Journal of Holistic Nursing and Midwifery
Volume:32 Issue: 3, Summer 2022

Self-harm has increased among adolescents in recent years, turning it to one of the major public and mental health concerns.

The present study aims to investigate the prevalence of self-harm and deliberate self-cutting in high school students in northern Iran, and its relationship with anxiety, depression, and stress.

In this analytical cross-sectional study, participants were 617 high school students in Rasht, Iran in 2018 who were selected through multistage cluster random sampling. Data collection tools were a demographic form, the Self-Harm Inventory (SHI), and the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Data analysis was done by independent t-test, Kruskal–Wallis test, one-way analysis of variance, chi-square test, Fisher’s Exact test, and linear and logistic regression.

The mean age of students was 16.11±1.35 years, and the majority of them were male (64.2%). The prevalence of self-harm behaviors was 54.9% (n=339), 20.3% in females and 79.7% in males. Deliberate self-cutting was found in 11% of students. The score of SHI was significantly higher in boys than in girls, while the prevalence of deliberate self-cutting was more in girls (P= 0.001). Self-harm behaviors increased with increasing depression, anxiety, and stress (P=0.001). Gender (B=0.704, 95%CI: 0.149-1.258, P=0.013), grade (B=-1.011, 95%CI:-1.517--0.504, P=0.001), family size (B=0.620, 95%CI: 0.344-0.895, P=0.001), age (B=0.624, 95%CI: 0.286-0.962, P≤0.001), and the grade point average in the past year (B=-0.945, 95%CI: -1.197- -0.693, P= 0.001) had significant relationship with self-harm behaviors (R2= 0.145). Moreover, gender (OR=4.874, 95%CI: 2.297-10.344, P=0.001), grade point average in the past year (OR=0.727, 95%CI: 0.567-0.932, P=0.012), substance abuse (OR=7.972, 95%CI: 3.424-18.564, P=0.001), depression (OR=1.163, 95%CI: 1.065-1.271, P=0.001), stress (OR=1.105, 95%CI: 1.006-1.213, P=0.036), and father's educational level (OR=7.897, 95%CI: 1.138-54.807, P≤0.001) had significant relationship with deliberate self-cutting.

Self-harm behaviors in adolescents are associated with anxiety, depression, and stress.

Many pregnant women experience discomforts during their pregnancy that are not severe, but may reduce their well-being. These minor discomforts such as vomiting, heartburn, and leg cramps can be troublesome and may affect the women’s quality of life.

This research aims to determine the relationship between socio-demographic variables and minor discomforts in pregnancy.
  

This is an analytical cross-sectional study. Participants were 202 pregnant women in Birnin-Kebbi, Kebbi State, Nigeria. Systematic sampling was used for their recruitment. A self-report questionnaire was used for surveying socio-demographic characteristics and assessing the pattern and severity of minor discomforts. Chi-square test and ordinal logistic regression analysis were used for analyzing the collected data at 95% Confidence Interval (CI).

The age range of most women (42.1%) was 20-24 years. Most of them had their 2-4th pregnancy (37.6%) and a tertiary education (62.4%). There was a significant relationship between the variables of age, number of pregnancies and occupation and the occurrence of minor discomforts in pregnancy (P< 0.05). There was a significant relationship between the occupation and duration of minor discomforts (P < 0.05), and between educational levels and mode of treatment for minor discomforts (P=0.05). The Odds Ratios (OR) in ordinal logistic regression models indicated that with one unit change in age, number of pregnancies and occupation, the duration of minor discomforts was 1.05 (95% CI;  0.457-1.722, P=0.0001), 1.07 (95% CI; 0.316-2.021, P=0.0001) and 1.07 (95% CI; 0.662-2.063, P=0.0001) times more likely to change, respectively.

Healthcare professionals should consider the factors of age, number of pregnancies, and occupation when providing care to pregnant women. More research to address the minor discomforts in pregnancy is recommended using different methods.

Women with Breast Cancer (BC) under chemotherapy are at risk of complications affecting their Quality of Life (QoL), which need specific discharge planning.

This study aims to investigate the effect of a discharge planning program on the QoL of women with BC.

This quasi-experimental study was conducted on 72 women with BC undergoing chemotherapy referred to oncology wards in Kermanshah, Iran. They were divided into groups of intervention (n=35) and control group (n=35) using the block randomization method. For the intervention group, the discharge planning program was implemented individually and in group at least 4 sessions, each for 30-45 minutes. Patients’ QoL in both groups was measured before, one month after, and three months after intervention using two questionnaires of European Organization for Research and Treatment of Cancer (QLQ C-30 and QLQ-BR23). The collected data were analyzed using ANOVA, chi-square test, t-test, and repeated measures ANOVA. The significance level was set at 0.05.

The mean age of participants was 47.71±10.4 years, and majority of them were in the second stage of BC. There was a significant difference in all functional scales of QoL in the intervention group over time from baseline to three months after discharge (P<0.05), except in sexual functioning (P= 0.119) and sexual enjoyment  (P= 0.210).

