فهرست مطالب

Evidence Based Care - Volume:7 Issue: 4, Winter 2018

Evidence Based Care
Volume:7 Issue: 4, Winter 2018

  • تاریخ انتشار: 1396/11/04
  • تعداد عناوین: 8
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  • Negar Yazdani, Farkhondeh Sharif, Nasrin Elahi *, Abbas Ebadi, Seyed Vahid Hosseini Pages 7-21
    Background
    Since studies have demonstrated that morbid obesity can exponentially impair quality of life, the measurement of quality of life is paramount to monitoring the effects of treatment and influences the development of clinical pathways, service provision, healthcare expenditures, and public health policy. Accordingly, clinicians, researchers, and policy makers must rely on valid instruments.
    Aim: This study aimed to review and critique the psychometric properties of some specific tools by COSMIN checklist and their application among morbidly obese individuals.
    Method
    We searched PubMed, Web of Science, PsycINFO, Ovid, Elsevier, and ScienceDirect by using the keywords related to the Quality of Life Questionnaire, namely “morbid obesity”, “tool”, and “scale”, to retrieve articles published during 1989-2017. Then, the psychometric properties of the selected tools were assessed using the COSMIN checklist.
    Results
    Most of the tools had not reported complete and desirable psychometrics properties. Demonstration of responsiveness from independent randomized controlled trials was not available in two of the eight questionnaires. These tools also did not report proper definition of interpretability. However, the data obtained by COSMIN checklist showed that Laval questionnaire is a proper scale for measuring quality of life in obese individuals, which can be recommended to researchers.
    Implications for Practice: Although Laval questionnaire was found a proper tool for measuring the quality of life among morbid obese patients, developing an instrument suitable for different societies with varied cultural and social characteristics is suggested because socio-cultural factors can influence the quality of life.
    Keywords: Checklist, Obesity, Morbid, Psychometric, Quality of life, Review of literature
  • Sedigheh Yeganeh, Niloofar Motamed, Saeid Najafpour Boushehri, Shahnaz Pouladi, Maryam Ravanipour * Pages 22-29
    Background
    Food insecurity denotes failure to provide adequate food. Knowledge and attitude play a key role in food security, which is of paramount importance in the first two years of life.
    Aim: This study aimed to evaluate mother's knowledge and attitude towards food security in complementary feeding of 1-2 year-old offspring.
    Method
    Using a cross-sectional study, 400 mothers of children 1-2 years old were selected from comprehensive health service centers in Bushehr, in 2016. The data collection instrument included a self-made questionnaire with 20 knowledge questions with CVR=0.95, CVI=0.95, and reliability 0.7 as well as a questionnaire with 26 questions on the attitude with CVI=0.94, CVR=0.91 and reliability 0.76 which were completed by the mothers and analysis with Spearman correlation, logistic regression and descriptive statistics.
    Results
    The mean age of the mothers was 29.5±4.9 years. We found that 74 (18.5%) of the mothers had an inappropriate level of knowledge and 10.5% of them had a negative attitude toward food security in complementary feeding. There was a significant positive correlation between knowledge and attitude (r=0.26, P=0.001). Maternal age (OR=1.10, PImplications for Practice: Long-term planning regarding demographic determinants such as educational level and identifying factors related to food security should be considered.
    Keywords: Attitudes, Complementary feeding, Food security, Iran, Knowledge, Mothers
  • Maliheh Shoja, Fatemeh Heshmati Nabavi *, Monir Ramezani, Azadeh Saki Pages 30-37
    Background
    Surgery is a stressful experience in children. Therefore, the familiarization of this population with treatment processes by means of appropriate training tools and techniques can be an effective way to control their anxiety.
    Aim: The aim of this study was to determine the effect of a preoperative preparation program on anxiety in school-age children undergoing surgery using a factorial design.
    Method
    This clinical trial was conducted on 81 children aged 6-12 years as candidates for elective surgery at Doctor Sheikh Hospital in Mashhad, Iran, in 2016. A preparation program was implemented with two methods (i.e., displaying video tutorials with and without nurses’ explanations) and on two different days (i.e., prior to and on the day of operation) using a factorial design. The estimation of children’s anxiety was accomplished by using the Revised Children’s Manifest Anxiety Scale administered before training and prior to operating room admission. The data were analyzed by statistical tests in SPSS software, version 16.
