Iranian Journal of Nursing and Midwifery Research1735-90661212008042911MSc, Department of Midwifery, Khorasgan Islamic Azad University, Isfahan, IranPhD, Shahid Beheshti University of Medical Sciences, Tehran, IranPhD, School of Medicine, Tarbiat Modares University, Tehran, IranPhD, Department of Statistics, Tarbiat Modares University, Tehran, IranPhD, Faculty of Iranian Institute for Health Sciences Research, Tehran, Iran20101113BACKGROUND: Statistics indicate that the rate of cesarean section increased in recent years. As complications of hospitalizations and surgery would affect the life quality, the current study was carried out to evaluate the life quality of mothers after normal vaginal delivery (NVD) and cesareane. METHODS: This is an anterograde analytic study of cohort type. To fulfill the study, a specialized questionnaire was designed, and its validity and reliability was approved. The designed questionnaire accompanied with Edinburgh Postnatal Depression Scale (EPDS) and Short-Form-36 (SF-36) was filled by 50 women underwent NVD and 50 underwent cesarean, 6 to 8 and 12 to 14 weeks, postpartum. Finally, the data was analyzed using chi square, independent t, paired t, Wilcoxon and Mann-Whitney tests. RESULTS: Comparing the scores of the two groups 6-8 and 12-14 weeks postpartum indicated that both groups got higher marks in all fields in second step of the study. Anyhow, the improvement of NVD group was higher which was significant in some areas. Comparing the EPDS scores of the groups showed that the cesarean group was more prone to depressive disorders. The difference was significant 6-8 weeks postpartum. Also, the results of SF-36 questionnaire indicate that quality of life in NVD group was better in some aspects and similar with the cesarean group in other aspects. CONCLUSIONS: Findings demonstrated that women undergoing NVD experience better quality of life post partum, comparing those undergoing cesarean. So, to terminate the pregnancy, the NVD is better to be considered as the first choice. KEY WORDS: Quality of life, postpartum, normal vaginal delivery, cesareahttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/1http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/1/1

Iranian Journal of Nursing and Midwifery Research1735-90661212008042922MSc, Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, IranMSc, Department of Midwifery, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, IranMSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran20101113BACKGROUND: Labor pain is the most severe pain a woman experience in her life. The severity and duration of labor pain is more, in primiparous women and may lead to undesirable psychological effects, lowered self-confidence and anxiety. New supportive methods like massage therapy could change the labor into a pleasant and desirable experience. Regarding this, the current study was fulfilled to evaluate the effect of massage therapy on severity of labor pain. METHODS: It is a clinical trial on sixty women undergoing delivery in selected hospitals of Tehran. Target population was all the women admitted in Mahdieh and Hedayat hospitals, Tehran, for delivery. The cases were primiparous women with single fetus in the age range of 20 to 34 with cervical dilatation of four centimeters and less and gestational age of 38 to 42 weeks. They were divided into massage therapy and control groups, randomly. Severity of pain was measured in visual analogue scale (VAS) and the questionnaires were filled at the cervical dilatation of 4, 8 and 10 centimeters. Massage therapy was done using effleurage method as a type of Swedish massage technique. The data was analyzed using descriptive (frequency distribution, mean and standard deviation) and analytical (independent t-test and chi square) statistical methods by SPSS software. RESULTS: The results demonstrated that the mean of pain severity at the first stage of labor was significantly different between the experiment group and the control group, at the start of active phase (p= 0.009), end of transitional phase (p= 0.014) and end of the first stage (p=0.01). Also, the duration of the first stage of the labor was different in experiment and control group. CONCLUSIONS: Massage therapy could be introduced as a new useful method during delivery; regarding its supportive role. It is supposed that the results of the study would introduce massage therapy as a non-pharmacological intervention during delivery to reduce the labor pain and causes a decrease in the number of cesarean sections, done to avoid the fear and anxiety, induced by normal vaginal deliveries in young mothers. KEY WORDS: Massage therapy, labor pain relief, primiparahttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2/2

