Journal of Holistic Nursing and Midwifery
Volume:33 Issue: 3, Summer 2023

Preschool sex education plays an important role in endorsing sexual health.

This qualitative study aims to determine the mothers’ and trainers’ perspectives regarding the sex education of 3-5 years old children living in Karaj City, Iran.

The study participations were 20 mothers and 10 kindergarten trainers. To collect data, semi-structured and deep interviews were held with them within 2 months. Interviews went on until data saturation. Simple random sampling was used to choose the kindergartens and purposeful sampling to select the study samples according to the inclusion criteria with maximum diversity. The interviews were recorded after permission was obtained from mothers and trainers. The interviews were typed instantly. Qualitative content analysis was used to analyze the data.

In this study, 20 mothers aged 27 to 51 and trainers aged 25 to 40 participated. After analyzing 92 codes, three main categories and one to three subcategories were extracted. The extracted themes were “sex education requirements” and “sex education situations.” Based on the results, mothers did not have a specific definition of sex education. Most participants believed that education must start from the family. Furthermore, the interviewed mothers thought, “You must not lie to children.” Some believed the mother is responsible for the child’s sex education, while some believed in sex analogy.

Based on the study results, mothers do not have an appropriate definition of sex education. The proper start age for sex education is over 3, and the closest person in one’s family must implement sex education.

Studies of the impact of the novel coronavirus 2019 (COVID-19) on pregnancy outcomes have yielded conflicting results.

This study examined pregnancy outcomes in COVID-19-infected and non-infected pregnant women.

In this retrospective cohort study, we included all pregnant women with (n=42) and without COVID-19 infection (n=185) admitted to a training and treatment center in Babol City, Iran, from March to November 2020. We abstracted the records of all pregnancies in women with COVID-19 (exposed cohort) and women without COVID-19 (non-exposed cohort). Patient information was taken from their medical records. The chisquare test and Student t-test were used for data analysis. Modified Poisson regression and mixed linear model were used to assess the adjusted risk ratio (aRR) and adjusted mean difference (aMD) between COVID-19 infection and pregnancy outcomes.

A total of 227 pregnant women (42 in the exposure group, 185 in the non-exposed group) were included in the study. The mean age of mothers was 28.12±6.27 years, and also 48.5% of them had their first pregnancy. In comparison with non-infected women, women with COVID-19 faced the highest risk of cesarean section (aRR: 2.22, 95% CI, 1.35%-3.65%, P=0.002) and preterm birth (aRR: 1.22, 95% CI, 1.02%-1.48%, P=0.026). Also, pregnant women with COVID-19 had a significantly higher duration of hospital stay (aMD: 2.20, 95% CI, 1.32%-3.08%, P=0.001) compared to pregnant women without COVID-19. There was no significant difference between the two groups in terms of postpartum hemorrhage and premature rupture of membranes.

This study suggests that COVID-19 infection is associated with an increased risk of cesarean section, preterm birth, and increased duration of hospital stay but not with other outcomes. However, the current evidence does not support its causal effects, given the methodological limitations and small sample size.

Preeclampsia is a common pregnancy complication with the multisystem variable disorder. Yet, the literature has not been systematically reviewed for the relationship between previous cesarean section and the risk of preeclampsia.

This study aimed to identify the relationship between previous cesarean delivery and the risk of preeclampsia.

This study was a systematic review and meta-analysis. PubMed, Scopus, ProQuest, and Web of Sciences were searched to identify eligible observational studies until May 25, 2019. The odds ratio (OR) and 95% confidence intervals (CI) were calculated as random effect estimates of association among studies. The quality of the included studies was examined based on the Newcastle-Ottawa scale.

This study included 7 eligible articles (2 studies with a case-control design, 4 with a cohort design, and 1 with a cross-sectional design). The meta-analysis results showed an increased risk of preeclampsia in the women with previous cesarean section compared to women without cesarean section (OR=1.28, 95% CI, 1.15%-1.41%, P=0.001), I2=37.2%. The quality of all studies except one study was high based on the Newcastle-Ottawa scale. The subgroup analysis was conducted based on the adjusted form of studies. The crude and adjusted studies were 1.29 (95% CI, 0.13%-2.46%, P=0.2) and 1.29 (95% CI, 1.22%-1.36%, P=0.001), respectively.

These findings showed that previous cesarean section is a risk factor for preeclampsia. Therefore, education programs and interventions should be considered to reduce elective cesarean section on maternal requests.

