Journal of Holistic Nursing and Midwifery
Volume:27 Issue: 1, Spring 2017

Today, psychological methods are being applied more often to reduce adverse effects of social life and to enhance positive and satisfying effects of communal life.One of these methods is psychological resilience training.
The present study was conducted to determine the effectiveness of resilience training on aggression and happiness among nursing and midwifery students of Islamic Azad University of Rasht during 2013-14 academic years.
This controlled quasi-experimental study with a pretest-posttest design used Oxford Happiness Questionnaire;Buss-Perry Aggression Scaleand Resilience Scale.The study population included 400 nursing students of Islamic Azad University of Rasht in the 2013-14 academic years. Inclusion criteria were willingness to participate in the study and no history of mental illnesses. Exclusion criteria were unwillingness to participate in the study, diagnosed psychological disorders, and the use of psychotropic medications and sedatives.According to the research methodology, the statistical sample consisted of 30 students selected using Morgan table by convenience sampling among eligible students who had low happiness score and high aggression score after completing the questionnaires. Then they were randomly assigned to the intervention and control groups (15 per group).The intervention group received twelve 75-minute sessions of resilience training by a consultant as a group and the control group received no training. After 12 sessions of resilience training, happiness and aggression among the students were measuredin both groups (post-test), and then the data were presented using descriptive statistics (mean, standard deviation).The covariance analysis was used to evaluate the effects of resilience components on happiness and aggression.
The statistical results showed that resilience training was effective on happiness and aggression reduction (P According to the findings, implementing resilience training programs can be effective in decreasing aggression and increasing happiness in students.Therefore, it is useful to add these programs to university curriculum.

Divorce, unwanted pregnancies and failed marriages inflict severe mental, emotional, physical and financial damages on individuals, families and the community. Meanwhile, premarital education programs are considered one of the effective factors to prevent such problems.
The present study aimed to determine challenges of premarital education program in Iran.
This systematic review was conducted by searching the PubMed, Elsevier, Magiran, IranMedex, SID Irandoc, Medlib, and Google scholar databases in order to find papers in Farsi and English with the keywords of couples, training, consultation, premarital, Iran, health program, preparation for marriage, educational needs, and divorce. We reviewed different case-control, descriptive, and descriptive-analytical studies on premarital education. Of the 28 published papers on premarital education, 17 articles met the inclusion criteria.
Factors and challenges associated with premarital education can be divided into two main categories: policy making challenges and operational challenges.
The results showed that marrying couples need the knowledge and skills that are not provided in the current premarital education. Complete execution of premarital education in Iran is possible only in the light of awareness, sufficient resources, considering the needs of the target group, and the presence of an accountable system.

Health promoting lifestyle is one of the determinants of health. University years are important phase of life when one can develop health promoting lifestyle. Given the high cost of healthcare there is need of shift from a treatment based approach to a preventive approach in which appropriate methods should be developed to promote health and productivity among youth.
This study was aimed to measure health promoting lifestyle among the students of Guilan University of Medical Sciences in 2013-14.
This cross-sectional study which measured six domains of health promoting lifestyle by using the 52-item Health Promoting Lifestyle Profile (HPLP II). Convenient sample of 343 students from the University was selected in 2013-14. The tool’s reliability was confirmed by a Cronbach’s alpha coefficient of 95% and intra class correlation coefficients of 67%-87% for the subscales. Data was presented in (frequency, mean, and standard deviation and (ANOVA and t-test) were used for comparing two or more variables.
The total score of health promoting lifestyle (129.46 ± 17.69) was undesirable in university students. There was significant differences in terms of spiritual development (P = 0.004) and inter-personal relations (P Health Promoting lifestyle scores were undesirable in university students and significantly related to eating and physical activities. Therefore, there is an urgent need of developing program on healthy lifestyle for them.

