Nursing and Midwifery Studies
Volume:12 Issue: 2, Apr-Jun 2023

Gestational Diabetes Mellitus (GDM) is one of the common medical complications during pregnancy, and a diet is the first line of treatment for it. This study determined the effect of okra powder on the blood glucose levels of women with GDM who were on diet. This non-blinded randomized controlled trial was conducted on 60 women with GDM who were randomly allocated into two groups. The usual diet for gestational diabetes was taught to both groups. The intervention group also consumed 6 grams of okra skin and seed powder orally in a divided dosage twice daily for 4 weeks. Before, two and four weeks after the start of the study, fasting and 2-hour postprandial glucose (PPG) was measured. The data were analyzed by t-test, Mann-Whitney U test, Chi-square, and Friedman test. The mean baseline fasting blood sugar (FBS) did not differ significantly between the women in the intervention and control groups (P=0.954). However, mean FBS was significantly lower in the intervention group at two weeks and four weeks after the baseline (P<0.001). The mean baseline 2-hour PPG did not significantly differ between women in the intervention and control groups (P=0.955). However, the mean 2-hour PPG was significantly lower in the intervention group at two weeks and four weeks after the baseline (P<0.001). The okra powder was effective in reducing FBS and 2-hour PPG in women with GDM who were on diet therapy.

The method used to wear the surgical gown and gloves has a critical role in the extent of surgical site contamination. The purpose of this study was to compare the effect of gown and gloves wearing in the integrated and closed methods on the extent of contamination of surgical team members' gowns and gloves.  A single-blind controlled trial was conducted with 70 eligible surgical staff who were randomly assigned to two groups of 35. The intervention group wore sterile, integrated gown-glove units, whereas the control group wore separate gowns and gloves using the closed technique. Glitterbug fluorescent powder was used to measure contamination. An ultraviolet flashlight was used to make the Glitterbug powder visible. Participants in both groups wore their gowns and gloves after dipping their hands in fluorescent powder. After one hour of the surgery, the gowns and gloves were removed from the body, a mobile phone was used to take photos of the areas containing powder, and ImageJ software was used to measure the area of contamination. The independent samples t-tests and chi-square test were used to analyze the data. The contaminated area of gloves was 0.06±0.24 mm2 for the integrated gown-glove unit method and 2.26± 5.87 mm2 for the closed gown and gloves wearing method (P= 0.03). The contaminated area of the gown was zero for the integrated method and 3.06±7.57 mm2 for the closed method (P= 0.02). The extent of contamination was less when using the integrated gown-glove unit than the closed method. The surgical staff are recommended to use integrated gown-glove units to reduce the risk of contamination of gowns and gloves used for surgery.

Patients with heart failure experience poor self-care and diminished quality of life (QOL). Enhancing the well-being of these patients necessitates the implementation of innovative educational methods. To determine the effects of education based on Leventhal's self-regulation model on self-care and QOL in patients with heart failure. This clinical trial was conducted with 100 patients hospitalized with heart failure at Farshchian Hospital in Hamadan, Iran. Subjects were selected using consecutive sampling and assigned to either an intervention group or a control group, using the randomized block permutation method. Prior to and two months after the intervention, patients completed the self-care questionnaire for heart failure patients and the Minnesota Quality of Life questionnaire. The control group received routine ward education, whereas the intervention group participated in an educational program based on the Leventhal model. Data were analyzed using the chi-square, Fisher's exact, paired t, and independent t tests. The two groups were homogeneous in their characteristics. The independent t-test showed no significant difference in mean baseline self-care and QOL scores between the intervention and control groups (P > 0.05). However, after the intervention, there was a significant difference (P < 0.05), with the intervention group showing an increase in self-care and QOL compared to the control group. Education based on Leventhal's self-regulation model resulted in improvement in self-care and QOL in patients with heart failure. It is recommended that this model be used in the education of patients with heart failure.