    Results
    The study groups were comparable in terms of demographic characteristics (P>0.05). There was no significant differences among the four groups regarding manifest anxiety based on the place of referral (i.e., department or clinic) (P=0.22), presentation or non-presentation of explanations by nurses (P=0.12), and their interaction effects (P=0.22).
    Implications for Practice: No significant difference was observed among the four groups in terms of manifest anxiety. Therefore, all four training methods were effective in reducing anxiety in children. Consequently, each of these methods can be used depending on human resources and infrastructure of each department.
    Keywords: Anxiety, Children, Preoperative preparation program
  • Zohreh Mahmoodi, Mahrokh Dolatian*, Mitra Jalal, Arash Mirabzadeh Pages 38-45
    Background
    Despite the large number of studies conducted on breastfeeding, no studies have yet examined the direct and indirect effects of socio-personal factors and mental health on breastfeeding.
    Aim: This study aimed to analyze of the effects of mental health and socio-personal factors on breastfeeding in infants aged less than six months.
    Method
    This analytical cross-sectional study was conducted on 465 eligible mothers visiting general health centers in a northern city of Iran, in 2015. Data were collected using the researcher-made scale of socio-personal factors of breastfeeding, Spielberger’s State-Trait Anxiety Inventory, Beck’s Depression Inventory, Cohen’s Perceived Stress Scale, the Breastfeeding Difficulties Questionnaire, the Access to Healthcare Questionnaire, and the Poor Health Behaviors Questionnaire.
    Results
    The path analysis of the mental health variables showed that breastfeeding problems are associated through a direct path with depression, through an indirect path with stress, and through both paths with anxiety; a positive correlation was thus observed between these variables and breastfeeding problems. Poor health behaviors also contributed to mothers’ breastfeeding problems through a direct path and indirectly by affecting their level of depression. Income had the highest positive effect (B=0.66), while the number of children had the highest negative effect (B=-3.16) on breastfeeding problems through a direct path. Poor health behaviors had the highest positive effect (B=0.75) and family support had the highest negative effect (B=-0.11) on breastfeeding.
    Implications for Practice: The early diagnosis of poor postpartum mental health in mothers can help reduce breastfeeding problems.
    Keywords: Breastfeeding difficulties, Mental health, Mothers, Path analysis, Socio-personal factors
  • Saeid Keshavarz, Tayebeh Mirzaei *, Ali Ravari Pages 46-54
    Background
    Management of agitation in Alzheimer's patients with non-invasive treatment methods, such as massage therapy, is of paramount importance.
    Aim: This study was conducted to determine the effects of head and face massage on agitation in elderly Alzheimer’s patients living in nursing homes in Yazd, Iran.
    Method
    This randomized controlled clinical trial was conducted on two groups (n=35 in each group) from 26 September to 5 October 2016. For the patients in the intervention group, massage therapy was performed using the effleurage and compression techniques, and no intervention was implemented in the control group. The usual way to control the symptoms of agitation was physical restraint. The Cohen-Mansfield Agitation Inventory (CMAI) was used to measure the agitation level. The data were analyzed by performing Wilcoxon and Mann-Whitney tests in SPSS, version 18.
    Results
    The mean ages of the intervention and control groups were 82.2±10.6 and 81.5±9.6 years, respectively. The mean scores of agitation in the intervention and control groups decreased from 77.2±14.4 and 82.1±17.3 before the intervention to 49.7±6.0 and 80.8±18.3 after the intervention, respectively. The results showed a significant difference between the two groups after the intervention (PImplications for Practice: The findings showed that head and face massage could reduce agitation in elderly Alzheimer's patients. Thus, this technique could be considered by nurses and caregivers to reduce agitation in this population.
    Keywords: Alzheimer's disease, Massage, Nursing homes, Psychomotor agitation
  • Samaneh Jouya *, Nahid Golmakani, Seyed Reza Mazloum, Hamid Abdi, Zohreh Yosefi Pages 55-62
    Background
    Colposcopy is an invasive medical procedure, which involves pain and discomfort. Auriculotherapy is a medical technique that can facilitate the reduction of pain.
    Aim: The aim of this study was to compare the impacts of auriculotherapy with electrical stimulation and Vaccaria seeds on colposcopy pain.
