Iranian Journal of Nursing and Midwifery Research
Iranian Journal of Nursing and Midwifery Research (IJNMR) applies the Creative Commons Attribution License (CCAL) to all of its published papers. Under the CCAL, authors retain ownership of the copyright for their article, but authors allow anyone to download, reuse, reprint, modify, distribute, and/or copy articles in IJNMR, so long as the original authors and source are cited. No permission is required from the authors or the publishers.
The Effects of Peppermint on Menstrual Disorders: A Systematic Review of Randomized Controlled Trials
Abstract Background: Various aspects of women’s functioning are affected by menstrual disorders. There are various treatment methods to control these conditions. This systematic review aimed to evaluate the effects of peppermint on menstrual disorders. Materials and Methods: A comprehensive search was performed in PubMed, EMBASE, Scopus, Web of Science, Science Direct, SID, and Google Scholar without any limitations until July 31, 2023. To identify those studies that were consistent with the main purpose of this review, the search focused on the keywords “menstruation disorders,” “Mentha piperita,” and their other synonyms in the title and abstract of the articles. Methodological quality was assessed using the Jadad scale. Results: A total of 238 articles were retrieved. After removing duplicates and irrelevant studies, 146 articles remained. After evaluating the titles and abstracts, the full text of the remaining eight articles was evaluated. At this stage, one article was excluded due to being in the Malay language, and two articles were excluded due to the use of water mint species. Finally, five Randomized Controlled Trials (RCTs) with a total of 499 participants were included. The quality rating of the included trials indicates that three studies were of high quality, and two studies were of low quality. The studies examined primary dysmenorrhea and premenstrual syndrome. Statistically significant reductions in pain severity, improved cognitive function, and gastrointestinal symptoms were observed. Conclusions: The findings suggest that peppermint may be effective in improving menstrual disorders. However, high‑quality RCTs that overcome the methodological limitations of the current studies are needed.
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e Professionalism in Psychiatric Mental Health Nursing: A Systematic Review and Narrative Synthesis
Background: This study systematically examines the challenges and issues of digital professionalism in Psychiatric Mental Health (PMH) nursing over the past decade, addressing the lack of recent research in this area. Materials and Methods: Conducted as a systematic review, it analyzed a subset of 12 studies focusing on e‑professionalism in PMH nursing. The search was performed in April 2023 across databases including Medline, EMBASE, PsycInfo, CINAHL, Web of Science, Scopus, and Cochrane, covering papers published between January 2013 and April 2023. The quality of the primary papers was evaluated using the Kmet standard criteria, and a narrative synthesis approach was used to summarize the findings. Results: The results reveal that e‑professionalism issues in PMH nursing, particularly in legal and ethical dimensions, have received little attention in recent studies. The study identified two competing scenarios in mental telehealth nursing, emphasizing the need to find a balance between them for successful implementation. Conclusions: The findings highlight the importance of psychiatric mental health nurses developing a comprehensive understanding of e‑mental health interventions, including knowledge, skills, affective factors, ethics, and regulatory considerations. The study concludes by calling for greater focus on digital professionalism in PMH nursing to address the evolving challenges in the field.
Nursing Managers’ Coronary Care Unit Management Experience
Background: The Coronary Care Unit (CCU) requires effective managers to consider‑ the patient’s acute condition. Studies have indicated that nursing managers of such units face many challenges. The purpose of the study is to explain nursing managers’ CCU management experience. Materials and Methods: The current study has been conducted with a qualitative approach from November 2017 to February 2020 in the CCU of Al Zahra Heart Hospital in Shiraz, Iran. The participants consisted of 18 individuals out of nursing managers and Coronary Care Unit Nurses in Charge selected as purposeful. The data has been collected using unstructured interviews, focus groups, and field notes. The researchers used content analysis proposed by Graneheim and Lundman for interpreting the content of textual data using regular classification. Results: Data analysis led to the emergence of 3 themes and 8 subcategories. The theme of Inadequate Interaction by the Nursing Managers has been derived from the conceptualization of three subcategories “Senior Managers Insufficiently Supporting the Nursing Manager”, “Nonempathetic Communication by Nursing Manager” and “Nursing Manager, not Providing Ground for Motivating and Promoting Staff”.The main theme “Impaired Control and Supervision” includes two subcategories “Lack of Sufficient Supervision on Nursing Care Performance”, “Lack of Suitable Instrument to Monitor Unit’s Equipment and Nursing Staff’s Performance”, and the main theme, “ Incapability to Organize Performance”, is made up of three Subcategories “Nursing Managers Being Incapable to Manage Time”, “Inappropriately Organizing Activities”, and “Nursing Managers’ Limited Power in Planning Managerial Activities.” Conclusions: The current study‑derived findings present a realistic image of nursing managers participating in CCU management, so the resulting themes indicate nursing managers’ perception of CCU management as ineffective. Thus, it is imperative to focus on promoting CCU nursing managers’ managerial performance.
