فهرست مطالب

Community Based Nursing and Midwifery - Volume:8 Issue: 3, 2020
  • Volume:8 Issue: 3, 2020
  • تاریخ انتشار: 1399/04/11
  • تعداد عناوین: 10
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  • Mona Larki, Robab Latifnejad Roudsari * Pages 190-208

    Inconsistencies between the number of patients, qualified caregivers and lack of adequate services andresources in the healthcare systems for people living with HIV/AIDS have led to the idea of providinghealthcare services for this vulnerable population at home. This study aimed to review the evidencerelated to the Home-Based Care (HBC) programs in the context of HIV. Literature search was carriedout without publication date limit through English databases of Cochrane Library, PubMed, EBSCO,Scopus, Google Scholar, Science Direct, as well as Persian databases including Magiran and SID bythe end of July 2019. Out of 1312 studies retrieved from the search of databases, six guidelines and 50articles met the eligible criteria. The results showed that the overall purpose of HBC is to create hopethrough providing appropriate care to help the patients and their families to maintain their independenceand have the best possible quality of life. The potential benefits of HBC could be discussed in threemain categories: 1) patients, including patients’ satisfaction, quality of life, adherence to antiretroviraltherapy, preventing mother-to-child transmission, as well as biochemical, social and psychologicaloutcomes, 2) families, consisted of promotinon of family members’ participation, enhancement offamily members’ awareness and provision of voluntary counseling and testing, and 3) healthcaresystems, containing health care costs, workload at healthcare centers and time spent on services. Giventhe lessons learnt from the existing HBC programs, developing an alternative approach for providinghealthcare at home in the context of HIV seems necessary and could be an agenda for action in healthpolicy making in Iran.

    Keywords: Acquired immunodeficiency syndrome, Healthcare systems, home-based health care, homecare services, Human immunodeficiency virus
  • Mitra Edraki, Afsaneh Zarei, Mitra Soltanian *, Hossein Moravej Pages 209-219
    Background
    Diabetes control in adolescents is a difficult and tedious process. Diabetic teens needtraining to control it and prevent its complications. This study aimed to investigate the effect of peereducation on self-care behaviors and glycosylated hemoglobin among adolescents with type 1 diabetes.
    Methods
    This controlled clinical trial was conducted in Iran from July 2018 to June 2019. 84 teenagers with type 1 diabetes were selected using a simple random sampling and randomly divided into control and intervention groups using block randomization. The intervention group received 4 sessions of training by peers on self care behaviors in diabetes. The control group received the routine training.The self-care questionnaire was filled out, and glycosylated hemoglobin was measured before andthree months after the intervention. Data were analyzed using SPSS version 23.0. The significancelevel was set at P0.05). Besides, the mean glycosylated hemoglobin significantly increased three months after the intervention in the controls (P<0.001).
    Conclusion
    The implementation of peer education can improve the self-care behaviors andglycosylated hemoglobin in adolescents. Hence, regarding its low cost and high safety, it is suggestedthat this approach should be established in the control of other chronic diseases in order to strengthen the self-care behaviors in adolescents.
    Keywords: Adolescent, Diabetes, education, Glycosylated hemoglobin, Peers, Self-care
  • Maryam Nekoolaltak, Zohreh Keshavarz *, Masoumeh Simbar, Ali Mohammad Nazari, Ahmad Reza Baghestani Pages 220-233
    Background
    Sexual compatibility between husband and wife is an effective factor in both sexual andmarital satisfaction. However, there is limited valid and reliable questionnaire to measure the degreeof sexual compatibility between the couples.
    Methods
    In this exploratory mixed method study, 54 individuals were interviewed in the qualitativephase and 448 persons participated in the quantitative phase. Totally 502 participants (261 woman,241 men) took part in this study. According to 205 final codes derived from the qualitative phase,102 initial items were developed, the number of which reached 69 items after deletion and mergingperformed by the research team. After face validity, content validity and construct validity, 68 itemswere introduced into the construct validity phase.
    Results
    Following exploratory factor analysis and promax rotation, the items were reduced to 35 in4 factors: “Requirements of a sexual relationship”, “Sexual agreement”, “Contextual obstacles” and“Outcomes of sexual compatibility”. The questionnaire Cronbach alpha and correlation coefficient ofthe test-retest method were 0.90 and 0.91, respectively.
    Conclusion
    Final Questionnaire included 35 items in 4 point-Likert scale with total score of between35-140. This valid and reliable questionnaire is brief, easily interpreted and can  measure the mainfactors affecting sexual compatibility with the spouse in clinics and research fields.
    Keywords: Couple therapy, Factor analysis, Psychometrics, Sexual compatibility, Sexual satisfaction Please cite this article
  • Abdorahman Zarepour, Maryam Hazrati *, AliAkbar Kadivar Pages 234-242
    Background

