Iranian Journal of Nursing and Midwifery Research1735-906630120250127110ENStudent Research Committee, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran2025012620250126<p><strong>Background: </strong>Maintaining and promoting sexual health in older women requires paying attention to and meeting their sexual health‑related needs. This study aimed to determine older women’s perceived sexual health needs through a systematic review. <strong></strong></p><p><strong>Materials and Methods: </strong>In this systematic review, studies conducted from the beginning of 2000 to August 28, 2022, were searched in Databases, Scopus, Web of Science, SID, Pub Med, and Google Scholar as a research engine. To access all English articles, keywords such as sexual health, sexual performance, sexual intercourse, sexual, need, demand, and women and their possible combinations were used using “AND” and “OR” operators. This research was implemented based on the criteria of the PRISMA checklist. The articles were evaluated using the STROBE and COREQ checklists. The thematic synthesis method was used to synthesize the data.</p><p><strong>Results: </strong>The sexual health needs of older women were categorized into four groups: restoration of violated sexual rights, elimination of age discrimination (ageism), promotion of sexual health literacy, and providing sexual health services.</p><p><strong>Conclusions: </strong>The sexual needs of older women have been neglected due to prevailing social structures of many countries, stigma, gender discrimination, and lack of sexual health literacy. In addition to the need for social and emotional support to adapt to the conditions of old age, these women need to achieve sexual rights, improve sexual health literacy, and receive health services.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2188http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2188/70707755

Iranian Journal of Nursing and Midwifery Research1735-9066301202501271117ENPhD, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Midwifery, Maybod Branch, Islamic Azad University, Maybod, IranMSc, Nursing and Midwifery Research Center, Department of Community Health Nursing and Elderly, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran2025012720250127<p><strong>Background</strong><strong>: </strong>Gestational Weight Gain (GWG) is an important indicator affecting pregnancy outcome, and thyroid hormones are also weight regulators. Researchers showed that thyroid hormones were correlated to prepregnancy Body Mass Index (BMI) and GWG. However, the normal ranges of thyroid parameters and GWG depend on the trimester of measurement. Therefore, we systematically reviewed the current knowledge on the association between thyroid function tests and prepregnancy BMI and GWG. <strong></strong></p><p><strong>Materials and Methods: </strong>This review was finally conducted on nine articles, while Google Scholar and databases such as Scopus, Medline, Cochrane Library, ISI Web of Science, Science Direct, and ProQuest were searched to find English articles from October 2022 to June 2023. <strong></strong></p><p><strong>Results: </strong>Thyroid‑Stimulating Hormone (TSH) was positively correlated with prepregnancy BMI, while Free Thyroxine (FT4) was inversely correlated. TSH was positively related to weight gain and BMI in the first trimester, while the relationship was negative for FT4. Free Triiodothyronine (FT3) had a positive relationship with BMI in the first trimester (<em>p </em>= 0.004). Furthermore, TSH level was not associated with GWG in the second and third trimesters, while FT4 was inversely correlated with GWG. FT3 also increased with BMI in the second trimester and not in the third trimester (<em>p </em>&lt; 0.001). Finally, there was a positive correlation between thyroid peroxidase autoantibodies values and prepregnancy BMI as well as maternal BMI, but the data were inconsistent. <strong></strong></p><p><strong>Conclusions: </strong>Determining the relationship between thyroid hormone levels and prepregnancy BMI and/or GWG may help researchers and clinicians manage weight gain and/or thyroid function in pregnancy.<em></em></p><p><em><br /></em><em></em></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2189http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2189/70707756

Iranian Journal of Nursing and Midwifery Research1735-9066301202501271824ENNursing Department, Mandala Waluya University, Lincoln University College MalaysiaFaculty of Nursing Department, Lincoln University College, Malaysia,Faculty of Applied Science, Lincoln University College, Malaysia20250127<p><strong>Background: </strong>In Indonesia, several hospitals have designed various forms of discharge planning in line with the guidelines provided by the Indonesian Endocrinology Association. These initiatives were implemented to enhance the quality of healthcare service. Despite the efforts made by the government, the rate of non‑compliance (9%) and readmission (20%) has continued to increase. This indicates that there is a need to reevaluate the existing discharge planning module. Therefore, this study aims to validate the contents of the diabetes mellitus discharge planning module, which was incorporated into the summary of diabetes self‑care activity. The effectiveness of the intervention in improving the compliance of patients with self‑care activity was also evaluated.</p><p><strong>Methods: </strong>This study used a mixed methodological approach, which combined an evaluation method and an experimental quantitative design. The content validity of the module used was carried out using professional judgment, involving competent experts in the bahteramas hospital in southeast Sulawesi, Indonesia. The sample population consisted of sixty‑five randomly selected respondents, who participated in the validation of the summary of Diabetes Self‑Care Activities (SDSCA) questionnaire, which had three phases, namely pre‑test, during, fieldwork, and post‑test.</p><p><strong>Results: </strong>The content validity of the module was tested using Aiken’s v, and the results ranged from 0.82 to 0.88 for each session, indicating that it was valid. Furthermore, the internal consistency (Cronbach’s alpha) obtained in this study was acceptable, with values ranging from 0.60 to 0.92.</p><p> <strong>Conclusions: </strong>The results showed that the diabetes mellitus discharge planning module could be used to improve self‑care among patients.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2190http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2190/70707776

