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Community Based Nursing and Midwifery - Volume:5 Issue: 3, Jul 2017

International Journal of Community Based Nursing and Midwifery
Volume:5 Issue: 3, Jul 2017

  • تاریخ انتشار: 1396/03/25
  • تعداد عناوین: 11
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  • Seyedeh Azam Sajadi, Abbas Ebadi*, Seyed Tayeb Moradian Pages 206-218
    Background
    Family caregivers are considered as hidden patients experiencing physical and mental disorders. This affects the quality of not only their lives but also the health care provided to patients. This study aimed to investigate the quality of life (QOL) and its related factors among the caregivers of patients undergoing hemodialysis.
    Methods
    This systematic review was conducted based on the eight-step guidelines presented by the York University. The databases relevant to the medical field including Nursing and Allied Health, Web of Science, Scopus, Pubmed, Embase, PsycINFO and Psychology Library were used. Finally, 12 articles observing the inclusion criteria and with regard to the research questions were found. The data obtained from these articles were summarized, classified, and analyzed.
    Results
    QOL among Family Caregivers of Patients on Hemodialysis is low, compared to the general population; however, their QOL is higher than the patients under their care. Factors relevant to the QOL for caregivers including age, gender, perceived social support, perceived burden of care, affliction with other diseases (lupus, hypertension, hypothyroidism and depression), intellectual understanding of the limitations of the patient’s disease in their daily life, employment of adaptation strategies, better marital relationships, accepting self and family relationship with the patient (mother and wife). Furthermore, the factors associated with care takers affecting the quality of caregivers’ lives were age, QOL and the type of treatment.
    Conclusions
    Caregivers of patients undergoing hemodialysis enjoyed low QOL. Since there is a direct relationship between family caregivers’ quality and patients’ QOL, health care system and health policy makers should pay more attention to family caregivers.
    Keywords: Quality of life, QOL, Family caregiver, Dialysis
  • Afzal Shamsi, Nahid Dehghan Nayeri*, Maryam Esmaeili Pages 219-230
    Background
    Hypertension affects many aspects of the patients’ life. Factors such as attitudes, beliefs and experiences, and social and cultural conditions of patients have effective roles in hypertension treatment process. The aim of this research was to explore perspectives and experiences of patients with hypertension while living with this disease.
    Methods
    This is a qualitative research using content analysis approach. 27 hypertensive patients who referred to hospitals affiliated to Tehran University of Medical Sciences were selected based on purposive sampling, and semi-structured interviews were carried out. Graneheim and Lundman’s approach was used for analysis of data and Lincoln and Guba’s criteria were used to confirm the trustworthiness of the study’s findings
    Results
    Experiences of the participants were divided into three main categories as follows: (1) disease shadow; (2) dual understanding of the effect of drug therapy consisting of two sub categories known as ‘‘perceived benefits,’’ ‘‘negative consequences’’; and (3) facing the disease that includes the two subcategories of ‘‘Compatibility’’ and ‘‘Negligence and denial’’.
    Conclusion
    Based on the findings, patients with hypertension had experienced many physical, psychological, social, familial and spiritual problems due to the disease and their cultural context. These patients obtained positive experiences following the compatibility with hypertension. Comprehensive planning tailored to the cultural, social context and their beliefs is necessary to solve problems in these patients.
    Keywords: Hypertension, Qualitative research, Experience
  • Azam Salamizadeh, Tayebeh Mirzaei*, Ali Ravari Pages 231-238
    Background
    Caring for people who suffer from Alzheimer’s disease is stressful. Family caregivers of these people usually experience physical and mental burnout and lose their efficacy in doing carerelated activities. The present study aimed to examine the impacts of spiritual care education on selfefficacy of the family caregivers of people with Alzheimer’s disease.
    Methods
    This study was conducted from October to December 2015 by using a two group pretestposttest quasi-experimental design. In total, 60 family caregivers of people with Alzheimer’s disease were recruited and randomly allocated to the intervention and control groups. A spiritual care educational intervention was implemented for the caregivers in the intervention group. The data were collected before and three weeks after the study intervention by using the ten item General Self Efficacy scale. The study data were analyzed in SPSS using Chi-square and independent t test.
