Journal of Hayat

Individual and familial factors influencing women’s reluctance to childbearing: A qualitative study

Saeideh Bazzazian

Background & Aim: Iran currently experiences a fertility rate below the replacement level, with decisions regarding childbearing influenced by various factors. This study focuses on individual and familial perspectives that contribute to women's reluctance to have children.
Methods & Materials: This qualitative research employed a conventional content analysis approach conducted during the period of 2022-2023. The sample comprised married women, aged 30 to 45, residing in different regions of Tehran (north, south, west, east, and central) who have voluntarily chosen not to have children. Participants were selected through purposive sampling, guided by specific inclusion and exclusion criteria, utilizing a snowball sampling technique. Data saturation was achieved with a sample of 19 women. Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman’s framework with the aid of MAXQDA 2022.
Results: Data analysis revealed two primary themes: familial factors and individual factors. Each theme comprised four categories, with two subcategories identified for each category. The familial factors include: (1) issues related to the family of origin, (2) mutual agreement on childlessness between partners, (3) instability in marital life, and (4) lack of marital satisfaction. The individual factors encompass: (1) idealism, (2) egocentrism and individualism, (3) negative health effects of childbearing on mothers, and (4) the conflict between maternal and professional roles, which are recognized as significant determinants in the decision not to have children.
Conclusion: This qualitative study sheds light on the complexity of the decision-making process regarding childlessness in this age group and highlights the need to address individual and familial factors alongside others, in population growth policies.

The effect of geranium aromatherapy on sleep quality in patients hospitalized in cardiac care units: A randomized controlled trial

Mohammad Abbasinia

Background & Aim: Sleep disorders are common among patients hospitalized in cardiac care units (CCUs), potentially impeding treatment outcomes and recovery processes. Aromatherapy has historically been employed to alleviate sleep disorders. This study aimed to determine the effect of geranium aromatherapy on sleep quality in patients hospitalized in CCUs.
Methods & Materials: This randomized controlled trial was conducted in 2022 at Shahid Beheshti Hospital in Qom. Seventy-two patients were selected via convenience sampling and randomly assigned to either the control group (n=35) or the intervention group (n=35). The intervention involved inhalation of geranium scent for three consecutive nights, whereas the control group received no such intervention. Data collection utilized the Richards-Campbell Sleep Questionnaire (RCSQ), administered pre- and post-intervention. Data analysis was performed using SPSS version 21, employing descriptive and inferential statistical methods.
Results: No significant differences were observed between groups regarding baseline demographic characteristics (P>0.05). Prior to the intervention, the mean sleep quality scores were 48.26±6.89 in the control group and 53.20±14.15 in the intervention group (P=0.110). Post-intervention, scores were 50.18±35.43 and 84.21±28.86, respectively, with the changes within groups being statistically significant (P<0.001). Across all dimensions of sleep quality, the intervention group demonstrated significantly better outcomes than the control group (P<0.05).
Conclusion: The results of this study showed that geranium aromatherapy appears to effectively improve sleep quality among CCU patients. Therefore, it is suggested that this method be used alongside existing treatments to enhance sleep quality in these patients.

Chemotherapy side effects in children and adolescents with leukemia and their relationship with maternal treatment Knowledge: A cross-sectional study

Arefeh Davoodi

Background & Aim: Although chemotherapy is effective in treating leukemia, it is associated with multiple adverse effects. Mothers, as key members of the healthcare team, need adequate information regarding these side effects to provide optimal care. This study aimed to investigate the side effects of chemotherapy in pediatric and adolescent leukemia patients and examine their relationship with maternal treatment knowledge.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2023 and involved 110 mothers and their children aged 6-18 years hospitalized for leukemia at educational hospitals in Tabriz. A convenience sampling method was employed. Data collection instruments included the American Cancer Society's chemotherapy side effects checklist and an information questionnaire for parents of children with cancer, developed by Motlagh et al. The data were analyzed using SPSS version 24, applying chi-square tests, one-way ANOVA, paired t-tests, Pearson correlation coefficients, and repeated measures ANOVA.
Results: The mean age of mothers was 37 years, and that of the children was 11.61 years. The majority of diagnoses were Acute Lymphoblastic Leukemia (ALL). The severity of complications—such as fever, nausea, vomiting, mouth mucositis, diarrhea, anorexia, and bleeding—showed a significant increasing trend over the four-week observation period (P<0.001). Additionally, a significant difference was observed in mothers' treatment knowledge between the first and fourth weeks (P<0.001). There was a significant relationship between chemotherapy complications and mothers' treatment knowledge (P<0.05).
Conclusion: Mothers actively seek and obtain information regarding their children’s chemotherapy treatment, with their knowledge increasing as complication severity rises. Awareness of side effects and their management strategies enables parents to provide appropriate care and empowers caregivers to offer the best advice and support to patients and their families throughout the treatment course.