Iranian Journal of Nursing and Midwifery Research1735-9066301202501272533ENMedical Surgical Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatera, IndonesiaMedical Surgical Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatera, IndonesiaMedical Surgical Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatera, IndonesiaMedical Surgical Department, Faculty of Nursing, Universitas Andalas, Padang, West Sumatera, Indonesia2025012720250127<p><strong>Background: </strong>Nurses working in Intensive Care Unit (ICU) for COVID‑19 are more at risk as they interact more with infected patients. Therefore, this study aimed to explore the experience of Indonesian nurses who work in ICU for COVID‑19 patients.</p><p><strong>Methods: </strong>A qualitative hermeneutic phenomenological approach was used. A total of 20 nurses working in the respective ICUs of eight COVID‑19 referral tertiary hospitals in Indonesia were recruited using purposive sampling. Semistructured individual video call interviews were conducted in June–September 2021; then, Diekelmann’s hermeneutic phenomenological approach was used to analyze and interpret the data.</p><p><strong>Results: </strong>Thirteen subthemes describing the following four themes, namely, the pleasing and bad feelings, new challenges of working, nursing professional growth, and nurse resource management for COVID‑19<strong>. </strong></p><p><strong>Conclusions: </strong>This study describes nurses’ experiences working in ICUs during the COVID‑19 crisis, such as their feelings, perceived challenges, and received support. Nurse leaders play a significant role in providing adequate Personal Protective Equipment (PPE), flexible work shifts, and a caring and healing work environment. However, being aware of the limit of pressure that an individual can manage and providing adequate allowance as rewards for work in risky areas are essential to avoid burnout.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2191http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2191/70707757

Iranian Journal of Nursing and Midwifery Research1735-9066301202501273440ENDepartment of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, JordanDepartment of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, JordanDepartment of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan2025012720250127<p><strong>Background: </strong>Pain experienced by intubated patients is caused by several extrinsic sources, including nursing care procedures such as endotracheal suctioning. Several nonpharmacological therapies, including listening to Quran recitation, have never been tested for their pain relief effects among intubated patients, despite these therapies being cost‑effective, easy to implement, and free of adverse effects. This study aimed to examine the pain‑relieving effect of listening to Quran recitation during pain‑inducing procedures in patients receiving mechanical ventilation support.</p><p><strong>Materials and Methods: </strong>This pilot study used an experimental design with 32 intubated patients at King Abdullah University Hospital in Irbid, Jordan. The Behavioral Pain Scale and Ramsay Sedation Scale were used to assess pain levels and sedation, and physiologic parameters were monitored before and during endotracheal suctioning. <strong></strong></p><p><strong>Results: </strong>The findings showed significant differences in Behavioral Pain Scale (BPS) scores and heart rate measures between the intervention and control groups after controlling for the level of sedation. The patients in the intervention group scored lower pain and HR measures than those in the control group (F5,26 = 11.47, <em>p </em>&lt; 0.001). <strong></strong></p><p><strong>Conclusions: </strong>The findings showed significant improvement in the levels of pain and heart rate measures among intubated patients who are exposed to Quran recitation. Complementary medicine is essential to the healthcare plans of critically ill patients and their families. Holy Quran recitation has been reported to be a useful nonpharmacological intervention for critically ill Muslim patients.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2192http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2192/70707758

Iranian Journal of Nursing and Midwifery Research1735-9066301202501274146ENGynecologist, Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, IranDepartment of Midwifery and Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IranMsc in Consultation in Midwifery, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IranDepartment of Midwifery and Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IranDepartment of Midwifery and Reproductive Health, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, IranDepartment of Pharmacognosy, School of Pharmacy, Medicinal Plants and Natural Product Research Center, Hamadan University of Medical Sciences, Hamadan, IranMedical Student, Medicine School, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Medical Student, Medicine School, Hamadan University of Medical Sciences, Hamadan, Iran,Nika Research and Traditional MedicineProduction Company, Department of Pharmacology, Hamadan, Iran2025012720250127<p><strong>Background: </strong>Uterine cervicitis in women requires careful selection of a suitable and straightforward treatment. This study aimed to examine the effect of Nika vaginal cream on the symptoms of uterine cervicitis in women. <strong></strong></p><p><strong>Materials and Methods: </strong>This double-blind, randomized, controlled clinical study was conducted on 66 women who where reffered to Hamadan health centers in 2021(33 people in each group). The participants in the intervention group were instructed to use Nika vaginal cream every night for 14 nights, along with a single dose of one gram of azithromycin, 400 mg of cefixime, and 500 mg of metronidazole twice a day for both the patient and her husband. The control group received a placebo cream and the same drugs as the intervention group. After the 14-day treatment period, clinical signs were assessed through examinations, and participants completed questionnaires again.</p><p><strong>Results: </strong>The study found that participants in the Nika user group experienced a 69.70% improvement in symptoms related to uterine cervicitis. This improvement was significantly higher than the control group, which only showed a 45.50% improvement. Although the Risk Ratio (RR) between the two groups was 53% higher in the intervention group, this difference was not statistically significant (<em>p</em>=0.06). However, the Risk Difference (RD) of 0.24 between the groups was found to be statistically significant (<em>p</em>=0.04). Additionally, participants in the intervention group reported a 76.00% reduction in dyspareunia (<em>p</em>=0.03) and an 84.00% reduction in urinary frequency (<em>p</em>=0.05). <strong></strong></p><p><strong>Conclusions: </strong>According to the result of RD, Nika vaginal cream had a significant effect on the improvement of cervicitis symptoms.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2193http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2193/70707759