    Results
    Before the study intervention, the means of pretest self-efficacy scores in the intervention and control groups were29.80±4.80 and 28.39±6.41, respectively. There was no significant difference between the groups regarding the mean score of self-efficacy (P=0.36). After the study, these two scores changed to 32.73±4.75 and 27.85±5.98, respectively. However, after the intervention, the mean score of self-efficacy in the intervention group was significantly higher than the control group (P=0.002).
    Conclusion
    Spiritual care can enhance the self-efficacy of the family caregivers of people who suffer from Alzheimer’s disease. Therefore, care providers are recommended to use such spirituality-based interventions for empowering family caregivers.
    Keywords: Spiritual care, Alzheimer's disease, Family caregivers, Self-efficacy
  • Kaori Baba*, Fumie Takauma, Katsuhiko Tada, Tomoko Tanaka, Kyoko Sakanashi, Yaeko Kataoka, Toshinori Kitamura Pages 239-247
    Background
    The Conflict Tactics Scale 1 (CTS1) is a widely used self-report measure of abusive attitudes of parents towards children. The factor structure of the CTS1 still remains to be clarified. The aim of this study was to examine the factor structure of the Japanese version of the CTS1 for postpartum women in community settings.
    Method
    The data in this study came from the Okayama and Kumamoto’s study. These were part of a larger survey using longitudinal questionnaire studies conducted in Japan from 2001 to 2002 and in 2011, respectively. In both study sites, the participant mothers were asked to fill in the CTS1 one month after delivery when they attended for check-up at the out-patient clinic.
    Results
    A total of 1,150 questionnaires were collected, excluding the participants with missing values in the CTS1. Finally, 1,078 were included in the statistical analyses. Data of 1,078 women were divided into two parts. In the first halved sample (n=578), an exploratory factor analysis was conducted for the CTS1 items after exluding nine items with extremely low prevalence. It revealed 2-factor or 3-factor models. Then, we conducted a model comparison with the second halved sample (n 500), using confirmatory factor analysis. In terms of goodness-of-fit indeces, the 2-factor model was superior. Its subscales were Reasoning and Psycholosical Aggression.
    Conclusion
    The 2-factor model of the CTS1 consisting of Reasoning and Psychological Aggression was superior to the 3-factor model. This is not inconsistent with the original authors’ theoretical model.
    Keywords: Infant, Perinatal care, Child abuse, Factor analysis, Psychometric testing
  • Masoumeh Simbar, Shiva Alizadeh*, Mahboubeh Hajifoghaha, Fatemeh Dabiri Pages 248-255
    Background
    Women’s empowerment was defined as their ability to achieve awareness and control their personal, social, economic and political forces aiming at taking measures in order to improve their lives. This study aimed to compare the empowerment of the married women in medical sciences university in social, economic and familial domains in three cities, IRAN.
    Methods
    This was a descriptive-analytical study conducted in 2016 on 399 married and employed women. Data collection instrument was a four-part questionnaire consisting of demographic, social, economic and familial domains and made by researchers. Collected data were analyzed using SPSS, version 16. Using paired t-test for intra-group and Chi-square and t-test for between groups comparisons. The significance level was set at
    Results
    The total score of empowerment in Rasht (126.34±17.51) was more than the two cities of Shiraz (123.46±15.62) and Bandar Abbas (123.42±12.34). There was a significant relationship between the mean score of the total empowerment and monthly income of the participants in Bandar Abbas (P=0.04), and job of their husbands in Rasht (P=0.004). The mean score of family empowerment of the women was significantly interrelated with the number of their children in Rasht (P 0.001), and with the education of the participants’ husbands in Shiraz (P=0.002).
