نشریه پرستاری و مامایی ارومیه
سال بیست و یکم شماره 1 (پیاپی 162، فروردین 1402)

One of the programs of the health system in Iran is providing services related to pregnancy, which is provided in three areas of pre-pregnancy, pregnancy, and postpartum care. Quality and quantity assessment shows how health care programs are implemented and identifies the inadequacies of the programs to solve the main problems. Therefore, the present study was conducted to investigate the quality and adequacy of pre-pregnancy care from the point of view of women referring to Urmia city hospitals.

This cross-sectional study was conducted on 765 pregnant women referring to hospitals in Urmia city by Quota sampling method. The data collection tool included demographic and midwifery information as well as a researcher-made questionnaire about the quality and adequacy of pre-pregnancy care. The questionnaires were completed about 2-3 hours before the mother was discharged from the maternity ward. Data analysis was done with descriptive and inferential statistics by SPSS software version 16. Statistical significance was considered at p<0.05.

The mean and standard deviation of the age of women participating in the study was 27.0±4.9 years. Of all the participatrd women, 159 (20.78 percent) had received pre-pregnancy care. The mean and standard deviation of the number of pre-pregnancy cares received by all women participating in the study was 15.8 ± 3.7 cares. The minimum and maximum received cares were 8 and 23, respectively, and the mean number of received cares was 15 cares. The total quality score of pre-pregnancy service was 66.60 ± 11.20. The mean scores of those who refer to private centers for the dimensions of selection, communication, interaction, and total score of service quality were significantly higher than the average scores of those who refer to public centers (p<0.05). The mean and standard deviation of the pre-pregnancy customer quality score was 59.31±11.98. The results showed that the customer quality levels were similar between women referring to public and private centers and there was no significant difference between them (p=0.859).

Despite the low coverage of pre pregnancy care, the adequacy of pre-pregnancy care was optimal, and there was no difference between private and public service providers. Considering the low quality of some aspects of pre-pregnancy care services in public compared to private centers, there is a need for planning and intervention to improve the quality of service delivery, especially in public centers.

The delay from the onset of acute myocardial infarction (AMI) symptoms to seeking medical help can have life-threatening consequences. This study was performed to determine the pre-hospital and in-hospital delay in treating the patients with AMI hospitalized in the hospital of Bonab city, Iran.

The present study was a descriptive, cross-sectional study performed from February 2020 to August 2020. Among 265 patients diagnosed with AMI referred to Imam Khomeini Hospital in Bonab city, 247 patients were eligible to include in the study. The data was collected by a three-part questionnaire including demographic information, the patient's medical history, and reasons for the delay in pre-hospital and in-hospital treatment. The validity and reliability of the questionnaire were checked by content validity and intra-class correlation coefficient, respectively. The data were analyzed in SPSS version 16 at a significance level of less than 0.05.

Most of the patients (%74.5) attributed symptoms of AMI to gastrointestinal and respiratory problems. The mean time for decision-making was 2.31±2.99 hours. Moreover, just a few numbers of them (%6.5) informed the emergency medical services after the onset of symptoms. The mean time of transmission of patients to the Cardiac Care Unit (CCU) was 3.81 hours. From them, %62.34 had not received thrombolytic therapy. Also, the mean time of taking the first dose of aspirin since the onset of symptoms was 3.75±2.99 hours. There was a significant relationship between decision-making time and sex (p= 0.03), rural residence (p= 0.04), and the job of the patients (p=0.001).

Prolonged delay was related to delay in patients’ decision-making for informing emergency medical services as well as referral of primary care services to the CCU ward. Interventions should be taken to recognize cognitive and behavioral factors involved in decision-making. New public health strategies should be developed to facilitate rapid access to acute care for AMI and to increase knowledge of people about the signs and symptoms of AMI.

Women gain important experiences during birthing which will remain with them throughout their lives. Fear of childbirth, both during pregnancy and after childbirth, leads to negative experiences of childbirth. On the other hand, ethnicity can play a role in increasing or decreasing pregnancy outcomes and experiences. This study aimed to compare childbirth experiences and fear of childbirth in two ethnicities, Kurdish and Turkish women, in Naqdeh.