Compare the Effect of Aromatherapy with Lavender and Valerian Essential Oil on Headache Caused by Nitroglycerin Infusion, Vital Signs, and Narcotic Use in Patients with Coronary Artery Disease: A Three-Blind, Randomized Controlled Trial
Background: Most patients receiving nitroglycerin infusion experience some degree of headache. This study aimed to determine the effect of aromatherapy with lavender and valerian essential oil on the severity of headaches caused by nitroglycerin infusion, vital signs, and narcotic use in patients with coronary artery disease admitted to CCU wards. Materials and Methods: This three‑blind clinical trial was performed with the participation of 90 patients with consent. Patients were randomly divided into three groups (lavender, valerian, and control). Samples of lavender and valerian groups were inhaled cotton soaked in 3 drops of fragrance for 30 minutes. In the control group, no intervention was performed and only the usual methods of pain control were performed for these patients. The severity of patients’ headaches in four time periods (before the intervention and 15, 30, and 60 minutes after the intervention) was measured using the visual scale of pain and vital signs before and after the intervention. Results: The results showed that in all three groups, there was a statistically significant difference between the different stages of pain measurements and the headache score had reduced (df: 4, p < 0.05) (X2: 5.98). There was no difference between the mean scores of the pain levels in the two fragrance groups after the intervention. But there was a significant difference between the fragrance and control groups (df: 6, p < 0.001) (X2: 49.04). Conclusions: Aromatherapy with lavender and valerian essential oils is effective in reducing headaches in patients receiving nitroglycerin infusion and reducing their use of painkillers and narcotics.
Analysis of the Management Strategies in Caring for Patients with COVID 19: Chinese Nurses’ Experience
Background: In order to improve the quality of nursing care and patient outcomes during the future pandemics, understanding the details of strategies used for the management of patients with COVID‑19 and its outcomes are crucial. The present study was conducted to reveal the management strategies that Chinese nurses utilized for COVID‑19 patients. Materials and Methods: Graneheim and Lundman’s approach of conventional content analysis was used in this study and participants included nine nurses caring the patients with COVID‑19 along with supervisors or matrons. Data were collected by semi‑structured interviews and were analyzed via MAXQDA 10. Results: Six main categories emerged in this study including “overcoming challenges of COVID‑19 pandemic”, “continuous online training of nurses”, “psychological support”, “ cooperative behavior of the public and government based on the previous pandemic experience”, “protecting medical staff from infection” and “application of smartphone technology”. Conclusions: The optimal management of emerging diseases depends on the cooperation of the people, the efforts of the healthcare team, and the measures of the managers. Hospital managers could create equipped units to be designated for probable health care emergencies, preparing educated team for quick training of staff, streamlining the expansion of standard work, and providing the necessary infrastructure for possible future pandemics.
Effectiveness of Dry Cupping Therapy on Fatigue and Quality of Life of Women with Multiple Sclerosis: Randomized Clinical Trial
Background: Fatigue is one of the most common symptoms in patients with Multiple Sclerosis (MS). It can cause severe psychological problems and reduce their Quality of Life (QOL). Cupping therapy is known as a method of alternative medicine that can be used to treat or reduce patient symptoms. Thus, this study was conducted to determine the effect of dry cupping therapy on the fatigue and QOL of women with MS. Materials and Methods: This randomized clinical trial was conducted on 60 patients (30 patients in each group) with MS referred to the Medical Center of Special Diseases in southeast Iran. Patients in the intervention group received eight sessions of dry cupping therapy twice a week over 4 weeks, while the control group received routine fatigue reduction methods. Data were collected before and after the intervention by using the demographic information questionnaire, the Fatigue Severity Scale, and the Multiple Sclerosis Quality of Life questionnaire. Data were analyzed using SPSS 18. The significance level was 0.05. Results: Thirty patients entered the study; none of them were excluded from the study, and 30 patients were finally analyzed. Before the intervention, there was no statistically significant difference between the two groups in terms of fatigue (intervention group: 47.67) 7.83); control group: 47.63) 8.76)) and QOL (intervention group: 48.85) 9.55); control group: 49.64) 9.90) (t = 0.018, p = 0.98 and t = 0.31, p = 0.75, respectively)). After performing cupping therapy in the intervention group, a significant decrease and increase were observed in the mean (SD) score of fatigue (intervention group: 34.48) 6.16); control group: 46.85 (8.95)) and QOL (intervention group: 60.14) 7.46); control group: 51.96) 9.45)), respectively (p < 0.001). Conclusions: The findings showed that cupping therapy significantly reduced the patients’ fatigue and increased their QOL. This method is recommended for reducing fatigue and improving QOL in patients with MS.
