Journal of Holistic Nursing and Midwifery
Volume:30 Issue: 4, Autumn 2020

One of the goals of the health system is to ensure that people are healthy. Reaching this goal is only possible through the provision of the proper services. The satisfaction of patients with the quality of health care services is used as a questionare to investigate the effectiveness of hospital services concerning consumption management and patient care quality. It assists managers and the decision-making network to identify the strengths and weaknesses of the system.

This study aimed to investigate the satisfaction of hospitalized patients in educational and medical centers of Rasht City, Iran with the “Health Care System Reform Plan” in 2019.

The present study is an analytical cross-sectional study. A total of 395 patients hospitalized in educational and medical centers of Rasht City were selected based on the stratified random sampling method and according to the inclusion criteria. The study data were collected by a questionnaire examining patientschr('39') satisfaction with the “Health Care System Reform Plan” developed by the Treatment Deputy of Guilan University of Medical Sciences. The questionnaire has 37 questions in 5 areas of patient’s satisfaction with hoteling, hospital bills reduction program, resident physician program, notification program, the program for the promotion of normal childbirth. Data analysis performed using descriptive statistics indicators and Mann-Whitney U, Kruskal Wallis, and logistic regression model.

The results showed the mean±SD of sampleschr('39') age was 43.51±18 years. The majority (23.8%) of the samples were less than 30 years old. Moreover, there was a significant difference between satisfaction score of the Plan (P = 0.009) in terms of gender, hospital bills (P = 0.001), resident physicians (P = 0.009), and notification program (P = 0.032). Also, men had a higher overall score than women. The findings of this study showed that the mean ± SD satisfaction was equal to 82.8 9.1 with a minimum score of 39.71. In the logistics model, only two variables of the hospital (P = 0.017) and job (P = 0.001) were considered as the most important factors related to the overall satisfaction with the “Health Care System Reform Plan.”

Based on the results of the study, patientschr('39') satisfaction with the implementation of the “Health Care System Reform Plan” was at the acceptable level and various factors have contributed to this level of satisfaction.

Mothers can immediately recognize the strength of their child’s development process, thereby, providing early stimulation to the child’s physical, mental, and social aspects of growth and development. Therefore, mothers and their skills play a beneficial role in the child’s overall development and growth process. 

This study aimed to determine the effect of the mother’s independent stimulation on the growth and development of infants.

This was a quasi-experimental study with a nonrandomized pretest-posttest design. The study population included mothers and their 0- to 12-month-old infants with a history of Low Birth Weight (LBW) who met the inclusion criteria. The study was conducted in Karang Pule Health Center’s service area in Mataram City, Indonesia. The length measuring tools and digital infant scale were used to measure the developmental factors. Also, the prescreening development questionnaire was used to assess the infants’ development. The frequency, mean, and standard deviation were used as descriptive statistical analysis, also, the Wilcoxon test was used for bivariate analysis.

The growth and developmental scores of the infants with LBW increased after receiving the independent stimulation from their mothers. The observed changes were as follows: The Mean±SD weight gain of 547.33±1459.40 g, the Mean±SD body length increase of 3.46±6.32 cm, the Mean±SD head circumference increase of 1.65±3.40 cm, and the Mean±SD infants’ development increase of 0.83±2.16 cm. Furthermore, the mother’s independent stimulation affected the growth (P=0.0001; body length, weight, and head circumference) and the development (P=0.04) of the infants with LBW history.

Mother’s independent stimulation significantly influences the growth (body length, weight, and head circumference) and the development of infants with LBW history. Further studies in this area are recommended.

Breastfeeding is one of the most important health-promoting behaviors and one of the main goals of the World Health Organization. Breastfeeding self-efficacy is an important variable in predicting the duration of breastfeeding and its continuation. Breastfeeding self-efficacy is a modifiable parameter that is affected by various individual and social factors.

This study aimed to compare breastfeeding self-efficacy levels of mothers with different ages referred to comprehensive health centers.

Methods and Materials: 

This is a correlational study with a cross-sectional design. Study samples were 460 breastfeeding mothers of different ages referred to comprehensive health centers in Rasht City, Iran in 2019. The data collection tool was a two-part questionnaire: a demographic form and a breastfeeding self-efficacy scale-short form (BSES-SF). Data analysis was performed using the independent t test, analysis of variance (ANOVA), and regression.

