Iranian Journal of Nursing and Midwifery Research1735-906617220121111780780EN20121111Click to download the index of this Issue.http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/780http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/780/555

Iranian Journal of Nursing and Midwifery Research1735-906617220120307457457ENMSc, Department of Adult Health Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Critical Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.2011062320111006<ul><li><strong>Background: </strong>Migraine is defined as a chronic disabling condition which influences all physical, mental, and social dimensions of quality of life. Some 12-15% of the world population suffers from migraine. The disease is more common among women. The onset, frequency, duration, and severity of migraine attacks may be affected by other predisposing factors including nutrition. Therefore, determining these factors can greatly assist in identification and development of its prevention. Considering the importance of nutrition in maintaining and promoting health and preventing diseases, the present study was conducted to determine the relationship between headaches and nutritional habits (frequency and type of consumed foods) of women suffering from migraine.</li><li><strong>Materials and Methods</strong>: This analytical case-control study was conducted on 170 women (in two groups of 85) selected by convenient sampling for the case group and random sampling for the control group. Data collection tool was a 3-section questionnaire including personal information, headache features, and nutritional habits. The questionnaire was completed in an interview performed by the researcher. The data was then analyzed in SPSS using descriptive statistical tests (frequency distribution, mean, and standard deviation) and inferential tests (chi-square, independent t, Mann-Whitney, and Spearman's correlation tests).</li><li><strong>Findings</strong>: The results demonstrated a significant relationship between headache and some food items including proteins, carbohydrates, fat, fruits and vegetables. To be more precise, there were significant relationships between headaches and the frequency of consumption of red meat (p = 0.01), white meat (p = 0.002), cereals (p = 0.0005), vegetables (p = 0.009), fruits (p = 0.0005), salad dressing (p = 0.03), and eggs (p = 0.001). Moreover, a significant relationship existed between headache and type of consumed oil, meat, dairy products, fruits, and vegetables (p &lt; 0.05).</li><li><strong>Conclusions: </strong>It is necessary to put more emphasis on the significance of correcting dietary patterns in order to prevent headache attacks and reduce the complications arising from drug consumption in migraine patients. Social and economical efficiency of the patients will thus be enhanced.</li><li>&nbsp;<strong>Keywords: </strong>Migraine, dietary habits, headache, women</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/457http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/457/475

Iranian Journal of Nursing and Midwifery Research1735-906617220120307514514ENMSc Student, Student Research Committee, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan university of Medical Sciences, Isfahan, Iran.201107312011100120120228<ul><li><strong>Background: </strong>Sexual instinct which is the cause of numerous changes in an individual&rsquo;s life could be influenced by different factors such as menopause and ageing. This study was designed to compare sexual dysfunction before and after menopause.</li><li><strong>Materials and Methods</strong>: This was a cross-sectional study. Participants were 174 menopausal women who referred to medical health centers of Isfahan, Iran. Data were collected through self constructed sexual dysfunctions questionnaire in relation to their sexual activities before and after menopause. The reliability and validity of this questionnaire was determined by content validity and Cronbach&rsquo;s alpha coefficient.</li><li><strong>Findings</strong>: Findings showed that the relative frequency of sexual dysfunctions was 38% in the productive period and 72.4% in the menopause period. There was a significant association between sexual dysfunctions before and after the menopause period (p &lt; 0.001). Sexual dysfunctions in these women in the productive and menopause period were 49.2% and 62.6% in desire disorder, 34.3% and 34.9% in dyspareunia, 26.8% and 75.3% in arousal disorder, 23.5% and 56.3% in orgasmic disorder and 16.4% and 15.6% in vaginismus, respectively.</li><li><strong>Conclusions: </strong>A considerable percentage of women experienced sexual dysfunctions in productive and menopause periods, and menopause could be a factor to maintain or intensify sexual dysfunctions.</li><li>&nbsp;<strong>Key words: </strong>Menopause, reproductive, sexual dysfunction</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/514http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/514/458

Iranian Journal of Nursing and Midwifery Research1735-906617220120307563563ENMSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Trauma Research Center, Kashan University of Medical Sciences, Kashan, IranMSc, Department of Midwifery, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.MSc, Department of Midwifery, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.2011091420120229<ul><li><strong>Background: </strong>Third stage of labor has been defined as the most dangerous stage. Due to the importance of the third stage, this study was performed in order to determine its length and related factors.</li><li><strong>Materials and Methods</strong>: This research is a cross sectional study which was carried out on 1000 deliveries in Shabihkhani Hospital (Kashan-Iran). Inclusion criteria consist of gestational age of higher than 20 weeks, singleton pregnancy, and vaginal delivery without any instrument.</li><li><strong>Findings</strong>: The mean, median and standard deviation of the third stage of labor were 6.03, 5 and 5.15 minutes respectively. The finding also showed that there was a significant association between Para, Induction of labor, use of analgesic drugs during labor (pethidin), and umbilical drainage for third stage management (p &lt; 0.05). There was no significant association between a history of Abortion, Gestational age and Third stage management (Oxytosine).</li><li><strong>Conclusions: </strong>The use of Induction, analgesic drugs during labor and umbilical drainage prolonged the third stage of labor, but multiparity decreased the duration of this stage. The diagnosis of these factors is recommended in order to predict and prevent the occurrence of the third stage dangers. </li><li><strong>Key words: </strong>Labor stage, third stage, placenta delivery,&nbsp;normal vaginal delivery, postpartum hemorrhage</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/563http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/563/461

