International Journal of Community Based Nursing and Midwifery
Volume:8 Issue: 1, Jan 2020

There is a high prevalence of multiple sclerosis (MS) among Iranian women ofreproductive age. However, very few studies have been conducted in Iran to assess the experiences with and concerns about pregnancy and motherhood of such patients. The present study was conducted to better understand the experiences and concerns of women with MS about pregnancy and motherhood. The present qualitative study was conducted from August 2016 to January 2017 among Iranian women with MS visiting the Iran MS Society in Tehran, Iran. The purposive sampling method was used to recruit the participants and the sampling was continued until data saturation. Based on the inclusion criteria, a total of 25 women with MS were recruited in the study. The data were collected by in-depth semi-structured face-to-face interviews and analyzed using the MAXQDA 10 software. The analysis of the interview data resulted in four main categories, namely “Pregnancy concerns”, “Fear of failing as a parent”, “Feeling of threatened fertility”, and “Lack of social support”.The results showed that Iranian women with MS avoided pregnancy due to the negative effects of the disease on their physical abilities and on life in general. They were also concerned about possibleinfertility, the effect of MS medications on their menstrual cycle, and the limitations of infertilitytreatments due to the presence of MS. These concerns led them to postpone pregnancy and lose time or opt for voluntary childlessness and consequently miss out on the experience of motherhood. MS poses a serious challenge to women who consider getting pregnant and wish to experience motherhood. Health care professionals should support such patients to overcome their concerns and indecisiveness by providing appropriate information and counseling.

Proper education can improve the quality of life. Multimedia as an interactive educational method and booklet as a traditional one have their own unique effects. This study aimed at compare the interactive multimedia and booklet methods at the time of discharge on the quality of life of kidney transplant patients. In this single-blind interventional study, 80 patients from Bouali Hospital, Shiraz, fromSeptember 2017 until June 2018 were selected by convenience sampling, and then divided into twogroups (booklet and interactive multimedia) by block randomization. Intervention for the first groupincluded short and long-term care information in the form of a booklet, and an interactive multimediaCD with the same content for the second group. Quality of life was assessed by kidney transplantquestionnaire (KTQ) at the time of discharge and after two months. Adherence to education wasverified by phone. The data were analyzed through SPSS v.24 software using independent and pairedt-tests. P The mean overall quality of life score in both groups increased significantly, P=0.044 for thebooklet group and P=0.039 for the multimedia group. In emotional, fatigue, uncertainty/fear domains, both groups showed improvement after the intervention (P<0.05). However, in physical symptoms and appearance domains, differences were not significant, before and after education. After intervention, no significant difference was observed between the two groups in the overall and specific domains of quality of life score (P=0.437). Both methods had positive impacts on the quality of life and emotional, fatigue and uncertainty/fear domains.

There are various causes of male infertility. Infertile men usually have a low quality of life (QoL) and a high level of stress compared with men without infertility problems. The present study aimed to examine the effects of a spousal support program to enhance the QoL of male patients undergoing infertility treatment. The present non-randomized controlled trial was conducted among 38 infertile couples in Tokyo (Japan) during April-August 2018. The study employed a quasi-experimental design (pretest-posttest with comparison) using purposive sampling. The levels of QoL, distress, and spousal support were measured using self-administered valid and reliable questionnaires. The paired t test was used to analyze pre- and post-intervention data with SPSS software (version 23.0). P There were significant differences between the pre-test and post-test scores for the relational and emotional sub-scales of QoL. The paired t test results showed that the post-test emotional sub-scale (66.9±16.9) was significantly higher than the pre-test emotional sub-scale (58.5±13.5; t (30)=2.2, P=0.04). Similarly, the post-test relational sub-scale (71.2±21.6) was significantly higher than its pre-test score (60.8±13.7; t (30)=2.3, P=0.03). The majority of the participants 23 (74.2%) expressed satisfaction with the program. The spousal support program was well-received and significantly improved part of the QoL of men who were infertile due to various causes.

Mental health is a fundamental and widespread concept with individual meanings. The purpose of this study is to perceive and clarify the factors influencing mental health from the perspectives of nursing students. The present qualitative study was conducted in Khoy, Iran from July-December 2018. Twenty nursing students were selected as the research participants through purposeful sampling method and interviewed using semi-structured in-depth interviews. All interviews were recorded, transcribed, and then analyzed with Graneheim and Lundman's approach of conventional content analysis. The Trail version of the MAXQDA 10 software was applied to conduct the coding process. Data analysis revealed four themes and 12 sub-themes. The themes included feeling of self-worth, religious beliefs, socio-economic factors, and behavioral factors.   The results showed that mental health in nursing students is a multidimensional phenomenon and is influenced by various factors. The current results could help the nurse educators to intervene and provide suitable, effective, practicable, and culture based mental health services and also help the nursing students achieve mental stability. Therefore, it is suggested that further qualitative and interventional studies should be conducted in this area.