    Due to the increasing population of elderly and the consequent increase in the numberof chronic diseases such as dementia, the psychological complications such as anxiety in the familycaregivers increase. The aim of this study was to determine the effect of educational intervention onthe anxiety of family caregivers of the elderly people with dementia.

    Methods

    This randomized controlled trial was performed in the elderly Neurology Clinics in Shirazfrom May to August 2017. This study was conducted on 70 families with elderly people with dementiawho were randomly divided into an intervention (receiving in groups for seven sessions of educationalintervention) and a control group (Conventional care). Data collection tool was Spielberger’s AnxietyInventory (40-items, score=20-80). Data were analyzed by SPSS version 21 using ANOVA test withrepeated measures and independent t-test.

    Results

    One and three months after the interventions, the mean scores of anxiety in the interventiongroup were 70.51±3.78 and 70.31±3.43 and in the control groups they were 76.45±3.45 and 76.22±5.08respectively. The results showed significant differences between the two groups regarding anxietyafter the intervention (P<0.001).

    Conclusion

    Educational programs held to promote and maintain the physical and mental health ofcaregivers could reduce the anxiety of family caregivers of the elderly with dementia

    Keywords: Anxiety, Dementia, education, Family caregivers
  • Zahra Shojaeian, Talat Khadivzadeh *, Ali Sahebi, Hossein Kareshki, Fatemeh Tara Pages 243-252
    Background
    Gaining adequate knowledge about high-risk pregnancy (HRP) and correctunderstanding of the condition, empowers women to improve the use of prenatal care, practice betterself-care, and reduce the risk of pregnancy complications. The present study aimed to assess thevaluation of knowledge by Iranian women with HRP.
    Methods
    The present qualitative study was conducted on 25 women with HRP from August 2017to August 2018 at various educational hospitals in Mashhad, Iran. The data were collected throughin-depth semi-structured interviews. The data collection process continued until data saturation.The data were analyzed using the conventional content analysis method and MAXQDA software(version10.0). Data collection and data analysis were conducted concurrently.
    Results
    Based on the analysis of the interviews, two main categories and eight sub-categories wereextracted. The main categories were “Positive valuation of credible problem-relevant knowledge” and“Avoidance of misleading and stressful information”. The results showed that various factors had apositive impact on knowledge gathering, namely personal and other people’s experiences, obtainingneed-based information, sympathetic advice from others, and faith-based health recommendations.On the other hand, factors that had a negative impact were related to the type of information thatcaused stress, was unreliable, inefficient or incompatible with personal goals.
    Conclusion
    The findings of the present study would help health care providers to offer suitable andempathetic counseling to women with HRP. Providing valid and accessible sources of information willlead to faster and timely referrals of such patients.
    Keywords: High-risk pregnancy, Knowledge, Valuation
  • Maryam Shaygan *, Zainab Karami Pages 253-263
    Objectives
    Pediatric chronic pain is prevalent and disabling. The present study aimed to assess the prevalence of chronic pain among adolescents in Shiraz, Iran. We also compared emotional intelligence, self-esteem and parenting style between adolescents with chronic pain and healthy adolescents. Finally, we examined the predicting role of these variables regarding chronic pain in adolescents.
    Methods
    This cross-sectional study, from January to June 2018, has been conducted on 734 adolescents in Shiraz. A clustering sampling method was used. Adolescents with chronic pain were identified by affirmative answers to screening questions based on the ICD-11 criteria. Participants completed validated self-report questionnaires: Trait Emotional Intelligence Questionnaire, Rosenberg self-esteem scale and Baumrind parenting style questionnaire.. The data were analyzed through SPSS v.22 software using Mann-Whitney and binary logistic regression tests. P
    Results
    There were 221(30.1%) adolescents meeting the ICD-11 criteria of chronic pain. Mann-Whitney tests showed that emotional intelligence (p <0.001), self-esteem (p <0.001), authoritative parenting style (p =0.004) and authoritarian parenting style (p=0.006) were significantly different in adolescents with chronic pain compared to healthy adolescents. Binary logistic regression revealed that emotional intelligence (p <0.001), self-esteem (p <0.001), authoritarian parenting style (p =0.04) and authoritative parenting style (p =0.01) were significantly correlated with chronic pain after controlling for demographic variables.
    Conclusions
    Our findings highlight that emotional intelligence, self-esteem and parenting styles could be important factors of development or maintenance of chronic pain in adolescents. The results have potential to inform future interventions for adolescents with chronic pain.
    Keywords: chronic pain, Adolescents, emotional intelligence, Self-esteem, parenting style
  • Asal Amintojari, Manijeh Nourian *, Lida Nikfarid, Parasto Ojian, Maliheh Nasiri Pages 264-274
    Background
    Parents tend to experience considerable amounts of anxiety before their children undergo open heart surgery and this anxiety leads to numerous negative outcomes for both the children and the parents. This study was conducted to assess the effects of taking a hospital tour on preoperative anxiety in the mothers of children undergoing open heart surgery.
    Methods
    This quasi-experimental study was carried out on the mothers of toddlers who were open heart surgery candidates at Shahid Modarres Hospital in Iran. Ninety-six mothers were assigned to three groups using simple randomization. The oral instruction group (N=32) attended two oral instruction sessions; the hospital tour group (N=32) participated in tours of the operation room and intensive care unit; the control group (N=32) was prepared according to the ward’s routine. Preoperative anxiety was evaluated using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State Trait Anxiety Inventory (STAI). Data were analyzed in SPSS-20.
    Results
    The results showed that the mothers’ anxiety about surgery (F=30.99, P≤0.001) and their scores of state anxiety (F=6.02, P<0.001) differed significantly between the three groups after the intervention. A significant difference was observed between the oral instruction and control groups (P<0.001) and the hospital tour and control groups (P<0.001) regarding the surgery-related anxiety scores. A significant difference was also observed between the oral instruction and control groups (P=0.002) regarding the mothers’ state anxiety scores.
    Conclusions
    Preparing mothers by oral instructions is more effective in reducing surgery-related anxiety and state anxiety before toddlers’ open heart surgery.
    Keywords: Anxiety, Mothers, Preoperative Care, Hospital Tour
  • Tayebe Pourghaznein, Sina Salati * Pages 275-276

