فهرست مطالب

Community Based Nursing and Midwifery - Volume:5 Issue: 1, Jan 2017

International Journal of Community Based Nursing and Midwifery
Volume:5 Issue: 1, Jan 2017

  • تاریخ انتشار: 1395/10/25
  • تعداد عناوین: 10
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  • Zainab Alimoradi, Nourossadat Kariman, Masoumeh Simbar, Fazlollah Ahmadi Pages 2-12
    Background
    Adolescence is a period of overwhelming changes and challenges, which expose the adolescents to high-risk behaviors. Risky sexual relationship is one of these behaviors that entails physical risks and psychosocial harms. Various factors have been recognized to shape sexual behaviors in adolescents. This paper is an attempt to investigate the factors contributing to high-risk sexual behaviors in Iranian adolescent girls.
    Methods
    A literature review of the research published by Iranian authors, in Farsi or English language in local and foreign journals, was conducted using PubMed, Science Direct, Scopus, Scientific Information Database (SID), IranMedex, IranDoc, and Google Scholar. The search in each database included all the years covered at that time using keywords such as “sexual, adolescents, and Iran”, and continued using other keywords such as “sexual behavior, high-risk behavior, sexual risk and reproductive behavior” individually and in combination
    Results
    Sixteen published articles were identified. Factors contributing to high-risk sexual behaviors in girls can be divided into four general groups including personal, family, peer, school and community.
    Conclusion
    Regarding the identified risk and protective factors, appropriate individual, family and school-based interventions can be designed and implemented to strengthen protective factors. While individual and family factors are considered more in research, factors related to peers, school and community have received less attention. Since social values, beliefs and norms are important factors in formation of sexual behaviors, further research regarding these factors is suggested.
    Keywords: Adolescent, unsafe sex, reproductive health, risk factors, Iran
  • Robab Sahaf, Ehteram Sadat Ilali, Hamid Peyrovi, Ahmad Ali Akbari Kamrani, Fatemeh Spahbodi Pages 13-21
    Background
    The chronic kidney disease is a major health concern. The number of the elderly people with chronic renal failure has increased across the world. Dialysis is an appropriate therapy for the elderly, but it involves certain challenges. The present paper reports uncertainty as part of the elderly experiences of living with hemodialysis.
    Methods
    This qualitative study applied Max van Manen interpretative phenomenological analysis to explain and explore experiences of the elderly with hemodialysis. Given the study inclusion criteria, data were collected using in-depth unstructured interviews with nine elderly undergoing hemodialysis, and then analyzed according to Van Manen 6-stage methodological approach.
    Results
    One of the most important findings emerging in the main study was “uncertainty”, which can be important and noteworthy, given other aspects of the elderly life (loneliness, despair, comorbidity of diseases, disability, and mental and psychosocial problems). Uncertainty about the future is the most psychological concerns of people undergoing hemodialysis.
    Conclusion
    The results obtained are indicative of the importance of paying attention to a major aspect in the life of the elderly undergoing hemodialysis, uncertainty. A positive outlook can be created in the elderly through education and increased knowledge about the disease, treatment and complications.
    Keywords: Aged, Renal dialysis, Uncertainty
  • Najmeh Maharlouei, Mojtaba Akbari, Maryam Akbari, Kamran B. Lankarani Pages 22-29
    Background
    The users’ satisfaction is a method for evaluating the efficacy of healthcare system. We aimed to evaluate the association between the users’ socioeconomic status (SES) and satisfaction with the healthcare system in Shiraz, Iran.
    Methods
    This cross-sectional study was conducted from December, 2013 to March, 2014, in Shiraz, Iran. 3400 households were recruited by multi-stage cluster random sampling. Information about demographic, insurance status, and users’ satisfaction was derived from face-to-face interviews. Satisfaction with healthcare system was assessed by using 5-point Likert scale statements, which ranged from “very dissatisfied” to “very satisfied”. All statistical analyses were performed using SPSS-21.
    Results
    Overall, 1.6% (55) of the respondents were very satisfied, while 6% (203) were very dissatisfied with healthcare system. Participants were classified into high SES (26.3%), middle SES (47.9%) and low SES (25.8%). It was discovered that the better the SES, the more frequent were the respondents dissatisfied with healthcare system (P
    Conclusion
    This study demonstrated that users’ sex, age, educational level, and SES were related to dissatisfaction with healthcare system. Meanwhile, clients’ age, SES, insurance status and marital status were recognized as determinant factors.
    Keywords: Healthcare system, Satisfaction, Socioeconomic status, Iran
  • Mahnaz Rakhshan, Alireza Ghanbari, Atefeh Rahimi, Issac Mostafavi Pages 30-37
    Background
    Hypothyroidism is a condition caused by a decrease in the thyroid gland hormones. This disease is very common at all age ranges. Regarding its long term therapeutic procedure, this disease can affect the quality of life and the mental health of the patients. The present study aimed to compare the quality of life and mental health in hypothyroid patients and normal people.
