Iranian Journal Of Nursing and Midwifery Research
Volume:28 Issue: 3, May-Jun 2023

Sucking and swallowing coordination did not achieve until 32–34 weeks of gestation in premature infants. Oral motor stimulations improve oral motor musculature and neurobehavioral synergism which improves the rate of oral feeding readiness and weight gain and ultimately reduces the duration of hospitalization. Premature Infant Oral Motor Interventions (PIOMI) is a specific oral motor therapy effective in improving the clinical outcomes among premature infants. Earlier no review had been conducted specifically to assess the effectiveness of PIOMI on oral feeding progression, weight gain, and Length of hospital Stay (LOS) among premature infants. So, the present review had been planned.

Review was conducted by searching databases like PubMed/Medline, Embase, Ovid, Clinical Key and Academia, Google and Google Scholar (from PIOMI inception to October 2020). Published articles on RCTs and clinical trials were included.

Six studies, with a total of 301 premature infants, were included in Meta Analysis (MA). PIOMI was found effective in early attainment of feeding progression (Mean Difference (MD) = −4.63 days at 95% Confidence Interval (CI) = −4.97 to − 4.29, p < 0.001) and shifting from gavage to independent oral feeding (MD = −2.54 days at 95% CI = −3.13 to − 1.95, p < 0.001), shows weight gain at discharge (MD = 51.61 grams at 95% CI = 19.84 to 83.38, p = 0.001), and reduces LOS (MD = −2.81 days at 95% CI = −3.51 to − 2.10, p < 0.001).

Review shows shows the effectiveness of PIOMI in improving oral feeding progression and early attainment of gavage to independent oral feedings, and it also showed weight gain at discharge and reduced LOS.

Tuberculosis (TB) control depends on healthcare professionals ‘knowledge, practice, and self‑efficacy when managing high‑risk groups. So the study aimed to evaluate the effectiveness of a structured educational program in improving nurses’ knowledge, practice, and self‑efficacy in caring for patients with TB.

A pre‑test post‑test quasi‑experimental design was conducted on 36 nurses at Chest hospital Al Masah al Bahri in port said city and the Chest Hospital in Damietta City, Egypt. Data were collected using three self‑administered questionnaires to assess knowledge, practice, and self‑efficacy by using convenience sampling from March to August 2019. Data analyses were done by using a paired t‑test, a Student t</em>‑test, and an F‑test analysis of variance.

Based on data related to the two groups before and after the study in knowledge, practice (t = 8.27, p </em>< 0.001), and self‑efficacy (t = 28.91, p </em>< 0.001), there was a significant difference between knowledge and overall knowledge scores (t=14, p </em>< 0.001). Mean scores were significantly increased for practice items about the nursing role in medication, directed observed therapy, and the overall practice score; and for self‑efficacy, which increased from 27.58 to 37.86 (p </em>= <0.001). The results indicate that nurses’ knowledge, practice, and self‑efficacy were enhanced by the implementation of the educational program.

There is scope for development in knowledge, practice, and self‑efficacy using the educational program among nurses. Training programs must be implemented in quality control to aid nurses in realizing the significance of information in reducing disease and death and enhancing the quality of care.

The investigation of Maternal Near‑Miss (MNM) risk factors is important for the global reduction of maternal mortality. This study aimed to identify the determinants of MNM among pregnant women in northeastern Iran.

A prospective case‑control study was conducted on 250 women referred to the maternity ward of Nohom‑e‑Dey hospital in Torbat‑e Heydarieh, Iran, from June 2018 to May 2020. Applying the criteria of the World Health Organization tool, near‑miss mothers were taken as cases, and mothers with normal obstetric outcomes were selected as controls with convenience sampling. Logistic regression models using Stata version 14.0 and odds ratios (95% confidence intervals) were reported.

