فهرست مطالب

Midwifery & Reproductive health - Volume:7 Issue: 3, 2019
  • Volume:7 Issue: 3, 2019
  • تاریخ انتشار: 1398/04/10
  • تعداد عناوین: 16
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  • Robab Latifnejad Roudsari Pages 1716-1717
  • Zahra Norouzi, Farzaneh Jafarnezhad *, Talat Khadivzadeh, Arya Hedjazi, Habibollah Esmaily Pages 1718-1725
    Background & aim

    Accurate history-taking from sexual assault victims is the basis of correct diagnosis and treatment. Considering the serious consequences of sexual assault and the necessity of students’ training through active educational methods, this study was conducted to compare the effect of standardized patient-based training and team-based learning on the midwifery student’ skill of history-taking from the victims of sexual assault.

    Methods

    This quasi-experimental study was conducted among 75 students of nursing and midwifery in Mashhad University of Medical Sciences, Mashhad, Iran. The subjects were randomly assigned to two groups of standardized patient-based training (38 students) and team-based learning (37 students). After holding a pre-test, each group trained separately for 2 hours. Post-test was held a week post-intervention. Data were collected using a questionnaire containing demographic data, educational profiles, and performance checklist. Data analysis was performed in SPSS software, version 4.

    Results

    The groups were equal regarding demographic, educational, and occupational data. The average score of students’ history-taking skill at the post-intervention phase was 32.0±2.3 and 30.0±4.5 in the standardized patient-based training and team-based learning groups, respectively (P=0.015). There was a significant difference between the groups considering the increase of scores (P=0.039).

    Conclusion

    The impact of using a standardized patient-based training approach on improving the skill of student in history-taking of sexual assault victims was more than team-based learning.

    Keywords: Standardized patient-based, Training, Team-based learning, History-taking, Rape
  • Shahrzad Tavakolipour, Marjan Beigi *, Nafiseh Nekuei, Fariba Shafiei Pages 1726-1731
    Background & aim

    Gestational hypertension is the leading cause of maternal mortality. The most effective ways to prevent this complication are the prediction and prevention of the factors accounting for the incidence of this condition. Regarding this, the present study aimed to investigate the prevalence of gestational hypertension and its associated factors.

    Methods

    This comparative descriptive study was performed on 2,477 pregnant women referred to four secondary and tertiary care hospitals in Isfahan, Iran in 2016 using the census method. Out of 2,477 referral cases, 148 cases were found to be suffering from various types of gestational hypertensive disorders. 200 mothers who had no pregnancy complication were also randomly selected from the 2,477 referral cases. The demographic, clinical, and therapeutic data of these mothers were collected using self-structured questionnaires through making regular visits to the maternity and obstetrics wards of the hospitals under study. Data analysis was performed in SPSS (version 18) using inferential statistical methods, including Chi-square test and independent t-test.

    Results

    The prevalence of hypertension was obtained as 6%, with preeclampsia as the most prevalent type (4.2%). The incidence of gestational hypertension showed a significant relationship with the mean number of prenatal care visits (P=0.01), type of care providers delivering preconception and prenatal care (P=0.01 and P<0.001), underlying diseases (P<0.001), and number of previous abortions (P=0.01). However, there was no significant relationship between the frequency of preconception care visits and this complication (P=0.42).

    Conclusion

    Despite the current policies targeted toward the promotion of maternal health, in the present study, the prevalence of gestational hypertension was notably higher than the rates reported in the literature. Therefore, it is highly recommended to plan for the standardization of referral hospitals and enhancement of care services to prevent this complication.

    Keywords: Gestational hypertension, Preconception care, prenatal care, Prevalence
  • Sharmila Shrestha *, Kumiko Adachi, Marcia A Petrini, Sarita Shrestha Pages 1732-1741
    Background & aim

    Childbirth and motherhood is a rewarding experience. A mother needs to adapt to her new maternal role after childbirth. The aim of the present study was to clarify the defining attributes of maternal role and identify its antecedents and consequences.