Promoting and maintaining breastfeeding is an important part of the healthcare, nutrition and other social measures required to promote proper growth and development of infants, and a major component of primary healthcare. Several factors affect onset and duration of breastfeeding. Self-efficacy is one of those factors that can be modified, buthas been less studied.
The present study aimed to determine some risk factors associated with breastfeeding self-efficacy of mothers within 6 weeks of delivery.
This cross-sectional descriptive-analytical study recruited 767 mothers presenting to Family Health and Research Center in Rasht in 2013, using consecutive sampling (for 6 months).Data was collected using demographic questionnaires and Dennis Breastfeeding Self-EfficacyScale (BSEF).Data was collected in two phases: on the 3rd-5th days and the 6thweek after delivery.The minimum and maximum breastfeeding self-efficacy scores in BSEF are 14 and 70, respectively. If a subject's score is above average, she has high breastfeeding self-efficacy and vice versa.Descriptive statistics (mean, standard deviation) and inferential statistics (chi-square test, Mann-Whitney test, Pearson’s correlation coefficient and multiple regressions) were used to analyze the data.The confidence interval of 95% and asignificance level of P The results showed that the mean and standard deviation of breastfeeding self-efficacy score were 57.64±9.94 and 62.66±7.57, respectively on the 3rd-5th days and the 6th week after delivery. The group that exclusively breastfed their newborns had higher than average breastfeeding self-efficacy scores compared to other mothers. The multivariate regression model showed that the variables of educational level (secondary schoolP=0.002, B=2.25; and high school diploma, P=0.03, B=1.51), pain (P=0.01, B=1.6), breastfeeding discontinuation because of pain (P=0.02, B=2.67), having a successful breastfeeding experience (P=0.01, B=1.93), and exclusive breastfeeding (P=0.01, B=6.28) had statistically significant relationships with breastfeeding self-efficacy.
According to the results, breastfeeding self-efficacy influenced the status and type of breastfeeding, hence, necessary interventions should be made to remove the barriers toand resolve the problems of mothers for exclusive breastfeeding.

Given the growing rate of accidents and disasters in the world, preparing nurses as the main group responding to these events is crucial; however, a review of literature suggests no comprehensive and theoretical or practical definitions for this concept in nursing, which has been often misunderstood and used as an alternative to other similar concepts.
The present study was conducted to analyze the concept and provide a practical definition for emergency and disaster preparedness in nurses.
Materialsand The eight-step Walker and Avant’s approach was used to clarify the concept of disaster preparedness in nurses. A total of 40 articles selected on the subject through an extensive review of literature up to 2013 were analyzed and the relevant definitions, applications, attributes, antecedents, consequences and empirical referents were extracted.
According to the analysis conducted, the concept attributes include gaining the disaster knowledge and management capability, response planning strategies, response behavior exercises and the evaluation of the knowledge level and the response program content. Improved knowledge and skills, professional accountability, more comprehensive programs and more accurate response behaviors were found to be the outcomes of disaster preparedness in nurses.
According to the present study, disaster preparedness in nurses refers to the knowledge, skills, abilities and comprehensive functions required for responding to natural or man-made events and disasters. Nurses’ preparedness in disasters refers to a process in which nurses involve to properly prepare and effectively respond to emergencies and disasters. Given the wide range of the concept, further studies are recommended.

Quality of life is individuals’ perception of their status in life in the context of the culture and value systems they live in. Pregnancy has a great impact on mothers and their quality of life. Prenatal classes provide mothers with information about pregnancy, labor process and newborn care.
The present study was conducted to evaluate the effect of prenatal classes on the quality of life of pregnant women.
This quasi-experimental study recruited 100 pregnant women in Amini Hospital of Langeroud, Iran. Mothers were divided into intervention group, who received education (n = 50), and control group who received only routine prenatal care (n = 50).Prenatal classes were held in 8 sessions. The quality of life of pregnant women was assessed before and after the intervention. Data was collected by a demographic questionnaire and a Quality of Life Short Form Survey (SF-36) which was completed by women before and after the intervention. After entering into the computer, the statistical data were analyzed using chi-square test and independent and paired t tests.
The results of comparing the means of quality of life domains in the intervention group showed that mental health (P=0.40), vitality (P=0.11), and emotional role functioning (P=0.87) had higher health scores in the intervention group compared to before the intervention, although the difference was not statistically significant and only physical functioning had a significant difference (P=0.001). However, the comparison of the mean and standard deviation of quality of life domains before and after classes in the control group indicated lower scores for all domains after theintervention. Differences were significant in terms of physical functioning (P=0.007), physical role functioning (P=0.011), emotional role functioning(P=0.039), and pain (P=0.002).
The study showed that women who received prenatal education had better scores and mental health. Therefore, prenatal educations are necessary to improve health and quality of life of mothers.

