Journal of Research Development in Nursing and Midwifery
Volume:18 Issue: 1, Spring-Summer 2021

The necessity of nurses’ cultural awareness in the caring process has been emphasized; however, there is a need to define this concept clearly; so the aim of this study was to clarify the cultural awareness concept in the nursing context.

in this qualitative study, a concept analysis using 6-steps Rodgers’s evolutionary method (Determining the intended concept and the related terms, selecting the appropriate domain for data gathering, determine attributes, antecedents, and consequences of the concept, data analysis, stating examples and generate a  hypothesis) was adopted based on thematic analysis. The articles published in English and Persian language from 2005 to 2019 were searched and then analyzed.

The 6 attributes of cultural awareness include “being a prerequisite to cultural competence, a dynamic and progressive process; having learning potential; being multidimensional; and including self-awareness and awareness about the service user”. Antecedents for cultural awareness consist of global diversity, cultural teaching, developing cultural skills, cultural immersion, and organizations supporting cultural awareness, and researches. Cultural competence or effectiveness, constructive intercultural interaction, and improvement of health outcomes are the consequences of cultural awareness. A definition of cultural awareness was proposed.

In todaychr('39')s global diversity, providing suitable infrastructure (including cultural teaching, development, immersion, and researches) can lead to cultural awareness that is a dynamic multidimensional process of self and service user awareness that causes constructive intercultural interaction, cultural competence, and improvement of health outcomes. So, it is suggested to providing the infrastructures and do more studies related to the development of this concept.

Substance abuse can cause problems for family members, especially spouses, and impair the addictschr('39') quality of life; hence, it seems necessary to identify issues that can endanger their quality of life and health. Therefore, the present study aimed to determine the quality of life of women with addicted husbands, and its related factors.

We conducted the present cross-sectional study on 300 women with addicted husbands who were in the list of clients of private and public addiction treatment centers in Gorgan in 2018. The convenient sampling was used for recruited participants. We gathered data using the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the higher scores indicated a better quality of life. We also analyzed the data in SPSS 16 using descriptive statistics, Chi-square and Mann-Whitney tests at a 95% confidence interval.

The results indicated that women with addicted husbands had lower mean scores of physical health (33.3±19.1), mental health (28±3.19), environmental health (31.5±18.1), social relationship (30.2±21.4), and total scores of quality of life (31±18). There were significant correlation between scores of quality of life and its dimensions with womenchr('39')s job, family income, duration of substance abuse, and type of substance (P<0.001). Also, the quality of life was directly associated with womenchr('39')s jobs and family income, but inversely related to the husbandchr('39')s duration of substance abuse and type of substance.

Women with addicted husbands needed more support due to their low quality of life. These findings help the healthcare provider pay more attention to the problems of women with addicted husbands.

According to the World Health Organization, aging anxiety decrease life expectancy and causes disease in old age. Negative attitude towards the older adults is a major factor associated with aging anxiety. Therefore, the present study aimed to determine the relationship between attitudes towards the older adults and fear of aging in the health care providers of Social Security Organization’s hospitals in Mazandaran province in 2018.

We conducted the present cross-sectional study on 232 health care providers of hospitals of Social Security Organization in Mazandaran province in 2018, selected them by stratified random sampling according to the job categories, and included them in the study. We utilized the Anxiety about Aging Scale (AAS) by Lasher and Faulkender and Koganchr('39')s Attitude toward Old People Scale (KAOPS) to collect data. We analyzed the data in SPSS16 using Pearson correlation, independent t-test, and one-way analysis of variance.

The participantschr('39') mean age was 37.85±6.40 years and the mean of aging anxiety was 67.90±10.60. Among the four subscales of aging anxiety, the highest fear was related to "fear of loss" (23.7±4.5) and then "fear of physical appearance" (21.25±4.65), and the lowest was related to "fear of the  older people " (10.12± 3.25). Despite the slightly higher mean aging anxiety among nursing and midwifery staff than medical staff, it was not statistically significant. Findings indicated that aging anxiety had a negative and significant relationship with attitudes towards the older adults in health care providers (r=0.35, P=0.001).

Given the high aging anxiety in health care providers and its importance in providing services for the older adults as well as the quality of their old age, we suggest promoting the health care providers’ positive attitudes towards the older adults through in-service training courses.

MS is a potentially disabling disease of the brain and spinal cord (central nervous system). Patients with MS have some problems in their general health. The purpose of this study was to determine the effects of Benson relaxation technique on general health in MS patients.

