Iranian Journal Of Nursing and Midwifery Research
Volume:28 Issue: 6, Nov-Dec 2023

Rape is a serious global problem linked to long‑term physical health complications in women. Women survivors of rape have different needs, the identification of which ensures optimal services and improves their health conditions. This study aimed to explore the needs of women survivors of rape through a narrative review.

This review was conducted by searching databases of ISI Web of Science, Scopus, Science Direct, Cochrane, PubMed, Scientific Information Database (SID), the Iranian Magazine Database (Magiran), Iranian Research Institute for Information Science and Technology (IranDoc), Iranian Medical Articles Database (IranMedex), and the Google Scholar engine.All English and Persian articles published from January 2000 to August 2022 were searched using the keywords rape, sexual assault, sexual violence, victim, survivor, demands, and needs. Two independent researchers conducted all steps of article extraction and review to avoid possible bias, and a third person reviewed the articles in the case of disagreement between the two researchers. The final related articles were selected and evaluated using a pre‑prepared checklist.

Out of 112 articles, 26 articles were selected for final evaluation. The needs of women survivors of rape were divided into six categories, including sociocultural, educational, legal and judicial, psychological, spiritual and religious, and healthcare.

Women survivors of rape need survivor‑centered, culturally appropriate services, necessitating careful planning and policymaking to address health and judicial issues from different dimensions considering their real‑world needs.

Some nurses leave their job because of working conditions, which will affect nurse turnover. Patients perceive that those nurses are distrustful, and feel unsatisfied, with patients' complaints about nursing service. This study explored factors about the professional self-concept of nursing students and nurses.

A systematic review of cross-sectional studies followed PRISMA guidelines. PubMed, Ovid, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were used from 1982 to August 2020 with the terms “factors” AND “nurse” AND “professional” AND “self-concept.” A total of 19 out of 4,349 articles were used for analysis. Joanna Brings Institute critical appraisal tools for the analytical cross-sectional studies were used in this study, and narrative synthesis was used to analyze data.

Professional selfconcept of clinical nurses is influenced by including organizational or job factors, and individual and emotional factors. Job factors consist of organizational support, professional ethic, clinical ladder system, nursing experience, position, and time. Besides, sex, age, marital status, education, health status, healthy lifestyle, and experience were categorized as individual factors. Emotional factors were as follows: interpersonal relationships, spiritual growth, management stress, and selfdescription. Meanwhile, student nurses are influenced by including personal (degree of study and sex), emotions (emotional intelligence, and interest in the nursing profession), and external factors (nursing courses, peer-mentoring experience, and academic burnout).

Thus, individual factors and emotions have a vital role in constructing clinical nurses' professional self-concept as student nurses. Improving individual and emotional/personal aspects will positively increase professional self-concept.

The increase in the average age of the population, the decrease in the size of the household and rising in the number of working women impose an increasing burden on home caregivers in Iran. The aim of this study was to measure care burden of informal caregivers in Iran through systematic review and meta‑analysis of existing literature.

A systematic review was conducted by using national and international databases of Scopus, PubMed, Embase, Web of Science, SID, Magiran, and IranDoc papers in English and Persian language up to the first half of 2020. In this meta‑analysis, we calculated the pooled care burden and 95% confidence intervals in Statistical Software For Data Science (STATA) V.15.

Forty‑four papers were included in the current study based on inclusion and exclusion criteria comprising of 8626 samples. Pooled mean of Burden of Care was 52.01 (95% CI: 48.21‑55.82). Highest pooled mean(SD) of care burden (64.37) was related to caregivers of schizophrenia patients (95% CI: 56.09–72.64). Highest care burden (53.45) was observed in most deprived areas (95%CI = 47.05–59.86). A statistically significant relationship was observed between caregivers gender and care burden (p < 0.05).

The reported care burden of informal caregivers requires the establishment of a support system to control mental and physical stress. Due to the dispersion and cultural diversity in Iran, more studies are needed to obtain more accurate data.