Iranian Journal of Nursing and Midwifery Research1735-9066301202501274752ENDepartment of Basic Nursing Science, College of Nursing, Al-Yarmouk University, Irbid, Jordan,Department of Clinical Nursing, College of Nursing, Al-Yarmouk University, Irbid, JordanDepartment of Basic Nursing Science, College of Nursing, Al-Yarmouk University, Irbid, Jordan,2025012720250127<p><strong>Background: </strong>Numerous national and international nursing research studies have used the 13-item Chronic Illness Therapy Functional Assessment-Fatigue (FACIT-F) scale to measure the level of self-reported fatigue among the elderly population. Nonetheless, a culturally adapted Arabic version of the scale of the same quality was required to boost its use in Arabic-speaking nations. This study cross-culturally validated the Arabic version of the FACIT-F scale and tested its validity and reliability in an Arabic-speaking population.</p><p><strong>Materials and Methods: </strong>We conducted the study among an elderly Jordanian population using a methodological cross-sectional approach. Using a cluster random selection technique, we randomly selected 250 older adults from a larger pool. We evaluated the scale’s validity, internal consistency, and acceptability. We analyzed the construct validity using both confirmatory and exploratory factor analysis. <strong></strong></p><p><strong>Results: </strong>The Arabic version of FACIT-F was proven to be acceptable for the one-factor model in the elderly Jordanian population. Cronbach’s alpha coefficient for the Arabic FACIT-F was 0.95, which indicated good reliability. Evidence suggested that construct validity for the FACIT-F was generally quite acceptable. <strong></strong></p><p><strong>Conclusions: </strong>With regard to evaluating fatigue in an older Jordanian population, the Arabic translations of the FACIT-F have been shown to be reliable and valid.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2194http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2194/70707760

Iranian Journal of Nursing and Midwifery Research1735-9066301202501275360Department of Nursing, Faculty of Health Sciences, Universitas Brawijaya, IndonesiaDepartment of Nursing, Faculty of Health Sciences, Universitas Brawijaya, IndonesiaDepartment of Nursing, Faculty of Health Sciences, Universitas Brawijaya, Indonesia2025012920250129<p><strong>Background: </strong>Self‑care prevents rehospitalization and reduces mortality from heart failure. The self‑care of heart failure patients is influenced by their sense of self‑efficacy. Traditional educational methods are time‑consuming, require patients to meet with health experts, and frequently cannot be accessed remotely. A web‑based educational platform might be one of the innovations included in the development of health education for people with heart failure. The aim of this study is to determine the effect of web‑based education on self‑efficacy and self‑care ability in heart failure patients.</p><p> <strong>Materials and Methods: </strong>This study design is quasi‑experimental. The study sample consisted of 80 individuals with heart failure with New York Heart Association (NYHA) II‑IV classes and separated into two groups: the intervention group (n = 40) and the control group (n = 40). The sampling technique used in this study is consecutive sampling. Self‑care is measured using the Self‑Care Heart Failure Instrument version. A pre‑test was administered before the intervention, and post‑test and follow‑up were administered two weeks after the intervention. The control group received information leaflets and the intervention group received web‑based education.</p><p><strong>Results: </strong>The results showed that the main group effect was significant, indicating a significant increase self‑care (F1,80 = 2769, <em>p </em>&lt; 0.001) and self‑efficacy (F1,67 = 1600, <em>p </em>&lt; 0.001) in the intervention group after web‑based education and two weeks follow‑up.</p><p><strong>Conclusions: </strong>Web‑based education is more effective in increasing self‑efficacy and self‑care abilities among heart failure patients. Providing education via a web‑based platform in phases and continuously can promote healthy behaviors.</p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2195http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2195/70707761