The acquisition of speech and language constitutes a dynamic part of two-year-old children’s growth. Expressive lexicon is a key indicator of language ability in these children. Premature birth, birth before gestational week 37, is one of the most common risk factors associated with learning skill development. A review of literature suggests inconsistent results on the relationship between preterm birth and the size of expressive lexicon in children.
The present study was conducted to investigate the relationship between preterm birth and the size of expressive Lexicon in 18-36-month-old Persian-speaking children.
The present controlled analytical cross-sectional study recruited 18-36-month-old children presenting to 17 Shahrivar Hospital in Rasht, Iran. The study children were divided into the term and preterm groups. Before beginning the sampling, the children were assigned to three age groups of 13 each, including 18-24 months, 24-30 months and 30-36 months. The data collection tools comprised the 688-itemMacArthur-Bates Communicative Development Inventory (CDI, form II), which was completed by the parents. Moreover, all the words were divided into four groups of social terms, common nouns, grammatical words and predicates, and the scores obtained for each category were compared among the groups. The data obtained were assessed using descriptive statistics of mean and standard deviation, and analytical t-test. P The overall mean size of expressive lexicon was found to be 352.48 ± 177.11in the term children and 240.28 ± 135.93 in preterm ones, suggesting significant differences between the two groups (P=0.002). Significant differences were also observed between the term and preterm 18-36-month-old children in terms of common nouns as a dimension of the tool (P=0.01).
Parents seem to play a key role in reducing preterm-birth associated lexicon differences at higher age by teaching their children.
re, these domains should be addressed and ways should be introduced for their provision in family-centered care.

Prematurity is the leading cause of mortality in newborns without congenital anomalies worldwide. A premature newborn has a devastating effect on parentsroles, especially the mothers’, and creates sentimental and vague feelings for mothers. Although advances in technology and high levels of nursing care provide mothers with adequate support and relative independence in child care, it is practically difficult to terminate nursing care and leave it to the mothers.
The present study aimed to determine the viewpoints of mothers of premature newborns about the importance and amount of the support received from nurses.
This cross-sectional study was conducted with a gradual approach over three months on 160 mothers of premature newborns with a history of hospitalization for at least 24 hours in NICUs of Rasht educational-medical centers in 2014.Data collection tool was a mother/child demographic questionnaire and the 21-item Nurse-Parent Support Tool. Data was analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (Spearman’s correlation coefficient).
The results showed that the highest and lowest amounts of support received by mothers were in the care giving support (69.87±3.0) and parental esteem (96.85±2.0), respectively. Also, according to the mothers, care giving support (39.7±4.0) was the most and emotional support (75.0±3.99) was the least important domain. The results revealed a significant relationship and inverse correlation between the mean score of giving and receiving parental esteem (r = -0.184, p = 0.02) and the mean total score of giving and receiving support from the viewpoint of mothers and nurses (r = -0.183, p = 0.012).
Mothers would like to have the highest amount of support in providing the best care for their newborns. Mothers’ most dissatisfaction was with the supportive communication and parental esteem domains which were important for mothers but received little attention from nurses. Therefore, these domains should be addressed and ways should be introduced for their provision in family-centered care.

Diabetic retinopathy is a major cause of blindness and a fundamental cause of disability in diabetic patients in the world. Investigation about the quality of life in these patients can help plan for taking nursing measures to prevent or control the disease and improve patients’ quality of life.
This study aimed to determine the quality of life in patients with diabetic retinopathy.
In this cross-sectional descriptive analytical study (2014), 316 patients with diabetic retinopathy who attended the laser unit in Amir-al-Momenin Medical Educational Hospital, Rasht, for treatment and had a follow-up record were selected by convenience sampling. The data were obtained by the Retinopathy-Dependent Quality of Life (RetDQoL) questionnaire, a socio demographic questionnaire and the Charlson Comorbidity Index (CCI). The final score for quality of life ranges-9 to 3. The closer to -9 is the final score; the better is the quality of life. Independent t-test, analysis of variance (ANOVA) and Pearson’s correlation were used to analyze the data.
The results showed that the mean score of quality of life in subjects was -1.73, indication glow quality of life. In addition, statistical tests indicated a significant relationship between quality of life in patients with diabetic retinopathy and income, employment and education (p According to the findings, based on which patients had low quality of life, it is recommended that authorities adopt consulting, training and financial programs to control the predictors of quality of life and improve patients’ quality of life.

