mojtaba qanbari qalehsari

Fetal and neonatal health is of particular importance in pregnant women. Secondhand smoke (SHS) can jeopardize the health of the mother, fetus, and neonate. The present study was conducted to determine the relationship between exposure to secondhand smoke during pregnancy and neonatal-related outcomes. This retrospective cohort study was conducted in 2022 on 270 mother-newborn pairs through convenience sampling in two equal groups (n=135), including exposure and non-exposure to SHS at  Rohani Hospital, Babol, Children's Hospital, Amirkola, and Imam Ali Hospital, Amol. In order to collect the data, a checklist including the demographic characteristics, medical variables, questions related to the exposure of mothers to cigarette smoke, the neonatal outcomes questionnaire, and the SNAPPE-II scale were used. Data analysis was performed using STATA statistical software (version 17), and the significance level of all tests was considered less than 0.05. The mean age of mothers was 28.30±5.83 years, and 61% of births were by cesarean section. The SNAPPE-II score was 8.23​±5.29 in the non-exposure group and 20.68±13.53 in the exposure group (P=0.005). The prevalence of neonates with a birth weight of less than 2500gr was higher in mothers exposed to SHS (P=0.033).  Considering confounding variables, the neonates in the non-exposure group were, on average, 1.46 cm taller than those in the exposure group (P=0.005). Exposure to smoking increases the risk of premature birth by 1.65 times (P=0.032).   Exposure of pregnant mothers to SHS is associated with adverse neonatal outcomes. Therefore, it is recommended to train families to avoid exposure to cigarette smoke, especially during pregnancy, and also for health centers to pay special attention to this matter in the care of pregnant mothers.

Covid-19 is a disease with different characteristics, ranging from symptomless carriers to death due to complications, which can induce a significant amount of stress. Resilience is very important for coping with stress and maintaining balance. The aim of this study was to investigate the relationship between resilience and clinical symptoms in patients with Covid-19.

This cross-sectional descriptive analytical study was conducted in 2022, with the participation of 100 patients hospitalized at Shahid Beheshti, Yahya Nejad, and Rouhani hospitals in Babol city, as well as Kausar hospital in Semnan city, who had received positive PCR test results and a definite diagnosis of Covid-19. They were selected using a convenience sampling method. Data collection tools included demographic information, a symptom checklist, clinical information, the Mini Mental Status Questionnaire (MMSE), and the Connor-Davidson Resilience Scale (CD-RISC)-10.

The mean age of the patients was 53±15.3 years, and 91% of them were married. Seventy-eight percent of the patients had a headache, 83% had a cough, and 88% had dyspnea. There was no significant difference in resilience scores between patients with symptoms and those without symptoms (P>0.05). The multiple regression model revealed no significant relationship between disease symptom severity and resilience levels, even when considering the confounding variables (P>0.05).

The absence of a relationship between Covid-19 symptoms and resilience may be attributed to the complex nature of the disease and the multidimensional aspect of resilience. We suggest conducting more comprehensive research on various facets of resilience and its mechanisms of impact on diseases in diverse contexts, with larger sample sizes.

Nurses who are involved in the caring of COVID-19 patients, are at risk of mental distress. The present study was conducted with the purpose of demonstrating the relationship between stress, anxiety, depression and characteristics of nurses who provide care to COVID-19 patients.

This descriptive cross-sectional study was conducted using the census method from May to June, 2020 on 224 clinical nurses who were working in hospitals affiliated with Babol University of Medical Sciences and were involved in caring for COVID-19 patients. The data collection instruments included the Depression, Anxiety and Stress Scale - 21 items (DASS-21) and the individual characteristic questionnaire. Bivariate and multivariate binary logistic regressions were computed to identify the associated factors.

The mean and the standard deviation for stress, anxiety and depression scores were 9.47±7.30, 9.29±7.51 and 8.84±7.22 respectively. 17.4% had stress, 54% had anxiety and 43% had a degree of depression. There were significant relationships between the nurses’ stress level and characteristics including age (OR =3.009, 95%CI 1.46–6.16, P=0.003), having children (OR=0.26, 95%CI 0.11-0.63, P=0.003), work experience (OR=4.50, 95% CI 2.17-9.96, P=0.000) and employment status (OR=0.39, 95% CI 0.16-0.95, P=0.04). Moreover, along with these characteristics, job satisfaction (OR =3.03, 95%CI 5.64– 1.63, P=0.000), level of physical activities (OR =0.26, 95%CI 0.08–0.82, P=0.02), exercising (OR =2.27, 95%CI 1.31-3.90, P=0.003) and violence in the workplace (OR =0.27, 95%CI 0.12– 0.56, P=0.001) also had significant relationships with the nurses’ anxiety level. Furthermore, the relationships between the nurses’ level of depression and characteristics including age (OR =2.07, 95%CI 1.15 – 3.72, P=0.014), work experience (OR =21.79, 95%CI 1.04 – 3.10, P=0.03), job satisfaction (OR=3.03, 95%CI 1.63–5.64, P=0.000), exercising (OR =1.76, 95%CI 1.02–3.04, P=0.04), having chronic diseases (OR =0.35, 95%CI 0.15–0.81, P=0.014), violence in the workplace (OR =0.39, 95%CI 0.20–0.75, P=0.005) and sleep (OR =1.77, 95%CI 1.00–3.16, P=0.050) were significant.