A total of 123 MNM cases and 127 controls were included in the study. The multiple logistic regression represented that having had previous abortion, living in rural or urban areas, whether the mother went through C/S or vaginal delivery and level of prenatal education were associated with MNM. Besides, having experienced chronic medical diseases during pregnancy had the strongest association with MNM, and next were complications during childbirth and neonatal outcomes which were associated with MNM, although in terms of statistical association, only the first two mentioned factors were statistically significant.

Determinants of MNM could be experiencing chronic medical disorders during maternal complications. Health providers need to carefully manage past medical history and adverse perinatal outcomes, especially in pregnant women who live in rural areas. Encouraging mothers to attend pregnancy training classes is effective in reducing MNM.

During COVID‑19 pandemic, the isolation, socialization, and extreme changes in daily life have some potential mental health consequences which should be recognized as a critical public health concern, especially for perinatal mothers. Therefore, it is very important to assess the needs for maternal mental health care in perinatal mothers during COVID‑19 pandemic. This study aimed to explore mothers’ needs for maternal mental health care in the perinatal period during COVID‑19 pandemic.

Realistic phenomenological approach was carried out in this qualitative study. The study was conducted at five community health centers in the city of Tangerang, Indonesia. In‑depth interviews were conducted to 11 mothers who were pregnant, in labor, during puerperium and two months after giving birth with purposive sampling. Data were collected from May to August 2021. Interviews were conducted face to face, audio recorded, and transcribed verbatim. Data were analyzed by using Van Manen’s phenomenological method.

Initial finding revealed 254 codes, which were then reduced to 122 codes, 98 sub‑categories, 22 categories, and 5 themes. There were five themes related to mothers’ needs for mental health care during COVID‑19, i.e.</em>, health protocol during pandemic, psychological support, health education, simple coping mechanism, and support system.

The needs can be fulfilled by the closest people the mothers have and healthcare system for perinatal mental health. Vaccination, health protocol, and psychological resilience should be delivered to mothers during COVID‑19.

The Covid‑19 disease was raised as a fundamental public health problem worldwide, and nurses were exposed to many problems and challenges at the front line of fighting this disease. Therefore, the present study aimed to explain the experiences of nurses who took care of Covid‑19 patients.

This study was a conventional content analysis qualitative study using Granheim and Lundman approach. The study participants included 20 nurses working in Corona referral hospitals in Isfahan, Iran. Participants were selected using purposive sampling and in‑depth semi‑structured interviews were conducted from September 2020 to March 2021. To assess the trustworthiness of the obtained data, credibility, dependability, confirmability, and transferability criteria were used.

Data analysis led to the production of 700 primary codes, 15 sub‑sub‑categories, 5 sub‑categories and 2 main categories. These two main categories consisted ofpsychological reactions and organizational challenges. Negative emotional experiences and positive emotional experiences were placed in the category of psychological reactions and expectations from superiors, lack of facilities and resources and insufficient quality of care in the category of organizational challenges.

The results of the present study showed that managers and policy‑ makers should prioritize the nursing empowerment to ensure effective epidemic fight and the psychological and financial support of Covid‑19 ward nurses.

COVID‑19 infection endangers pregnant women and newborns. Infection prevention measures are available and easy to apply, but the problem is the application continuity. Empowering pregnant women to increase their intention for self‑protection is very important. This study explores the effect of educational intervention based on the Protection Motivation Theory (PMT) on pregnant women’s knowledge and self‑protection regarding COVID‑19.

A randomized, controlled trial was conducted at the Obstetrics and Gynecology outpatient clinic at El Shatby Hospital, Alexandria governorate/Egypt, from November 2020 to May 2021. The study included a convenient sample of 163 pregnant women using the randomization block technique. A self‑reported questionnaire was used for data collection. For the intervention group, the PMT‑based education included need assessment, planning, implementation, and evaluation. Two months later, a reevaluation was done.