    Methods

    As suggested by Walker and Avant, the present concept analysis utilized the eight-step methodology. A search of the English literature was accomplished by searching the databases including CINAHL, Google Scholar, PubMed, and Medline, from 1994 to 2016 using the keywords of maternal role, maternal identity, maternal role attainment, transition to motherhood, and motherhood.

    Results

    The antecedences of maternal role were pregnancy, maternal identity, maternal behaviors, adjustment to child-rearing, and bonding with the child.  The defining attributes of maternal role were considered nurturing, protecting, caretaking, and managing household affairs.  The consequences were the awareness of neonatal status, balanced fulfillment of multiple roles, maternal role strain, and role conflict.

    Conclusion

    The present analysis identified the common attributes, antecedents, and consequences of maternal role. In addition, this analysis differentiated the concept from similar and related concepts that led to greater clarification of maternal role in nursing and midwifery. Considering the maternal role, this conceptual structure provided clarity and contributed to the body of knowledge representing a method to guide nurses and midwives in their practice and research.

    Keywords: Concept analysis, Maternal role, Maternal behavior, Maternal identity
  • Parvin Mirzaie, Lida Nazarian *, Hossein Zare Pages 1740-1746
    Background & aim
    Four decades of war in Afghanistan has led to an increased rate of depression among the population. Given the importance of depression in adolescents, it is essential to introduce an appropriate tool for the early detection of depression in adolescents. Therefore, this study was conducted to standardize the Maria Kovacs Questionnaire among schoolchildren in Herat, Afghanistan.
    Methods
    In order to validate the Maria Kovacs children’s depression inventory for the reference group, 57385 adult girls and boys studying in secondary schools in the Herat were selected during 2016. The 500 high school students (grades 7, 8, and 9) were randomly selected and questionnaires were localized by the researcher. Moreover, the reliability of the test was evaluated by means of a mock-up test in split-half format, and Beck's depression inventor was used as gold standard for identifying depression in school children.
    Results
    Using the split-half method, the two inventories of Maria Kovacs and Beck were reported to have the reliability of 0.789 and 0.526, respectively. Moreover, the comparison of Maria Kovacs with Beck inventory (as criterion test) indicated that when the score of non-depression in Kovacs inventory ranged 0-8, it had the sensitivity of 97.2%, specificity of 46.1%, positive, and negative predictive value of 85.7%.
    Conclusion
    According to the obtained sensitivity of the investigated group, Maria Kovacs Depression Inventory has an acceptable level of reliability and validity to be implemented in the target community. So it could be recommended as an appropriate scale to assess depression among school childrenin Afghanistan.
    Keywords: Adolescents, Depression, Mood disorders, Validity
  • Maryam Nasrabadi, Mohammad Vahedian, Shahroodi, Habibullah Esmaily, Hadi Tehrani, Mahdi Gholian, Aval * Pages 1747-1762
    Background & aim
    Considering the important role of exclusive breastfeeding in the first six months of birth and its relation with sociocultural beliefs, this study was conducted to explore the factors affecting exclusive breastfeeding in the first six months of birth in women residing in Neyshabour, Iran.
    Methods
    This qualitative study was based on an exploratory-descriptive design, which was conducted using focus group interviewing based on the PEN-3 model. Thirty-seven women from four groups (i.e., mothers with an infant under six months of age, grandmothers with an infant grandchild, pregnant women in the third trimester of pregnancy, as well as health care providers and health volunteers) participated in group discussions. The interviews were recorded and transcribed. A framework was used to analyze the data including five stages of identifying a thematic framework, indexing, drawing a table, mapping, and interpreting. Also, for better data management, MAXQDA software was employed..
    Results
    Factors affecting exclusive breastfeeding were categorized in three dimensions of the PEN-3 model, namely cultural identity, relationships and expectations, and cultural empowerment and the six main factors of individual factors (factors related to the mother and the child), family, neighborhood, nurturers (influential people), enablers (socially influential), and cultural beliefs. Relaxation and lack of stress, adequate knowledge of the mother and her relatives, adequate lactation skills, desirable growth, lack of crying and restlessness of the child, and support of others were the most important affect successful exclusive breastfeeding.
    Conclusion
    We recommend social and political support of authorities, continuous support for employed mothers during lactation, and the implementation of 10 Steps to Baby-Friendly hospitals. Developing and implementing of educational programs during pregnancy and postpartum period is also suggested for the promotion of exclusive breastfeeding.  Monitoring of the breastfeeding process as well as encouraging nursing during the night can also help to maintain exclusive breastfeeding.
    Keywords: Exclusive breastfeeding, Qualitative research, Group discussion
  • Mina Ghalenovi, Zahra Abedian *, Seyed Reza Mazloom, Negar Asghari Pages 1763-1773
    Background & aim
