azadeh arasteh

 Anxiety is an unpleasant condition that occurs in the majority of people before surgery, and it can cause bleeding and complications after surgery and it can also affect the induction of anesthesia and recovery from it. Nowadays, due to the side effects of medications, non-pharmacological and non-invasive treatments are receiving a lot of attention.The purpose of this research is to determine the effectiveness of acupressure and recommended recitals on the patients’ anxiety before surgery in the hospitals of Ferdows city in 2019-2020.

 This study was a double-blind clinical trial research that was conducted on 150 patients who were candidates for surgery. The samples were selected using convenience sampling. The participants were randomly assigned to one of the three acupressure groups (n=50), recommended recitals (n=50) and the control group (n=50). In order to apply acupressure, the third eye point (Yintang) was pressed for 10 minutes, and in the recommended recitals group, the patients listened to Surah Hamad and Zekr several times using an audio source and headphones. In the control group, pressure was applied to the false point for 10 minutes. The level of anxiety was measured using the VAS questionnaire in all three groups before, after and 30 minutes after the intervention respectively. Data were entered into SPSS software version 19 using descriptive and inferential statistical methods. 

 In recommended recitals group, the average anxiety score before, after and 30 minutes after the intervention had a significant difference with each other (P<0.001). Also, the average anxiety score after the intervention was significantly lower than immediately and 30 minutes after the intervention in this group (P<0.001). Meanwhile, the average score of anxiety in the acupressure group (p=0.06) and the control group (p=0.10) did not show any significant difference with each other at three times.

 Recommended recitals can reduce anxiety before surgery and can be used as a non-drug, safe and cheap method to reduce anxiety before surgery.

Fertility is among the major components of the population, the reduction of which can cause irreparable socioeconomic damage to the country. Unfortunately, the fertility rate is declining, and it is lower than the critical level in Iran. Therefore, this study aimed to investigate the factors influencing fertility desire in order to reveal more aspects of this issue.  This descriptive-analytical study included all the rural and urban families referring to healthcare centers in Ferdows, Iran, in 2020. The participants were selected using a multi-stage sampling method. Finally, 400 married men and women referring to the centers were assessed by the fertility desire scale (FDS). The data were analyzed using descriptive statistics as well as the Mann- Whitney and Spearman tests by SPSS 19.0.  In this study, 81.2% of the participants were female, 52.5% of who aged 25-35 years old. The mean scores of fertility desire among urban and rural households were 66.69 ± 9.61 and 65.06 ± 9.08, respectively (P = 0.03). In all dimensions of the questionnaire except for childbearing worries, significant differences were observed between urban and rural households. These dimensions included positive childbearing motivations (P = 0.05), social beliefs (P = 0.04), and preferences (P = 0.004).  The results obtained from this study can be used in population policies in order to build culture, support parents, and increase childbearing desire, especially in rural areas.

The process of motherhood affects the marital relationship and the mother's attachment to the fetus. Therefore, the present study was designed and conducted to determine the quality of marital relationship and its relationship with maternal-fetal attachment in wanted and unwanted pregnancies.

This descriptive-analytical comparative study was performed on 150 mothers with wanted and unwanted pregnancies referred to health centers in Zanjan in 2017. Data collection tools included demographic information checklist, Glasser Marital Relationship Quality Questionnaire, and Cranley Fetal Attachment Questionnaire (CMFAS). Data were analyzed by appropriate statistical tests (ANOVA, Kruskal–Wallis, Chi-Square, Spearman, Pearson) using SPSS 16 software.

The total score of marital destructive behaviors in wanted pregnancies was lower than unintended and unwanted pregnancies (p˂0.001), results show that the quality of marital relations was favorable. The total score of maternal -fetal attachment in wanted pregnancies was higher than unintended and unwanted pregnancies and this difference between the groups was statistically significant (p˂0.001). There was also an inverse relationship between destructive behaviors of marriage and maternal attachment to the fetus in all three groups of wanted pregnancy (r=-0.98, p = 0.49), unintended pregnancy (r = -0.341, p ˂0.001), and unwanted pregnancy (r=-0.456, p = 0.015).

Reducing the destructive behaviors of marriage can lead to an increase in the mother's attachment to the fetus in unwanted pregnancies and consequently improve the mother and child's mental health.

Nurses have an important role in the process of providing information and helping  patients prepare for and receive bad news and understand and cope with the bad news they have  been given. This study was conducted to evaluate the effect of communication skills training on  the level of skill and participation of nurses in breaking bad news.