Reproductive health during youth is considered one of the pivotal aspects of sustainable development. In this regard, students are more exposed to reproductive health problems and risks. Accordingly, the aim of this study was to determine the effect of the reproductive health self‑care educational booklet on the self‑care ability of female university students.

This study was a quasiexperimental research in which a reproductive health self‑care educational booklet designed based on needs assessment was provided to 75 newly admitted female university students at Isfahan University of Medical Sciences in 2018‑2019 who were selected by quota sampling method from all faculties. Using a researcher‑made questionnaire on reproductive health self‑care ability (knowledge, attitude, practice), data were collected before, immediately after, and 6 weeks after the intervention. Data analysis was performed using descriptive and analytical statistics in SPSS version 20.

As the results showed, the mean score of self‑care ability (F = 208.46, p < 0.001), knowledge (F = 130.88, p < 0.001), attitude (F = 76.09, p < 0.001), and practice (F = 89.76, p < 0.001) of the subjects immediately and 6 weeks after the intervention was significantly higher than before the intervention. However, no significant difference was observed in these scores, between immediately after and 6 weeks after the intervention.

The results indicated that the designed self‑care educational booklet led to a relatively constant promotion of the reproductive health self‑care ability of female students. Thus, this booklet seems to be useful in meeting the educational needs of female students in various aspects of reproductive health.

Inappropriate working conditions during pregnancy can negatively affect health‑promoting behaviors and pregnancy outcomes. This study aimed to explore the experiences of health‑promoting behavior in the workplace among Thai pregnant women.

Giorgi’s phenomenological methodology was used, and data were gathered through semi‑structured interviews with 21 working‑pregnant women in large industries in two regions of Thailand. Data were collected from December 2019 to June 2020. Purposive and snowball sampling were used to recruit pregnant women at 13–42 weeks of gestation. To analyze the data, three steps of Giorgi’s phenomenological approach were employed.

The pregnant women described their lived experiences with health‑promoting behaviors in the workplace into four major categories. Firstly, “positive attitude toward work in promoting health behaviors” contained three subcategories (“self‑discipline,” “social interaction,” and “self‑esteem”). Secondly, the idea that “changing temporary health behaviors is worthwhile for infants” was expressed into two subcategories (“eating adaptation” and “managing negative emotions”). Thirdly, “insufficient support from workplace policy” had three subcategories (“inconvenient accommodations,” “inflexible break times,” and “lack of healthcare support”). Finally, “negative perception of new work positions” consisted of two subcategories (“stress” and “low self‑efficacy”).

Positive attitudes toward work and infant health may encourage pregnant women to engage in healthy behaviors, while workplace support and policies are important in promoting healthy behavior and avoiding negative emotions. Health promotion interventions should encourage the value of work, promote maternal– fetal attachment, and increase health support policy to avoid mental health issues and promote healthy behaviors among working‑pregnant women.

Early Antenatal Care (ANC) initiation is aimed at improving maternal and perinatal health outcomes through the identification of complications and determining the level of care needed. This study aimed to determine the voices of midwives on the provision of early initiation of ANC following positive gravindex.

The phenomenology approach underpinned the study. The participants included midwives providing ANC at health facilities under Tshino–Mutsha local area in May–December 2020. Nonprobability, purposive sampling was used to select four clinics and to sample 20 midwives. Semistructured face‑to‑face, in‑depth interviews were conducted using an interview guide. Data saturation was reached at Participant 15; however, the researcher continued until Participant 20. Trustworthiness was ensured and ethical principles were adhered to. Data analysis was done using Tesch’s open coding approach.