Nursing Educators’ Experiences of Clinical Internships during Coronavirus Pandemic (COVID 19): A Qualitative Study
Background: The COVID‑19 pandemic has challenged the clinical training of nursing students. Because the quality improvement of nursing clinical training, in which nursing educators play a major role, requires the continuous monitoring of the status quo, this study aimed to explore the nursing educators’ experiences of clinical internships during the COVID‑19 pandemic. Materials and Methods: This descriptive qualitative study was conducted in 2021 in Tehran, Iran. Participants (n = 10) were faculty members of Tehran University of Medical Sciences and were training nursing students in medical‑surgical wards in educational hospitals. Data were collected from November 2021 to January 2022 through deep, semi‑structured, and face‑to‑face interviews until data saturation by nurse researchers and were analyzed by the Graneheim and Lundman (2004) method. Results: Analysis revealed five main categories including “fear of coronavirus disease,” “increased attention to health protocols,” “educational challenges,” “shortage of personal protective equipment” and “adaptation to pandemic conditions.” Conclusion: These findings showed nursing educators face many problems in teaching clinical skills to students during the COVID‑19 pandemic; so, health policymakers should put policies that can manage this crisis in future occurrences. In educational curricula, critical conditions affecting the quality of student’s education should be taken into consideration to reduce obstacles.
Effect of Using 5A’s Model for Self management Counseling on Quality of Life and Self Efficacy in Women with Polycystic Ovary Syndrome: A Randomized Clinical Trial
Background: Polycystic ovary syndrome (PCOS) has adverse effects on mental health and quality of life. International guidelines recommended the provision of cognitive behavioral models to support self‑management for these women. The patient‑centered 5A’s model might meet this need. Thus, this study aimed to evaluate the effect of using the 5A’s model for self‑management counseling on quality of life and self‑efficacy in women with PCOS. Materials and Methods: This study is a randomized clinical trial, and the research population included women with PCOS referred to Baghaeipour Clinic in Yazd, Iran, between April 2023 and October 2023. Sixty‑four women were randomized to the intervention (the self‑management program based on the 5A’s model) and active control groups (educational booklet). PCOS Quality of Life and General Self‑Efficacy Scale were completed by participants. Data were analyzed using SPSS 19, independent t‑test, and repeated measures (p < 0.05). Results: The mean difference between quality of life (F2,60 = 75.25, p < 0.001) and self‑efficacy (F2,60 = 29.09, p < 0.001) scores before, after, and follow‑up in the intervention group was significant. The mean difference between quality of life (F2,62 = 24.64, p < 0.001) and self‑efficacy (F2,62 = 20.39, p < 0.001) scores before, after, and follow‑up in the active control group was significant. However, the increase in the quality of life and self‑efficacy score in the intervention group was higher than in the control group. Conclusions: The 5A’s model and educational booklets to improve self‑management increased quality of life and self‑efficacy of women
Mental Health of Hospital Staff During COVID-19: A Comparative Longitudinal Study
Background: Staff burnout was a major challenge for healthcare systems globally during the COVID‑19 pandemic. In this regard, this study aimed to examine the mental health status of employees in two hospitals: one that admitted patients with COVID‑19 (COVID‑19 hospital) and another that did not admit such patients (non‑COVID‑19 hospital). Materials and Methods: This multistage case‑control study was conducted on 1241 participants who were selected using the census sampling method. The participants completed the Symptom Checklist 25 and a demographic checklist, along with the assessment of other relevant variables. Data collection occurred at 3 (June 2020), 6 (September 2020), and 9 (December 2020) months following the COVID‑19 outbreak. The data were analyzed in using the Kruskal–Wallis and Mann–Whitney tests for statistical analysis. Results: Among the 300 staff members at the COVID‑19 hospital, 187 (62%), 73 (24%), and 40 (13%) members were medical, nonmedical, and administrative staff, respectively. At the non‑COVID‑19 hospital, out of 300 staff members, 235 (78%), 53 (18%), and 12 (4%) members were medical, nonmedical, and administrative staff, respectively. The staff at the COVID‑19 hospital showed higher total SCL‑25 scores, compared to those at the non‑COVID‑19 hospital. Despite an overall upward trend in psychiatric disorders in both groups, significant differences were observed at 6 months (p = 0.02) and 9 months (p < 0.001) following the outbreak. Conclusions: The staff at the COVID‑19 hospital were at a higher risk of developing mental health disorders. The mental health status of employees at both hospitals evolved over time.