The authorities should consider a number of the individual characteristics of nurses including age, work experience, gender, marital status, having children, job satisfaction, sleep, violence in the workplace and history of chronic disease in their planning and provide psychological support for them. Psychological support services may be needed for nurses in order to protect and promote their mental

The birth of a pre‑mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short‑term health outcomes of pre‑mature infants admitted to neonatal intensive care units (NICUs).

In this quasi experimental study, 80 mothers of pre‑mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother–infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant’s Maternal Attachment Assessment Strategy. Moreover, infants’ short‑term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis.

On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4–42/11) and 37 (31/85– 42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05).

Instructing mothers in attachment behaviors clinically improved short‑term health‑related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre‑mature infants.

Professional identity includes the values and beliefs of a nurse that guide her thinking, action, and interaction with patients. The stressful conditions of the COVID‑19 pandemic may have affected nursing students’ resilience and attitudes toward their profession. Therefore, the aim of this study was to investigate the professional identity and resilience in nursing students during the COVID‑19 pandemic.

This cross‑sectional descriptive study was performed in November and December 2020 with the participation of all nursing students of Babol University of Medical Sciences who spent at least one semester of internship in a hospital during the COVID‑19 pandemic. Data were collected using demographic questionnaire, Connor‑Davidson resilience scale, and nursing students’ professional identity scale. Data analysis was performed using independent t‑test, ANOVA, and correlation tests at a significance level of 0.05.

Nursing students in the 3rd, 5th, and 7th semesters have spent a minimum of 13 and a maximum of 151 days of internship during the pandemic period. The mean score of professional identity of nursing students was 61.86 ± 9.34 and their mean resilience score was 32.08 ± 13.54. The resilience score of 92% of students was below 50. Professional identity was significantly stronger, and resilience was considerably higher in students who were satisfied with their profession and lived with their families (P < 0.05). In other words, students with higher professional identity scores had higher resilience (r = 0.39, P = 0.000).

Despite a good professional identity score, the resilience of nursing students during the COVID‑19 pandemic is low. Therefore, professors and the clinical education system should provide more support for students in such stressful times as the COVID‑19 pandemic period.

The COVID-19 pandemic put a lot of strain on staff and the health care system. The aim of this study was to determine the stressors in nurses involved in caring for COVID-19 patients in the hospitals of Babol University of Medical Sciences.

This cross-sectional study was conducted on nurses working in the care of COVID-19 patients (Rohani and Yahainejad hospitals) in Babol University of Medical Sciences in 2020. The number of samples was estimated using Cochran's statistical formula was 224 people. Then, the proportion of nurses involved in corona in each hospital, stratified sampling of corona departments was done. Data collection tools were a researcher-made questionnaire. The Stressors Questionnaire in Nurses was in five areas (interpersonal, patient care, physical and environmental, individual and managerial) and the questionnaire was about the demographic characteristics. The collected data were analyzed using SPSS software version 23 and parametric statistical tests of one-way analysis of variance and independent t-test were also performed in the absence of non-parametric Kruskal-Wallis and Mann-Whitney tests.

Physical and environmental stressors with an average of 29±10.12 and the patient care stressors with 13.38±5.02 had the highest and lowest intensities of stress, respectively. The most important stressors in nurses are insufficient support (68.2%), high workload (63.9%), tight work schedule (63.5%), heaviness and discomfort of the nurse with protective clothing and boots (63.3%), lack of nurses (61.5%), lack of suitable space to change protective clothing (60.2%), etc. Nurses' occupational stressors were significantly associated with gender, work experience and type of hospital, physical and environmental stressors with shift work, interpersonal stressors with education and patient care stressors with overtime (P<0/05).

Since physical and environmental factors were recognized as the most source of stressors, with appropriate measures, it is possible to eliminate or correct these factors, to help reduce stress and improve the health of nurses.