ANCOVA showed a significant improvement in the intervention group’s knowledge (F1 = 8.56, p </em>< 0.001) when taking the pretest as a reference. The effect size shows that 25.8% of the intervention group’s knowledge improvement and 58.80% of the difference between the two groups were due to intervention. ANCOVA showed a significant improvement in the intervention group’s PMT constructs when taking the pretest or group as a reference (p </em><0.001). The effect size shows that 56.10% of the intervention group’s total PMT constructs improvement and 89.60% of the differences between the two groups were due to the intervention.

PMT‑based intervention is effective in improving pregnant women’s knowledge and self‑protection intention regarding COVID‑19. PMT is recommended to tailor educational intervention for pregnant women.

Infants undergo extremely painful procedures in a Neonatal Intensive Care Unit (NICU), which if left uncontrolled may cause complications. Therefore, this study was conducted to investigate gentle touch effect on cardiorespiratory indices and pain behaviors related to venipuncture and blood sampling in preterm infants.

A quasi‑experimental study was undertaken in gentle touch and control groups in three stages. The population included premature infants in NICU of Al‑Zahra Hospital, Isfahan, Iran. Using convenience sampling, 52 infants were randomly selected and assigned to two groups (n = 26). Gentle touch technique and measurement of cardiorespiratory indices were performed 5 minutes before, during, and 5 minutes after procedure, and routine care was provided for control group. Neonatal pain and cardiorespiratory indices were assessed using the Neonatal Infant Pain Scale (NIPS) and an intensive care monitor. Data was analyzed using repeated measures ANOVA, independent t‑test, and Chi‑square test in SPSS software.

The independent t‑test revealed a significant difference between mean pain score of the infants in two groups during the procedures (t50 = ‑3.32, p </em>= 0.002), but no significant different was between groups before and after the procedure (p > 0.05). However, the cardiorespiratory indices were not significantly different before, during, and after the procedure (p > 0.05).

The results suggest that gentle touch reduced the infants’ pain during venipuncture and blood sampling. Thus, it is recommended this method be applied to mitigate pain in premature infants.

Chronic diseases are a huge threat to public health in Kazakhstan and around the world. Many deaths can be prevented by using evidence‑based behavioral interventions. Nurses, as the most numerous health care workers, can perform behavioral therapy for the prevention of Non‑Communicable Diseases (NCDs). This study was conducted in order to explore the behavioral interventions performed by nurses, to analyze current problems, barriers and the attitude of nurses to these activities.

A cross‑sectional study was conducted among 260 nurses in the city of Nur‑Sultan from 2019 to 2020. The sample was calculated using a formula and simple random sampling. The study was conducted using a specially compiled questionnaire. Descriptive statistics were chosen as a statistical method. Pearson’s Chi‑square criterion was used to identify a statistically significant relationship between variables.

Among 260 nurses, 208 participants (80%) had the desire to conduct behavioral interventions among patients. Most nurses do not have enough time to conduct behavioral interventions. A short work experience affects to a greater extent nurses use passive training methods. Almost half (47.30%) of nurses rate their level of knowledge about the real effects of drugs, tobacco, alcohol, and preventive measures on the body as “average”.

The work of nurses on the prevention of NCDs is not performed enough due to lack of working time and available domestic literature, heavy workload. Behavioral therapy should be based on reliable scientific evidence, which can be achieved through the development of clinical guidelines and continuous training of nurses.

Polycystic Ovary Syndrome (PCOS) is the most common reproductive endocrine disorder, which affects approximately one in every five women at the age of reproduction. The first line of PCOS management is recommended to be lifestyle modification. This study aimed to evaluate the effectiveness of lifestyle modification on Health‑Related Quality of Life (HRQoL) among women with PCOS.