The prevalence of obesity is increasing worldwide, especially among pregnant women. Maternal obesity is a serious risk factor during pregnancy associated with pregnancyrelated complications for the mother and her child.

This study aimed to estimate the prevalence of Jordanian pregnant women who are overweight or obese. The relationship between high body mass index and selected obstetrical conditions was also investigated.

A descriptive, correlational, cross-sectional design was used on a purposive convenience sample of 411 pregnant women in Jordan. Results were obtained through structured interviews, antenatal routine lab tests, physical measurements (height and weight), body mass index (BMI), thyroid function tests (free thyroxine [FT4] and 2e [TSH]), and Edinburgh postnatal depression scale. Descriptive statistics, including means, standard deviation, and inferential statistics, such as Pearson correlation, t-test, and ANOVA, were used to describe and examine the relationship among the study variables.

Based on the results, 58.4% of the participants had one to four pregnancies, and 54.5% had at least one abortion. Based on their weight before pregnancy, there was a high frequency of overweight (29.7%) and obesity (25%) among pregnant women. High maternal BMI for the mother is correlated significantly with pregnancy complications and offspring neurocognitive impairments. Additionally, maternal obesity is a risk factor for hypothyroidism. BMI was correlated with hypothyroidism (r=0.141, P=0.004), fetal distress (r=0.217, P=0.0001), postnatal depression (r=0.161, P=0.0001), and preterm labor (r=0.115, P=0.020). The thyroid function tests and thyroid stimulating hormone levels were correlated with maternal and fetal conditions, such as infertility, fetal death, hemorrhage, and cerebral palsy among children.

High BMI associated with old age is a critical factor related to many maternal and infant health conditions. Repeated pregnancy failures, fetal health conditions, and maternal complications, including hypothyroidism, can be associated with maternal obesity. Healthcare providers should raise awareness among mothers and care providers on the serious conditions associated with obesity.

A midwife needs to know how to assess fetal heart rates, recognize and interpret fetal heart patterns, report any substandard patterns, and initiate supportive measures as necessary.

This study aims to assess the knowledge and attitudes of midwives concerning the interpretation and use of cardiotocographs.

This cross-sectional study involves 183 midwives working in maternity units across all Jordanian regions. An online survey was used to collect data, including 6 demographic questions, 10 questions about knowledge, and 25 questions about attitude. The data were analyzed using descriptive statistics (Mean±SD, No. [%]), ANOVA, and the Pearson correlation tests. The significance level was set to be <0.05.

Most participants were 21 to 30 years old, and most midwives (59.6%) had no more than six years of experience. The result showed that the total scores for the knowledge and attitude regarding cardiotocographs (CTGs) interpretation and usage were 68.7% and 73.0%, respectively. There is a significant relationship between the knowledge about the interpretation and use of CTGs and the years of experience (P=0.003), with higher knowledge scores among midwives with fewer than 6 years of experience. Furthermore, there is a significant relationship between the knowledge of CTGs and level of education (P=0.002), indicating higher knowledge scores among midwives with a degree. The knowledge about classifying the CTG traces was significantly correlated with the region of work (P=0.018), with higher scores among midwives from the southern region. Finally, there was a positive correlation between knowledge and attitude (r=0.007, P<0.05).

Based on the study result, the participant’s knowledge and attitudes are not satisfactory; thus, comprehensive education and training should be prioritized to improve midwives’ knowledge and attitudes toward using cardiotocograph.

Several cultural and social factors have influenced virginity testing as a medical procedure. This procedure is performed, but sometimes there is no scientific reason to perform it.

This study investigated the views of midwives working in Tabriz, Iran, about virginity testing.

This cross-sectional study was conducted among 210 midwives using the sociodemographic and a researcher-made questionnaire to assess midwives’ views on virginity testing. The samples were selected by random sampling among midwives working in Tabriz City, Iran. The Pearson correlation test, independent t-test, and one-way ANOVA were used to determine the relationship between sociodemographic characteristics and midwives’ views on virginity testing.

The Mean±SD age of the participants was 35.25±8.9 years. The overall score of the midwives’ view on virginity testing was 206.98, of an attainable range from 55 to 275. There was a significant relationship between the overall score of midwives’ views on virginity testing with the variables of age (P=0.033), education level (P=0.001), ethnicity (P=0.012), place of residence (P=0.001), and place of employment (P=0.001). Most midwives (56.2%) believe virginity testing has no therapeutic value and prevention of problems and should not be done, and 59.1% opposed virginity testing motivated by a man’s right to impose a healthy virginity condition on marriage. Most participants (81.9%) agreed to perform virginity testing to investigate rape and sexual abuse.

