فصلنامه حیات
سال بیست و پنجم شماره 4 (پیاپی 84، زمستان 1398)

Due to repeat emergency patients, the high quality obstetrics and gynecology triage is essential in the obstetrics and gynecology department. Given the importance of improving the healthcare quality, clarifying the aspects and features of the concept of obstetric triage quality would be helpful for determining criteria and standardization of obstetric triage quality. Therefore, the aim of the study was to explain the quality index of obstetric triage.

Methods & Materials: 

This qualitative study was conducted using a directed content analysis method on 15 participants. Participants included obstetric triage service providers and key specialists in obstetric triage. The data were collected through in-depth, semi-structured interviews. Data analysis was performed using the MAXQDA software version 10.

At this stage of the study, conducted with in-depth, semi-structured interviews, 824 initial codes and 97 merged codes were extracted. The quality of obstetric triage was explained by three main themes, including process quality, structure quality and outcome. The concept of process quality included 35 codes in two sub-categories: actions and care, interactions and communications. Structure quality included 51 codes in five sub-categories: routine and process of triage, pattern and standard, equipment, physical space, and manpower. Outcome included eleven codes in five sub-categories: waiting time, satisfaction, physical implication, psychological implication, and cost.

The index of obstetric triage quality is influenced by the quality of the process (actions and care, communications), the quality of the structure (routine and process of triage, pattern and standard, equipment, physical space, manpower), and outcome (waiting time, satisfaction, physical implication, psychological implication and cost).

Maintaining and improving the health of the elderly through effective interventions requires the recognition of their lifestyle, including exercise using a valid and appropriate culture-specific tool. The aim of this study was to design and evaluate the psychometric properties of a tool for measuring exercise self-efficacy in the elderly.

Methods & Materials:

 A sequential exploratory mixed method study was performed in the form of a questionnaire with two qualitative and quantitative sections in 2019. The qualitative section consisted of item generation including three stages: theoretical stage (targeted search of existing literature), field work (semi-structured interviews with the elderly) and final analysis (integration of the results from the two previous stages). In the quantitative section, the psychometric properties of the questionnaire was evaluated using face, content and construct validity as well as the reliability through internal consistency and stability.

Out of 37 initial items, four items were removed after calculating the item impact score.  Seven items were removed after assessing the content validity ratio and content validity index. Also, five items were omitted due to having a load factor less than 0.03. The result of exploratory factor analysis consisted of three factors “recognition”, “situational compatibility” and “self-control” which all together could explain 90.180% of the variance. The Cronbach’s alpha and the Intraclass correlation coefficient were found to be 0.957 and 0.949 respectively.

The data analysis approved that the designed tool can be used for measuring exercise self-efficacy among the elderly due to having acceptable reliability and validity, simplicity and a short completion time.

Some women, throughout their life cycle, experience unintended pregnancy and had to decide on continuing or terminating it. Although the decision-making process always recurs, few studies have so far shed light on this complex, and context-based process. The aim of the present study was to explore Iranian women’s decision-making process to abort or continue an unintended pregnancy.

Methods & Materials:

 This was a qualitative study using grounded theory approach. Data were collected through unstructured, in-depth interviews with 29 participants in Tabriz from March 2016 to May 2017. The participants were selected through the purposeful sampling method and data collection were continued until reaching data saturation. Data analysis was carried out concurrently with the data collection, using the MAXQDA software version 10.

Data analysis gave rise to four axial categories: “perceived threats”, “resistance mixed with indecision”, “values and supportive resources”, as well as “acceptance and confirmation of decision”. This means that the decision-making process among women with unintended pregnancy initially starts with a perceived threat as a main concern leading to their resistance towards accepting such a pregnancy, then exposure to threats arising from abortion can cause indecision and uncertainty in practicing abortion. In this respect, given the social support, women affected by religious values make efforts to choose the procedure with the least harm and threats and maximum acceptability and confirmability. “Confirmation of decision” is as well the outcome of the interactive process of decision-making.

What can differentiate the theory of decision-making on abortion or continuation of an unintended pregnancy from the general theories of decision-making is its sociocultural confirmability. Social acceptance of abortion and childbearing in line with moral evaluation of fetal development directs the confirmability process of decision-making about unintended pregnancy.

Patient participation is an important component of the patient-centered care approach and part of patients’ rights, with positive outcomes for the health care system. The aim of this study was to explore the nurses' experiences of patient participation in nursing care and its related factors.

Methods & Materials: 

This qualitative study was carried out with the participation of 18 nurses working in educational hospitals of Tabriz in 2019. The purposeful sampling through semi-structured interviews and focus group sessions was used to collect the data. Data analysis was performed using conventional content analysis. To achieve the accuracy of the data, the Lincoln and Guba criteria were used.

Analysis of the data resulted in four main categories "giving information, decision-making, collaboration and respect". The patient’s participation from the nurses’ perspectives was: an interactive process of decision-making and collaboration between the nurse and the patient with the exchange of information, respect, and permission from the patient. The results also included the prerequisites, domains, outcomes, barriers, and solutions for patient participation in nursing care.

Patient participation today is considered the legal right of the patient and also the gold standard of international health care systems. So nurses, health system policy makers, patients and academic centers can use these results to improve patient participation in the care.

Nursing is a shift-working job at different hours of the day. Therefore, sleep disorders caused by disruption of sleep-wake cycle and circadian rhythm commonly occur in this group. The Benson’s relaxation technique is an easy, non-invasive, and non-pharmacological method that can affect the sleep quality in people. Therefore, this study was conducted to evaluate the effect of Benson's relaxation technique on sleep quality among shift-working nurses in hospitals.

