International Journal of Community Based Nursing and Midwifery
Volume:7 Issue: 1, Jan 2019

  Prenatal care reduces the risk of adverse pregnancy outcomes. The present study aimed to determine the effect of health literacy education on self-care in pregnant women. The present randomized controlled clinical trial was conducted at two comprehensive health service centers in Pakdasht (Tehran province, Iran) during January-June 2016. Out of the ten comprehensive health service centers in the city, two centers were selected using a simple randomized sampling and randomly assigned to a control group and an intervention group. From each center, 40 pregnant women were recruited into the study. Dedicated questionnaires on self-care and health literacy during pregnancy were developed by the author as data collection tool. The validity and reliability of the questionnaires were confirmed using the test-retest reliability method and by the opinion of ten experts, respectively. The questionnaires were completed before the intervention, and at 1 and 2 months after the intervention. The intervention consisted of four 45-minute educational sessions and group counseling. The data were analyzed using the SPSS software (version 16.0) with the independent t test, Chi-square test, Mann-Whitney test, and repeated measures ANOVA. P<0.05 was considered statistically significant. There was no significant difference between the groups before the intervention. However, 1 month after the intervention, there was a significant difference (P<0.001) in the mean scores of the total self-care and total health literacy between the control and intervention groups (65±6.23 versus 76.77±4.28 and 30.95±4.63 versus 40±3.54). Similarly, there was a significant difference (P<0.001) between the mean scores 2 months after the intervention. Intervention for the promotion of physical and mental self-care during pregnancy should emphasize on increasing health literacy in computational comprehension, reading comprehension, and behavior. Trial Registration Number: IRCT2017030415650N8

Psychological disorders such as depression, anxiety, and stress are among the most common health problems in old age. Continuous care and support can be effective and help elderly people to adapt to successive losses, especially if provided within the framework of a model. The present study aimed to determine the effects of the continuous care model (CCM) on depression, anxiety, and stress (DAS) in the Iranian elderly in Shiraz. The present quasi-experimental study was performed on older adults who attended the Soroush elderly day care center in Shiraz (Iran) from September 2014 to June 2015. A total of 50 eligible elderly participated in the study and were randomly assigned to an intervention group (N=25) and a control group (N=25). The CCM was implemented in the intervention group, whereas the control group received the routine care as offered by the day care center. CCM involves four stages, namely orientation, sensitization, control, and evaluation. The data were collected using the depression, anxiety, stress Scale (DASS-21) questionnaire and a demographic data sheet. The data were analyzed using the SPSS software (version 22.0) with the independent sample t test, paired sample t test, Chi-square test, fisher exact test, multivariate analysis of covariance and the Pearson correlation coefficient. P<0.05 was considered statistically significant. The majority of the participants were women, 44 (88%), with the mean age of 63.4±2.96 years. Following the implementation of the CCM, there was a statistically significant difference in the mean DAS scores between the intervention and control group (P<0.001). The implementation of CCM not only reduced psychological problems (DAS) in the elderly, but also improved and strengthened their psychological condition

  Pregnant women are often ill-prepared for the health of their unborn child in the case of abnormal findings, and experience several difficulties following the detection of fetal anomalies. Therefore, this study was conducted to explore the emotional and cognitive experiences of pregnant women following prenatal diagnosis of fetal anomalies in Mashhad, Iran. This qualitative conventional content analysis study was designed through two referral centers for fetal anomaly. The data were collected from April 2017 to January 2018 in Mashhad (Iran) through individual semi-structured in-depth interviews, from 25 pregnant women with a prenatal diagnosis of fetal anomalies. Four categories and 10 subcategories emerged. Category one, grief reactions during the time of diagnosis, contained two subcategories: shocked and panicked, and distressed and disbelieved.Category two, perinatal loss through a pregnancy termination, contained four subcategories: guilt and shame during pregnancy termination, loss of their expected child, suffering and emotional distress process, and unmet needs by health professionals. Category three, fears of recurrence in future pregnancies, had two subcategories: worried about inadequate prenatal care in the future pregnancies and worried about abnormal fetus in next pregnancies. Finally, Category four, a dilemma between hope and worries contained two subcategories: hope for normality and worried about future. It is important to monitor emotional reactions of women following prenatal anomaly diagnosis. So, training clinicians and health-care professionals for proper response to grief reaction in post therapeutic abortion is essential.  

  Self-management (SM) as a dynamic process enables Ulcerative colitis (UC) patients to live with this chronic illness. The present study aimed to investigate the effect of SM education on self-efficacy (SE) and quality of life (QoL) in patients with UC. This randomized controlled clinical trial study was conducted on 64 patients with UC from December 2016 to February 2017 at Motahari clinic, Shiraz. Patients were randomly divided into two groups of intervention and control. The education program included six 90-minute sessions in 3 weeks and one month telephone follow-up. Before, immediately and one month after the intervention, the participants filled out the Strategies Used by People to Promote Health (SUPPH) for SE, and the Inflammatory Bowel Disease Questionnaire-9 (IBDQ-9) for Qol. Then, data were entered into SPSS 18.0 and analyzed using independent samples t-test, Chi-square, repeated measures ANOVA and Pearson’s correlation coefficient. A significant increase was observed in terms of the overall mean score for SE and its dimensions in the intervention group (P<0.001). These scores were significantly higher than those of the control group (P<0.001), except for positive attitude (P=0.15). The scores for overall Qol and its dimensions significantly increased in the intervention group immediately and one month after the intervention (P<0.001), and the difference between the two groups was significant (P<0.001). There was a significant positive correlation between SE and Qol (r=0.32, P=0.01). SM improved the SE and Qol in patients with UC. SM educatoin is recommended in nursing care of patients with UC. Trial Registration Number: IRCT2016092429823N1

