مجله دانشکده پرستاری و مامایی مشهد
پیاپی 17-18 (پاییز و زمستان 1382)

Background and Infertility and its numerous treatment programs create crisis in infertile women’s life and is a potent source of anxiety. There is evidence that cognitive behavioral therapy might be efficacious for emotional aspect of infertility. Therefore we designed a study for evaluation of cognitive behavior therapy effect on anxiety level in primary infertile women undergoing IUI in Montaserieh Infertility Research center from May to August 2001. In this randomized controlled clinical trial, 110 women with primary infertility that were undergoing IUI for first time randomly allocated to two groups (55 experimental, 55control group). In first visit for IUI treatment (beginning of study) state and trait anxiety of all subjects measured by Spielberger Anxiety Inventory. The experimental group complete a cognitive behavior therapy program include cognitive restructuring and relaxation for 12-13 days. Control group received only routine cares. State and trait anxiety were measured in 30 minute before and after IUI for two groups. Findings showed that state and trait anxiety scores in beginning of study were not significantly different between groups. But state anxiety score before (p<0.001) and after (p<0.0001) IUI were significantly different. Trait anxiety score were not significantly different, before and after IUI. The difference between state and trait anxiety score at beginning and before IUI [State anxiety (p<0.0001), trait anxiety (p<0.0001) were significantly different. The results of study showed that cognitive behavior therapy is effective in reduction of anxiety in women undergoing IUI treatment, so we recommend it to securing psychological well – being in women undergoing infertility treatment.

Background and Considering the effects of belief to God on calmness and reducing the anxiety, this quasi experimental study was conducted to examine the effects of listening to the Holy Koran on anxiety of patients before open heart surgery. The open heart surgery unit of Ghaem hospital (related to Mashad University of medical sciences) was used as the sitting for this study. Sixty- one patients admitted to the open heart surgery unit were selected for this study. Patients were randomly designed to an experimental or control group. The state- trait anxiety inventory (STAI) (Spielberger) and interview slip were instruments for collecting data. The anxiety of patients and the Vital signs (pulse- respiration- Blood pressure) were measured in two different periods (eight and nine clock) in night before operation. The experimental groups listened to the following. Suras: Noor (verses 1-22), Maedeh (verses 12-21) and Toubeh (verses 62-77) in two periods for 15 minutes (every time) with the sound of master Abdolbaset by means of a stereo cassette recorder with headphones. These suras were randomly assigned. The control group lying quietly and uninterrupted. The conclusions indicated that listening to the Holy Koran causes the relief of the patient’s anxiety before operation. Therefore investigator suggested that for decreasing anxiety of patients, hearing the Holy Koran is effective. Listening to the Holy Quran can reduce the patients anxiety, which in consistent to the findings of other researches. It is suggested to use this way to relief the patients anxiety.

Background and The unique of exclusively breast feeding for 4-6 months infants is diagnosed. Not enough milk is the most important complaint which lead discontinuation of breast feeding and starting complementary foods and milks in early stages of infancy. This study was conducted to determine the effects of shirafza drop (Lacto drop) by nursing mothers on weight gain of their under 6 month exclusively breast fed infants. In this double – blind clinical trial 162 healthy mothers with complaint of not enough milk, That their infants growth was lower than normal were randomly allocated into two groups. One group received 30 drop of shirafza drop three time in a day and control group received placebo. The mother and infants were visited weakly for 4 week. Data was gathered by weighing infants in each visit and collecting information through reviewing the mothers, and was analyzed using chi-square and t-test analysis of variance and covariance. There was no significant difference in mean of weight gain in two groups. The mean of weight gain was significantly higher in 0-3 month infants whose mothers received.Shirafza, that was 866240 vs 558265 in control group. The mothers in two groups mentioned a sense of increasing breast milk. Shirafza drop had significant effect in weight gain of 0-3 month infants and had no effects after that. It improved the sense of having breast milk in mothers of two groups, which is a placebo effect. More investigations is suggested.