The discharge planning program has a positive effect on the Quality of Life of women with Brest Cancer.

The pain relief effect of Paracetamol, as a safe analgesic drug in labor, compared to Pethidine, as a well-known analgesic drug, need to be more evaluated.

This study aims to compare the effects of Paracetamol and Pethidine on the first-stage labor pain relief and neonatal and maternal complications.

This single-blind, parallel group, randomized clinical trial conducted on 100 nulliparous pregnant women referred to a maternity hospital in Rafsanjan Iran in 2018 who were selected using a convenience sampling method and by assigned into two groups Paracetamol (n=49, receiving 100 mg intravenous Paracetamol) and Pethidine (n= 51, receiving 50 mg intravenous Pethidine) using the minimization method. The drugs were administered when there was at least a 4-cm cervical dilation. Maternal complications and infant's 1 and 5-min the Apgar scores and ability to breastfeed were evaluated. Pain intensity measured by the Visual Analogue Scale (VAS) and compared using two-way repeated measures ANOVA before and 30 minutes, 1, 2, 3 and 4 hours after drug administration.

There were no significant differences between the two groups in term of age, body mass index, and gestational age, and no significant difference in pain intensity in any groups among the time points. Maternal complications were significantly lower in the Paracetamol group than in the Pethidine group; however, the difference was statistically significant only in terms of nausea (P=0.04). Infants’ breastfeeding ability was significantly better in Paracetamol group than in the Pethidine group (P=0.04). The results of two-way ANOVA showed that the mean VAS score was not significantly different between the two groups (P=0.67).

Paracetamol can alleviate the first-stage labor pain similar to Pethidine, but with fewer maternal and neonatal complications.

Caregivers play a critical role in health management of patients with chronic diseases. Caregiving is associated with experiencing different emotional and psychological problems.

This study aims to determine the relationship between caregiver burden and cognitive function in adult patients with Type 2 Diabetes (T2D).

In this cross-sectional study, 215 family caregivers of adult patients with T2D were selected by a systematic random sampling method. A socio-demographic form, the Caregiver Burden Inventory (CBI), and the Mini-Mental State Examination (MMSE) were used for data collection. Data were analyzed using Kruskal-Wallis test, Spearman’s rho correlation test. The multinomial logistic regression model was used to examine the power of Cognitive Impairment (CI) in predicting the caregiver burden. P<0.05 was considered as the statistically significance level.

The mean age of caregivers and patients were 48±9 and 52±2 years, respectively. The mean score of CBI was 24.57±18.2, indicating a moderate level of caregiver burden. The mean score of MMSE was 25.25±3.6, indicating a mild CI in patients. Caregiver burden showed a significant correlation with cognitive function (r=-0.336, P=0.001, 95% CI; 0.53–0.89) such that the decreased CI was associated with an increase in total caregiver burden (r=-0.348, P=0.001, 95% CI; 0.43–0.87). The regression results showed that the CI levels were not predictors of caregiver burden severity.

The CI of patients with T2D may affect their caregivers’ burden. Therefore, assessing the cognitive function of these patients can help healthcare providers conduct interventions to enhance the caregivers’ quality of life.

The efficacy of Growth Monitoring and Promotion (GMP) program depends on active participation. However, its low acceptance by mothers is believed to reduce their participation in the program.

This study aims to assess maternal beliefs and knowledge about GMP and examine its association with the child growth parameters.

This cross-sectional study was conducted on 470 mother-child dyads who were recruited from public health centers of Ahvaz and Bushehr cities from August 2018 to February 2019 using a convenient sampling method. A questionnaire surveying anthropometric and socio-demographic characteristics as well as maternal knowledge and beliefs based on the Health Belief Model (HBM)was used to gather data. Child growth parameters were obtained from their medical records. Multinomial logistic regression was applied to determine the predictors of child growth parameters from among the HBM domains.

The mothers had a mean age of 29.56±5.10 years, and 92% had a planned pregnancy. Favorable growth percentage based on parameters of length-for-age, weight-for-age, weight-for-length and head circumference-for-age was 94.3%, 93.2%, 90.6%, and 93.1%, respectively. The mean scores for HBM constracts of self-efficacy, cues to action, risk susceptibility, barriers to action, benefits to action, risk severity, and GMP knowledge were 64.09±9.92, 89.95±11.77, 44.71±6.73, 54.81±10.52, 60.23±9.59, 66.52±9.33, and 46.83±5.44, respectively. Higher GMP knowledge was associated with higher weight-for-length (β=0.345, 95%CI; 0.064- 0.625, P=0.016) and head circumference-for-age (β=0.287, 95%CI; 0.022- 0.596, P=0.025). Higher weight-for-age was significantly associated with higher scores of GMP knowledge (β=0.409, 95%CI; 0.011-0.806, P=0.044), barriers to action (β=0.155, 95%CI; 0.025-0.284, P=0.019) and cues to action (β=0.190, P=0.03, 95%CI; 0.017- 0.362).

