Iranian Journal Of Nursing and Midwifery Research
Volume:23 Issue: 3, May-June 2018

There is an assumption that sexual health research has great influence on the quality of human life through elevating sexual health standards, and their results will eliminate the burden of sexual health challenges on family relationships. The aim of this study was to review ethical considerations in sexual health research.
This narrative review was conducted between January 1990 and December 2017 based on the five‑step approach of York University. The keywords used to search for the studies included ethical issues, research, sexual health, reproductive health, and sensitive topics. The language of the literatures was English and the search process was performed on Pub Med, Elsevier, Ovid, Springer, Google Scholar, Research Gate, SAGE Publishing, ProQuest, WHO website, Kinsey Confidential, and World sexology.
After assessing the quality and eligibility of 94 articles, 13 were selected. The results of the present study showed that the most important ethical considerations were protecting the confidentiality and privacy of participants, obtaining informed consent, and paying attention to vulnerable people.
The review of literature exhibited several considerations that sexual health researchers are faced with. In order to manage these considerations, the researcher should have sufficient understanding of them. The important matter is that strategies to manage these challenges should be completely rational and practical according to each context. These strategies can also be applied in other societies with great similarities in their context.

The aim of the present study was to determine the association between body image and psychological wellbeing during pregnancy.
This descriptive correlational study was conducted on 320 pregnant women who were referred to health centers in Isfahan, Iran, during 2016 and had the inclusion criteria. They were selected by nonprobability convenient sampling. Data were gathered using standard psychological wellbeing and body image satisfaction questionnaires. The data were analyzed using Statistical Package for the Social Sciences software by descriptive and inferential statistical methods.
The results showed that the mean (SD) score of psychological wellbeing among participants was 77.50 (10.10) and their mean (SD) score of satisfaction with body image was 89.30 (14.60). Moreover, the results revealed a positive and significant relationship between the scores of psychological wellbeing and body image satisfaction (r=0.354, p The findings revealed a significant positive relationship between body image satisfaction and psychological wellbeing. Therefore, the training of positive attitude with respect to body image or increasing the level of knowledge on psychological wellbeing can create a positive cycle for these variables, and thus, make the pregnancy more enjoyable and acceptable.

Despite the increased survival of premature infants, many infants are discharged from the hospital while they still require care and follow‑up. The present study aimed to determine the effect of empowerment program on maternal discharge preparation and infants’ length of hospital stay.
In this pretest‑posttest clinical trial, 60 premature infants along with their mothers were selected from the neonatal intensive care unit (NICU) of a teaching hospital in Kermanshah in 2016 via convenience sampling and were allocated to experimental and control groups. Mothers in the control group performed routine care and those in experimental group, in addition to the routine care, performed an intervention program, training sessions including touching and massage, bathing, infection prevention, warning signs, and neonatal resuscitation. Data were collected by a maternal and neonatal demographic questionnaire and a discharge preparation checklist, performed twice (at admission and before discharge), by the researcher. The collected data were analyzed by independent and paired t‑test.
The mean (standard deviation) of the total score of maternal discharge preparation in intervention group 44.65 (3.90) was significantly higher than that of the control group 33.00 (8.28) (t = ‑6.58, p The increasing maternal discharge readiness and reducing the length of neonatal hospital stay would decrease the medical costs and supply more beds for admission of other infants.

Failure to provide proper respiratory care leads to incidence of certain complications such as ventilator‑associated pneumonia. Nurses have a crucial role in providing this care. The aim of this study is to assess the performance of ICU (Intensive Care Unit) nurses in providing respiratory care.
The present descriptive cross‑sectional study recruited 120 nurses working in selected hospitals affiliated to Isfahan University of Medical Sciences from March to August 2016. The questionnaire used included demographic and employment details and performance observation checklist (containing 39 items in four care domains) based on recommendations in clinical guidelines. The performance of each nurse during a working shift was observed. Data were analyzed by SPSS 18, using tables of frequency, mean, and standard deviation.
According to the results obtained, mean (SD) total performance score of nurses in providing respiratory care was 15.46 (2.16). The highest score was obtained in preventing contamination of respiratory equipment 5 (0), and the lowest score was in oral care 0.68 (0.73).
Considering that respiratory care is one of the main pillars of patient care in ICU and that nurses scored poorly in this area, it is imperative to pay greater attention to this area. It is essential to provide necessary training to nurses and adequate facilities for improving the quality of clinical care.

