International Journal of Community Based Nursing and Midwifery
Volume:3 Issue: 3, Jul 2015

There are high levels of sexual harassment in health care systems. Also, workplace violence occurs against ethnic and racial minorities. This study aimed to identify the frequency of and the factors contributing to and preventing sexual and racial harassment in the workplace towards health professionals in Iran. This cross-sectional study was conducted on 6500 out of 57000 health workers who were selected by multistage random sampling from some teaching hospitals in Iran. Data were collected using the questionnaire of “workplace violence in the health sector” developed by the International Labor Organization, International Council of Nurses, World Health Organization, and Public Services International. According to the findings, the frequencies of sexual harassment and racial harassment were, respectively, 4.7% and 12% for the 12 months prior to the study (2011). Among healthcare workers, nurses reported the highest rate of violence. The most important contributing factors in sexual and racial harassment were lack of security facilities (45.8%) and people’s ignorance of employees’ tasks (55.7%). The presence of security force, safety measures in the wards, and guards were noted as the most important preventive factor to harassment. Based on the results, the frequency of sexual and racial harassment is low, which can be attributed to underreporting due to cultural sensitivity or fear. So, identifying the reasons for refusal to report harassment, developing a clear mechanism for reporting and providing the necessary trainings to health workers are essential in order to deal with harassment.

Pregnant women rely heavily on informal information while making a decision about the mode of delivery they would rather have, either as normal vaginal delivery (NVD) or cesarean section (CS). Through recognition of social attitudes towards different modes of delivery, societies can be directed towards a positive understanding of vaginal delivery, which can ultimately lead to maternal health promotion. Thus, this study aimed to explore the common beliefs, values and traditions surrounding women’s preferred mode of birth in the North of Iran. Using a focused ethnographic approach, twelve pregnant women, 10 women with previous experience of childbirth, seven midwives, seven obstetricians, and nine non-pregnant women were included in this study through a purposeful sampling in health clinics of Tonekabon in the North of Iran. Semi-structured interviews and participant observations were used for data collection. Study rigor was confirmed through prolonged engagement, member check, expert debriefing, and thick description of the data. Data were analysed using Braun & Clarke thematic analysis (2006) and MAXqda software. Through analysis, three major themes and 10 subthemes emerged. They included: 1) sociocultural childbirth beliefs with five subthemes: a) CS as protector of genital tract integrity, b) blind imitation in choosing mode of birth, c) NVD as a low cost type of delivery, d) CS as a prestigious mode of birth and, e) NVD as a symbol of woman’s power and ability; 2) traditional health beliefs with two subthemes: a) NVD as a guarantee for woman’s health, b) traditional childbirth facilitators; 3) religious beliefs and values with three subthemes: a) NVD as a symbol of God’s power, b) call for help from the Mighty God, and c) NVD as a sacred phenomenon. The results of this study indicated that cultural beliefs, values and traditions can significantly affect individuals’ attitudes towards modes of delivery, their definitions of different modes, and the decisions they make in this regard. In order to develop a positive cultural and religious attitude towards vaginal delivery, women’s awareness has to be raised through various ways and the existing misconceptions need to be corrected.

Responsibility for diabetes management tasks must shift from caregivers to adolescents as adolescents grow older. Also, family-centered care is a way to provide efficient care for them at home. This study aimed to identify the effect of family-centered care on management of blood glucose levels in adolescents with type 1 diabetes mellitus (T1DM). This is a Pre-experimental study with a pre- and post-test design. The participants consisted of forty adolescents with T1DM, aged between 10-14 years, with their caregivers who were selected through simple random sampling from Hamadan Diabetes Research Center in Iran in 2013. The sample was divided into four similar groups. Educational sessions were conducted for each group for 30 to 40 minutes. Data collection tools were “Supervisory Behaviors of Caregiver” (SBC), “Management Behaviors of adolescents” (MBA) questionnaires, and the “Blood Glucose Levels Record Sheet”. Data were analyzed using SPSS 19 and based on descriptive statistics, Kolmogorov-Smirnov, paired t-test and Pearson coefficient. There was a significant difference between the subjects’ MBA and SBC mean scores before (110.17±26.6) and after (134.6±1.28) intervention in four domains: “blood glucose testing”, “insulin therapy”, “meal plan” and “physical activity” (P<0.001). There were significant differences between the mean levels of recorded blood glucose during a week before and after intervention and between the mean levels of Glycated Hemoglobin level (HbA1c) before (8.4±1.12) and three months after (7.78±1.2) it (P<0.001). Pearson coefficient showed a positive relationship between the supervisory behaviors of caregivers with management behaviors of adolescents before and after the intervention (P<0.001). Empowering adolescents with T1DM and their caregivers in home-centered care could improve diabetic adolescents’ management of blood glucose levels and reduce their HbA1Clevels. Therefore, Family-centered care could provide for better regime adherence at home.

Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes (average 52 minutes). Constant comparative analysis was used to analyze the data. Three main categories appeared at the end of the analysis: “going out of the road of usual life”, “challenge of meeting older person, family and caregivers care needs”, and “the appearance of inconstancy in the family”. They explained exclusively how family caregivers of old people give up caregiving. Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers.

