Iranian Journal Of Nursing and Midwifery Research
Volume:23 Issue: 2, Apr-Jun 2018

In recent years, the Internet has become one of the most popular sources of health information for users, and pregnant women are no exception. This study aimed to investigate Internet usage among pregnant women for achieving health information on the finding of related studies.
This review study was conducted by searching databases such as IranMedex, Magiran, Scientific Information Database, Irandoc, PubMed, Science Direct, Cochrane, Google Scholar, and Scopus in December 2016. Restrictions were placed on publication to within 16 years and language of publication was restricted to English and Persian. Keywords used in the search included information‑seeking behavior, information‑seeking, information needs, access to information, pregnancy, and pregnant women.
This search resulted in 106 related publications and among them sixteen articles met inclusion criteria. This review showed that the use of the Internet by pregnant women was driven by information needs, ease, and speed of access and finding people with the same situation. Fetal development, symptoms, and complications of pregnancy, prenatal tests and nutrition, activities during pregnancy, and stages of delivery were the most often mentioned topics of interest. The benefits of internet use include reduced anxiety, personal support, creating an emotional connection and an increased confidence.
Health providers must have sufficient ability for interpreting the achieved information from the Internet and should allocate efficient amount of time for discussing information‑seeking manners with pregnant women. Furthermore, they must try to respond to the doubts of pregnant women and provide valid and reliable online educational resources.

Labor pain is the most severe pain women would experience, which could lead to loss of emotional control that plays a key role in creating a traumatic delivery experience and psychological disorders. The goal of this study was to evaluate the effect of acupressure on anxiety level and sedative and analgesics consumption in women during labor.
This study was a randomized, single‑blind clinical trial performed at Maryam Hospital in Tehran, Iran. One hundred and thirty‑one pregnant women in Labor Ward were selected by convenience sampling. Subjects were randomly allocated to three groups, namely experimental group (pressure group), control group 1(touh group) and, control group 2 (routine care group). The study data were gathered using demographic information form, and assessed with Faces Anxiety Scale (FAS). For participants belonging to the experimental group, pressure was applied to the Spleen 6 acupoint for 30 min, and for those with only light touch was applied to the Spleen 6 acupoint for 30 min. The collected data were analyzed using Statistical Package for the Social Sciences 16 and descriptive statistics.
There was a significant difference between the three groups in terms of the mean of anxiety after 30 min of starting the intervention and 30 min after termination of the intervention; the anxiety of the experimental group was significantly decreased (p = 0.03). Sedative and analgesics consumption was significantly lower in the experimental group compared to the other groups (p = 0.006).
This study showed that compression of the Spleen 6 acupoint was an effective complementary method to decrease maternal anxiety and analgesic consumption, especially pethidine.

The process of becoming a mother is considered as an enjoyable and evolutionary event of women’s life. However, due to physical and mental changes, it can be associated with some degree of stress and anxiety that may lead to mental health problems. This study aimed to compare the effects of mental health training during pregnancy on stress, anxiety, and depression between two groups of couples and pregnant women.
This randomized clinical trial was conducted on 120 pregnant women referring to health centers in Isfahan, Iran, from September to February 2016. The participants were randomly divided into three groups: couples (with the partner present), pregnant women (without the partner present), and control group (routine care). After completing the pretest, the intervention groups received four sessions of pregnancy mental health training. Data were collected using the Depression, Anxiety, and Stress Scales (DASS‑42) and a demographic characteristics form. The collected data were analyzed using Statistical Package for the Social Sciences software.
Before the intervention, no statistical difference was observed among the three groups in the mean scores of stress, anxiety, and depression. The mean score of depression, anxiety, and stress decreased significantly in the intervention groups 2 weeks after the intervention respectively (F=5.84, p=0.004), (F=14.76, p The results of this study showed that mental health training for pregnant women, especially with the presence of the partner, is a useful intervention in preventing stress, anxiety, and depression.

Exploring the expectations of postgraduate nursing students from their supervisors is required in order to meet the expectations, raise the general students’ satisfaction, and enhance the students’ capabilities to the highest degree possible. The present study was conducted to explore the expectations of postgraduate nursing students from their supervisors.
This qualitative study was done through semi‑structured individual interviews with seven PhD students and 14 master’s students in two focus groups from three universities in Tehran, Iran. The data were analyzed using the inductive approach and through conventional content analysis.
The analysis of the data led to the extraction of five categories (support for the students, good communication skills, professional competence, guiding the students, and professionalism) within 12 subcategories.
The results revealed that postgraduate students expect their supervisors not only to guide and support them in education and research but also have good communication skills, be professional, and value professionalism. Therefore, supervisors should try to meet these expectations and offer practical strategies for better realization of their needs.