Two themes and seven subthemes emerged, as challenges related to the provision of midwifery practice and to pregnant women. The seven subthemes were the shortage of resources, poor support of midwives, poor adherence to the available protocol for the provision of ANC, blaming of midwives by management and community, late ANC booking by pregnant women, denial of pregnancy by young women ignorance leading to a general resistance to ANC instructions, hence late booking

It was concluded that shortage of human and material resources hindered the initiation of early ANC to detect, prevent, and manage the existing and potential causes of maternal and newborn mortality and morbidity.

People all over the world, including pregnant women, have experienced stress and anxiety due to the coronavirus disease 2019 (COVID‑19) pandemic. Providing services during the pandemic is something that midwives in primary health care cannot avoid. This study assesses a midwife’s knowledge, attitude, and anxiety toward providing maternal care during the pandemic.

A cross‑sectional design was used in this study, which involved 183 midwives who provided midwifery services at hospitals and health centers and had experience with the perinatal and breastfeeding phases. Using the Google Forms tool, respondents completed a questionnaire regarding their knowledge, attitudes, and anxiety toward maternal care during the COVID‑19 pandemic.

One hundred eighty‑two midwives (99.50%) understood maternal care well during the COVID‑19 pandemic. In addition, the maternal care provided during the COVID‑19 pandemic was viewed favorably by almost all the participants. The percentage of midwives working in primary care in the perinatal phase who had moderate‑to‑severe anxiety levels during the COVID‑19 pandemic was 17 women (27.42%).

The knowledge and attitudes of midwives about the COVID‑19 pandemic in this study were good, and there was a smaller percentage of midwives with an extreme level of anxiety.

Health care‑Associated Infections (HCAIs) are among the most common adverse events (AEs) that can negatively affect both patients and health systems. The elderly is among patients at high risk for infections. Some controllable risk factors have received less attention in research. Therefore, this study aims to investigate the relationship between prevalence of HCAIs among elderly inpatients, job satisfaction of nurses, and working condition.

This cross‑sectional study was conducted on 211 nurses working in hospitals affiliated with Iran University of Medical Sciences, Tehran, in 2021. The data were collected from HCAIs reports by the Nosocomial Infection Control Committee, a demographic questionnaire, the Practice Environment Scale of the Nursing Work Index (PES‑NWI), and the Minnesota Satisfaction Questionnaire (MSQ). The data were statistically analyzed using Pearson correlation coefficient, ANOVA, t‑test, and multiple linear regression (MLR) in SPSS 26.

The results showed that there was a significant relationship between the PES‑NWI and MSQ (r = 0.68, p < 0.00). The MLR results indicated that staffing and resource adequacy, nurse participation in hospital affairs, job satisfaction, nursing manager’s leadership, and nursing foundations for quality of care are predictive factors that these could explain 78% of the changes in the prevalence of HCAIs and the goodness of fit of the regression model was acceptable [F6.210 = 129.47, p < 0.001].

Since job satisfaction and the work condition could predict HCAIs among the elderly patients, healthcare administers are recommended to consider these two variables in the development of HCAIs prevention and control programs.

Some women experience the Fear of Childbirth (FOC) during pregnancy, labor, and birth which can have consequences for their health and well‑being. To provide the right conditions for having a positive experience of childbirth, the needs of pregnant women must be correctly recognized. The present study was conducted with the aim of investigating the needs of women in managing the FOC with a qualitative design. 

This qualitative study was conducted using conventional content analysis from January to November 2021. To this aim, 15 pregnant women, 21 healthcare providers, and four maternal health policymakers were purposefully selected from Kermanshah health centers, with maximum diversity. Data were collected through in‑depth semi‑structured interviews. Data accuracy was guaranteed using Lincoln and Guba criteria. The MAXQDA software was used for data analysis.

From the analysis of the data obtained from the interviews, three main categories emerged concerning the needs of mothers to properly manage the FOC: “need to provide awareness and empowerment of mother and family,” and “the need to pay attention to the mental health of pregnant women,” and “supporting needs (seeking support).”