    Conclusion
    The score of social empowerment in Rasht was more than two other cities. In economic domain, the scores of Rasht and Bandar Abbas were more than those of Shiraz. Scores of Rasht and Shiraz were more than Bandar Abbas in the familial domain. It is useful to carry out qualitative studies aiming at determining the effects of various factors on women’s empowerment and strategies for improving it.
    Keywords: Empowerment, Iran, Social, Women
  • Parisa Mansouri*, Maryam Ghadami, Seid Saeed Najafi, Shahrzad Yektatalab Pages 256-263
    Background
    Cirrhosis is a chronic and progressive disease that causes various complications for patients due to disturbance of the liver’s usual function. Self-efficacy refers to an individual’s belief in one’s ability to perform the necessary behaviors to achieve one’s goals. Self management is also an important criterion for long-term change in behavior. The present study aimed to investigate the effect of self-management training on self-efficacy of patients suffering from liver cirrhosis.
    Methods
    This randomized controlled clinical trial was conducted on 74 patients with liver cirrhosis randomly assigned to an intervention (receiving self-management training) and a control group (routine care) from 2012 to 2013. The data were collected in the transplantation center affiliated to Shiraz University of Medical Sciences. Self-management training was performed in six 90-minute sessions twice a week. Besides, the intervention group was followed up for a month via telephone. Levo selfefficacy questionnaire was filled out by the patients before, immediately after, and one month after the intervention. Then, the data were entered into the SPSS statistical software (v. 16) and analyzed using independent t-test, Chi-square test, and repeated measures ANOVA.
    Result
    At the beginning of the study, no statistically significant difference was found between the two groups regarding self-efficacy (P=0.18). However, the total score of the questionnaire and those of all its dimensions significantly improved in the intervention group immediately and one month after training self-management skills (P
    Conclusion
    The results showed that the self-management program resulted in improvement of selfefficacy n the patients with liver cirrhosis. Therefore, this supportive strategy could be useful in atients with chronic illnesses for improvement of care and prevention of complications.
    Keywords: Self-management, Self-efficacy, Liver cirrhosis
  • Mohammad Hasan Sahebihagh, Seyedeh Zahra Hosseini*, Mina Hosseinzadeh, Seyed Morteza Shamshirgaran Pages 264-274
    Background
    Child abuse is a widespread social phenomenon with serious life-time consequences. Since parents bring their children to healthcare centers for growth screening and vaccinations, Community Health Workers play an important role in identifying and reporting child abuse cases. Thus, the current study aimed to investigate knowledge, attitude and performance of Community Health Workers regarding child abuse in Tabriz.
    Methods
    This is a descriptive (cross-sectional) study; census method was used for sampling. Study population consists of 265 people, employed at units of family health and vaccination in Tabriz healthcare centers in 2015-2016. A questionnaire was used to collect the data. Data analysis was carried out using SPSS, version 23 through descriptive (mean and standard deviation) and analytical (Two Independent Samples T-test and analysis of variance) statistics.
    Results
    Findings indicate that 58.5 percent of Community Health Workers had good knowledge about causes of child abuse and 45 percent had good knowledge of the signs, symptoms and complicationsof child abuse. Their total knowledge was good (57%). The mean score of awareness (knowledge) was significant according to the variable of training participation (P=0.04). The participants had a favorable attitude toward dealing with child abuse (91.3 %); the mean score of attitude was significant according to the educational field (P
    Conclusion
    Community Health Workers had good knowledge regarding child abuse, favorable attitude toward dealing with child abuse, and poor performance in dealing with child abuse. This may be due to fear of side issues to deal with child abuse, or lack of clear legal guidelines regarding this.
    Keywords: Child abuse, Knowledge, Attitude, Practice, Community health workers
  • Roghaye Komeilifar, Nahid Javadifar*, Poorandokht Afshari, Mohammad Hosein Haghighizade, Azam Honarmandpour Pages 275-283
    Background
    Urinary incontinence (UI) is a common health problem and has a profound effect on the quality of life and psychosocial aspects of the affected women. The aim of this study was to investigate the prevalence and risk factors of UI in reproductive age women.