Hardiness and optimism are two general health promoting factors, which enable the individuals to remain both psychologically and physically healthy despite encountering negative life events. But there is lack of knowledge about the current state of these constructs and their relationship in breast cancer patients in an Iranian context.
This was a descriptive study which was completed in Sayyed‑AL‑Shohda Hospital affiliated to Isfahan University of Medical Sciences, Iran, in 2015. Two hundred and ten women with breast cancer were conveniently selected to complete the personal/demographic/illness questionnaire, Hardiness Scale, and Life Orientation Test. Data were analyzed by t‑test, analysis of variance, and Pearson correlation with a significance level of p The mean (SD) age and duration of illness were 46.73 (10.12) years and 29.48 (19.70) months, respectively. Most patients were married (86.23%), without university education (92.61%) and unemployed (85.69%). Most patients received chemotherapy as their main treatment (39.43%). Also, 61.42 and 58.10% of patients had high hardiness and optimism, respectively. There was a significant positive correlation between the score of hardiness and optimism (r = 0.22, p ≤ 0.01).
The results showed that most of the breast cancer patients had moderate to high hardiness and optimism, so healthcare providers can use these personality properties in their care planning to improve coping strategies. Also, the findings of this study can assist healthcare team in order to pay more attention to coping strategies in cancer patients during their treatment and also considering the relationship of these issues in their evaluations.

Weakness of curriculum development in nursing education results in lack of professional skills in graduates. This study was done on master’s students in nursing to evaluate challenges of neonatal intensive care nursing curriculum based on context, input, process, and product (CIPP) evaluation model.
This study was conducted with qualitative approach, which was completed according to the CIPP evaluation model. The study was conducted from May 2014 to April 2015. The research community included neonatal intensive care nursing master’s students, the graduates, faculty members, neonatologists, nurses working in neonatal intensive care unit (NICU), and mothers of infants who were hospitalized in such wards. Purposeful sampling was applied.
The data analysis showed that there were two main categories: “inappropriate infrastructure” and “unknown duties,” which influenced the context formation of NICU master’s curriculum. The input was formed by five categories, including “biomedical approach,” “incomprehensive curriculum,” “lack of professional NICU nursing mentors,” “inappropriate admission process of NICU students,” and “lack of NICU skill labs.” Three categories were extracted in the process, including “more emphasize on theoretical education,” “the overlap of credits with each other and the inconsistency among the mentors,” and “ineffective assessment.” Finally, five categories were extracted in the product, including “preferring routine work instead of professional job,” “tendency to leave the job,” “clinical incompetency of graduates,” “the conflict between graduates and nursing staff expectations,” and “dissatisfaction of graduates.”
Some changes are needed in NICU master’s curriculum by considering the nursing experts’ comments and evaluating the consequences of such program by them.

Hand hygiene is one of the key ways of preventing healthcare‑associated infections (HCAI), especially in patients with cancer. The aim of this study was to determine nurses’ compliance with hand hygiene guidelines in caring for patients with cancer in a selected center in Isfahan, Iran, in 2016.
The present observational study was conducted on nurses in a cancer center in Isfahan in 2016. The participants were selected via convenience sampling method. Nurses serving at bedsides and willing to participate were entered into the study. Data were collected through the direct observation of nurses during delivering routine care, using the standard checklist for direct observation of the “five moments for hand hygiene” approach.
In the present study, 94 nurses were studied at 500 clinical moments. The overall hand hygiene compliance rate was 12.80%. The highest hand hygiene compliance rate was observed in the after body fluid exposure moment (72.70%). In addition, hand hygiene compliance rate in preprocedure indications (before patient contact and before aseptic procedure) and postprocedure indications (after patient contact, after body fluid exposure, and after patient surrounding contact) were 3.40 and 21%, respectively, which had a significant correlation (p = 0.001).
The findings indicate that the hand hygiene compliance rate among nurses was low. Further research in this regard is recommended in order to find the causes of low compliance with hand hygiene and design interventions for improvement in hand hygiene compliance rate among nurses.

Nutrition during pregnancy is undoubtedly one of the most important factors affecting maternal health. In this regard, considering the cognitive‑behavioral factors associated with feeding, behaviors will play an important role in the effectiveness of interventions. Therefore, this study aimed to investigate the correlation between food habits and structures of social cognitive theory in pregnant women.
In this cross‑sectional study, 192 pregnant women were randomly selected. Data were collected using a questionnaire based on the social cognitive theory structures and food habits questionnaire in the questioning manner and was also analyzed using Pearson correlation and multiple linear regression with the software Statistical Package for the Social Sciences, version 19.
There was a significant correlation between nutritional behavior with self‑regulation (p = 0.001), self‑efficacy (p = 0.001), outcome expectations (p = 0.001), social support (p = 0.002), and access (p = 0.001). A significant correlation was observed between lack of consumption of unnecessary and unhelpful food with self‑regulation (p = 0.02). In the multivariable regression analysis, only self‑regulation revealed significant and direct contribution in relation to nutritional behavior (p Results of this study showed that self‑regulation is one of the important factors associated with feeding behavior in pregnant women so that it is suggested to be considered in nutritional interventions in order to improve nutritional behavior.