    The decision on whether or not to do episiotomy is ultimately made by midwives. Problem-solving is an essential skill in the workplace situations, which help overcoming unpredictable circumstances without relying on the others. The aim of this study was to investigate the effect of problem-solving skills training on the frequency of selective episiotomy among midwives.
    Methods
    This randomized clinical trial was conducted on 60 midwives with a minimum of 6 months work experience at selected maternity hospitals in Mashhad, Iran in 2012. The participants were assigned into two intervention (N=30) and control (N=30) groups. The intervention included two 4-hour problem-solving skills training sessions. The midwives in the intervention group conducted two primiparous births before and two after the intervention. The control group just conducted four births. Both groups were asked to complete demographic, occupational as well as Baron problem-solving questionnaire before and after the study and their practice was assessed as selective or non-selective episiotomy based on a checklists.Data were analyzed in SPSS software (version 16) using the Chi-square, Wilcoxon and Mann-Whitney U tests. 
    Results
    There was no significant difference between mean scores of the problem-solving skills among midwives in intervention group before and after the intervention (23.2±2.2 vs 23.1±2, P=0.320). It was the same for control group (P=0.537). Also, no significant difference was observed between the two groups regarding selective episiotomy before (P=0.847) and after the intervention (P = 0.582); although, the rate of selective episiotomy in the intervention group was higher before than after intervention (33.3% vs 41.7%).
    Conclusion
    Problem-solving skills training had no effects on the increased number of selective episiotomies. More research studies with larger sample size are recommend.
    Keywords: Midwife, Primiparous, Problem-Solving, Selective episiotomy
  • Asefa Eticha *, Gurmesa Tura, Tsedach Alemu Pages 1774-1783
    Background &  aim
    The prevalence rate of contraceptive use in Ethiopia is 42%; however, only 5% of Ethiopians use the long-acting contraceptive methods. This rate is 4.8% in Benishangul Gumuz Region in this country. Regarding this, the present study aimed to assess the determinants of long-acting reversible contraceptive method use among married women in Assosa town, Ethiopia.
    Methods
    This community-based unmatched case-control study was conducted on 384 married women from April 26 to May 10, 2016. The study population consisted of the users (case group; n=128) and none-users (control group; n=256) of one of the long-acting methods. Multivariate logistic regression analysis was performed to identify the variables having a significant association.
    Results
    A total of 382 women participated in this study with a response rate of 99.5%. The determinants of long-acting contraceptive use were identified as the lack of decision-making power (OR=0.29, 95% CI: 0.11-0.80), poor attitude toward such birth control methods (OR=0.13, 95% CI: 0.06-0.29), wrong expectation regarding method availability (OR=0.23, 95% CI: 0.07-0.73), low level of knowledge about long-acting contraceptive methods (OR=0.19, 95% CI: 0.08-0.47), future intention to get pregnant (OR=0.39, 95% CI: 0.18-0.82), and walking distance of more than 30 min from associated health facilities (OR=0.36, 95% CI: 0.15-0.85).
    Conclusion
    Women’s decision-making power, knowledge and attitude regarding contraceptives, expectation regarding method availability, distance from associated facilities, and intention to get pregnant in the future were identified as the independent predictors of long-acting contraceptive method use.
    Keywords: Long-acting contraceptive, married women, Case-control study
  • Tahereh Sadeghi, Nooredin Mohammadi *, Ali Mohammadpour, Mohammad Abbasi Pages 1784-1794
    Background & aim
    The experience of having a child is a new experience that can be challenging for mothers. However, this experience can be different for mothers who are subjected to assisted reproduction techniques, compared to mothers with normal fertility experience. The assisted reproductive techniques influence the attitudes and expectations of mothers towards their children, as well as the mother-child relationship. This study aimed to investigate the challenges mothers face after assisted reproduction techniques.
    Methods
    This study was conducted using a descriptive-interpretive phenomenological approach. The participants in this study included a total of 13 ART mothers, who took part in 21 in-depth interviews. Data were collected using semi-structured interviews. Six methodical activities introduced by van-Manen, were used during data collection, data analysis, and reporting the findings.
    Results
    Challenges of mothers who had children through assisted reproduction techniques was summarized in the main theme of "Over Challenging Mothers".  This theme incorporated into three sub-themes: (1) child-centered maternity; (2) maternity in an aura of fear; (3) doubts in accepting the maternal role..
    Conclusion
    Undoubtedly, the experience of motherhood through assisted reproduction techniques is a challenging and stressful condition. In fact, this experience is a big challenge for mothers since these mothers used to be nulliparous. They may feel considerable anxiety about their child’s health. Most of these mothers had their newborns after a long period of time, emotional investment, difficulty, and anxiety. These experiences lead to the emergence of the main theme of over challenging mother.
