meeting was held for 200 qualified subjects about the study and they were requested to respond the inventory if agree. After responding to the inventory, 57 subjects got lower scores on self-esteem and adjustment. Then it was known that 30 subjects had been selected randomly; they divided into two groups of 15 subjects; control group and test group. Everybody was told they may leave the study anytime they want, and it was emphasized that during the whole training sessions, all names and study results would be kept secret. Moreover, it was reminded that upon completion of the training programs for test group, and in order to take the advantages of training programs, the control group will be under hardiness training, as well. After these processes, hardiness Training sessions were performed as lecture and group discussion for ten 90-minute sessions for test group while control group received none.
At the end after performing the sessions, during the last training sessions, the two control and test groups will complete the research tools again. In order to describe the demographic specifications of the participants and data of pre-test and post-test, the descriptive statistics were applied. ANCOVA was used to distinguish the significant effect of the independent variable on dependant variable.
The subjects were with mean age of 26.1 and majority of them (% 46.6) had secondary education. Analysis of data showed that the mean score of self-esteem in the experimental group in pretest was 21.87.42± 3.502 and 21.93±2.154 in the control group. The mean score of the Adjustment was 59.73±8.59 in the experiment and 60.67±7.62 in the control group. In the posttest, the mean score of self-esteem equaled 33.07±3.43 and the control group 23.13±2.26. Moreover, in the post test the mean of adjustment of the experimental group and the control group were 37.27±6.17 and 57±7.20, respectively. The using of covariance analysis showed that hardiness training increased self-esteem and adjustment significantly (P=0.001)
The results of this study show that participating in hardiness training meeting can affect promotion of self-esteem and adjustment in addicted men. Therefore resistance to mental stress can be increased by promoting hardiness and doing so promote health

Nowadays maintaining mental health in stressful conditions and occupations, apart from reducing sources of stress, strengthening interpersonal resources such as hardiness and resilience is considered.
Present study aimed to determine the relationship of psychological hardiness and resiliency with mental health in pre-hospital emergency technicians in Guilan Province.
This is a cross-sectional study conducted in 2013 on 70 male technicians working in pre-hospital emergency in Guilan province with at least education level of diploma to bachelor degree using Demographic Inventory, Ahvaz Hardiness Inventory (AHI), Connor Davidson Resilience (CD-RIS) and General Health Questionnaire (GHQ 28). Samples were chosen randomly from 35 pre-hospital emergency wards from a total of 53 wards Data were collected were selected randomly from overall 53 pre-hospital emergency wards and questionnaire were completed by 70 employed technicians. Stepwise multiple regression analysis was used for statistical analysis.
A significant relationship was shown between hardiness and resiliency and mental health (p The findings indicate that hardiness and resiliency are important and fundamental in the preservation and promotion of mental health in pre-hospital emergency technicians. Hardiness and resiliency

Prenatal mortality is important indicator of health and health care services at birth, therefore understanding the major prenatal mortality causes will help the society to plan better prenatal and neonatal care system.
This study aimed to determine the causes of Prenatal Mortality in Medical Centers of Alborz Province
This was a retrospective study conducted on 446 cases of intrauterine and neonatal deaths in 2012 which occurred in Medical Centers of Alborz Province and was recorded by relevant authorities in the application INFO PATH. Data were analyzed using descriptive statistics, chi-square test.
324 cases (72.6%) died in the uterus and 122 cases (27.4%) of neonate died after birth from 44.6 cases intrauterine and neonatal deaths, most time elapse of death was 50 hours after birth. 101 cases (24%) of death at birth was due to congenital abnormality and 62 patients (61.4%) were in the group of intrauterine deaths and 39 cases (38.6%) in the group of death 30 days after delivery. The most common congenital abnormality was neural tube defects (15.2%). 57 (12.8 %) mothers had disease and diabetes was the most prevalent (3.8%). By category (ICD10) in this study, the highest rate of fetal death in 359 cases (805%) were in a group of disorders with unknown origin and 186 cases (40.6%) of this group were in sub group of related disorders of duration of pregnancy and fetal growth and premature delivery was the most complication of pregnancy.
Prenatal mortality rate in this study was 11.5 in 1000 live birth. Result of present study showed that most of intrauterine fetal death causes were preterm delivery and unknown death. Therefore, in addition to health needs, identifying the causes of preterm labor and its related factors are also recommended. In this study, none of the causes of death had been determined by autopsy. Autopsy of death due to unknown causes is also recommended so that better and more proper intervention can be taken to prevent intrauterine deaths