A healthy mental state is essential throughout pregnancy. The Coronavirus disease 2019 (COVID-19) pandemic has posed a challenge to psychological resilience, especially among pregnant women. This study measured the mental health and social support of Saudi pregnant women during the COVID-19 pandemic. The study utilized a cross-sectional design, with 243 respondents as its convenience sample from hospitals and health centers in Al Duwadimi, Saudi Arabia. This study applied the “Arabic Version of the Depression, Anxiety, and Stress Scale” and the “Multidimensional Scale for Perceived Social Support for Arab Women.” The Pearson correlation was used to measure the association between respondents’ profiles and social support. Multiple regression analysis was used to measure predictors of mental health. The pregnant women had normal depression levels, extremely severe anxiety, and severe stress. The pregnant women also perceived high social support. A very weak inverse association was found between age and number of children with overall social support. Social support, especially from the husband, decreased the depression level in the pregnant women. Pregnant women in Saudi Arabia experienced higher levels of depression, anxiety, and stress during the COVID-19 outbreak, which was linked to the support they received from their relatives. This finding implies the need to enhance support from family members during infectious disease outbreaks.

Compassion fatigue (CF) is a progressive process of absorbing patients’ pain and suffering resulting from caring interactions between caregivers and patients. Since compassion fatigue is strongly influenced by cultural and ethnic differences, the question arose, "How do Iranian deal with CF?” This study aimed to obtain a deep understanding of Iranian nurses’ strategies in dealing with CF. The study was conducted using the conventional content analysis method. Purposive sampling was conducted to select clinical nurses working in hospitals of Tehran and Kashan Universities of Medical Sciences, Iran. Using semi-structured face-to-face interviews, data were collected from 13 nurses who had experienced CF. Data analysis was performed according to the steps proposed by Graneheim and Lundman. To prove the trustworthiness of the data, the four criteria of credibility, dependability, confirmability, and transferability were used. Participants included 13 nurses whose average age was 31 years. Three categories emerged from the participants' experiences, namely "creating a work-life balance," "trying to ignore," and "use of support circle." All categories were placed under the theme of “struggling to survive in a turbulent workplace”. Nurses make lots of effort to deal with CF in personal and social levels. Healthcare managers can help nurses by providing them with more support, such as spiritual and organizational ones.

Frailty and fear of falling (FOF) are highly prevalent in older adults undergoing hemodialysis (HD). However, there is no reliable evidence of the association between FOF and frailty in older adults undergoing HD. This study aimed to determine the association between FOF and frailty in older adults undergoing HD. This cross-sectional study was conducted on 194 older adults undergoing HD in the east of Mazandaran province, Iran. Data were collected using of demographic and clinical characteristics questionnaire, Edmonton Frail Scale (EFS), and Falls Efficacy Scale–International (FES-I). Independent t-test, analysis of variance, Pearson’s correlation coefficient, and stepwise multiple regression were used to analyze the data. The mean score of the FOF was 34.41±12.20, and most of the participants (38.4%) had moderate FOF. The mean score of the frailty was 6.91±3.12 and most of older adults (34.3%) were vulnerable to frailty. There was a positive and significant association between FOF and frailty in older adults undergoing HD (r=0.802, P<0.001). The majority of older adults receiving chronic HD have moderate to high FOF and are prone to frailty. Therefore, it is necessary to perform appropriate educational, behavioral, and cognitive interventions to reduce the FOF in these patients.

Nurses involved in healthcare delivery during the Coronavirus disease 2019 (COVID-19) pandemic experience higher levels of burnout, job satisfaction, and mental symptoms than other healthcare professionals did. This study examined nurses' burnout level, job satisfaction, and mental symptoms during the COVID-19 pandemic. A descriptive, correlational study was conducted on 262 nurses working at a foundation university hospital in Istanbul between July and December 2021. The data were collected by using the Nurse Information Form, Maslach Burnout Inventory, Minnesota Job Satisfaction Scale, and Mental Symptom Checklist. Data analysis was performed using the Mann-Whitney U test, Kruskal-Wallis H test, Spearman correlation, and Bonferroni post hoc test. Nurses’ Burnout, Job Satisfaction, and Mental Symptom average scores were 70.36±11.00, 2.80±0.49, and 1.20±0.79, respectively. A statistically significant negative and weak relationship was found between burnout, and job satisfaction average scores (r=-0.380; P<0.001). Age, marital status, and income level were associated with burnout, job satisfaction, and mental symptoms (P<0.05). Nurses had a moderate level of burnout, a low level of job satisfaction, and a high level of mental symptoms.