This  semiexperimental study was performed on 60 nurses working in educational hospitals of Birjand,  Iran in 2019. Convenience sampling was performed and the participants were randomly assigned  to the two groups of intervention and control. For the experimental group, an integrated workshop  on communication skills was held. Before and after the intervention, the Setting, Patient  Perception, Invitation, Knowledge, Empathy, and Strategy (SPIKES) SPIKES questionnaire  (breaking bad news skills) and the questionnaire of participation in breaking bad news were  completed. The collected data were analyzed using descriptive and inferential statistics (independent  t‑test) in SPSS software.

The mean (SD) of breaking bad news skills after the intervention  was 57.42 (10.13) in the control group and 65.12 (5.68) in the experimental group and the  between‑group difference was statistically significant (t</em>  59,41 = 3.93, p </em>< 0.001). After the intervention,  the mean (SD) of nurses’ participation in delivering bad news was 21.17 (5.21) in the control group  and 25.77 (4.96) in the experimental group and the between‑group difference was statistically  significant (t</em>  75,48 = 3.94, p </em>< 0.001).

It seems that to increase the ability of nurses in the  process of breaking bad news, it is necessary to teach them communication skills. 

Women with unplanned pregnancy experienced a number of psychological problems. Thus, the present study aimed to examine the effectiveness of midwifery counseling based on cognitive approach in improvement of adaptation to pregnancy, mother-fetal attachment and quality of life among unplanned pregnant women.

This pre-test posttest control group single blind study was done on pregnant women who were chosen from the healthcare centers of Zanjan city, Iran.Of 187 women screened for eligibility to participate in the study, 54 unplanned pregnant women met inclusion criteria and were randomly assigned into intervention group or control group. The intervention group received eight weekly group cognitive therapy sessions. The control group received prenatal routine care. The participants answered WHO Quality of Life Questionnaire, Maternal–Fetal Attachment Scale, and Lederman Prenatal Self-evaluation Questionnaire at pretest, posttest, and one-month follow- up periods. 

The two groups were not different in terms of age (p = 0.89), educational status (p = 0.56), and job status (p = 0.31). In addition, they were not different regarding pre-test scores of Lederman Prenatal Self-evaluation Questionnaire (p = 0.27), Maternal–Fetal Attachment Scale (p = 0.22), and WHO Quality of Life Questionnaire (p = 0.37). At posttest and one-month follow- up, the intervention group showed significant improvement in adaptation to pregnancy (p < 0.0001), Maternal-fetal attachment (p < 0.0001), and quality of life (p < 0.0001) than the control group.

Midwifery counseling based on cognitive approach could be an effective approach to improve adaption to pregnancy, maternal-fetal attachment, and quality of life among women who became pregnant unintentionally.

Physical and psychological problems and stressors sometimes impair the human adaptation and lead to maladaptive behaviors that may interfere with pregnancy acceptance and fetal communication. On the other hand, a parent's attachment style plays a role in the creation of child insecure attachment style and an irreplaceable context for emotional and social development. It continues until the adulthood and affects the individual ability in various contexts as a defective cycle.

Therefore, the present study was designed and conducted to determine the rate of pregnancy adaptation and its association with maternal attachment styles in both wanted and unwanted pregnancies.

The study was a descriptive and comparative research on 178 pregnant women who visited health centers of Zanjan, Iran in 2017. The data collection tool included the demographic data checklist, Adult Attachment Scale (AAS) by Hazen & Shaver, and the prenatal self-evaluation questionnaire (PESQ) by Lederman for measuring the pregnancy adaptation, and it was completed by the self-report. Data were analyzed using chi-square, Mann-Whitney, independent t, Spearman, and linear regression tests via SPSS 16.

The median (interquartile range (IQR)) of the total score of pregnancy adaptation in the wanted pregnancy group 118 (13.5) was lower than the unwanted pregnancy group 244 (33.5), indicating better adaptation in the wanted pregnancy group. Secure attachment style was significantly higher in the wanted pregnancy groups than the unwanted pregnancy group (p˂0.001). In the unwanted pregnancy group, there was an inverse relationship between secure attachment style and pregnancy self-assessment score (r=-0.335 and p=0.001) (A more secure attachment style and lower self-evaluation score indicate higher pregnancy adaptation); and a positive relationship between avoidant attachment style and prenatal self-evaluation score (r=0.248 and p=0.019).

Since the increase in secure attachment style was associated with a decrease in prenatal self-evaluation score, or in other words, was associated with an increase in adaptation with pregnancy, education and counseling for improving secure attachment styles is suggested to reduce adverse consequences of unwanted pregnancy and improve the children's psychological health.