Nowadays, the most important problem of the educational system is the vast spread of school failure. Therefore, detection of the factors leading to or preventing students’ academic achievement is of utmost importance. Family function is considered to be a critical component of academic success. This study aimed to investigate the relationship between family functioning and academic achievement in high school female students in Isfahan.
This descriptive correlational study was conducted through random sampling among 237 female high school students in Isfahan during school year 2013‑2014. Data were collected by participants’ personal characteristics and Bloom family function questionnaires. To analyze the data, descriptive statistics (mean and standard deviation) and inferential statistics (Pearson correlation and linear regression analysis) were adopted and computed using SPSS software.
The results showed a significant correlation between family function (except lack of independence) and students’ academic achievement (p The results of this study showed that students’ academic achievement is highly correlated with the performance of their families. Therefore, to improve students’ educational status in cultural and educational programs, which are specified for them, family function centered plans should be at the heart of attention.

A critical component of cancer care, rarely addressed in the published literature, is an expected competency in oncology nursing education. The present text describes an effort to develop cancer‑nursing competencies in Iran and the process of the needs assessment.
A 3‑phase, mixed‑method approach for needs assessment was used, incorporating modified Delphi technique, literature review, interviews, and an expert panel. Different stakeholders, consisting of nurses, faculty members in fields related to oncology nursing education, and patients and their families, participated in different phases of the study. Data were analyzed using manual content analysis.
In the present study, totally 123 sub‑competencies were identified under holistic physical healthcare for patients, psychological and social care, spiritual care, palliative care, ability to prevent at three levels, teamwork and inter‑professional competencies, management and leadership competencies, ability to conduct research and evidence‑based nursing, supportive care, communication skills, professionalism, provision of education and counselling to patients and their families, and reasoning, problem solving, and critical thinking skills, respectively.
An updated and applicable list of competencies was extracted, which can be used to design and develop educational programs, which seek to train qualified oncology nurses for an effective nursing care.

Ethical approach is one of the paramount aspects of life. The position of this approach in medical occupations has always been noticed. This study was carried out to analyze the types of ethical approaches in midwives and their relationship with their demographic features.
The current descriptive‑correlation and cross‑sectional study was conducted from October to December 2014 using quota random sampling technique. The participants consisted of 189 midwives employed in Isfahan, Iran. The data collection tool was a researcher‑made questionnaire. The midwives’ attitudes were examined in the four fields of virtue ethics, deontologism, utilitarianism, and religious ethics. Data were analyzed using descriptive and inferential statistics in SPSS software (p The highest score belonged to religious ethics with the mean value of 64.36 out of 100. A positive significant relationship was found between deontologism and education level (F = 8.74; p = 0.004), and total ethical approach and workplace (F = 2.60; p = 0.053). There was a reverse significant relationship between age and work experience and virtue ethics (r = −0.15; p = 0.035 and r = −0.20; p = 0.005, respectively).
The existing high percentage of religious ethics shows the religious tendency of the participants. The determination of ethical approach among midwives as one of the important medical groups and creation and improvement of the most appropriate attitude among them based on the present regulations and requirements in society are principles that we should attempt to achieve.

Infertile couples have a lower quality of life (QoL) than that of the general population. Religious coping strategies (RCOPE) could affect QoL in distressing situations. The present study aimed to assess the association between the RCOPE of infertile people with their own QoL and that of their spouses’.
This cross‑sectional study was conducted among 200 infertile couples referring to Infertility Center of Qom, Iran in 2015. The data was collected using three questionnaires including Brief RCOPE scale, Short Form Health Survey, and a demographic questionnaire. p value of ≤0.05 was considered as significant level.
Multivariate analysis showed relationship between wives’ RCOPE‑N with their own QoL (β = −1.31, p In summary, we could not find an obvious and significant relationship between RCOPE of each spouse with QoL of the other spouse in infertile couples. Hence, further investigations with more participants of various religions are recommended.