The Caregiver Burden and Family Coping in Families with Schizophrenia: Cross sectional Study
Background: Schizophrenia causes social conflict because it brings a burden of care for family caregivers. Thus, effective handling and management strategies are needed. This study aims to identify the relationship between family caregiver burden and family coping in schizophrenia patients. Materials and Methods: This cross sectional study design was conducted on 73 family caregivers of schizophrenia patients in Lamongan Regency, Indonesia, in 2023 through a purposive sampling technique. The Burden Scale for Family Caregivers (BSFC‑s) was used to measure the burden of care, and the Brief‑COPE scale was used to measure family coping felt by families of schizophrenia patients. Data were analyzed using univariate and bivariate analysis, including the Spearman rank test, using Microsoft Excel and IBM Corp SPSS Statistics 24 applications. Results: There was a significant negative relationship between the emotional support dimension in the family coping variable and the burden of family caregivers (r = −0.71, p = <0.001), and a significant negative relationship between the acceptance dimension in the family coping variable and the burden of family caregivers (r = −0.80, p = <0.001). Overall, the Spearman rank test results showed a significant negative relationship between family coping and family caregiver burden (r = −0.82, p = <0.001). Conclusions: There is a significant negative correlation between caregiving burden and family coping in schizophrenia patients. This requires increased reciprocal cooperation to reduce the burden on families in providing care for schizophrenia patients.
Exploring Intrapersonal and Extrapersonal Factors Influencing Iranian Women’s Indescribable Pleasure: A Content Analysis Study
Background: Natural childbirth is one of the most challenging psychological events in women’s lives. Women’s perceptions of this experience exert a profound influence on their psychological state and can impact maternal and infant health outcomes. Therefore, this study aimed to explain Iranian women’s experience with pleasant natural childbirth. Materials and Methods: This qualitative study employed conventional content analysis. Semistructured, in‑depth interviews were conducted with 17 primiparous women who experienced natural childbirth. Purposive sampling, aiming for maximum variation, continued until data saturation was achieved. The analysis followed Granheim and Lundman’s conventional content analysis method. Results: The analysis revealed a central theme of indescribable pleasure, supported by two main categories: intrapersonal factors and extrapersonal factors. The intrapersonal subcategories included mothers’ self‑confidence, feelings of security, heartfelt faith, feelings of empowerment, and a sense of worthiness. Extrapersonal factors encompassed respect for the mother, maternal support, midwives’ professional skills, service quality, and the physical environment. Conclusions: The study’s findings emphasize the importance of several intrapersonal and extrapersonal factors that help women experience immense pleasure during natural childbirth. We highlight the need for mental and emotional readiness before conception, acquiring essential skills for pregnancy and delivery, and ensuring high‑quality, respectful care to guarantee a positive birthing experience.
Assessment of Public School Teachers’ Knowledge of Type 1 Diabetes among Adolescent Students in Saudi Arabia: A Cross sectional Study
Background: The prevalence of diabetes among children and adolescents in Saudi Arabia highlights the need for enhanced teacher education and training in diabetes management within the school environment. This study aimed to evaluate the knowledge of public school teachers regarding diabetes among adolescent students in Saudi Arabia. Materials and Methods: We used a cross‑sectional design and distributed an online questionnaire via social media and email to collect data between April and June 30, 2022. A convenience sample of 290 intermediate and secondary public school teachers was recruited. Statistical analysis, including Chi‑square tests and logistic regression, assessed associations and predictors of diabetes knowledge among teachers. Results: Of the 290 responses, 80.3% were female, 61% lived with a family member with diabetes mellitus, and 33.4% had prior diabetic training. The study found that 62% of participants had fair knowledge about diabetes. Age, education level, and speciality were significantly associated with knowledge (p < 0.001). Regression analysis showed no statistically significant influence of the combined variables on knowledge (F9, 86.97 = 1.585, p = 0.129), but age group significantly influenced knowledge (β = 1.171, p = 0.008). Conclusions: The study revealed that Saudi teachers require additional educational programs to enhance their understanding of diabetes. The findings suggest training courses to improve teachers’ knowledge, providing written instructions for diabetic emergencies, and incorporating trained nurses in educational institutes.