Iranian Journal of Nursing and Midwifery Research1735-906617220120307571571ENMSc, Department of Adult Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Adult Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.2011092720120229<ul><li><strong>Background: </strong>Tube feeding is used for patients, who are not able to eat orally but their digestive system can digest food. This method is safe and economical for patients, maintains the functions of the digestive system and reduces the risk of infection and sepsis. However, incorrect administration of this method of feeding results in problems such as aspiration pneumonia, infection, diarrhea, NG tube obstruction, and etcetera. If tube feeding is performed according to its standard procedure, it can have a major role in reducing complications, providing adaptability and the desired lifestyle, reducing the duration of hospitalization, and reducing the relevant costs.</li><li><strong>Materials and Methods</strong>: This research is a descriptive-analytic cross-sectional study on 37 nurses who worked in the general surgery and neurology wards and fed patients suffering from gastrostomy. A valid and reliable checklist was used for data collection. To analyze the data, the descriptive statistical method (frequency and mean) and inferential method (paired t-test, Spearman Correlation Coefficient and variance Analysis with repetition of observations) were used.</li><li><strong>Findings</strong>: The findings showed that the mean score of measures in all the stages (before, during, and after administration) was significantly lower than the standard (p &lt; 0.001). There was a significant reverse relation between the score of measures in all the three stages (before, during, and after administration), and work record and work experience in the ward. Furthermore, the mean score of measures in all the three stages was significantly different between female and male subjects (p value = 0.031), in that the mean score of women was higher than that of men. There was also a significant difference between the mean score of measures in all the three stages, and the employment status of samples; so that the mean score of provisionally employed personnel was higher than that of permanently employed personnel.</li><li><strong>Conclusions: </strong>The findings of the research showed that the mean score of measures before, during, and after administration of feeding through gastrostomy was lower than the standard (p &lt; 0.001). Therefore, a gastroenterology advisor, a clinical nurse and a nutrition specialist should train the patients and their families, and the personnel about preparation and storage of food, method of administering food, protection of tube entrance and NG tube by considering the problems and complications arising from this type of feeding. Based on the findings of the present research, it is necessary to retrain the nurses and especially male nurses, nurses with more work experience, and permanently employed nurses in terms of correct performance of clinical nursing skills including this type of feeding.</li><li><strong>Key words: </strong>Tube feeding, nursing management, gastrostomy, nutritional support</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/571http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/571/480

Iranian Journal of Nursing and Midwifery Research1735-906617220120307569569ENMSc, Department of Critical Care Nursing, Kidney Disease Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc Student, Student Research Committee, Department of Surgical-Nursing Education, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.201109262011100920111009<ul><li><strong>Background: </strong>Chronic renal disease is a health problem in today&rsquo;s world. In the end-stages of renal disease patients depend upon alternative therapies including dialysis for their survival. However, dialysis causes several stressors on physical, mental and social performance of patients. The present study aimed to review and compare the self-concept in patients undergoing hemodialysis and peritoneal dialysis.</li><li><strong>Materials and Methods</strong>: This was a case-control study including two groups of patients, undergoing hemodialysis and peritoneal dialysis, who referred to Al-Zahra and Ali Asghar Hospitals, which are affiliated to Isfahan University of Medical Sciences. These groups were compared to the control group. Data were collected through completing the form of demographic characteristics and a questionnaire, written by the researcher, pertaining to the self-concept which was collected by the samples. The data were analyzed by the Software SPSS version 18.</li><li><strong>Findings</strong>: ANOVA (analysis of variance) showed that statistically there was a significant difference between mean score of self-concept in the three physical (body-image), psychological, and social self aspects in the two groups of hemodialysis and peritoneal dialysis with the control group; however, Duncan&rsquo;s post-hoc analysis showed no significant difference between mean score of self-concept in the three mentioned aspects in the two groups of hemodialysis and peritoneal dialysis. Furthermore, ANOVA (analysis of variance) showed that there was no significant difference between mean score of the spiritual aspect of the self-concept in the two groups of hemodialysis and peritoneal dialysis with the control group. Duncan&rsquo;s post-hoc analysis also showed no significant difference in this aspect between the two groups of hemodialysis and peritoneal dialysis.</li><li><strong>Conclusions: </strong>Patients undergoing dialysis have many psychological disorders and the type of dialysis is not of much importance in this regard; therefore, adequate education and information for clients in order to use appropriate methods of adaptation as well as appropriate social relationship, continuing social support and developing health policies seem necessary in order to prevent mental disorders and providing required services and supports for patients. </li><li><strong>Key words: </strong>Self-concept, hemodialysis, peritoneal dialysis</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/569http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/569/450

