Journal of Holistic Nursing and Midwifery
Volume:31 Issue: 4, Autumn 2021

Assessment of fetal weight is a vital factor in antenatal care, not only in the management of labor and delivery but also in identifying fetal weight disorders.

This study compares the accuracy of clinical methods and ultrasonography in Estimating Fetal Weight (EFW) with Actual Birth Weight (ABW) in term pregnant women.

This diagnostic test evaluation study was performed on 247 single-term pregnant women admitted to an educational, therapeutic hospital in Rasht City, Iran. In this study, abdominal palpation, Johnson’s formula, Insler’s formula, and ultrasonography were used to estimate fetal weight. One-sample t-test, the Chi-square, and the Bland-Altman plot were used to compare the diagnostic value of fetal weight estimation methods. The accuracy of tests was estimated based on sensitivity and specificity in fetal weight groups (below 2500 g, 2500- 4000 g, and above 4000 g) by the Bland-Altman plot.

The participating pregnant women had a Mean±SD age of 28.86±4.24 years, body mass index of 32.98±6.0 kg/m2, and gestational age of 39±1.04 wk. Their Mean±SD actual birth weight was 3343.352±432.799 gr, Also, the Mean±SD birth weight found by abdominal palpation was 3371.053±345.561 gr, Mean±SD birth weight by Johnson’s formula 3041.206 ±411 gr, by Insler’s formula 3556.316±531.567 gr, and by ultrasonography 3294.28±380.09 gr, Based on the one-sample t-test, the abdominal palpation had the lowest (P=0.261), and the Insler’s formula (P=0.001) had the highest difference with the actual birth weight. Regarding the fetal weight groups, Insler’s formula (96.33%) was highly accurate in Low Birth Weight (LBW), but abdominal palpation (91.09%) was more accurate in normal weight and macrosomia (94.72%) groups. There was a significant difference between clinical methods with ABW (P=0.026).

Clinical methods are accessible, affordable, and available and can estimate fetal weight in developing countries, especially in our country.

Death anxiety is one of the main elements in mental health in older adults.

This study aimed to determine the effects of improving emotional intelligence on death anxiety in older adults in Kashan City, Iran.

This quasi-experimental study was carried out on 60 older adults referred to health clinics in Kashan City, Iran, in 2019. The participants were randomly allocated to the control and experimental groups. Before the intervention, a demographics data questionnaire and death anxiety scale was filled out by the two groups. The experimental group received emotional intelligence education in eight sessions (twice a week). The control group received no intervention. The study measures included a demographic checklist and the Templer Death Anxiety Scale (TDAS). Immediately and one month after the intervention, both groups filled out the death anxiety scale again. The collected data were analyzed using descriptive and analytical tests such as t test, the Chi-square, and repeated-measures Analysis of Variance (ANOVA).

The results showed that 22 participants (73.3%) and 17 (56.7%) were in the 61-65 age range in the experimental and control groups, respectively. Based on the Chi-square test, there was no significant difference between the two groups regarding demographical data, including age, gender, marital status, education, and job. The results of repeated-measures ANOVA in the experimental group showed that the mean scores of death anxiety decreased over the 3 time points (P<0.05). Also, the post hoc test showed a significant difference in death anxiety scores at different time points in the experimental group (P<0.05). The t test results showed no statistically significant difference in the mean score of death anxiety before the intervention between the two groups, but at the end of the sessions (P=0.006) and one month after the intervention (P=0.001), this difference was significant.

The results indicated that improving emotional intelligence in older adults decreased their death anxiety. It is recommended that nurses use this method to decrease death anxiety in older adults.

Despite interest in improving performance management in universities, few studies have examined this topic. Because of the absence of validated tools in Iran for assessing behavior performance management, this study was conducted to validate the behavior performance management scale.

This study aimed to assess the psychometric adequacy of the Performance Management Behavior Questionnaire (PMBQ) for the heads of university departments in Iran.

This cross-sectional study was conducted in four phases. The first and second phases included PMBQ translation and its modification in accordance with the educational setting. The third phase consisted of the content and face validation, and the fourth phase aimed to evaluate the construct validity and reliability of this scale. All 400 faculty members (200 for exploratory factor analysis and 200 for confirmatory factor analysis) were studied. After translation, the 27-item PMBQ was evaluated for validity and reliability. Content Validity Ratio (CVR) and Content Validity Index (CVI) were computed for content validity. For construct validation, the exploratory factor analysis and confirmatory factor analysis were used. The PMBQ reliability was assessed by the Cronbach α coefficient.