Family is the main part of a society and achieving a healthy society is because of a healthy family. Exact description of societal characteristics requires studying profoundly and clearly about the family relationship in that very society. Therefore, the most important thing for improving a society is to improve the family and the relationship between its members.
This study was conducted to determine the effectiveness of Satir family therapy on family cohesion and flexibility.
The research employed a semi-experimental method with pre-test, post-test and control group design. The statistical population included all the female students studying in the first grade of high schools located in Some Sara City from 2012 to 2013. A sample of 16 students along with their mothers was randomly selected from those who had scored lower on family flexibility and cohesion and randomly assigned to the experimental and control groups. The group then underwent eight 90-minute sessions of group counseling. Our data gathering tools included family cohesion questionnaire and family flexibility questionnaire. Data were analyzed by multi-variable covariance.
Case study students were in range of 13 year old and the mean age of mothers of the students in the experimental group was 38.5±4.54 and 39.16±3.88 in the control group. The results indicated the mean score of family cohesion in the experimental group in pretest was 85.33±15.46 and 77.83±11.97 in the control group. The mean score on family flexibility was 49±6.09 in the experimental group and 41±9.13 in the control group. In the post-test, the mean score of family cohesion was 99.83±10.36 and the control group 79.83±12.07. Moreover, in the post-test the mean of family flexibility of the experimental group and the control group were 55.50±5.99 and 42.66±9.23, respectively.
Covariance analysis indicated that Satir family therapy significantly increased family cohesion (F=9.901, P≤0.05) and flexibility (F=13.47, P≤0.005).
Satir family therapy is effective on family cohesion and flexibility.

Elders due to retirement and reduction in income, more than other community members face financial difficulties and subsequently mental health problems such as depression and distress. Exercise can improve flexibility and mobility capabilities, cognitive function and improve mental compatibility and consistency of performance contributing to the quality of life of the aged people.
This study aimed to determine the effect of exercise on mental health of elderly in Golestan Province.
In this Quasi experimental study with Salamon design, 48 elderly referring to daily centers in Golestan province in 2011 were selected by convenience sampling method and randomly divided to control and test groups. Then each group were divided to 12-member in two intervention and control groups one and two; the intervention and control groups 1 took pre-test while the intervention and control groups 2 did not take any tests. Intervention groups did the 15- 25 minutes exercise for four weeks during 16 sessions under the supervision of researcher. Exercise started with muscle warm ups for five minutes and then exercise movements were done and finally to cool down muscles, stretching the muscles were performed again. Finally, both demographic questionnaire and Mental Health Checklist were completed. Data were analyzed using descriptive and inferential statistics (ANOVA bilateral).
The average age of participants in this study was 76.71± 7.5 years, 32% of subjects were female and 68% male. 56% were married and 36% of them lost their spouse and 4% were single. Controlling the effect of the two-way ANOVA test showed significant differences between the intervention and control groups in self-esteem and life satisfaction scores (p= 0.004). And most level of mental health was observed in first intervention group with mean 21.57±2.89.
Lack of physical activity (which is a phenomena of modern life) caused waste and lack of potential force that exists in each elderly to protect health and well being. Exercise improves flexibility and mobility capabilities, cognitive function and psychological adjustment, compatibility performance which contributes to the quality of life that is not possible to achieve with other therapies. Results showed regular exercise program promoted the mental health of elderly in intervention group. Therefore it is suggested to include regular exercise program suitable for elderly along with other care programs. It also seems the duration and type of activity in the elderly should be determined based on their ability and more fun activities such as walking and outdoor exercises in nursing homes to be included in their care plan.

