Journal of Nursing and Midwifery Sciences
Volume:10 Issue: 4, Oct -Dec 2023

 Endometriosis is a chronic disease in women of reproductive age accompanied by chronic pelvic pain and painful intercourse. It has a severe negative impact on these patients' psychosocial parameters. The noninvasive treatment of endometriosis remains challenging.

 This study aimed to investigate the effectiveness of hypnotherapy on the pain intensity of endometriosis patients treated with dienogest.

 In this preliminary study (a pilot double-blind, randomized clinical trial), conducted from November 2021 to July 2022, 22 patients (18 to 45 years old) with endometriosis treated with dienogest in Shahid Akbar Abadi Hospital (Tehran, Iran) were enrolled. Via block randomization, they were divided into a control group and an intervention group (n = 11 each). The patients of both groups were given 2 mg of dienogest tablets daily as prescribed by the gynecologist. The main intervention involved hypnotherapy, which was administered only for the intervention group individually for 8 weekly sessions online (on WhatsApp) for 30 - 45 minutes. Dysmenorrhea, dyspareunia, and chronic pelvic pain were evaluated using the visual analog scale (VAS) at the beginning of the intervention, immediately after the intervention, and 4 weeks after the intervention in both groups. Mean, standard deviation, frequency, chi-square, Fisher's exact test, Mann-Whitney U, and Friedman test were used for data analysis.

 Dysmenorrhea severity score in the intervention group was 6.30 ± 1.25 before the intervention, 5.50 ± 1.08 after the intervention, and 4.60 ± 0.97 during the follow-up, and the changes were significant (P < 0.001, effect size = 0.93). Dyspareunia severity score was 3.14 ± 4.50 before the intervention, 2.91 ± 4.30 after the intervention, and 2.42 ± 3.50 during the follow-up. These changes were also significant (P = 0.015, effect size = 0.41). However, the pelvic pain score did not significantly change despite the average decrease of 0.2 during the follow-up (P = 0.135).

 Hypnotherapy, along with drug treatment, was more effective in relieving endometriosis pain than drug treatment alone.

 Fears about the future and uncertainty in multiple sclerosis (MS) can affect the patients’ adaptation and well-being.

 This study investigated the effect of collaborative care on the fear of disease progression in MS patients.

 In this randomized controlled trial, patients and their main caregivers were assigned into study groups (36 in the intervention and 43 in the control group) by randomized minimization method. For the intervention group, the collaborative care model was implemented in seven sessions over nine weeks. The data were collected using the Fear of Progression Questionnaire-Short Form (FOP Q-SF). Data analysis was done using descriptive statistics, Shapiro-Wilk, chi-square, Fisher Exact, independent, and paired t-tests.

 A near-significant difference was found between the groups after the intervention (P = 0.051). However, in intragroup comparisons, the FOP score significantly decreased in the intervention group (P = 0.001) and increased in the control group after the intervention (P = 0.001).

 Collaborative care could potentially be an effective strategy for managing FOP in patients with MS.

 Cervical ripening and achieving a favorable Bishop score are crucial for a successful delivery. When the cervix is not adequately ripe, exclusive labor induction might not succeed. Therefore, there is a need to identify safe concurrent interventions to improve the Bishop score.

 This study aimed to compare the effects of oral (capsule) and vaginal evening primrose oil, in conjunction with labor induction, on the Bishop score and various labor outcomes in pregnant women.

 This randomized, triple-blind clinical trial was conducted on 170 pregnant women admitted to terminate their pregnancies at Niknafs Maternity hospital in Rafsanjan, Iran, in 2020. The subjects were randomly allocated to 2 intervention groups: the oral evening primrose oil group (n = 57) and the vaginal evening primrose oil group (n = 56). A control group (n = 57) received oxytocin induction alone. Group assignment was performed using the minimization method. The first intervention group received two oral evening primrose 1 000 mg capsules; however, the second group received two 1 000 mg vaginal capsules, both in conjunction with labor induction using 10 units of oxytocin per 1 000 cc of Ringer’s serum. The data were collected using a checklist with three parts: The mother’s demographic characteristics, obstetric characteristics, and childbirth details. Descriptive statistics, including frequency, percentage, mean, median, and standard deviation (SD), were employed. Statistical analyses included one-way analysis of variance (ANOVA), independent t-tests (the Kruskal-Wallis test and Mann-Whitney test for non-parametric tests), and the chi-square test.