Debate still exists regarding physical and cognitive factors associated with Body MassIndex (BMI) in the elderly population. This study aimed to determine the association between BMIand comorbidity, Quality of Life (QOL), and cognitive function in the elderly population. This cross-sectional study was conducted from October 2017 to January 2018. Theparticipants included 246 old people who referred to Imam Reza elderly clinic, Shiraz, Iran. Thedata were collected using Leipad Quality of Life Questionnaire and Mini-Mental State Examination(MMSE). Indeed, weight and height were measured to assess the BMI. The data were entered intoSPSS, version 21, and analyzed using ANOVA, Chi-square test, Pearson correlation coefficient, andmultiple regression analysis. This study showed that 104 (47%) of the participants were overweight and obese. Themean±SD score of QOL was 46.14±12.01. Additionally, 93 (37.8%) of the participants had cognitiveimpairment. The results showed a significant difference among normal weight, overweight, and obesegroups regarding the mean scores of QOL (P<0.001) and cognitive function (P<0.001). Moreover,29% of the changes in BMI was explained by QOL, cognitive function, and having hypertensionand cancer. Among these variables, the associations between BMI and QOL (r=–0.52, P<0.001) andcognitive function (r=–0.28, P<0.001) were significant. The results showed that half of the old people suffered from overweight and obesity.Moreover, roughly one-third had cognitive impairment. In addition, BMI was associated with QOLand cognitive function in the elderly. Therefore, healthcare workers might use these findings to design prevention and treatment programs targeting the elderly population.

The concept of social participation is highly valued in old age. However, there is ambiguity and disagreement in the definition and attributes of this concept among the elderly. This study aims to clarify and reduce the ambiguities in the concept of social participation in order to achieve a clear and understandable definition among the elderly people. For concept analysis, Walker and Avant's 8-Step method of concept analysis was used. The published papers between 2000 and 2018 were searched. 57 articles related to the concept were included in the study and accordingly, the definition, applications, attributes, antecedents, consequences and empirical referents of the concept were extracted after reviewing the resources. According to the analysis, the defining attributes of the concept of elderly people’s social participation included emphasis on community-based activities and interpersonal interactions, based on resource sharing, active participation and individual satisfaction. Social participation among the elderly people had individual, environmental, and social antecedents as well as individual and environmental consequences. The present study provided an objective and understandable picture of the concept of the elderly people’s social participation. The study has pedagogical implications for promoting this concept and developing tools.

During the lactation period, mothers are at an increased risk of nutritional deficiencies due to improper dietary patterns, physiological changes, and various socio-demographic factors. The present study aimed to examine the nutritional status, dietary intake, and related factors among lactating women in the urban and rural areas of Khorramabad, Lorestan province in the southwest of Iran. The present population-based cross-sectional study was conducted in Khorramabad (Iran) during April-July 2012. The study population included 708 lactating mothers who were referred to the health centers in Khorramabad (10 urban health centers and 30 rural health/community centers). A multi-stage sampling method was used to recruit the participants. The nutritional status and food intake of the participants were assessed over three days using the 24-hour dietary recall (24HDR) and dietary record (DR) questionnaires. The data were analyzed using SPSS software (version 16.0) with the Chi-square test, Fisher’s exact test, paired t test, independent t test, and Pearson correlation coefficient. P The mean age and body mass index (BMI) of the mothers were 29.78±6.24 years and 26.11±3.70 kg/m2, respectively. There was a significant difference in calorie intake between the different categories of age, BMI, education level, job status (P<0.001) and lactation stage (P=0.034). The energy and nutrient intakes, except iron and phosphor, were statistically lower (P<0.05) than the prescribed Recommended Dietary Allowances (RDA). The intake of vitamins K, B1, B2, B3, and C; protein, magnesium, phosphor, zinc, copper, and iodine by mothers in the rural areas was significantly higher (P<0.05) than those in the rural areas. Higher intakes of energy and macronutrients by the lactating mothers had a significant negative correlation with an increase in age and had a significant positive correlation with a higher BMI (P<0.001). Lactating women in the urban and rural areas of Khorramabad (Iran) had a poor nutritional status. Nutrition education and a modified dietary pattern during the lactation period are recommended.

Spiritual health and maternal-fetal attachment behaviors are considered as beneficialcoping strategies used to adapt to pregnancy. The present study was conducted to determine thecorrelation between spiritual health and maternal-fetal attachment behaviors in pregnant womenreferring to health centers in Qazvin. The present descriptive correlational study was conducted on 200 pregnant women referring to health centers in Qazvin, in 2015. A multi-stage sampling was carried out and data were collected in a self-report manner, using the Persian version of Spiritual Well-Being scale developed by Paloutzian and Ellison, Persian version of Cranley’s maternal-fetal attachment scale, and a demographic and midwifery questionnaire. Data were analyzed in SPSS-20, using Pearson’s correlation coefficient and the multivariate linear regression. P The mean scores of attachment and spiritual health were 95.91±8.92 and 104.15±10.59,respectively. A weak positive correlation was observed between attachment behaviors and spiritualhealth (P<0.001, r=0.40). Regression analysis showed that spiritual health (P<0.001, β=0.40), religious health (P<0.001, β=0.30), and existential health (P<0.001, β=0.43) could predict the maternal-fetal attachment behaviors. The results showed that a higher spiritual health was associated with an increase inmaternal-fetal attachment behaviors. These results suggest the importance of strengthening spirituality during pregnancy as an effective strategy for increasing the attachment behaviors.