مجله مراقبت پرستاری و مامایی ابن سینا
سال بیست و هشتم شماره 4 (پیاپی 76، پاییز 1399)

 To reduce mortality occurrence on the day of birth, it is recommended to evaluate the health of the fetus during pregnancy. The most widely used technique in most centers as the ideal screening for fetal health assessment is non-stress test. Due to the fact that reducing fetal movement is one of the immediate symptoms of fetal death, this study was conducted to determine the effect of music on fetal movement during non-stress test.

This randomized double-blind clinical trial was performed on 160 first-time pregnant women aged 37-40 weeks who had referred to Fatemieh Hospital in Hamadan, Iran, with a complaint of reduced fetal movement in 2019. Individuals were randomly assigned to two control and experimental groups of 80. In the experimental group, 30 minutes of intervention was performed by listening to non-verbal music, but in the control group, no intervention was performed. Data analysis was performed using SPSS 20 and Chi-square test, Mann-Whitney U test and T test. P-value<0.05 was considered significant.

In the intervention group, the average difference in the number of fetal movements was more than the control group and this difference was significant. It had a significant decrease in the number of non-reactive tests in the intervention group compared to the control group (P<0.001). The number of basal fetal heart in the intervention group decreased significantly compared to the control group (P=0.01).

Music can improve fetal movements and increase the number of reactive tests.

The aim of this study was to compare some of the maternal blood parameters and Apgar score of their infants in conventional vaginal delivery with physiological delivery.

This semi-experimental study was performed in 2018 with the participation of 400 pregnant women candidates for physiological childbirth and 400 pregnant women candidates for conventional vaginal delivery, using the available sampling method. Mothers in the physiological delivery group were those who did not receive any major labor intervention, and during the labor, training was given on how to breathe, pelvic rotation, delivery ball, hot shower, and massage. In the common vaginal delivery group, the mother went through the usual steps as soon as she was hospitalized. All motherschr('39') intravenous blood samples were examined in two groups to measure the amount of hemoglobin and hematocrit at the time of hospitalization and 6 hours after delivery and the Apgar score of the first and fifth minutes of infancy in both groups. Data analysis was performed using Stata-13 software and the significance level was considered to be 0.05.

The mean age of Hemoglobin and Hematocrit in the conventional vaginal delivery group was 27.37(5.75) years and in the physiological delivery group was 27.70 (5.73) years. The results showed that at the time of hospitalization, the mean hemoglobin in the physiological delivery group was significantly higher than the conventional vaginal delivery 11.64 (1.20) and 11.93 (1.20), respectively (P<0.001). The results showed that at the time of hospitalization, the mean hematocrit in the physiological delivery group was significantly higher than conventional vaginal delivery 36.53 (3.33) and 35.50 (3.33), respectively (P<0.001). Comparison of the Apgar scores of the newborns in two groups in the 1st and 5th minutes also showed that the Apgar score in the physiological delivery group was higher than the conventional vaginal delivery (P<0.05).

The results showed that at 6 hours postpartum, the mean of hemoglobin and hematocrit in the physiological delivery group was significantly higher than conventional vaginal delivery (P<0.001). Comparison of neonatal Apgar scores of the two groups in minute 1 and minute 5 also showed that the amount of Apgar score in physiological delivery group was higher than conventional vaginal delivery (P<0.05).

Patient safety culture has been identified as one of the important factors in reducing hospital adverse events and improving patient safety. The present study was conducted to investigate the relationship between patient safety culture and adverse events among nurses of selected teaching hospitals in Tehran.

This cross-sectional study was performed in 2019 on 260 nurses in 7 hospitals affiliated to Tehran University of Medical Sciences. Data was collected using the patient safety culture questionnaire and the frequency of adverse events. Multiple logistic regression was used to investigate the relationship between patient safety culture and adverse events in SPSS 22.

Among the dimensions of patient safety culture, the highest mean score was related to the dimension of "organizational learning" and the lowest score was in the area of "information exchange and transmission". Between 35.4% and 51.9% of nurses estimated that they had experienced one of six adverse events in the past year. Logistic regression results indicated that dimensions of management support for patient safety, general understanding of patient safety culture, teamwork within organizational units, communication and feedback about errors, staffing issues and information exchange and transmission were significant predictors for adverse events (P<0/05).

The results of the present study confirmed the hypothesis that improving the patient safety culture leads to decrease in the incidence of adverse events among nurses, therefore promoting the safety culture in hospitals of country should be considered as one of the main priorities of management programs.

 Anxiety during pregnancy is a special emotional state related with different concerns during pregnancy including infant health and parturition, which is associated with an increased risk of a range of negative consequences for both mother and child. Therefore, the aim of this study was to investigate the effect of cognitive and behavioral therapy on the anxiety of mothers with pregnancy constipation.

The present randomized clinical trial, which included 60 pregnant women with a gestational age of 10 to 20 weeks referred to two comprehensive urban health services in Takestan during 2019. Subjects were randomly divided into intervention (n=30) and control (n=30) groups. Study tools included the short form of pregnancy-related anxiety questionnaire (PRAQ-17) and a constipation assessment scale in pregnancy. Intervention included 6-week 90-minute consultation sessions (one session each week) for five groups of 6 persons. Follow-up included immediately and one and two months after session completion. Repeated measures and Chi-square analysis were used for data analysis. P-value<0.05 was considered significant.

The mean of pregnancy anxiety scale, immediately, one month and two months after the intervention was significant (P<0.001). In terms of time and group interaction significant difference was observed (P<0.001; F=29.776), In other words, there was a significant difference between the two groups in terms of pregnancy anxiety over time.