    Since the outbreak of the New Corona Virus in Wuhan, China and its spreading to Iran, first casesof COVID-19 positive were identified in Qom, Iran and in a short period of time many other mainprovinces including Isfahan, Tehran, Markazi, and Semnan were also infected with the virus shortlyafter that in all 31 provinces the virus spread.1 Super Spreading power of this disease is the reasonwhy we have many infected people daily and according to global epidemiological information, thenumber of infected people will reach to 74877 in April 15,2020.2 like many other countries, Iran startedmedical and hygienic measures with the establishment of a National committee for fighting CoronaVirus. Our country imposed limited commuting to religious, recreational places and trading centers,closed schools and universities, decreased working hours, and cleaned crowded areas and passagewayswith disinfectants (subway stations, bus stations, and gas stations). Other efforts include: Establishingoutposts in order to identify cases of Corona Virus at City entrances and Telephone screening through4030"that is a hotline for COVID-19 detection and providing relevant health information1." Despite thenecessary precautions taken, there were problems in fighting the Corona Disease, the most importantof which include: Insufficiency regarding personal protective equipment like masks, disinfectants andhospital gowns,3 Inadequate number of hospital beds and equipment in some of the cities and shortageof health workers. This issue has caused a high concern in the society and amongst the health workerswho take care of Corona virus cases in hospitals. Also, due to the experienced mental disorders ofthe health care workers while COVID-19 outbreak,4 the role of such shortages in the fight against thisdisease is crucial. In a situation like this where the number of infected people shoots up, hygienic needsof Iran increases, too. A new trend in fighting the disease has begun. In this trend, different groups ofpeople like clerics and cleric students, Basij, medical and non-medical students have taken measuresin fighting the Corona Virus which are in line with the World health organization and Ministry ofHealth and Medical Education standards. These measures are taken in 4 general areas, including:1. disinfecting the pssageways (Streets, Alleys), highly populated areas (Trading Centers, Bus andSubway stations, Gas stations) and vehicles, 2. producing personal protective equipment (Masks, faceshields, gowns and disinfectants), 3. helping with the Telephone Screening by Medical students, and4. Volunteer medical students participation in health care centers and hospitals.Now, despite the exigent circumstances regarding the spread of COVID-19 worldwide,volunteer measures and organized activities in Iran have led to provision of telephone screeninginformation and details about the COVID-19 to more than 65 million people until March 31, 2020;5and production of thousands of hygienic products daily has had a significant role in controllingand fighting the Corona Virus Pandemic. Although in the early period of the virus outbreak,Iran was the third country to have the most cases of Corona positive cases after China and Koreauntil 2nd of March, and the number of identified cases increased in April 15, 2020 which mightbe due to the efficient and comprehensive screening process, it became the 8th country with themost positive cases of Corona after the United States, Spain, Italy, France, Germany, England,and China.2 It is also expected that with adequate health equipment, specialized human resourcesand provision of scientific information to the community, the public and health workers who takecare of Corona virus cases will have tranquility.Therefore, Iran’s approach towards facing the COVID-19 clearly states the fact that nationalapproach in fighting the Corona Virus is an important factor among other measures taken and itis mentioned as a modern approach in managing a health crisis in a large scale.

