International Journal of Community Based Nursing and Midwifery
Volume:10 Issue: 3, Jul 2022

Sleep disorders are so prevalent during pregnancy. The present study was conducted to investigate the impact of aromatherapy with Citrus aurantium essential oil on sleep quality in pregnant women with sleep disorders. This randomized clinical trial study was conducted on 68 pregnant women in their 28-34 weeks of pregnancy who sufferred sleep disorders and referred to Jiroft health centers in 2021 (January-June). Those meeting the inclusion criteria were divided into the intervention and placebo groups, using random sequence generated through the randomization website. They were given five drops of Citrus aurantium essential oil and the placebo twice a day, every day for one month in the form of facemasks which they inhaled through normal breathing for 20 minutes. Sleep quality was assessed before the intervention and one month after the start of the intervention. The demographic questionnaire and Pittsburgh Sleep Quality Index (PSQI) were used for collecting the data. Data analysis was performed using SPSS 24 software. The Mann–Whitney-U, Wilcoxon and fisher exact tests were carried out. P-value<0.05 was considered statistically significant. Before the intervention, the mean and standard deviation scores of pregnant women’s sleep quality in the intervention (9.89±3.00) and placebo (8.12±2.53) groups were not significantly different (P=0.10). One month after the intervention, the score was significantly lower in the intervention group (4.37±1.85) than the placebo group (8.48±2.62) (P<0.001). Based on the results of the present study, it seems that aromatherapy with Citrus aurantium essential oil enhances the sleep quality in pregnant women with sleep disorders, so it can be used to diminish sleep disorders in these women.Trial Registration Number: IRCT20200512047414N1.

A successful response to the risk of human immunodefficiency virus (HIV) infection among immigrants requires improved access to HIV prevention, diagnosis, and treatment services. However, most immigrants face significant challenges in accessing HIV/AIDS services. The aim of this study was to explore the aspects influencing access to HIV/AIDS services among Afghan immigrants in Iran. This was a qualitative study using conventional content analysis that was conducted from June 2018 to April 2020 in Tehran, Iran. Purposeful sampling method was performed. We conducted 25 semi-structured interviews with three groups of stakeholders including Afghan immigrants infected with or at risk of HIV (n=8), service providers (n=8), and policymakers/managers/experts (n=9). Inductive qualitative content analysis was applied according to the Granheim and Lundman method. Data were analyzed using Open Code software version 4.03. Aspects influencing access to HIV/AIDS health services were categorized into 3 themes (that were extracted from 9 categories): 1. Cultural aspects (cultural similarities and differences, values and beliefs); 2. Psychosocial aspects (social support, stigma and discrimination); and 3. Service delivery related aspects (awareness, health services coverage and integrity, health services financing, accessibility, and continuity of care). The findings suggest that efforts to improve Afghan immigrants’ access to HIV/AIDS health services in Iran need to consider the cultural aspects, increasing HIV awareness, providing support, reducing stigma and discrimination, and improving health services coverage, integrity, financing, and continuity of accessible services.

One of the most important causes of marital dissatisfaction is the lack of life skills. This study aimed to compare the effects of training self-awareness and problem-solving skills on marital satisfaction of married women. This study was a randomized field trial conducted in Gorgan since October 2019 to September 2020. A total of 105 married women were allocated to one of two interventions or a control group based on triplex block randomization. Data collection tools were the Persian version of the self-awareness questionnaire, problem-solving questionnaire and Four ENRICH Couple Scales. The participants completed the questionnaires before (T1), immediately (T2), and one month after the intervention completion (T3). The first intervention group received self-awareness skills training and the second received problem-solving skills training one session per week for four weeks. The control group did not receive any training. Data were analyzed using One-way ANOVA, Kruskal-Wallis, Chi-square, Fishers exact test, exact test, repeated measure ANOVA, and Bonferroni test, using SPSS 16. A P value <0.05 was considered significant. The mean score of ENRICH Scales in the three groups, immediately and one month after the intervention, were not statistically significant (P>0.05). However, in the problem-solving group, the scale of marital satisfaction was significantly different at T2 and T3 (31.40±4.55, 33±5.21, P=0.008). In the self-awareness training group at T1 and T3, the mean of the conflict resolution scale (32.60±63.28, 33.94±5.74, P=0.03) was significantly different. The results showed that problem-solving skills training was more effective in increasing the score of marital satisfaction compared to self-awareness skills training.Trial Registration Number: IRCT20190721044290N1.

Males’ viewpoint about sexual and reproductive health (SRH) and their situation are essential components of men’s and women’s health in the community. Men have been overlooked in reproduction health, especially with reproductive issues such as contraception, sexually transmitted infections (STIs), infertility, and sexual function. This study aimed to investigate the males’ perceptions of their SRH situation in Iran. A qualitative study was conducted from May 2016 to April 2017 on data retrieved through semi-structured interviews with 19 adult males aged 18 to 59 years. The participants were purposefully recruited from among populations of health centers in Alborz province, Iran. Conventional content analysis in OneNote software version 2016 was used for data analysis. Three main themes and nine categories emerged including 1) Perceived SRH needs, including “need to increase men’s awareness about SRH”, “need to have an accessibility to SRH services”, and “need to have a high-quality sexual relationship”; 2) perceived SRH responsibilities, including “health-seeking behaviors”, “sexual skills”, “childbearing responsibilities”, and “ethical commitment”, and 3) Men’ perception of trends of social and cultural norms, including “changing SRH priorities” and “changing marital prototype”. In this study, men perceived SRH as an important issue due to the changes in social and cultural trends, and many of their SRH needs have not yet been addressed. Hence, along with socio-economic changes, the policymakers of the health system should develop strategies and interventions to meet these needs.