This randomized controlled trial study was done on MS patients who registered in MS center in Kashan, Iran, from March 2017 to July 2018.  The first sixty eligible patients were recruited through convenient sampling method and then patients were randomly assigned to experimental and control groups. Patients in both groups were completed the Goldberg General Health Questionnaire (GHQ-28) before and after the intervention. Benson relaxation technique was performed by patients in the intervention group twice a day, 20 minutes per session, over a period of eight weeks. Data were analyzed using Chi-square, independent t-test, and paired t-test in the SPSS software (version 16). The level of significance was set at 0.05.

There was significant difference in the mean scores of general health before (44.22±12.4) and after (31.14±11.09) the intervention in the experimental group (P=0.002). After intervention, the difference between the mean difference scores of general health in the control (1.78±3.5) and experimental (13.08±2.88) groups was significant (P=0.002).

According to the findings, the Benson relaxation technique can be effective for improving MS patients’ general health, physical and mental status, and social function. Due to the cost-effectiveness and safety of this technique, we propose the inclusion of the technique in the treatment protocol for MS patients.

Coronary angiography causes anxiety in patients and family that is a major cause of anxiety and lack of awareness. Choosing the right educational method is effective in increasing family awareness and support of patients. The present study aimed to compare the effects of Face-to-Face    and group education on awareness and anxiety of family members of candidates of coronary angiography

This randomized clinical trial study was conducted on 90 family members of candidates of coronary angiography at Amiralmomenin Hospital of Kordkuy as a referral center in Northeast of Iran in 2017. Eligible family member of patients was recruited through convenience sampling method and then allocated three; face-to-face education (A), group education (B), and control groups randomly. Family members in both intervention groups received same educational content about the method of performing coronary angiography, and the necessary care. The control group only received routine information. Data were collected using the Spielberger State-Trait Anxiety Inventory (STAI) and awareness questionnaire. SPSS Statistics for Windows, version x.0 (SPSS Inc., Chicago, Ill., USA). Software using descriptive statistics, paired t-test, Chi-square, Wilcoxon, and Kruskal-Wallis tests. The significance level was considered less than 0.5

The score of anxiety and awareness in patients’ family members were not significantly different in the three groups before the intervention. After intervention, the mean scores of anxiety were 42.12±4.71 and 42.37±5.53 in the participants of group A and B respectively, and it was significantly different from the pre-intervention score (P<0.001). The mean awareness score was significantly higher in group B than in the other two groups (P<0.001)

According to the results, group education was more effective than face-to-face education in increasing awareness and reducing anxiety in families. We suggest developing programs in this regard

Poisoning is a common cause of hospitalization in intensive care units (ICU). The present study aimed to investigate   the frequency of poisoning leading to hospitalization in the intensive care units of an educational hospital, Golestan University of Medical Sciences, in Gorgan in 2008-2018.

This cross-sectional study conducted on patients with acute poisoning admitted to the ICUs of 5 Azar Hospital in Gorgan from 20 March 2008, to 20 March 2018. We collected data from all patientschr('39') medical record using a checklist.  Data was presented in proportions, mean and standard deviation.

All of 631 patients with poisoning were admitted to the ICUs were male (61.3%) and 40.3% were in the age range of 20-29 years. The mean length of hospital stay in the ICU was 4.21±3.45 days. The most common type and cause of poisoning were suicide attempt (65.3%) and drugs (65.6%), respectively. The common drugs were used including the benzodiazepines (38.9%) and narcotic drugs (18.6%). The rate of death of poisoning was 11.1%, of which 44.3% was due to aluminum phosphide.

Benzodiazepines and aluminum phosphide were the most common causes of poisoning and death due to poisoning in the ICU. Due to the high mortality rate, it seems necessary to provide more education and information via the media, especially in the field of aluminum phosphide hazards.

Lifestyle modification is an important factor in promoting the health of middle-aged women. Therefore, this study aimed to determine the effect of telephone counseling on the nutritional status and physical activity of middle-aged women in Yazd, Iran.

This randomized controlled clinical trial was done on 50 middle-aged women during September to February 2017. Eligible women was recruited from religious places and then were randomly assigned into two intervention and control groups. The participants in the intervention group received the counseling program in 8 calls for 20-30 minutes twice per week. The control group received no intervention. Data were gathered using a health promoting life-style questionnaire for middle-aged women in three time points; before intervention, immediately, and one month after the intervention. Data were analyzed in SPSS 16 software using Chi-square, repeated measures ANOVA and independent t-test. A significance level was considered P<0.05.

