Journal of Hayat

Effect of Tai Chi Chuan on Quality of Life in Women with Multiple Sclerosis

MohammadAli Hosseini

Background & Aim: Multiple Sclerosis (MS) is a chronic disease of central neurologic system that has a wide effect on neurological function and can cause disability or poor quality of life in patients. The purpose of this study was to assess the effect of the Tai Chi Chuan on quality of life in women with the MS .

Methods & Materials : This was a clinical trial which covered 34 women with MS in Iran Multiple Sclerosis Society in 2012. The participants were selected using purposive sampling and were randomly assigned to the experiment (n=16) and control (n=18) groups. Intervention was Tai Chi Chuan classes twice a week for 12 weeks. In this study, demographic questionnaire and Multiple Sclerosis quality of life questionnaire (MSQOL-54 scale) were used to collect data . Data were analyzed using the Chi-squared, independent samples T-test, paired samples T-test, Mann-Whitney U and Wilcoxon in the SPSS v.18.

Results: There were no significant differences between the mean quality of life and its subscales among patients in the experiment and control groups at baseline except for the emotional well-being subscale. After the Tai Chi training intervention, significant differences were found between the two groups in the mean of some subscales of the quality of life including role limitation due to emotional problems, pain, emotional well-being, energy, social function, health distress, overall quality of life, physical health composite score, mental health composite score and also total quality of life score (P<0.05).

Conclusion : The results suggested that Tai Chi Chuan could be an alternative exercise intervention to increase quality of life in patient with the MS.

Comparison of Perceptions of Nurses and Premature Infants’ Mothers about Mothers’ Needs in Neonatal Intensive Care Unit

Zahra Ahmadi

Background & Aim: An important goal of nursing care in the Neonatal Intensive Care Unit (NICU) is to provide holistic care as well as the best possible outcome. Understanding perceived needs of mothers is valuable to achieve these goals. This study aimed to compare perceptions of nurses and premature infants’ mothers about mothers’ needs in the NICUs.

Methods & Materials : This was a cross-sectional study in which 63 nurses and 63 mothers with premature infants were selected from the NICUs of four educational hospitals affiliated to the Mashhad University of Medical Sciences through stratified sampling method in two months. Data were gathered using the NICU Family Needs Inventory of Ward and were analyzed using descriptive-analytical statistical methods in the SPSS v.16.

Results: Among the subscales related to family needs, the following items were reported to be important by mothers: Proximity (95.3%), Assurance (94.1%), Information (91.1%), Support (79.7%) and Comfort (72.8%). On the other hand, nurses believed that the following items were the most important needs of the mothers: Assurance (80.3%), Proximity (75.2%), Information (70.8%), Comfort (66.3%) and Support (64.8%).

Conclusion : According to study findings, nurses should periodically assess needs of the mothers in the NICUs to be aware of the actual needs instead of placing subjective assumptions on mothers needs. This can improve effective communication and interaction with mothers and enhance satisfaction of the mothers with care.

Predicting Factors of Breast Self-Examination based on Health Belief Model and Locus of Control among Women Aged 20-50 Years

Azita Noroozi

Background & Aim: Although breast self-examination (BSE) is no longer recommended for screening of breast cancer, its training and practicing is a gateway to health promotion and provides women with knowledge and attitudes that set the stage for clinical breast examination and mammography screening later in life. The aim of this study was to recognize predicting factors of the BSE based on the Health Belief Model (HBM) and the locus of control model among women aged 20-50 years old.

Methods & Materials : Inthis cross-sectional study,400 women were selected through theconvenience sampling method from health centers. Data were collected using four questionnaires including the Champion’s Scale, health locus of control, and demographic and functional questionnaires. Data were analyzed in the SPSS using independent T-test, Chi-squared test, logistic and linear regression models.

Results: The results showed that 10.9% of the participants reported performing BSE regularly. Perceived self-efficacy was the strongest positive predictor in the BSE performance (Exp (B) =1.863). Awareness had direct and indirect effects on the BSE. The locus of control did not predict the BSE (p=0.05).

Conclusion : Improving self-efficacy, especially in young women, and increasing awareness about cancer among women is necessary to increase the rate of the BSE.

Impact of Pre-Hysterectomy Counseling on Depression among Patients Reffered toTUMS Hospitals

Maryam Modarres

Background & Aim: Hysterectomy is the second most common major surgery among women of reproductive age. Studies have suggested that women do not usually receive adequate information regarding hysterectomy before the surgery. Depression is a common psychiatric condition diagnosed after hysterectomy. The aim of this study was to assess the impact of pre-hysterectomy counseling on depression among women.

Methods & Materials : In this clinical trial, 100 women who had undergone hysterectomy for non-malignant conditionswere selected from two hospitals (women’s’ hospital and Imam Khomeini hospital) and completed the informed consent forms. Participants were randomly divided into two intervention and control groups. In the intervention group, we implemented the supportive counseling within two sessions. Depression was assessed 1-2 weeks before the surgery and two monthsafter the surgery. Data were gathered using the 30-item SAMA questionnaire (modified BECK questionnaire in Iran)for depression and a demographic questionnaire. The two groups were assessed using the Wilcoxon rank-sum test, Mann Whitney U test and paired-t test. Data were analyzed in the SPSS-14.0. The p-value less than 0.05 was considered significant forall tests.

Results: Mann Whitney U test showed no significant difference between the control and intervention groups in the mean score of depression (p<0.001). In the intervention group, the mean score of depression was 44.46 ± 6.7 at baseline and 20.86 ± 5.9 after the intervention.

