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Community Based Nursing and Midwifery - Volume:4 Issue: 4, Oct 2016

International Journal of Community Based Nursing and Midwifery
Volume:4 Issue: 4, Oct 2016

  • تاریخ انتشار: 1395/08/03
  • تعداد عناوین: 11
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  • Fahimeh Jafari, Mohsen Shahriari *, Fakhri Sabouhi, Alireza Khosravi Farsani, Maryam Eghbali Babadi Pages 286-296
    Background
    Lack of knowledge, attitude and practice are some of the barriers of having a healthy lifestyle and controlling high blood pressure. This study aimed to determine the effectiveness of a lifestyle modification program on knowledge, attitude and practice of hypertensive patients with angioplasty.
    Methods
    This study was a randomized controlled clinical trial conducted from November to April 2014 on 60 hypertensive patients with angioplasty in Shahid Chamran hospital of Isfahan, Iran. The samples were randomly assigned to two equal groups. Data collection was performed in three stages by a researcher-made questionnaire. The intervention plan was 6 education sessions and then follow up were done by phone call. The gathered data were analyzed via SPSS (V.20), using t-test, Chi-square, repeated measurement, and post hoc LSD test and ANOVA statistics.
    Results
    The mean score of knowledge, attitude and practice in the experimental group immediately after the intervention was 77.8±7.2, 88.3±6.4 and 86.2±6.5, respectively and one month after the intervention was 80.8±7.4, 91.1±3.5 and 92.5±2.2, respectively. But in the control group, the mean score of knowledge, attitude and practice immediately after the intervention (34.90±11.23, 61.11±6.28, and 38.64±7.15) and one month after the intervention was (38.64±7.15, 59.56±6.31 and 37.27±7.26.
    Conclusion
    Lifestyle modification program can be effective in promoting the knowledge, attitude and practice of hypertensive patients with angioplasty. Nurses can use this program in their care provision programs for these patients.
    Keywords: Attitude, Hypertension, Knowledge, Lifestyle, Practice
  • Elham Zare, Masoumeh Simbar*, Zohreh Shahhosseini, Hamid Alavi Majd Pages 297-308
    Background
    Given the importance of adolescents’ health in establishing health in the newly thriving generation of every society, the first step for adolescents’ health promotion is health needs assessment. The present study was, therefore, conducted to design a valid and reliable scale for health needs assessment of male adolescents.
    Methods
    This is an exploratory sequential mixed method study (2014-2015). The qualitative part was performed using content analysis approach and aimed to generate items pool. Data collection was performed by 7 focus group discussions with 51 male adolescents, and 10 semi-structured in-depth interviews with 10 other adolescents. Nine further in-depth interviews were also performed with 9 key informants. Purposive sampling was used and continued until data saturation. In the quantitative part, the designed scale was psychometrically assessed through the examination of the face and content validities using qualitative and quantitative methods and also the construct validity using the exploratory factor analysis along with the tool’s internal consistency and stability.
    Results
    The content analysis of the data from the qualitative part led to the extraction of 4 main themes and 103 items, which moved to the quantitative stage. The mean content validity index of the scale was estimated 0.91 and content validity ratio was 0.89. The exploratory factor analysis showed 4 factors for the designed scale (49 items), including physical, psychological, social and sexual health needs. The internal consistency and the stability assessment of the scale showed 0.79 and 0.89, respectively. (P
    Conclusion
    According to the psychometric assessment, MAHNAS is a valid and reliable scale compatible with the Iranian culture that can be used in the health needs assessment of male adolescents.
    Keywords: Health, Needs assessment, Adolescents, Scale
  • Masoume Rambod, Farkhondeh Sharif*, Zahra Molazem, Kate Khair Pages 309-319
    Background
    Pain, as a crucial subsequence of joint hemorrhages in hemophilia patients, is chronic, debilitating, and distracting. This study aimed to describe and interpret pain experiences of hemophilia patients in their lives.
    Methods
    This qualitative study with hermeneutic phenomenological approach was conducted on fourteen hemophilia patients who had been referred to a hemophilia center affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The study question was “what is the meaning of pain in hemophilia patients’ lives? The data were collected through semi-structured interviews and field notes through purposeful sampling. Then, thematic analysis with van Manen’s six-step methodological framework was used. MAX.QDA qualitative software package, 2010, was used to analyze the data.
    Results
    The three main themes that emerged in this study were “alteration in physical health”, “engagement in psychological problems”, and “impairment in social relationships”. Alteration in physical health consisted of three subthemes, namely “impairment of physical function”, “change in body physics”, and “disturbance in sleep quality”. In addition, two subthemes including “nostalgia of pain in adults with hemophilia” and “psychological distress” emerged from engagement in psychological problems. Finally, “loss of social activity” and “change in relationships” were related to impairment in social relationships.
    Conclusion
    The present study highlighted alteration in physical health, engagement in psychological problems, and impairment in social relationship as a result of pain in hemophilia patients. Thus, healthcare providers and family members have to pay special attention to these problems. Besides, providing complementary therapy interventions is suggested for reducing these issues.