Iranian Journal of Nursing and Midwifery Research1735-9066301202501276167ENMSc, Lorestan University of Medical Sciences, Isfahan, Iran, 2Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Lorestan University of Medical Sciences, Isfahan, Iran, 2Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Lorestan University of Medical Sciences, Isfahan, Iran, 2Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran2025012920250129<p><strong>Background: </strong>Currently, fertility and childbearing rates in Iran are below the replacement level (1.2 children), and Iranian families have a low propensity to have children. The COVID‑19 pandemic will also have a negative impact on the decision of couples to have children. The present study was conducted with the aim of investigating the effectiveness of an educational program on women’s childbearing intention under the conditions of the COVID‑19 pandemic. <strong></strong></p><p><strong>Materials and Methods: </strong>This study was a clinical trial with a pretest–posttest design, conducted on 80 women (control group = 40 and intervention group = 40) in comprehensive health centers in 2019. The educational program was delivered to the intervention group in 3 sessions. The data collection tools included the Attitudes to Fertility and Childbearing Scale (AFCS), Demographic Information Questionnaire, and researcher‑made fertility intention questionnaire. Data were analyzed using <em>t</em>‑test, Mann–Whitney, Chi‑square test, ANOVA, Bonferroni <em>post hoc </em>test, and Wilcoxon test.</p><p><strong>Results: </strong>The women in the intervention group were in the age range of 18 to 44 years and in the control group were in the age range of 19 to 44 years. The results showed that the mean scores of attitude toward fertility and intention to have children after training were significantly different between the two groups. However, after the training, it was significantly higher in the intervention group than in the control group (F1,67 = 1037, <em>p </em>&lt; 0.001).</p><p><strong>Conclusions: </strong>It seems that the implementation of the use of theoretical models can be effective in the informed decision of families, especially women, for childbearing.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2196http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2196/70707762

Iranian Journal of Nursing and Midwifery Research1735-9066301202501276873ENNursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranCritical Care Nursing Department, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMedical Education Department, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, IranNursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran2025012920250129<p><strong>Background: </strong>The workplace and the context in which oncology nurses work are unique due to the complex and dynamic nature of cancer care. Nurses who care for cancer patients are exposed to varying degrees of psychological pressure. The present study was conducted to explore oncology nurses’ perceptions regarding mental health in the workplace.</p><p><strong>Materials and Methods: </strong>This study was conducted in 2018–2019. The participants were recruited through purposive sampling from eight educational specialty cancer treatment centers in Iran. Data were collected through individual semistructured interviews and analyzed using the conventional qualitative content analysis method. The Consolidated criteria for Reporting Qualitative research (COREQ) checklist was used to document the report of the study.</p><p><strong>Results: </strong>The extracted concepts were classified into three main categories and 17 subcategories. The main categories included attention to nurses’ occupational stress‑provoking factors, attention to emotional/psychological responses in the workplace, and healthy mental atmosphere in the workplace. <strong></strong></p><p><strong>Conclusions: </strong>The findings indicate that oncology nurses need to be supported to enhance their mental health in the workplace. The findings of this study could help policymakers and nurse managers to understand the importance of improving the mental health of nurses in cancer care. In this regard, it is essential to make the necessary plans and scientific decisions to design and provide strategies to alleviate workplace problems and improve nurses’ mental health.</p><p><strong>Keywords: </strong><em>Neoplasms, occupational health, oncology nursing, qualitative research</em></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2197http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2197/70707763

Iranian Journal of Nursing and Midwifery Research1735-9066301202501277480ENMaternal Child Care and Midwifery, Faculty of Nursing, Mahasarakham University, Kantharawichai, Maha SarakhamMaternal Child Care and Midwifery, Faculty of Nursing, Mahasarakham University, Kantharawichai, Maha SarakhamAntenatal Clinic, Roi Et Hospital, Mueang Roi Et, Roi Et, Thailand2025012920250129<p><strong>Background: </strong>The decision and experience of high‑risk pregnant women to undergo amniocentesis can depend on their setting, context, social structures, and significant others, including cultural values and beliefs. What is less understood is women’s experience with decision‑making, which may contribute to their anxiety during and after amniocentesis. This study aimed to explore the decision‑making experiences of Thai pregnant women undergoing amniocentesis.</p><p><strong>Materials and Methods: </strong>A qualitative content analysis approach was employed to collect and analyze data. Purposive sampling and in‑depth interviews were conducted between July and October 2021 with 15 Thai high‑risk pregnant women after undergoing amniocentesis. Data analysis involved multiple readings of transcriptions to discern themes and understanding of the women’s stories. <strong></strong></p><p><strong>Results: </strong>Four themes of decision‑making experiences were identified: (1) “Shocked, worried, and questioned why the risk was high”; (2) “Does my baby have Down syndrome? I want to know”; (3) “Worried”; and (4) “Relief from anxiety.” <strong></strong></p><p><strong>Conclusions: </strong>Women’s experiences with amniocentesis involved uncertain positive and negative feelings through the journey of undergoing, waiting, and receiving the test results. The nurses and nurse‑midwives played an important role in counseling Thai pregnant women about whether to undergo amniocentesis.</p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2198http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2198/70707764

