International Journal of Community Based Nursing and Midwifery
Volume:9 Issue: 3, Jul 2021

Primary dysmenorrhea is characterized by pain during menstruation without any pelvic pathology. It is a common problem among females in their reproductive age which is caused by increased production of prostaglandin in the endometrium as one of leading causes. Chamomile extract ceases the production of prostaglandins and leukotrienes. The aim of this study was to systematically review the clinical trials to determine the effect of Chamomile on pain and menstural bleeding in primary dysmenorrhea.

Search process to find relevant articles was conducted on electronic Iranian (MagIran, SID) and international databases (Google Scholar, Science Direct, PubMed, ProQuest, Cochrane library, Scopus, Web of Science and EBSCO), using English keywords and Persian equivalents such a “Dysmenorrhea”, “Pain”, “Menstrual bleeding” and “Chamomil” without a time limit until March 2020. Irrelevant, duplicate, descriptive, or qualitative studies were excluded. To evaluate the quality of articles, we used the Cochran’s Risk of Bias tool.

Among124 articles found in the initial search, finally 7 clinical trials (with a sample size of 1033) were systematically examined. Two out of 7 studies examined the effect of Chamomile on the pain of primary dysmenorrhea, 2 studies on the effect of Chamomile on menstrual bleeding volume, and 3 on the effect of Chamomileon pain and menstural bleeding in primary dysmenorrhea.

Based on results of the most reviewed studies, Chamomile can be considered as an effective treatment for primary dysmenorrhea and reducing menstrual bleeding.

Most hemophilia patients experience pain in their lives. Some complementary interventions might affect pain belief. This study aimed to determine the effect of Benson’s relaxation technique on pain intensity, pain belief and perception, and pain acceptance in hemophilia patients.
In this clinical trial study, 80 hemophilia patients were divided into an intervention (relaxation technique) and a control (routine care) group based on block randomization. This study was conducted in the hemophilia center of Shahid Dastgheib hospital affiliated to Shiraz University of Medical Sciences from October to December 2018. The intervention group listened to a voice containing relaxation technique twice a day for eight weeks. Numeric rating scale, pain belief and perception inventory, and chronic pain acceptance questionnaires were completed at the beginning and eight weeks after the intervention. Data were analyzed by SPSS 21 using independent t-test, Paired-t-test, Chi-square, Mann-Whitney U test, and ANCOVA. P-value <0.05 was considered as significant.
After the intervention, the mean scores of pain intensity, pain belief and perception inventory, and pain acceptance in the intervention group were 4.26±2.17, -13.35±1.50, and 67.24±9.49 and in the control groups were 5.85±2.61, -2±1.70, and 56.57±11.04, respectively. After the intervention, a difference was found between the groups regarding the mean score of pain intensity (P=0.007), pain belief and perception inventory (P<0.001) and its subscales (P<0.05) as well as total pain acceptance (P<0.001).
This study showed relaxation technique can be applied to reduce these patients’ pain intensity, improve their pain belief and perception, and enhance their pain acceptance.

Chronic heart failure can lead to frequent hospitalizations. Improving the discharge planning is an approach to reduce hospitalization. Since there has not been enough structured and effective discharge plan in Iranian hospitals, the present study was designed to optimize this program.
This is a participatory action research based on Hart and Bond’s framework, conducted in a cardiovascular center in Iran from June 2016 to April 2018 during two cycles. Based on the optimization strategies obtained through semi-structured interviews with 15 participants, three focus group discussions and six expert panels, the operational discharge plan, including three areas of patient empowerment, telephone follow-up and home visit, was designed, implemented for three months and evaluated for 23 patients. European Heart Failure Self-Care Behavior Scale and information registration form to record the number of hospitalization and length of hospital stay were used to collect the quantitative data. The non-parametric Wilcoxon test was used to analyze the data by SPSS 16. Qualitative participatory evaluation was performed during a group discussion and analyzed based on qualitative content analysis method with conventional approach P<0.05 was statistically significant.
Considering the solutions provided by the participants, the operational discharge plan was designed and implemented with the cooperation of relevant stakeholders. Evaluation showed significant effects of designed discharge plan on self-care behavior (P<0.001), number of hospitalizations (P<0.001), and length of hospital stay (P<0.001).
Changes were made to improve the heart failure patients’ discharge plan using action research, which resulted in reduced re-hospitalization and improved self-care behavior.