Cervical cancer is the second most common cancer in women in the world. All women who are sexually active can be at risk for cervical cancer. Cervical cancer is almost entirely preventable, if detected and treated at an early stage.
This study aimed to explore women's perspective on cervical cancer till proper recognition and more comprehensive information on the experiences; understanding and viewpoint of clients are provided.
In this qualitative content analysis study, 56 married women aging 17-60 years were selected among patients attending prenatal care, gynecology, and family planning clinics of Alzahra educational hospital in Rasht city, Iran during 2012-2013. Data was collected through 8 focus group discussions. The participants were selected through purposive sampling and considering maximal variation. The inclusion criteria for women were as follows: volunteer to participate in the study, married, Iranian nationality, proficiency in Farsi, no history of mental disorders or physical disabilities based on participant's self report and interviewer's observations. Each interview session lasted 1-1.5 hours. All interviews were continued up to data saturation. All interviews were recorded by means of a digital sound recorder. Also, the non verbal interactions were recorded by the secretary and were used during data analyzing and extracting the codes. After each interview, the recorded data was transcribed and typed verbatim and were analyzed concurrently. Data analysis was done based on steps recommended by Graneheim and Lundman. To ensure rigor in this study, the criteria stated by Guba and Lincoln were considered. In this study, all ethical considerations related to human participation and qualitative research were considered. In this regard, oral and written permissions were obtained from the participants for participating in study and recording their interviews.
Mean age of participated women was 36.5 years. Many participants (40.6 %) had incomplete secondary education, 15.5 % were illiterate, 39.1 % had completed secondary education, and 4.3 % had an academic degree. Among the participants 92.8 % were housewives, 78.3% were residing in the city, 14.5 % never had a pregnancy, 29% had no children, 24.6% had one child, and 26.1% had two children or more. The participants’ viewpoints about cervical cancer were yielded to 275 primary codes and 3 main categories: “Weak health information”, "Negligence of disease", and "The necessity for support and care".
Understanding the women's experiences, perspectives and points of view about one of the most prevalent and preventable cancers in women can have potential benefits such as exploring the client's educational and counseling needs, common challenges and barriers, and support facilitative factors. On the other hand, based on our findings, the health policy makers can be encouraged to develop long term evidence based on educational interventions according to the health needs of society, particularly women

Febrile convulsion is the most common seizure disorder and cause of hospital admissions in emergency and neurology wards. This disease due to the combination of two important phenomenons at one time in child causes disorder in family life, stress and anxiety. It also causes irreversible harm to the health of child. Due to the high prevalence of febrile seizures, the need to conduct a study to determine the knowledge and practice of mothers of children with and without recurrence seemed necessary and by identifying these factors, prevention of future attacks, its complications and high costs of treatment, an effective step can be taken to improve children's health.
This study aimed to compare knowledge and practice of mothers of children with febrile convulsion with or without recurrence referring to one of educational-therapeutic centers in Rasht city.
This is a descriptive-comparative study. Samples included 156 mothers with 6 months to 6 year old children with febrile convulsion (78 patients in each group with and without relapse) referring to one of educational-therapeutic centers in Rasht city. Samples were chosen by referring to patient files as well as the follow-up patients from neurology clinic. Samples were chosen by simple and convenience sampling method. Data collection instrument consisted of a two-part questionnaire including demographic information for parents and children and a researcher made questionnaire on mother's knowledge and practice. In order to determine the instrument validity, 10 faculty members commented on content validity. Content validity of the questionnaire to all terms was more than 0.7 and content validity index was between 0.7 to 1. Test re-test method was used to detecting reliability of questionnaire respectively 10 samples completed the questionnaire twice within a week. The test-retest reliability of the outer top 90%. After collecting information and using descriptive statistics (mean and standard deviation) and analytical statistics (t-test, chi-square, Mann-Whitney, regression) were analyzed.
The findings show that the majority of samples group with and without recurrence were male. The average age of children in the group without recurrence 35/4 ± 17/85(months) group, in the group with recurrence 41/85 ± 18/32(months). 62/8% of the subjects in the group without recurrence, 58/97% groups, with recurrence were first child. .5± 3.8 more than the mothers of children with relapsed 28.1± 3.9 is. This difference is statistically significant (P In this study only predictor, the knowledge of mothers. Poor maternal awareness about diseases due to poor performance and Followed by the repeated seizures. Given the importance of the issue To prevent the occurrence of febrile seizures in children in the first place, should be trained community health nurses in health centers for pregnant women and mothers of infants seizures before they happen.