    Methods
    This descriptive-analytic investigation was performed using convenience sampling on 95 patients with hypothyroidism and 95 normal cases referring to Motahari clinic between October 2014 and August 2015. Data were collected through General Health Questionnaire (consisted of 4 fields; physical signs, anxiety, social function disorder, depression) and Quality of life Questionnaires. Data were analyzed using Independent t- test, Pearson correlation coefficient and Variance analysis. P-values
    Results
    Both control (normal) and test (patient) groups were matched in demographic characteristics in this study (P>0.001). The results showed that there was no significant difference between the quality of life of patients and that of the normal people (test and control groups) (P>0.001). But the comparison of mental health level of patients (59.70) and normal people (48.68) showed a significant difference at all aspects (P
    Conclusion
    Considering and improving the mental health status of such patients can be positively effective in their treatment procedure. Considering this key point in a country like Iran with rich religious backgrounds can be useful in designing self-care and therapeutic programs and even for all people.
    Keywords: Quality of life, Mental health, Nursing, Hypothyroidism
  • Parvin Mangolian Shahrbabaki, Esmat Nouhi, Majid Kazemi, Fazlollah Ahmadi Pages 38-48
    Background
    Many patients with heart failure grapple with related problems that threaten their feeling of well-being and quality of life. Patients look for ways to cope with the new situation. The present study aimed to explore religious coping from the perspective of patients with heart failure
    Methods
    This qualitative study used the content analysis of the semi-structured interviews. The data were collected from 18 participants referring to training hospitals in Kerman University of Medical Sciences in southeastern Iran. The data were analyzed using Lundman and Graneheim qualitative content analysis.
    Results
    The main theme of “Spiritual coping, a dominant strategy” was extracted with two categories: 1- “religious belief” having the sub-categories of “inner faith” and “search of meaning” 2- “connection to God as the supreme power” with sub-categories of “seeking healing through supplication and rituals”, “worship as a barrier to the flood of problems”, and “submission to and trust in God”.
    Conclusion
    The findings suggest that a spiritual strategy helps the patients effectively to cope with heart failure. Patients learn to use religious beliefs and faith to accept the reality of the disease and its stages and to manage their condition with patience, tolerance, and hope calmly and confidently for a bright future.
    Keywords: Heart failure, Chronic disease, Coping, Spirituality, Qualitative study
  • Ali Dehghani, Nahid Dehghan Nayeri, Abbas Ebadi Pages 49-60
    Background
    Due to many physical and mental disorders that occur in multiple sclerosis patients, identifying the factors affecting coping based on the experiences of patients using qualitative study is essential to improve their quality of life. This study was conducted to explore the antecedents of coping with the disease in patients with multiple sclerosis.
    Methods
    This is a qualitative study conducted on 11 patients with multiple sclerosis in 2015 in Tehran, Iran. These patients were selected based on purposive sampling. Data were collected using semi-structured and in-depth interviews and coded. These data were analyzed using the conventional content analysis. The rigor of qualitative data using the criteria proposed by Guba and Lincoln were assessed.
    Results
    Five main categories were revealed: (1) social support, (2) lenience, (3) reliance on faith, (4) knowledge of multiple sclerosis and modeling, and (5) economic and environmental situation. Each category had several distinct sub-categories.
    Conclusions
    The results of this study showed that coping with multiple sclerosis is a complex, multidimensional and contextual concept that is affected by various factors in relation to the context of Iran. The findings of the study can provide the healthcare professionals with deeper recognition and understanding of these antecedents to improve successful coping in Iranian patients suffering from multiple sclerosis.
    Keywords: Qualitative research, Multiple sclerosis, Iran, Coping
  • Zohreh Parsa Yekta, Fatemeh Sadeghian, Rizi, Taraneh Taghavi Larijani, Abbas Mehran Pages 61-69
    Background
    Anxiety among patients after surgery can affect their physiological and psychological well-being. The aim of this study was to investigate and compare the effects of Benson’s relaxation and rhythmic breathing techniques on postoperative anxiety in candidates for the mastectomy surgery.
    Methods
    This randomized controlled clinical trial study was conducted with ninety patients in 2013. The patients were hospitalized for the mastectomy surgery in three surgical wards in a teaching hospital, Tehran, Iran. They were randomly assigned into three groups: Benson’s relaxation including the cognitive relaxation technique type, rhythmic breathing including the somatic relaxation technique type and control groups. According to the Davidson and Schwartz multi-process theory, the Benson’s relaxation and the rhythmic breathing techniques have cognitive and somatic effects, respectively. One day before the surgery, the patients in the intervention groups were trained regarding relaxation and breathing techniques and were asked to perform the techniques under the supervision of the researcher in the night before the surgery. The cognitive somatic anxiety questionnaire was used to measure anxiety before the intervention and half an hour after recovery of consciousness after the surgery. Descriptive and inferential statistics were used for data analysis via the SPSS v.21 software.