Iranian Journal of Nursing and Midwifery Research1735-906617220120307589589ENPhD, Assistant Professor, Department of Adult Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc Student, Student Research Committee, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Lecturer, Department of Adult Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.201110202012022920111105<ul><li><strong>Background: </strong>The most common complication of hospitalization in intensive care units (ICUs) is infections caused by health care. Although sepsis results in a small percentage of infections, it has a high mortality rate. Intensive care nurses play a critical role in the prevention, early detection, and beginning of therapeutic interventions in patients with sepsis. This study aimed to review the effects of an educational program on knowledge, attitude, and practice of ICU nurses in Shariati Hospital, Isfahan, Iran.</li><li><strong>Materials and Methods</strong>: This was a quasi-experimental study on 64 nurses with at least one year of experience in ICU. The subjects were randomly selected and divided into test and control groups. Scores of knowledge, attitude, and practice of the participants were reviewed through a researcher-made questionnaire before and immediately and three weeks after a one-day workshop.</li><li><strong>Findings</strong>: Compared to baseline, there were significant increases in mean scores of knowledge, attitude, and practice in the test group immediately and three weeks after the education. Mean scores of knowledge in the test group before and immediately and 3 weeks after the intervention were 64.5, 84.9 and 85.2, respectively. The corresponding values for attitude were 73, 79.7, and 83.3. Mean scores of practice were 81.8, 90.5, and 91.3 before and immediately and 3 months after the intervention, respectively. In the control group, mean scores of knowledge before and immediately and 3 weeks after the educational course (which they did not attend) was 63.7, 63.9, and 63.5, respectively. Mean scores of attitude were respectively 72.8, 73.3, and 73.2 at the mentioned intervals. The corresponding values for practice were 82.1, 82.9, and 82.7.</li><li><strong>Conclusions: </strong>Training significantly improved levels of knowledge, attitude, and practice of ICU nurses in sepsis care. Therefore, compiling and organizing seminars and continuous basic educational workshops for sepsis care are recommended for health caregivers.</li><li><strong>Key words: </strong>Continuing education, sepsis, knowledge, attitude, practice</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/589http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/589/459

Iranian Journal of Nursing and Midwifery Research1735-906617220120307592592ENMSc, Department of Pediatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.2011102720120228<ul><li><strong>Background: </strong>These days, diabetes is deemed as one of the most important health and social-economic problems of the world. Since parents play a major role in treatment of diabetes, the most important part of managing diabetes is in the hands of the parents of children affected by diabetes. This special responsibility will increase the stress and family challenges and impacts parents&rsquo; emotional responses. The affective reactions or responses of the parents can also be conveyed to the child himself and reduce self-care, increase glucose levels, increase the possibility of complications and reduce the quality of life. Thus, it is highly important to recognize the affective reactions of parents during various stages of the disease for the purpose of intervention.</li><li><strong>Materials and Methods</strong>: All parents of children diagnosed with insulin-dependent diabetes who referred to Sedigheh-ye-Tahereh Endocrinology and Metabolism Research Center, Isfahan, Iran, were selected and the Symptom Checklist-90 (SCL-90) was filled in five stages (immediately, one month, three months, six months and twelve months after diagnosis). Convenient sampling was used to select 45 consecutive subjects out of whom 10 dropped out during the study.</li><li><strong>Findings</strong>: The major problems of the study subjects at the beginning of diagnosis were depression, anxiety and physical problems, respectively. Three, six and twelve months later, they were depression, obsession and physical problems. Over time, the mean score of parents&rsquo; affective reactions declined which indicated the acceptance of the disease by parents over time.</li><li><strong>Conclusions: </strong>In view of the fact that both mother and father of children with diabetes suffer from affective problems and since fathers refer to diabetes centers less than mothers, some decisions should be made to mentally support both fathers and mothers.</li><li>&nbsp;<strong>Key words: </strong>Affective responses, parents, after diagnosis, type 1 diabetes, children</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/592http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/592/483

