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Holistic Nursing and Midwifery - Volume:29 Issue: 4, Autumn 2019

Journal of Holistic Nursing and Midwifery
Volume:29 Issue: 4, Autumn 2019

  • تاریخ انتشار: 1398/06/10
  • تعداد عناوین: 8
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  • Ali Reza Balaafkandeh, Ezzat Paryad*, Atefeh Ghanbari Khanghah, Ehsan Kazemnezhad Leili Pages 184-191
    Introduction

    Cognitive status of patients before Coronary Artery Bypass Grafting (CABG) affects their activities of daily living. Evaluation of cognition status and its related factors can help caregivers to plan suitable care programs.

    Objective

    This study aimed to evaluate the patient’s cognition status and its related factors before CABG.

    Materials and Methods

    This cross-sectional study was done in 2016 on 139 patients before CABG who were selected by convenience sampling method. The study data were collected by Cognition Failure Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and a sociodemographic questionnaire. CFQ scores range from 0-100, and higher score shows the weaker status of cognition. The obtained data were analyzed by descriptive and inferential statistics of the Man-Whitney U test, the Chi-squared test, and logistic regression.

    Results

    The Mean±SD score of cognitive status of the samples was 12.92±12.73. The findings showed significant relationship between cognitive status and age (P=0.002) and anxiety (P<0.05). The results of logistic regression showed that age (P=0.020, OR =1.070, 95%CI=1.011-1.133), moderate anxiety (P=0.007, OR =6.067, 95%CI=1.62-22.60), and case of anxiety (P=0.001, OR=14.331, 95%CI=2.82-72.72) are the patients’ cognitive status predictors before CABG.

    Conclusion

    Based on the findings, age and preoperative anxiety are related to the cognitive status before CABG. These variables should be emphasized in preoperative nursing care in cardiac surgery wards.

    Keywords: Coronary artery disease, Coronary artery bypass graft surgery, Cognitive impairment
  • Mahboobeh Ahmadi, Farzaneh Rahimi*, Firoozeh Rosta, Hamid Alavimajd, Mahboobeh Valiani Pages 192-199
    Introduction

    Postpartum blues is one of the complications that can affect the health of the mother and how she communicates with the baby, and as a result, her physical and mental health. Therefore, its prevention can influence the mental health of the family.

    Objective

    This study aimed to determine the effect of Progressive Muscle Relaxation (PMR) therapy on the postpartum blues of high-risk pregnant women.

    Materials and Methods

    This randomized clinical trial was conducted on 150 women with high-risk pregnancy referred to health centers in Shahreza City, Isfahan Province, Iran. They were selected by multi-stage sampling technique and randomly assigned into two groups of PMR (n=75) and control (n=75). The control group received only routine pregnancy care, while the PMR group, in addition to routine pregnancy care, received PMR education (Jacobson Method). The severity of postpartum blues was assessed by Zung’s self-rating depression scale on days 1, 3, and 10 after delivery. For analyzing data, we used the Chi-squared test, t-test, and the Mann-Whitney U test.

    Results

    Both groups had no significant difference with each other in terms of demographic and obstetric factors. No significant difference was observed between the control and PMR groups in the severity of postpartum blues on the first day; however, the difference was significant on days 3 and 10 (P<0.05).

    Conclusion

    Progressive muscle relaxation therapy can be useful in reducing the severity of postpartum blues in women with a high-risk pregnancy.

    Keywords: Progressive muscle relaxation, High-risk pregnancy, Postpartum blues
  • Maryam Shabaani Mehr*, Tahereh Khaleghdoost Mohammadi, Shirin Jafroudi, Ehsan Kazemnezhad Leyli, Zahra Majd Teimoori Pages 200-209
    Introduction

    Stroke is the most prevalent debilitating neurological disease in adults, which damages the motor system. Therefore, rehabilitation programs are essential to improve the condition of these patients. One of the novel rehabilitation methods is Mirror Therapy (MT).

    Objective

    This study aimed to evaluate the effect of MT on the walking ability of patients after stroke.

