فصلنامه حیات
سال پانزدهم شماره 4 (پیاپی 43، زمستان 1388)

Pregnancy and post-partum period are accompanied by important changes in women's quality of life. Patient counseling is an effective way to improve quality of life. This study aimed to assess the effect of telephone counseling on the quality of life among women with a normal vaginal delivery in Razi hospital in Marand.Methods & Materials: In this randomized clinical trial, 260 women were recruited to the study. The participants who had met the inclusion criteria were randomly allocated in two intervention and control groups. The intervention group (n=130) received telephone counseling twice at the first week for 20 minutes and then once a week from the 2nd week to the 6th week. Moreover, we had provided a 24-hour hotline for women. The control group (n=130) received the routine care. Data were gathered using a demographic sheet, a postpartum problem's checklist, and the SF-36 quality of life questionnaire. Data were analyzed using SPSS-13. The results showed no significant differences in physical and mental quality of life in the first day of post-partum between two groups. The women's quality of life in both physical and mental dimension were significantly higher in the intervention group in the 42nd day after childbirth (P<0.001). Telephone counseling by midwives could help to improve women's quality of life in post-partum period. More studies are recommended.

Surgery is a stressful experience. Fear of postoperative pain causes anxiety. The purpose of this study was to investigate the effect of patient education about pain control on patient's anxiety before abdominal surgery.Methods & Materials: In this quasi-experimental study, 89 patients who were planned to undergo elective abdominal surgery in an educational hospital were recruited to the study. Informed consents were obtained. The participants were randomly allocated in two control (n=45) and experimental (n=44) groups. The questionnaire included demographic information, clinical characteristics, and the Spielberger's State Trait Anxiety Inventory (STAI). Patients in the experimental group received education about pain control one day before surgery. The education method was oral explanation for 20-30 minutes. The control group received no intervention. Data were analyzed through descriptive and inferential statistics (chi-square, t-test, Fisher's exact test, Wilcoxon signed ranks and Mann-whitney's tests) in the SPSS. Findings indicated that there was a significant difference in anxiety level between the experiment and control groups before surgery (P<0.001). There was also a significant difference between anxiety level in the surgery day (P<0.001) between the two study groups. The anxiety level was significantly decreased in the experiment group. Based on our findings, patient education about pain control led to reduce preoperative anxiety in patients undergoing abdominal surgery. Patient education is a non-medical simple intervention that is recommended for using in surgery wards.

Premenstrual syndrome (PMS) is a common psychosomatic disorder that affects 30-50% of women in reproductive ages. The purpose of this study was to determine the effect of a counseling program on premenstrual syndrome related symptoms.Methods & Materials: This study was a randomized clinical trial in which the effect of a 3-sessioned counseling program on the PMS symptoms were assessed in 123 adolescent with PMS. The program included information providing, life style alteration, and providing stress management skills on symptoms of PMS. The participants were randomly allocated to intervention (n=67) and control (n=61) groups. Participants completed the demographic questionnaire, the PMS symptom's daily record scale, and the symptom checklist 90-revised (SCL-90-R). Data were analyzed using the SPSS-11.5. The comparison of baseline data showed no significant difference between two groups regarding demographic characteristic and the PMS related symptoms. There were significant differences in the mean of total PMS severity, somatic symptoms (P<0.001), anxiety, interpersonal sensitivity, and hostility (P<0.05) between two intervention and control groups. There was not any significant difference in depression between intervention and control groups (P=0.11). Group counseling resulted in a significant reduction in severity of total PMS, somatic symptoms, anxiety, interpersonal sensitivity and hostility in intervention group compared to the control group. There was no statistically significant difference in depression between two groups

Prenatal period is a unique opportunity to assist the women to adopt healthy behaviors. The nutritional behaviors of pregnant women affect not only their own health but also the fetal growth and development. The purpose of this study was to determine the effect of nutrition education on nutritional behaviors in pregnant women.Methods & Materials: In this randomized trial, 272 primigravida women were recruited using stratified cluster sampling method from eight family health clinics in Semnan. The participants were allocated in two groups randomly. The intervention group received the nutrition education through two 90-minute sessions with one week interval. Data were gathered using a questionnaire including demographic characteristics and nutritional behaviors at baseline and six weeks after the education. Data were analyzed in the SPSS. The results showed that there was not any significant difference in the mean score of the nutritional behaviors between two groups before the intervention. Significant difference was found between two groups after the intervention. The mean score in the intervention group was higher than in the control group (P<0.001). The results of the study showed that nutrition education affected the nutritional behaviors in pregnant women. Therefore, the nutrition education should be integrated in educational topics provided for pregnant women.