Iranian Journal of Nursing and Midwifery Research1735-906617220120307602602ENMSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran And PhD candidate, Tehran University of Medical Sciences, Tehran, Iran.MSc, Navvab Center, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Fundamental Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Pediatric Nursing , School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.201111162012022220120121<ul><li><strong>Background: </strong>Social adaptability is an important requirement of the social life of adolescents, which can be affected by their mother&rsquo;s parenting style (PS). The purpose of this study is to compare the social adaptability in four parenting styles (authoritative, authoritarian, permissive and neglectful) through which mothers interact with their adolescent girls.</li><li><strong>Materials and Methods</strong>: This survey is a cross-sectional and analytical study on 737 adolescents that study in the all girls junior high schools in Isfahan. Data collection was done with a questionnaire. The questionnaires were completed by the adolescents. After data collection, the parenting styles were determined and the social adaptability of the four groups was compared.</li><li><strong>Findings</strong>: The mean social adaptability in adolescents who their mothers have the authoritative parenting style was <br /> 49.6 &plusmn; 6.1, in the permissive parenting style 50.1 &plusmn; 5.8, the authoritarian parenting style 44.2 &plusmn; 6.5 and in the neglectful parenting style was 42.2 &plusmn; 7.5. The social adaptability of the four groups was significantly different (p &lt; 0.001).</li><li><strong>Conclusions: </strong>This study shows that the permissive parenting style and after that authoritative parenting style were followed by higher social adaptability in adolescent girls.</li><li><strong>Key words: </strong>Social adaptability, parenting style, adolescent</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/602http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/602/460

Iranian Journal of Nursing and Midwifery Research1735-906617220120307608608ENMSc, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Algonquin College, Ottawa, Canada.PhD, Assistant Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.2011112020120206<ul><li><strong>Background: </strong>The negative attitudes and behaviors of Iranian nursing students impede learning and threaten their progression and retention in nursing programs. The need to understand students&rsquo; perception and experiences of nursing provide knowledge about effectiveness of nursing education program as well as their professional identity. The purpose of this study was to discover experiences of nursing students.</li><li><strong>Materials and Methods</strong>: In a descriptive, exploratory and qualitative study, twelve senior nursing students of Isfahan University of Medical Sciences (School of Nursing and Midwifery) were participated. Data was collected via unstructured in-depth interview, and thematic analysis method was used for analyzing the data.</li><li><strong>Findings</strong>: The findings from this study revealed that the nursing students in Iran experienced altered experiences during their education program as positive and negative. Two major themes were constructed from the thematic analysis of the transcripts: professional dimensions and professional conflicts.</li><li><strong>Conclusions: </strong>Regarding the findings, positive experiences of students have leaded them to acceptance and satisfaction of nursing and negative experiences to rejection and hating of nursing and lack of adaptation with their professional roles. Therefore, it is recommended that revision and improvement in nursing education program is essential to facilitate positive experiences and remove negative experiences of nursing student&rsquo;s educational environment.</li><li><strong>Key words: </strong>Perception, nursing, students, qualitative research</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/608http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/608/513

Iranian Journal of Nursing and Midwifery Research1735-906617220120307671671ENMSc, Nursing and Midwifery Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.PhD, Water and Electrolytes Research Center, Kidney Diseases Research Center, Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Gynecologist, Isfahan Fertility and Infertility Center, Isfahan, Iran20120307<ul><li><strong>Background:</strong> Endometriosis is defined as the existence of endometrial-like tissue outside the uterus. Diagnosis of endometriosis is a challenging theme. Despite the broad search for innovative laboratory tests and advances in imaging technologies, there are still no easy, non-invasive diagnostic tests available. Due to inflammatory process of endometriosis, still C-reactive protein (CRP) level may be the target of initial screening. The aim of this study was to investigate CRP levels as a marker of inflammatory process in serum and peritoneal fluid of patients with endometriosis.</li><li><strong>Materials and Methods:</strong> In a case control study, 179 patients with endometriosis (N = 90) and without endometriosis <br /> (N = 89) were evaluated. The venous blood samples were obtained from all patients before laparoscopy and the peritoneal fluid samples were collected from pelvis before any manipulation. Student&rsquo;s t-test was applied to compare the parameters between two groups.</li><li><strong>Findings:</strong> There was no significant difference between the CRP serum level in patients with endometriosis and infertile women without endometriosis. There was a significant difference in peritoneal level of CRP between case and control groups (p &lt; 0.05).</li><li><strong>Conclusions:</strong> The findings suggested that measurement of this marker in patients&rsquo; serum or plasma cannot be used to diagnose endometriosis. It is further recommended that a combination of different markers might be helpful in this regard that could be studied in future.</li><li>&nbsp;<strong>Key words</strong><strong>:</strong>&nbsp;Endometriosis, inflammation, C-reactive protein, serum, peritoneal fluid, infertility</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/671http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/671/478