    Keywords: COVID-19, Iran, National Approach
  • Maryam Shaygan *, Farzaneh Bahadori Pages 277-279

    There have been numerous outbreaks of infectious diseases in the world. On January 30, 2020, theWorld Health Organization (WHO) declared the outbreak of novel coronavirus disease (COVID-19)a Public Health Emergency.1 The pandemic has caused not only the risk of death, but also too muchpsychological pressure on people all over the world.Older adults are more susceptible to severe infections, cascade of complications, disability, anddeath.2, 3 The elderly might also be more vulnerable to mental health problems because of theirhigher risk of infection.4 They may experience adverse feelings such as fear of death because ofthe potential lethality of the illness. Some of them claim that dying from coronavirus is a horriblenuisance for them because none of their family members would be able to attend their funeral.They are also afraid of being hospitalized in medical facilities that lack sufficient equipment.They fear that if they contract the virus, no one will be able to visit or help them. The otherfear the elderly experience is the infection of their spouses, children, and siblings. Dismal anddisappointing news spreading via social media could also increase their fear and anxiety. Socialdistancing; reduced contact with others, especially loved ones; inability to take part in routineday-to-day activities (e.g. shopping for necessities); and cancellation of community events leadto boredom, frustration, and a sense of loneliness and isolation, which is distressing to olderadults. This problem is particularly prominent in older adults who have limited access to theInternet-based services and smartphones.5, 6The statement “coronavirus is mostly deadly to the elderly” increases a sense of fear andworthlessness in them. Some older adults have become extremely dependent on their childrenbecause they fear in-store shopping of essential items in large supermarkets, while they are notskilled in shopping online; this problem adds to their sense of worthlessness.Furthermore, restrictions on public transport and the fear of referring to treatment centersbecause of the contagion have become major barriers to receiving maintenance treatments forthis age-group. Limited access to Internet-based services and smartphones increases the problemsof this age-group.Therefore, stakeholders and health policymakers should take measures to prevent the potentialmental health problems that might arise in older adults who are quarantined during the COVID-19 outbreak. Here are some suggestions to help mitigate the consequences of quarantine amongolder adults:- Give older adults as much information as possibleOlder adults often have catastrophic appraisals of any physical symptoms they experience,which may further increase feelings of fear and anxiety. This fear might be exacerbated byinadequate information. There is long-standing evidence to suggest that news has a direct impacton mental health. Feelings of uncertainty and doubt have long been associated with anxiety.6Therefore, it is necessary to ensure that older adults shape a good understanding of the diseaseand the reasons for quarantine.- Provide information to older adults mainly via broadcast mediaFast transmission of COVID-19 restricts face-to-face educational interventions. Moreover,Internet-based services, smartphones, social media (e.g. WhatsApp), and electronic books are notwidely available to older adults. Therefore, governments and community-based health servicesshould provide enough information about the disease via mass media, such as radio and television,which are most accessible to the elderly.- Provide community-based health services to address health issues of older adultsCommunity-based health services, including primary care, community nursing, and pharmacyservices should provide telephone-based consultation services addressing health status, treatment,and medication management. Health services must also communicate adequate information toolder adults in quarantine about what to do in the case of developing illness symptoms. It wouldhelp reassure the elderly that they would be taken care of if they fell ill.- Provide mental health services to guide older people on how to manage their negativeemotions and feelings of isolationMental health services should consider strategies to guide older people on how to managestress, anger, and other negative emotions, and how to have effective communication with lovedones who do not live with them, so that the feelings of loneliness, stress, and anger are reduced.Such psychoeducational programs should be broadcast on mass media, which are most accessibleto the elderly. Moreover, the elderly should receive practical advice on the ways which help themto reduce boredom and about the importance of having constant communication with their lovedones to overcome feelings of isolation.- Provide adequate suppliesPublic health authorities should provide the older adults with basic supplies, such as food,masks, and disinfectants during quarantine. Some studies have shown that insufficient basicsupplies during quarantine are associated with the feelings of frustration, anxiety, and anger.6Considering the conditions in near future and the possibility of lengthy quarantines, respectiveorganizations should practice effective strategies to enhance mental health in the society, especiallyamong older adults. Some strategies that stakeholders and health policy-makers should implementto provide effective services to older adults who are quarantined at home during the COVID-19pandemic are suggested in the present article.