Despite the advancement of medical science, readmission of the heart failure patient remains a serous problem. The aim of this study was to assess the effect of continuous care and educational intervention on the rate of readmissions, refers to physician, and health costs in patients discharged from hospital.Methods & Materials: This study was a randomized clinical trial in which 110 patients were studied. The participants were allocated in two experimental and control groups. Data were gathered using questionnaires. Home visits were carried out in the experimental group during six months. At the end of the intervention, the rate of readmissions, referrals, and health care costs were compared in the two groups. Data were analyzed using independent t-test, Fisher's exact test, and Chi-square test. Results indicated that the rate of readmissions (1.65±1.01 vs. 2.74±1.07, respectively), and refers to physicians (2.73±1.24 vs. 3.32±0.94, respectively) were lower in the experiment group than the control group (P<0.05) after the intervention. The average health care cost in the intervention group (2494000±172150 Rials) did not differ significantly with the control group (2736800±167360 Rials) (P>0.05). The results of this study indicated that the nursing interventions such as home visits are effective in lowering readmissions and refers to physicians in patients with heart failure. It seems that home visits are necessary in promoting the patients health.

Life style has potential role in bone mass density and prevention of osteoporosis in adolescents. The aim of this study was to determine the life style of female students influencing osteoporosis prevention in Nursing and Midwifery school at Zanjan University of Medical Sciences.Methods & Materials: All female students (n=166) were recruited in this cross-sectional study. Data were gathered using three questionnaires: 1) demographic questionnaire, 2) General Practitioner Physical Activity Questionnaire, and 3) dietary recall questionnaire. Validity and reliability of the questionnaires were determined. Date was analyzed using descriptive statistic, Chi-square, and t-test. Mean calcium intake was statistically different between dormitory and non-dormitory students (P<0.001). Regarding physical activity, only 19.2% of the students had appropriate activity. The main activity of the students was walking (83.5%). There was a significant difference between economic status and life style (P=0.047). There was no statistically significant difference between life style with the parent's educational level, and the educational program. It seems that life style-related osteoporosis preventive behaviors are not appropriate among nursing and midwifery students. Planning appropriate educational programs could promote high standard nutritional plans and physical activity among the female students.

The prevalence of cardiovascular diseases is high in most of the countries. Cardiac catheterization is a routine diagnostic test for coronary heart diseases. In order to minimize the post-procedure complications, patients are restricted to bed for 8-24 hours in flat position. The aim of this study was to assess the effect of changing position and early ambulation on back pain and the amount of bleeding after cardiac catheterization. Methods & Materials: In this quasi-experimental study, 90 patients undergoing diagnostic angiography were selected using convenience sampling method in Shariati hospital. The patients were allocated in two intervention and control groups. The control group remained in supine position for 8-24 hours and the sandbag remained for eight hours. The patient's position in the intervention group was intermittently changed during the first hour after catheterization. The head of bed was set at 15 degree angle. In the second hour, the position changed to flat and the head of bed raised to 30 degree. In the third hour, the head of bed angle was set in 45 degree. In the first three hours sandbag was placed in catheter insertion site. After the third hour, patients could rest in any position (15-30 degree). Patients were ambulated in the sixth hour. Back pain intensity and level of bleeding were assessed immediately after admission, in the sixth, 24th hour; and after the seventh day of catheterization. The results indicated that there was no statistically significant difference in age, gender, education level, back pain intensity, and the level of bleeding immediately after the catheterization. Back pain intensity was lower in the intervention group than the control one after 6 and 24 hours of catheterization (P<0.001). There was no statistically significant difference between the intervention and control groups in the level of bleeding after 6 hours, 24 hours, and seven days of catheterization (P>0.05). Patients should be allowed to change their positions in bed cardiac catheterization. Patients can be ambulated earlier (in the sixth hour) after cardiac diagnostic catheterization.

Regarding the importance of determining the determinants of diabetes self-care, this study aimed to examine two major determinants of self-care activities, i.e. perceived barriers, and perceived self-efficacy among type two diabetic patients in Tehran, Iran. Methods & Materials: In this cross-sectional study, 128 patients were recruited to the study using convenience sampling. The validated diabetes instruments were completed by the patients. The included participants aged older than 18 years. Data were analyzed using bivariate correlation and path analysis. The mean score of the perceived barriers and perceived self-efficacy were 3.05 and 2.18, respectively. The maximum score of self-care was 4.18. There was a positive correlation between self-efficacy and the self-care (r=0.22; P<0.01). Positive correlations were also found between education with self-efficacy and self-care (r=0.28; P<0.05), (r=0.29; P<0.05). There was a negative correlation between perceived barriers and self-care behaviors (r=-0.68; P<0.000). Using serial multiple regressions and path analysis, we had a final model (RMSEA=0.05; GFI=0.95; CFI=0.98; P=0.44; and Chi-Square=26.5). This model showed that perceived barriers were the strongest predictor for self-care behaviors. Perceived barriers mediated the effect of self-efficacy on the self-care behaviors. The intervention efforts that address the studied determinants related to self-care behavior could potentially impact type two diabetic patient's self-care activities. These determinants should be mentioned in the program developing