Iranian Journal of Nursing and Midwifery Research1735-906617220120307635635ENMSc, Department of Surgery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc Student, Student Research Committee, School of Nursing and Midwifery, Medical Students Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Faculty Member of Cardiac Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.PhD, Department of Surgery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, Department of Surgery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.20120108<ul><li><strong>Background: </strong>Cardiovascular diseases have the highest death rates in human society. Coronary artery disease is among the most important of these diseases. No treatment of cardiovascular disease has as much impact on the quality of life of the patients as the heart surgery. The recovery from heart surgery is associated with symptoms of pain and psychological distress. In the early recovery period, the patients will face moderate symptoms of anxiety and depression. In this regard, various measures of nursing, as complementary therapy practices have been performed to help the patients for overcoming the physical and psychological needs. One of these methods, in recent years has been the use of complementary and alternative therapies, particularly massage therapy, after heart surgery. Thus, the aim of this study was to determine the effectiveness of massage therapy on the mood of patients after open-heart surgery in Isfahan Chamran Hospital during 2010-11.</li><li><strong>Materials and Methods</strong>: In this study 72 patients, who underwent coronary artery bypass surgery, were selected. They were randomly assigned to the two case and control groups. The patients of the case group (n = 36) received Swedish massage for 20 minutes in 4 sessions in 4 consecutive days, 3 to 6 days after the open-heart surgery. The patients in the control group received only the routine care. The mood questionnaire (POMS) which was used in this study has been completed the day before the start of the study and intervention and again after the last day of the intervention. SPSS software version 12 and descriptive and inferential statistical methods were used for data analysis.</li><li><strong>Findings</strong>: The comparison of study results showed that massage decreased the overall rating of the patients&rsquo; mood after the surgery.</li><li><strong>Conclusions: </strong>The use of massage therapy as an effective nursing intervention can improve the patients&rsquo; mood after open-heart surgery. Due to the low cost and simplicity of this method, it can perhaps be used as a complement to drug therapy and postoperative interventions used in these patients.</li><li>&nbsp;<strong>Key words: </strong>Massage, mood, heart surgery</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/635http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/635/454

Iranian Journal of Nursing and Midwifery Research1735-906617220120307672672ENPhD, Associate professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MD, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, School of Nursing and Midwifery, Gilan University of Medical Sciences, Isfahan, Iran.BS, Disease Control Unit, Isfahan University of Medical Sciences, Isfahan, Iran.20120307<ul><li><strong>Background: </strong>The tragedy of having breast cancer can cause many challenges for women. Patients seek for someone to compare their emotional and physical reactions with. This study was conducted to evaluate the impact of implementation of peer support group on the quality of life of breast cancer patients.</li><li><strong>Materials and Methods</strong>: This clinical trial was conducted on patients who underwent modified radical mastectomy and/or lumpectomy in surgical wards of Isfahan and Tehran (2 cities in Iran). The members of the peer group were trained after they volunteered to enter the study and their capacity was evaluated. They started contacting the patients after the surgery and continued it during treatments and several months after completion of the treatments. Patients were placed in 2 groups of case and control by simple random sampling. The quality of life of patients in both groups was measured during and after the completion of treatment using standard instruments of National Medical Center and Beckman Research Institute.</li><li><strong>Findings</strong>: The mean score of the physical dimension of life quality in the case and control groups in Tehran had a significant difference during 2 stages. There was no significant difference between the mean scores of physical dimension of life quality between the 2 groups during the 2 stages in Isfahan. Moreover, the mean scores of mental dimension of the quality of life showed a significant difference between the 2 groups in Tehran during the 2 stages. The mean scores were also significantly different during the second stage in Isfahan. There was a significant difference between the social dimension of quality of life between the 2 groups in Isfahan (p = 0.001). The mean scores of the social dimension of quality of life had significant differences between the 2 groups in Tehran during the 2 stages (p &lt; 0.001). There was a significant difference between the 2 groups regarding the mean score of spiritual dimension of quality of life in Tehran (p &lt; 0.001).</li><li><strong>Conclusions: </strong>The results showed that patients supported by a peer group enjoyed a higher quality of life compared to others. Although significant differences were observed in scores of both case and control groups in Tehran, similar findings were not obtained in Isfahan. This may be due to incomplete matching of the peer group members and incapability of the volunteers to maintain an effective and constructive communication with the patients.</li><li>&nbsp;<strong>Key words: </strong>Peer support group, quality of life, breast cancer</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/672http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/672/481