The process of puberty is one of the most important events of one’s life and onset of menstruation (menarche) is one of the important phenomena during the maturation process of females. Undoubtedly, genetics is the main determinant factor in the onset of puberty but several environmental factors contribute to the age of menarche.
The purpose of this study was to investigate the association between age of menarche and environmental factors in of 11-14 year old students in Rasht city.
This is a descriptive-analytic study conducted on 700 female students in elementary and secondary schools in Rasht city. The sampling method was conducted on at two-stage cluster random sampling basis. The data were collected by a researcher-designed questionnaire, a tape measure, and a digital scale. The questionnaire was checked for validity by means of content validity. For data collection, the questionnaires with the letters of consent were given to the students who were entitled to take part in the study. The data were analyzed by descriptive and inferential methods such as t-test, chi-square and Cox regression.
Mean and Standard deviation of age at onset of menarche was 12.093±0.051years.In examining environmental factors, the results of t-test indicated a significant difference in using cell phones, computer, frequency of use of cell phones during the week, use of a cell phones daily, time of cell phones use during the day, and daily use of computer, use of computer during the day and type of exercise based on Chi square test (P In fact, the indicator of health care planning awareness of the age of menstruation is one of the requirements for good health in puberty and fertility. In addition, it is necessary for the youth to have the basic knowledge on time in such a local context with religious and cultural beliefs. Therefore, the findings of this research project can help the managers and planners to run in-service training classes for the health workers in schools to provide the students with the timely proper information in order to prevent the student’s wrong performance resulting from excessive use of cell phones and internet and improper information obtained from their peers and unsuitable sources.

The prevalence of human papilloma virus (HPV) is growing in the world. According to the precancerous role and the importance of prevention, human papilloma virus vaccination is considered in all countries. The knowledge and attitude of patients have a considerable effect on HPV injection. It seems that higher knowledge level of physicians can have significant effect on justification and informing target group for vaccination.
The aim of this study was to determine the level of knowledge and attitude of medical students regarding human papilloma virus vaccination and associated factors in Guilan University of Medical Sciences.
This analytic cross-sectional study was carried out on 90 medical students who entered in 2005 and 2006 by census method. Inclusion criteria were studying in final year and would like to participate in the study. In 2012 Data were gathered by a questionnaire including three sections: demographic characteristics (6 questions), knowledge (20 questions) and attitude (26 questions). In scoring knowledge questionnaire, correct, don’t know and incorrect answers received 1, 0 and -1 respectively. 1-3 likert scale was used to score the attitude questions. Agree, don’t know and disagree received 3, 2 and 1 respectively. The level of knowledge score was -20 to 20 points and the attitude included 26-78 points. For data analysis, descriptive statistics including mean, standard deviation, frequency and analytic statistics including T-test and Pearson correlation coefficient were used.
Findings indicated that most participants (82.2%) were female and 66.7% aged less than 25 years. The main source of information about HPV was from courses taken during medical school (57%). Mean of knowledge score was 5.17±3.24 (answers ranging 5-13) and mean of attitude score was 52.16±5.04 (answers in ranging 38-63). There was no significant difference between knowledge and attitude about HPV and sex, age groups, marital status and medical student’s source of information. Also, no correlation was noted between knowledge and attitude about HPV (P=0.28, r=0.11).
Based on study results, the level of Knowledge and attitude of medical students about HPV vaccination was low. Also in attention to the source of student's information, special attention to educational contents for knowledge and attitude promotion is important for future physicians. Therefore educational programs are needed to increase student's knowledge during study especially during clinical education on HPV and vaccination. On the other hand with attention to the role of physicians in giving information to society, better knowledge and understanding of students regarding role of vaccination and decreasing mortality of cervical cancer can take a step to promote the condition of societal health.