Iranian Journal of Nursing and Midwifery Research1735-9066301202501278186ENNursing Research Center, Kerman University of Medical Sciences, Kerman, IranNursing Research Center, Kerman University of Medical Sciences, Kerman, IranGeriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, IranNeuroscience Research Center, Institute of Neuropharmacology Kerman University of Medical Science, Kerman, IranDepartment of Oncology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran2025012920250129<p><strong>Background: </strong>Despite progress made in antiemetic control, most cancer patients still experience chemotherapy‑induced nausea and vomiting. In oncology departments, nurses can evaluate the effects of complementary therapies such as use of essential oil on reducing nausea and vomiting of patients undergoing chemotherapy. Therefore, this study was conducted to explore the effect of cinnamon essential oil on the chemotherapy‑induced nausea and vomiting of cancer patients. <strong>Materials and Methods: </strong>This is a two‑group experimental study with a pretest‑posttest design that was conducted between January 20 and March 15 of the year 2020. Through convenience sampling, 70 patients experiencing chemotherapy‑induced nausea and vomiting were recruited to participate in this study. The participants were randomly allocated to two control and intervention groups. A pad moistened with 2 ml of isotonic saline and 0.2 ml of cinnamon essential oil was first placed inside a plastic bag, and then patients in the intervention group were asked to take three deep breaths while their face was towards the bag for two times at five‑minute intervals. Patients in the control group used a placebo (a pad moistened with 2 ml of isotonic saline) instead of cinnamon essential oil during the intervention period. Participants in the two groups received routine antiemetic treatment. Using Visual Analog Scale (VAS), the severity of nausea and vomiting was measured in both groups before the intervention. For this reason, the severity of nausea and vomiting was measured after the first three breaths, and then after the second three breaths. Data were analyzed by SPSS software, using independent <em>t</em>‑test, Chi‑squared test, and Fisher’s exact test. Repeated measures ANOVA were also used to evaluate nausea and vomiting between the two groups across times. The significant level of 0.05 was considered for all tests. <strong>Results: </strong>There were no significant differences between the two groups in terms of demographic characteristics and the severity of chemotherapy‑induced nausea and vomiting before the intervention. The severity of chemotherapy‑induced nausea and vomiting was significantly lower in the cinnamon group than the control group after the first 3.08 (0.55), (F2 = 13.27, <em>p </em>&lt; 0.001) and second breaths 1.91 (0.33) (F2 = 11.39, <em>p </em>&lt; 0.001). <strong>Conclusions: </strong>Nurses can educate patients and their families to use of cinnamon essential oil. Nursing managers can also emphasize on the use of cinnamon essential oil, which is one of the non‑pharmacological, low‑cost, and effective methods of reducing chemotherapy‑induced nausea and vomiting, by holding in‑service training classes.</p><p><strong>Keywords: </strong><em>Cancer, chemotherapy, cinnamon oil, nausea, vomiting</em></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2199http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2199/70707765

Iranian Journal of Nursing and Midwifery Research1735-9066301202501278791ENCommunity Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, IranCommunity Nursing Research Center, Zahedan University of Medical Sciences, Zahedan, Iran2025012920250129<p><strong>Background: </strong>Middle age serves as a crucial transitional phase between youth and old age in women’s health, making it a critical period for women. Accordingly, this study aimed to explore the experiences of life changes among middle-aged women.</p><p><strong>Materials and Methods: </strong>This study was conducted using qualitative content analysis from September to December 2022 in Zahedan. The participants included 10 middle-aged women selected via purposive sampling. Data were collected through individual face-to-face interviews, and all interviews were subsequently transcribed and analyzed. Categories representing the beginning, middle, and end of the narratives were extracted. First, thematic similarities were identified, leading to the emergence of subcategories. Then, the related subcategories were reviewed and placed into the same category. <strong></strong></p><p><strong>Results: </strong>At the beginning of the narratives, the identified subcategories included perception of middle age, gaining experience, and behavior change. In the middle of the narratives, understanding the developmental stages and gaining experience in managing life were extracted as the subcategories. At the end of the narratives, maturity was identified as the main category. <strong></strong></p><p><strong>Conclusions: </strong>The findings from this study revealed that development occurs through the accumulation of experience. Although this study did not explore development in contextual terms, addressing and identifying the challenges of middle age in their context may facilitate quicker development. Furthermore, recognizing and investigating physical problems associated with middle age could lead to more timely treatment.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2200http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2200/70707766