    Keywords: Assisted reproductive technology, Interpretive phenomenology, Motherhood
  • Shahla Nourani, Fatemeh Seraj Shirvan *, Mohammad Taghi Shakeri, Naghmeh Mokhber Pages 1795-1803
    Background & aim
    Birth of the first child is one of the major life events for every woman. This event can make extensive changes in couple’s life, which lead to the reduction of marital satisfaction or incidence of conflicts in wifehood and parenthood. Regarding this, the present study was conducted to determine the relationship between transition to parenthood and marital satisfaction among housewives and employed women.
    Methods
    This correlational study was carried out on 120 women referring to the healthcare centers of Mashhad, Iran. The study population was selected using the three-stage cluster sampling technique. The participants were assigned into two groups of housewife and employed women based on their occupational status. The data were collected using the Transition to Parenthood Scale and ENRICH Marital Satisfaction Inventory. Data analysis was performed in SPSS (version 16) using t-test, Mann-Whitney U test, as well as Spearman and Pearson correlation tests.
    Results
    The results showed a significant correlation between transition difficulty to parenthood and marital satisfaction among housewives and employed women (P<0.005). There was a significant difference between the housewives and employed groups regarding the transition difficulty to parenthood (P<0.05). The employed women faced more difficulty in transition to parenthood. However, no significant difference was found between the two groups in terms of marital satisfaction (P=0.26).
    Conclusion
    As the findings indicated, the employed women had more difficulty in transition to parenthood, compared to the housewives. Thus, it is recommended to devote more facilities and social support including spouse support to provide employed women with essential education assisting their transition to parenthood
    Keywords: Marital satisfaction, Transition to parenthood, Employed women, Housewives
  • Fatemeh Rajab Dizavandi, Azam Salar Haji, Masoumeh Kordi, Nastaran Vaghei, Saeed Vaghei * Pages 1804-1812
    Background & aim
    Obsessive-Compulsive disorder is considered as one of the most common disorders in pregnancy and postpartum period. There are few studies in this regard in Iran. Therefore, the purpose of the current study was to compare the severity of obsessive-compulsive symptoms in pre-pregnancy, pregnancy, and postpartum period among women of reproductive age.
    Methods
    This descriptive-comparative study was carried out on 900 eligible women (500 non-pregnant women, 200 pregnant women, and 200 in postpartum period) referred to health centers in Mashhad in 2011, who were selected using multi-stage sampling method. The data were collected by Madezly and Yale Brown Obsessive-Compulsive scale and analyzed using descriptive statistics, Kruskal–Wallis one-way analysis of variance, and Mann-Whitney U test in SPSS software (version 11) with the confidence level of 95%.
    Results
    The obtained results of Kruskal-Wallis test showed that there was significant statistical difference between the groups of pre-marriage (15.9±7.1), pregnancy (20.6±4.5), and postpartum period (20.9±5.1) in terms of mean score of obsessive-compulsive symptoms (P=0.007).
    Conclusion
    Women in their pregnancy and postpartum period are at risk of obsessive-compulsive disorder that mostly are not recognized. As a Consequence, it is necessary for healthcare centers to take required measures in this regard.
    Keywords: Obsessive-Compulsive, Postpartum, pregnancy, Women, Reproductive age
  • Nasim Baradaran Akbarzadeh, Mahin Tafazoli *, Seyed Reza Mazloom, Morteza Mojahedy Pages 1813-1821
    Background & aim
    One of the most important factors for couples' happiness is having a good sexual function. One of the issues that affect couples' sexual function is their temperament. In this regard, the present study was conducted to determine the relationship of hot and cold temperaments with sexual function among women of reproductive age.
    Methods
    This descriptive-correlational study was conducted on 200 non-pregnant women aged 20-40 years referring to the health centers of Mashhad, Iran, in 2017. The study population was selected using convenience sampling technique. The data were collected using the temperament questionnaire, 21-Item Depression, Anxiety, and Stress Scale, Female Sexual Function Index, and Female Sexual Distress Scale. Data analysis was performed in SPSS software (version 16) using independent t-test, Mann-Whitney U test, and Spearman’s rank-order correlation.
    Results
    Sexual function and all its subscales had a significant relationship with hot temperament. In this regard, the subjects with a higher score in sexual questionnaires had hot temperament (P<0.05). In addition, the total score of sexual function and subscales of libido, satisfaction, and pain during intercourse showed a significant relationship with cold temperament (P<0.05). The hot temperament subjects had a higher sexual function, compared to the cold temperament ones (P<0.001).
    Conclusion
    Based on the findings, women with hot temperament had a better sexual function, compared to the cold temperament ones. Consequently, the healthcare providers should pay more attention to women with cold temperament in order to promote their sexual function.
    Keywords: Cold temperament, Hot temperament, Sexual function, Reproductive age, Women
  • Mitra Tadayon, Fariba Khavayet *, Parvin Abedi, Amal Malehi Pages 1822-1832
    Background & aim