Considering eigenvalues above one, five factors were identified that jointly explained 58.22% of the variance observed. Based on the arrangement of the factors, they labeled as monitoring performance management (9 items), coaching (6 items), goal setting (6 items), communication (3 items), and providing consequence (2 items). Results showed that the Average Variance Extracted (AVE) varied between 0.51 and 0.60; composite reliability was between 0.7 and 0.81, and the Cronbach α coefficient was between 0.70 and 0.82.

PMBQ as a valid and reliable tool can be used for assessing the behavior of the heads of departments from the viewpoints of faculty members.

Death anxiety and low self-esteem are major problems in patients with Multiple Sclerosis (MS). Spiritual interventions, along with other nursing interventions, can restore the balance between body and soul.

This study aimed to determine the effect of the spiritual care program on death anxiety and self-esteem in MS patients. 

In this clinical trial, 60 patients with MS were randomly assigned into the intervention (n=30) and control (n=30) groups. The intervention group received spiritual care program in four sessions. Templer death anxiety and Rosenberg self-esteem scale were completed by samples before and after the intervention. Data analysis was performed using the independent t test, Chi-square, and Fisher exact tests. The significance level is considered less than 0.05.

The Mean±SD ages of the intervention and control group samples were 32.8±6.39 and 35.1±8.35 years, respectively. The Mean±SD scores of death anxiety in the control group 12.27±0.85 and the intervention group 11.8±0.88 before the intervention were not significantly different. After the intervention, the difference between the Mean±SD scores of the control group 12.10±0.61 and the interventional group 8.13±0.71 was statistically significant (P=0.001). The Mean±SD scores of self-esteem in the control group 14.63±1.51 and the interventional group 15.5±1.5 before the intervention were not significantly different. The difference between the Mean±SD scores of self-esteem in the control group 14.67±1.9 and the interventional group 18.03±1.85 was significant after the intervention (P=0.001). The results of ANCOVA demonstrated a significant difference between the control and intervention groups in terms of death anxiety (F=6.41, P=0.014, partial Eta2=0.101) and self-esteem (F=13.079, P=0.001, partial Eta2=0.187) of MS patients.

Since spiritual care intervention in patients with MS reduced their death anxiety and increased their self-esteem, this simple and low-cost care program can be recommended for those suffering from this disease.

Ethical decision-making by nursing managers is influenced by various essential factors, such as courage, without which it is impossible to act on them.

This study aimed to explore the experiences of nursing managers about courage in ethical decision-making.

The current study was conducted in Iran by a qualitative content analysis approach in 2018. Nineteen nurse managers were selected purposefully from hospitals in Tehran and Shahrekord cities. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method.

Based on data analysis, we extracted 2 categories (obligation, decisiveness) and 8 subcategories (clearness in expressing decisions, the ability of the manager to make decisions in critical and complex situations, authority/decision-making as a religious responsibility, follow the decision process, being responsible, making compensatory decisions, making preventive decisions).

The findings showed that managers who are committed to ethical decision-making have enough assertiveness to make the decisions. Educating, empowering, and sensitizing managers and enhancing their insight into ethical issues through problem-solving and role-playing techniques can play an essential role in promoting their commitment and responsibility.

Oral health plays an important role in determining food intake patterns, meeting nutritional needs, and consequently keeping the health of the elderly and their quality of life. Health literacy is also one of the biggest determinants that significantly impacts disease prevention in the elderly.

This study aimed to determine oral health status and the relationship between health literacy and nutritional status in the elderly referring to health centers in Tabriz City, Iran.

This research is a cross-sectional analytical study performed on 300 older people in Tabriz in 2020. Data collection tools included the geriatric oral health assessment index, seniors in the community: risk evaluation for eating and nutrition, health literacy for Iranian adults, and demographic information questionnaire. To analyze the data, descriptive statistics were used to sort out the data. The Shapiro-Wilk test was used to check the data normality, and then simple and multiple linear regression analyses were performed to evaluate the relationship between variables and control the effect of intervening variables. The level of significance in this study was considered less than 0.05.

The Mean±SD age of the elderly was 69.7±6.7 years. The number of men and women participating in this study was equal. A total of 257 people (85.7%) were married. The results showed that the oral health status of 51% of the elderly was below mean, 65.33% of the elderly were illiterate, and 69.33% were severely malnourished. Based on the results of multiple regression, the nutritional status of the individuals was a predictor of the oral health score of the elderly (Β=-13.5, 95% CI; -11.3, -15.69, P=0.001). So, people with malnutrition, mildly malnourished, and severely malnourished had lower oral health scores than healthy individuals with the control of the other variables. The R2 value in this study was 0.59.

