سیما خاوندی زاده اقدم

 Stress is a psychological pressure that affects an individual's physical health, including skin health. Skin disorders can also exacerbate stress, creating a vicious cycle in which stress and skin diseases reinforce each other. The aim of this study was to determine the level of stress in patients with fungal skin infections and compare it with healthy individuals.

 This descriptive-analytical study was conducted with the participation of 152 patients with fungal skin infections referred to Ardabil medical centers and 148 of their companions as a healthy group in 2023. The sampling method was available sample. A total of 300 individuals were selected through convenience sampling. The Perceived Stress Scale by Cohen was used to assess stress levels. After completing the questionnaires by both groups, perceived positive and negative stress levels were evaluated. Data were analyzed using the independent t-test and SPSS Statistics for Windows, version 26.0 (SPSS Inc., Chicago, Ill., USA).

 A total of 152 volunteers with fungal infections, including 108 women and 44 men, aged 18 to 48, and 148 healthy volunteers, including 76 women and 72 men, participated in the study. The mean (SD) age of the patient group was 31.5 (5.0) and the healthy group was 31.2 (6.6) years. In the patient group, the mean (SD) of perceived negative stress was 23.6 (0.3) higher than in the healthy group 22.8 (0.2) (P=0.01). There was no difference in the level of perceived positive stress between the healthy 17.0 (3.8) and the patient 16.7 (5.4) groups.

 The level of negative perceived stress was higher in patients with fungal skin infections compared to healthy individuals. Psychological interventions aimed at training patients in perceived stress management appear to be necessary.

Pregnancy and delivery are of nature wonderful phenomenon that should be done with natural process without intervention. This study was performed with aim to evaluate the effects of prenatal preparation classes on labor pain intensity, mother's satisfaction of delivery experience, and some outcomes of normal vaginal delivery in nulliparous women.

This quasi-experimental interventional study was done in 2022-2023 on 100 nulliparous women who were admitted in Sabalan hospital of Ardabil city for prenatal care and delivery from January to April of 2023. The samples were placed in two groups of receiving training and control (n=50 per group). Data collection tool was questionnaire. The group receiving training participated in prenatal preparation classes and the control group received pregnancy usual care. Then labor pain intensity after start of labor pain and at the end of first stage of labor, and at the end of second stage, need for episiotomy and prineal laceration, and need for oxytocin during labor were recorded. Immediately after delivery, first minute Apgar score and mother's satisfaction of delivery, and ultimately one hour after delivery, initiation of breast feeding were investigated and recorded by the researcher. The data were analyzed by SPSS software (version 26), Chi-square, t-test, Mann-Whitney U and Fisher tests. P<0.05 was considered statistically significant.

Prenatal educations significantly reduced labor pain intensity, need for episiotomy, prineal laceration, need for augmentation with oxyto cin (P<0.001) and also increased mother's satisfaction of delivery experience, first minute Apgar score and early onset of breast feeding (P<0.001).

The prenatal preparation classes have many positive outcomes; therefore, it is suggested to be used more seriously and widely in all pregnancy and childbirth care centers.

The purpose of this research was to evaluate the effectiveness of self-compassion training on the resilience and quality of life of mothers with mentally retarded children.

The current research was practical in terms of purpose. The research method was experimental with a pre-test-post-test design in two groups. The statistical population of the research was mothers with mentally retarded children in Ardabil city in 1401 and also, the availability sampling method was used. Among the qualified volunteers, 100 people entered the study and were randomly replaced in two groups of 50 people (self-compassion training and control). The self-compassion training group received eight 90-minute sessions. Standard questionnaires on resilience and quality of life were used to collect information. The data collected in the pre-test and post-test stages were analyzed by multivariate analysis of covariance using SPSS version 26 statistical software.

The findings of the present study showed, there is a significant difference between the control and experiment (p<0.01) groups in the post-test scores in terms of perception of individual competence (F=441.15), trust in individual instincts and tolerance of negative emotions (F=423.05), positive acceptance of change and secure relationships (F=399.82), control (F=261.60) and spiritual effects (F=241.62) variables. Also, in respect of individual physical health (F=66.60), mental health (F=157.29), social relations (F=146.62) and environmental health (F=135.45) variables in the post-test scores, there is a significant difference between control and experiment (p<0.01) groups.

Therefore, it can be concluded that self-compassion training has a positive effect on the dimensions of the resilience of mothers with mentally retarded children and improves individual competence, trust in individual instincts and tolerance of negative emotions, positive acceptance of change and safe relationships, control and spiritual effects. Also, self-compassion training has a positive effect on the dimensions of the quality of life of mothers with mentally retarded children and improves individual physical health, mental health, social relationships and environmental health.