The present study indicated the beneficial effect of cognitive and behavioral therapy model on the anxiety of pregnant women with constipation, and it is recommended as a non-pharmacological approach to reduce their anxiety.

 Cancer is one of the most important diseases of the current century and the third leading cause of death after cardiovascular disease and accidents, and affects the psychological well-being of cancer patients. The aim of this study was to determine the effect of individual, family and social factors on the psychological well-being of patients with breast cancer in order to develop a structural model.

The present study was descriptive in the form of structural equation modeling. Its statistical population consisted of all women with breast cancer being treated in medical centers and specialized hospitals for cancer in Tehran in the first quarter of 2019 (1350 people). The statistical sample was determined based on the research plan of 300 people and using multi-stage clustering method, clustering of medical centers based on geographical areas and then selection of a cluster was performed randomly. Data were collected using Reefchr('39')s psychological well-being questionnaires, Baer et al.chr('39')s mindfulness, five neo-personality factors, Connor and Davidsonchr('39')s resilience, Ritchie and Fitzpatrickchr('39')s family communication patterns, and Zymetchr('39')s social support. Finally, the data were analyzed using multivariate linear regression test in the text of structural equation modeling and by AMOS software version 21.

The results of model analysis indicated that among the individual factors, the openness to experience, positively and neurosis has a negative effect on psychological well-being (P<0.01). Also, resilience and mindfulness have both positively increased mental well-being (P<0.01). In the case of familial factors and among the family communication patterns, the factor of orientation of conformity has reduced mental well-being (P<0.01). Finally, social support can increase psychological well-being (P<0.05).

Thus, it can be acknowledged that, despite the difficult physical conditions that people with cancer face, it is possible to take appropriate social support to strengthen the resilience of these patients and finally, expect that the ability to adapt and cope with cancer will also increase in people with the disease.

Multiple sclerosis (MS) is a chronic and debilitating disease of the central nervous system. Chronic illness and lack of definitive treatment reduce all aspects of physical and social functioning and thus reduce quality of life. The aim of this study was to compare the effectiveness of a group of yoga and psychotherapy group exercises based on acceptance and commitment to fatigue and quality of life of patients with MS.

In the present quasi-experimental study (pre-test-post-test design), 60 women with MS referred to the Neshat Clinic in Hamadan were selected randomly, considering entry criteria and then divided into two equal groups of yoga exercises and acceptance and commitment-based therapy groups (both 12 sessions each). Data were analyzed using independent t-test, Chi-score and Fisherchr('39')s exact test, analysis of covariance and LSD with 95% confidence level by SPSS software version 22.

The results showed that compared to group psychotherapy based on acceptance and commitment, yoga group demonstrated -5.29±0.69 units of reduction in the fatigue score and 8.39±1.11 units of decrease in quality of life score which was statistically significant (P <0.001).

It can be concluded that yoga and group psychotherapy based on acceptance and commitment reduce fatigue and increase the quality of life of patients with MS. It is effective that these results can promise a new development in interventions, so that in addition to drug treatment, complementary therapies can be used to reduce the complications of the disease.

The current study investigated the relationship between nurseschr('39') communication features and patient safety culture in educational hospitals in Sanandaj city, Iran.

This correlational study was performed on 278 nurses working in educational hospitals in Sanandaj, Iran. The standard safety culture questionnaire made by Barton J.chr('39')s quality and health care research and communication skills agency was used. The standard questionnaire used was in two sections. Data analysis was conducted using SPSS 19. In the descriptive statistics section, mean and standard deviation, and in the inferential statistics, correlation tests, Mann-Whitney, Kruskal-Wallis, and linear regression were used.

The mean of total positive responses to 12 dimensions of patient safety culture was 59.11%. The negative response was 22.07% and the neutral responses were 17.94%. These results indicated an acceptable status of safety culture in the studied hospitals. The average of communication skills among nurses in Sanandaj was 66.98±9.57 (maximum score is 90). The inferential analysis showed that there is a significant relationship between variables such as age, work experience, marital status, educational level, and type of employment with two main variables (communication skills and patient safety culture). The results of linear regression showed that the components of communication skills (verbal, listening, and feedback) have a positive and significant effect on improving the patientchr('39')s safety culture. These components may explain 55.2% of the variation of the dependent variable (the patientchr('39')s safety culture).

Based on the results of the research, the status of the patient safety culture and communication skills was moderate. To improve the patientchr('39')s safety status, nurses’ communication skills should be improved. This is possible during the nurse’s formal education or in-service training.

The present study was conducted to investigate the effect of breastfeeding counseling on the self-efficacy of lactating mothers.

This study was conducted as a two-group clinical trial on 60 pregnant women referred to Malayer womenchr('39')s hospitals. Pregnant women were selected by available sampling method. Sampling was performed in two groups by block random method and the size of the blocks was considered as a multiple of the number of groups. Data collection tools included a demographic and midwifery characteristics questionnaire and a Fox and Dennis breastfeeding self-efficacy questionnaire. The intervention was carried out in accordance with GATHERchr('39')s advisory principles. Maternal breastfeeding self-efficacy was assessed before intervention and one month after delivery in both groups.

The research units in the two control and test groups were homogeneous in terms of demographic characteristics. The change in motherschr('39') breastfeeding self-efficacy score after intervention was significantly higher than before in test group (P<0.001).

The results of the study showed that providing counseling has been very effective in increasing the self-efficacy of breastfeeding mothers and their performance.