  Cervical cancer has a high prevalence and mortality, while early diagnosis greatly reduces its complications. Therefore, it is important to identify the factors affecting the screening of cervical cancer. Studies have shown that health locus of control plays an important role in beliefs about screening. This study aimed to identify the correlation between health locus of control and beliefs about Pap smear among women. This was a descriptive study which was conducted cross-sectionally. It was conducted on 250 married women who had the inclusion criteria and attended health centers selected by Shahid Beheshti University of Medical Sciences in Oct. 2017 to February 2018 (a period of 5 months). Data collection tools included a demographic information questionnaire, multidimensional health locus of control scale, and the Pap Smear Belief Questionnaire (PSBQ). Data analysis was carried out through SPSS (v.17) using statistical tests including correlation and regression. The significance level was considered 0.05. Among the participants, 50.8% never had a history of undergoing a Pap smear test. The mean scores for the internal health locus of control (IHLC), chance health locus of control (CHLC), and powerful others health locus of control (PHLC) were 22.59±5.32, 22.84±4.65 , and 24.54±4.28, respectively. The total score for the Pap smear belief had a significant positive correlation with two dimensions: IHLC (r=0.209, P=0.001) and PHLC (r=0.216, P=0.001). In addition, based on the results of the linear regression analysis, the scores of IHLC (R2=0.03, P=0.004), PHLC (R2=0.036, P=0.003), and CHLC (R2=0.16, P=0.04) were the predictors of the total score for the Pap smear belief. Our results showed that all dimensions of the health locus of control were the predictors of belief in women’s Pap smear screening. It is necessary that health care providers hold programs for health locus control of cervix cancer prevention in Iranian women

  Recurrent post-traumatic stress disorder (PTSD) can devastate the life of a veteran. Despite the widespread use of mobile learning technology in health care and nursing, few studies have examined its potential in PTSD patients and the effect on quality of life (QoL). The present study aimed to investigate the effect of a text messaging-based psychiatric nursing program on QoL in veterans with PTSD symptoms. A single-blinded, randomized, controlled trial was conducted at the outpatient clinic of Sadr Hospital in Tehran (Iran) from January 2014 to October 2015. A total of 98 veterans with PTSD who referred to the outpatient clinic of the hospital were initially assessed for eligibility to participate in the study. Based on the inclusion criteria, 66 veterans were recruited in the study and randomly allocated to a control group (n=33) and an intervention group (n=33). Due to the lost to follow-up, 9 participants (control=4, intervention=5) were excluded from the analysis phase. The intervention group received psychiatric support via short text messages for 6 months, whereas the control group received the routine hospital care. The self-rating scale for PTSD (SRS-PTSD) and the short form 36 (SF-36) were used to evaluate the severity of symptoms and the QoL, respectively. The results were analyzed using the SPSS software (version 18.0) with the Chi-square test, Fisher’s exact test, independent sample t test, and paired sample t test. P<0.05 was considered statistically significant. A significant improvement in PTSD (P=0.001) and QoL (P=0.001) was observed in the intervention group compared to the control group. Moreover, the recurrence frequency in the intervention group was significantly lower (P=0.03). The text messaging-based psychiatric nursing program reduced the severity of symptoms in veterans with PTSD and improved their QoL. Trial Registration Number: IRCT2013101214983N1

  Gynecological surgeries associated with loss of feminine organs evoke more personal, interpersonal and psychological distress that may diminish women’s quality of life. Women need and seek support to cope with various distresses which may change over the course of diagnosis to treatment. This study aimed to explore Iranian women’s needs to cope with hysterectomy and oophorectomy. This qualitative study was conducted in Kerman and Tehran, Iran from 2015 to 2017. Thirty interviews were conducted with 28 eligible participants including 24 main participants including one gynecologist, one midwife and one nursing faculty member, one gynecologist and one midwife and 2 husbands. They were recruited through purposeful sampling. Data were collected through semi-structured and in-depth interviews and analyzed with Graneheim and Lundman’s method of conventional content analysis. The trial version of the MAX QDA 10 Software was used to manage the coding process. “Tender care” emerged as the main theme. It was comprised of three categories: “to be well-informed, “to be treated with compassion in healthcare setting”, and “to be welcomed in the society”. Women after hysterectomy/oophorectomy were preoccupied with many physical and emotional concerns. They need a whole package of care which consists of proper information to know what to do, a well-prepared/trained healthcare setting to meet their needs, and visibility in the society as a whole person. A multidisciplinary approach must be activated to meet their coping requirements and it is necessary to address these needs in each level of healthcare services.  

  Post-divorce regret is a context-based phenomenon and in every community it is affected by the personal, social and cultural factors of that community. This study was conducted to investigate the post-divorce regret among Iranian women. This qualitative content analysis study was conducted from November 2015 to December 2017 in Tehran. 15 divorced women were selected through purposeful and snowball sampling. The data were collected through in-depth individual semi-structured interviews. Interview with participant no. 13 was conducted in two sessions (not having enough time for a long interview). Data were analyzed using Graneheim and Lundman’s proposed method. The MAXQDA 10 software was used for the management of data. Four main categories and 12 subcategories of data were extracted. The main categories and their subcategories were identity threat (stigma, becoming a sex object, discrimination), loss of independence (economic dependence, lack of independence in choosing a place to live, being controlled), vague future (concerns about children’s future, little chance of having an appropriate remarriage, fear of loneliness) and the absence of the husband and his role (emotional and sexual needs, children’s need for their father, need for a supporter and security). The findings of this study showed that many of the participants had got involved in multiple social, economic and support problems after divorce. Most of the participants were not able to adjust to life after their divorce and consequently regretted their decision to divorce. Therefore, it is necessary to provide the appropriate social and economic support for these women based on the culture of the society.