Journal of Holistic Nursing and Midwifery
Volume:29 Issue: 1, Winter 2019

Stillbirth is one of the saddest experiences in a woman’s life, which can have a wide range of cognitive, psychological, spiritual and physical consequences. The health system should consider appropriate educational interventions for mothers in critical situations. The purpose of this study was to determine the educational needs of Iranian women who experienced stillbirth and help them adapt to this event and improve their health as well as their families’ health. This study was conducted using qualitative content analysis. The participants were 15 women with stillbirth experience who were selected through purposive sampling method among the volunteers referring to health centers in Isfahan Province, Iran. The relevant data were collected and by individual interview recording method. The extraction codes were categorized and three main categories extracted in this regard. The analysis of the participants’ opinions in describing the required education in the case of stillbirth led to the emergence of three main themes; “management of postpartum changes”, “education for the next pregnancy”, and “teaching how to communicate with children”. Based on the findings, many mothers complained of their lack of necessary education in this matter. They believed that if they received their educational needs, they would easier adapt to this experience. According to the results, review and modification of the care program (to provide women’s required education) is necessary to promote the health of women experienced stillbirth. Midwives and health care providers should work on the development of educational and counseling programs for women with stillbirth experience and provide better care for these women.

Job and career is one of the social aspects that affects the health of individuals. Nurses spend much of their time at work in close contact with patients, so the quality of their working life can have a significant impact on their health.  This study aimed to investigate the relationship of Quality of Work Life (QWL) dimensions and general health dimensions in Iranian nurses working in treatment and educational centers of Rasht City, Iran. This is an analytical cross-sectional study conducted on 404 nurses working in eight treatment and educational centers in Rasht, Iran. The samples were selected by stratified random sampling method. For collecting data, a demographic form, Brooks’ Quality of Nursing Work Life (QNWL) questionnaire, and Goldberg and Hillier’s General Health Questionnaire (GHQ) were used.  The obtained data were analyzed using descriptive statistics and inferential statistics of Spearman correlation, Chi-Squared tests, and multiple logistic regression analysis. The majority of the studied nurses (55.4%) had desirable QWL and most of them (61.1%) were suspected of having health disorder. There was a significant and negative relationship between total nurses’ QWL scores and its dimensions with total nurses’ general health and its dimensions (P<0.001). Regression analysis results indicate that the first dimension (work life/home life, OR=3.581, P<0.001), second dimension (work schedule, OR=1.932, P=0.038), and the third dimension (work conditions, OR=1.879, P=0.05) were the predictors of the nurses’ general health. Since the highest relationship was between work life/home life and general health, hospital managers are recommended pay more attention to this dimension of QWL, and use appropriate strategies such as providing child care services (like kindergarten services) and reducing nurses’ working hours to improve nurses’ general health.

Although humor plays an important role in improving people’s mental and physical health, empirical studies on the effectiveness of humor skills training to improve the symptoms of the patients with schizophrenia are scarce. This study aimed to determine the effectiveness of humor skills training on positive and negative symptoms in male patients with chronic schizophrenia spectrum. This research has a quasi-experimental design with pretest-posttest and control group. The statistical population consisted of male patients with chronic schizophrenia admitted to rehabilitation centers in Ardabil City, Iran. A sample of 30 patients were selected with cluster random sampling method and randomly divided into two groups of experimental (n=15) and control (n=15). Members of both groups were pretested and humor skills training program using the McGee 8-step plan was administered to the experimental group for 8 sessions. To collect the data, the Positive and Negative Syndrome Scale (PANSS) was used. The obtained data were analyzed using Analysis of Covariance (ANCOVA). Positive and negative symptoms scores significantly decreased after 8 sessions of humor skills training in the experimental group (P=0.001) while there was no significant difference between pretest and posttest scores in the control group (P>0.05). Humor skills training decreased positive and negative symptoms in patients with schizophrenia. Therefore, using this program is recommended to reduce the problems of patients with schizophrenia.

Women experience unique events during their lives, two examples of which are pregnancy and childbirth. Sexual desire and activity in pregnant women and their husbands are unpredictable during pregnancy and their sexual function may increase, decrease, or remain unchanged. This study aimed to predict sexual function based on the love styles and maladaptive schemas among pregnant women. This study employed a cross-sectional analytical research design and the study population included all pregnant women who referred to healthcare centers and clinics in Shiraz City, Iran in 2016. The research sample consisted of 300 pregnant women who were selected through purposive sampling method from all pregnant women referring to healthcare centers in Shiraz. The data collected through questionnaires of Female Sexual Function Index Questionnaire (FSFI), love attitude scale, and Young schema questionnaire. The collected data were analyzed using Pearson correlation coefficient and stepwise regression analysis. The results indicate that subscales such as abandonment and rejection (β=-0.459, P<0.001), autonomy dysfunction (β=-0.253, P=0.003), extreme orientation (β=-0.2, P=0.005) and awareness (β=-0.021, P=0.014) are negative significant predictors of sexual function. In addition, Eros and Pragma styles are positive significant predictors of sexual function, while Ludus and Mania styles are negative significant predictors of sexual function. The familiarity of couples with love styles and cognitive schemas is worthy of attention because they are important in preventing sexual dysfunction and increasing sexual satisfaction.