Experiences of Home Care Team Members and Family Caregivers in Addressing the Care Needs of Patients with Severe Traumatic Brain Injury During the Post-discharge Period
Background: Providing care for unconscious patients with severe brain injuries at home can be challenging. One of the main difficulties is identifying and addressing their specific care needs. Therefore, the aim of this research is to extract the experiences of home care team members and family caregivers in addressing the care needs of patients with severe traumatic brain injury during the post-discharge period. Materials and Methods: This qualitative study was conducted on caregivers and healthcare providers of patients with severe traumatic brain injury in 2024-2025. Data were collected through semi-structured in-depth interviews with 22 patientsʼ caregivers and health care providers in home. The recorded interviews were transcribed and then analyzed through inductive content analysis. Results: The care needs of patients with severe traumatic brain injury during the post-discharge period were categorized into 15 subcategories and four main categories: physical care needs (maintaining respiratory function, maintaining digestive function, maintaining urinary tract function, maintaining skin integrity, Enhancing physical mobility, Balancing Sleep and Rest, pain management, maintaining personal hygiene, and treatment coherence), mental care needs (managing emotions, improving self-efficacy), social care needs (patient Support, maintaining patient care environment, caregiver support), and spiritual care needs (promoting sense of meaning in life). Conclusions: The results of this study provide a clearer understanding of these needs, aiming to develop a holistic care program tailored to the patientsʼ conditions at home, ultimately improving their quality of life and holistic care.
Complication and Dwell Time of Neonatal Peripheral Venous Catheters with and without Splint: A Descriptive, Correlational, and Prospective Study
Background: The main challenge of using Peripheral Intravenous Catheters (PICs) for neonates is their short dwell time, which requires frequent catheterization. Interventions have been made to increase the length of time intravenous catheters stay in neonates, such as the use of splints. Therefore, this study was conducted with the aim of determining the complications and dwell time of PICs with and without splints in infants admitted to the neonatal intensive care unit. Materials and Methods: This descriptive, correlational, and prospective study included all eligible neonates based on the inclusion criteria in Mahdieh Hospital, Tehran (2024), who were divided into two groups with and without splints. The sampling method was census and for 3 months, the assessment of intravenous catheters of newborns was checked three times a day, and all related complications and dwell time catheterization using a researcher‑made checklist. The data was analyzed using IBM SPSS 16 software. Results: Extravasation was the most common complication (52.40%) in the splint group, and obstruction was the most common (34.50%) in the non‑splint group. The dwell time of peripheral venous catheterization mean, and standard deviation was 43.29 (33.12) hours in neonates with splints and 37.18 (7.70) hours in those without splints. The t‑test demonstrated a significant positive impact of splints on catheter dwell time (t375 = 2.59, p = 0.01). Conclusions: There was a significant positive effect of splints on length of stay. However, splints may aid in the delayed detection of extravasation, whereas the absence of a splint may lead to an increased incidence of catheter occlusion, necessitating earlier catheter removal.
The Effects of Evidence based Management of Labor and Normal Delivery on the Satisfaction and Childbirth Experience among Primiparous Women: A Randomized Clinical Trial
Background: According to the World Health Organization (WHO), implementing evidence‑based care is vital for improving maternal and neonatal healthcare and outcomes. This study aimed to evaluate the effects of an evidence‑based labor and normal delivery management plan on childbirth satisfaction and experience among primiparous women. Materials and Methods: A single‑blind randomized clinical trial was conducted in 2023 at Sina Hospital in Ahvaz, Iran, involving 256 primiparous women with term, singleton, and low‑risk pregnancies. Participants were selected using non‑probability sampling and randomly assigned to either the intervention or control groups (128 in each) through block randomization. The intervention included the use of the WHO Labor Care Guide, consideration of maternal preferences such as freedom of movement and positioning, nutritional choices, and the preservation of maternal dignity. Trained healthcare providers implemented the evidence‑based labor and delivery management program for the intervention group. Maternal satisfaction was measured using the Mackey Childbirth Satisfaction Rating Scale, and the childbirth experience was evaluated using the Childbirth Experience Questionnaire. Data were analyzed using an independent t‑test, Chi‑square tests, and Fisher’s exact test. Results: The mean score for maternal satisfaction was higher in the intervention group compared to the control group (t245.93 = 6.63, p < 0.001). In addition, a statistically significant difference was observed in the average birth experience scores between the intervention and control groups (t254 = 8.57, p < 0.001). Conclusions: Evidence‑based labor and normal delivery management enhances maternal satisfaction and fosters a more positive natural childbirth experience.