 Two hours after induction, the mean Bishop scores in the oral, vaginal, and control groups were 5.47 ± 1.67, 6.28 ± 1.91, and 4.09 ± 1.61, respectively (P < 0.001). Four hours after induction, the respective scores were 7.63 ± 1.59, 8.00 ± 1.20, and 5.18 ± 1.97 (P < 0.001). The vaginal group had significantly higher Bishop scores. Furthermore, the duration of the first and second phases of labor was significantly shorter in the vaginal group than in the oral and control groups (P < 0.001).

 Vaginal evening primrose oil was significantly more effective than oral capsules and induction with oxytocin alone in terms of the Bishop score and most labor outcomes.

 Failure in treatment plans is very common in patients with mental disorders due to the patient's non-adherence to treatment, which has serious effects on public health and imposes additional costs on the community. Thus, patient-centered methods can be used to empower patients to improve their mental health care.

 This study aimed to examine the effect of King's patient-centered nursing as a goal-attainment process in patients with mental disorders to improve interpersonal, personal, and social systems and adaptive responses in these patients.

 A quasi-experimental single-group study with a pre-test/post-test design was conducted on 34 patients with mental disorders. The patients were selected using convenience sampling from patients admitted to psychiatric centers in Tehran in 2022. First, the socio-demographic information questionnaire was completed for all patients. Then, an intervention program designed based on King's goal attainment process was implemented for the patients: (1) nursing assessment (identification of the patient's needs and problems according to the mutual understanding between the patient and the nurse and based on three personal, interpersonal, and social systems using King's standard checklist), (2) planning with the participation of the patient (setting at least 3 goals, prioritizing the goals, and formulating a care plan for each goal), (3) interventions (interactive sessions and presentation of educational content), and (4) evaluation (determining the level of patient's adaptive responses using the same checklist). Data analysis was performed using descriptive and inferential statistics, including the paired samples t-test and analysis of covariance (ANCOVA), with SPSS-26 software.

 Thirty patients with an average age of 39.23 ± 6.33 were examined in this study. The initial assessment showed that the main problem faced by the patients was related to the interpersonal system (communication and interaction), followed by the personal system (self-perception) and social system (control). The post-intervention evaluation showed that the patients scored higher in all three personal, interpersonal, and social systems, and there was a statistically significant difference in their scores for these systems (P < 0.001). Moreover, socio-demographic variables had no significant effect on the patients' adaptive responses (P > 0.05).

 In line with King's theory, the present study showed the benefits of patient-centered care protocols, such as interpersonal relationship development, improvement of self-perception, and patients' interactive performance. Ultimately, this theory can lead to improving the patient's health status and the hospital's quality indicators. Therefore, nurses can enhance the effectiveness of nursing care, especially in psychiatric departments, using patient-centered care protocols based on King's theory.

 Despite a lower teenage pregnancy rate in Iran compared to the global average, there is an anticipation of increased teenage pregnancy rates by 2025 due to changes in population policy programs.

 This study aimed to compare the challenges faced during the transition to motherhood and the quality of infant care between adolescent mothers and young mothers in Karaj, Iran.

 This descriptive-analytical study was conducted in 2020, involving 160 adolescent and young mothers selected through multistage sampling in Karaj, Iran. The data were collected using demographic characteristics, a modified questionnaire assessing the challenges of the transition to parenthood, and an infant care checklist. Descriptive statistics, including frequency, percentage, mean, and standard deviation (SD), were reported. Data analysis was carried out using the chi-square test and Mann-Whitney U test.