Background and According to the WHO statistics, 60-85 percent of the world people havent motion enough. While low or no motion have bad effect on the human physical and psychological and it's impact on the health of the society, this research is accomplished to evaluate " the effect of regular exercise program on Sabzevar health care worker's self- esteem in 1381. In this clinical trail research, 57 person of Sabzevar health care worker were chosen by non randomized and simple method and randomly divided in two group, include exercise and control groups, the samples had at least 6 months record of service, didn’t have any exercise activities regularly, and had no physical defects, such as blindness, organ amputation. Data were gathered by utilizing demographic, and work questionnaire, and cooper- smith self- steem inventory. exercise group accomplished their exercise for 36 times for 45 minutes during six weeks program. Control group continued their common life without any changes in their regiemes or physical activities. After gathering, the compatible data was evaluated by utilizing x2, Man - Whitney and fisher tests. The effect of regular exercise on self- steem was measured by T-Test, and two-ways ANOVA was used for surveying the relations between effective factors on the self-steem changes.Mean self-esteem score in exercise group before and after doing the exercise was 99.2±9.0 and 104.3±7.6 respectively, and according to paired T-Test, this increase was significant (p<0.0001) means regular exercise program increase the self-steem but in control group the mean of self-steem before and after research was 99.8±9.9 and 99.9±8.6 respectively, so according to paired T-Test there was no significant difference between them (p=0.77). Regular exercise program cause significant difference in health care worker's self-steem. Although the rate of this increase is not so much, but according to the ease of utility, cheapness, Lack of specific side-effect and its physical and psychological privilege, researcher purposes to utilize this regular exercise program for increasing the self-steem of health care workers.

Background and Low back pain is reported by 15-74 percent of women in labor. Acupuncture is one of the pain relief methods mentioned in scientific resources. The purpose of this research was to evaluate the relief of low back pain in labor with intradermal injection of sterile water. In this clinical randomized trial, 100 pregnant Women at term with a singelton, and vertex presentation and normal labor progress were selected in two Mashad hospitals, randomized into two groups: one groups received intradermal injection of sterile water (0.1ml) in the lumbosacral region and the other group received intradermal dry needle (placebo). The mother was asked to express the intensity of her low back pain by VAS before the blocks were given and immediately 10, 54, 90 minutes after blocks and also Just before delivery. Data were analyzed with x2, T-test, Monova, Manwithney by using SPSS software. The mean reduction in VAS scores in intradermal injections of sterile water group, immediately, 10, 45, 90 minutes after injection and also just before delivery were 6.04, 6.28, 5.58, 5.50, 4.92 respectively and placebo group were 1.14, 1.04, 0.30, -0.28-0.86 respectively (p<0.001).The maximum effects last for 13.20 hours and 3.75 hour in the intradermal water injection and placebo respectively (p<0.001). The rate of lasting effects until delivery were 82% and 8% in intradermal water injection group and placebo group respectively (p<0.001). The findings suggest that intradermal injections of sterile water are an effective and simple method to reduce back pain and are easily performed by clinical personnel.

Physical pain is one of the most feared consequences for patients with cancer. Chronic pain may be at all stages of cancer especially advanced stage. While pharmacological treatments are the central component of cancer pain management, but optimal pain management may require attention to psychosocial variables and the inclusion of nonpharmacological strategies. Management of cancer pain must be individualized; effective pain management can improve the quality of life throughout all stages of the disease. According to review of studies, nonpharmacological methods of cancer pain management include:- Physical interventions: massage, touch, pressure, vibration, heat, cold, electrical nerve stimulation (TENS), acupuncture, exercise and physical therapy.- Thinking and Behavioral interventions: Relaxation, hypnosis, guided imagery, biofeedback, autogenic training, distraction (talking, reading, music, television…) patient education, psychological support, support groups and counseling. Thomas and Weiss (2000) introduced three effective nonpharmacological strategies in reducing cancer pain: 1) Patient psychoeducation, has empowered patients to actively participate in pain control strategies.2) Supportive psychotherapy can assist patients in managing the stressors associated wit h cancer. 3) Cognitive-Behavioral therapy helps patients to recognize and modify thoughts, behaviors and the factors that contribute to physical and emotional distress. Many researches have proved the effects of these interventions on reducing cancer pain as methods complementary and alternative therapy (CAM). Cancer pain is a complex phenomenon and psychosocial variable and emotional distress (anxiety, depression…) has emerged as predictive of patient pain levels. Appropriate cancer pain management requires assessing characteristics of pain, attention to its different aspects and helping Nurse, physician, psychologists, family and other health professionals that is as an example of true comprehensive and integrative care.

Rooted in the eastern culture, therapeutic touch (TT) is currently a widely used complementary therapy in western countries. TT is an organized kind of touch, which emphasizes on body mind connection on healing and well being. Receiving approval from high nursing centers, TT is now recognized as a standard nursing intervention. Using modern techniques such as TT in nursing care system, can reduce the final expenses, side effects and duration of treatments.

Reflexology is a natural therapy based on the theory that points on the feet and hands correspond to specific organs and systems in the body. Thus by applying gentle pressure to these points the related area of the body is stimulated and cleared of congestion. Reflexology promotes deep relaxation which encourages the body's self healing process. It is a calming, relaxing and enjoyable treatment. From the early stages of morning sickness to delivery discomfort, pregnancy can be physically demanding. Maternity reflexology can help with relief of the mother's complaints during pregnancy birth and babies.