    The nutritional status of children is assessed by height, weight and body mass index (BMI). Several factors affecting the child's BMI. Parents act as models for children regarding the consumption of food and nutrition, and their nutrition practices and lifestyle affect a child's diet and weight indirectly. This cross-sectional study was conducted to assess the association between maternal lifestyle and child's body mass index in Abadan, Iran.
    Methods
    In this cross-sectional study, 500 children within the age range of 3-6 years were selected with their mothers from nine health centers in Abadan, Iran. Data were collected using socio-demographic and lifestyle questionnaire through interviewing with mothers as well as measuring children's height and weight. The BMI of mothers was also measured in this study. Data were analyzed using Kruskal-Wallis, the Chi-square, and logistic regression tests.
    Results
    The results showed no significant relationship between the total score of mother's lifestyle and children's BMI. However, some aspects of mothers' lifestyle including physical health, weight and nutrition management, as well as disease prevention and mental health of the mothers had significant relationship with children’s BMI (P<0.05). Also a significant relationship was seen between mothers' lifestyle with children’s appetite and mothers' socioeconomic status. The prevalence of underweight, overweight, and obese children were 15.2%, 6.8 %, and 5.8 %, respectively.
    Conclusion
    Although there was no significant relationship between the total score of the mothers' lifestyle and the children's BMI, a significant relationship was observed between some lifestyle dimensions and the children’s BMI. The results of this study confirm the leading role of the mothers' lifestyle in children's growth and health.
    Keywords: Body mass index, lifestyle, Obesity, Overweight, Underweight
  • Jila Agah *, Roya Baghany, Seyed Mohammad Mireskandari, Mohammad Hassan Rakhshani Pages 1833-1839
    Background & aim
    Nausea and vomiting are considered as the main post-cesarean complications in women undergoing cesarean section. Therefore, the present study aimed to examine the efficacy of intramuscular metoclopramide before cesarean section to prevent post-cesarean nausea and vomiting.
    Methods
    Study population in the present study consisted of 617 women scheduled for cesarean section. The participants were randomly divided into intervention and control groups. The intervention group received 10 mg intramuscular metoclopramide prior to the surgery, compared to the control group taking an aquatic neutral placebo. Nausea, vomiting, feeling of hunger, and eating time were assessed postoperatively using a visual analog scale every 4 hour. Data were analyzed using the Chi-square test and t-test in SPSS software (version 17).
    Results
    During 12-hour postoperative observation, the incidence and intensity of nausea were lower in the metoclopramide group (P=0.005). Metoclopramide group clearly needed a less severe therapeutic approach for nausea (14% vs. 44%). Furthermore, participants in the intervention group showed a decline in vomiting; however, this decline was not significant (P=0.4). The metoclopramide group developed the feeling of hunger and eating sooner than those in the control group (P=0.003, P=0.002, respectively). None of the participants reported any side effects of this medication.
    Conclusion
    The intramuscular injection of 10 mg metoclopramide before cesarean section decreased the incidence and intensity of nausea as well as discharge time from the hospital. Metoclopramide is recommended as a safe, available, and inexpensive medication, which can result in a higher level of maternal health and shorter period of hospitalization.
    Keywords: Cesarean section, Metoclopramide, Nausea, vomiting
  • Somayeh Makvandi, Khadigeh Mirzaiinajmabadi *, Najmeh Tehranian, Masoumeh Mirteimouri, Ramin Sadeghi Pages 1840-1849
    Background & aim
    Recently, the use of birth ball in childbirth has been widely considered. This review study aimed to critically evaluate the evidence regarding the effect of using the birth ball on the mode of delivery and length of labor.
    Methods
    For the purpose of the study, the articles related to the subject of interest and published up to August 5th, 2018 were searched in several scientific databases, including Cochrane library, CENTRAL, and PubMed. This review included all randomized control trials evaluating the use of birth ball for giving birth. Two study outcomes were considered in the present study, namely the type of delivery and length of labor stages. Finally, five studies were entered into the systematic review and meta-analysis. The risk of bias was calculated by means of the Cochrane’s tool.
    Results
    The included studies had a different range of quality, mostly lower than the standard level. The results of the reviewed articles revealed that the group who used birth ball had shorter active labor phase, as compared to the control group (P=0.048). However, the use of birth had no statistically significant effect on the length of the second stage of labor (P=0.128). In addition, using birth ball did not increase the chance of vaginal delivery (P=0.922).
    Conclusion
    Given the findings of the present study, it is essential to perform further high-quality studies with more scientific design to provide clinical evidence on the use of birth ball as a maternity service.
    Keywords: Birth ball, Childbirth, Mode of Delivery, Length of labo
  • Zeinab Nazari, Jila Torabizadeh, Taraneh Geran, Hamed Jafarpour *, Amir Shamshirian Pages 1850-1854
    Background