Conclusion : Pre-hysterectomy counseling should be provided for women in order to reduce negative psychological consequences.

Voiceless shout: Parents' experience of caring for child with cerebral palsy

Farahnaz Mohammadi-Shahboulaghi

Background & Aim: Children with cerebral palsy need permanent care and attention in various stages of growth and development. The parents experience problems in taking care of these children and making them independent. This study was conducted to explore these experiences.

Methods & Materials : This qualitative study was conducted in 2011-2012 using content analysis. Purposeful sampling was used to recruit 19 parents of children with cerebral palsy referred to rehabilitation centers in Tehran. The data were gathered using in-depth and semi-structured interviews and were analyzed inductively.

Results: Data analysis results revealed three original categories including "life with hardness" ، "being in ambiguity" ، and "need to be supported" ، and several subcategories including "physical strain" ، "psycho-emotional strain" ، financial burden" ، "restriction in social activities" "facing with anonymous" ، "lack of having an advisor" ، "need to get help from professionals and specialists" ، "need to have emotional- spiritual support" ، and "need to have help in caring the child".

Conclusion : Parents in permanent care of children with cerebral palsy face with new and various situations consistently and experience difficulty and bewilderment because of insufficient family and social support. Further studies are needed to explore the support process of caregiver parents of these children.

Factors Influencing Tooth Brushing Behaviour based on Health Belief Model among Bushehr Primary School 5th & 6th grade Students

Rahim Tahmasebi

Background & Aim: Oral health is one of the most important components of personal health. Understanding current status of oral health is necessary to provide future oral health interventions. The aim of this study was to determine factors influencing tooth brushing behavior based on the health belief model (HBM) among 5- and 6-grader students.

Methods & Materials : : In this cross-sectional study, 370 primary school students were selected using the stratified cluster sampling method. Data were collected using a questionnaires based on the HBM. The obtained data were analyzed in the SPSS-20.

Results: The results showed that 95.7% of the students brushed their teeth once or more daily. Mean and standard deviation of the brushing frequency in one week was 8.66±3.54. There was a significant correlation between the perceived barriers (P=0.00, r=-0.14) and self-efficacy (P=0.04, r=0.10) with the brushing behavior.

Conclusion : According to the results, educating students and decreasing different barriers seems to be necessary to improve brushing behavior.

Development of “Intention to Use Oral Contraception” Questionnaire based on Theory of Planned Behavior in women Using Withdrawal Method

Alireza Hidarnia

Background & Aim: Need assessment for promotion reproductive health is important subject and development a questionnaire is essential. Thus the aim of this study was development of questionnaire of intention to use of oral contraception in withdrawal users based on construct of Theory of Planned Behavior (TPB).

Methods & Materials : In-depth interviews were conducted to elicit the salient beliefs relevant to oral contraception among withdrawal users. Then a cross-sectional study carried out in Tehran, Iran for validate of questionnaire. Participants recruited from attending five family planning clinics of public health services in the Eastern district of Tehran, Iran. Validity and reliability was evaluated using concurrent, content validity and Cronbach's alpha and test- retest respectively. Factor structure of the questionnaire was extracted by exploratory factor analysis (EFA). Confirmatory factor analysis (CFA) conducted to assess how well the EFA extracted model fits observed data. The SPSS version 16 and Lisrel programs were used to analyze the data.

Results: Reliability and validity were confirmed. The principal component analysis revealed a three-factor structure for the questionnaire including attitude, subjective norm and perceive behavior control that explained 50.4 percent of the total of variance.

Conclusion : In general, the findings suggest that questionnaire of intention to use of oral contraception in withdrawal users based on Theory of Planned Behavior is a reliable and valid measure.

Relationship between Mother’s General Health Status with Quality of Life of Child with Cancer

Shoelh Rahimi

Background & Aim : Childhood cancer discloses family, and mother in particular, to a number of challenges. It consumes a lot of time, energy, and money of parents to fulfill their caring responsibilities. In some cases and along with increase of caring pressure, mental health of parents deteriorates. The vesting consequences of such events may alter the process of children caring and their quality of life (QoL). The purpose of this study was to examine the relationship between mother’s general health status with the QoL of the child diagnosed with cancer.

Methods & Materials : In this descriptive cross-sectional study, 124 mothers of children diagnosed with cancer and aged 6-14 years old, referred to Imam Reza and Amir Hospitals in Shiraz during a four month period (from early November to late February) were selected to the study. Data were gathered using the following instruments: 1) the questionnaire of factors related to QoL in children 2) mother's general health status form 3) TNO_AZL Children Quality of Life (TACQOL) and 4) Ped QL Cancer Module. Data were collected through interviewing with mothers and reviewing the medical records of the hospitals. Data were analyzed using the Kruskal–Wallis, Spearman correlation coefficient, Mann-whiteny test and logistic regression in the SPSS-19.

Results: : A few number of mothers (7.3%) reported good general health status and a large number described their general health status as moderate (55.6%) and poor (37.1%). The mean of health related QoL score and the specific QoL score for children were 78.45±10.05 and 65.51±17.54, respectively. According to the multi-factorial logistic regression, demographic and social factors such as child’s age and treatment-related factors including the period of radiotherapy, along with the duration of disease were more correlated with health and specific QoL scores in children, compared to the mothers’ general health status score.

Conclusion : Results from this study suggested that emotional support is as important as financial empowerment. The QoL in these patients and their families may improve by identifying the families who are at risk of mental problems.