This quasi‑experimental study was conducted on 124 women with PCOS recruited from the outpatient clinic at El‑Takhassosy Obstetrics Hospital, Port‑Said, Egypt, in 2021 and allocated to two groups; an educational group (n </em>= 62) and a control group (n </em>= 62). For data gathering, two tools were used; an interviewing questionnaire for assessing the demographic characteristics and a standardized HRQoL questionnaire. Healthy lifestyle modification educational sessions included nutritional guidelines for PCOS, physical exercise (walking for 30 min five times weekly), and instructions to relieve stress.

The mean (SD) of HRQoL score was 97.52 (8.75) in the educational group higher than the control group 87.32 (18.68) at 3 months postintervention and at 6 months postintervention; it reached 106.74 (11.53) in the educational group and 89.47 (22.14) in the control group. They were statistically significant after intervention (3 and 6 months) between studied groups (after 3 months was t86,563 = 3.891, p </em>< 0.001 and after 6 months was t91,826.

Women with PCOS should receive structured education about lifestyle modification next to treatment to ensure improvement, particularly in patient‑centered care.

Cultural and language differences are necessary factors for diabetes management and self‑care education programs in patients suffering from diabetes. This study aims to investigate the effectiveness of culture‑based self‑care intervention on health literacy, quality of life, and glycemic parameters in patients with type 2 diabetes.

This randomized clinical trial has been carried out in selected centers in Darreh Shahr, Iran; 80 participants were randomly assigned into intervention and control groups. The intervention group received an educational program for 6 sessions twice a week, but the control group only received routine services. Data were collected using health literacy and life quality scales for diabetic patients, which were completed by both groups before, immediately after, and 3 months after the intervention; hemoglobin A1C (HbA1c) was checked before and 3 months after the intervention. SPSS software was also analyzed data using χ2, Fisher’s exact, independent t</em>, and repeated measures analysis of variance tests.

There were no significant differences between the 2 groups before the study (p </em>>0.05) goes forward. But, mean scores of health literacy (F</em>2,40 = 5.61, p =</em>0.007), quality of life (F</em>2, 40 = 4.09, p =</em>0.01), and HbA1c levels (t</em>, 39 = 6. 91, p </em><0.001) have shown significant differences between the 2 groups immediately and 3 months after the intervention have been applied.

Culturally appropriate intervention should be offered as a part of the nurse’ care program for diabetic to control HbA1c, and improve their life quality and health literacy.

Critical care nurses are at especially high risk of burnout. Burnout is a maladaptive response to work‑related stress that is associated with negative consequences for patients. Emotional intelligence enables nurses to make better decisions and manage their patients more effectively. It impacts positively on the quality of care. This study aimed to assess the effect of emotional intelligence training on job burnout for nurses at the critical care units.

A quasi‑experimental study was conducted at two critical care units: the Cardiac Surgery Academy and El Demerdash Hospital, both of which are affiliated to Ain Shams University. The subjects were 200 critical care nurses. Each group of nurses trained for five sessions, each lasting about two hours, in the form of seminars. Researchers collected data through self‑administered questionnaires containing three parts (demographic data of nurses, Wong and Law’s Emotional Intelligence Scale and Maslach burnout inventory).

For emotional intelligence, the mean (SD) score of studied nurses pre‑intervention was 19.95 (6.30), while post intervention it was 36.4 (9.57), a significant difference (t </em>= 14.01 p </em>= <0.01). Regarding burnout, the mean score of studied nurses pre‑intervention was 59.61 (19.58), while post intervention it was 89.90 (19.60), (t </em>= 16.05 p </em>= <0.01). The regression model explains 67% of the variation in total emotional intelligence detected through R</em>2 value 0.67 (F </em>= 12.980 p </em>= <0.001).

The present study revealed that emotional intelligence training had positive effects on nurses’ experience of burnout at work. Providing educational training programs about emotional intelligence for newly hired nurses is recommended.

Maintaining oral health during pregnancy has been considered an essential public health issue worldwide. One of the various preventive strategies is to train antenatal care providers to guide pregnant women. This study aimed to design, implement, and evaluate an educational program’s effect on the oral health‑related knowledge, attitudes, and practice of antenatal care providers in Iran.

