Evidence Based Care
Volume:10 Issue: 1, Spring 2020

It is essential to keep the reproductive organs and surrounding areas hygienic during menstruation to prevent health issues. Inadequate menstrual self-care knowledge, poor attitudes, and behavior among female adolescents can lead to increased morbidity and other complications among them, such as reproductive tract infections. This study aimed to investigate the effect of the jigsaw technique on menstrual self-care knowledge, attitude, and behavior among adolescents. This quasi-experimental research was performed on 100 female students who were divided into control (n=50) and intervention (n=50) groups (jigsaw intervention) in Al-Musaddadiyah boarding school in Garut, in 2016. The jigsaw technique was performed by dividing the students into small groups of 5-6 where students worked together using interdependent and responsible independent methods to receive education on menstrual self-care. The required data were collected using a questionnaire about knowledge, attitude, and behavior and they were analyzed using independent and paired t-test. A p-value of less than 0.05 was considered statistically significant. Based on the results, mean difference of the intervention group before and after the intervention regarding the level of knowledge, attitude, and behavior were -7,08 (P=0.001), -11.54 (P=0.001), and -16.62 (P=0.001), respectively. While the mean difference of the control group, before and after the intervention regarding the level of knowledge, attitude, and behavior were -0.240 (P=0.06),  -0,180 (P=0.37), -3,4 (p=0.21), respectively. Implications for Practice: The jigsaw method could be effective in increasing menstrual self-care knowledge, attitude, and behavior among female adolescents.

Infertility affects women more profoundly than men, even when the male partner is the cause of infertility. Therefore, identifying the coping strategies of women in confrontation with their husbands' infertility is very important.

This study aimed to explore women’s coping strategies following the diagnosis of infertility in their husbands.

This qualitative study was performed on 18 women whose husbands were diagnosed with infertility. The subjects were selected from those who referred to Milad Fertility Clinic and public health centers in Mashhad, Iran, through purposive sampling within 2014-2016. The data were collected by conducting semi-structured interviews. Data analysis was manually carried out using conventional content analysis.

The main theme emerged from the content analysis was the attempts to overcome the threat, including two categories, namely emotional coping and active coping. Emotional coping included strategies like attributing infertility to herself and others, selective disclosure, religious coping, seeking emotional support, as well as being considerate and offering verbal support to the spouse. active coping consisted of strategies namely attempting to verify the diagnosis, accepting infertility, searching for information, adhering to medical and surgical treatments, trying fertility superstitions, using alternative medicine, and changing lifestyle. Implications for Practice: Women may use a diverse set of coping strategies to adapt to their husbands’ infertility. A deep perception of these strategies is critical for controlling and managing the consequences of this diagnosis, designing interventions to strengthen preferred actions and strategies, as well as facilitating women’s coping with the infertility crisis of their spouses.

Lifestyle and behaviors of human beings are major factors in cardiovascular diseases. Therefore, a discharge program based on Self-determination Theory could improve the lifestyle of the patients. This study aimed to determine the effect of this program on the lifestyle and readmission of patients with heart failure. This clinical trial was performed on 60 patients with heart attack in a city in north-east of Iran, during 2018-19. The participants were selected by convenience sampling method and divided randomly into intervention and control groups. Subsequently, the intervention group was subjected to a 12-week SDT-based discharge program. However, the control group received the routine program. The data were collected using a demographic characteristics form, the Health-Promoting Lifestyle Profile II questionnaire, and the readmission questionnaire. Moreover, the data were analyzed in SPSS software (version 20) using the Chi-square, independent t-test, paired t-test, and Wilcoxon. In total, 20.0% and 46.7% of the subjects in the intervention and control groups were re-hospitalized, respectively. The Chi-square showed a significant difference in this regard (P=0.028).The results also showed a significant increase in the lifestyle score of the patients at post-test stage, in the intervention group (164.6±16.9), compared to the control group (119.1±17.2) (P<0.001). Furthermore, the mean score of various lifestyle subscales significantly increased in the intervention group, compared to the control group, three months after discharge (P<0.01). Implications for Practice: The design and implementation of a SDT-based discharge program could be included in the nursing care program as an effective method to create and maintain health-promoting behaviors.

Spiritual health is one of the dimensions of health. Currently, studies have identified a link between happiness and spiritual health; however, the effects of spiritual interventions on happiness have not been evaluated among the elderly. This study aimed to evaluate the effects of spiritual interventionson the happiness of the female elderly.   A total of 40 subjects were randomly allocated to two intervention and control groups in Madar Nursing Home in Sabzevar, Iran, in 2019. In the intervention group, spiritual interventionswere performed as active listening, supporting religious rituals, using supportive systems, and arousing hope for 4 weeks. The happiness level of the participants was assessed before, immediately after, and a month after the intervention using the Oxford Happiness Questionnaire. Data analysis was performed by SPSS software (version 21) using descriptive and inferential statistics. The mean scores of happiness before the intervention were 45.6±1.2 and 36.5±11.9 in the intervention and control groups, respectively. However, the scores altered to 65.1±9.9 and 35.3±9.4 immediately after the intervention, as well as 64.7±9.7 and 35.1±8.9 a month following the intervention, in the intervention and control groups, respectively. The repeated measures analysis of variance indicated a significant difference among the groups by determining the effect of the happiness score before the intervention (P<0.0001). Implications for Practice: According to the obtained results, spiritual interventions increased the happiness level of the female elderly. Therefore, it is concluded that spiritual interventions can be considered practical approaches to improve the happiness of the elderly.