According to the study results and the relationship between malnutrition and oral health, it is necessary to conduct studies on the factors affecting malnutrition in the elderly by intervening on the factors affecting malnutrition, changing the oral health status of the elderly, and improving their quality of life.

Irritable bowel syndrome is the most common, costly, and disabling dysfunction of the gastrointestinal tract. Mental disorders can be one of the main factors in the onset, continuation, or exacerbation of gastrointestinal signs and symptoms in people with this syndrome. Commitment and acceptance therapy is a mixture of four approaches of awareness, acceptance, commitment, and behavior change, and its overall goal is to achieve psychological flexibility to move towards thought-based behavior. This treatment focuses less on reducing symptoms and more on improving the quality of life.

This study aimed to determine the effectiveness of acceptance and commitment-based therapy on the immune function and activity limitations in patients with irritable bowel syndrome.

This study was a quasi-experimental research with a pre-test, post-test design and a control group. Thirty patients with irritable bowel syndrome were randomly selected from those referred to a hospital clinic in Tabriz City, Iran. They were randomly divided into the intervention and control groups (15 in each group). The intervention group received acceptance and commitment group therapy for 8 sessions, while the control group did not receive any intervention. Both groups were assessed before and after the intervention, and in the follow-up phase using the activity limitations subscale of quality of life questionnaires (to measure activity limitations) and stool calprotectin test to assess safety performance. Data analysis was performed using descriptive statistics indices (mean and standard deviation) and analysis of variance with repeated measures, Bonferroni test, and analysis of covariance to test the study hypotheses.

The Mean±SD age of the intervention group was 34.53±18.38 years, and the Mean±SD age of the control group was 42.80±17.97 years. The significance levels of Levene’s and the Shapiro-Wilk test for all variables were greater than 0.05. Based on the results, the Mean±SD score of the activity limitations variable in the intervention group was 7.53±4.24 in the pre-test, 17.66±3.41 in the post test, and 17.26±3.65 in the follow-up. According to the results, activity limitations (P=0.027) and safety performance (P=0.034) were significantly different before and after the intervention.

The present study’s findings show that acceptance and commitment-based therapy can play an influential role in improving patients’ immune function and promoting their activity limitations. Therefore, this treatment is recommended as a complementary therapy in patients with irritable bowel syndrome.

It is necessary to identify the factors affecting the posttraumatic growth of cancer patients to minimize the consequences of its psychological trauma.    

This study aimed to determine the structural relationships of coping styles, the collapse of core beliefs, social support, spirituality/religious coping with posttraumatic growth variables, and the mediating role of positive reassessment and deliberate mental rumination within a causal pattern. 

This cross-sectional study was performed using path analysis and structural equation modeling (SEM) by convenience sampling method on 213 patients with breast cancer in Mashhad, Iran, in 2019.  The pattern of variables relationships was tested in a conceptual model by SEM and used the partial least squares regression method to test the measurement pattern and research hypotheses.  In the measurement model section, three convergent validity indices, i.e., Average Variance Extracted (AVE), Composite Reliability (CR), and the Cronbach α, and in the structural model section, two indicators of coefficient of determination (R2) and Stone-Geisser coefficient (Q²). 

The Mean±SD age of the patients was 52±16 years. The standardized coefficients of the overall effect of core beliefs pathways, positive religious coping, search for meaning, presence of meaning, deliberate rumination over positive re-evaluation were 0.953, 0.386, -0.250, 0.248, and 0.238, respectively (P=0.001).  The direct coefficient of the positive reassessment path to posttraumatic growth was 0.085 (P=0.01). Also, the coefficient of collapse path of core beliefs to intrusive rumination was 0.687, which was significant at the level of P=0.0001.  Finally, the standardized coefficients of the overall effect of all paths for negative religious coping, the collapse of core beliefs, presence of meaning, problem-based coping style, search for meaning, deliberate rumination, social support, positive religious coping, emotion-based coping, intrusive rumination over posttraumatic growth were -0.481, 0.227, 0.182, 0.146, -0.136, 0.066, 0.060, 0.059, 0.056, and -0.043, respectively (P=0.0001).

The results of the present study showed that in addition to confirming the direct paths of independent variables to the posttraumatic growth, positive reassessment had a mediating role between pathways of the presence and search of meaning, conscious rumination, religious coping, and the collapse of core beliefs in posttraumatic growth.