This descriptive and analytical study was conducted on 630 pregnant women with Kurdish and Turkish ethnic groups referred to Comprehensive Health Centers in Naqd in 2021. The data collection tool was a demographic questionnaire, Wijma Delivery Expectancy/Experience Questionnaire (WDEQ) versions A and B, and Childbirth Experience questionnaire. To conduct the study, in each center the list of pregnant women is extracted by the Sib system; and then, the questionnaires were completed through telephone interviews. Completing the questionnaires were done in two stages. In the first stage, the WDEQ versions A was completed from 32-36 weeks of pregnancy in both groups. In the second stage, which was done one month after giving birth, the the WDEQ versions B was completed. Data were analyzed using SPSS version 21 software, and using descriptive statistical tests, Mann-Whitney test, paired t test, independent t test, and correlation coefficient test.

The difference in the mean score of fear of childbirth before and after delivery between two groups of Turkish and Kurdish pregnant women was statistically significant at the level of 0.05%, as the average score of fear of childbirth in Kurdish women was lower than that of Turkish women. The average score of childbirth experience in the group of Kurdish women (67.87 ± 4.26) was much higher than the group of Turkish women (55.69 ± 5.88). The average score of childbirth experience had an inverse correlation with the fear of childbirth before and after childbirth, which was significant at the error level of 0.05. The greater the fear before and after delivery, the more negative the delivery experience.

There is an inverse and significant correlation between the intensity of fear of childbirth and the experience gained from the childbirth process in primiparous women. The mean experience and fear of childbirth among Kurdish and Turkish pregnant women have differed. It seems that the experience and fear of childbirth in women is influenced by several factors such as ethnic, cultural, social, and environmental influences.

With the onset of the Corona crisis, nurses suffered from many psychological problems that needed interventions. The present study aimed to determinate the effect of process-based cognitive behavioral therapy on rumination and worry of the nurses during the Corona crisis epidemic.

The present research method was semi-experimental with pre-test and post-test along with a control group. The statistical population was all the nurses of Shahid Beheshti and Shahid Yahyanejad hospitals in Babol City in 2021. The statistical sample size was 30 people, which were selected by convenience sampling method and randomly assigned by lottery method to two experimental and control groups. The process-based cognitive behavioral therapy was implemented in 10 sessions of 90 minutes for the experimental group, and the control group did not receive any training. Nalen-Hoeksma, Maro's rumination, and Penn state worry questionnaires were used as research tools to collect data. Data analysis was done with descriptive statistics (mean and standard deviation) and univariate covariance analysis using SPSS version 22 software at a statistical level of 0.05.

The results showed that process-based cognitive behavioral therapy had an effect on rumination and worry of the studied nurses (P<0.001). The amount of this effect based on the eta coefficient was 0.48 on rumination and 0.53 on worry.

According to the results of this research, it is suggested that health-field consultants and planners expand interventions according to process-based cognitive behavioral therapy to increase nurses' awareness of occupational concerns.

Invasive cervical cancer is the second most common cancer among women worldwide. There are many methods based on artificial intelligence to accurately diagnose the normality or cancer of the cells, which help the specialist to diagnose cancer cells better and faster. This study aimed to present a new and efficient method for automatically detecting normal and abnormal cells.

This was a descriptive study. In order to create the database, 2600 images were prepared from 150 cytological slides. Images were evaluated, identified, and classified by specialists. In order to evaluate the proposed method in the prepared database, out of 2600 images prepared, 1300 images were considered for system training and 1300 images for testing. This research used MATLAB software version R2014b to evaluate and compare the proposed method with other methods.

Morphological extractors were used to extract the characteristics of the cells in all three stages, and support vector machine, logistic regression and C4.5 classifications were used for classification, respectively. The accuracy of the proposed method in detecting cervical cells in both normal and abnormal groups was 98.23%, which is more than other methods, and also the ratio of false positives (0.92%) and false negatives (0.85%) is lower than other methods.

The proposed method can help significantly in the field of diagnosis in medicine with the early detection of cancer and, in many cases, can be very effective in timely treatment of the patients and prevention of their mortality.

Surgical Site Infection (SSI) is a common complication following surgery that in addition to imposing a high cost on the patient and the health system, increases the risk of death. However, most of these infections are preventable, and Nurses, as the medical staff most involved with the patients, play a vital role in this field. The high knowledge of nurses regarding the prevention of surgical infection plays a vital role in identifying people at risk and controlling this situation. This systematic review and meta-analysis study was conducted to assess the status of nurses' knowledge about SSI.

