فصلنامه حیات
سال بیست و هشتم شماره 1 (پیاپی 93، بهار 1401)

Compliance with health behaviors during pregnancy plays an important role in the health of mothers and their neonates. The aim of the study was to determine factors predicting adherence to COVID-19 health protocols among pregnant women in Zanjan province in 2020.

 A cross-sectional, descriptive study was conducted on 2336 pregnant women referred to comprehensive health centers in Zanjan province in 2020. The samples were selected by the multi-stage sampling method. Data were collected by telephone using a researcher-designed questionnaire on health practices and overall perception of COVID-19 disease. To analyze the data, descriptive statistics and multiple linear regression model were used at the confidence level of 95% through the SPSS software version 16.

Most women were in the second trimester of pregnancy and living in the urban areas. Considering the median score as a cutting point, the participants’ adherence level was 46.5% over the median score and at a desirable level. The handwashing adherence was 84.7% and mask use was 76.6%. Location, age, education, occupation, household income, and family history of COVID-19 disease were the most important predictors of compliance with COVID-19 health protocols (P<0.001).

Adherence to health protocols was at a relatively desirable level in almost half of the participants. It is suggested that education and support programs be designed and implemented for young and low-income groups living in rural areas.

Nurses constitute the majority of the workforce in the healthcare system. The use of digital technologies, including mHealth applications, is essential and effective in improving the quality level of healthcare services provided by nursing staff. Therefore, the primary purpose of this study is to investigate the use of mHealth applications for professional purposes by nurses during the COVID-19 pandemic.

 This is an applied study conducted using the descriptive, cross-sectional method in 2021. The study population was nurses in four public hospitals in Isfahan. The sampling method was a one-stage cluster sampling. The data collection tool was a questionnaire whose validity and reliability was assessed. Data analysis was performed using descriptive and inferential statistics on the SPSS software version 26.

The data of 93 questionnaires were analyzed. About 63 percent of nurses answered (with a reason) that they did not use these applications. This study showed that the use of mHealth applications is not common among the nurses. They need the training to use the applications. There were concerns regarding the mHealth applications' quality. The nurses believed that using a mHealth application would help them perform their nursing duties during the COVID-19 pandemic.

Based on the study results, planning for the development of mHealth applications tailored to the nurses' needs and training nurses to use the applications in clinical settings are recommended. There is also a need to provide and develop specialized evaluation tools and working groups to review and report on the quality of mHealth applications.

Reduced quality of life and self-efficacy are among problems of mothers of children with chronic diseases. This study aimed to determine the effect of empowerment based on the Gibson model on self-efficacy and quality of life in the mothers of children with thalassemia.

In this quasi-experimental study, the study population were the mothers of children with thalassemia referred to rare disease clinics in Rafsanjan and Kerman in 2020. The sample size was 25. Mothers were selected by the convenience sampling method and divided into two groups. In the intervention group, mothers participated in five training sessions based on the Gibson model, and in the control group, mothers received routine care. Data collection tools included the Zhang’s self-efficacy questionnaire and the SF-36 which were completed before the intervention and six weeks after the intervention. Data were analyzed using chi-square test, independent and paired t-test via the SPSS software version 18.

Before the intervention, the mean score of self-efficacy (P=0.31) and quality of life (P=0.47) were not statistically significant between the groups, but after the intervention, the mean score of self-efficacy in the intervention group (68.81±9.36) was significantly higher than that of in the control group (44.69±6.87) (P<0.001). But there was no significant difference in the mean score of quality of life between the intervention (60.64±10.08) and control (56.19±11.41) groups after the intervention (P=0.19).

According to the results, empowerment based on the Gibson model is an appropriate method for improving self-efficacy in the mothers of children with thalassemia. However, further studies are recommended about its effect on quality of life.

Performing daily activities is a major element of quality of life in heart failure patients. The Duke Activity Status Index (DASI) is a tool to measure factional capacity. We aimed to examine the psychometric properties of the DASI in patients with heart failure.

 In this methodological study using convenience sampling, we included 120 patients with heart failure referred to the heart clinic of Afshar hospital, Yazd in 2018.  We first translated the original DASI to Farsi using forward and backward translation method. Then, we evaluated its face validity, content validity, criterion-related validity, construct validity (Exploratory Factor Analysis), and reliability (internal consistency).

In quantitative content validity, the content validity index and content validity ratio were confirmed. The criterion-related validity was confirmed using the Spearman correlation coefficient between the New York Heart Association functional classification scores and the DASI score (r=-0.77, P<0.001) with a significant correlation. To assess construct validity, exploratory factor analysis revealed two factors, explaining 52.61% of the total variance. Factor 1 included items with high MET values and factor 2 included those with low MET values. The reliability of the DASI was determined using the Cronbach’s alpha coefficient that was 0.81.

The DASI is of good validity and reliability and due to its appropriate psychometric properties, this tool can be used to evaluate the functional status of patients with heart failure.