 The study showed no significant differences between adolescent and young mothers in terms of mean scores related to the challenges of the transition to parenthood, such as responsibility and commitment, pleasure and satisfaction, fondness and stability, and self-commitment (P ≥ 0.05). However, significant differences were observed between the 2 groups in the total score of infant care (33.07 ± 2.77 and 34.57 ± 2.65, P = 0.002), child disease care (10.63 ± 0.73 and 11.03 ± 1.20, P = 0.034), routine child care (5.38 ± 1.23 and 5.83 ± 1.28, P = 0.039), and maternal health (13.37 ± 1.60 and 14.29 ± 1.29, P < 0.0001) for adolescents and young mothers, respectively.

 Based on the study’s results, teenage mothers might benefit from support programs provided by healthcare providers, particularly midwives and doctors, to enhance their abilities to care for their children.

 Emotional intelligence and moral performance are considered 2 very important components in the quality of care and improvement of patients.

 The purpose of this study was to examine the relationship between emotional intelligence and the moral performance of nurses.

 The present study was a cross-sectional study of the correlation type. A number of 220 nurses from the departments (internal and surgery) of medical educational hospitals affiliated with Qazvin University of Medical Sciences were selected by a stratified random sampling method between December 2022 and March 2022. The Standard Questionnaire of Siberia Schering's Emotional Intelligence (Goleman model) and the Nurses' Performance Questionnaire according to the nursing code of ethics were used to collect data. The collected data were analyzed using SPSS version 26 and descriptive and inferential statistical tests (t-test, Pearson's correlation coefficient, simple and multivariate linear regression).

 The average scores of emotional intelligence and moral performance were 90.12 ± 11.93 and 124.55 ± 24.62, respectively. Pearson’s correlation test showed a significant relationship between emotional intelligence and moral performance (r = 0.232, P = 0.001). In the examination of emotional intelligence among nurses, 100 nurses (45.5%) obtained scores lower than the overall average of 4.92, while 120 nurses (54.5%) achieved scores higher than the average. In the examination of the frequency of ethical performance scores, the majority of nurses, 158 individuals (71.8%), demonstrated high ethical performance, while 60 individuals (27.3%) exhibited average ethical performance, and only 2 individuals (0.9%) had low ethical performance. The test results also indicated a statistically significant difference between emotional intelligence and job position (P < 0.001) and work experience (P = 0.12), as well as ethical performance of nurses and job position (P = 0.035), work experience (P = 0.001), and gender (P = 0.009).

 Emotional intelligence and moral performance are 2 important interrelated factors that influence each other. Therefore, these results have important consequences for the policymakers of health care systems, including improving the level and quality of nursing care.

 Nursing students must cultivate moral courage to be able to provide ethical care in morally challenging situations. Moral courage is influenced by various factors, including spirituality and religion. Spirituality is a crucial component of ethics, and an individual’s religious orientation shapes his/her beliefs and actions.

 This study aimed to examine the role of religious orientation in shaping moral courage among nursing students.

 This cross-sectional study focused on nursing students at the Mazandaran University of Medical Sciences during the 2021 - 2022 academic year. A total of 153 students were selected using simple random sampling. Data were collected using Allport’s Religious Orientation and Sekerka’s Moral Courage Scale and analyzed using descriptive and inferential statistics in SPSS 18.

 The mean moral courage score was 58.74 ± 10.56, indicating an average level of moral courage among nursing students. The mean religious orientation score was 52.84 ± 6.06, indicating a high level of religious orientation. A significant positive correlation was found between moral courage and religious orientation (r = 0.62, P < 0.05). Specifically, external religious orientation showed a positive and significant correlation with moral courage (r = 0.76, P < 0.05).

 The findings of this study demonstrated a positive correlation between religious orientation and moral courage among nursing students. It can be concluded that religious orientation does influence moral courage in nursing students, with the external dimension of religion playing a predominant role. Therefore, nursing educators should consider both the internal and external aspects of religious orientation when designing interventions to enhance moral courage among nursing students.