Iranian Journal of Nursing and Midwifery Research1735-9066301202501279296ENNursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran2025012920250129<p><strong>Background: </strong>Teaching clinical reasoning to nursing students is essential for professionalizing and improving cancer patient care. This study investigates how training duration with Virtual Patients (VPs) impacts clinical reasoning and learners’ evaluation of their experiences. <strong></strong></p><p><strong>Materials and Methods: </strong>The present semi‑experimental study was conducted with a pretest–post‑test design and a control group. Through the census sampling method, 74 nursing students from Isfahan University of Medical Sciences, Iran, (in their 4th and 5th semester) who had taken the cancer course were selected (2019‑2022) and, upon obtaining their consent, were enrolled in the study. The study began with a pretest, followed by engagement in five VP scenarios over 6 weeks, which was followed by the post‑test phase. Data were collected via 23‑item tests and the Huwendiek Questionnaire. The collected data were analyzed in SPSS software using correlation tests and <em>t</em>‑tests. <strong></strong></p><p><strong>Results: </strong>The outcomes revealed a noteworthy disparity between the mean scores recorded in the pre‑test and post‑test stages after training, for both the 4th and 5th semester cohorts (<em>p </em>≤ 0.001). Moreover, a notable discrepancy surfaced between the duration of training with VPs and the average post‑test score (<em>p </em>≤ 0.001). The correlation coefficient, for the 4th semester, stood at 0.65, while for the 5th semester, it was 0.213. Notably, the participants exhibited contentment with the learning experience through VPs. <strong></strong></p><p><strong>Conclusions: </strong>The survey found that 85.60% of participants prefer using VPs for clinical reasoning education. Our study underscores the link between the duration of VP interaction and improved clinical reasoning skills in nursing students.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2201http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2201/70707767

Iranian Journal of Nursing and Midwifery Research1735-90663012025012797102ENDepartment of Nursing, Shiraz University of Medical Sciences, Shiraz, IranPh.D in Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, GhanaGrand Canyon University, Phoenix, Arizona, USA,Imam Ali Hospital, Mazandaran University of Medical Sciences, Sari, Iran,Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran,Student Research Committee, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran2025012920250129<p><strong>Background: </strong>Despite the prevalence of unintended pregnancies, little is known about the connections between psychosocial and sociodemographic characteristics. This study explored the predictors of fetal attachment, worry, anxiety, and stress in unintended pregnancies.</p><p><strong>Materials and Methods: </strong>This descriptive, cross‑sectional study was conducted on 229 father and mother pairs from two primary healthcare centers in Fars province in southern Iran. Data were collected in a face‑to‑face survey using the Parents Fetal Attachment Scale, Spielberger State‑Trait Anxiety Inventory (STAI), Cambridge Worry Scale (CWS), Perceived Stress Scale (PSS), and Parental Worry Scale. The participants were selected using the two‑stage random cluster sampling method from November 2022 to February 2023. Data were analyzed in SPSS software using binary logistic and multiple linear regression tests. <strong></strong></p><p><strong>Results: </strong>According to the findings, education level and previous parenting experience were found to have a statistically significant effect on the attachment levels of mothers (F4,224 = 5.14; <em>p </em>&lt; 0.05). However, there was no statistically significant difference between the perceived stress of mothers and fathers (<em>p </em>&gt; 0.05). Previous parenting experience significantly affected mothers’ anxiety (odd ratio: 3.20; <em>p </em>&lt; 0.05). The age variable had a significant relationship with the mothers’ perceived stress (<em>p </em>&lt; 0.05). <strong></strong></p><p><strong>Conclusions: </strong>According to the results, unwanted pregnancy had a significant relationship with fetal attachment, anxiety, stress, and worry. It is recommended that to enhance the mental health of couples who have experienced unintended pregnancy, a platform should be provided for the development of their psychosocial environment.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2202http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2202/70707768

Iranian Journal of Nursing and Midwifery Research1735-906630120250127103109ENDepartment of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,Patient Safety Research Center, Clinical Research Institute, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran2025012920250129<p><strong>Background: </strong>Nurses are exposed to higher stress, anxiety, and depression due to the nature of their work. Considering the differences between specialized and general hospital units, this article focuses on comparing the levels of stress, anxiety, and depression among nurses in these two types of units.</p><p><strong>Materials and Methods: </strong>This descriptive‑analytical study was conducted in 2023 on 135 nurses in specialized units and 219 nurses in general units selected through stratified random sampling out of 1681 nurses. For this study, 6 public hospitals in the West Azerbaijan province of Iran were selected. Data were collected through a demographic questionnaire and the Depression, Anxiety, Stress Scales‑21 (DASS‑21) and analyzed using SPSS software. A significance level of 0.05 was considered for this study. <strong></strong></p><p><strong>Results: </strong>This study reported that stress, anxiety, and depression affected 72.04%, 46.33%, and 53.68% of nurses, respectively, with mild to extremely-severe intensity levels. No significant differences were observed in stress, anxiety, and depression between specialized and general units (<em>p </em>&gt; 0.05). Among specialized units (ICU, CCU, and dialysis ward), dialysis unit nurses had significantly lower depression scores (<em>p </em>&lt; 0.05). Additionally, a significant correlation existed between demographic variables and DASS‑21 constructs (<em>p </em>&gt; 0.05).</p><p><strong>Conclusions: </strong>The similarities among nurses in specialized and general units outweigh the observed differences. Given the high prevalence of stress, anxiety, and depression among nurses and the negative correlation with job satisfaction, managers should improve job satisfaction to support nurses’ mental health.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2203http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2203/70707769