Methods & Materials: 

In this quasi-experimental study, 80 nurses working in three hospitals in Rafsanjan in 2019, who had poor sleep quality score on the Pittsburgh Sleep Quality Questionnaire were selected by the convenience sampling method, and were assigned into either intervention- or control group, using stratified random sampling method. The intervention group was taught the Benson’s technique and they were asked to perform it before sleeping for one month. After one month, the Pittsburgh Sleep Quality Questionnaire was completed again by the both groups. The data were analyzed by independent t-test, paired t-test, Chi-square and fisher exact test using the SPSS software version 18.

the mean and standard deviation of sleep quality score for the intervention group and control group before the intervention were 7.79±2.53 and 7.95±2.78 respectively and there was no significant difference between the two groups. One month after performing the technique, the mean and standard deviation of the sleep quality score for the intervention group were 5.58±2.32 and for the control group were 8.53±2.93, and the two groups were significantly different from each other (P<0.0001).

In this study, the Benson’s relaxation technique, which is a simple, low-cost, and non-invasive method with no side effects, improved the sleep quality of shift-working nurses. Therefore, nurses’ education and the implementation of this technique is recommended to improve their sleep quality.
Clinical trial registry: IRCT20180306038981N1

Caring for children with chronic illness is associated with the care burden of families and affects their self-efficacy. In addition, family-centered care can have positive outcomes. The aim of this study was to determine the relationship of the perception of family-centered care, burden of care and self-efficacy in the mothers of children with chronic illness.

Methods & Materials:

 This descriptive-analytical study was conducted in 2019 on 220 mothers of children with chronic illness, admitted to pediatric hospitals in Tehran and were selected using the convenience sampling method. Data were collected using the Perception of Family-Centered Care-Parent, Perceived Maternal Parenting Self-Efficacy, and the Impact-on-Family Scale. Data were analyzed by SPSS software version18 using descriptive and inferential statistics such as Pearson correlation and regression tests at the significance level of 0.05.

Results showed that perception of family-centered care is directly associated with self-efficacy and inversely associated with the burden of care (respectively P<0.001 and P=0.022), so that for each 1-unit increase in the score of perception of family-centered care, self-efficacy of mothers increased by 0.25 and the burden of care decreased by 0.23. No significant association was found between self-efficacy and the burden of care (P=0.962).

Given that family-centered care can lead to an increase in self-efficacy and a reduction in the burden of care, nurses can improve mothers’ self-efficacy and reduce their burden of care by improving family-centered care.

Considering the importance of accidents prevention especially in children under 5 years, the study was conducted to determine the predictor factors for household accidents in children under 5 years based on protection-motivation theory (PMT) in Bushehr.

Methods & Materials:

 In this descriptive study, 700 mothers with a child aged 6 months to 5 years, referred to health centers in Bushehr were selected by the convenience sampling method from March to August 2018. To collect the data, a valid and reliable self-structured questionnaire including demographic characteristics, questions on constructs of PMT and questions on the household accidents prevention behaviors was used. Data were analyzed by the SPSS software version 22.

In this study, 86% of mothers (602) were housekeeper and 46% (326) had academic education. The most common accident prevention behavior was preventing access to drugs, chemicals and toxins (98%). Perceived self-efficacy (P<0.001, B=0.259) and perceived cost (P<0.001, B=-0.159) were significant predictors for household accident prevention behaviors in children under 5 years, and perceived self-efficacy was the most predictors construct. Based on the linear regression model, these two constructs along with a history of prior accident, predicted 15% (R2=0.150) of behavioral changes.

According to the results of the study, the PMT is a poor predictor for accident prevention behavior, and in educational programs, emphasis on promoting self-efficacy and providing assistance to reduce barriers and difficulties in creating safety in the home (decreasing perceived cost) are necessary for reducing household accidents in children under 5 years.

Menopause is a period in women’s lives with complications and consequences that can reduce the quality of life. The most common complications are vasomotor disorders which can affect sleep, life enjoyment, social activities and work. The usual treatment for these effects is hormone therapy but due to its side effects, most people tend to have complication-free treatments. One of these strategies is nutritional measures. The aim of this study was to determine the effect of group counseling about the nutritional measures of Iranian traditional medicine on vasomotor disorders in postmenopausal women.

Methods & Materials:

 This clinical trial study with multistage sampling was performed in 2018-2019 on 62 postmenopausal women referred to health center number 2 in Mashhad. Two health centers were selected as control or intervention group by Heads or Tails method in order to prevent the dissemination of the material. The intervention group received three sessions of the group counseling about the nutritional measures of Iranian traditional medicine. There was no intervention for the control group. The data collection tool was a questionnaire on the quality of life in menopause that was completed two months before and after the intervention. Data were analyzed on the SPSS software version 24 using independent t-test, Chi-square, Mann-Whitney, and Wilcoxon tests.

There was no significant difference in the mean score of vasomotor between the two groups before the intervention (P>0.05) but after the intervention, the difference between the mean score of vasomotor before and after the intervention was -2.18±4.08 for the intervention group and 0.59±3.30 for the control group. A significant decrease in the vasomotor score was observed in the intervention group compared to the control group (P<0.001).

Group counseling about the nutritional measures of Iranian traditional medicine can help reduce vasomotor disorders. Clinical trial registry: IRCT20180626040239N1