فهرست مطالب

Community Based Nursing and Midwifery - Volume:7 Issue: 2, 2019
  • Volume:7 Issue: 2, 2019
  • تاریخ انتشار: 1397/12/20
  • تعداد عناوین: 8
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  • Sedigheh Farzi *, Saba Farzi, Azam Moladoost, Maryam Ehsani, Mohsen Shahriari, Mahin Moinei Pages 89-96
    Background
    Caring role, especially in chronic diseases, has a negative impact on the health of family caregivers and can affect their quality of life. Therefore, this study aimed to investigate the care burden and quality of life in family caregivers of hemodialysis patients and their relationship with some characteristics of caregivers and patients.
    Methods
    This study was conducted as a descriptive-analytic study in Isfahan from January to February 2017. Sampling was done using census. The number of participants was 254. The data gathering tools consisted of a three-part questionnaire including demographic characteristics, the Zarit questionnaire for caring burden, and SF-36 quality of life questionnaire. Data were analyzed using descriptive statistics, Pearson correlation coefficient test, Spearman’s coefficient, ANOVA, and univariate general linear regression. A significant level of 5% was considered.
    Results
    The mean scores of the quality of life and caring burden were 30.54±9.89 and 44.98±6.82, respectively in caregivers. The age of the patient under care (P<0.001), cost of medications (P=0.008), and hours of care in 24 hours (P<0.001) had a significant relationship with care givers’ quality of life. Also, univariate general linear regression revealed that care burden had a significant relationship with the quality of life (P=0.003).
    Conclusion
    Family caregivers who experienced more caring burden had a low quality of life. The researchers suggest that supportive and educational programs should be designed and implemented for this group of patients and their caregivers.
    Keywords: Care burden, Caregivers, Quality of life, Renal dialysis
  • Hamid Sharif Nia_Marzieh Hatef_Kelly A Allen_Vida Shafipour *_Ravanbakhsh Esmaeili Pages 97-108
    Background
    To provide better health care to chronic patients, the use of valid and reliable tools is necessary. This study aimed to assess the psychometric properties of the Persian version of the Chronic Disease Self-Efficacy Scale (CDSES).
    Methods
    In the objective of the present methodological study 401 patients with chronic disease including renal and cardiac disease, diabetes and hypertension were selected by convenience sampling from three hospitals in Mazandaran province in Iran and filled out the CDSES. The 33-item CDSES has three dimensions. The face, content, construct, convergent and discriminant validities of the scale were assessed. Reliability was determined by internal consistency and construct reliability.
    Results
    Based on exploratory factor analysis, a five-factor solution was selected, explaining 55.03% of the total variance. By confirmatory factor analysis, the five-factor solution and the second-order latent factor model were supported. The convergent and discriminant validities of all the factors were acceptable. The reliability of CDSES exceeded α>0.7.
    Conclusion
    The present study results showed that the five-factor construct of CDSES had a suitable validity and reliability; thus, the Persian version of this scale can be used in assessing self-efficacy in chronic patients.
    Keywords: Chronic diseases, Psychometric methods, Reliability, Self-efficacy, Validity
  • Mahsa Alimohammadi, Leila Neisani Samani *, Sedighe Khanjari, Hamid Haghani Pages 109-117
    Background
    Adolescents, as a large group of the world population, face many physical and psychological changes in their puberty period. They struggle with adjusting to the intensive changes that can lead to the development of low self-esteem. This study was conducted to determine the effect of multimedia-based puberty health education on male students’ self-esteem in the middle school.
    Methods
    It is a quasi-experimental study by using multi-stage sampling method which was done on 118 boys from two middle schools in Ilam (an Iranian city) from November 2017 to April 2018. Students were divided into two intervention (N=58) and control (N=60) groups. Then, the intervention group students were trained using a multimedia application. Data were gathered using a demographic questionnaire and Rosenberg’s Self-Esteem Scale completed by students in three phases including before, immediately after, and three months after the end of the educational program. The collected data were analyzed using independent t-test, Chi-square, Fisher’s exact test, post hoc test, and repeated measures ANOVA. Statistical analysis was performed using SPSS 16, and P<0.05 was considered significant.