All of the antenatal care providers working at Isfahan health centers were invited for this study in April 2019. A total of 340 volunteers (120 midwives and 220 others) finally participated in this interventional study with a pre‑test–post‑test design. A questionnaire was developed to assess the participants’ knowledge, attitudes, and practice before and after the intervention. A lecture‑based educational session containing similar issues asked in the questionnaire was held for all the participants. The participant’s total knowledge scores before and after the intervention, and their attitudes and practice were evaluated and compared through paired t‑test.

The participants’ mean total knowledge scores before and after the intervention were 42.87 and 52.25, respectively. The paired t‑test revealed a statistically significant difference between pre‑ and post‑intervention scores (p < 0.001). The frequency of participants’ answers to attitude and practice questions was also determined.

Improving oral health‑related knowledge of antenatal care providers can be achieved through a single educational session designed by accurately assessing their needs. The participants’ attitudes revealed barriers to seeking dental care by pregnant women; however, the participants’ oral health‑related practice was acceptable.

Delirium is a common problem among patients in Intensive Care Units (ICUs); however, it remains underdiagnosed. We aimed to determine the impact of a nursing education program on Jordanian nurses’ knowledge, practice, attitudes, self‑efficacy, and ability to detect delirium among ICU patients.

We conducted a nonequivalent, quasi‑experimental design from January 2019 to January 2020. A total of 175 nurses who work in an ICU were included at the baseline and divided into two groups: (1) intervention (86 nurses), who received education for 6 hours each day across two different days and (2) a control group (89 nurses), who maintained their usual routine of care. Data were collected by means of a booklet of questionnaires about the nurses’ knowledge and practice, attitudes, and self‑efficacy.

Data from 160 nurses were included in the analysis. The education program intervention (n = 81) significantly increased nurses’ knowledge and practice, positive attitudes, and self‑efficacy compared with the control group (n = 79, p </em>< 0.001). In addition, nurses who received the educational intervention were able to detect more cases of delirium (28%, from a total of 51 patients) than the controls, who detected three (6.50%) out of a total of 31 patients (p </em>= 0.003).

The ICU nurses who received the delirium‑focused educational program increased their knowledge and practice, positive attitudes, and their self‑efficacy; in addition, their ability to detect delirium was increased. The implementation of such a program is recommended for the health policymakers and stakeholders.

Hypertension in the second trimester of pregnancy is accompanied by proteinuria that is called Preeclampsia Syndrome (PES). Body relaxation is a technique which makes harmony between mind and body. The aim of this study was to investigate the effect of Body Relaxation Technique (BRT) on some symptoms of Preeclampsia Syndrome (PES).

This clinical trial was conducted on 96 high‑risk pregnant women who were selected by random sampling method from among women referring to community health centers of Isfahan city. The samples were divided into intervention and control groups by even and odd numbers. The intervention group members received BRT during 16 sessions. Blood pressure and proteinuria were measured and recorded before and after the intervention in both groups at the beginning and in the 36th week of pregnancy. The collected data were analyzed.

According to the Chi‑square test, the frequency of PES was 11.10% and 23.50% in the intervention and control groups, respectively (χ2 = 3.95, df = 1, p </em>= 0.046). After the intervention, there was no significant difference between the two groups in terms of the diastolic blood pressure and proteinuria. Systolic blood pressure and stress were also significantly reduced in the intervention group. However, proteinuria was not significantly different between the two groups.

Based on the results, the relaxation technique, as an easy technique, is recommended for pregnant women who are susceptible to pregnancy hypertension and preeclampsia. Moreover, as a clinical complementary method, it can be recommended for preventing the symptoms of PES.