Iranian Journal of Nursing and Midwifery Research1735-90661212008042933MSc, Department of Nursing, School of Nursing and Midwifery, Ardebil University of Medical Sciences, Ardebil, IranMSc, Department of Nursing, School of Nursing and Midwifery, Ardebil University of Medical Sciences, Ardebil, IranMSc, Department of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran20101113BACKGROUND: Today, endoscopic evaluation of digestive system is an important diagnostic approach in gastrointestinal diseases. As it is an invasive method, it causes fear and anxiety in patients. The current study was fulfilled to evaluate the effect of music therapy during endoscopy on the anxiety of patients by measuring blood pressure. METHODS: This is an experimental study of single blind clinical trial type. The participants were patients in the endoscopy unit in the age range of 30 to 60, undergoing endoscopy or colonoscopy for the first time with negative history of cardiovascular diseases or hypertension. Cases were randomly placed in two groups: the experiment group who listened to music during the procedure and the control group who did not listen to music during the procedure. The patients’ blood pressures, arterial blood oxygen saturation during the procedure as well as their demographic information were recorded. Finally, the data was analyzed using t- test and analysis of variance by SPSS software. RESULTS: Our results demonstrated that patients of the experiment group had lower systolic and diastolic blood pressure and higher arterial blood oxygen saturation comparing to control group, but the difference was not statistically significant. Also it was showed that the blood pressure altered more in the patients underwent colonoscopy comparing those underwent endoscopy. The difference was statistically significant. (p= 0.034) Mean duration of endoscopy procedure in control group was higher than that of the experiment group. CONCLUSIONS: Light music has useful effects on cooperation and tolerance of patients during the procedure by regulating blood pressure and oxygen saturation of blood and reducing the duration of the procedure. KEY WORDS: Music, endoscopy, blood pressure, anxiety IJNMRhttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/3http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/3/3

Iranian Journal of Nursing and Midwifery Research1735-90661212008042944PhD, Assistant Professor, Department of Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.20101113BACKGROUND: Today, nurses are exposed to everchanging complicated conditions in health care services, they provide. To be able to cope with these conditions effectively, they should be competent decision makers. Besides, as decision making conditions get more complicated, using critical thinking is a need. The current study was carried out to evaluate the relationship between critical thinking and clinical decision making, in nurses of critical and general care units of hospitals in Isfahan. In addition, it is also aimed to compare the nurses of critical and general units in critical thinking and clinical decision making. METHODS: This is a correlation, descriptive study of cross-sectional type. The participants are 140 nurses; 70 working in critical care unit and 70, working in general units. Sampling method was random stratified sampling and the data was collected using a questionnaire with three sections; containing items on demographic data, clinical decision making and California critical thinking skills test. The validity and reliability of the questionnaire was approved using content validity, test-retest method and internal correlation test. The data was analyzed using variance analysis, Pearson correlation and t-test. RESULTS: The mean score of critical thinking and clinical decision making was 10.61, 63.27 and 10.67, 61.66 for nurses of critical care and general units, respectively. No statistical significant difference between two groups was observed in the area of clinical decision making and critical thinking. In addition, no statistical correlation was observed between the clinical decision making and critical thinking. CONCLUSIONS: The findings of the study demonstrated that the mean score of critical thinking was low in nurses. Probably, it originates from the educational system shortages and also, the professional environment problems. Some experts believe that the reason for lack of correlation between critical thinking and clinical decision making goes back to the absence of appropriate tool to measure the correlation. KEY WORDS: Critical thinking, clinical decision making, nursehttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/4http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/4/4

Iranian Journal of Nursing and Midwifery Research1735-90661212008042955MSc Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranPhD, Associated Professor in Isfahan Medical Education Development Center, Isfahan University of Medical Sciences, Isfahan, IranPhD of Physical Education, Faculty of Physical Education, Isfahan University, Isfahan, Iran20101113BACKGROUND: Mothers are potentially susceptible to some complications, postpartum which would affect their wellbeing. So, it is essential to deliver appropriate postpartum care, to improve physical, mental and social wellbeing. The current study was carried out to assess the effect of physical exercise on postpartum maternal physical, mental, social and general wellbeing. METHODS: This is a semi-experimental, anterograde study which was fulfilled on experiment and control groups. The data was gathered by interviewing and a self-made questionnaire. The data was analyzed using independent t-test by SPSS software. RESULTS: Findings demonstrated that the experiment group scored higher in all aspects of life quality. Significant statistical difference was noted in general (P= 0.000), social (P= 0.011) and mental wellbeing (P= 0.005); while, the difference between two groups in physical wellbeing was statistically significant. CONCLUSIONS: Various aspects of life quality would be affected by postpartum physical exercise. So, women should be encouraged to take exercise, postpartum to improve their quality of life. KEY WORDS: Exercise, postpartum, quality of lifehttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/5http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/5/5