Psychosocial consequences of Humanity Immunity Virus infection may create more problems than disease itself. One of the psychosocial consequences of perceived social stigma in patients with acquired immunodeficiency syndrome is decrease of self-esteem, because this disease has numerous negative effects on self-esteem of patients through cognitive and psychological changes.
The aim of this study was to determine the relationship between perceived social stigma and self-esteem among patients with AIDS.
This study was conducted with correlation and cross-sectional design. Data were collected from 63 patients with HIV symptoms who referred to Yazd behavioral disease clinic in 2012. These patients were chosen by convenience sampling method. Sample size was determined using Cochran formula. Measuring tools included Rosenberg Self-esteem Scale and Perceived Stigma Questionnaire and reliability of tools was calculated using Alpha Cronbach. Data were analyzed using zero-order Pearson correlation, independent t-test, one-way analysis of variance (ANOVA), and the hierarchical multiple regression methods.
Sixty-three patients (48 men and 15 women) with symptoms of immune deficiency syndrome were studied. Participants aged between 14 and 56 years with an average of 36±7.77 years. Mode and number of HIV infection included: drug injection 33 (52.4 percent), sexual intercourse, 17 (27%), unknown 9 (14.3%), blood and blood products 3 (4.8%) and transmission from mother to fetus 1 patients (1.6%). Also, the duration of HIV infection was between 1 and 15 years with an average of 3.15 ± 7.85. There was no significant difference between men and women with symptoms of immunodeficiency in terms of perceived social stigma. Also, way of contracting the HIV virus did not make a difference in patient's perceived stigma. There was reversed significant correlation between perceived social stigma and self-esteem (P Perceived social stigma acts as a risk factor for decease of self-esteem in patients with HIV/AIDS. Therefore, presenting proper socio-cultural interventions to these patients, families and people to correct their beliefs regarding HIV can help promote patients’ self-esteems

Childhood aggression is a major health problem throughout the world, particularly in recent years. Aggression in the preschool years, when the child starts extensive interaction with age group, becomes an important issue. The reason for problem could be attributed to a set of biologic, psychological, cultural, and familial variables.
This study aimed to determine the level of aggression and socioeconomic factors associated with aggression in preschool children in Rasht city.
This cross-sectional descriptive analytical study was conducted among preschool children in Rasht city in 2013.Study samples included 614 children aging 5 to 7 years who were chosen by two-stage cluster sampling from preschool centers affiliated to Education and Welfare departments in Rasht. Data collection tool included two questionnaires, Preschool Children Aggression Scale completed by teachers to evaluate verbal, physical aggression, relationship and impulsive anger of children and questionnaire of related socioeconomic factors, completed by parents. Then data were analyzed by using descriptive and analytical statistics (Kruscal Wallis, Mann Whitney U and Multiple Linear Regression Test).
The mean aggression score was in the area of verbal aggression 4.5 ± 7.5, physical aggression 2.3 ± 4.3, relationship 4.5 ± 6.3, impulsive anger 4.5 ±5.7 and total aggression score 15.8 ± 20.8. There was a statistically significant relation between location change of stressful events and relationship aggression (p According to the results of the study it seems that socioeconomic factors are the main predictors of aggression in children, especially in the area of relational aggression and impulsive anger. Therefore, to prevent aggression in children, special attention must be paid to these factors

Loneliness as a predictor of children and adolescents adjustment problems has been focused on by mental health researchers. Increasing virtual relationship instead of family and social relationship especially among adolescents has led to loneliness and other problems.
The aim of this study was to determine the relationship between loneliness and associated factors of internet and cell phone usage in secondary high school students in Rasht city in 2014.
This analytic cross-sectional survey was conducted on 581 students of second cycle high schools in Rasht city who were selected by cluster sampling. For collecting data a researcher made questionnaire for demographic and associated factors of internet and cell phone usage and University of California at Los Angles Loneliness Scale loneliness questionnaire were applied. Data were analyzed by descriptive and inferential statistics (Mann-Whitney U test, Kruskal-Wallis, Chi-square, Spearman correlation and multiple logistic regressions).
Findings indicated that 16.9% of the samples have gained more score than the mean of loneliness tools. Most students used the internet for downloading music, movies or books (68%) and participation in social networking websites such as face book (%36/1), and cell phone for texting ( 31.7%) and taking picture/ film (25.8%). There was a significant correlation between age (p=0.022), number of close friends (p=0.0001), field of study (p=0.002), father's education (p=0.003), mother`s education (p=0.006), visiting the scientific websites and doing homework (p=0.015), spending leisure time (p=0.0001) and downloading music, movies or books (p=0.029) and loneliness. Based on regression analysis, variables mother’s education (having high school diploma) (OR=0.470, p=0.014). How to spend free time (OR= 2.391, P=0.0004) and the number of close friends (OR= 0.949, p=0.01) and Presence in social network such as Face book (OR=1.952, p=0.016) remained in the final model as significant predictors of loneliness.
Because of the direct and significant correlation between loneliness and some personal and social characteristics and factors associated with internet and cell phone usage among students, it is necessary to focus more attention on the new communication technologies and to plan appropriate educational programs to prevent the adverse consequences of problematic use of them on the adolescent's mental health.