Professional Competence of Nursing Students in Providing Spiritual Care: The Role of Spiritual Competence and Religiosity
Background: Spiritual care is a critical component of holistic healthcare, significantly contributing to patients’ well‑being and recovery. Understanding the factors influencing nurses’ competence in providing spiritual care is crucial for improving patient outcomes. This study aimed to examine the relationship between spiritual competence, religiosity, and professional competence in delivering spiritual care among Iranian nursing students. Materials and Methods: This cross‑sectional study was conducted in Qom, Iran, from September to November 2022. A total of 150 nursing students from a medical sciences university were randomly selected to participate. Data were collected using demographic questionnaires, spiritual competence scale, and the Spiritual Care Competence Scale (SCCS). Descriptive statistics and multiple linear regression analyses were performed to assess the relationships between variables. Results: The mean (SD) SCCS score among students was 101.88 (17.33) (range: 44–135). Spiritual competence showed a significant positive correlation with all dimensions of the SCCS (p < 0.05). However, no significant association was found between religiosity and SCCS scores. According to the multiple linear regression model, interconnectedness (β = 0.36, p = 0.001) and self‑awareness (β = 0.19, p = 0.045) emerged as the strongest predictors of spiritual care competence. Conclusions: This study highlights the importance of spiritual competence in enhancing nursing students’ ability to provide spiritual care. The findings suggest that awareness of interconnectedness and self‑awareness are key predictors of spiritual care competence. These insights emphasize the need for comprehensive training programs focused on strengthening spiritual competence among nursing students to improve patient care.
Explaining Palliative Care Needs for Families with Cancer Children (A Qualitative Study)
Background: Childhood malignancies give parents and children substantial psychological anguish and life disruption. One of the best strategies to enhance cancer patients’ lives is palliative care. The present study aims to define the palliative care needs of families with children with cancer, identify strategies to address these needs, educate nursing staff to react as much as possible, and improve health care services. Materials and Methods: The current research was a qualitative investigation undertaken with the involvement of families of children diagnosed with cancer who were sent to educational hospitals in Ilam City in 2024. The data were collected via purposive sampling. Subsequently, data were gathered using semistructured interviews, and a guided content analysis was conducted for data analysis. The first stage of coding started by identifying the analysis unit, which encompasses words, phrases, topics, and sentences that possess distinct meanings. The primary ideas inside each analysis unit will be organized under the heading of the semantic unit. Results: This study included 10 individual interviews with diverse subjects. The interviews revealed four main categories and 12 subcategories of palliative care needs for families with children with cancer: psychological care (mental distress, homesickness, cancer taboo, and collapse of mental image), social care (lack of coherent support network, financial challenges, displacement, and out‑of‑hospital/telephone care), and physical care. Rethinking Spirituality was removed. Conclusions: Palliative care for children addresses medical, psychological, social, and spiritual issues to improve quality of life for the child and family. Correct and ethical treatment based on clinical recommendations is crucial.
Investigating the Effect of Chewing Gum on Head, Neck, and Facial Edema in Burn Patients: Doubled blinded Randomized Controlled Trial
Background: Burns are a sort of trauma that may cause life‑threatening consequences, including edema, which delays recovery. So, the aim of the present study was to investigate the effect of chewing gum on reducing edema of burns in the head, face, and neck areas after second‑degree burns. Materials and Methods: In 2024, a double‑blind, randomized clinical trial was conducted on 64 second‑degree burn patients, who were randomly allocated into two groups using permuted block randomization. The 32 participants in the intervention group received head elevation and chewed mint gum every 3 hours for 20 minutes until 3 days after hospitalization. However, the 32 participants in the control group only did head elevation. The Edema Size Detector was completed before and after the intervention. Statistical tests included paired t, independent t, Chi‑square, and difference‑in‑difference regression, which were analyzed in SPSS V.16 at a significance level of less than 0.05. Results: The mean (SD) of burn percentages was 31.86 (2.71). Before the intervention, there were not any significant differences between the two groups for frontal, maxillary, and superior– inferior diameters (p > 0.05). However, after the intervention, these differences were significantly meaningful (p < 0.001). Additionally, assessing the group effect and time effect and adjusting the model showed that in the intervention group, frontal (T = −15.33, p < 0.001), maxillary (T = −12.88, p < 0.001), and superior–inferior diameters (T = −19.20, p < 0.001) have statistically significant variation. Conclusions: Chewing gum for 20 minutes three times a day can reduce burn edema in the head, face, and neck after second‑degree burns.
