Journal of Caring Sciences
Volume:1 Issue: 1, Mar 2012

Increasing the knowledge of women on effectiveness of contraceptive methods can lead to the use of more effective methods and reduce unwanted pregnancies and adverse outcomes. We aimed to compare three different approaches for increasing women’s understanding of effectiveness of contraceptive methods. We randomly assigned 630 eligible women of reproductive age to one of the three groups. Each woman received one of three charts presenting pregnancy risk with each contraceptive method. Participants before and while reviewing the chart, answered to three key questions about the effectiveness of the methods. The data were analyzed using chi-square, ANOVA and McNemar's tests in SPSS version 13. The most important reasons for choosing contraceptive methods were their effectiveness (45%), ease of use (18%) and few side effects (14%). At baseline, the participant's knowledge about the effectiveness of the methods was poor. Correct answers were 44% about comparing the effectiveness of the combined pills vs. that of condoms, 50% about intrauterine devices vs. injectable, and 52% about condoms vs. withdrawal. While reviewing the charts, the percentages significantly (p < 0.001) increased to 80%, 84% and 85%, respectively. All the three charts almost equally increased the correct responds to the questions. The three approaches had considerable and nearly identical effects on the promotion of women's knowledge about effectiveness of the contraceptive methods. Therefore, appropriate use of the charts is required during counseling sessions for contraceptive choice because it is impossible to have informed choice of the method without understanding their effectiveness.

There are many opportunities for nurses to assist improving patient’s experience of cancer. In fact, in every stage of cancer process, nurses can provide the required and necessary cares and supports by representing substantial caring behaviors. Thus, by identifying and understanding the importance of caring behaviors which led to nurse-patient effective interactions, nurses would be able to care better for patients and so to enhance patients’ satisfaction toward nursing services. However, a few studies have ever been done about perception of oncology nurses about prioritization of caring behaviors. This was a descriptive study done among all the nurses of oncology wards (n = 40) in Shahid-Ghazi-Tabatabaei Hospital of Tabriz in 2009. Data collection performed using Larson’s CARE-Q tool that assessed the importance of caring behaviors in six subscales as the following: “Monitors and follows through”, “Explains and facilitates”, “Physical and emotional comforts”, “Trusting relationship”, “Anticipates” and “Being accessible”. In this study, the importance of caring behaviors was evaluated in moderate to high level and the priorities of care dimensions were determined. “Monitors and follows through” and “Being accessible” received a high priority and “Anticipates”, “Explains and facilitates”, “Physical and emotional comforts” and “Trusting relationship” were given the low priority by nurses. The difference of caring prioritization by the nurses of this study compared to other studies can be attributed to the influence of cultural background on caring. Considering the high prioritizing of “Monitors and follows through” and “Being accessible”, nursing service officials and planners are recommended to attempt providing prerequisites of these two caring aspects.

Some studies have reported that diabetic patients do not adhere well to the foot care recommendations. Reasons for non-adherence are less evident and the methods used in education programs may have an effect. Therefore, the aim of the present study was to compare the effects of lecture method and combined method of education on foot care of patients and healing rates of diabetic foot ulcers. A matched controlled trial study was conducted on a sample of 45 diabetic patients with foot ulcers. The two intervention groups were taught with similar content but different methods. Patients’ foot care and healing rates of diabetic foot ulcers were assessed at the beginning of study and after 3 months in the two training groups as well as the control group. Ulcer surface was decreased by 46%, 61% and 81.6% in the control, lecture group and combined group, respectively. The ulcer depth was also decreased by 66.7%, 97.5% and 69.1% in the three groups respectively. A significant relationship was observed between the group adherence of the self-care program and the amount of decrease in the ulcer surface area (r = 0.36, p = 0.04). The foot care education could significantly affect the healing of diabetic foot ulcer, especially in terms of the ulcers’ surface area. Therefore, a self-care education program should be integrated in the health system to empower those living with diabetes to manage their own foot appropriately.

Experience of chronic stress in children plays an important role in enhancing future physical, mental and social problems. It is very essential and vital that families, teachers and professional groups possess necessary abilities to diagnose stress symptoms in children. According to the statistics of Education Ministry, there were almost 5.5 million primary school students in Iran in 2008-2009. However, there are very limited studies about stress in 7 to 12-year-old children. The present study aimed to review stress symptoms in school-aged children. In a descriptive study, 839 third to fifth grade students were selected from five randomly chosen districts of Tabriz using random sampling method in the schools. The data were collected by means of children’s stress symptom scale (CSSS) through interviewing by children. Accuracy of translation was checked and content validity and reliability were confirmed using test retest method. The entire twenty-six items of the questionnaire were reported as stress symptoms. More than half of the study subjects reported worry, fast heart beating, being afraid, chills and feeling sad as their signs of stress. Headache (46.6%) and tiredness (41.8%) were also reported. In examining every stress symptoms, there was a statistically significant correlation between some symptoms with age, grade and type of school. Children showed a wide range of symptoms in facing with stressful events. Accurate identification of symptoms can inform parents, teachers and professional health staff about physical and mental status of school-aged children and result in interventions to reduce their stress.

