فهرست مطالب

Community Based Nursing and Midwifery - Volume:6 Issue: 1, 2017
  • Volume:6 Issue: 1, 2017
  • تاریخ انتشار: 1396/10/09
  • تعداد عناوین: 10
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  • Prativa Dhakal, Mangala Shrestha, Dharanidhar Baral, Santosh Pathak Pages 2-11
    Background
    In Nepal, the maternal mortality ratio is 281 per thousand live births, among which 40% mortality occurs during home delivery. Home delivery increases the risk of maternal and neonatal mortality and morbidity due to the birth not assisted by skilled attendant. This study was carried out to determine the factors affecting the place of delivery among the mothers residing in Jhorahat VDC, Morang district, Nepal.
    Methods
    A mixed method study using interviews based on semi-structured questionnaire (n=93) among mothers and two focus group discussion among decision makers of the house and female community health volunteers was conducted between November to December 2012. For quantitative data, Chi-square test and Fischer’s Exact test were used to examine the association between the selected variables and place of delivery.
    Results
    More than half (58.1%) of the mothers had institutional delivery and 41.9% of them had home delivery. The most common reason for home delivery was easy and convenient environment (66.7%) and that for institutional delivery was safety (77.8%). There was a significant association between caste, education of mothers, education of spouse, occupation of spouse, per capita income, time to reach the nearest health center, parity, previous place of delivery, number of antenatal visit, knowledge about place of delivery, planned place of delivery, and place of delivery.
    Conclusion
    Maternal health services, such as prenatal care, skilled assistance during delivery and post-natal care, along with adequately equipped health institutions, play a major role in the reduction of maternal morbidity and mortality. Concerted efforts should be made both at community and government levels to increase institutional delivery.
    Keywords: Antenatal care, Home delivery, Maternal health, Place of birth, Traditional birth attendant
  • Mahboobe Hoseini Moghadam, Iran Jahanbin, Mohammad Ali Nazarinia Pages 12-20
    Background
    Rheumatoid Arthritis (RA) is a chronic and inflammatory disorder which is the major cause of disability in adults. Patient training is a vital aspect of nursing care for people with arthritis aiming to enable them to live as independently as possible. In the present study, we aimed to evaluate the effect of the educational program on self-efficacy on women with rheumatoid arthritis.
    Methods
    This study was an open randomized controlled clinical trial during May to July 2013. Women (64 participants) with confirmed RA and a mean±SD age of 48.6±9.83 years were enrolled; they were randomly assigned into intervention and control groups (32 in each group). The patients in the intervention group participated in a training programs consisting of two 30-minute sessions per week for 8 consecutive weeks. Data were collected by using Arthritis Self-Efficacy Scale (ASES) and demographic questionnaire. ASES questionnaire was filled in three times by the participants: before, immediately after, and three months after the intervention. Data were analyzed using SPSS software, version 20, and statistical tests including Chi-square and t-test.
    Results
    The results showed that the mean of self-efficacy scores of the intervention group, immediately and three months after the intervention, significantly enhanced in all dimensions compared with the control group (P
    Conclusion
    It can be concluded that training programs is effective for improving self-efficacy in the patients suffering from RA by raising their awareness towards their disease and methods of adaptation with it. But as to the sustainability of the impact of educational courses on self-efficacy, it seems that more research is required.
    Keywords: Educational program, Rheumatoid arthritis, Self-efficacy
  • Rajendran Rangasamy Kavitha, Sethuramachandran Kamalam, Ravi Philip Rajkumar Pages 21-28
    Background
    Bipolar Disorder (BD) is a common long standing mental illness which is episodic in nature, affecting approximately1-2% of the world adult population. BD frequently affects the patient’s life. Few studies have examined the functional impairment in patients with affective illness. The main objective of the current study was to assess specific domains of functioning as well as the overall functioning of the clients with BD.
    Methods
    This cross-sectional study aimed to assess the level of function among the clients with BD in JIPMER Hospital, Puducherry during 2015-2016 and to identify the socio- demographic and clinical factors associated with the level of functioning. Ninety clients who fulfilled the inclusion criteria of having the diagnosis of BD were selected after written informed consents were obtained. After collecting basic demographic and clinical variables, function was assessed using 2 different sets of tools LIFE-RIFT and FAST. Data were analyzed using SPSS 20. Independent sample t-test, ANOVA and Pearson correlation were used as different statistical methods. A P value less than .05 was considered as statistically significant.
    Results
    Based on the results, the functional level assessed using LIFE -RIFT showed a mean score of 26.7±4.7for the admitted clients and 21±12.5 for outpatients. The functional level of clients was significantly related to admission and remission status of the clients with a P=0.001 Similarly, FAST scale score for the admitted clients was 51±4.5, clients on remission had 24±12.1 with a P=0.001.
    Conclusion
    Results revealed that even during remission the clients with BD had functional impairment. More interventions are needed to improve the functional ability of clients with BD.