 The numerous pre-hospital emergency medicine operational staff interactions with different people cause many conflicts. In addition to affecting their physical and mental health, these conflicts lead to severe problems for the health of society and patients.

 This study aimed to determine the relationship between resilience and conflict management styles from the perspective of pre-hospital emergency medicine operational staff of the Medical Emergency and Accident Management Center in Golestan Province in 2022.

 This descriptive correlational study recruited 200 operational staff working in the pre-hospital emergency center in Golestan Province. They were selected using a stratified sampling method with proportional allocation. The data were collected using a demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), and the Rahim Organizational Conflict Inventory-II (ROCI-II).

 Pearson correlation results demonstrated a direct and significant relationship between resilience and conflict management styles (P = 0.011, r = 0.180); the resilience score increased with an increase in the score of conflict management styles. In addition, resilience was directly associated with compromising (P = 0.012, r = 0.178) and integrating styles (P = 0.001, r = 0.276). Finally, a direct and significant relationship existed between job interest and resilience (P = 0.01). The linear regression analysis showed a significant relationship between the resilience score and the score of conflict management styles (β = 0.17).

 Resilience can improve the conflict management styles of pre-hospital emergency medicine operational staff. Moreover, job interest can enhance resilience, indirectly affecting conflict management. Pre-hospital emergency managers and officials should hold resilience training courses for pre-hospital emergency operatives.

 Ethical leadership plays a key role in professional settings. Nurses play an essential role in care provision and health promotion. The present study aimed to determine the impact of ethical leadership on the nursing profession in Iran. The objective of this study was the assessment of the relationship between ethical leadership and the improvement of clinical services by nurses.

 Terms defined as MESH keywords were searched in PubMed, Scopus, ProQuest, SID, and Magiran up to October 2022. In this study, only observational and qualitative studies were selected and included.

 A total of 16 studies met the inclusion criteria. The results showed the association of ethical leadership with moral courage, self-efficacy, turnover, general health, errors, organizational citizenship, moral distress, job satisfaction, stress, risk management, and psychological empowerment. It was shown that ethical leadership is in direct association with nursing performance.

 The present study confirmed the positive effect of nursing ethical leadership on the nursing profession. Further studies are needed to examine the association between ethical leadership and clinical outcomes in patients.

 Evidence, especially in the last two decades, indicates the effect of social factors on health. Social determinants of health (SDH) are the environmental conditions in which people are born, live, grow, educate, work, and age.

 Hence, this study intended to identify the SDH of the reproductive age women's sexual health dimensions.

 To conduct this scoping review, the researchers searched the databases, including PubMed, Medline, ProQuest, Cochrane Library, Web of Sciences, Scientific Information Database (SID), and Magiran, disregarding language limit. They searched the original observational articles (cohort, cross-sectional, case-control) on social determinants of reproductive age women's sexual health, assessing at least one social determinant of health for sexual health between January 2010 and January 2023.

 A total of 4704 articles were extracted in the initial review; however, 30 entered the scoping review. The results revealed that the social determinants of reproductive age women's sexual health in different societies are socioeconomic status (socio-economic constraints, economic gradient, poverty, lack of food at home, homelessness, low prospects, and poor educational and job outlook), personal determinants (age, gender, religious affiliation, marital status, education level, employment/unemployment status, economic status, age at the first sex, age over 40, dissatisfaction with the sexual potency of the spouse, high body mass index, partners' sexual education, sexual intimacy, relationship duration, frequent contact with a given partner, perceived social support, and perceived safe sex norms), social support (social networks of peers, friends, and family, emotional support and strong attachments to families), neighborhood, violence, addiction, migration, stress, early life experiences, and education that can affect different sexual health dimensions. The sexual health dimensions encompass sexual function, sexual satisfaction, risky sexual behaviors, receiving sexual health services, condom use, and forced sexual behavior.

 Considering each person's conditions and needs, health policymakers and health services providers should evaluate the various dimensions of the SDH to promote women's sexual health. Moreover, they should plan and implement the required strategies to eliminate the identified obstacles.