Cardiovascular diseases are the leading causes of death around the world. Identification of triggers that lead to acute coronary events in ischemic heart diseases and their prevention can reduce the complications of myocardial infarction. The purpose of this study is to determine emotional triggers in patients with acute Myocardial Infarction (MI). This is a cross-sectional study conducted on 269 patients with acute MI hospitalized in two medical centers in Rasht, Iran in 2015. The relevant data were collected by a researcher-designed questionnaire completed by interview. The obtained data were analyzed using descriptive and inferential statistical methods, Cochran test and Generalized estimating equations of logistic regression. P values less than 0.05 were considered statistically significant. The Mean±SD time of patients’ exposure to studied emotional triggers were reported as 4.99±5.50 h for anger; 13.1±2.4) h for insomnia; 4.71±4.85) h for quarrels; 5.78±5.01) h for unexpected news; 1.9±2.9) h for partner bereavement; and 5.17±4.80) h for watching sport games before acute MI onset. Regression analysis results indicates that the risk of having acute MI is associated with exposure to quarrels (95%CI1.19-3.38, OR=2.01, P=0.008), unexpected news (95%CI1.35-3.53, OR=2.19, P=0.001), and partner bereavement (95%CI0.08-0.84, OR=0.27, P=0.024) prior to acute MI onset. The most important emotional triggers of acute MI were quarrels, unexpected news, and partner bereavement during hazard period.  Therefore, it is necessary to take these factors into account in order to raise awareness among at-risk people, and to use appropriate emotional control mechanisms to reduce stress after these events.

The surge in the aging population is a global phenomenon. Thus, it calls for attention to the issue of health, comfort, and welfare of the elderly in different aspects including Social Well-being (SW). In this regard, this study aims to investigate the SW status and its related areas in the elderly people living in nursing homes of Rasht City, Iran with respect to socio-demographic variables. This cross-sectional study was conducted on 185 elderly aged over 60 years living in the nursing homes in Rasht. Sampling was done by census method. Data collection tools were socio-demographic form and the Iranian social well-being questionnaire. For analyzing data, descriptive statistics and statistical tests of Mann-Whitney, Kruskal-Wallis, and logistic regression analysis were used. The Mean±SD SW score of the participants was 4.64±0.91 (from 5), where the highest score was in the area of family, and the lowest in the area of friend/relative. The SW status of the majority of subjects in the area of family was “good” (56.2%); in the area of friend/relative, was “poor” (53.5%); and in the area of community, was “moderate” (63.8%). On the whole, the SW status of most subjects was moderate (56.2%). Among socio-demographic variables, the type of nursing home (OR=2.8, P<0.024), and receiving phone calls (once a week) (OR=19.7, P<0.0001) were predictors of SW. Considering the specific structure of Iranian families and the importance and position of the elderly, their SW score in the field of family is not appropriate, and there is still room for concentration on the family along with the community. Also, outside-family communications of the elderly people need more attention and should be considered in planning and care of this age group.

Marital satisfaction is important for several reasons, including individual and mental health of the husband, wife and children. One of the main factors in marital satisfaction is the division of household tasks, which varies according to the gender-role beliefs of the couples. This study aims to examine the association between marital satisfaction, division of household labor, and gender-role beliefs of couples. This is an analytical study with correlational design conducted on 120 couples referred to the health care centers in Mashhad City, Iran, in 2013. They completed a demographic form, Persian version of Evaluation  and Nurturing Relationship Issues, Communication, and Happiness (ENRICH) marital satisfaction scale, a researcher-designed household labor division questionnaire, and another researcher-designed gender-role belief questionnaire. The collected data were analyzed using descriptive and inferential statistics. Marital satisfaction of spouses had no significant relationship with their gender-role beliefs.  Performing household tasks by wives were not significantly associated with their marital satisfaction, but when their husbands participated in household labor, their marital satisfaction increased which was statistically significant (r=0.18, P=0.004). Husbands’ participation in household labor was significantly correlated to their marital satisfaction (r=0.20, P=0.025). Although most husbands believe in traditional gender-roles and wives in modern beliefs, these attitudes do not correlate with their marital satisfaction and the division of household labor. Husbands who had higher marital satisfaction reported more participation in housework.

Multiple Sclerosis (MS) as a stressful event, despite causing negative psychological changes, may lead to positive ones as well. This study was mainly conducted to examine the implications of posttraumatic growth and demoralization and also to determine the relationship between them in patients with MS. This was a cross-sectional study, in which the research population included all patients with MS who were the member of Ardabil Multiple Sclerosis Association. Using convenience sampling method, 146 eligible patients completed the posttraumatic growth tool and the demoralization scale.  The obtained data were analyzed by using descriptive (mean, range, frequency, standard deviation) and inferential (Pearson correlation coefficient) statistics. The Mean±SD age of the participants was 33.59±8.70 years, and most of them were female (67.8%), married (67.1%) and had a high school diploma (49.3%). The Mean±SD scores of posttraumatic growth and demoralization were 65.23±17.1 and 34.71±18.22, respectively. Also, a significant inverse correlation was obtained between demoralization with posttraumatic growth (P<0.001; r=-0.57) and its dimensions (P<0.001; r=-0.23 to -0.57). By decreasing the score of negative psychological changes (demoralization), the score of positive psychological changes (posttraumatic growth) increases in the MS patients. Nurses, psychological counselors, and other community caregivers can provide the context to create positive changes in MS patients, by reducing demoralization and resolving patients’ psychological problems.