    Keywords: Bipolar disorders, Functional impairment, Function
  • Leili Borimnejad, Soroor Parvizy, Hamid Haghaani, Belgheis Sheibani Pages 29-38
    Background
    Chronic nature of thalassemia causes changes in different aspects of life in patients, including their self-efficacy. The aim of this study was to determine the effect of family-centered empowerment program on the self-efficacy of adolescents with Thalassemia major.
    Methods
    A quasi-experimental study was performed on adolescents with thalassemia major in 2013 in Bandar Abbas, Iran. The participants were divided into intervention and control groups, respectively. Research instruments included demographic data questionnaire, need assessment self-made questionnaire, general self-efficacy scale, and sickle cell self-efficacy scale. After collecting the data from the pre-intervention step, family-centered empowerment program was implemented for the intervention group and secondary test was conducted six weeks after the intervention and the results were analyzed by statistical SPSS-21 software, using independent t-test, paired t-test, Chi-square and Fisher’s exact test, and descriptive statistics. A significance level of P
    Results
    The mean and standard deviation of the adolescents’ age were 16±1.9 in the intervention group and 15.2±2 in the control group. Independent t-test showed a significant difference between the two groups after the intervention for both self-efficacies (P
    Conclusion
    Implementation of family-centered empowerment program for patients with thalassemia major is practically feasible and it can increase self-efficacy in these patients. It is suggested that the program should be used in comprehensive care protocols of children and adolescents.
    Keywords: Family, Self-efficacy, Thalassemia
  • Salma Tavakol Moghadam, Seyed Saeed Najafi, Shahrzad Yektatalab Pages 39-46
    Background
    The role of Emotional Intelligence (EI) in glycemic control in type 2 Diabetes Mellitus (DM) has not been fully understood. The present study aimed to investigate the effect of self-care education on EI and hemoglobin glycosylated (HbA1c) in patients with type 2 diabetes.
    Methods
    In this randomized controlled clinical trial, 48 patients with type 2 DM referred to Shahid Motahari Diabetes Center in 2015 were divided into an intervention and a control group using block randomization. The study data were collected using Bar-On questionnaire and blood testing immediately and two months after the intervention. The educational content was presented to the intervention group through 1-1:30-hour sessions held once a week for 8 continuous weeks. The control group, however, only received the clinic’s routine cares.
    Results
    The results showed a significant difference in the mean level of HbA1c in the intervention group before and two months after the intervention (P=0.003). However, this difference was not significant in the control group. Moreover, the mean of EI was higher in the intervention group compared to the control group (P=0.08).
    Conclusion
    Self-care education improved the HbA1c level and EI among the patients with type 2 DM. Therefore, it is recommended that health care providers, specially nurses, should train the diabetic patients for self-care, which can lead to better glycemic control.
    Keywords: Emotional intelligence_Hemoglobin glycosylated (HbA1c)_Self-care_Type 2 diabetes mellitus
  • Sedigheh Moghasemi, Giti Ozgoli, Fazlollah Ahmadi, Masomeh Simbar Pages 47-55
    Background
    Sexual problems are common among the middle-aged women; however, there is no deep understanding of sexuality in midlife. The current study aimed to investigate Iranian women’s attitudes and experiences about sexual life changes in midlife.
    Methods
    This is a descriptive qualitative study. Seventeen women aged 40 -65 years old were purposively selected from urban health centers in Gorgan, Iran, in 2015. Face-to-face, semi-structured and in-depth interviews were conducted for data collection until data saturation was attained. The resulting data were analyzed based on Graneheim and Lundman’s approach. MAXQDA 10 was used for organization of data.
    Results
    Data analysis demonstrated seventh sub-themes and three themes. The emerged themes were entitled (1) “Continuous paradox over being a sexual agent” with three subthemes of beliefs on asexuality as socially accepted view for women in midlife, changing in motivation for sex and changing in sexual performance, (2) “Considering menopause; opportunities and threats for sexual life” with two subthemes of menopause related cons for sexual life and menopause related pros in sexual life, and (3) “Coping strategies for changes in sexuality in midlife” with two subthemes of different psychological reactions to changes that have influenced the sex and take practical steps for restoration of sexual attraction.
    Conclusion
    The findings demonstrated that middle-aged women in a male-dominant culture encounter paradox over being a sexual agent. In a bio-psycho-social approach, they perceived menopause as an opportunity or threat for their own sexuality. Following the conflicts, threats and changes of sexuality in midlife, they adopt diverse coping strategies to improve their sexual relationships and preserve their family.
    Keywords: Iran, Menopause, Middle-aged, Qualitative research, Sexuality
  • Pakestan Mohammad Amin, Jila Mirlashari, Alireza Nikbakht Nasrabadi Pages 56-64
    Background
    Suicide is a major psychiatric emergency that has always been a topic of great interest to researchers. Self-immolation is a heinous suicide method that is common in Eastern societies. The present study was conducted to explore probable issues which might lead to self-immolation in young Kurdish Iraqi women.
    Methods
    The present qualitative study was conducted in Soran, Erbil Governorate in Iraq, and the surrounding villages of Soran District (March 2015 to May 2016). Using purposive sampling, we conducted 24 in-depth interviews with women who had done self-immolation. The obtained data were analyzed using conventional content analysis.