Iranian Journal of Nursing and Midwifery Research1735-906617220120307673673ENMSc, Department of Midwifery, Nursing and Midwifery Care Research Center, 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.MD, Associate Professor, Nursing and Midwifery Care Research Center, Department of Pediatrics, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.20120307<ul><li><strong>Background: </strong>Birth weight is considered as the most important index of neonates' growth as well as the most important determinant of infants' mortality. This study was conducted to investigate the growth pattern in normal, low and very low birth weight neonates for 18 months in the health care centers of Isfahan, Iran.</li><li><strong>Materials and Methods</strong>: In a cross-sectional and retrospective study, 214 neonates (90 with normal, 90 with low and 34 with very low birth weights) were enrolled in the health care centers of Isfahan and their growth in the 2^nd, 4^th, 6^th, 9^th, 12^th, 15^th and 18^th months were investigated. The data collection tool was a 3-part questionnaire which was validated using content validity. A part of data was completed based on the health file of the family. <strong></strong></li><li><strong>Findings</strong>: The mean of weight, height and head circumference in the months 2, 4, 6, 9, 12 and 15 in the three groups with normal, low and very low birth weights were significantly different. In the ages of 6, 15, 12 and 18 months, there was the highest frequency of horizontal trend in the growth pattern of children in the three groups. In the growth rate of neonates with low birth weight, , there was the highest frequency of horizontal trend at the age of 12 months and there was the highest frequency of descending trend in the 15^th months.</li><li><strong>Conclusions: </strong>The findings showed that according to National Center for Health Statistics (NCHS) percentiles, low and very low birth weight infants had lower growth in weight, length and head circumference compared to normal birth weight infants. Therefore, special attention should be given to healthcare and post-birth growth surveillance of these two groups to maintain and improve the health level of them.</li><li><strong>Key words: </strong>Neonate, very low birth weight, low birth weight, children, growth surveillance</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/673http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/673/482

Iranian Journal of Nursing and Midwifery Research1735-906617220120307674674ENMSc, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.MSc, School of Nursing and Midwifery, Najafabad Branch, Islamic Azad University, Najafabad, Iran.PhD, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.20120307<ul><li><strong>Background: </strong>Ischemic heart disease (IHD) is one of the leading causes of death and disability among young and older women, respectively. Researches in this area mostly focused on manifestations, risk factors, and treatment of the patients with IHD. Therefore, there is a lack of information on the aspects of affects and feelings of such patients. This study aimed to describe lived experience of women with IHD to provide a suitable guide for nursing practice.</li><li><strong>Materials and Methods</strong>: This was a descriptive phenomenological study. Participants were 8 women with IHD who were hospitalized in critical care units (CCUs) and ambulatory cardiac care centers of Isfahan University of Medical Sciences in Iran. They voluntarily responded to open-ended questions of semi-structured interviews. Data was analyzed using Colaizzi's method to extract meanings and concepts.</li><li><strong>Findings</strong>: After analyzing the statements of the participants, 14 subthemes forming 5 main concepts of pain and relief, resistance, introversion, loss of control, and mutual communication were emerged.</li><li><strong>Conclusions: </strong>Ischemic heart event is an experience with multidimensional impact on various aspects of the patient's life. This study demonstrated this experience as having 5 fundamental elements. Women with IHD expressed their suffering from frequent cycles of pain that drove their feelings and thoughts toward themselves and provoked their sense of resistance. They also faced loss of control on various aspects of their lives and changes in their relationships with others, too. This image would help nurses design their care plan based on a better understanding of these patients.</li><li><strong>Key words: </strong>Females, qualitative research, ischemic heart disease, life experiences</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/674http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/674/471

Iranian Journal of Nursing and Midwifery Research1735-906617220120307675675ENMSc, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MSc Student, Student Research Committee, School of Nursing and Midwifery, Medical Students Research Center, Isfahan University of Medical Sciences, Isfahan, IranBSc Student, Student Research Committee, School of Nursing and Midwifery, Medical Students Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc Student, Student Research Committee, School of Nursing and Midwifery, Medical Students Research Center, Isfahan University of Medical Sciences, Isfahan, IranMSc, Department of Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences.MSc, Isfahan Department of Education, Isfahan, Iran20120307<ul><li><strong>Background: </strong>Teachers, parents and foundations should become objective-oriented for children with visual impairment so that learning and sensitization of necessary knowledge and skills for the behaviors of these children are assisted. Where there is impairment in the relations of children caregivers, their emotional security is disturbed and its effects will appear in their behaviors. Therefore, strong dependence on parents, teachers and other adults is the characteristics of most of the children with physical problems including blind children. Since use of the experiences of caregivers of these children increases their efficiency and life skills, this study was conducted aiming to understand the experiences of blind children caregivers in Isfahan.</li><li><strong>Materials and Methods</strong>: This study was a qualitative study with a phenomenological approach to investigate the experiences of blind children caregivers including mothers and teachers. Four mothers of blind children and four caregivers of blind children were purposefully selected and interviewed from 2007 to 2009. Data were collected through interviews which were recorded on cassette tapes. The obtained data were analyzed using Collizzi method.</li><li><strong>Findings</strong>: The experiences of the blind children caregivers were divided into two groups of challenge and role.</li><li><strong>Conclusions: </strong>The results of this study showed that upon diagnosing the child&rsquo;s blindness, the parents suffer from mental stress. At first, they deny the problem, but then they begin to come along and accept the blind child. At this time, they analyze the effective factors in keeping and educating the child. At the same time, they act in response to the child influenced by several factors including the role of the society.</li><li><strong>Key words: </strong>Caregivers, blind, phenomenology</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/675http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/675/477