Identifying and paying attention to woman’s needs in the areas of education, mental health, and support can help them manage crisis‑ridden situations, including the FOC. In response to the needs of mothers to empower them in managing the FOC, it is recommended to formulate special guidelines in this field.

Pulmonary Rehabilitation (PR) is recommended as a standard, effective, and important treatment for COVID‑19 survivors who remain symptomatic after the acute phase. Therefore, we aimed to compare the effect of mobile phone‑based PR application with face‑to‑face PR on the quality of life, anxiety, depression, and daily life activities of COVID‑19 survivors.

A quasi‑experimental was conducted on 65 COVID‑19 survivors during 2022. Convenient sampling was done based on the inclusion criteria. The intervention group (n = 31) received PR through a mobile phone application, and the control group (n = 34) received face‑to‑face PR. Data were collected before and after the intervention in both groups using a demographic information questionnaire, SF‑12, the hospital anxiety and depression scale, and Barthel scale. For all tests, a maximum error of 5% was considered.

The two studied groups had no statistically significant difference with respect to all the investigated variables at baseline (p > 0.05). After the intervention, the mean anxiety and depression score of the patients in the control group was significantly lower than the intervention group (t = −3.46, f = 63, p = 0.01). After our intervention, there was no statistically significant difference in the mean quality of life and daily life activity scores between the two groups (t = −0.68, f = 63, p > 0.05).

The application of PR does not show a statistically significant difference in terms of improving the quality of life and daily activities compared with the face‑to‑face method; we suggest that the PR application be used as a cost‑effective method when face‑to‑face PR is not possible.

Considering the increasing prevalence of Polycystic Ovarian Syndrome (PCOS) and its related complications—such as obesity, cardiovascular diseases, and infertility—in the Middle East, it is imperative to create sufficient public awareness about this issue. Accordingly, the potential link between PCOS awareness and health literacy level with the lifestyle choices of Arabic‑speaking female university students was examined in this cross‑sectional study.

This research was conducted in the Sultanate of Oman and involved 446 Arabic‑speaking female university students, who completed a self‑administered online questionnaire, Single Item Literacy Screener, and PCOS Awareness Tool.

The findings showed that, while 53.50% of the study participants had inadequate health literacy, 79.80% demonstrated an acceptable level of PCOS awareness. However, this did not seem to influence their lifestyle, given that 59.20% of the respondents were physically inactive and 83.30% regularly consumed fast food. Regression analysis results nonetheless revealed that health literacy and PCOS awareness were significant predictors of lifestyle choices (F2,44 = 5.98, p < 0.05, 95% CI [4.44–5.35]).

The Arabic‑speaking female university students’ health literacy level and PCOS awareness are significant predictors of their lifestyle choices. Thus, the policymakers in the Arab region need to develop effective strategies aimed at PCOS prevention, focusing specifically on raising public awareness about PCOS and its negative consequences on female reproductive health. In addition, university administrators should ensure the availability of healthy food choices at their campuses as well as opportunities for physical activity to promote healthy lifestyle among all students.

Job alienation of nurses leads to adverse consequences such as occupational dysfunction and low quality of health‑care services provided by these individuals to patients. This study aimed to explain nurses’ experience of occupational alienation in the clinical setting.

This qualitative study was conducted using the content analysis method. Data were collected via 18 in‑depth and semistructured interviews from nurses working in the hospitals in Sabzevar, Iran. The participants were selected via purposive sampling and continued till data saturation. The obtained data were simultaneously analyzed using conventional qualitative content analysis.

The qualitative analysis of data content led to the extraction of the themes that reflected the nurses’ experience of occupational alienation in the clinical environment. After the transcription of each interview, the obtained data were broken down into codes in the form of sentences and paragraphs related to the main concept. The codes were reviewed several times and the relevant semantic unit codes were written down and classified based on conceptual and semantic similarity. Qualitative data analysis led to the emergence of 260 initial codes, 120 subcategories, 30 main categories, and 6 themes. Finally, the main theme of the “nursing gradual separation from caring and clinical aspect” was extracted.