The relationship between nurses’ compassion fatigue and alarm fatigue with patient safety in ICUs

Khadijeh Yazdi

Background & Aim: Nurses today experience high levels of fatigue that significantly impair their performance in delivering care, thereby affecting patient safety. This research aimed to determine the relationship between nurses’ compassion fatigue and alarm fatigue with patient safety in intensive care units (ICUs).
Methods & Materials: This cross-sectional, descriptive-analytical study was conducted in 2023 among 248 nurses working in the ICUs of hospitals in Golestan. A stratified sampling method with proportional allocation was employed. Data collection involved a demographic information checklist and three questionnaires assessing patient safety, alarm fatigue, and compassion fatigue. Data were analyzed using SPSS version 22, with a significance level set at P<0.05. Both univariate and multiple linear regression analyses were applied.
Results: The mean scores were as follows: compassion fatigue (86.13±25.20), alarm fatigue (22.67±7.38), and patient safety (62.23±13.67). A significant correlation was found between alarm fatigue and compassion fatigue (P<0.001). However, no significant relationship was observed between compassion fatigue (r=0.101, P=0.112) or alarm fatigue (r=0.090, P=0.158) with patient safety. Multiple linear regression analysis revealed significant associations between patient safety and work experience (P=0.031), income level (P=0.012), and employment type (P=0.039).
Conclusion: Despite moderate levels of compassion and alarm fatigue, patient safety remained within acceptable ranges, indicating that nurses continued to provide safe care even amidst occupational fatigue risks.

Impact of family-centered education on medication adherence in patients with cardiomyopathy: A clinical trial

Fatemeh Kheirkhah

Background & Aim: Medication adherence remains a significant challenge in the management of patients with cardiomyopathy, with many patients relying on external support systems to maintain compliance. The study aimed to assess the impact of family-centered educational interventions on medication adherence among patients with cardiomyopathy.
Methods & Materials: This controlled clinical trial employed convenience sampling to select 80 patients attending the Heart Failure Clinic at Shahid Rajaee Hospital in Tehran in 2023. Participants were randomly assigned to two groups of 40 each. The intervention consisted of two 30-minute family-centered education sessions delivered to the intervention group, while the control group received standard informational care. Medication adherence was assessed using the Morisky Medication Adherence Scale two weeks post-intervention. Data were analyzed with SPSS version 22, using both descriptive and inferential statistics.
Results: The groups were comparable regarding demographic variables and disease characteristics (P>0.05). Prior to the intervention, the mean (±SD) medication adherence scores were 5.00±1.19 for the control group and 4.35±1.05 for the intervention group (P=0.12). Post-intervention, adherence scores improved significantly in the intervention group, with a mean (±SD) of 6.43±0.78 compared to 5.10±1.19 in the control group (P=0.001).
Conclusion: Family-centered educational programs can effectively enhance medication adherence in patients with cardiomyopathy. The results highlight the valuable role nurses play in leveraging the potential of family members to provide education and support to patients, ultimately contributing to improved quality of life.
Clinical trial registry: IRCT20230216057433N1

The effect of the continuous care model on drug side effects and quality of life in patients with hyperthyroidism