The mean ± SD scores of breastfeeding self-efficacy were as follows: 43.69 ± 12.48 in mothers under 19 years old, 50.26 ± 10.93 years in mothers aged 19-35 years, and 58.35 ± 8.53 years in mothers over 35 years old. There were statistically significant relationships between breastfeeding self-efficacy and maternal age (P= 0.0001), housing status (P= 0.0001), monthly income (P= 0.0001), breastfeeding history (P= 0.0001) and source of breastfeeding education (P=0.014), number of pregnancies (P= 0.0001) and number of deliveries (P = 0.0001). The variables of maternal age (b= 4.130, P= 0.0001, 95% CI; 2.165-6.051), monthly income (b = 1.735, P = 0.002, 95% CI; 1.239-3.922), breastfeeding history (b= 5.505, P = 0.0001, 95%CI; 4.598-9.183) and number of pregnancies (b= 3.553, P =0.0001, 95% CI; 1.278-4.098) were predictors of breastfeeding self-efficacy.

Breastfeeding self-efficacy increases with the older age and its level is lower in mothers aged < 19 years than in other age groups. Counseling support for mothers at this age is more necessary, and the need-based educational program should be designed for them.

Improving the Quality of Life (QoL) is considered one of the main objectives in the care of cancer patients. Achieving this objective, it is essential to determine the factors affecting QoL in cancer patients. The studies in the literature have determined the effects of various factors on QoL but social support from family has remained to be studied. 

The present study aimed to determine the relationship between perceived social support from family and QoL in cancer patients.

This cross-sectional study was conducted in an oncology unit of a university hospital in İzmir City, Turkey, from March to October 2019. A convenience sample of 276 cancer patients participated in the study. A patient identification form, the Perceived Social Support from family scale (PSS-Family), and the Quality of Life index-cancer version (QLI-C) were used for data collection. The scores of PSS-Family and QLI-C range from 0 to 20 and from 66 to 396, respectively. Regression analysis was used to estimate the effect of perceived social support from family on QoL.

Of the participants, 65.2% were female. The Mean±SD age of the study sample was 47.5±14.4 years. Also, the Mean±SD scores of PSS-Family and QLI-C were 16.43±3.01 and 307.77±27.48, respectively. Regression analysis revealed that perceived social support from family was associated with a relative increase in QoL index (B=3.44, P=0.001, R2=0.141).

Perceived social support from family is positively associated with QoL in cancer patients. Nurses should consider this relationship when they plan to improve the QoL of cancer patients.

Climate change, which affects human health, is one of the most important public health concerns. Few studies have examined the effects of humidity and atmospheric pressure as risk factors on the cardiac system and Out-of-hospital Cardiac Arrest.

This study aimed to determine the relationship between climatic variables (humidity and atmospheric pressure) with Out-of-hospital Cardiac Arrest , and its outcome over 3 years (2016-2018).

This is an ecological time-series study. Participants were 392 patients with Out-of-hospital Cardiac Arrest referred to Hospital in Rasht City, Iran from 2016 to 2018. Meteorological data and information related to Out-of-hospital Cardiac Arrest and its consequences were collected from reliable resources and were analyzed in R software.

Low humidity increased the relative risk of Out-of-hospital Cardiac Arrest (OR=1.54, 95%CI: 1.001-2.69, P=0.001) and failed cardiopulmonary resuscitation (OR=1.76, 95% CI; 1.006-3.79, P=0.001). Higher atmospheric pressure was associated with increased risk of Out-of-hospital Cardiac Arrest (OR=1.16, 95%CI; 1.001-1.78, P=0.001) and unsuccessful cardiopulmonary resuscitation (OR=1.039, 95% CI; 1.005-1.91, P=0.001).

Decreased humidity and increased atmospheric pressure are associated with an increased number of Out-of-hospital Cardiac Arrest cases and failure of cardiopulmonary resuscitation. Informing people with cardiovascular disease to avoid such weather conditions, as well as preparing the medical care team and designing early warning systems, can reduce the adverse effects of climate change on the heart.