Iranian Journal of Nursing and Midwifery Research1735-906617220120307676676ENPhD Student, Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.PhD, Associate Professor, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.PhD, Associate professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.20120307<ul><li><strong>Background: </strong>Nowadays, the concept of family planning has been detached from the population control and it is expressed as an essential element in women&rsquo;s reproductive rights, empowering them and promoting their status in society. Family planning services have an important role in fertility decisions using contraception methods in women. This study was carried out to explore the experience of women from the role of health centers in empowering them for family planning.</li><li><strong>Materials and Methods</strong>: This qualitative study was performed on 37 married women who were volunteer and eligible for contraception as well as 8 staffs and directors of family planning services. They were selected useing purposeful sampling method in Isfahan, Iran. Data were collected by recording discussions of focused group in 7 sessions and 5 individual interviews. Conventional content analysis was used for coding and classification of data.</li><li><strong>Findings</strong>: Participants descriptions about the role of health centers in empowering the family planning was classified into 4 main categories including: encouraging male&rsquo;s participation in family planning, providing comprehensive reproductive health services, expanding free services for family planning and appropriate technology for public awareness.</li><li><strong>Conclusions: </strong>Accessibility to health centers and offering free services for family planning are not sufficient for empowering women in terms of their fertility desires. The health centers should offer comprehensive reproductive health services and provide family planning services with a new approach for helping women and men to consciously and freely make a responsible decision in order to have more control over their fertility.</li><li><strong>Key words: </strong>Women empowerment, family planning, health centers, Iran</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/676http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/676/479

Iranian Journal of Nursing and Midwifery Research1735-906617220120305666666ENPhD, Assistant Professor, Department of Operating Room, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.PhD, Assistant Professor, Department of Nursing, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.PhD, Associate Professor, Department of Nursing, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.PhD, Assistant Professor, Department of Medical-surgical, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.20120305<ul><li><strong>Background: </strong>Kidney transplant needs long term treatment, care and a follow up. Patients with kidney transplant need support in fields of knowledge, skills and motivations. Several researches showed existing challenges regarding education of these patients. A qualitative study was conducted to define patients' experiences from their received education about the process of kidney transplant.</li><li><strong>Materials and Methods</strong>: This was a qualitative study with a content analysis approach. Sampling was purposive up to data saturation. The participants aged 18-60 years, had experienced transplantation. The data were collected by semi-structural individual in-depth interviews with 18 participants. The interviews were analyzed by Graneheim and Lundman content analysis method.</li><li><strong>Findings</strong>: Three general themes of "educational experiences at the beginning of transplantation", &ldquo;educational experiences in post transplantation care", and "patients' struggle to enhance their awareness in order to preserve their transplanted kidney" were emerged.</li><li><strong>Conclusions: </strong>The findings showed that patients' did not receive adequate knowledge about kidney transplant process. This issue reveals an unstructured and uncoordinated education given to kidney transplant patients by health team members during kidney transplant process. With regard to high motivation of the patients, designing such educational program based on self-management in the process of kidney transplant for these recipients is essential. Nurses in their educational role can enable the patients through educating them about problem solving methods and selection of the best solution to preserve their transplanted kidney and consider renal transplant recipient self-management as their first priority toward these patients.</li><li><strong>Key words: </strong>Nursing, qualitative research, education of patients, kidney transplantation, Iran</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/666http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/666/453