Considering the numerous physical and psychological problems in hemodialysis patients, they are dependent on others in some daily activities and in fact, they do not have full self-care ability. A few studies have ever been done, particularly in Iran, on self-care ability of hemodialysis patients. The present study aimed to determine self-care ability of these patients in addition to evaluate its association with some demographic characteristics. This was a descriptive study in 2009 done in Maragheh, Bonab and Miandoab Hospitals. The study population included 115 hemodialysis patients who were eligible. Data were collected using a combined and modified questionnaire including demographic characteristics and self-care ability items. Self-care ability was desirable in 78.3 percent of the patients. The highest desirable self-care ability in the study participants was related to vascular access (73%) and the highest undesirable self-care ability was related to follow the diet. There was a significant association between self-care ability and some demographic characteristics including age, gender, marital status and employment status. Hemodialysis patients did not have full self-care ability. It is necessary to enhance their knowledge about diet, complications of hemodialysis and preventive methods through accurate and permanent education so that they can increase their self-care ability.

Breast cancer is the most common cancer and the second principal cause of cancer death in women as well as the most common cause of death in Iranian women aged 35-55 years. Detection of breast cancer in its early stages is amenable to almost complete cure. Breast cancer screening comprises breast self-examination (BSE), clinical breast examination (CBE) and mammography. The study aimed to examine the performance of CBE and mammography among women referring to health centers of Tabriz, Iran. This was a descriptive-analytical research carried out on 400 women aged 20-50 years. The samples were chosen through random multistage sampling among health centers of Tabriz then active records of women. A questionnaire and observational checklist was used to elicit socio-demographic information and performance of women towards breast cancer screening methods. Descriptive and inferential statistics (chi-square and Fisher’s exact test) were used to analyze the data through SPSS 13. Only 19.1% of women had clinical breast examination and 3.3% had mammogram. The main reasons why women had not performed breast cancer screening were as follows: being unaware of breast screening methods, not having a breast problem and not feeling the necessity... There was a significant correlation between performing CBE and history of breast tumor and also, between performing the mammography and family history of breast cancer and history of breast tumor (P < 0.05). The findings showed that the performance of breast cancer screening methods was not satisfactory. In addition, their performance in high risk women was very desirable than others. The presentation of imperative education about breast cancer screening methods through health staff especially in pregnancy, post-partum and even in premarriage councelling periods seems necessary.

The process of pregnancy and labor has a dramatic impact on society’s health. Considering the importance of obstetrical cares and the role and presence of midwife at parturient bedside, this study aimed to evaluate the impact of care and continuous presence of midwifery on labor duration. This was a semi-experimental study. The study population included parturient women referred to 29 Bahman Hospital in Tabriz who had normal vaginal delivery indication. 100 women were randomly selected and divided into experimental and control groups (50 in each group). In the experimental group, obstetrical cares were provided by one midwife since the beginning of active phase of labor with her continuous presence at the bedside of parturient (continuing care) whereas in the control group, cares were provided by several midwives and without their continuous presence. Labor consequences (including labor duration) recorded for both groups. The data were analyzed through SPSS13 and inferential statistics including independent sample t-test. In the experimental group, the lengths of the first and second stages were shorter (per minute) than those of control group (p = 0.001). However, the length of the third stage of labor had no significant difference between the two groups (p = 0.083). Totally, the lengths of delivery including the first, second and third stages were shorter in the experimental group than in control group (p = 0.001). The results showed that low number of midwives and their continuous presence on bedside of parturient had a positive effect on reducing the delivery duration. Therefore, being with “parturient” not only does promote the quality of obstetric care, also can promote the health of society.

Emergency contraceptives are accessible and acceptable methods for most women, which their proper use could prevent about three quarters of unwanted pregnancies. In this study, we aimed to determine the providers’ knowledge, attitudes and their relation with the pills and condoms users’ knowledge of and attitudes towards emergency contraception at public health centers/posts in Tabriz, Iran. In this cross-sectional study, subjects were 140 health providers working in randomly selected 19 health centers and 33 health posts and 280 married women aged 15 to 49 years who were using contraceptive pills or condoms (two clients of each selected provider). A self-administered questionnaire was used to collect data from the providers, while the questionnaire for the clients was filled up by face-to-face interview. The relationships were determined by Pearson’s correlation test. Mean score of the providers’ knowledge and attitude was 69.4 ± 11.8 and 70.1 ± 12.8, respectively (possible score range was 0-100). The providers’ knowledge score was good only in 35¬% (score > 75.0). High majority (95.7%) had positive attitudes (score > 50.0). Overall, there were no significant relationships, neither between the provider's and user's knowledge nor between their attitudes (p > 0.05). The providers’ knowledge was insufficient, and there was no significant association between the provider's and users’ knowledge and attitudes. Thus, in addition to the need for promoting provider's knowledge, the other barriers should also be recognized and removed in order to promote using this method.