Health literacy plays a vital role in health education and health promotion and has received increasing attention as a means to improve health outcomes and reduce health inequality. The students’ awareness of health literacy and their weaknesses in this area are essential for educational planning.

This study aimed to investigate the health literacy of non-medical college students and it’s affecting factors.

This is a correlational study conducted on 250 non-medical students at the Islamic Azad University of Rasht branch, Rasht City, Iran in the academic year 2018-2019. They were selected using a random sampling method. The data collection tool was the Health Literacy For Iranian Adults (HELIA) questionnaire. The collected data were analyzed using the descriptive and analytical statistics (t-test, the Pearson correlation test, and the Chi-square test).

The Mean±SD of the HELIA score was 68.44±12.72 (out of 100). About 6.8% of students had inadequate health literacy, 29.6% problematic health literacy, 54.4% adequate health literacy, and 9.2% excellent health literacy. Students had the highest score in the dimensions of understanding Mean±SD (77.11±15.82) and access Mean±SD (72.35±16.73), while in decision-making and applying health information Mean±SD (55.62±15.01) they had the lowest score. There was no statistically significant correlation between students’ age and health literacy scores, but a statistically significant relationship was reported between their gender and health literacy levels (P=0.049). The Internet (54.8%) and physicians and health workers (27.2%) were the most important sources of information about health for students.

 Many students lacked sufficient health literacy. Since most of them received information about health issues through the Internet, educational health programs and contents can be provided to them through the Internet and social networks.

In nursing, the communication between the nurse and the child is the core of child care. Some barriers can affect the nurse-patient relationship to have proper communication skills for child care.

This study aimed to examine the correlation between communication skills and early maladaptive schemas in nurses working in pediatric wards.

This is an analytical and correlational study. The participants were 178 nurses working in a children’s hospital in Rasht City, Iran in 2016. The data collection tool was a three-part questionnaire: A demographic form, the interpersonal communication skills scale (ASMA), and the Young Schema Questionnaire-Short Form (YSQ-SF). The collected data were analyzed using descriptive statistics and the Friedman and Spearman tests.

The majority of nurses were younger than 30 years (80.8%), had a bachelor’s degree in nursing (89.0%), were married (65.1%), had children (54.8%), were living in urban areas (95.2%), had employment status (63.3%) and less than 15 years of work experience (46.5%). The highest mean scores of ASMA (44.12±0.53) and YSQ-SF tools (2.65±1.04) were related to general communication skills and then disconnection and rejection, respectively. The results of the Spearman correlation test showed that the overall ASMA score had significant negative correlations with early maladaptive schemas of impaired autonomy and performance (r= -0.283), impaired limits (r= -0.421), other-directedness (r= -0.303), and disconnection and rejection (r= -0.302) (P=0.0001).

Nurses who have a higher level of early maladaptive schemas showed poorer communication skills. Examining maladaptive schemas in nurses may provide appropriate strategies to improve their communication skills.

Psychological factors play a key role in peoplechr('39')s emotional responses to different social situations. 

This study aimed to investigate the mediating role of defense mechanisms in the relationship between social phobia and alexithymia, in the students of Farhangian University, Sari City, Iran.    

This was an analytical, correlational study that specifically used structural equation modeling. The statistical population included all students of the Farhangian University of Sari city, Iran, in the academic year of 2019-2020. A sample of 234 people was recruited with the available sampling method. The social phobia inventory, defense mechanism questionnaire, and Toronto alexithymia scale were used to measure the research variables. Finally, the proposed model was evaluated using structural equation modeling.  

The results showed that social phobia variables, undeveloped defensive mechanisms, and psychotic defensive mechanisms are positively correlated with alexithymia. Also, there is a significant negative correlation between developed defensive style and alexithymia (P = 0.001). The results indicated significant correlations of social phobia (r = 0.28), undeveloped defensive style (r = 0.31), psychotic defensive style (r = 0.28), and developed defensive style (r = -0.30) with alexithymia (P = 0.001). Moreover, the research model was approved: defensive mechanisms mediate the relationship between social phobia and alexithymia in the students. The defensive mechanisms and social phobia affect 48% of the alexithymia variable.   

The students with adaptive defensive mechanisms experience lower social phobia and alexithymia symptoms. Also, social phobia indirectly affects alexithymia through the mediating role of defense mechanisms.