Assessment of quality of life (QOL) is of paramount importance for improving postpartum QOL which will in turn enhance QOL of mothers, children, individuals, and the community. The present study aimed to evaluate and compare postpartum QOL after Cesarean Section (CS), Normal Vaginal Delivery (NVD), and water birth delivery. This descriptive analytical, cross-sectional study was conducted on postpartum women referred to urban health centers and two public hospitals in 2012-13 in Shiraz, Iran. Overall, 59 women with NVD, 39 with CS, and 39 with water birth, all at 2 months postpartum, were recruited into the study through multi-stage sampling. Postpartum QOL was measured using Short Form Health Survey (SF-36) which hadbeen adapted previously in Iran. Then, the data were analyzed using descriptive statistics and one-way analysis of variance (ANOVA) in SPSS, version 18. The results showed that the NVD group had the highest mean score in physical health domains; the women with water birth had the highest mean score in mental health domains and total QOL. Regarding postpartum QOL the results of one-way ANOVA showed no statistically significant differences between the three modes of delivery. Women with water birth and NVD had the highest and second highest total QOL mean scores, respectively; women with NVD and water birth experienced better physical health. Thus, providing more information to pregnant women to encourage them to use NVD and water birth is suggested.

The period of hospital stay and the first month after discharge have been found to be the most problematic stages for family caregivers of stroke survivors. It is just at home that patients and caregivers actually understand the whole consequences of the stroke. The adult offspring often have more different needs and concerns than spousal caregivers. However, relatively little attention has been paid to the needs of this particular group of caregivers. Therefore, this qualitative content analysis study aimed to explore the supportive needs and coping behaviors of daughter and daughter in-law caregivers (DILs) of stroke survivors one month after the patient’s discharge from the hospital in Shiraz, Southern of Iran. This is a qualitative content analysis study using semi-structured and in-depth interviews with a purposive sampling of seventeen daughter and daughter in-law caregivers. The data revealed seven major themes including information and training, financial support, home health care assistance need, self-care support need, adjusting with the cultural obligation in providing care for a parent in-law, and need for improving quality of hospital care. Also, data from the interview showed that daughter and daughter in-law caregivers mostly used emotional-oriented coping strategies, specially religiosity, to cope with their needs and problems in their care-giving role. The results of this qualitative study revealed that family caregivers have several unmet needs in their care-giving role. By providing individualized information and support, we can prepare these family caregivers to better cope with the home care needs of stroke survivors and regain control over aspects of life.

Several studies are available on the lifestyle, psychological and mental health of the elderly adults. This study aimed to compare the spiritual well-being and happiness in the elderly who lived in sanitariums with those lived in the community. A comparative study was conducted on 384 elderly adults. A census sampling was used in sanitariums and a convenience sampling was performed to select the community dwelling (CD) older adults. A demographic questionnaire, the Pauloutzian and Ellison’s spiritual well-being scale and the Oxford happiness questionnaire were used in this study. Descriptive statistics and Kolmogorov-Smirnov, Chi-square and Mann-Whitney U tests and Spearman correlation coefficient were employed for data analysis, using the SPSS software, version 13.0. From the total participants, 56% were CD elderly and 44% were in sanitariums. Among the CD older adults, no one was at a high level of spiritual well-being while in sanitariums 24.4% were at a high level of spiritual well-being. Also, 71.2% of the community dwelling older adults were at a high level of happiness while only 3.6% of those living in sanitariums expressed a high level of happiness. A significant association was found between the level of spiritual well-being and happiness in those who lived in sanitariums (r=0.177, P<0.021). Most of the elderly living in the community and in sanitariums showed moderate spiritual well-being and low happiness. Therefore, nurses and health authorities are responsible not only to inform the community about the importance of spiritual well-being and happiness, but also to establish some strategies in this regard.

Osteoporosis is a common disease characterized by reduction in bone mass, due to depletion of calcium and bone protein. A pivotal role of the sympathetic nervous system in bone remodeling has been considered. On the other hand, elevated central sympathetic activation in postmenopausal women is involved in the creation of vasomotor symptoms. Also, sympathetic skin response (SSR) has been performed for evaluation of the peripheral and central autonomic nervous system dysfunctions. Therefore, to determine the association of the autonomic nervous system and osteoporosis, we evaluated the correlation between the bone mineral density (BMD) with the frequency of vasomotor symptoms and also sympathetic skin responses. This is a cross-sectional study in which thirty-three postmenopausal osteoporosis women, as the case group, and 31 age-matched postmenopausal women with normal BMD, as the control group, were included in our study. To evaluate the autonomic function, we assessed the frequency of vasomotor symptoms with a questionnaire and performed SSR test for the two groups. According to the parametrical or the nonparametrical distribution of the data, Independent Samples t-test or Mann Whitney test, respectively, were used to compare group differences. The onset latencies of SSR recorded from both hands and feet were significantly prolonged in the case group compared with the control group (P<0.001). Amplitudes of SSR in the case group were significantly less than those of the control group (P<0.001). The postmenopausal osteoporotic women reported a significantly higher frequency of hot flashes and night sweats when compared with non-osteoporotic women (P<0.001). The higher frequency of vasomotor symptoms and impaired sympathetic skin responses in postmenopausal osteoporotic women suggests a role of autonomic dysfunction in osteoporosis.

End stage renal disease negatively affects the patients’ quality of life. There are different educational methods to help these patients. This study was performed to compare the effectiveness of self-care education in two methods, face to face and video educational, on the quality of life in patients under treatment by hemodialysis in education-medical centers in Urmia. In this quasi-experimental study, 120 hemodialysis patients were selected randomly; they were then randomly allocated to three groups: the control, face to face education and video education. For face to face group, education was given individually in two sessions of 35 to 45 minutes. For video educational group, CD was shown. Kidney Disease Quality Of Life- Short Form (KDQOL-SF) questionnaire was filled out before and two months after the intervention. Data analysis was performed in SPSS software by using one-way ANOVA. ANOVA test showed a statistically significant difference in the quality of life scores among the three groups after the intervention (P=0.024). After the intervention, Tukey’s post-hoc test showed a statistically significant difference between the two groups of video and face to face education regarding the quality of life (P>0.05). Implementation of the face to face and video education methods improves the quality of life in hemodialysis patients. So, it is suggested that video educational should be used along with face to face education.