Stigmatization and discrimination by health workers, particularly midwives are obstacles to the achievement of universal access to Human Immunodeficiency Virus (HIV) prevention, treatment, and care programs. Therefore, it is necessary to evaluate midwifery students’ knowledge and attitude regarding Acquired Immune Deficiency Syndrome (AIDS) and HIV, and their willingness to care for patients with AIDS and HIV before they enter the field of health and medical activities. Thus, the aim of this study was to investigate the level of knowledge and attitude in this regard, and willingness to care for patients with AIDS and HIV among midwifery students of selected universities in Iran in 2020.

A descriptive‑analytical, cross‑sectional study was performed on 618 midwifery students in Iran in 2019–2020. Data were collected using a five‑part questionnaire: a demographic characteristics form, an academic profile form, the HIV Knowledge Questionnaire (HIV‑KQ), the AIDS Attitude Scale (AAS), and the Jordan Standard Questionnaire. Data analysis was performed through descriptive and inferential statistical methods. p </em>value of ≤ 0.05 was considered significant.

The mean (SD) age of the subjects was 23.10 (5.63) years. The mean (SD) of knowledge, attitude, and willingness scores were 26.93 (6.64), 80.45 (9.27), and 29.55 (9.10), respectively. Single individuals had higher attitude scores.

Iranian midwifery students had the desired level of knowledge, although the mean score was not much higher than the threshold. The level of the midwifery students’ attitude was appropriate and more than that, but none of them had a 100% positive attitude. They had a moderate or neutral willingness to provide services to and care for patients with AIDS.

Birth represents an influential moment in women’s lives that can be a powerful or traumatic experience. Therefore, the aim of this study was to assess the relationship among maternal perception of childbirth experience, spiritual health, and maternal‑infant relationship in the postpartum women.

This descriptive‑analytical study was conducted on 305 postpartum women referred to Health Centers in Karaj. The data were collected using the Perception of Birth Scale (POBS), maternal postnatal relationship scale, and spiritual health questionnaire.

In this study, the mean (standard deviation (SD) age of the participants was 27.50 (5.56) years. The Spearman’s correlation test results showed that there was a significant positive relationship among the maternal perception of childbirth experience, the general maternal‑infant relationship (r = 0.34, p </em>< 0.001), quality of relationship (r = 0.17, p </em>= 0.002), pleasure with interaction (r = 0.32, p </em>< 0.001), and absence of hostility (r = 0.28, p </em>< 0.001). In addition, a positive relationship was observed among spiritual health and general maternal‑infant relationship (r = 0.21, p </em>< 0.001), pleasure in interaction (r = 0.08, p </em>= 0.164), absence of hostility (r = 0.15, p </em>= 0.008), and the maternal perception of childbirth experience (r = 0.11, p </em>= 0.039).

It seems that to promote maternal‑infant relationship, health care providers should not only try to promote physical intimacy between mother and infant but also create a positive emotional state for the mother during birth.

Daily spiritual experiences and spiritual care competence have positive health effects on patients and form an integral part of the nursing profession. This study was conducted to determine the relationship between daily spiritual experiences and the dimensions of spiritual care competence in nursing students.

This cross‑sectional study was conducted on 401 nursing students in their last year of the program. The participants were selected from nursing schools in Tehran Province, Iran, in the academic year 2019–2020. The required data were extracted using a demographic information questionnaire, the Daily Spiritual Experiences Scale (DSES), and the Spiritual Care Competence Scale (SCCS). The collected data were analyzed in SPSS software at the significance level of 0.05.

The mean (SD) of daily spiritual experiences and total spiritual care competence was 67.15 (16.33) and 101.77 (16.26), respectively. The personal support and patient counseling dimensions had the highest mean (SD) [22.10) 4.80)]. Among all these dimensions of spiritual care competence, only professionalization and improvement of the quality of spiritual care were predictors of the students’ daily spiritual experiences (p </em>< 0.05).