  Childbirth is a physiological process that must be accomplished without any interventions. The main objective of this study was to evaluate the effects of prenatal preparation classes on the duration of labor and delivery type in primiparous women. This clinical trial was conducted on 100 primiparous women referring to the Sabalan Hospital in Ardabil, Iran, for prenatal care and delivery in 2017. The subjects were randomly assigned into two groups of intervention (n=50) and control (n=50). The intervention group participated in childbirth preparation classes (from 20th to 37th weeks of gestation) for eight 2-hour sessions implemented biweekly by a midwife. The control group received only usual pregnancy care. Trainings in the intervention group included the anatomy and physiology of women's genital organ, modifiable activity during pregnancy, personal health, abdominal breathing, nutrition, high-risk pregnancy, mental health, types of delivery, postpartum problems, newborn, and breastfeeding. After the initiation of labor, the duration of active phase, second stage of labor, and method of delivery were recorded by the researcher for both groups. The data were analyzed in SPSS software (version 18) using t-test, Chi-square, and Fisher’s exact test. P-value less than 0.05 was considered statistically significant. The results of the study showed that the prenatal preparation classes reduced the duration of delivery (P<0.001) and rate of cesarean section (P=0/023). Prenatal preparation classes led to the reduction of labor duration and rate of cesarean section. Therefore, it is suggested to implement these preparation classes at a wider scope in prenatal care centers.

Period of menopause is known as a time of disorders or changes in such women’s bodies. However, these women dont know what these changes exactly are and how they can decrease this changes and disorders. This study mainly aimed at evaluating the effect of education on life style in menopausal women.
This is a quasi-experimental study accomplished on 75 menopausal women of 50-60 years old referred to Sabalan hospital in Ardabil (easren Iran). A questionnaire of two parts was used to gather the necessary data. At first, the researcher invited menopausal women, and filled out their questionnaires through hearing their answers, then divided them into 5 groups of 15 members, and finally completed the pretest. Afterwards, the researcher trained every group in 8 sessions of one hour and a half for 8 weeks. After 8 weeks from finishing of training sessions, the researcher performed the posttest using the same questionnaire by interviewing. At the end, the data were analyzed by SPSS software (12 version), T kandal, and Mc Namar tests. Range of P value was less than 0/05.
Findings: The results of this study showed that education is positively effective on the habits of nutrition, exercise, walking, and exposure to sun light, leisure time, and sleeping.
Discussion & Education affect women manner to improve life style in menopausal period and it can cause promotion of women’s health.

Labor is one of the most important events in the lives of women، therefore، the factors that reduce the pain and duration of delivery with minimal interference have been always considered by the researchers. Since the presence of a trained attendant midwife (doula) beside the partituate may facilitate the uterus blood flow and contractile activity through reducing maternal anxiety، this study was performed with aim to determinethe effect of continuous care by trained doula on delivery length. This clinical randomized trial was performed on 80primigravida women referred to Alavi Hospital of Ardabil for delivery and were hospitalized in 2014. 40 women in control group (without attendant) received routine obstetrics care in the delivery room and 40 cases in intervention group (with attendant) in addition to routine care of delivery room were supported by a trained midwife. Data collection tools included the questionnaire of demographic characteristics، the standard timer، the form of recording the duration of the active phase and the second phase of labor. Data was analyzed by SPSS software (version 16) and Independent t-test، Chi square and Exact Fisher test. P<0. 05 was considered significant. Independent t-test results showed that mean duration of the active phase of labor was significantly different in the intervention and control groups (P<0. 001). Also، mean duration of the second stage of labor in the two groups showed a statistically significant difference (P<0. 001) that indicates the effect of presence of doula on reducing the duration of first and second stages of labor in the intervention group. The support of a trained attendant midwife doula beside the partituate reduces the duration of labor، and this has a positive effect on relations between mother and baby without substantial interference of doula in midwifery and medical care. Therefore، it is recommended to use this method for the support of partituate and increase the positive experiences of labor and reduce maternal and neonatal complications in patients following reducing the duration of labor.

Length of delivery and labor pain، are the factors that can affect on maternal and neonatal outcomes. Doctors and researchers believe that safe and secure methods which have no complications for mother and fetus should be used to decrease the duration and severity of labor pain. Since، no fetal and maternal complication was observed in usage of non-pharmacological methods. This study was done aimed to evaluate the effects of massage on pain and length of delivery in nulliparous women. This quasi-experimental study was conducted on 100 nulliparous women who were admitted in social security hospital of Ardabil، Iran for delivery in 2013. 50 women were located in case group (massage was done from the end of sacrum vertebral to Lumbar vertebral) and 50 women in control group (without massage). The massage group received massage during contractions and in cervical dilatation of 4، 6، 8 and 10 cm for 30 minutes. Then، pain intensity at the end of the second stage، duration of active phase and the second stage of labor were recorded in two groups. Data were analyzed using SPSS software version 12، chi-square، t-test and Mann-Whitney tests. P value less than 0. 05 was considered significant. Massage reduced the intensity of labor pain (p<0. 001) and length of the first stage of labor (p<0. 001). Massage during labor reduces length of delivery and intensity of labor pain، and could be use as a safe and easy method without any side effects.