Inflammatory bowel disease (IBD) is a broad term that refers to a group of chronic inflammatory disorders that have an unknown origin and might be associated with other diseases. The aim of this study was to determine the frequency of chronic diseases in patients with IBD.

In this case-control study, 280 patients with IBD were compared with 280 healthy individuals, frequency-matched by age, sex, place of residence and marital status. Random sampling was performed in patients that referred to the internal medicine and gastroenterology wards of hospitals affiliated to Babol University of Medical Sciences. Data collection tools included a demographic questionnaire and a checklist for chronic diseases, which were completed through interviews with the case and control groups.

Two hundred and twenty-nine (81.78%) patients with IBD had at least one chronic disease. Patients with IBD were at increased risks of rheumatoid arthritis (OR= 4.48, 95%CI: 1.48, 13.54, P= 0.008), eye diseases (OR= 3.49, 95%CI: 1.68, 7.28, P= 0.001), liver diseases (OR= 2.74, 95%CI: 1.40, 5.34, P= 0.003 ), anemia (OR = 2.53, 95%CI: 1.56, 4.13, P= 0.000), depression (OR= 2.43, 95%CI: 1.58, 3.74, P= 0.000), skin diseases (OR= 2.36, 95%CI: 1.18, 4.74, P= 0.015) and hypertension (OR= 1.77, 95%CI: 1.06, 2.95, P= 0.028).

  The frequency of chronic diseases associated with IBD has been high, therefore, physicians and health care professionals should consider the possibility of other chronic diseases when dealing with IBD patients.

 High adherence to antibiotic therapy is essential for complete cure, reduction of treatment costs, and prevention of drug resistance.

 The aim of this study was to evaluate adherence to antibiotic treatment and its associated factors in patients after hospital discharge.

 This was a cross-sectional study. This study was conducted on 313 patients discharged from the hospital on antibiotics from October 6 to December 21, 2020. Demographic information of the participants was obtained at the time of discharge from the hospital, and the Morisky medication adherence scale was completed one week after discharge. Data were analyzed using descriptive statistics and the chi-square test at a significance level of < 0.05.

 The mean age of patients was 44.17 ± 19.51 years, and 95% of them were discharged with only one oral antibiotic. The mean score of drug adherence in this research was 6.45 ± 1.41. Those under 40 years of age had poorer adherence to antibiotic treatment than patients aged over 40 years (P = 0.04). The patients who should have consumed antibiotics thrice a day forgot taking their medications more than others (P = 0.02). The patients who received antibiotics twice a day were less likely to discontinue their medication without informing their physicians (P = 0.03).

 Adherence to antibiotic treatment after hospital discharge is poor among patients. All patients, especially those under 40 years of age and those who should receive medications more often, must be given serious considerations for treatment adherence.

Patient’s support is one of the most controversial issues of nursing profession in recent decades. Observing the standards of professional ethics in nursing practice leads to improvement of nursing services, which needs to be considered seriously in order to improve patientschr('39') well-being. Nurses face a number of challenges to support patient. The purpose of this study was to determine the factors affecting nurseschr('39') support of the patient and professional ethics.

In this review study, the key words of professional ethics, patient’s support, nursing staff, hospital and hospitalized patients were searched in SID, Magiran, Iran Medex, Google Scholar and PubMed. The studies were reviewed in two stages based on inclusion and exclusion criteria so that the title and abstract were firstly reviewed, and the whole article was secondly reviewed. Finally, 28 articles were selected in the study.

The environmental-organizational, individual-care and managerial factors were identified as effective ones on patient’s support and professional ethics. Responsibility of nurses, lack of time and work pressure of nurses, shortage of personnel, lack of nurseschr('39') support, nurseschr('39') inadequate knowledge of support role, medicocracy, limited communication, support risks and lack of motivation were the most important factors influencing nurse’s support of the patient and professional ethics.

Several factors affect the nursechr('39')s support of the patient and professional ethics. These factors include environmental-organizational, individual-care and managerial factors. Therefore, in order to facilitate patient’s support and observe the professional ethics of managers, the health planners and nurses should pay more attention to these areas.

 The coronavirus disease 2019 (COVID-19) has been associated with a wide range of clinical symptoms.

 The present study aims to investigate the neurological manifestations among patients hospitalized with COVID-19 in Rouhani Hospital in Babol.

 This is a descriptive cross-sectional survey conducted in March and April 2020 on patients admitted to Rouhani Hospital in Babol with COVID-19. A number of 230 medical records were selected randomly from a list. The data were collected using the demographic characteristics questionnaire and a checklist for the neurological symptoms.