Domestic violence (DV) can threaten women’s health. Healthcare providers (HCPs) may be the first to come into contact with a victim of DV. Their appropriate performance regarding a DV victim can decrease its complications. The aim of the present study was to investigate HCPs’ performance regarding women experiencing DV in emergency and maternity wards of hospitals in Isfahan, Iran.
The present descriptive, cross‑sectional study was conducted among 300 HCPs working in emergency and maternity wards in hospitals in Isfahan. The participants were selected using quota random sampling from February to May 2016. A researcher‑made questionnaire containing the five items of HCPs performance regarding DV (assessment, intervention, documentation, reference, and follow‑up) was used to collect data. The reliability and validity of the questionnaire were confirmed, and the collected data were analyzed using SPSS software. Cronbach’s alpha was used to assess the reliability of the questionnaires. To present a general description of the data (variables, mean, and standard deviation), the table of frequencies was designed.
The performance of the participants regarding DV in the assessment (mean = 64.22), intervention (mean = 68.55), and reference stages (mean = 68.32) were average. However, in the documentation (mean = 72.55) and follow‑up stages (mean = 23.10), their performance was good and weak respectively (criterion from 100).
Based on the results, because of defects in providing services for women experiencing DV, a practical indigenous guideline should be provided to treat and support these women.

Traumatic brain injury (TBI) is a main health problem among communities. There exists a variety of effective factors on the outcome of patients with TBI. We describe the demographic, clinical, and injury related variables of the patients with severe TBI, and determine the predictors of outcome.
We did this cross‑sectional study on all 267 adult patients with severe TBI admitted to three trauma centers of Isfahan University of Medical Sciences (IUMS) from March 20, 2014 to March 19, 2015. Data were extracted from patients’ profiles. We considered the patients’ outcome as discharged and died. We analyzed the collected data using descriptive (frequency, mean, and standard deviation) and analytical (independent t‑test, Mann– Whitney U‑test, Kruskal–Wallis test and logistic regression) statistics in Statistical Package for the Social Sciences (SPSS) 16.0. We considered p The mean (SD) age of patients was 43.86 (18.40) years. The majority of the population was men (87.27%). Road traffic accidents (RTAs) were the most common mechanism of trauma (79.40%). The mean (SD) of Glasgow coma scale (GCS) was 6.03 (3.11). In 50.19% of the patients, the pupillary reflex was absent. One hundred and twenty‑four patients (46.44%) died before discharge. We found age, gender, GCS, pupillary reflex, hypernatremia, and increased intracranial pressure (IICP) as the predictors of death in severe TBI.
In this study, the mortality rate of patients with severe TBI was high. In addition, some factors were determined as the significant predictors of outcome. The findings can assist in planning to enhance the quality of care and reduce the mortality rate in the patients with severe TBI.

Fundamentals of nursing course are prerequisite to providing comprehensive nursing care. Despite development of technology on nursing education, effectiveness of using e‑learning methods in fundamentals of nursing course is unclear in clinical skills laboratory for nursing students. The aim of this study was to compare the effect of blended learning (combining e‑learning with traditional learning methods) with traditional learning alone on nursing students’ scores.
A two‑group post‑test experimental study was administered from February 2014 to February 2015. Two groups of nursing students who were taking the fundamentals of nursing course in Iran were compared. Sixty nursing students were selected as control group (just traditional learning methods) and experimental group (combining e‑learning with traditional learning methods) for two consecutive semesters. Both groups participated in Objective Structured Clinical Examination (OSCE) and were evaluated in the same way using a prepared checklist and questionnaire of satisfaction. Statistical analysis was conducted through SPSS software version 16.
Findings of this study reflected that mean of midterm (t = 2.00, p = 0.04) and final score (t = 2.50, p = 0.01) of the intervention group (combining e‑learning with traditional learning methods) were significantly higher than the control group (traditional learning methods). The satisfaction of male students in intervention group was higher than in females (t = 2.60, p = 0.01).
Based on the findings, this study suggests that the use of combining traditional learning methods with e‑learning methods such as applying educational website and interactive online resources for fundamentals of nursing course instruction can be an effective supplement for improving nursing students’ clinical skills.