Iranian Journal of Nursing and Midwifery Research1735-906630120250127110115ENDepartment of Health Information Technology, Neyshabur University of Medical Sciences, Neyshabur, IranDepartment of Operation Room, Neyshabur University of Medical Sciences, Neyshabur, Iran,1. Department of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran, 2. Department of Midwifery, Neyshabur University of Medical Sciences, Neyshabur, Iran2025012920250129<p><strong>Background: </strong>The assessment of learners is a fundamental element in medical science curricula. The Direct Observation of Procedural Skills (DOPS) exam is a valuable way to assess clinical skills. The present study aimed to assess the clinical skills of operating room students of Neyshabur University of Medical Sciences, Iran, using the DOPS exam, and determine the effect of the exam on the learning and satisfaction of the learners. <strong></strong></p><p><strong>Materials and Methods: </strong>The current study was a semi‑experimental study that used a single‑group posttest study design. The statistical sample included 30 operating room students. The 5 skills were selected for assessment and the assessment checklist was designed by the researcher and approved by the expert panel. Moreover, 3 researcher‑made questionnaires were used to examine the students’ skills and opinions regarding facilitating learning and their satisfaction with the DOPS examination. Mann‑Whitney, Kruskal‑Wallis, and Wilcoxon tests were used to analyze the data.</p><p><strong>Results: </strong>The results showed that there was a significant difference between the scores of the students in the first and second examinations (z = ‑4.243, <em>p </em>&lt; 0.001), and the students› scores increased significantly on the second examination. The learners were satisfied with the way the DOPS exam was conducted, and their satisfaction score of this exam was 90.7 out of 120. Furthermore, students agreed that this exam affected learning facilitation. Their score on the effectiveness of this exam was 93.9/120.</p><p><strong>Conclusions: </strong>Although the DOPS examination is one of the clinical assessment methods for learners, it can be used as an instructional tool in the learning process.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2204http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2204/70707770

Iranian Journal of Nursing and Midwifery Research1735-906630120250127116122ENStudent Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranNursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranNursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran2025012920250129<p><strong>Background: </strong>Emotion regulation strategies help family caregivers of chronic psychiatric patients to manage caring behaviors. However, evidence pointed out problems and therefore a need to execute respective programs to improve emotion regulation for caregivers. This study aimed to investigate the effectiveness of mental health literacy promotion programs on emotion regulation strategies of family caregivers of chronic psychiatric patients.</p><p><strong>Materials and Methods: </strong>This is a clinical trial study, with two‑group pretest–post‑test design with a follow‑up period conducted in 2023. Sixty family caregivers of chronic psychiatric patients were randomly allocated to intervention control groups. Data collection was done using a demographic characteristics questionnaire and Gross and John’s Emotion Regulation Scale. The mental health literacy promotion program was implemented for the intervention group in six sessions weekly. Immediately and 1 month after the last meeting, the questionnaires were completed. The data were analyzed using Chi‑squared and Fisher’s exact tests, Mann–Whitney test, and analysis of covariance by SPSS‑22. The significance level was set to 0.05. <strong></strong></p><p><strong>Results: </strong>The results showed that the frequency distribution of demographic variables in the control and test groups had no statistically significant difference (<em>p </em>&gt; 0.05). The intervention had significant effects on the mean score of emotion regulation strategies, and its subscales included re‑evaluation and suppression of family caregivers of chronic psychiatric patients in both the post‑test and follow‑up periods (<em>p </em>&lt; 0.001). <strong></strong></p><p><strong>Conclusions: </strong>According to improving the emotion regulation of family caregivers of chronic psychiatric patients through the mental health literacy promotion program, it is suggested to use this program to achieve the desired emotion regulation.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2205http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2205/70707771

Iranian Journal of Nursing and Midwifery Research1735-906630120250127123129ENDepartment of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, IranNursing Care Research Center, Clinical Sciences Institute, Baqiyatallah University of Medical Sciences, Tehran, IranDepartment of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran,Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran2025012920250129<p><strong>Background: </strong>Effective pain assessment in neonatal care is crucial for ensuring the well‑being of newborns. However, barriers to its successful implementation persist. This study aims to identify the obstacles that hinder effective neonatal pain assessment by neonatal intensive care units (NICUs) nurses. <strong>Materials and Methods: </strong>This qualitative study was conducted using the method of conventional content analysis. Purposive sampling was employed from February to September 2023, selecting 14 female nurses working in NICUs of hospitals in Tehran and Karaj as participants. Indepth, semistructured interviews were conducted to collect the data. The software “MAXQDA” version 2016 was utilized for managing qualitative data. <strong>Results: </strong>Four main themes and eleven subthemes were identified: “Overtasked,” “Discordant atmosphere,” “Soulless care,” and “Lack of awareness.” Each of these main themes is further elaborated through the subsequent subthemes. <strong>Conclusions: </strong>This study found that the lack of knowledge and understanding of neonatal pain assessment tools, the busyness of nurses, lack of time, excessive documentation, and the inadequacy of staff relative to the number of newborns were the most significant obstacles to the assessment of newborn pain. Addressing these challenges is critical for optimal neonatal pain assessment and management, promoting the well‑being of newborns.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2206http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2206/70707772