According to the results, occupational alienation reduces the quality of patient care, weakens nurses, and reduces the continuity of their effective and active presence in the provision of care services and clinical decision‑making. Therefore, managerial and organizational interventions are required to address this issue.

Diabetes Self‑Management Education and Support (DSMES) as a framework focuses on seven self‑care behaviors. Moreover, technology‑assisted self‑care education is increasingly suggested for patients with Type 2 Diabetes Mellitus (T2DM). Therefore, we examined the effect of a web‑based program on self‑care behaviors and glycated hemoglobin values in patients with diabetes mellitus. 

This randomized controlled clinical trial was conducted at Alzahra Hospital in Isfahan, Iran, between April and November 2020 and included 70 patients with T2DM. Data were collected using a questionnaire that included a demographic information section and a diabetes self‑management section with 21 questions on a Likert scale. Fasting blood samples (2.50 ml) were collected before and after the interventions to measure HbA1c levels. The study intervention involved a web‑based program that included multimedia educational content (such as videos, lectures, educational motion graphics, text files, posters, and podcasts) presented in seven sections based on DSMES over a 21‑day period with monitoring by an instructor.

The mean scores for healthy eating (F = 3.48, p = 0.034) and medication adherence (F = 6.70, p < 0.001) significantly increased in the interventional group, while the mean scores for being active, monitoring, reducing risks, problem‑solving, and healthy coping did not significantly change. Additionally, the mean differences in HbA1c values significantly improved in the interventional group compared to the control (F = 5,1, p = 0.026).

A web‑based program in accordance with DSMES improved HbA1c levels and increased scores for healthy eating and medication adherence in patients with T2DM. However, further research with larger sample sizes and qualitative interviews is needed.

The number of older people with dementia was continuously increasing globally. Unfortunately, many of them had received inappropriate medical treatment to overcome the dementia they suffered. This current research aimed to analyze the factors that affected family‑based caregiver empowerment.

An analytic observational method with a cross‑sectional approach was applied. The population was all families with dementia elderly in East Java, Indonesia, in 2021, who met the inclusion and exclusion criteria. The sample size was determined to be 100 respondents.

The results showed that the factors (i.e., elderly factors, family factors, health service factors, family’s filial value, family assessment, and the need for care) had significant effects directly or indirectly on the family’s ability to do home care.

Factors that influenced directly (i.e., elderly factors, family factors, family assessment, and care needs) and indirectly (i.e., health service factors) were essential in constructing a structural model of family care for the elderly with dementia.

Women experience physical, hormonal, and psychological changes during pregnancy. Similarly, some traditions are prevalent among Javanese women, which could affect their pregnancy. The experiences of first‑time pregnant women in this area remain unclear. This study aimed to explore the lived experiences of women during their first pregnancy.

The qualitative study with a phenomenological approach was conducted in Kesambon village in Malang Regency, Indonesia. Eight women in their third trimester were selected purposively. Data were gathered using semi-structured interviews and subsequently open-coded using the NVivo-12 software manufactured by the QS International.

The participants were married primigravida women aged 17 to 22 years. Four themes emerged as follows: pregnancy is a positive experience, pregnant women are not independent, belief in pregnancy‑related myths and traditions, and pregnancy‑related information seeking.

During the first pregnancy, pregnant women believed and practiced Javanese traditions regarding pregnancy. Although they were happy, they were still dependent and lacked the motivation to seek pregnancy‑related information. Hence, midwives should provide them with adequate pregnancy‑related information while addressing harmful myths and misconceptions. This should culminate in a successful pregnancy.

Despite the mutual benefit of adoption, due to the adverse attitude related to the barriers perceived by the couples, some people are not interested in adoption. The purpose of this study was to develop and validate a questionnaire to measure attitudes toward child adoption.