Kolsoum Abdolahi

Background & Aim: Patients with hyperthyroidism need targeted interventions aimed at improving their quality of life and increasing awareness of potential drug side effects. This study aimed to investigate the effect of an intervention based on the continuous care model on drug side effects and quality of life in patients with hyperthyroidism.
Methods & Materials: This quasi-experimental study was conducted in 2021 on 75 hyperthyroid patients attending the endocrine clinics of Imam Khomeini Hospital and Shariati Hospital in Tehran. Participants were allocated into two groups of 38 patients each, using block randomization. The intervention group received care based on the continuous care model, while the control group received routine care. Data collection employed questionnaires assessing drug side effects and quality of life, administered before and after the intervention. Data were analyzed using SPSS version 25, employing both descriptive and inferential statistical methods.
Results: Analysis of covariance showed significant differences between the groups in both quality of life and drug side effects scores (P<0.001). Post-intervention, the mean quality of life scores across all dimensions were significantly higher in the intervention group compared to the control (P<0.001). Conversely, the mean scores for drug side effects and their respective dimensions were significantly lower in the intervention group following the intervention (P<0.001).
Conclusion: The findings suggest that implementing a continuous care model over a three-month period can positively influence the quality of life and decrease drug side effects among patients with hyperthyroidism.

The relationship between clinical competence and compassion fatigue among emergency department nurses in Urmia hospitals in 2024

Yousef Mohammadpour

Background & Aim: Clinical competence may influence the level of compassion fatigue experienced by nursing staff. This study aimed to determine the relationship between clinical competence and compassion fatigue among emergency department nurses.
Methods & Materials: This descriptive-analytical study was conducted among nurses working in the emergency departments of teaching hospitals in Urmia in 2024. A total of 120 nurses were randomly selected for participation. Data collection was performed using three questionnaires: a socio-demographic characteristics questionnaire, Leo’s Clinical Competence Questionnaire, and Figley's Professional Quality of Life Scale. Data analysis was performed using the Chi-square test and Pearson correlation coefficient with SPSS version 23.
Results: The results showed a significant inverse relationship between clinical competence and compassion fatigue (r=-0.45; P<0.05). The mean score of clinical competence among participants was 201.13±0.54. The average scores for compassion fatigue, compassion satisfaction, and secondary traumatic stress were 27.73±8.54, 38.73±1.81, and 28.45±4.82, respectively.
Conclusion: The results suggest that higher levels of clinical competence are associated with lower levels of compassion fatigue among emergency nurses. To mitigate compassion fatigue, nursing administrators and policymakers should consider implementing targeted strategies, such as comprehensive training, ongoing in-service education, and staffing with experienced and specialized nurses, thereby fostering a supportive work environment that reduces compassion fatigue.

The effect of tuinatherapy with chamomile oil extract on the severity of back pain in female operating room technologists: A randomized clinical trial

Soheila Bakhtiari

Background & Aim: Back pain is highly prevalent among operating room technologists, and conventional treatments—such as non-steroidal anti-inflammatory drugs—are often associated with adverse long-term side effects. This study aims to evaluate the effect of Tuinatherapy massage with chamomile oil extract on the severity of back pain in female operating room technologists.
Methods & Materials: This double-blind, randomized controlled clinical trial included 105 female operating room technologists selected via convenience sampling from several hospitals in Isfahan. Participants were randomly assigned to three groups of 35 individuals each: (1) Tuinatherapy massage with liquid oil supplemented with chamomile oil extract, (2) Tuinatherapy massage with liquid oil alone, and (3) a control group receiving no intervention. The Tuinatherapy massage sessions consisted of 10 sessions, each lasting 20 minutes and conducted every other day. Pain intensity was measured using the Visual Analog Scale (VAS) both before and after the intervention. Data analysis was performed using SPSS version 27, using one-way ANOVA and Tukey’s post hoc tests.
Results: Significant reductions in pain intensity were observed in groups one and two following the intervention compared to baseline (P<0.001). The control group showed no significant change. Prior to the intervention, there were no significant differences in pain scores among the three groups (P=0.230); however, post-intervention, pain intensity in group one was significantly lower than that in groups two and three (P<0.001).
Conclusion: Tuinatherapy massage effectively reduces back pain severity among female operating room technologists. Moreover, the inclusion of chamomile oil extract enhances this therapeutic effect. As an alternative to pharmacologic treatments, Tuinatherapy massage with chamomile oil may serve as a method for alleviating back pain in this population.
Clinical trial registry: IRCT20220725055548N1