Nowadays, burnout syndrome (BS) symptoms appear to have increased in healthcare workers, specifically midwives, but there are no studies on burnout among midwives in Catalonia. The present study aimed to assess and describe the prevalence of BS in midwives working in labour rooms.
A cross-sectional descriptive study was conducted on 122 midwives working in 24 maternity hospitals in the Barcelona (region) which were selected using purposive sampling from January to March 2017. Data were collected using two questionnaires (demographic information, job burnout using Spanish Burnout Inventory with 20 items and four subscales). Data analysis was performed using SPSS software version 21 and Chi-Square, U Mann-Whitney, and Kruskall-Wallis. P<0.05 was considered statistically significant.
None of the participants obtained a critical level of BS. 37 (30.33%) participants scored medium burnout and 47 (38.52%) recorded low burnout. Statistically, work stress (P=0.01), marital status (P=0.006), attendance of more than three women per shift (P=0.001), the number of children (P=0.01), parity (P=0.005), health status (P=0.04), and being on sick leave over last year (P=0.04) were significantly correlated with medium-high levels of burnout. Burnout scores were higher in midwives having a life partner and those without children. 
Following the results, no participant obtained a critical level of BS; about one-third of them scored medium-high burnout. However, specific interventions are suggested to be conducted to maintain the midwives’ motivation and prevent burnout development.

Non-adherence complicates the management of patients with cardiovascular disease. This study aimed to determine the effect of applying the information-motivation-behavioral skills (IMB) model on the treatment adherence among these patients.
This quasi-experimental study was conducted on 112 patients with cardiovascular disease in Nemazee and Al-zahra hospitals in Shiraz, Iran, from October 2019 to July 2020. Eligible patients were selected and divided into intervention and control groups. The intervention was based on an integration of IMB model constructs and included 10 motivational-educational sessions for three months, followed by telephone consultations for six months. Data were collected before, and three and six months after the end of the motivational-educational sessions using adherence questionnaire in patients with chronic diseases, and adherence in chronic disease scale for medication adherence. Data were analyzed using SPSS 22, and descriptive statistics, chi-square, independent t-test, and repeated measure ANOVA were performed. P<0.05 was considered significant.
The intervention and control groups were homogenous based on demographic characteristics. Repeated measure ANOVA findings revealed an increasing trend in the mean scores of the intervention group in treatment adherence from 51.10±3.20 at baseline to 66.40±5.50 three months and 73.80±6.80 six months after the end of the intervention (P<0.001). Furthermore, based on repeated measure ANOVA findings, the mean score of the intervention group in medication adherence significantly increased from 20.10+3 at baseline to 24.10+2.40 three months and 24.50+3.20 six months after the end of the intervention (P<0.001).
Applying the IMB model promoted adherence to treatment and medication among patients with cardiovascular disease. Therefore, such interventions are recommended for these patients.

Midwives are at high-risk during the coronavirus disease (COVID-19) pandemic outbreak. Risks include virus exposures, extra working hours, psychological stressors, fatigue, work burnout, stigma, and physical and psychological violence. However, attention is needed to prepare the midwives during this crisis and help them overcome their challenges. The current study aims to explore Jordanian midwives’ experiences of providing health care during the COVID-19 pandemic crisis.
A descriptive phenomenological qualitative study was used. Semi-structured interviews using telephone calls were conducted to collect data from April to May 2020. Each interview lasted for 30-45 minutes. Purposive and snowball sampling strategies were used to recruit 20 midwives from two hospitals. Colaizzi’s method was used to analyze the data manually.
Four main themes and eight subthemes were obtained. The main themes included: “Living in turmoil”; “Communication dilemma”; “Positive experience over time”, and “Seeking support”.
Jordanian midwives experienced a stressful and interruptive routine life while providing care to their clients during the COVID-19 pandemic. This study recommends more attention towards the psychological state and factors that might affect the midwives during this crisis. The management and administrative teams should do their best to reduce the work pressure and arrange holidays appropriately. Policymakers and the government should provide the midwives with a safe work environment, good information resources, and financial rewards.

Quality of life (QOL) and marital contentment, especially marital satisfaction, are important aspects of life. These items are more important in couples involved in HIV due to the present social stigma among this population considering women more vulnerable. The aim of this study was to determine the QOL and marital contentment status among seroconcordant and serodiscordant HIV couples compared to non-HIV ones.
In this cross-sectional study, 66 serodiscordant, 74 seroconcordant, and 70 non-HIV couples who referred to Lavan High-risk Behavior Counseling Center, Shiraz during September 2017 and December 2019 were studied. QOL and marital contentment were assessed by World Health Organization Quality of Life-BRIEF (WHOQOL BREF) and ENRICH questionnaire, respectively. Chi-square test for qualitative variables, independent T-test and ANOVA followed by LSD post hoc test for quantitative variables were performed. All statistical analyses were performed using SPSS 19.0, and P<0.05 was set as the significant level.
The score of QOL questionnaire was significantly higher in non-HIV couples than serodiscordant and seroconcordant groups (P<0.001). There was no significant difference among seroconcordant and serodiscordant groups (P=0.99), and infected males vs. females (P=0.13). Non-HIV couples had significantly higher marital contentment in comparison to serodiscordant and seroconcordant groups (P<0.001). No difference was detected among seroconcordant and serodiscordant groups (P=0.81) although more contentment was observed among the males (P=0.01).
Our study revealed that QOL and marital contentment were different among non-HIV and HIV infected couples. Besides, marital contentment was higher among males than female’s in infected patients.