A Qualitative Study of Iranian Women’s Experiences with Dimensions of Childbirth Violence in Health System
Background: Women who choose natural childbirth feel empowered and in control. Support from midwives can enhance the experience. Women’s childbirth experiences affect their care quality, physical/mental health, and future preferences. A study aimed to comprehend women’s experiences of childbirth violence within the health system. Materials and Methods: The research in Iran focused on creating a questionnaire about childbirth violence by interviewing 26 women who recently gave birth. Participants met specific criteria such as age, delivery experience, and Persian language proficiency. Data from the interviews was analyzed using qualitative content analysis between August and December 2019 in Ilam province, Iran, as part of a broader mixed‑method study. Results: Dimensions of childbirth Violence in the health system are classified into two main categories based on the mothers’ narratives: “The superiority approach of the health system towards the mother” and “deprivation of the mother from desirable health system”. These two main categories are described in eight subcategories (physical abuse, psychological abuse, ignoring the human dignity of the mother, refusal of optimal care, poor interaction with mother, lack of resources, lack of skilled care, and weak accountable regulatory policies which included 22 final codes. Conclusion: This study serves as a crucial step in recognizing and addressing the multifaceted issue of childbirth violence in Iran, aiming to enhance the quality of care and protect the rights of mothers during one of the most significant experiences of their lives.
Students’ Assessment of Digital Technologies in Nursing Education
Background: E‑learning, including platforms like Google Classroom and Moodle, has become integral to nursing education, offering flexibility and adapting to the changing educational system. Despite varied student responses, the COVID‑19 pandemic accelerated the shift to online nursing education at Karaganda Medical University, prompting an evaluation of platforms like Zoom, WebEx, Google Classroom, and Moodle for their quality and convenience. This study, based on the students’ perspective, contributes to ongoing efforts to optimize online platforms for nursing education at Karaganda Medical University. Materials and Methods: This cross‑sectional study was conducted by a group of lecturers in December 2023 at Karaganda Medical University, Kazakhstan. The study adopted a quantitative approach, employing a survey methodology administered to 154 second‑year students enrolled in the academic bachelor’s degree program in Nursing. Participants were chosen through convenience sampling, and they were tasked with rating educational platforms and programs based on predefined criteria, utilizing a 5‑point scale. Data analysis was carried out using descriptive statistics, calculating relative values for comparative analysis. Results: Comparative analysis was conducted on two prominent educational platforms—Google Classroom and Moodle— and two programs designed for online consultations and classes—WebEx and Zoom. All obtained data is presented in tables for clarity. Conclusions: An analysis of the preferences of second‑year undergraduate students regarding educational platforms and online programs identified the main criteria important for the learning process. This research can be used to further improve educational platforms and enhance the quality of education.
Effect of Skin to Skin Contact between the Biological Mother and Their Baby Who Born Via Surrogacy on Mother Infant Attachment
Background: The attachment between mother and infant, beginning from pregnancy and reaching a peak with skin‑to‑skin contact, has a considerable effect on infants’ growth and development. As stress and anxiety in contact with infants and unwillingness to embrace them have been reported in biological mothers in surrogacy, this study was conducted to assess the effect of skin‑to‑skin contact between the biological mother and their baby who born via surrogacy on mother‑infant attachment. Materials and Methods: In this clinical trial, 50 biological mothers were randomly assigned to either intervention (with skin contact) or the control group. The data collection tools included a personal information questionnaire and Avant’s mother‑infant attachment questionnaire. Results: The results indicated a significant difference between the intervention group, with skin‑to‑skin contact with the biological mother in surrogacy, and the control group (no skin‑to‑skin contact) in terms of the mean score of biological mothers’ attachment (p < 0.001). Conclusions: The results suggested that biological mother‑infant skin‑to‑skin contact immediately after birth is effective in creating and increasing attachment and affecting mothers’ quality of infant care. As this does not routinely occur in hospitals, taking necessary measures and educating nurses and authorities in maternity and neonatal wards is crucial to improving the quality of care and creating the desired attachment between mothers and infants.