The professionalization dimension of spiritual care competence was identified as a predictor of daily spiritual experience in nursing students. Therefore, the researchers recommend the highlighting of this dimension in nursing programs to promote the students’ spiritual care competence.

This study investigated the association between internalized stigma and hope, self‑esteem, self‑efficacy, and treatment adherence and explored the most influential and predictive factor of internalized stigma among patients with severe mental disorders.

This correlational descriptive study was conducted on 257 outpatients diagnosed with severe mental illness according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‑V) diagnostic criteria. The participants were seeking treatment at outpatient and affiliated clinics of Razi Hospital, Iran, from October 2018 to May 2019. We used a convenient sampling design. Internalized Stigma of Mental Illness scale, Dispositional Hope Scale, Rosenberg’s Self‑Esteem Scale, General Self‑Efficacy Scale, and Drug Attitude Inventory were used to gather data. The data were analyzed using inferential statistics (Pearson correlation, coefficient logistic, and regression analyses) at a 0.05 significance level.

The mean (standard deviation) score of internalized stigma was 1.57 (0.49), and 58% of the participants reported moderate to high internalized stigma. A negative significant relationship was found between internalized stigma and hope (r </em>= −0.55, p </em>< 0.05), self‑esteem (r </em>= −0.66, p </em>< 0.05), and self‑efficacy (r </em>= −0.64, p </em>< 0.05). Treatment adherence was not found to be significantly associated with the internalized stigma. In the final regression model, self‑esteem and self‑efficacy significantly predicted internalized stigma.

Given the crucial role of self‑esteem and self‑efficacy in predicting internalized stigma, nurses should devote special attention to these factors and use strategies to improve individuals’ self‑esteem and self‑efficacy.

Breastfeeding is a highly efficacious, health‑promoting activity that prevents many disorders and diseases. Successful breastfeeding depends on various maternal physiological and psychological factors, among which breastfeeding self‑efficacy is an adjustable framework. This study investigates the effect of breast massage training on self‑efficacy and perceived stress in primiparous women.

This study is a clinical trial study on 132 eligible primiparous mothers referred to Bahar Hospital from August 15, 2019, to December 15, 2020. The women were randomly divided into intervention and control groups. The massage was performed in the intervention group before breastfeeding. The data were collected using a standard breastfeeding self‑efficacy questionnaire and the Sheldon Perceived Standard Questionnaire. Data were entered into SPSS 18 and analyzed using descriptive statistics, Chi‑square, and analysis of variance.

The results of this study showed that the mean (SD) breastfeeding self‑efficacy in the breast massage training group with direct midwife involvement was 61.63 (9.21), higher than the one in the control group 51.51 (11.62). In addition, perceived stress was 19.81 in the intervention group and 24.84 in the control group, which was also statistically significant.

Due to the increase in self‑efficacy scores and decrease in stress scores after breast massage, this method can improve breastfeeding performance in women. Therefore, educational strategies should be developed in this area.

Distal Radial Artery (DRA) is a new arterial access for coronary catheterization. Assessment of the vascular complications of this new procedure is important in the provision of nursing care to cardiac patients. The aim of this study was the nursing assessment of vascular complications of DRA in angiography and angioplasty.

This qualitative longitudinal study was conducted on 315 consecutive patients who were candidates for coronary catheterization via DRA from 2017 to 2020 in three hospitals in Tehran, Iran. Patients who had palpable DRA and were capable and willing to consent to inclusion in the study were evaluated. Moreover, patients whose DRA access failed, and those who had previously undergone coronary artery bypass graft were excluded from the study. Vascular complications were assessed on the day of the procedure and about 1 month later.

After the procedure, 29 cases of ecchymosis, 8 cases of hematoma, and 1 case of arteriovenous fistula in the DRA were observed. We did not observe any major vascular complications.

Nursing assessment of the snuffbox area indicated that this approach is a safe and convenient technique for cardiac catheterization with few minor complications.