The authorities and the legislators should take the necessary measures to prepare the regulations and provide appropriate training to this group.

Patient feedback on safety-related factors provides valuable preventative information to manage safety and improve hospital care quality.

This study aims to determine the perspective of hospitalized patients toward safety. These patients were admitted to the medical and surgical wards in two hospitals in Tehran, Iran.

This research is a descriptive-analytical study. A total of 290 patients hospitalized in the medical and surgical wards of two hospitals in Tehran were recruited between April and November 2020. They were selected using a stratified sampling method with proportional allocation. Participants were requested to evaluate and report the safety factors using the patient measure of safety questionnaire. The obtained data were analyzed using the independent t-test, variance analysis, and Pearson correlation coefficient.

Fifty-three percent of the participants in this study were male, with a mean age of 50.75±17.36 years. Approximately one-fourth of the patients had cancer, with 35.1% suffering for 1 to 6 months. The patients’ most and least favorite perspectives mean scores were toward dignity and respect (3.80±1.07) and access to resources (3.31±0.66), respectively. Moreover, patients’ views on safety were related to their disease type (P=0.021).

For successful aging, it is necessary to evaluate social health as a basic component of the health system. Older adults are an increasingly large proportion who are potential candidates for vulnerability in social health.

This study aimed to determine social health and its related factors in older adults referred to urban comprehensive health service centers.

This cross-sectional study was conducted on 400 older adults referred to urban comprehensive health service centers in Ardabil City, Iran, between February 2021 and April 2022. The multistage sampling method was used to select the older adults. The social health scale for older people was used for data collection. Data were analyzed using an independent t-test, one-way analysis of variance, the Tukey post hoc test, the Pearson correlation coefficient, and linear regression with a stepwise method.

The Mean±SD age of the participants was 69.49±7.16 years. The mean score of social health was 57.27±8.7, and for subscales of social support, social adjustment, and perceived environment resource were 30.16±5.9, 15.15±4.14, and 11.95±2.83, respectively. Multivariate analysis showed that marital status (B=4.68, 95% CI, 2.82%-6.54%, P=0.001), education (B=-2.89, 95% CI, -4.87% to -0.9%, P=0.004), job (B=-2.15, 95% CI, -4.1% to -0.21%, P=0.03), income (B=1.48, 95% CI, 0.63%-2.89%, P=0.04), visiting exhibitions (B=4.69, 95% CI, 2.39%-6.98%, P=0.001), and recreational or fun activities (B=-2.36, 95% CI, -3.99% to -0.72%, P=0.005) were predictors of social health in older adults (R2=20%).

The social health of older adults is moderate. Our study showed that several factors would influence social health. Healthcare providers should plan necessary interventions to enhance the social health of older adults.

Reducing childbirth rates is a serious problem in some countries. Iran is one of the countries experiencing a decrease in the fertility rate, with a more than 50% decrease in avery’s child statistics.

This study aimed to determine childbearing desire and its related factors among married women.

In this cross-sectional study, 550 women aged 15 to 49 referring to comprehensive health centers in Rasht City were selected by multi-stage random sampling. Information was collected using a questionnaire consisting of three parts. The audience was asked about their willingness to have children in the personal and social profile section, the fertility information section, and the third section that to detect degree of desire to have children. Descriptive statistics and the chi-square and logistic regression were used to investigate the factors affecting the reluctance to have children.

The results of the research showed that the mean age of the women, the spouse, the age at marriage, and the duration of their marriage were 31.57±6.2, 35.69±6.6, 22.42±4.52, and 9.05±6.5 years, respectively and 54.9% of women were currently willing to have children. The relationship between unwillingness to have children was significant regarding the husband’s age (OR=1.112, 95% CI, 1.050%-1.177%, P=0.001). Also, the relationship between reluctance to have children and the age at marriage was not significant; however, it became significant with the length of marriage (OR=1.090, 95% CI, 1.019%-1.167%, P=0.013). The relationship between unwillingness to have children and the women’s opinion about the desired number of children was significant (OR=8.101, 95% CI, 3.518%-18.654%, P=0.001). The relationship between unwillingness to have children and the number of current children was significant (OR=16.515,95% CI, 8.293%-32.888%, P=0.001).

Our analysis showed that the inability to accept the responsibility of being a parent is one of the reasons why people postpone childbearing to the fourth decade of life and even beyond. Detailed studies are needed to correct the current trend of population decline.