This secondary analysis is part of a larger study on 178 infertile couples referring to the Afzalipour Infertility Center in Kerman, Iran. Factor Analysis (FA) was performed. The sampling was conducted using the convenience sampling method. The questionnaire was implemented using a mixed‑method approach in three phases. Firstly, a pool was created. The second phase involved content validity. Lastly, construct validity was conducted.

The final version of the questionnaire with 20 questions had a total Cronbach’s alpha of 0.70%. Six factors with eigenvalues of higher than 1.00 were extracted, which accounted for 52% of the total variance. These factors were “spiritual–psychological status of the new parents,” “psychological status of the adopted child,” “undesirable behaviors of others in the future,” “anxiety of the new parents,” “physical–behavioral characteristics of the adopted child,” and “socio‑economic factors.” The model extracted from the Exploratory Factor Analysis (EFA) was confirmed by Confirmatory Factor Analysis (CFA). The 6‑factor structure adequately fitted the data (Comparative Fit Index (CFI) = 0.93; root mean square error of approximation [RMSEA] = 0.047; X2 /df = 1.393; p = 0.002.

The internal consistency and construct validity of the questionnaire were confirmed. This instrument can be used in clinical and research practices.

Infertility is a psychological crisis for a couple, spouse, and their families. Due to the positive effects of spiritual intelligence on the positive adaptation and growth of the individual under difficult circumstances, this study was conducted to determine the relationship between spiritual intelligence and resilience in infertile couples in Isfahan.

This cross‑sectional study was performed in 2020 on 162 infertile couples. Data were collected by the convenience sampling method from infertile couples referring to Infertility Centers in Isfahan through two standard questionnaires. Data analysis was performed using descriptive statistical methods for quantitative variables. The relationship between spiritual intelligence and resilience score was investigated using inferential statistical methods of Pearson’s correlation coefficient and multiple linear regression. A p value of less than 0.05 was considered significant.

The results showed that the mean age Standard Deviation (SD) of women and their spouses was 32.01 (5.86) and 36.30 (5.82) years, respectively. Pearson’s correlation coefficient showed that there was a significant positive direct relationship between resilience score with total spiritual intelligence score (r = 0.36, p < 0.001) and its dimensions Critical Existential Thinking (CET) (r = 0.60, p < 0.001), personal meaning production (PMP) (r = 0.38, p < 0.001), Transcendental Awareness (TA) (r = 0.43, p < 0.001), and Conscious State Expansion (CSE) (r = 0.53, p < 0.001). The PMP (t = 6.38, p < 0.001) and the CSE (t = 2.15, p = 0.03) were significant predictors of resilience scores.

The result of our study showed that couples with a higher level of spiritual intelligence had a better understanding of the problems and harms of primary infertility and would cope with it more efficiently.

Even though nurses take various measures to decrease acute pain after surgery in older adults with dementia, it is unclear why most of them suffer from severe pain. This study aimed to evaluate the factors affecting acute pain management in older adults with dementia after hip fracture surgery.

This cross‑sectional study used single‑stage cluster and convenience sampling to select 330 nurses working in hospitals located in Western Mazandaran, Iran, in 2020. The demographic characteristic questionnaire and the Obstacles to Postoperative Pain Management in Dementia Scale (OPOPMDS) were used to collect data.

The study results confirmed the modified model. The second‑order Confirmatory Factor Analysis (CFA) indicated that the Critical Ratio (CR) for all three factors was more than 1.96, and the significance level was considered 0.05. Based on the values of standard coefficients, older people‑related (β = 0.86, p < 0.001), system‑related (β = 0.70, p < 0.001), and healthcare provider‑related (β = 0.61, p < 0.001) factors had the highest impacts on the OPOPMD.

The study results suggested that older adult‑related factors had the most significant impact on the OPOPMD.

Patient adherence to the treatment regimen is an important goal of treatment; finding appropriate strategies to improve treatment adherence is a nursing challenge. This study aimed to explore strategies to improve nurses’ performance to enhance cardiovascular patients’ adherence to treatment regimens.