    Materials and Methods

    In this clinical trial, 93 patients with stroke were studied in one of the physiotherapy centers in Rasht City, Iran, in 2016. They were assigned into three groups using block randomization technique. In the MT and nonreflective groups, the rehabilitation exercises besides routine rehab program were administered in twenty 15-min sessions every other day in front of the mirror (reflective plane for the MT group) and wood (nonreflective plane for the nonreflective group). The control group received only routine physiotherapy program. The walking ability of the samples was evaluated by the Functional Ambulation Category (FAC) test before and after the intervention. For analyzing the collected data, we used the Chi-squared test, ANOVA, Shapiro-Wilk test, Kruskal-Wallis test, Friedman test, Mann-Whitney U test, and Generalized Estimating Equation (GEE) model.

    Results

    There were no significant differences between the three groups before the intervention in terms of FAC test score and confounding variables. But all three groups showed a significant difference compared to their pretest scores (P<0.05). Also, the MT group showed more significant improvement in walking ability compared to the other two groups.

    Conclusion

    Mirror therapy, as a simple and client-centered treatment, combined with the routine rehabilitation programs, can improve patients’ ability to walk after a stroke.

    Keywords: Mirror therapy, Walking ability, Stroke, Rehabilitation
  • Zahra Baghersad, Fatemeh Mokhtari*, Parvin Bahadoran Pages 210-217
    Introduction

    The role of Fathers’ involvement and support in the care of mother and child during postpartum is crucial. This support promotes the health of the mother and the family.

    Objective

    This study aimed to determine the effect of home care on the husband’s support during the postpartum period.

    Materials and Methods

    This is a clinical trial conducted on 64 women given birth in one of the hospitals in Isfahan, Iran. They were randomly assigned into two groups of intervention and control. A researcher-made questionnaire was used for collecting data. The validity and reliability of the questionnaire were already evaluated. For analyzing the collected data, descriptive statistics, and independent t-test, Fisher’s exact test, Chi-square test, and Mann-Whitney U test were used considering the significance level of P≤0.05.

    Results

    After receiving home care, the husband’s support in the intervention group (96.74±9.11) was significantly different (P=0.001) from the control group (81.17±14.43). There was also a significant difference between the intervention and control groups in the areas of “confidence in wife”, “listening to her”, “attention to her care needs”, “attention to her financial needs”, “attention to her problems and trying to fix them”, “buying necessary things for her”, “buying gifts for her”, “helping with housekeeping”, and “helping with childcare” after the intervention (P<0.05).

    Conclusion

    Home care program could desirably increase husband’s support leading to a safe postpartum period. Providing home services requires careful planning and proper management by midwives.

    Keywords: Home care, Husband, Social sciences, Postpartum period
  • Reza Zahedi*, Mojgan Baghaei, Mohammad Reza Yeganehfarzand, Ehsan Kazemnezhad Leili Pages 218-227
    Introduction

    The rising prevalence of metabolic syndrome and its serious side-effects have drawn the attention of researchers to the importance of adherence to self-care behavior and recognizing its related factors such as patients’ health literacy.

    Objective

    This study aimed at determining the relationship of health literacy with adherence to self-care behaviors in patients with metabolic syndrome living in Rasht City, Iran, in 2016.

    Materials and Methods

    This analytical cross-sectional study has been conducted on 184 patients with metabolic syndrome who referred to selective specialist clinics of Rasht. The subjects were recruited by consecutive sampling method. The study data were collected with a three-part research instrument consisting of a disease-related and demographic questionnaire, hypertension self-care activity level effects, and health literacy for Iranian adults. The obtained data were analyzed by descriptive and inferential statistics (The Chi-square test and multiple logistic regression).

    Results

    The findings have shown that a high percentage of samples have adhered to not smoking (90.2%) and avoidance of alcohol consumption (98.9%), and a low percentage to diet (21.2%) and physical exercise (18.5%). Most samples had adequate health literacy (44.6%). Their total health literacy had only a significant relationship with self-care behaviors related to losing weight (P=0.0001). On the whole, regression test analyses confirmed the predicting ability of decision making and health literacy behaviors in adherence to medication (β=0.006; 95%CI=1.269-2.948; P=0.001), diet (β=1.525; 95%CI=2.108-10.006; P=0.001), smoking (β=1.244; 95%CI=1.814-6.632; P=0.001), and weight control (β=0.931; 95%CI=1.458-4.415; P=0.001).

    Conclusion

    The findings of the research call for further attention to health literacy promotion, especially in decision making and behavior dimension in patients with metabolic syndrome.