Diabetes-induced anxiety, depression, and decreased self-efficacy lead to poor adherence to treatment in diabetic children. Since painting therapy seems to be helpful to express their feelings, this study aimed to investigate the effects of virtual directed painting therapy on anxiety, depression, and self-efficacy in diabetic children. This randomized controlled trial was conducted on 40 children with type 1 diabetes aged 8-12 years who were referred to Imam Reza Clinic of Diabetes in Shiraz, from July to October 2020. Children were randomly selected and assigned to intervention and control groups, using block randomization. The intervention group received the routine care plus virtual painting therapy directed by WhatsApp (six 2-hour group sessions once a week for six weeks). Spence Children’s Anxiety Scale, Maria Kovacs Children’s Depression Inventory, and Diabetes Management Self-Efficacy Scale were completed before and after the intervention. Data were analyzed through SPSS 23, using Chi-square, Mann-Whitney U, and Wilcoxon tests. P value <0.05 was considered as significant. After the intervention, the median (interquartile range) total scores for anxiety, depression, and self-efficacy in the intervention group were 48.50 (45.00-51.75), 7.00 (4.00-9.00), and 169.00 (154.00-178.00), and in the control group 55.00 (48.50-62.25), 13.00 (10.00-17.50), and 152.00, respectively (110.50-184.00). After the intervention, there was a significant difference between the groups regarding anxiety (P=0.02) and depression (P<0.001); however, the difference in self-efficacy was not significant (P=0.20). Painting therapy should be considered as a part of care programs in diabetes centers and other community settings to control anxiety and depression of diabetic children.Trial Registration Number: IRCT20200118046181N1.

Sexual life can be affected through different aspects of living with diabetes. This study aimed to explore the perception and experiences of Iranian women with diabetes at reproductive age regarding the impact of diabetes on their sexual life. This qualitative study was conducted from August 2018 to February 2019 in five diabetes centers in Tehran. Purposeful sampling method was used to select the participants, and data were collected by in-depth semi-structured interviews. Data were analyzed manually using the conventional content analysis method. Data saturation occurred after interviewing 24 women with diabetes. Three themes were identified. The first theme was “diabetes-related threatened sexual life” with three categories: change in sexual functioning, negative sexual self-evaluation, and concern in sexual relationships. The second theme was “diabetes treatment challenges in sexual life,” which included two categories: adverse effects of diabetes treatment in sexual life and the psychosocial distress related to diabetes treatment. “Couples’ relationship adjustment to diabetes,” was identified as the third theme, including four categories: the need for spouse’s understanding of living with diabetes problems, perceived need for spouse’s support, perceived need for intimacy, and the need to cope with diabetes-related childbearing challenges. According to the participants’ perception and experiences, in addition to sexual problems, diabetes had affected their sexual life through diabetes treatment challenges in sexual life and the way the couples’ relationships adjust to diabetes. Therefore, sexual problems screening and providing counseling services in community-based diabetes care planning are recommended.

After recovery from acute phase of the COVID-19, some patients suffer from persistent/late-onset complications. The main objective of this study was to investigate the prevalence of such complications in a large scale of COVID-19 patients in Tehran, Iran. In this cross-sectional study, those patients who called Tehran emergency medical services center and were visited by the emergency medical technicians from 20 March 2020 until 21 September 2020 and diagnosed as a confirmed COVID-19 case were enrolled. The minimum required sample size was estimated 385 cases, and they were selected randomly. The patients were interviewed by phone at least 4 weeks since initiation of their symptoms. Using a pre-prepared checklist, made by an expert panel who were involved in management of COVID-19 patients, data were collected on the types and duration of the complications, clinical information, and factors which could interfere with developing the complications. All analyses were performed using STATA 16 software. The association of the prevalence of each complication with independent factor was assessed using Chi-square test (or Fisher’s exact test) for categorical variable, and the mean difference of numerical variables in the two groups (with and without complication) was assessed using independent t-test. Statistical significance was accepted at P value<0.05. Four-hundred forty-seven patients participated in the study. Among our total population, 345 (77.2%) patients experienced at least one of the persistent/late-onset complications. Cardiopulmonary and then skin-related symptom categories were reported in 179 (40.0%) and 173 (38.7%) patients, respectively, and were the most prevalent persistent/late-onset complications. The associations of long term persistent/late-onset complications with older ages (P=0.04), female (P<0.001), psychological stress (P=0.01), and inadequate rest after illness (P<0.001) were significant. The findings of this study indicate that a significant number of patients will experience persistent/late-onset complications, both physically and mentally, after recovering from acute phase of COVID-19. Thus, physicians should have adequate resources and support to care for the patients to help them cope with the condition.

As many countries cannot ensure sufficient or good quality of health, there are many community interventions around the world.