    Results
    There were no statistically significant differences between the groups in terms of demographic characteristics. The application of both techniques reduced the level of patients’ anxiety after the surgery. The patients in the Benson’s relaxation technique group reported only the relief of somatic anxiety. However, the breathing technique patients reported a reduction in both cognitive and somatic anxiety.
    Conclusion
    The Benson’s relaxation and rhythmic breathing techniques can reduce postoperative anxiety in patients after the mastectomy surgery.
    Trial Registration Number: IRCT2014042017350N1
    Keywords: Anxiety, Breast cancer, Relaxation, Mastectomy
  • Zahra Imanigoghary, Hamid Peyrovi, Esmat Noohi, Majid Kazemi Pages 70-81
    Background
    Vegetative state (VS) occurs through return of the brain stem after coma state. After hospital discharge, responsibility of caring for VS patients is transferred to their families, which causes a high burden on them. Nurses have an important role in helping the family caregivers to meet their needs and cope with difficulties. To explore the role of nurses during coping process of family caregivers of VS patients.
    Methods
    This study is a part of a larger qualitative study which was performed in Kerman province, Iran during 2014 - 2015. Purposive and theoretical sampling was used. 14 caregivers participated in the study. Data were gathered using face-to-face in-depth interviews and managed by MAXQDA 10 software. Analysis was done through constant Comparative Method.
    Results
    Three themes of “nurse as a pursuer teacher”, “nurse as a compassionate caregiver”, and “nurse as a supporter” were derived from analysis that represent various roles of a nurse in the coping process of family caregivers of vegetative patients during the care process.
    Conclusion
    Nurses can play an effective role in improving the caregivers’ well-being by considering the importance of training at discharge time and during home care, helping families in providing care and support them during care process.
    Keywords: Family caregivers, Nurses role, Qualitative study, Vegetative state
  • Alireza Salehi, Maryam Marzban, Maryam Sourosh, Farkhondeh Sharif, Mahmoud Nejabat, Mohammad Hadi Imanieh Pages 82-90
    Background
    According to the World Health Organization viewpoint, social well-being is an important dimension of health along with physical and mental aspects. Evaluation of social well-being is necessary in students, especially in medical sciences students due to future responsibility as health care professionals. The present study attempted to investigate the level of social well-being, five domains of it (like actualization, integration, contribution), and some related factors in the school of nursing and midwifery students.
    Methods
    This cross-sectional study was carried out between Julys to December 2015 and comprised 346 students in the school of nursing and midwifery in Shiraz University of Medical Sciences, Shiraz, Iran. Social well-being, socio-demographic status and physical activity were measured by valid questionnaires. Univariate linear regression analysis, multiple imputation method, ANOVA and independent sample t-test were used as different statistical methods. The P values less than 0.05 were considered as statistically significant.
    Results
    The mean score of social well-being was 50. The minimum and maximum scores of social well-being were 20 to 100. Married students had higher social well-being than single students in univariate linear regression (Beta: 2.111, 95% CI: (0.387 to 3.738), P=0.017). Also, social integration had higher scores in married students (P=0.015). Social actualization was higher in male students (P=0.015); on the other hand, social contribution was higher in female students (P=0.026).
    Conclusion
    The results of our study showed that social well-being status of students in this research was not satisfactory. Designing and conducting programs for promotion of social well-being, for example preparing facilities for marriage of students, can be helpful. Evaluation of social well-being in students of other schools with multicenter studies seems to be useful.
    Keywords: Social wellbeing, Nursing, Midwifery, Shiraz, Iran
  • Fariba Taleghani, Effat Al Sadat Merghati Khoie, Mahnaz Noroozi, Mahgol Tavakoli, Ali Gholami Pages 91-98
    Background
    Youth’s sexual behaviors have various consequences such as unwanted pregnancy, acquired immunodeficiency syndrome and sexually transmitted infections. Little information is available about the impact of mass media in the development of premarital sexual relationships. This study aimed to explore the role of mass media on premarital sexual relationships among Iranian youth.
    Methods
    This qualitative study was conducted with 26 single boys and girls aged 18-24 years who were living in Isfahan, Iran and have already been started their sexual relationships. Also, 12 other participants who were involved in such an experience were recruited in this study. Data was collected using semi-structured interviews and the observation of youth’s sexual interactions in different fields. Conventional content analysis method was used for data analysis.
    Results
    Three main categories were developed: “foreigner media as the role model”, “the ease of access to sexual contents and materials” and “the ease of interactions and relationships with the opposite sex”.
    Conclusion
    The prominent role of mass media in the formation of premarital sexual relationships was described in this study. This issue needs to be taken into consideration by policy makers for taking necessary actions for reducing the impact of mass media on the youth’s engagement in premarital sexual relationships.
    Keywords: Sexual behavior, Premarital sexual behavior, Mass media, Youth, Adolescent