The reduction in fertility and increase in the number of single‑child families in Iran will result in an increased risk of population aging. One of the factors affecting fertility is women’s empowerment. This study aimed to evaluate the relationship between women’s empowerment and fertility in single‑child and multi‑child families.
This case‑control study was conducted among 350 women (120 who had only 1 child as case group and 230 who had 2 or more children as control group) of 15–49 years of age in Isfahan, Iran, in 2016. For data collection, a 2‑part questionnaire was designed. Data were analyzed using independent t‑test, Chi‑square test, and logistic regression analysis.
The difference between average scores of women’s empowerment in the case group 54.08 (9.88) and control group 51.47 (8.57) was significant (p = 0.002). Simple logistic regression analysis showed that under diploma education, compared to postgraduate education, (OR = 0.21, p = 0.001) and being a housewife, compared to being employed, (OR = 0.45, p = 0.004) decreased the odds of having only 1 child. Multiple logistic regression results showed that the relationship between women’s empowerment and fertility was not significant (p = 0.265).
Although women in single‑child families were more empowered, this was not the main reason for their preference to have only 1 child. In fact, educated and employed women postpone marriage and childbearing and limit fertility to only 1 child despite their desire.

Health communication (HC) is considered an important task of nurses to provide high quality and holistic care as well as to improve patient health. The nursing student–patient HC is an abstract concept and needs to be clarified. Therefore, this study was conducted to increase the knowledge about nursing students’ HC with patients by considering various participants’ viewpoints.
In this conventional qualitative content analysis, 18 semi‑structured interviews were conducted with six nursing students, six nursing instructors, and six patients in educational hospitals affiliated to the University of Medical Sciences. Credibility, confirmability, dependability, and transferability were established to validate the trustworthiness of the data. The process of data collection and analysis lasted 9 months.
After data analysis, two categories were generated: (A) “junior nursing student–patient communication,” with two subcategories of “performing social communication with patients” and “failure to build therapeutic relationships with patients,” and (B) “senior nursing student–patient communication” with two subcategories of “establishing effective communication with patients” and “performing one‑way communication with patients.”
More attention should be paid to improve HC through shifting towards student‑centered approaches in nursing curriculum. Further, role model nurses and clinical educators should guide nursing students for institutionalizing HC in future nurses.

Myocardial infarction is a major complication of coronary heart disease, and due to high mortality, is a part of important medical emergencies. Today, complementary and alternative medicine, as nonpharmacological and health promotion methods is considered. Therefore, this study was designed to evaluate the effectiveness of acupressure on physiological parameters of patients with myocardial infarction.
This clinical trial was carried out among two groups and three stages in 2015. Study participants included 64 patients hospitalized in Iran, Isfahan Shahid Chamran hospital. Acupressure in five points and at any point for 2 minutes, twice per day for 3 days was done in the experimental group and as the same at a false point for the control group. Physiological parameters were recorded before, immediately, and 30 minutes after intervention. Data were analyzed using SPSS 20 and independent t‑tests, Chi‑square, Mann–Whitney test, repeated‑measurements analysis of variance.
Independent t‑test immediately and 30 minutes after the intervention showed that mean systolic blood pressure and arterial oxygen saturation in the intervention group were significantly lower and higher than the control group, respectively; however, mean diastolic blood pressure and heart rate were not significantly different. However, 30 minutes after intervention, diastolic blood pressure and heart rate were significantly lower in the intervention group.
Acupressure in five points of body had a positive effect on physiological parameters, and showed that after a short time of interventions these parameters lead to promotion over time.

Attention deficit hyperactivity disorder (ADHD) is one of the most common chronic childhood disorders that lead to dysfunction and disability in childhood and subsequently be careful. This study aimed to understand the needs of the children’s caregivers in Iran.
This qualitative research was conducted in 2016. Using purposive sampling, 27 participants from 20 families of children with ADHD were interviewed. Unstructured interviews were conducted within 6 months in Isfahan. Data gathering continued until no new data were accessed. Data were analyzed using qualitative content analysis.
The results of this research are shown in three main categories: (1) The caregiver’s need for having sufficient information about the disorder, its cause and treatments (pharmacological and nonpharmacological); (2) the need to have enough knowledge about communication problems while caring for a sick child; and (3) the need to improve the performance of care. They were classified under the relevant concept.
Caregivers of children with ADHD have different needs and problems and assessing them would decrease the child’s problems and consequently, the family’s problems. It would also increase the sense of control and authority over the child’s condition in the caregivers. Since this disorder is chronic and permanent, ignoring the needs of caregivers not only would cut the process of the child’s treatment but would also intensify the family’s and child’s problems. So it is recommended to conduct further studies about each of the resulted concepts in this study and the obstacles for reaching them.