    Keywords: Experience, Hemophilia, Pain, Qualitative research
  • Samira Abbasi, Nasrollah Alimohammadi, Saeid Pahlavanzadeh* Pages 320-328
    Background
    Multiple sclerosis is accompanied by secondary clinical signs such as insomnia. Considering the side effects of drugs and also increasing acceptability of psychotherapy methods in health systems, we aimed to determine the effect of group cognitive behavioral therapy on the quality of sleep in women with multiple sclerosis in 2014.
    Methods
    This study is a randomized controlled clinical conducted on 72 women with multiple sclerosis who referred to medical centers of Isfahan. After convenience sampling, participants were randomly allocated into two equal groups of control (n=36) and intervention (n=36). In the intervention group, cognitive behavioral therapy was performed in 8 sessions. The control group, along with receiving the common drugs, participated in 3 group sessions and talked about their feelings and experiences. Data were gathered using Pittsburgh Sleep Quality Index (PSQI) and analyzed through independent t-test, Chi-square, Mann Whitney, ANOVA with repeated measure, using SPSS 18.
    Results
    There was a significant difference between the mean score of sleep quality of the control and intervention groups immediately and one month after the intervention (P
    Conclusions
    According to the results of this study, cognitive behavioral therapy, as an effective and cost-effective therapy, could improve sleep quality in patients with multiple sclerosis.
    Keywords: Sleep disorders, Cognitive behavioral therapy, Multiple sclerosis
  • Zahra Aslani, Nasrollah Alimohammadi *, Fariba Taleghani, Parvaneh Khorasani Pages 329-338
    Background
    Self-care needs are major problems among stroke patients. Nurses can support them through interventions such as education, a change in their attitude and emphasis on their remaining abilities. However, research has shown some weak points in the quality of care given to these patients. So the aim of this study was to improve the nurses’ practice in self-care education to stroke patients.
    Methods
    This is a participatory action research, conducted in internal neurology ward of Al-Zahra hospital in Isfahan, Iran during 2013-2014 in five stages of diagnosis, planning, action, reflection and evaluation. Participants comprised 27 nursing personnel including staff nurses, matrons, educational supervisors and the staff in charge of Nurse Educators’ Al_Zahra Role Expansion Action Research (NEAREAR) project. In the evaluation stage, data were collected from five personal interviews and two focus group discussions and analyzed by qualitative content analysis.
    Results
    The findings of evaluation phase showed that during action research, approaching the nurses’ empowerment in self-care education to stroke patients has been set in motion. The nursing practice improvement, knowledge based practice, nurses’ attitude change, ability to respond against routinization, and motivation promotion emphasize the success of change process. Facilitators and barriers of educating patients are acknowledged by the participants as a factor influencing the continuation of change.
    Conclusions
    The lack of nurses’ educating performance skills was overcome using action research and changes were made to improve the performance of nurses.
    Keywords: Action research, Empowerment, Nursing, Self, care, Stroke
  • Ali Taghipour, Narjes Sadat Borghei *, Robab Latifnejad Roudsari, Afsaneh Keramat, Hadi Jabbari Nooghabi Pages 339-351
    Background
    Women’s empowerment programs during pregnancy focus primarily on increasing women’s health goals and psychological empowerment has been considered important in most issues related to pregnant mothers’ mental health. Using path analysis, this study aims to examine the direct and indirect components of psychological empowerment of pregnant mothers.
    Methods
    This model-testing study was conducted in Gorgan, northwest of Iran during three months in spring of 2015. Through random cluster sampling, a total number of 160 pregnant women were selected from 10 urban medical centers and clinics as primary centers. We used Spritzer’s Psychological empowerment scale. Suitable sampling based on Nunally and Bernstein was followed in the model. The relationships between the dependent variables were then examined by means of path analysis using Amos 18.
    Results
    The psychological empowerment of pregnant mothers (PEPW) model is impacted by individual factors, such as marriage age and employment, including some subjectively rated factors such as marital satisfaction and experience of violence. The PEPW model was deemed appropriate as optimum conditions indicators of goodness of fit; low index of χ2/df shows little difference between the conceptual model and observed data, while RMSEA value indicated the goodness of fit. Other indicators such as CMIN=0.957, CMIN/DF=0.957, P-CLOSE=0.418, χ2=0.957 and probability level=0.328 the fact that the model is ideal. The mothers’ employment had the highest coefficient in the PEPW path model .731 (0.443, 0.965) bootstrap confidence intervals by 95%, and with a p-value of less than 0.05.
    Conclusions
    The mothers’ employment is the most important factor in psychological empowerment, but it cannot be addressed quickly. Programming to increase marital satisfaction followed by a decrease in family violence and prevention of early marriage are necessary for promotion of psychological empowerment during pregnancy.
    Keywords: Power (Psychology), Pregnancy, Health, Statistical models
  • Heidarali Abedi, Abbas Abbaszadeh, Minoo Motaghi* Pages 352-362
    Background
    Students’ health and future health of the community are related to providing health care in schools and since in every society, different contextual factors affect this matter, the present study aims to recognize the factors influencing the health care elementary students are provided with.