Mothers’ beliefs and knowledge about GMP can affect child growth and should be considered in educational interventions to increase their participation in GMP program and ultimately improve their child growth.

As a biopsychosocial phenomenon, substance abuse is a major public health problem with negative economic, social, and cultural consequences.

This study aims to determine the effect of Motivational-Enhancement Therapy (MET) on substance abuse patterns in postpartum women with Substance Use Disorder (SUD)

This clinical trial was conducted on 60 eligible postpartum women with SUD (30 in the intervention group and 30 control), who were selected using a random sampling method from the postpartum unit of a hospital in Kerman, Iran in 2019. The participants in the intervention group attended four individual MET sessions and received four telephone follow-ups. All participants completed a researcher-made substance use pattern checklist before and after the intervention. Data analysis was carried out using McNemar's test, paired t-test, independent t-test, Fisher’s exact test, and chi-square test. A P<0.05 was considered statistically significant.

The mean age of women was 29.25±5.89 years, and most of them were housewives with elementary education. A significant reduction was observed in the number of opium (P=0.008) and methadone (P= 0.003) users after the intervention. Moreover, there was a significant difference in the amount of opium and methadone use (P<0.05). However, no significant difference was found between the two groups in the method and frequency of substance use before and after the intervention.

MET is effective in the type and amount of opium and methadone used in postpartum women with SUD. Therefore, it can be used along with other treatments for the treatment of SUD in women after delivery.

Bone Marrow Aspiration and Biopsy (BMAB) is a painful procedure that can causes anxiety in patients. Music can help reduce pain and anxiety levels in patients by directing their attention from negative stimuli towards pleasant and encouraging thoughts.

 This study aims to determine the effect of classical Turkish music on pain and anxiety of patients undergoing BMAB.

This is a randomized, controlled trial conducted on 68 patients undergoing BMAB who were selected from the hematology outpatient clinics in a hospital in İzmir, western Turkey. They were randomly divided into two groups of control (n=34) who received the general procedure only and the music group (n= 34) who listened to classical Turkish music for 15 minutes before the procedure. Data were collected using a demographic form, Visual Analogue Scale (VAS), and State Anxiety subscale of Spielberger's State-Trait Anxiety Inventory. Chi-square was used for comparing categorical variables, and t-test and ANOVA ​​were used for comparing numerical variables. Bonferroni test was used for post hoc comparisons. A P<0.05 statistically significant. In case of a significant difference between the groups, Cohen's d effect size was calculated.

In the music group (Mean age=63.73±14.81 years), 62% were male, 71% were married, 76% had a secondary education or lower, and 49.1% reported that biopsy was for diagnostic purposes. In the control group (Mean age=51.76±19.45 years), 50% were female, 53% were married, 62% had a secondary education or lower, and 50.9% reported that biopsy was for diagnostic purposes. A statistically significant difference was found in the mean VAS scores of both groups before and after the treatment (P=0.001). A significant difference was found in the state anxiety level only in the music group before and after the treatment (P= 0.003).

Classical Turkish music prior to BMAB can reduce the pain and anxiety of patients. It is recommended for nurses to use music therapy to reduce the pain and anxiety of patients undergoing BMAB.

Substance use disorder is one of the most critical social problems in Iran. For this disorder, weneed a proper assessment tool based on our indigenous culture.

This study assesses the factor structure and psychometric properties of 10-item and 20-item Persian versions of Drug Abuse Screening Tests (DAST-10 and DAST-20).

In this cross-sectional study, we randomly selected 200 participants referred to addiction treatment centers in Rasht City, Iran. After translation to Persian and back-translation to English, the face and content validity of DAST-10 and DAST-20 Persian versions were evaluated using the opinions of a panel of expertsand calculatingthe content validity ratio and content validity index. Then, the construct validity was evaluated by Confirmatory Factor Analysis(CFA), the Cronbach α coefficient was used for assessing internal consistency, and the Intraclass Correlation Coefficient (ICC) was used for assessing test-retest reliability.

The Mean±SD age of participants was 39.02±11.67 years. The majority (50%) were in the age range of 30-50 years. Based on the CFA fit indices, the two instruments had a good fit to the data, confirming the theoretical model Root Mean Square Error of Approximation (RMSEA) (RMSEA for DAST-20=0.080; RMSEA for DAST-10=0.055). The Cronbach α values of DAST-20 and DAST-10 were 0.772 and 0.749, respectively, indicating their good and acceptable internal consistency. Their test-retest reliability was reported at 0.997 and 0.995 based on the results of ICC, respectively. There was a strong and significant positive correlation between the scores of Persian DAST-20 and DAST-10 (r=0.851, P=0.001).

The DAST-20 and DAST-10 Persian versions which after correcting the model using confirmatory factor analysis, they were studies in DAST-8 and DAST-16 have good validity and reliability and can be used for screening the possible involvement of drugs in Iranian samples.