Iranian Journal of Nursing and Midwifery Research1735-906630120250127130134ENInstituto Dante Pazzanese de Cardiologia, São Paulo, BrazilSchool of Nursing, University of Campinas (Unicamp), Campinas, BrazilSchool of Nursing, University of Campinas (Unicamp), Campinas, BrazilEpidemiology Surveillance Center, University of Campinas (Unicamp), Campinas, Brazil,College of Nursing, University of Rhode Island Rhode Island, United States2025012920250129<p><strong>Background: </strong>Clinical deterioration occurs due to changes in vital signs, which can be identified early to prevent negative outcomes. We used the NEWS2 system to assess the potential for early clinical deterioration in adult inpatient units at a public university hospital in southeastern Brazil. <strong></strong></p><p><strong>Materials and Methods: </strong>This was an exploratory study conducted at a public hospital in southeastern Brazil, following the guidelines of the Reporting of Strengthening Observational Studies in Epidemiology (STROBE) initiative. Data was collected from January to April 2021, involving 251 inpatients. A questionnaire was used to gather sociodemographic and clinical data, and the Brazilian version of NEWS2 was used to assess the risk of clinical deterioration. Data analysis included descriptive analyses, linear correlation tests, and comparative tests.</p><p><strong>Results: </strong>The average NEWS2 score was 2.9 points among 251 patients, indicating a moderate level of care complexity and recommending assessment by a registered nurse every 4–6 hours. There was no significant correlation between age and NEWS2 score, but the NEWS2 score was significantly higher for men. <strong></strong></p><p><strong>Conclusions: </strong>This study highlights the necessity of using robust assessment tools to evaluate the risk of early clinical deterioration, enabling clinicians to manage patient conditions effectively.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2207http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2207/70707773

Iranian Journal of Nursing and Midwifery Research1735-906630120250127135139ENDepartment of Health Studies, College of Human Sciences, School of Social Sciences, University of South Africa (UNISA), Pretoria, South AfricaDepartment of Health Studies, College of Human Sciences, School of Social Sciences, University of South Africa (UNISA), Pretoria, South Africa2Centre of Microbiology Research, Kenya Medical Research Institute (KEMRI), NairobiSchool of Nursing and Midwifery, Aga Khan University, Nairobi,Department of Clinical Nursing and Health Informatics, Masinde Muliro University of Science and Technology, Kakamega,School of Economics, University of Nairobi, Nairobi,School of Nursing, Kaimosi Friends University, Kaimosi,School of Nursing, Kibabii University, Bungoma, Kenya2025012920250129<p><strong>Background: </strong>Global health agencies advocate that no mother should die while giving life, more so from preventable causes. However, there are persistently high maternal mortalities in various regions with a current global maternal mortality ratio of 211/100,000 live births. This study sought to investigate the causes and determinants of maternal mortality.</p><p><strong>Materials and Methods: </strong>A four‑year retrospective, cross‑sectional study was conducted in three tertiary hospitals within Migori county in Kenya. Data were extracted from 101 maternal mortality records from January 1, 2016 to December 31, 2019. <strong></strong></p><p><strong>Results: </strong>Leading complications were hemorrhage 34.70%, eclampsia 20.80%, and sepsis 15.80%. Mothers who were unmonitored using partograph, had reactive HIV status, were in the postpartum period, were referred from periphery facilities, and low socioeconomic levels were most vulnerable.</p><p><strong>Conclusions: </strong>Improvement in healthcare systems to enable optimal care to mothers diagnosed with leading complications and socioeconomically empowering women in Migori county is urgently needed.</p><p><strong><br /></strong></p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2208http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2208/70707774

Iranian Journal of Nursing and Midwifery Research1735-90663012025012722092209ENDepartment of Community Health Nursing, Teerthanker Mahaveer University, College of Nursing, Moradabad, Uttar Pradesh, India2025012920250129<p>The Lamaze Technique in antenatal care empowers parents through informed decision‑making and active involvement. It effectively reduces childbirth‑related anxiety with comprehensive fear management tools and emphasizes the importance of partner involvement in fostering teamwork.[1] The technique prioritizes non‑medical pain management methods and holistic coping mechanisms, enhancing the overall childbirth experience. Trust in natural birth enhances the experience, offering additional benefits including smoother postpartum recovery and comprehensive childbirth education. The adaptability of Lamaze technique makes it suitable for various settings, ensuring accurate information for informed decisions and promoting empowerment, anxiety reduction, and fostering a positive childbirth experience. Lamaze uptake hurdles include: Awareness, cultural factors, medical needs, and rural accessibility.[2]…………………….</p>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/2209http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/2209/70707775