Cultural competence is one of the main components of health care. Attention to cultural competence is essential to reduce healthcare inequalities and identify potential for improving healthcare delivery. The aim of this study was to investigate cultural competence and its related factors in health care providers working in comprehensive health centers affiliated with Tehran University of Medical Sciences (TUMS).

In this descriptive, cross-sectional study, 250 health care providers working in health centers affiliated with TUMS were selected using the convenience sampling method in 2020. The demographic characteristics form and the cultural competence scale for health workers (CCSN) were used to collect the data. Data were analyzed using descriptive and inferential statistical tests (t-test and ANOVA) through the SPSS software version 16 at a significance level of 0.05.

The mean total score of cultural competence in health care providers was 162.66±28.41 (range: 33-231). According to the findings, the mean score of cultural competence for all dimensions was desirable. The mean score of cultural competence had a statistically significant relationship with intra-ethnic marriage (P>0.005) and work experience (P=0.012) while no statistically significant difference was observed with other demographic variables.

The study results showed that cultural competence in health care providers was at the desirable level. These results may be useful for managers and planners in the development and management of human resources and quality assurance of health services delivery.

Due to the importance of breastfeeding in the health of premature infants, the present study was conducted with the aim of determining the effect of telephone counseling on the continuity and breastfeeding status of mothers with late preterm infants.

In this randomized controlled trial, 65 eligible mothers from Ahvaz in 2019-2020 were selected using the convenience sampling method and divided into two intervention and control groups using block randomization (with block sizes of 4). The routine care was provided for the control group. The intervention group received a daily telephone support counseling for 14 days after discharge. Data were collected using a questionnaire on the continuity of breastfeeding and breastfeeding status at the pre-counseling phase and then monthly up to four months after discharge. Data were analyzed using chi-square test, independent t-tests and Kaplan Meyer survival analysis at a significance level of 0.05 through the SPSS software version 16.

According to Kaplan Meyer survival analysis, the rate of exclusive breastfeeding interruption in the control group was higher than that of in the intervention group (5 vs. 8) but it was not statistically significant. Improvement of breastfeeding status one month after discharge was significantly different between the two groups (P=0.048).

The results showed that telephone support counseling was effective in improving breastfeeding status up to the first month after discharge. Continuous telephone support counseling can be a good approach to improving breastfeeding and its continuity in the first month after discharge.

Although pain control in patients with burns has improved over recent years, the ineffectiveness of some treatments to reduce pain in this group of patients remains a challenging issue for health care professionals. This systematic review was conducted to investigate nursing interventions in the field of pain relief in burn patients.

 In this systematic review and meta-analysis, relevant information was searched from databases PubMed, Science Direct, Scopus, Irandoc, SID, and Cochrane library with keywords nursing interventions, pain, burns and their equivalent Persian keywords in the period 2010-2020. To increase the validity and reliability of the study, three people evaluated the quality of the articles separately and Jedad criterion was used to evaluate the articles.

After assessing 181 articles on the databases, 19 articles were systeatically reviewed. Nursing interventions to reduce pain in burn patients included using breathing techniques, new dressings, muscle relaxation, music therapy, transcutaneous electrical nerve stimulation (TENS), electrical brain stimulation, play therapy, aromatherapy, use of Zekr Allah, massage, guided imagery, distraction techniques, and eye movement desensitization. In eight meta-analyses, total mean differences of pain relief score were estimated 1.28 (0.95% CI: 0.78-1.78).

Most nursing interventions reduced pain in burn patients. Easier-to-use pain relief techniques such as muscle relaxation, guided imagery, and spiritual care are emphasized.

Physiological and psychological needs of intensive care unit (ICU) patients are not met due to lack of effective communication. To facilitate communication, nurses can use augmentative and alternative communication strategies (AACs). The aim of this study was to determine the effect of using these strategies on the quality of nurses’ communication with patients with endotracheal intubation in the cardiac surgery intensive care units.

 In this quasi-experimental intervention study with before-after design, 70 patients (35 at each stage) who were unable to communicate verbally after heart surgery due to intubation were recruited by the convenience sampling method, and also 10 nurses in the cardiac surgery ICU were randomly selected. In the pre-intervention stage, nurses communicated with patients using conventional methods, and after training in the post-intervention stage, using AACs. Data were analyzed using descriptive and inferential statistics through the SPSS software version 22.

The lowest content of communication in the pre- and post-intervention stages was related to emotions, the frequency of which was higher in the post-intervention stage compared to the pre-intervention stage. The most commonly used methods in the post-intervention phase were the communication board and head gesture. In both stages, communication was mostly initiated by the patient. In the post-intervention stage, the number of times the nurse started the communication increased (P<0.05). In the post-intervention phase, patients’ and nurses’ satisfaction with communication increased (P=0.0001).

Training nurses about AACs and using them for the ICU patients increase the success of communication and patients’ and nurses’ satisfaction with communication. Therefore, the use of these strategies in these wards is recommended to nurses and nursing managers.