    Methods
    This cross-sectional study was conducted on 2000 reproductive age women from February to June 2015. The women were selected from all of the primary health care centers of Dezful, using easy access sampling method. Body mass index (BMI) was measured and data were collected by demographic, detailed information regarding obstetric and International Consultation on Incontinence Questionnaire- Urinary incontinence – Short Form(ICIQ-SF) ICIQ-SF questionnaires.
    Results
    The women’s mean age was 33.6±8, and 57.7% (1154) of them reported UI. The prevalence of UI subtypes was recorded in 38.2% (441) stress UI (SUI), 44.9% (518) mixed UI, and 16.9% (195) urge UI. There was a significant association between the mean of pregnancies, mean of deliveries, mode ofdelivery, abortion, neonate>4 kg, irregular menstruation and UI (P
    Conclusion
    The findings suggest that a significant proportion of reproductive age women were undiagnosed with UI and MUI was the most common type of UI in this age group. Regular menstruation was a protective factor but older age and vaginal delivery were risk factors for UI in this study.
    Keywords: Urinary incontinence, Prevalence, Reproductive age
  • Mahbobeh Sajadi, Sharareh Khosravi* Pages 284-291
    Background
    Febrile convulsion in children is a frightening experience for the mothers. This experience may have unknown aspects, which must be investigated in order to plan better support for the mothers and children. This study is conducted with the aim of exploring the experiences of mothers whose children suffer from febrile convulsion.
    Methods
    This study was based on a qualitative content analysis. 12 mothers in Amir Kabir hospital of Arak city participated in the study and shared their experiences through semi structured interviews. The gathered data were analysed using Graneheim and Lundman’s (2004) method.
    Results
    Exploring the experiences of mothers whose children suffered from febrile convulsion reflected three themes: perceived threat, seeking solution, and difference in adaptation.
    Conclusion
    Regarding the findings of this study, comprehensive supportive care plans can be designed for enabling the mothers to better cope with their children’s febrile convulsion.
    Keywords: Febrile convulsion, Child, Mother, Experience, Qualitative research
  • Robab Latifnejad Roudsari, Maryam Zakerihamidi, Effat Merghati Khoei, Anoshirvan Kazemnejad Pages 292-302
    Background
    A tool which can help to decide on the determinants in selecting the delivery type is an effective step towards the goals of the World Health. This study aimed to develop and evaluate the psychometric properties of a scale based on Iranian culture to make decision on the type of delivery.
    Methods
    This is a methodological study using a questionnaire proposed by Schneider. The following steps were used to design the project. In the first step, perceptions and experiences of 45 pregnant women, postpartum women, midwives, gynecologists and non-pregnant women were determined based on interviews and observations using focused ethnography. In the second stage, the terms in the questionnaire based on qualitative study was assessed. Then, in the third stage, psychometric testing of the decision making on the type of delivery scale (DMTDS) based on the cultural concepts of decision making towards the type of delivery and its influencing factors based on focused ethnography using face validity, content validity, construct validity, internal consistency and reliability was done on400 pregnant and postpartum women.
    Results
    The initially developed scale consisted of 60 items on a 5-point Likert scale, which reduced to 43 items following measurement of the face and content validity. The results of the exploratory factor analysis elicited 36 items and a seven-factor structure including motivational beliefs on vaginal delivery, social beliefs towards childbirth, motivational beliefs on cesarean delivery, personal beliefs, sources of information, catastrophic thinking and child birth experiences. Cronbach’s alpha coefficient (0.80) confirmed the high internal consistency of the scale.
    Conclusion
    The developed questionnaire appears to be a valid and reliable tool for healthcare providers to measure the women’s decision making towards type of delivery. Therefore, this tool canbe used in the Iranian community. The scale may help the midwives and obstetricians to be aware of the women’s decision regarding their choice of delivery and as a result to plan appropriately in order to reduce unnecessary cesarean sections.
    Keywords: Psychometrics, Decision making, Scale, delivery, Iran