Relationship between Perceived Stress, Coping Strategies, and Life Satisfaction among Women with Breast Cancer
Background: Breast cancer (BC) can be a distressing experience, necessitating substantial life adjustments. That being the case, this study aimed to explore the connection among perceived stress, coping strategies, and life satisfaction in women with BC, as well as the demographic and disease‑related factors. Materials and Methods: A cross‑sectional study was conducted at the Cancer Institute of Tehran University of Medical Sciences. A total of 372 women who met the inclusion criteria were selected through convenience sampling. The study utilized the Perceived Stress Scale (PSS‑14), Coping Inventory for Stressful Situations (CISS‑21), and Satisfaction With Life Scale (SWLS), as well as demographic and disease‑related characteristics. Data analysis was performed with SPSS 18.0. Results: The mean (standard deviation [SD]) of perceived stress and life satisfaction were 30.10 (8.7) and 13.86 (4.11), respectively, with emotion‑oriented coping strategy being the most employed 24.13 (6.36). The results indicated a strong negative correlation between perceived stress (r = −0.484, p < 0.001) and the problem‑oriented strategy (r = −0.203, p < 0.001). There was also a significant negative correlation between perceived stress and life satisfaction (r = −0.547, p < 0.001). However, a positive correlation was found between perceived stress and emotion‑oriented strategy (p < 0.001). The regression analysis indicated that economic status was correlated with perceived stress, emotion‑oriented strategy, and life satisfaction (β = −0.25, p < 0.001), (β = −0.18, p < 0.001), (β =0.30, p < 0.001). Additionally, occupation was found to predict problem‑oriented strategy (β = −0.30, p < 0.001) and avoidance‑oriented strategy (β = −0.18, p < 0.001). Conclusions: These findings help identify psychological issues in women with BC and lead to effective interventions for mitigating stress, improving coping strategies, and life satisfaction.
The Impact of a Blended Learning Approach Incorporating Microlearning and Spaced Learning on Clinical Competence in Nursing Students
Background: Nursing education focuses on clinical skill development. This study evaluated the effectiveness of combined microlearning and spaced learning to improve final‑semester nursing students’ clinical competence. Materials and Methods: A quasi‑experimental study (2022–2023) at Lorestan University of Medical Sciences involved 48 final‑semester nursing students (27 control, 21 intervention). The intervention group received a 3‑month structured microlearning and spaced learning program using videos, workshops, texts, and podcasts. Clinical competence was assessed via Ministry of Health standardized forms, and data were analyzed using SPSS software. Results: Demographic characteristics in the two study groups were similar (P > 0.05). The posttest mean (SD) clinical competence score in the intervention group was 18.34 (0.96), while in the control group, it was 16.64 (0.89). The difference was statistically significant (t46 = 6.34, P < 0.001). Conclusions: Microlearning and spaced learning significantly improved clinical competence, suggesting their effectiveness as innovative nursing education strategies.
The Relationship between Infectious Diseases and Stunting among Toddlers in Indonesia
Background: Chronic malnutrition can cause children to be underweight for their age, leading to stunting. This study aimed to examine the association between infectious diseases and stunting in toddlers. Materials and Methods: A cross‑sectional study was conducted across Indonesia in 2021, involving 90,897 toddlers. Data were obtained through maternal interviews and anthropometric measurements. Bivariate and multivariate analyses were used. Results: Results showed that toddler age, gender, place of residence, and parental education and occupation were significantly associated with stunting, p < 0.001 (OR = 1.1–3.6). Infectious diseases, including Acute Respiratory Infections (ARIs), diarrhea, pneumonia, and worm infections, were also significantly associated with stunting, p < 0.05 (OR = 1.1–1.5). Conclusions: Infectious diseases, including ARIs, diarrhea, pneumonia, and worm infections, are significantly associated with stunting. These findings highlight the importance of preventing and managing infections to reduce stunting in Indonesian toddlers.
Empowering Voices: The Transformative Role of Digital Storytelling in Chronic Illness Care
Dear Editor, In an era increasingly shaped by technological advancements, the fusion of narrative expression with digital media presents a groundbreaking avenue for reimagining chronic illness care.[1] Digital storytelling (DST) has emerged as a compelling methodology, empowering patients while fostering enhanced communication and mutual understanding within the healthcare ecosystem.[2,3].................