    Results
    The analysis of the data obtained from the interviews led to the extraction of five categories which seems to be related to self-immolation attempts, including not having control over personal life, marital conflicts, seeking attention, instilling guilt in the family members, and resentment towards male dominant community.
    Conclusion
    Self-immolation is a multidimensional phenomenon that has not come to exist overnight and is rooted in various factors that join to encourage self-immolation attempts by women in critical situations. Comprehensive preventive strategies, such as cultural changes, along with education are required to help lower the rate of self-immolation.
    Keywords: Qualitative study, Self-immolation, Women
  • Shima Chahardah-Cherik, Mahin Gheibizadeh, Simin Jahani, Bahman Cheraghian Pages 65-75
    Background
    Health promoting behaviors are known to be a key factor in managing type 2 diabetes and improving the quality of life in diabetic patients. However, there is little known about the factors influencing these behaviors in diabetic patients. This study aimed to find the relationship between the health literacy and health promoting behaviors in patients with type II diabetes.
    Methods
    This correlational study was conducted from August to September 2016 on 175 eligible diabetic patients (20 to 65 year-old) who referred to the selected centers of diabetes control in Ahvaz City. Patients were chosen using convenience non-probable sampling. Data were collected by diabetic patients’ health promoting behaviors’ questionnaire and health literacy questionnaire. Data were analyzed using SPSS 22, descriptive statistics and Pearson’s correlation coefficient.
    Result
    The mean scores for health promoting behaviors and health literacy were determined 100.45±19.82 and 76.14±15.26, respectively. The highest and lowest scores in health promoting behaviors belonged to nutrition (26.11±6.85) and physical activity (6.70±2.75), respectively. There was a significant relationship between all dimensions of health promoting behaviors and health literacy (P
    Conclusion
    Since health literacy has a positive relationship with health promoting behaviors in diabetic patients, health care providers need to concentrate on increasing the health literacy of their patients rather than solely concentrating on increasing their knowledge, thereby facilitating the development of health promoting behaviors in patients.
    Keywords: Health behaviors_Health literacy_Type 2 diabetes mellitus
  • Maryam Khandan, Farokh Abazari, Batool Tirgari, Mohammad Ali Cheraghi Pages 76-88
    Background
    Following the confirmed type 1 diabetes in children and their discharge from the hospital, the care responsibilities are transferred from nurses to mothers. These mothers are faced with many challenges to play this caring role. The aim of this study was to explore the experiences of the diabetic children’s mothers from the transfer of caring role.
    Methods
    In 2016, semi-structured interviews with Eleven Iranian mothers of children (aged≤14 year) with type 1 diabetes were conducted. Data were analysed using Colizzi’s phenomenological method.
    Results
    The following themes emerged in this study: ‘Facing the care management challenges,’ ‘care in the shadow of concern’, and ‘hard life in the impasse of diabetes’.
    Conclusion
    Them mothers of children with type 1 diabetes, who undertake the caring role that has been transferred to them by healthcare providers, are faced with many challenges. They feel a lot of concerns and experience a hard life. Thus, understanding the experiences of these mothers by the health professionals, to improve the quality of care, is necessary.
    Keywords: Child_Mothers_Qualitative research_Type 1 diabetes
  • Hassan Sharifi, Mohammad Ali Rezaei, Nastaran Heydari Khayat, Neda Mohammadinia Pages 89-98
    Background
    To decrease the readmission rate of heart failure (HF) patients, patients and their caregivers (CGs) should participate in symptoms assessment. This study aimed to assess the agreement between HF patients and their CGs on symptoms assessment.
    Methods
    Using a correlational design, 100 HF patients with their CGs (100 dyads) were recruited from Department of Cardiology, Iranshahr, during August–December 2014. Data were collected using modified Heart Failure Symptom Survey (HFSS).Pearson and intra-class correlation coefficients (ICC) were used to analyze the degree of agreement within HF dyads, using SPSS16. The level of significance was set at 0.05.
    Results
    The most frequent and severe symptom assessed equally by partners was shortness of breath (SOB). Dyads had a good agreement on assessment of extremity swelling (r=0.87, P≤0.01, ICC=0.861 CI: 0.798–0.901), SOB at rest (r=0.83, P≤0.01, ICC=0.775, CI: 0.680-0.845), SOB with activity (r=0.81, P≤0.01, ICC=0.795 CI: 0.711-0.858), and feeling depressed (r=0.77, P≤0.01, ICC=0.769, CI: 0.675–0.838). 28.6% of HF dyad had a good, 50% had a moderate, and 21.4 % had a poor agreement in assessment of HF symptoms.
    Conclusion
    Most of the HF dyad members did not agree with each other on the assessment of symptoms. Knowledge, skills and ability of each dyad in HF symptoms assessment should be included in the patients’ discharge planning and nurses must modify their misunderstanding or inability.
    Keywords: Agreement, Caregiver, Consensus, Heart failure, Symptom assessment