This is a qualitative content analysis study that was performed in an educational hospital of the Urmia University of Medical Science. Data were collected through semi‑structured individual and group interviews. Sixteen individual interviews were conducted with nurses, patients, and physicians. A focus group was conducted with the presence of six nurses and nursing managers. Data were analyzed by conventional content analysis using MAXQDA 2020.

After analyzing the interviews, five strategies were explored; these strategies include: follow‑up of the patient after discharge (systemic and organizational follow‑up, educational follow‑up, counseling follow‑up, and motivational follow‑up), sending reminders for necessary cases to the patients (risk reminders, care reminders); improving patient education methods (modern and up‑to‑date education, conventional and routine education), improving support services (home care services, social support, Psychological support), and optimizing the structure and processes of the hospital (making structural changes, making process changes).

Much needs to be done to improve patient’s adherence to treatment. Nurses are at the forefront of this work. In this study, we introduced ways to improve nurses’ performance in order to increase patient adherence.

Encountering the coronavirus disease 2019 (COVID‑19) pandemic, nurses face many challenges due to various strategies and resources that can compromise the quality of care. This study aimed to identify nursing care challenges for patients with COVID‑19 from nurses’ viewpoint in Iran.

This descriptive qualitative study was conducted in one of the main admission centers in Isfahan to treat patients with COVID‑19. Data were collected through semi‑structured in‑depth interviews with 19 nurses from April 2020 to June 2020. The recorded interviews were transcribed and then analyzed through inductive content analysis.

The challenges of nursing care for patients infected with COVID‑19 from the nurses’ viewpoint were categorized into 11 subcategories and four main categories: work overload in disaster (lack of nurses with adequate clinical qualification and restrictions on the compliance of the infection control protocols), immersion in an ocean of psychological and social tensions (personal and family tensions, work environment tensions, perception of organizational injustice, and social stigma), quality of care in fragile condition (self‑preservation rather than patient care and contradictory patient care standards), and disaster preparedness, response, and management (passive resource management, information system challenges, and lack of guideline‑supported protocols).

The findings of this study suggest that policymakers should actively participate in supporting nurses in the form of reducing physical and mental stress in pandemics such as COVID‑19. Having the right perception of the challenges nurses face in such crises can contribute to providing patient safety, improving the quality of care, maintaining organizational resources, and properly managing the disaster.

A preterm birth exposes the mother to many challenges in caring for and supporting the baby. This study aims to use training and auriculotherapy techniques as two simple methods to reduce anxiety and increase the mother’s self‑efficacy.

This single‑blind three‑group clinical trial study was conducted in the Bahar Hospital in Shahroud, Iran, in 2019. The target group of primiparous mothers was premature infants. For the first group, premature infant care training was provided, and for the second group, auriculotherapy techniques were performed, and the third group (the control group) received routine care. Anxiety, general self‑efficacy, and maternal breastfeeding self‑efficacy were measured at the beginning of the study and before neonatal discharge.

Before the intervention, three groups were not significantly different in demographic characteristics, obvious and hidden anxiety scores, and general self‑efficacy and lactation (p > 0.05). There was a significant difference between the control group and the two intervention groups with ANOVA test for self‑efficacy (F2,87 = 6.60, p = 0.002), breastfeeding self‑efficacy (F2,87 = 15.20, p < 0.001), obvious anxiety (F2,87 = 56.20, p < 0.001), hidden anxiety (F2.87 = 62.90, p < 0.001), after the intervention. In addition, there was no significant difference in the length of hospital stay in the neonatal intensive care unit (p = 0.732). Still, the neonate’s infant’s mean weight before discharge in the two intervention groups was significantly different from the control group (p = 0.034).

Teaching mothers how to care for premature infants and implement auriculotherapy techniques reduces anxiety and increases mothers’ general self‑efficacy and breastfeeding.