    Methods
    This qualitative content analysis was performed in 2014 in Isfahan. This study was conducted on school health instructors of elementary schools. Through targeted sampling, 15 health care providers, two mothers and 3 principals from 23 elementary schools were selected. Twenty-two semi-structured interviews were performed. Qualitative data analysis was done using qualitative content analysis.
    Results
    In this study, 3 concepts were extracted: family umbrella over health (with two sub-categories of ‘family’s social status and its effect on health’ and ‘family and health’), functional resources (with two sub-categories of ‘opportunity’, ‘availability of resources for diagnosis’) and health components (with two sub-categories of ‘culture’, ‘the value of school health’). These contextual factors must be considered in providing health care for schools.
    Conclusions
    Consideration of effective contextual factors on providing elementary students with health care can help improve health for this group.
    Keywords: School health, Primary schools, Content analysis
  • Elham Azmoude, Mahbobe Firoozi *, Elahe Sadeghi Sahebzad, Neghar Asgharipour Pages 363-373
    Background
    Evidence indicates that sexual assertiveness is one of the important factors affecting sexual satisfaction. According to some studies, traditional gender norms conflict with women’s capability in expressing sexual desires. This study examined the relationship between gender roles and sexual assertiveness in married women in Mashhad, Iran.
    Methods
    This cross-sectional study was conducted on 120 women who referred to Mashhad health centers through convenient sampling in 2014-15. Data were collected using Bem Sex Role Inventory (BSRI) and Hulbert index of sexual assertiveness. Data were analyzed using SPSS 16 by Pearson and Spearman’s correlation tests and linear Regression Analysis.
    Results
    The mean scores of sexual assertiveness was 54.93±13.20. According to the findings, there was non-significant correlation between Femininity and masculinity score with sexual assertiveness (P=0.069 and P=0.080 respectively). Linear regression analysis indicated that among the predictor variables, only Sexual function satisfaction was identified as the sexual assertiveness summary predictor variables (P=0.001).
    Conclusion
    Based on the results, sexual assertiveness in married women does not comply with gender role, but it is related to Sexual function satisfaction. So, counseling psychologists need to consider this variable when designing intervention programs for modifying sexual assertiveness and find other variables that affect sexual assertiveness.
    Keywords: Femininity, Masculinity: Gender identity, Sexual behavior
  • Sakinne Sabzevari, Monirsadat Nematollahi *, Tayebeh Mirzaei Pages 374-385
    Background
    Mothers play a key role in caring for their sick children. Their experiences of care were influenced by culture, rules, and the system of health and care services. There are few studies on maternal care of children with congenital heart disease. Also, each of them has studied a particular aspect of care. The present research aimed to understand care experiences of mothers of children with congenital heart disease.
    Methods
    A conventional content analysis was used to obtain rich data. The goal of content analysis is “to provide knowledge and deeper understanding of the phenomenon under the study”.
    The study was conducted in Kerman, Iran in 2014, on mothers of children with CHD. The purposive sampling technique was used to select the participants. Participants were 14 mothers of children with CHD and one father and one nurse of open heart surgery unit, from two hospitals affiliated with Kerman University of Medical Sciences. Eighteen semi-structured interviews were constructed. Data were analyzed using conventional content analysis. MAXQDA 2007 software (VERBI GmbH, Berlin, Germany) was used to classify and manage the coding. Constant comparative method was done for data analysis. The reliability and validity of the findings, including the credibility, confirm ability, dependability, and transferability, were assessed.
    Results
    According to the content analysis, the main theme was the catastrophic burden of child care on mothers that included three categories: 1) the tension resulting from the disease, 2) involvement with internal thoughts, and 3) difficulties of care process
    Conclusion
    The results of this study may help health care professionals to provide supportive and educational packages to the patients, mothers and Family members until improving the management of patient’s care.
    Keywords: Congenital heart disease, Qualitative study, Family, Iran: Burden of care
  • Manijeh Nourian, Farahnaz Mohammadi Shahboulaghi *, Kian Nourozi Tabrizi, Maryam Rassouli, Akbar Biglarrian Pages 386-396
    Background
    Resilience is a quality that affects an individual’s ability to cope with tension. The present study was conducted to determine resilience and its contributing factors in high-risk adolescents living in residential care facilities affiliated to Tehran Welfare Organization in order to help develop effective preventive measures for them.
    Methods
    The present descriptive study was conducted on 223 adolescents living in 15 different governmental residential care centers in 2014. Participants were selected through convenience sampling. The data required were collected via the Wagnild and Young Resilience Scale with content validity (S-CVI=0.92) and a reliability of α=0.77 and r=0.83 (P
    Results
    The adolescents’ mean score of resilience was 84.41±11.01. The level of resilience was moderate in 46.2% of the participants and was significantly higher in the female than in the male adolescents (P=0.006); moreover, the score obtained was lower in primary school children as compared to middle school and high school students (P
    Conclusion
    Directors of care facilities and residential care personnel should adopt preventive resilience-based strategies in order to optimize resilience among adolescents, particularly the male. It is important to provide a basis to prevent adolescents’ academic failure and place a stronger value on education than the past.
    Keywords: Resilience, Adolescents, Residential care facilities