There was no significant difference between the two groups in terms of nutritional status and physical activity (PA) before the intervention, but there was significant difference between them immediately and one month after the intervention. Also adjusting the baseline values, repeated measures ANOVA test showed a significantly premiere mean of nutritional status in telephone counseling compared to the control group (P<0.001).

The results of the study showed that telephone counseling significantly improved the lifestyle of the middle-aged women. Also, recommended that health care providers use of telephone counseling that effective and efficient tool for promoting womenchr('39')s health.

The Iran-Iraq War has left many consequences on veterans and their families over the years and it has potentially affected the veteranschr('39') quality of life. The present study aimed to determine the mediating role of marital satisfaction and perceived social support in the relationship between spiritual attitudes and quality of life in psychiatric veterans in Kermanshah province, Iran.

The present cross-sectional study had a structural equation modeling performed on all psychiatric veterans under the protection of Martyr and Veterans Affairs of Kermanshah province in 2018. We used the simple random sampling method, and selected 10 to 15 samples for each parameter according to the rule of thumb; hence, the sample size was 280. We collected data using The World Health Organization Quality of Life-BREF (WHOQOL-BREF), the Spiritual Attitude Scale, and the Multidimensional Scale of Perceived Social Support. Furthermore, we utilized the bootstrap method to evaluate the significance of indirect relationships (paths) and mediation effects. We performed all analyses of the structural equations using AMOS 22.

The results indicated that the direct effects, and factor loadings of indicators on the latent variables of the model were significant at an alpha level of 0.05. Direct coefficients of spiritual attitude on marital satisfaction (β =0.45, P= 0.001) and spiritual attitude on perceived social support (β =0.14,P= 0.05) were positive and significant. Spiritual attitude had a positive and significant effect on the quality of life through marital satisfaction and perceived social support (β =0.22, P= 0.001).

The results showed that spiritual attitudes increased the veteranschr('39') quality of life through mediating variables, namely marital satisfaction and perceived social support.

Time management skill learning and identification are very effective in the study process, and can reduce the adolescentschr('39') waste of time and help them increase the academic achievement. The present study aimed to determine the effect of time management skill on the academic achievement of female students.

This interventional study was a randomized controlled field trial. The statistical population consisted of all 2785 female second-grade high school students in 2017-2018 covered by health centers of Gorgan, Iran. Forty eligible students were selected and allocated into intervention and control groups. In the intervention group, a group counseling session of time management training was held for 6 hours in two days. A month after intervention, all students completed the questionnaire, and the studentschr('39') grade point average (GPA) of the first and second semesters were extracted in 2017-2018. To compare the academic achievement we used the Mann-Witny U test, paired t-test, and Wilcoxon test in SPSS-16.

The mean of the GPA of students in control group before and after intervention were 17.95±1.47 and 17.86±1.67, respectively (P=0.43). The GPA in the intervention group was 17.61±0.84 before intervention and showed an increase to 17.75±1.08 after the time management skill training; but the increase was not statistically significant (P=0.43). The results indicated a statistical significant difference in mean scores of 2 subscales; short-term planning and time attitude in the intervention group in comparison with the control group.

Despite the fact that time management skill training did not lead to the academic achievement in students, it could improve the short-term planning. Since the follow-up of the present study was short-term, it needs time to improve planning and affecting the academic achievement. It is suggested to examine this assumption in longitudinal and long-term studies.

Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome that emerged in early December 2019. Global proliferation, abrupt increases in confirmed cases, and the risk of self-infection have caused significant stress and anxiety among staff working in opioid treatment services (OTS). The aim of our study was to determine the psychological status of staff working in OTS during the outbreak period of COVID-19 in Tehran. 

In a short-term longitudinal survey, 621 staff members, including physicians, psychologists, nurses, and social workers, who were selected using probability-based online panel. Data was gathered using online questionnaires including the Patient Health Questionnaire-4 (PHQ-4), the Brief Fatigue Inventory (BFI), and the Jenkins Sleep Scale (JSS). Longitudinal assessment of anxiety, depression, fatigue and sleep problems in three periods including pre-outbreak, outbreak, and non-epidemic outbreak was done through the online panel. Data were analyzed by paired t-test and repeated measures correlation.

The rates of anxiety, depression, fatigue, and sleep problems of the staff working in OTS during the outbreak period were significantly higher than that of the pre-outbreak period (P<0.001), and it remained significantly higher during the non-epidemic outbreak and did not decrease significantly (P>0.05). The correlation coefficient between the anxiety, depression, fatigue, and sleep problems was significant in all three periods and the highest correlation was in the outbreak period (P<0.001).