Gestational diabetes is one of the most common health problems in pregnancy that requires participation through self‑care to reduce the maternal and neonatal complications. The present study aimed to determine the needs of women as an essential first step to formulate a self‑care guide fitting the Iranian culture.
The present qualitative study was conducted through interviews with 13 diabetic pregnant women and 10 care providers using semi‑structured questionnaires in several cities of Iran in 2016. Further, the data analysis was performed using conventional content analysis. In addition, purposive sampling was performed at the diabetes clinic of Kermanshah University of Medical Sciences, Imam Reza Hospital, and health centers across Kermanshah, Shahroud, and Tehran.
In the present qualitative content analysis study, four themes were identified: awareness and ability (knowing diabetes, mothers training and empowerment, continuity and quality, information resources), lifestyle (healthy diet, physical activity), mental health (counseling, interaction, spirituality, and religion), and supportive family (the husband’s unique role, the psychological atmosphere at home).
The present study highlighted main aspects of self‑care educational/supportive needs, specifically in the domains of lifestyle, awareness and capability, mental health, and family. The results of our analysis highlighted the needs that can be useful for developing comprehensive self‑care educational programs, with a higher focus on physical activity, mental health, the role of the family, and the use of religious interests.

Nursing adverse events (AEs) are well‑defined problems in the healthcare system and may have irreparable consequences. Due to the complexity of care, many factors contribute to AEs and affect patient safety, one of which is occupational stress. The present study aimed to determine the relationship between nursing AEs and occupational stress in nurses in centers affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, in 2015.
In this descriptive correlational study, the participants were selected through random and quota sampling methods. The data collection tool was a three‑part questionnaires consisting of a demographic characteristics form, the Nurses’ Job Stress Questionnaire, and Nursing Adverse Events Questionnaire. Descriptive and analytical statistics were used to analyze the data in Statistical Package for the Social Sciences software.
Among the four factors affecting occupational stress in nurses, administrative factors had the highest impact; subsequently followed, by environmental factors and interpersonal factors. The mean score of AEs was reported as 30 cases per year. There was a significant correlation between the overall mean score of occupational stress and AEs (r = 0.12, p = 0.04).
According to the results of this study, moderate to high levels of job stress were observed among nurses. The results also showed that occupational stress can lead to nursing AEs. Given that nurses believe the highest mean of occupational stressors is related to administrative factors, an appropriate and comprehensive leadership is necessary to improve the current conditions.

Numerous empirical evidences have shown that social and environmental circumstances and social relations have an important impact on pregnancy outcomes, women’s ability to cope with stressful situations, and childbirth pain management. The present study was conducted to determine the relationship between perceived social support and fear of childbirth.
The present descriptive correlational study was conducted on 270 nulliparous pregnant women who referred for pregnancy care in 2016. The subjects were selected through convenience sampling method. The data collection tools were a demographic characteristics form, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Wijma Delivery Expectancy/Experience Questionnaire (W‑DEQ). The collected data were analyzed using descriptive and inferential statistics tests.
The mean perceived social support score of the participants was 77.90 and a significant correlation was observed between the perceived social support score and fear of childbirth score (β = −0.18, p = 0.004). The participants’ mean score of fear of childbirth was 36.8. The results of study after the evaluation of the effect of predictive variables on the fear of childbirth are as follows: pregnancy preparation classes: (β = 3.50, p = 0.220); observation of natural childbirth videos: (β = 5.26, p = 0.040); and use of educational software: (β =5.82, p = 0.080).
In order to reduce the fear of childbirth, women’s social support structure during pregnancy should be assessed. Moreover, demographic characteristics form the structure and determine the extent of individuals’ social network and, through the evaluation of these characteristics during pregnancy, the rate of effective support can be predicted in individuals.