Patient-nurse relationship has been recognized as the key factor in nursing practice. Considering the importance of professional relationship in nursing discipline, and especially empathy and its professional role, the need to address this phenomenon in nursing education in Iran is profoundly felt.
The present study was conducted with the aim to compare level of empathy with patients and related factors between first- and final-year nursing students of Guilan University of Medical Sciences.
The present descriptive-analytical study was conducted on 180 nursing students of Guilan University of Medical Sciences (ShahidBeheshti School of Nursing and Midwifery in Rash and Langrood) selected by census from the academic year 2014-15. Data collection tool was a two-part questionnaire consisting of socio demographic data details and Jefferson Scale of Empathy containing 20 items, scored according to Likert scale from strongly agree (7 points) to strongly disagree (1 point), in which students chose items based on the level their agreement. Student's mean empathy score was calculated from maximum seven points (higher empathy) and minimum one point (lower empathy). In total, the maximum score for the 20 items was 140 points and minimum 20 points. Data thus collected were analyzed using descriptive and analytical statistical tests (independent t, Pearson’s correlation coefficient and logistic regression).
Student's mean age was 22.21±2.94 years, and the majority were female (63.3%). No significant difference was observed between empathy among first-year students (5.03±0.041) and final-year students (4.94±0.7) (P The results obtained showed no significant difference between first- and final-year students in terms of empathy score. Since reinforcing predicting factors leads to greater student empathy with patients, empathy skills education in the course of study and generating interest among students appears to increase their sense of empathy.

With a prevalence of 4-25%, polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of the reproductive age. This syndrome causes different metabolic, reproductive, and psychological issues. Therefore, performing research and raising awareness in this regard seem essential.
This study measured self-efficacy, quality of life, and marital adjustment in women with PCOS.
This cross-sectional, descriptive study used convenience samplingto recruit 129 women with PCOS and 125 healthy women during 2013-14. The Rotterdam Diagnostic Criteria was used to confirm the diagnosis of PCOS. The participants completed the General Self-Efficacy Scale (GSE-10), the World Health Organization’s Quality of Life Questionnaire-Short Form (WHOQOL-BREF), and the Dyadic Marital Adjustment Scale (DAS-32). The data were analyzed using t-tests and multivariate analysis of variance.
The mean scores of marital adjustment were 139.05 ± 16.984 in healthy women and 132.78 ± 20.633 in those with PCOS. The corresponding scores of quality of life were 98.62 ± 11.370 and 93.48 ± 13.372. The mean self-efficacy scores in healthy women and women with PCOS were 28.72 ± 5.65 and 27.92 ± 4.750, respectively. Healthy women had significantly higher marital adjustment and quality of life compared to women with PCOS (t = 2.641; P = 0.009 and t = 3.234; P = 0.001, respectively). However, the two groups had no significant difference in terms of self-efficacy (t = 3.234; P = 0.001).
Compared to healthy women,women with PCOS have lower performance in some psychological aspects. Therefore, it is essential to raise women’s awareness about the symptoms and psychological effects of PCOS. A referral system should also be designed to provide the patients with counseling services. level of empathy diminished with a higher level of father's education (β=-0.142).
The results obtained showed no significant difference between first- and final-year students in terms of empathy score. Since reinforcing predicting factors leads to greater student empathy with patients, empathy skills education in the course of study and generating interest among students appears to increase their sense of empathy.

Brain injury induced coma is the main cause of hospitalization of patients in the intensive care unit (ICU) and their consequent stressful physiological complications, which can be prevented using sensory stimulation as a therapeutic method. Nevertheless, identifying and using the optimal sensory stimulation program is crucial.
The present study was conducted to determine the effects of organized auditory stimulation by familiar voice on blood pressure and body temperature in patients admitted to ICUs.
The present clinical trial was conducted on 60 comatose patients with traumatic brain injury (TBI) admitted to the ICU of Poursina Teaching Hospital, Rasht, Iran. The patients were randomly assigned to the intervention group (N=30) and the control group. In the intervention group, auditory stimulation was conducted using significant others’ voices in three consecutive evening shifts, 10 minutes each time. Blood pressure and body temperature were evaluated using a checklist, and the findings obtained were analyzed using ANOVA, the t-test and the Chi-square test.
The results obtained revealed significant differences in the mean blood pressure and body temperature before and after auditory stimulation in the intervention group (P Given the significant effects of auditory stimulation on hemodynamic indicators, auditory stimulation by familiar voice is recommended in comatose patients admitted to ICUs through face-to-face visits with their family members or by playing their recorded voice.
uld also be designed to provide the patients with counseling services. level of empathy diminished with a higher level of father's education (β=-0.142).
The results obtained showed no significant difference between first- and final-year students in terms of empathy score. Since reinforcing predicting factors leads to greater student empathy with patients, empathy skills education in the course of study and generating interest among students appears to increase their sense of empathy.