Different studies have emphasized the effects of the acupressure on labor and delivery، so its effects are as important as medical and midwifery factors. This study was aimed to evaluate the effects of the acupressure at Hugo point on the process and outcome of labor in nulliparous women. This quasi- experimental study was held on 100 nulliparous women who were admitted in Social Security Hospital of Ardabil city for delivery from October to March of 2010. 50 women were located in the case group (acupressure group) and 50 women in the control group (placebo group). The acupressure group received acupressure at Hugo point (between the thumb and index finger) but placebo group received acupressure at points other than Hugo point on two hands. This intervention was performed during contractions and in 4، 6، 8 and 10 cm cervical dilatation for 20 minutes. Then، duration of active phase، the second stage of labor، need for oxytocin during labor، labor pain intensity at the end of the first and second stage of delivery، Apgar score of neonates at first and fifth minutes، kind of delivery، mothers'' satisfaction of delivery experiences، and onset of breast feeding were recorded. The gathered data were analyzed by SPSS statistical software version 12، chi-Square، T، and Mann Whitney tests. P value less than 0. 05was considered statistically significant. The results of the study showed that acupressure at Hugo point reduced the length of delivery (p<0. 001)، need for augmentation with oxytocin (p<0. 001)، labor-pain intensity at the end of first and second stage (p<0. 001)، cesarean section (p=0. 026)، significantly increased mothers'' satisfaction of delivery experience (p=0. 006)، and early onset of breast feeding (p=0). Duration of second stage (p>0. 05)، Apgar score of first and fifth minutes were not significantly different in two groups (p>0. 05). Acupressure at Hugo point improves many outcomes of labor such as: length of delivery، need for augmentation with oxytocin، labor-pain intensity، cesarean section، mothers'' satisfaction of delivery experience، and breast feeding. Therefore، it can be used in normal deliveries without any complications.

Nausea and Vomiting are the most common disorders of digestive system in the pregnancy. This study was done to evaluate the effects of acupressure in reducing the severity of nausea and the episodes of vomiting in primigravida women (10-16 gestational ages). In this clinical-trial study, 100 primigravida women with nausea and vomiting in gestational age of 10-16 weeks were randomly selected and divided in two groups, 50 women in the acupressure group and 50 women in the placebo group. Age, education, profession, BMI, gestational age, nausea and vomiting were matched in both groups. Treatment lasted for 4 days in both groups. In the acupressure group sea bands were placed on neiguan point on hands but in placebo group sea bands were placed on points other than the neiguan point. Then, daily severity of nausea and vomiting were recorded during treatment period. The data were analyzed by SPSS software (12 versions), Chi-Square, t- test, Mann Whitney and Will Kaksun tests. There was not significant difference in the severity of nausea and frequency of vomiting before treatment in two groups. Severity of nausea and frequency of vomiting decreased significantly after treatment in Acupressure group.(P=0.60 and P=0.55 respectively). This study showed that the acupressure (by sea-bands that is free of side effects and economical) is effective in reducing severity of nausea and frequency of vomiting in pregnancy.

Different studies have been emphasized on the importance of different maternal’ position on labor and delivery. This study wants to investigate the effects of elective position of maternal during active phase on the process and outcome of Labor and delivery in primigravida women. The subjects of this quasi- experimental study were 150 women; 75 women in trail group (allowed to choice their labor’s position as walking, sitting, standing, and other) and 75 women in control group (sleeping in the bed of the pain room). Duration of the first and the second stage of labor, pain intensity of the second stage, Apgar score of the first and fifth minutes, mothers’ satisfaction of delivery experiences, and onset of breast feeding were recorded. The results of the study showed that the elective position of maternal significantly reduced length of active phase (p= 0.002), need for augmentation with oxytocin (p=0.0058), labor' pain intensity (p=0.026), cesarean section (p=0.0393), also significant increase of Apgar’ score in the first minute (p)

Different studies have emphasized the psycho-social aspects of delivery, so that these aspects are no less important than medical and midwifery factors. This is a quasi- experimental study, the main objective of which was to evaluate the effects of the continuous labor support from a supportive companiom on the process and outcome of labor in primigravida. 50 women in supported group (case) and 50 without supporative companion (control) were selected. All women were between 18-30 years, and had term pregnancy, single fetus, cephalic presentatation or spontaneous onset of labor without any complications. The supportive companions were students of midwifery. The support consisted of talking, touching, reassurance, soothing, giving encouragement and physical comfort (e.g, helping to change position, keeping lips wet and cooling). The data were analyzed using student t-test, chi-square and Fisher test. The findings showed that the continuous labor support by a companion reduced length of active phase (p<0.01), cesarean section (p=0.026) and increased APGAR score in the first minute (p=0.015) and led to the early onset of breast feeding (p<0.01). Duration of second labor and fifth-minute Apgar were not significantly different in two groups. This study showed that the continuous labor support can result in better outcomes in deliveries.