Breastfeeding is a two-way interaction between mother and infant, the sustainability of which requires the presence of both parts given their complementary roles.

The present study was conducted to investigate the effect of breast milk expression during kangaroo mother care (KMC) on milkvolume in mothers with premature neonates.  

This quasi-experimental study was performed on 40 mothers with premature newborns admitted to a neonatal intensive care unit in a city in the west of Iran in 2019. The participants were randomly assigned into two groups of intervention and control. Breast milk in both groups was expressed 8 times a day from day 4 to day 6 after birth using a 20-cc syringe and recorded in a checklist. In the intervention group, two milking sessions were performed during the KMC. However, in the control group, milking was conducted according to the ward routine. Data were analyzed in SPSS software (version 23) using repeated-measures ANOVA.

The mean ages of the participants in the intervention and control groups were 29.05±4.09 and 27.85±3.58 years, respectively. There was a statistically significant difference between the milkvolume of the intervention and control groups on days 4 (P=0.04), 5 (P=0.02), and 6 (P=0.007) and between the total volume of milkduring the three days (P=0.01).Implications for Practice: Breast milk expression duringKMC could have a positive effect on increasing milkvolume. Therefore, can be recommended as an intervention to support mothers with insufficient milk.

Cancer treatment has been increasingly fulfilled on an outpatient basis by family caregivers. The variety and severity of caregivers' responsibilities expose them to physical and mental risks. Investigating the effect of education and telephone counseling on patient and family outcomes requires performing further studies.

This study aimed to determine the effect of education and telephone counseling on caregiver strain and unmet needs in family caregivers and self-care behaviors in cancer patients.  

The present randomized controlled trial was conducted on 60 caregivers-cancer patients referred to urban health education clinics in northeastern Iran within 2018-2019. A 20-minute face-to-face training session was held for the caregivers of cancer patients, and seven training pamphlets were given to the caregivers. Moreover, the intervention group received four telephone counseling sessions during three courses of chemotherapy. The strain and unmet needs of caregivers were measured by the Zarit Burden Interview and Supportive Care Needs Survey-Partners and Caregivers questionnaires, respectively. The patient self-care was assessed by the Nail Self-care Diary questionnaire. The data were analyzed by SPSS software (version 16) using an independent t-test and paired t-test.

The mean values of caregivers’ age were 38.9±12.7 and 37.7±8.6 years in the intervention and control groups, respectively. The results of the independent t-test showed no statistically significant difference between the two groups (P=0.42). The results also revealed that the mean scores of caregiver strain and unmet needs decreased following the intervention, and the mean scores of self-care behaviors increased in the intervention group after the intervention (P=0.001).Implications for Practice: Education and telephone counseling can simultaneously help to follow up problems, improve self-care behaviors in cancer patients, alleviate the caregiver strain, and meet the needs of family caregivers.

Perineal pain is the most common post-episiotomy complication, and delay in episiotomy wound healing can lead to infection. Linalool and linalyl acetate are the most effective compounds of lavender. The present systematic review was performed on the effect of lavender on episiotomy wound healing and pain relief.

Systematic review of clinical trials to determine the effect of lavender on episiotomy wound healing and pain relief

In the present study, the research question was determined based on PICO, and search process to screen the related articles was conducted on electronic databases of SID, Iran Medex, Pubmed, EMBASE, Scopus, Science Direct, and Google Scholar using English keywords and Persian equivalents of Episiotomy, healing, Pain, Lavender, and Complementary Medicine from inception until March 2020. Inclusion criteria entailed randomized human clinical trials published in Persian and English on the effect of lavender on episiotomy wound healing and pain relief with a Jadad score of 3≥. Irrelevant, duplicate, descriptive, or qualitative studies were excluded. Cochrane risk-of-bias tool was used for the quality assessment of included articles.

Out of 143 articles found in the primary search, five clinical trials were systematically reviewed. All five studies examined the effect of lavender essential oil on episiotomy pain relief, while the effect of lavender essential oil on episiotomy wound healing was measured only in three studies.Implications for Practice: Lavender essential oil (sitz bath twice daily) can be suggested as the treatment of choice in episiotomy wound healing and pain relief. Further studies are suggested to obtain stronger scientific evidence on the effective dose, complications, and the feasibility of meta-analysis.

Menstrual hygiene education in adolescence is an important factor to prevent fertility problems. The present study aimed to compare the effect of menstrual hygiene education based on peer and small group teaching methods on hygiene behaviors in female adolescents. This randomized controlled clinical trial was performed on 90 high school students in 2018. Three high schools in Mashhad, Iran, were allocated to three groups by drawing lots. The peers and small groups were provided with educational content within a month and over four sessions, respectively. Moreover, the control group received routine education. The data were collected by a researcher-made questionnaire before and after the intervention and analyzed by SPSS software (version 16) using the analysis of variance, as well as Chi-square and Kruskal-Wallis tests. According to the Kruskal-Wallis test, the three groups were homogeneous regarding age (P=0.12). Furthermore, the mean scores of hygiene behaviors in the intervention groups (after the intervention) were significantly higher than in the control group (P<0.001) and higher in the peers than in the small groups (P<0.001). It is recommended to employ peer teaching on menstrual hygiene by health planners.