    Results
    Mean and standard deviation of the self-esteem scores in the intervention and control groups were 28.37±3.58 and 27.89±3.82 before the education, 32.17±3.12 and 27.50±3.56 immediately after the education, and 33.83±3.32 as well as 27.32±4.37 three months later, respectively. Mean self-esteem scores were significantly different post-intervention (P<0.001) and three months later (P<0.001) between the two groups.
    Conclusion
    Education on puberty health assisted by multimedia application can increase self-esteem in adolescent boys.
    Keywords: Adolescent, Health education, Multimedia, Puberty, Self-esteem
  • Naser Lotfi Fatemi, Hossein Karimi Moonaghi *, Abbas Heydari Pages 118-127
    Background
    Home care has gradually become a nursing model for nursing care. The nurses’ experiences of challenges they have in home care have remained unknown. The aim of this study was to explore the hidden aspects of challenges related to home care in Iran.
    Methods
    This study was conducted to explore the challenges of home nursing care using a qualitative content analysis method. Purposeful and snowball sampling methods were used for sampling. The study was conducted from September 2016 to September 2017 in the provinces of Khorasan and Tehran in Iran.  Semi-structured interviews were conducted on 33 nurses who were providing home care. After data saturation, the data were analyzed.
    Results
    The data analysis led to the development of five main categories of “difficult instances “, “economic problems”, “professional barriers”, “social difficulties”, and “bureaucratic tension”.
    Conclusion
    The results of this study showed how nurses faced with a variety of challenges in home care and how they were different from hospitals. Facilitating the nursing processes, supporting home care, and recruiting nurses that had the potential to cope with the existing stressful factors and economic incentives can increase the quality of home care.
    Keywords: Challenges, Home health care, Nursing
  • Parvin Yadollahi, Ziba Taghizadeh *, Abbas Ebadi, Farhad Khormaei Pages 128-137
    Background
    Women’s perceptions of childbirth pain have not been measured adequately. The current study aimed to develop and validate the Iranian Women’s Perception of the Labor Pain Questionnaire.
    Methods
    The study included three phases. In the first phase, women’s perception of labor pain was explored and analyzed using content analysis. Then, an item pool was generated based on the results of the first phase. Lastly, psychometric properties of the scale were evaluated. The reliability and validity of the scale was determined.
    Results
    Findings of the qualitative phase generated a pool of 63 items. The Content Validity Index (CVI) and Content Validity Ratio (CVR) was calculated for each item and they were satisfactory in an acceptable range. After confirming the content and construct validity, 31 items were retained. Finally, the exploratory factor analysis displayed a five-factor structure for this scale. Perception of Labor Pain Questionnaire and subscale scores showed a good test-retest reliability (Interclass Coefficient, 0.96, P<0.001). The Cronbach’s alpha for the Perception of Labor Pain Questionnaire scores was 0.80 and for subscales it ranged from 0.68 to 0.83.
    Conclusion
    This scale developed a multidimensional, valid, and reliable instrument to evaluate the women’s perceptions of labor pain.
    Keywords: Labor pain, Perception, Psychometrics, Questionnaire
  • Negar Yazdani, Farkhondeh Sharif *, Nasrin Elahi, Seyed Vahid Hosseini, Abbas Ebadi Pages 138-149
    Background
    Morbid obesity (body mass index≥40 kg/m2 or >35 kg/m2 with co-morbidity) is an important factor in reducing the quality of life which is influenced by the characteristics of the individual, his social, cultural, and environmental conditions; also, each disease has unique effects on it. Although most of the studies have been conducted on obesity (25>BMI>40), how to prevent it and improve life quality, there is lack of knowledge about what morbid obese people really experience about their life quality. Thus, this qualitative study aimed to explore the viewpoints of morbid obese people about life quality.
    Methods
    In this conventional content analysis, data were collected using semi-structured interviews with 20 morbid obese patients who were referred to nutrition and obesity clinics of Shiraz and Ahvaz Jundishapur University of Medical Sciences. Purposeful sampling was processed from May 2016 to January 2017. The sampling continued until data saturation. Each interview was recorded by audio recorder and typed in the MAXQDA10 software. Data were analyzed after each interview. The meaning units were encoded and the codes were categorized. This trend continued until the main and sub-categories emerged.