    Primary fallopian tube cancers (PFTCs) are rare gynecological malignancies by the prevalence of 0.3-1%. The PFTCs occur in individuals within the age range of 18-88 years, more specifically at the age range of 40-65 years with the mean age of 55 years. The PFTC usually is observed with the chronic inflammation of the fallopian tube, infertility, tuberculous salpingitis, and tubal endometriosis. This study aimed to discuss the diagnosis of PFTC and the follow-up procedures of such patients. Moreover, it investigated inguinal lymph node metastasis as an uncommon occurrence and also reported a review of the literature about PFTC. Case report: The case in this study was a 57-year-old woman (G5P5) referring to the clinic of Imam Hospital of Sari, Iran, in May 2016 after right inguinal lymphadenopathy. Total bilateral salpingo-oophorectomy with omentectomy, abdominal-hysterectomy, exploratory-laparotomy, as well as pelvic and para-aortic lymphadenectomy were performed for the patient. The pathogenic report indicated metastatic adenocarcinoma of a small tumor at the end of the right fallopian tube.

    Conclusion

    Since it is difficult to conduct initial diagnosis after primary surgery and definitive diagnosis of the disease, the surgeons complete the previous surgical procedure by performing an additional surgery. However, this issue seems to increase mortality among patients. As a result, it is essential to conduct more comprehensive studies to find the effective methods of diagnosis and apply the best medical management protocols for a better treatment of the disease, and therefore reduce mortality.

    Keywords: Fallopian tube cancer, Lymphadenopathy, Lymphatic metastases