    Keywords: Older Adults, psychological impacts, Mental health, COVID-19 pandemic
  • Mostafa Ghasempour *, Majid Purabdollah Pages 280-281

    Today, emergence of infectious diseases has overshadowed many health beliefs and played a greatrole in the history of health development. The United Nations Secretary-General has introduced“Communicable diseases” as one of the challenges of our time. Viruses can be one of the causes ofcontagious diseases. The Coronavirus disease 2019 (COVID-19) outbreak, recently launched fromWuhan, China, has spread to more than two-thirds of the world, including Iran, and has reached thepandemic stage.1 In particular, COVID-19 disease further affects the healthcare sector and leads tomany challenges for this important part of society.These challenges include increasing need for medicalstaff; increasing costs for preventive and personal protective equipment for personnel, diagnosticand laboratory costs and treatment costs; increasing the need for Intensive Care Unit (ICU) beds andventilators; and increasing mortality.1In the meantime, health care professionals play an important role in managing such crises.Nurses, as the largest group of health care workers, spend more time with patients than otherhealthcare professionals and play an important role in the care, control and treatment of thesediseases. During the epidemic of emerging diseases, all social organizations, even the patients’family members, are distanced from him/her, and it is the duty of the medical staff to take careof the patient despite the potential health risks.2 To understand the significance of the issue, it issufficient to know that about 50% of those who died in the Severe Acute Respiratory Syndrome(SARS) coronavirus epidemic were health workers who were somehow exposed to patients inthe hospital.3Past studies show that mental disorders, including post-traumatic stress disorders, anxiety,depression, panic attacks, irritability, delirium, mistrust, and even suicidal thoughts, wereprevalent among nurses who cared for patients with SARS. Developed mental disorders can leadto psychological disorders, loss of appetite, fatigue, impaired physical ability, sleep disorders,irritability, apathy, numbness, fear, and hopelessness.4In accordance with the ethical Reciprocity Principle, hospitals have a reciprocal duty towardsthe health care staff. Health facilities should provide the necessary infra-structure to support thestaff in the care of patients with emerging diseases, including communicating with the staff tocontrol infection, providing sufficient support to increase the staff motivation, providing personalprotective equipment, and especially psychological screening for nurses, psychiatric counselingand psychological support.2 According to a recent report by the National Federation of Nurses inItaly, the second Italian nurse has committed suicide after being informed of a positive coronavirus test.5 Therefore, the importance of paying attention to the psychological issues of nursesduring and after caring for patients with COVID-19 is obvious.However, due to the increasing prevalence of the virus and also the increasing number of deathsof nurses, which can be a stressor for other nurses, it is necessary to pay attention to mental healthof nurses. Stress and mental disorders can, like a vicious cycle, weaken the immune system andlead to coronavirus infection, especially where nurses with a history of mental disorders are moreconcerned. Nurses’ mental disorders can also significantly reduce their quality of care. Despitethe major importance of this issue and the findings of previous studies, this issue has not beenaddressed yet. Therefore, it is imperative to pay attention to the mental and psychological issuesof nurses in the care of patients with coronavirus 19 as the current priority of care for nurses.In this regard, experiences and measures can be used in the epidemic of SARS, Middle EastRespiratory Syndrome-related coronavirus (MERS) and Ebola patients, including screening ofnurses for mental health, psychological counseling, or training courses to provide comprehensiveand patient-centered care.

    Keywords: Coronavirus, 2019, emerging diseases, Nurse, Mental health