Mental health problems of staff were common during the outbreak of COVID-19. Mental health problems of staff can limit the effectiveness of addiction treatment programs in the long time.

Women experience psychological problems during pregnancy affecting their quality of life. Since weakness in life skills, including communication skills (CS), is a factor of reducing the quality of life, we conducted a study to determine the effect of group counseling based on communication skills on the quality of life in pregnant women in Gorgan.

The parallel randomized field study trial carried out in 2016 on 72 pregnant women who referred to the health centers in Gorgan, Iran. The pregnant women at the gestational age of 14-18 weeks were recruited in convenience sampling method, and then randomly assigned in to the intervention and control groups using the block randomization method. The data collection tool included the quality of life questionnaire (SF-36) that was completed by both groups before the intervention. The samples of the intervention group received 6 sessions of group counseling based on communication skills for a one-hour session per week. A week after the sessions, the questionnaires were completed again by both groups. We analyzed the data in SPSS-16 using the independent t-test, Mann-Whitney test, Wilcoxon test, Paired t-test, and Chi-square test.

The mean of womenchr('39')s age was 28.4±4.3 years in the intervention group, and was 26.8±4.5 years in the control group, and the mean age of their husbands were 33.14±5.3 and 31.22± 4.8 in the intervention and control groups, respectively. There was statistically significant difference between the intervention (60±15.2) and control (49±13.4) groups after the intervention in  total quality of life (P=0.002). The results indicated that the mean scores of quality of life of women in the intervention group versus the control group after the intervention had statistically significant differences in all areas except for the "physical function" (65.3±17.4 vs. 61.5±20.1, P=0.4) and "role limitation due to physical problems" (50±36.8 vs. 45.1±27.3, P=0.56).

The health centers need to be taught about the communication skills in line with physical training during pregnancy by midwives and midwifery counselors.

The elderly population is projected to increase in Iran and the world. A large number of chronic diseases observed in the elderly could be prevented or treated by improving their lifestyle, including nutrition. The present study aimed to determine nutritional status and the affecting factors in the elderly in Gonbad Kavus, Iran. 

This descriptive-analytical study was performed on 139 elderlies aged more than 60 years who resided in Gonbad (northeast of Iran) in 2013. The subjects were selected via two-stage cluster sampling, and each health center was considered as a cluster. Data were collected using a demographic questionnaire and mini nutritional assessment (MNA) questionnaire. Moreover, anthropometric indices (e.g., weight and height) were measured using a fabric meter, stadiometer, and Seca scale. Data was analyzed in SPSS version 11.5 using Chi-square and ordinal logistic regression model. 

In total, 36% of the elderlies had a normal nutritional status, whereas 59% and 5% were at the risk of malnutrition and malnourished, respectively. Among the subgroups, the female elderlies (78.6%) and single participants (87.1%) were at the risk of malnutrition or malnourished. Gender was the only independent variable affecting malnutrition. In addition, malnutritional status and marital status were the only variables affecting the body mass index even in the presence of other variables. 

Based on the nutritional assessment of the elderly, special attention must be paid to elderly women with lower education levels and financial dependence. It is also recommended that periodic assessments be carried out in the elderly population using the MNA questionnaire.

 General and sexual self-concept are affected by various life problems, including infertility. Mood regulation skill also promotes physical and psychological health by affecting people's knowledge, values and attitudes.
The aim of present study was to determine the effect of mood regulation skill training on general and sexual self-concept of infertile women.

 This clinical trial was performed on 34 infertile women referred to Gorgan Infertility Center in 2018 that were selected using convenience sampling method and randomly assigned to intervention and control groups through block allocation. The mood regulation training program was administered to the intervention group during four 90-minute sessions once a week. Both intervention and control groups completed Rogers Self-Concept and Snell Sexual Self-Concept Questionnaires before and immediately and one month after the intervention. The data were analyzed in SPSS version 16, using repeated variance analysis and Bonferroni adjusted test. 

 The results showed that before the intervention, the mean score of general self-concept in the intervention group was 9.41, and the positive, negative and situational sexual self-concept were 123.76, 12.18 and 43.18, respectively, and one month after the intervention, general self-concept was 6.21, positive sexual self-concept was 139.29, negative was 5.71 and situational was 54.24. Repeated analysis of variance showed that the intervention had a positive effect on the general and sexual self-concept of infertile women one month after the intervention and this effect was statistically significant (P<0.05).

 Mood regulation training has a positive effect on general and sexual self-concept of infertile women and can be used in service centers.