 Among the 230 patients with COVID-19 (mean [SD] age, 59.85 [16.22] years; 138 men [60%]), 127 (56%) patients had at least one neurologic symptom. The most common symptoms of the central nervous system disorder were headache (34%), dizziness (25%), and impaired consciousness (20%), and the most prevalent symptoms of the peripheral nervous system disorder were taste impairment (17%) and smell impairment (16%). The occurrence of transient ischemic attack (TIA) in women was significantly higher than in men (P = 0.02). Moreover, the incidence of dizziness, impaired consciousness, ataxia, cerebrovascular accident (CVA), anorexia, and smell impairment had a significant relationship with age (P < 0.05).

 The neurological manifestations are prevalent and substantial among patients with COVID-19. Therefore, it is suggested that the healthcare workers take these symptoms seriously, especially in the outbreak of COVID-19, and take the pertinent preventive and protective measures.

Clinical education requires creating a supportive atmosphere for learners and nursing students, who need support to be prepared for their future profession. The purpose of this study is to investigate the challenges of supporting the nursing students in clinical education. This article reviewed studies conducted between 2009 and 2019 with the keywords including support, challenge, students, education, and nursing using SID, Magiran, IranMedex, Google Scholar, Elsevier, and PubMed as databases. Among the 926 articles obtained during the two review stages, which were based on the inclusion and exclusion criteria and the first one analyzed the title and the abstract and the second one analyzed the whole article, ultimately 32 articles were selected for the study. The types of articles used in this study are as follows: qualitative (16 articles), descriptive analytical and cross‑sectional (12 articles), review (3 articles), and mixed‑methods (1 article). The focus of all studies was on the students’ clinical education environment. The participants of the studies were undergraduate nursing students (in 22 articles), graduate students (in 2 articles), nursing instructors and students (in 4 articles), and nursing instructors and managers (in 1 article). Most of the challenges of supporting the students included violence, fear, and anxiety; socio‑cultural challenges, environmental‑organizational stresses; and ineffective clinical education. The findings of this study showed that nursing students face many challenges in the clinical setting. Therefore, the managers of educational and health‑care centers should give a high priority to their students’ support programs.

Context: 

Hepatitis B is the most prevalent chronic viral infection in humans, which imposes limitations on patients and has many physical, psychological, and social consequences due to its chronic nature. The purpose of this study was to evaluate the physical, psychological, and social challenges of patients with hepatitis B virus (HBV).

 Evidence Acquisition:

 First, a set of keywords, including hepatitis B, challenge, physical, psychological, and social, were searched in databases, such as Google Scholar, PubMed, SID, Magiran, and IranMedex. Then, the articles published between 2009 and 2019 were reviewed according to the inclusion and exclusion criteria in two stages – the title and the abstract in the first stage and the whole paper in the second stage. Finally, 34 articles were selected out of 1426 articles.

The articles used in this study were as follows: descriptive and cross-sectional studies (10 articles), review studies (9 articles), qualitative studies (9 articles), cohort studies (3 articles), randomized controlled trials, mixed-methods studies, and field studies (one article each). Most studies had considered patients with hepatitis B with an emphasis on physical issues (10 articles), social stigma (7 articles), psychological reactions (5 articles), the discovery of patients’ experiences (3 articles), and discrimination (2 articles). In 25 studies, the samples were patients with HBV.

It is necessary to understand and support the patients to treat them properly and help them live with minimum challenges and limitations. Therefore, it is necessary to consider educational and counseling programs to identify different aspects of this disease.

Adult children of elderly and sick parents face many challenges and may experience the compassion fatigue, which can affect the care process. The aim of this study was to investigate the dimensions and symptoms of compassion fatigue in children who take care of their elderly and sick parents.

In this study, data bases including SID, Magiran, IranMedex, Google Scholar, Elsevier and PubMed were searched for studies published between 2000 and 2019 with the following keywords: Parent, Family Caregivers, Compassion Fatigue, Adult Children and Elderly. By this means, a number of 426 articles were acquired which were reviewed in two stages (first, the title and the abstract and then the whole article) based on the inclusion and exclusion criteria. In the end, 17 articles entered the present study.

The type of articles used in this study were as follows: descriptive-analytical and correlational (7 articles), review (3 articles), qualitative (5 articles) and case study (2). The focus of the studies was on the different aspects of compassion fatigue. According to the reviewed studies, compassion fatigue is often accompanied by the symptoms of anxiety, helplessness, disappointment, insomnia, social isolation, reluctance as well as physical and mental fatigue. Ethical Considerations: Publication of the results is carried out honestly without bias and by citing the original reliable resources and references.

Since fatigue compassion creates various physical, psychological and social dimensions in adult children of elderly and sick parents, Support centers, counselors, and nurses need to consider this in regard to the families of elderly patients in their support program.