To access related articles, Scopus, PubMed, and Web of Science/ISI databases were searched with these keywords: surgical wound infection, surgical site infection, postoperative wound infection, knowledge, epistemology, awareness, nurse, and their combination without time limit. Observation studies published in English that reported nurses' knowledge of SSI prevention were analyzed. Cochrane's Q test and I2 index were used to evaluate heterogeneity among selected studies. Data analysis was performed with a random effects model using STATA software version 16.

In the initial search, 204 articles were found, and 12 qualified and entered the analysis. In 6 studies, the standard score of nurses' knowledge about SSI prevention was reported to be 55% (95% confidence interval [CI]: 40-70). Meta-regression findings showed that over time, nurses' knowledge scores had an upward trend (p = 0.019), but with increasing sample size, knowledge scores decreased significantly (p = 0.01). Publication bias was significant (p = 0.01). In other 6 studies, the level of knowledge of nurses was ranked, and the level of knowledge was good and moderate in 51% and low in 49% of nurses.

Nurses have insufficient knowledge about surgical infection prevention, and providing training on using up-to-date guidelines to improve their knowledge seems necessary.

Overweight and obesity in women of reproductive age cause chronic diseases, fertility problems, adverse consequences of pregnancy, and mental diseases. Among the inappropriate behaviors that affect obesity are fast food consumption and growing sedentary lifestyle. This study aimed to determine the effect of educational and counseling intervention through smartphone applications on awareness of behaviors related to lifestyle and fast food consumption in the women of reproductive age with high body mass index.

In this experimental study, 106 women of reproductive age covered by comprehensive health service centers were selected by random sampling and assigned into intervention and control groups. The tools used in this research were a researcher-made questionnaire that included demographic information, a questionnaire of awareness about sedentary behaviors, and prepared foods. The educational intervention was carried out in the intervention group using the application. The control group received routine training from comprehensive health service centers. Three months after the intervention, the questionnaires were completed in both groups. Data analysis was done with SPSS ver. 20.0 software at a significance level of P<0.05

The study results showed that there was a significant difference between the mean scores of awareness of fast food consumption (P<0.001) and sedentary behaviors (P<0.001) before and three months after the intervention among the two groups. However, there was no significant difference in weight before and three months after the intervention (P>0.05).

Educational and counseling programs with applications can be used to improve awareness about the symptoms related to sedentary and consumption of fast foods.

Pregnant women were a risk group needing special attention during the Covid-19 epidemic. Most studies conducted in this regard are case reports, studies with small population sizes, and conflicting results in pregnancy outcomes. The research team conducted a systematic review and summarized studies that reported adverse pregnancy outcomes in pregnant women with Covid-19 infection.

A comprehensive literature review was conducted in PubMed and Scopus with no initial time limit until September 2022 to retrieve original articles published evaluating the association between Covid-19 infection and adverse pregnancy outcomes. The appropriate keywords were used in the search process. From 1790 articles obtained in the primary search, 141 eligible studies, including 1,843,278 pregnant women were examined. The evaluation of the quality of the included studies based on the critical evaluation checklist showed that 65% have high quality, 34% have average quality, and 1% have low quality.

Pregnant women are at greater potential risk for adverse pregnancy outcomes. The most common adverse pregnancy outcomes reported were preterm birth (9 studies), premature rupture of membrane (4 studies), gestational diabetes (1 study), hypertensive disorders (4 studies), fetal distress (2 studies), intrauterine fetal death (2 studies), low birth weight (3 studies), and NICU admission (3 studies). In most studies, there was no evidence of vertical transmission of Covid-19 from mother to fetus.

Covid-19 infection may cause adverse pregnancy outcomes during pregnancy. Vertical transmission from mother to fetus may occur, but the immediate and long-term effects on the infant are unknown. Therefore, considering the possibility of vertical transmission of this virus, the treatment team should be aware of this and take the necessary measures and attention. Also, if the mother is seriously ill, separation from the baby should be considered. Further studies are needed to clarify the causal relationship between these outcomes and covid-19 infection.