    Results
    Data analysis indicated 1835 codes, 76 sub-subcategories, 26 subcategories and 6 main categories including physical changes, psychological experiences, socio-personal dysfunction, negative body image, financial pressure, and change in the spirituality.
    Conclusion
    Final results indicated that life quality had a special definition in morbid obesity and includes very different dimensions. This study can promote health care providers’ knowledge (nurses) for supporting obese people and improving their quality of life by community-based care approaches.
    Keywords: Morbid obesity, Iran, Qualitative study, Quality of life
  • Maryam Rabiee, Zahra Jouhari *, Ashraf Pirasteh Pages 150-160
    Background
    The primary goal of prenatal aneuploidy screening is the early detection of pregnancies at high risk of Down syndrome (DS). The present study aimed to assess the knowledge about the prenatal screening test (PST), DS, and amniotic fluid test (AFT) among Iranian pregnant women.
    Methods
    The present cross-sectional study was conducted from April 2013 to July 2014 in Mostafa Khomeini Educational Hospital, Tehran, Iran. The participants were recruited among pregnant women referred to the Obstetrics and Gynecology Clinic of the hospital for their routine medical evaluations. A total of 471 consecutive women fulfilling the inclusion criteria were enrolled in the study. The data collection instruments included a 9-item socio-demographic information form and a 23-item knowledge questionnaire. The latter included 9 items on DS, 10 items on PST, and 4 items on AFT. The data were analyzed using the SPSS software (version 20.0) with the Kruskal–Wallis and Mann-Whitney tests. P<0.05 was considered statistically significant.
    Results
    The mean score of total knowledge, PST, DS, and AFT was 9.93±4.86, 5.26±2.19, 3.25±2.42, and 1.41±1.39, respectively. There was a significant correlation between the mean score of total knowledge and the age of the mother (P=0.019), gestational age (P=0.001), educational level of the mother and spouse (P=0.001), history of birth abnormality (P=0.03), history of birth abnormality in the family (P=0.02), and sources of information (P=0.001).
    Conclusion
    The results showed that the mean score of knowledge in pregnant women was less than half of the total scores, and total score was related to various parameters. Intervention factors that could contribute to improved knowledge and informed decision-making among pregnant women should be considered.
    Keywords: Amniocentesis, Down syndrome, Pregnancy, Prenatal, Screening
  • Tantut Susanto *, Syahroni Bachtiar, Turwantoko Turwantoko Pages 161-168
    Background
    Public Healthcare Services (PHCs) provide health care activities, including home visits by public health nurses (PHNs), as part of the Indonesian nursing care program. The present study aimed to evaluate the performance of PHNs and the coverage of the nursing care program by CHCs in Jember (East Java, Indonesia).
    Methods
    A cross-sectional study based on secondary analysis, obtained from the Health Department of Jember District (East Java, Indonesia), was conducted in 2016. The data included quality improvement initiatives and outcomes of the nursing care program, which had been collected from 50 CHCs in Jember. The performance of PHNs and the coverage of the nursing care program by CHCs were evaluated based on three categories, namely nursing care for vulnerable families, nursing care for community groups, and family self-care empowerment. The data were analyzed using the SPSS statistical software (version 22.0).
    Results
    The coverage of the nursing care program by PHCs in the category of vulnerable families, community groups, and self-care empowerment was 48.28%, 44.87%, and 49.50%, respectively. The average coverage (low vs. high) by CHCs in the category of vulnerable families, community groups, and self-care empowerment was 50.0% versus 50.0%, 52.0% versus 48.0%, and 52.0% versus 48.0%, respectively. A significant correlation was found between the pre-defined targets and the coverage of the nursing care program by PHCs in vulnerable families (r=0.488; P<0.001), nursing care in communities’ groups (r=0.316; P=0.026), and empowerment of families’ self-care (r=0.531; P<0.001).
    Conclusion
    The results showed that 50% of the CHCs did not meet the required program coverage. The performance of PHN to achieve target of PHCs was correlated with the program coverage of PHCs. The competence of PHNs in providing care to the families and the community, particularly in rural areas, should be improved through an integrated training program.
    Keywords: Community health center, Indonesia, Nursing care, Public health nurse