Intuition is one of the key factors in decision-making leading to timely recognition of problems and quality care.

The purpose of this study was to determine the extent of intuition and the factors influencing it in pediatric nurses.

A cross-sectional study was conducted in 2020 with 100 pediatric nurses working in hospitals of Bandar Abbas, Iran. Smith Intuition Instrument was used to collect data. Descriptive statistical methods, t-test, and analysis of variance were used for data analysis.

Most nurses (59%) demonstrated moderate use of intuition whereas the others (41%) showed high use of intuition. Nurses with less than 10 years of work experience and those working in pediatric intensive units scored significantly higher on the reassuring feelings subscale (P<0.001).

The pediatric nurses’ intuition was appropriate. Nurses are encouraged to confidently use their intuition without fear of blame in the difficult and sensitive situations of pediatric care.

Coronavirus disease 2019 (COVID-19) pandemic had significant negative impact on sexual and reproductive health (SRH) with devastating impact on pregnant women in resource constrain humanitarian settings. This paper provides detailed account of a community midwife-led intervention in ten humanitarian settings of Afghanistan using world health organization (WHO) emergency disaster risk management (EDRM) framework. The project is aimed at increasing access to Integrated Package of Essential SRH Services and Minimal Initial Service Package (MISP) with a specific focus on prevention of Postpartum Haemorrhage (PPH) and screening and management of preeclampsia and eclampsia. The project was implemented through 150 Community outreach midwives (COMs). Each midwife served 300 households; mentored by gynaecologists and supervisors. Midwives were trained through a digitally enabled, simulation based training and equipped with a set of off-the shelf devices and kits. During COVID-19 pandemic and in absence of health care services during crisis, this intervention has played as a lifesaving intervention for the community in Afghanistan. Variable digital literacy, sociocultural barriers, reluctance in adapting to digital platforms, security and uncertainties were some of the challenges faced. Adaptation of outreach methods integrated high impactful digital technologies has been the most appropriate strategy "to reach the unreached". Through this model, national and global stakeholders were engaged even during the crisis in Afghanistan. It also provided vital inputs for the donors, governments, civil society organizations and other stakeholders for sustaining and advancing the delivery of quality SRH services in humanitarian settings.

High body mass index (BMI) is associated with many health risks. Studies on the effect of excessive use of electronic media (EM) on high BMI are inconsistent. The purpose of this study was to investigate the relationship between excessive use of EM and BMI among adolescents. A cross-sectional study was conducted with 382 students from middle and secondary schools in Kerbala City, Iraq. Data were collected from October 10, 2022, to December 20, 2023. Data collection was performed using a two-part self-report instrument. The first part contained items on participants’ characteristics (including BMI) and the second part was the Excessive Use of Electronic Media Questionnaire (EUEMQ). Data were analyzed using independent t-test, analysis of variance, and linear regression analysis. The mean age of the students was 15.90 ± 1.36 years, and most of them were middle school students (62.6%). Approximately half of the students had a normal BMI, while 22.2% were overweight or obese. Mean BMI differed significantly between males and females (21.02±5015 vs. 23.14±4.33, P< 0.001). The majority of students (47.4%) spent 2-5 hours on the Internet each day. Approximately 56.8% and 18.1% of the students reported moderate and severe EM use, respectively. The mean hours spent on the Internet and mean EM use did not differ significantly among students in different BMI categories. However, linear regression analysis showed that male gender (P < 0.001), number of hours spent online (P = 0.026), and excessive use of EM (P < 0.001) significantly influenced BMI. Excessive use of EM was found to increase the likelihood of being overweight in adolescents. Because of the health risks associated with high BMI, education and health authorities, and nurses, need to educate adolescents, about the health risks of excessive use of EM.