Iranian Journal of Nursing and Midwifery Research1735-90661212008042966MSc, Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Fundamental Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran20101113BACKGROUND: Occupational stress is one of the most important occupational hazards in modern life which could lead to decrease in productivity, work absence, workforce transfer and high costs for the personnel. American National Association for Occupational Safety has placed nursing at the top of the list of the first forty high-stress jobs. There are various factors known as stressors in nursing. The current study was carried out to evaluate the severity of some of them. METHODS: This is a descriptive, correlative study. 170 nurses in various wards of Isfahan University of Medical Sciences hospitals who met the inclusion criteria took part in the study. The data was gathered using standardized Toft- Anderson questionnaire and then was analyzed using SPSS soft ware with Spearman correlation test, mean and frequency distribution. RESULTS: Findings demonstrate that most of the nurses (73.47%) experienced stress at the medium level. In addition, a positive statistical correlation was found between the overall and fractional stress scores. Conflicts with physicians have the greatest relationship with the overall severity of occupational stress in nurses. Among the demographic parameters, only marital status and work hours had significant statistical correlation with the severity of stress. (p< 0.001) CONCLUSIONS: Regarding the findings of the study, it is recommended to employ appropriate methods in preventing and handling occupational stresses at the personal and organizational level. KEY WORDS: Occupational stress, nurse, stressorhttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/6http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/6/6

Iranian Journal of Nursing and Midwifery Research1735-90661212008042977MSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, Kashan University of Medical Sciences, Kashan, IranMSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranPhD, Associated Professor, Depatmenet of Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran20101113BACKGROUND: Regarding the recent increase in elective cesarean and satisfaction of women and physician, the Iranian government has tried to solve this problem by epidural painless delivery (E.P.D). Because of opposite views of people and society about epidural, this Study was done to find the real experiences of people. Its aim was description of mother's experiences of epidural painless delivery. METHODS: This is a qualitative, phenomenological study. We selected 12 pregnant women that under wont epidural painless delivery in Shabihkhani Hospital. We used sampling method of based on object and continued until reaching fullness of information. We used depth interview for collection of information. Data analysis was done via collaizzi seven-stage method. RESULTS: findings of these interviews were classified in 195 codes and 9 themes and 3 main concepts, consisting of choice of painless delivery, nature of painless delivery, the role of human resources and managing system. CONCLUSIONS: Mothers' good experience of epidural painless delivery leads to choosing this kind for the next delivery, suggesting it to others and results in decreasing elective cesarean rate. KEY WORDS: Painless delivery, epidural, phenomenologyhttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/7http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/7/7

Iranian Journal of Nursing and Midwifery Research1735-90661212008042988MSc, Department of Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranBS of Education, Isfahan, Iran20101113BACKGROUND: Bringing up children is one of the most complicated responsibilities an adult experience in his/her life. However, most people are not completely prepared to be a parent. Current study was carried out to analyze the attitude of participants toward becoming parent. METHODS: This is a descriptive study in which questionnaire 1-1-PI which is consisted of 32 items was used. Sampling method was stratified random sampling. 400 questionnaires were distributed among participants and the data was analyzed using descriptive statistical methods. RESULTS: Findings demonstrated that 116 cases (31 percents) scored 0-64 and 63 cases (17 percents) scored 65- 95 and 192 cases (52 percents) scored 97- 160. These scores were respectively considered positive, neutral and negative overall attitude toward parenting. CONCLUSIONS: Some parents considerably lack fundamental parenthood skills. They are unaware of their children&rsquo;s needs, capabilities and potentials. A solution could be planning to improve (future) parents&rsquo; awareness of children&rsquo;s development. KEY WORDS: Parental attitude, children, parents&rsquo; behaviorhttp://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/8http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/8/8