    Keywords: Health literacy, Patients, Self-care, Metabolic syndrome
  • Shahab Papi, Zeynab Karimi, Marzie Zilaee, Parvin Shahry* Pages 228-235
    Introduction

    Nutrition is one of the essential determinants of health in the elderly so that in older age, malnutrition and chronic diseases become prevalent, and one leads to another and vice versa.

    Objective

    This study aimed to investigate the prevalence of malnutrition and its association with general health and multimorbidity among older people living in nursing homes in Ahvaz City in 2016.

    Materials and Methods

    This analytical cross-sectional study was conducted on 184 older people living in nursing homes located in Ahvaz. The participants were assessed using a demographic form, mini nutritional assessment tool, and the 12-item general health questionnaire. The collected data were analyzed in SPSS V. 18 using descriptive statistics as well as the Spearman correlation coefficient, independent t-test, and one way ANOVA.

    Results

    Of 184 participants, (66.2%) were female and (33.8%) male with a Mean±SD age of 68.9±7.8 year. Also, (19.2%) had malnutrition, (52.17%) risks of developing malnutrition, (28.8%) normal nutritional state, and (99.26%) undesirable general health status. There was no statistically significant relationship between their general health and nutritional status. About (35%) of the elderly had 3 or more diseases, where their most common disease was depression. Based on the results, their nutritional state had a significant correlation with multimorbidity (r=0.92, P=0.02) and between high-protein food intake and skin problems (r=0.71, P<0.001).

    Conclusion

    Regarding the undesirable nutritional status and the low level of general health in the elderly, nutritional, and psychological interventions for this group seems necessary.

    Keywords: Nursing home, Nutritional status, Aging, General health
  • Fatemeh Paknejadi, Farideh Hasavari*, Tahereh Khaleghdoost Mohammadi, Ehsan Kazemnejad Leili Pages 236-242
    Introduction

    Palliative care is the science of promoting the patient’s quality of life. It can improve the quality of life of a patient, which is effective not only in patient’s late-life but also useful in dealing with a chronic illness over many years. In this regard, nurses, as the largest providers of health care services, play an important role in palliative care.

    Objective

    This study aimed to investigate the palliative care knowledge of nurses and its contributing factors.

    Materials and Methods

    This cross-sectional study was conducted on 280 nurses working in different departments of hospitals affiliated to Guilan University of Medical Sciences (GUMS). They were recruited using the stratified random sampling technique. Their data were collected by a demographic form and the Palliative Care Quiz for Nursing (PCQN) instrument. The collected data were analyzed by Kruskal-Wallis and Mann-Whitney U tests.

    Results

    The Mean±SD score of palliative care knowledge of study nurses was reported as 7.86±2.16 indicating their imperfect knowledge. Among studied factors, only the personal study about palliative care had a significant association with the nurses’ knowledge (P=0.038).

    Conclusion

    Nurses had poor knowledge of palliative care and its subscales that is one of the main obstacles in providing optimal palliative care. So, increasing their quality of palliative care services by improving their knowledge through in-service education and on the job retraining could promote the quality of palliative care services for the patients.

    Keywords: Palliative care, Knowledge, Nurse
  • Mahsa Shaali, Ziba Farajzadegan, Alireza Turk Nezhad Azerbaijani, Zahra Boroumandfar* Pages 243-251
    Introduction

    Husband’s addiction often leads to the disruption of family roles and duties. In this process, women as wives in families with addicted husbands may tolerate pressures from everywhere and are emotionally, physically, mentally, and behaviorally at risk. 

    Objective

    Armed with a qualitative approach, the present study tries to recognize the nature of the problem, defines and investigates this phenomenon deeply and describe the self-efficacy and self-esteem of the women with drug addict husbands.

    Materials and Methods

    This study was a qualitative study using content analysis method. The data gathering process consisted of 20 semi-structured interviews with women who referred to social support centers in Isfahan City, Iran. The sampling was done by purposive sampling method until data saturation. The obtained data were analyzed using qualitative content analysis method.

    Results

    According to the results of the data analysis, 16 subcategories and 4 main categories, including “glass roof”, “from injury to relief”, “hope for empowerment”, and “silent victim” were extracted.

    Conclusion

    The results of the present study indicate that the wives of addicted men have a low level of self-efficacy and self-esteem; thus, they require supportive attention and counseling of psychologists. Since women play an essential role in the formation of a family, authorities should adequately know about their mental and psychological problems and support them concerning their husband’s addiction.

    Keywords: Husband, Drug users, Addiction, Self-efficacy, Self-esteem