    Method
    This controlled randomized, clinical trial was conducted on 93 females undergoing colposcopy in Ghaem Hospital, Mashhad, Iran, in 2017. The study population was selected through convenience sampling technique, and then randomly assigned into three groups, namely transcutaneous auricular stimulation (TAS), Vaccaria seeds, and placebo. The TAS group was subjected to electrical stimulation at four auricular acupuncture points 40 min before colposcopy, using a Pointer Excel stimulator (2 Hz). In the Vaccaria seed group, the seeds were fixed on the same acupoints three days prior to colposcopy. The participants were asked to press each point for 1 min, three times a day. The placebo group were provided with three adhesive patches without any seeds. After colposcopy, pain intensity was monitored using the visual analog scale. Data analysis was performed using Kruskal-Wallis and exact Chi-square tests in SPSS software, version 22.
    Results
    The three groups were comparable in terms of the demographic data (P>0.05). The mean pain intensities in theTAS, seed, and placebo groups were 49.0±24.2, 49.5±26.0, and 65.1±26.6, respectively. A significant difference was observed among the three groups regarding the pain intensity (P=0.02). There were also significant differences between the TAS and placebo groups (P=0.01) and between seed and placebo groups in this respect (P=0.02). However, the TAS and seed groups showed no significant difference in this regard (P=0.94).
    Implications for Practice: The use ofauriculotherapy with TAS and seeds could effectively reduce the patient’s pain during colposcopy.
    Keywords: Auriculotherapy, Colposcopic Biopsies, Colposcopy, Electrical Stimulation, Pain
  • Atefe Salimi Akin Abadi, Mitra Zandi *, Marzieh Shiva, Azita Pourshirvani, Anoshirvan Kazemnejad Pages 63-72
    Background
    Primiparous mothers are likely to lose their sense of value in the absence of maternal skills, and mothers with a history of infertility may suffer from more anxiety and decreased self-esteem than their normal peers do.
    Aim: The aim of this study was to determine the effect of a maternal role preparation program on self-esteem of pregnant mothers undergoing in-vitro fertilization (IVF).
    Method
    This randomized clinical trial was performed at Royan Institute in 2016. Sixty mothers undergoing IVF were assigned to intervention and control groups. The research instrument was a version of Maternal Self-Report Inventory. Before implementing the preparation program, the questionnaires were completed by both groups; then, the given preparation program was held in four sessions for mothers in the intervention group. Immediately after the completion of the program and one month later, both groups took the test again. To analyze the data, t-test, Chi-squared test, and repeated measures analysis of variance (ANOVA) were run in SPSS, version 21.
    Results
    The mean ages of the intervention and control groups were 32.8±4.3 and 31.4±3.9 years, respectively. Repeated measures ANOVA showed no significant intergroup difference in the mean score of maternal self-esteem before the intervention; however, a significant difference was observed one month post-intervention between the intervention and control groups (PImplications for Practice: The maternal preparation program could enhance maternal self-esteem. Thus, implementing such programs along with providing other infertility care services could contribute to preparation for assuming maternal role.
    Keywords: Infertility, In-vitro fertilization, Maternal self-esteem, Preparation program
  • Somayeh Saadatpanah, Najmeh Valizadeh Zare*, Javad Malekzadeh, Tahereh Sadeghi, Fatemeh Khorashadizadeh Pages 73-77
    Patients with end-stage renal disease (ESRD) encounter various challenges following kidney transplantation, which should be managed appropriately. These problems can be partly controlled by considering spirituality as one of the care components. Regarding this, the aim of this study was to investigate the relationship between coping and spiritual health in the renal transplant recipients. This descriptive correlational study was conducted on 169 patients referring to the Organ Transplantation Center at Montasserieh Hospital in Mashhad, Iran. The study population was selected through convenience sampling method. The data were collected using demographic characteristics form, Renal Transplant Coping Scale by Valizadeh et al. (2015), and Spiritual Health Questionnaire developed by Khorashadizadeh et al. (2015). The mean scores of coping and spiritual health were 321.2±15.3 and 123.3±6.2, respectively, which were desirable. There was a significant linear relationship between coping and spiritual health mean scores (P˂0.001, r=0.37). Based on the findings, the reinforcement of spiritual beliefs in patients could be a strategy to promote their coping level.
    Keywords: Coping, Kidney Transplantation, Spiritual Health, Post-transplant problems