Journal of Midwifery & Reproductive health
Volume:3 Issue: 1, Jan 2015

Self-confidence, as one of the key elements of clinical competence, plays an important role in one’s actions and behaviours. Selection of proper instructional methods influences students’ self-confidence. Therefore, this study aimed to compare the effects of web-based training and educational simulation on midwifery students’ self-confidence in postpartum hemorrhage management. This experimental study was conducted on 44 midwifery students of Mashhad School of Nursing and Midwifery, Mashhad, Iran, in 2013. The subjects were selected via convenience sampling. The web-based group was trained at the clinical skill laboratory of School of Nursing and Midwifery; both groups were taught the same educational content. Data were collected using a demographic questionnaire, visual analogue scale to evaluate students'' self-assessment of their ability to manage postpartum hemorrhage and C-scale to measure students'' self-confidence Descriptive analysis, independent t-test, paired t-test, and two-way ANOVA were performed, using SPSS version 11.5. Both groups showed a significant increase in self-confidence in postpartum hemorrhage management one month after the training (P=0.003 and P=0.030 in web-based and simulation groups, respectively). No significant difference was found between the two groups in terms of self-confidence in postpartum hemorrhage management. Since the two groups showed no significance difference in self-confidence, web-based education, which is a more accessible method, could be applied as an alternative to the conventional method of simulation.

Considering the fact that cesarean section (c-section) poses greater risks of maternal and neonatal complications, compared to vaginal delivery, scholars seek different strategies to decrease the prevalence of this surgical procedure. Birth ball exercises during pregnancy are among the proposed strategies. Thus, this study aimed to determine the effect of using birth ball during pregnancy on mode of delivery in primiparous women. This clinical trial was conducted on 54 women, referring to the maternity ward of Omolbanin Hospital. Subjects were randomly assigned to intervention and control groups. The intervention group performed birth ball exercises for 4-6 weeks; on the other hand, the control group only received routine care. Data were collected using questionnaires, forms of examination and observation, and checklists for recording exercise movements on a weekly basis. Chi-square, Fisher’s exact test, and Mann-Whitney U test were performed, using SPSS version 16. Rates of vaginal delivery and c-section in the intervention group were 92.6% and 7.4%, respectively, while the corresponding values in the control group were 66.7% and 33.3%, respectively. Chi-square showed a significant difference between the two groups in terms of mode of delivery (P=0.018). Considering the significance of promoting vaginal delivery among women, performing birth ball exercises is recommended as a useful, non-pharmacological, and inexpensive strategy for reducing c-section rate.

Gender roles are affected by biosocial and cultural factors. These roles have significant impacts on one’s professional, social, and family life. Therefore, given the recent changes in gender roles in Iran, we aimed to determine the relationship between demographic factors and gender role attitudes among women. This cross-sectional study was conducted on 712 females, selected via stratified sampling. Data were collected using a demographic checklist and a gender role questionnaire including 2 sections: gender role stereotypes and gender egalitarianism. The validity of this questionnaire was confirmed by content validity and its reliability was verified by internal consistency (α=0.77). For data analysis, ANOVA and correlation coefficient tests were performed, using SPSS version16. The mean scores of gender role stereotypes and egalitarianism were 29.55±4.33 and 112.55±14.64, respectively. Stereotypic and egalitarian attitudes were significantly correlated with age, family size, duration of marriage, women’s age at first childbirth, educational level, intentions to pursue education in future, and occupational status. As to the finding, gender role attitudes were influenced by social, economic, and demographic factors in Iran. By paying attention to these factors, we can implement proper interventions in order to promote personal and social health among women.

The aim of this study was to evaluate and compare the relationship between body image and quality of life in female patients with breast cancer and healthy women. In the current descriptive, causal, comparative, cross-sectional study, 50 women with breast cancer, referring to the radiotherapy and oncology clinic of Imam Reza Hospital (Mashhad, Iran) and 50 healthy women, referring to the same clinic, were selected via available sampling. Informed consent forms were obtained from the subjects. A demographic questionnaire, Multidimensional Body-Self Relations Questionnaire (consisting of 46 items), and short-form health survey (SF-36) were used as the study tools. For data analysis, Pearson’s correlation test and t-test were performed to determine the differences between the two groups. Data were analyzed, using SPSS version 16. The results showed a statistically significant difference between female patients with cancer and healthy women in terms of quality of life (t=-4.1, P<0.001). Moreover, a significant direct relation was found between body image (and its components) and quality of life (and its components). The current findings suggest a significant difference between healthy and cancer-stricken women in terms of quality of life and body image. Also, higher scores of body image in cancer patients were associated with higher quality of life.