Iranian Journal of Nursing and Midwifery Research1735-906617220120305644644ENMSc, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranMSc, School of Nursing and Midwifery, Najaf-Abad University of Medical Sciences, Isfahan, IranMSc, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran20120118<ul><li><strong>Background: </strong>Considering the relationship of low and high levels of&lrm; hemoglobin and hematocrit with some pregnancy complications, we decided to study their relationship with pregnancy outcome. This study also aimed to investigate the changes in hemoglobin and hematocrit values during the second and first half of pregnancy and its relationship with pregnancy outcome.</li><li><strong>Materials and Methods</strong>: In a prospective cohort study, 520&rlm;&lrm; Iranian pregnant women, aged 15 to 45&lrm;&rlm;&rlm; years that were supported by health centers in Isfahan, Iran, were recruited using quota sampling method. Exclusion criteria comprised of 36&rlm; conditions that were related to the maternal and infant outcomes. Hemoglobin and hematocrit were measured in eligible mothers during the 6^th-&rlm;11^&rlm;^th weeks and 26^{&lrm;&rlm;&rlm;}^th-30&lrm;&rlm;&rlm;^th weeks of pregnancy. They were monitored until delivery and the data regarding their pregnancy outcome were collected.</li><li><strong>Findings</strong>: Low levels of hemoglobin during the first&lrm; half of pregnancy was associated with preeclampsia (p = &lrm;&rlm;0.024). Moreover, &lrm;low levels of hemoglobin during the second half of pregnancy was associated with the risk of preterm premature rupture of membranes &lrm;(p =&lrm;&rlm;&lrm; 0.01). In addition, mothers with lower blood dilution, as a physiological process during pregnancy, were more prone to preeclampsia (p = 0.04&lrm;&rlm;&rlm;&lrm;).&lrm;</li><li><strong>Conclusions: </strong>Hemoglobin levels in the first and second half of pregnancy can predict preeclampsia and premature preterm rupture of membranes. Increased hematocrit levels in the second half of&lrm; pregnancy or lack of reduction of hematocrit levels in the second half compared to the first half can estimate preeclampsia.&lrm;</li><li><strong>Key words: </strong>Hemoglobin, hematocrit, pregnancy outcome</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/644http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/644/455

Iranian Journal of Nursing and Midwifery Research1735-906617220120105511511ENPhD, Assistant Professor, Nursing and midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.PhD, Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.PhD, Assistant Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.MD, Assistant Professor, Department of Psychiatry, Tehran Psychiatric Institute, Tehran University of Medical Sciences, Tehran, Iran.2011072720110926<ul><li><strong>Background: </strong>Nurses and other members of health care team provide mental patients with health services through interprofessional collaboration which is a main strategy to improve health services. Nevertheless, many difficulties are evidently influencing interprofessional collaboration in Iranian context. This paper presented the results of a study aimed to explore the context.</li><li><strong>Materials and Methods</strong>: A qualitative study was conducted using in-depth interviews to collect data from 20 health professionals and 4 clients or their family members who were selected purposefully from the health centers affiliated with Isfahan University of Medical Sciences. Themes were identified using latent qualitative content analysis. Trustworthiness of the study was supported considering auditability, neutrality, consistency and transferability. The study lasted from 2010 to 2011.</li><li><strong>Findings</strong>: Some important challenges were identified as protecting professional territory, medical oriented approach and teamwork deficits. They were all under a main theme emphasizing professionals' divergent views. It could shed insight into underlying causes of collaboration gaps among nurses and other health professionals</li><li><strong>Conclusions: </strong>The three introduced themes implied difficulties mainly related to "divergences" among health professionals. Moreover, the difficulties revealed the need for training chiefly to improve their convergent shared views and approaches. Therefore, it is worthwhile to suggest interprofessional education for nurses and other professionals with special attention to improving interpersonal skills as well as mental health need-based services.</li><li><strong>Key words: </strong>Mental health services, interprofessional collaboration, challenges, Iran</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/511http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/511/434

Iranian Journal of Nursing and Midwifery Research1735-906617220120307677677ENPhD Student, Department of Critical Care Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, IranPhD, Associate Professor, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, IranPhD, School of Qom Baqerololum University, Qom, Iran20120307<ul><li><strong>Background: </strong>Each group or profession has its own discourse. Discourses create identity, support institutions and reproduce power relationships. Professional identity of Iranian nurses, which has recently had the opportunity to represent itself in social arena, needs investigation. This study aimed to make internal aspect of this identity clear.</li><li><strong>Materials and Methods</strong>: This study was conducted by discourse analysis, using data of 23 semi-structured individual interviews and 4 focus group interviews with nurses and senior nursing students of Tehran and Isfahan University of Medical Sciences, Iran, to evaluate their professional identity.</li><li><strong>Findings</strong>: In professional self-concept, elements like spirituality value and low financial benefits were identified as well as conflicting features of holiness and humility, identity emerging, identity escape, low professional self-confidence and justice seeking, lost professional authority and pride.</li><li><strong>Conclusions: </strong>Nursing professional identity has been formed based on cultural social structure, values and beliefs governing health system. This is a spectrum of a growing and emerging identity to a developed but forgotten identity. Although nursing discourse is subordinate in health system discourse, signs of moving toward professional maturity have emerged.</li><li>&nbsp;<strong>Keywords: </strong>Professional identity, nursing, discourse analysis</li></ul>http://ijnmr.mui.ac.ir/index.php/ijnmr/article/view/677http://ijnmr.mui.ac.ir/index.php/ijnmr/article/download/677/484