High-risk pregnancies increase the risk of Intensive Care Unit (ICU) and Neonatal Intensive Care Unit (NICU) admission in mothers and their newborns. In this study, we aimed to identify the association between the recurrence of high-risk pregnancy and mothers’ previous experience of having an infant admitted to NICU. We performed a cohort, retrospective study to compare subsequent pregnancy outcomes among 232 control subjects and 200 female cases with a previous experience of having a newborn requiring NICU admission due to intrauterine growth retardation, preeclampsia, preterm birth, premature rupture of membranes, and asphyxia. The information about the prevalence of subsequent high-risk pregnancies was gathered via phone calls. As the results indicated, heparin, progesterone, and aspirin were more frequently administered in the case group during subsequent pregnancies, compared to the control group (P<0.001). Also, pregnancy-induced hypertension, preeclampsia, preterm labor, and gestational diabetes mellitus were more frequent in the case group, compared to the control group (P<0.05). There was a positive correlation between recurrent high-risk pregnancy and previous experience of having a newborn requiring NICU admission. As the results indicated, mothers in the case group were at a higher risk for preeclampsia, preterm labor, and gestational diabetes mellitus, compared to the control group. Therefore, earlier diagnosis, prompt treatment, and prevention should be taken into account by physicians.

The most important risk factor for one’s sexual health is high-risk sexual behavior. Implementation of educational programs has been considered as one of the most crucial interventions in the prevention and treatment of these behaviors. Therefore, this study aimed to determine the effect of an educational program on the knowledge and attitude of female sex workers toward preventing high-risk sexual behaviors. This pretest-posttest, one-group study was conducted on 40 female sex workers, imprisoned in Mashhad Vakil Abad prison in 2013. Data were collected using a questionnaire including demographic characteristics, as well as knowledge- and attitude-related data. An educational program was designed after the pretest and conducted in four 70-minute sessions. Immediately and four weeks after the educational program, post-test was performed. Data were analyzed by Friedman and Wilcoxon tests, using SPSS version 16. A positive significant increase was found in the mean scores of knowledge and attitude of female sex workers immediately and four weeks after the program (P<0.001). Considering the increased knowledge and improved attitude of female sex workers in this study, it is necessary to design and implement educational programs in prisons.

Episiotomy is a common medical procedure for widening the perineum. In fact, perineal pain is the most common complaint after episiotomy. Therefore, it is important to determine factors associated with postoperative pain following episiotomy in order to provide comfort for women after delivery. This study aimed to investigate factors associated with postoperative pain following episiotomy in primiparous women. This analytical, descriptive study was conducted on 119 eligible mothers, selected via convenience sampling, referring to Mashhad Omolbanin Hospital. Childbirth-related information was collected using a questionnaire. Neonates and mothers were also evaluated using Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scale and McGill Pain Questionnaire for perineal pain on days 1, 7, 10, and 14after delivery. Kolmogorov-Smirnov, one-way ANOVA, Spearman’s test, and Pearson’s correlation were performed, using SPSS version 16. P-value ≤ 0.05 was considered statistically significant. A significant direct relationship was found between the severity of episiotomy pain on day 7 and length of wound cut (P=0.034), neonatal weight (P=0.040), and number of sutures (P=0.028). There was also a significant relationship between the severity of episiotomy pain on day 10 and the duration of active phase during the second stage of labor (P=0.047), duration of sitting position (P=0.011), and number of sutures (P=0.020). However, a reverse significant correlation was found between the severity of postoperative pain following episiotomy and wound recovery on days 7 (P=0.015) and 10 (P=0.035). Perineal pain was related to factors such as long perineal cut, slow wound recovery, prolonged active phase in the second stage of labor, neonatal overweight, and mother’s prolonged sitting position. Therefore, it is recommended to train health care providers and mothers about these factors.

While ovarian masses are common findings in gynecology, unusually huge masses are quite rare. However, such cases can still be found today. Mismanagement of common complaints in patients can be a leading cause of facing such findings. Herein, we introduce a case of a giant ovarian cyst, which was mismanaged in a young virgin female patient. The patient had received gastrointestinal medications for months before being admitted to our clinic, given the bloating sensation and lack of any gynecologic problems. Ultrasonography disclosed a giant cyst, probably related to the ovary, originating from the pelvis and extending toward the diaphragm. After a successful surgery, the ovarian cyst, measuring 40 centimeters and weighing 8 kilograms, was removed. Pathology report revealed serous cystadenoma. Existence of such cases can be an alarming sign for physicians to manage prevalent complaints more seriously, particularly those non-responsive to treatment.