Journal of Hayat

Comparison of the effect of soaking feet in warm water and foot reflexology on sleep quality of patients undergoing radiotherapy: A randomized clinical trial

Seyed Reza Mazloum

Background & Aim: Decreased sleep quality is one of the most common complications of radiotherapy in cancer patients. Although soaking feet in warm water and foot reflexology are two easy, inexpensive, and accessible ways to improve sleep quality, which one is more effective, has not been evaluated in existing studies. The purpose of this study was to compare the effect of soaking feet in warm water and foot reflexology on sleep quality in patients undergoing radiotherapy.
Methods & Materials: This two-group randomized clinical trial was conducted on 62 cancer patients undergoing radiotherapy at Reza (AS) Medical Center in Mashhad in 2020. Patients were randomly allocated into two groups of soaking feet in warm water and reflexology. In the group of soaking feet in warm water, patients soaked their feet in 41 °C water for 20 minutes every night from the seventh day after starting radiotherapy for two weeks. In the foot reflexology group, the intervention was performed from the seventh day after starting radiotherapy for two weeks every night for 10 minutes for each foot in three areas including solar plexus, pituitary gland and pineal gland. Sleep quality score was assessed using the Petersburg Sleep Quality Questionnaire on the seventh day of radiotherapy (pre-test) and then 7, 14 and 28 days later. Data were analyzed by the SPSS software version 20 using descriptive/inferential statistics.
Results: The results showed the total score of sleep quality in the two groups decreased significantly over time (P<0.001), and this reduction was from 13.81±1.33 on the pre-test day to 4.86±1.73 on the day 28 for the reflexology group, and from 13.55±1.23 to 7.92±1.97 for the group of soaking feet in warm water. It should be noted that a decrease in the score of Petersburg questionnaire means an improvement in sleep quality.
Conclusion: Foot reflexology and soaking feet in warm water improve sleep quality in patients undergoing radiotherapy but foot reflexology is more effective in improving sleep quality. Therefore, using this method is recommended.
Clinical trial registry: IRCT20190625044009N1

Relationship between the educational phase of the PRECEDE model and the quality of life among postmenopausal women referred to the clinics of Asadabad city in 2021

Mina Maheri

Background & Aim: Identifying the factors affecting the quality of life in postmenopausal women will help to design and implement the quality of life-improving interventions tailored to these women’s needs. This study aimed to determine the relationship between the educational phase of the PRECEDE model and the quality of life among postmenopausal women.
Methods & Materials: The present cross-sectional study was conducted on 240 postmenopausal women in Asadabad in 2021. The data collection tool included demographic information, the menopause-specific quality of Life questionnaire (MENQOL), and a questionnaire based on educational phase constructs of the PRECEDE model about menopause and behaviors related to the control of menopause complications. Data were analyzed using the SPSS software version 16.
Results: The mean score of quality of life in the women was 72.72±23.15. Perceived self-efficacy (β=-0.367, P<0.001) and attitude (β=-0.155, P=0.009) were significant predictors of quality of life. The educational phase constructs of the PRECEDE model explained about 33.6% of the variance of quality of life among the postmenopausal women in Asadabad.
Conclusion: Educational phase constructs of the PRECEDE model are useful for identifying the factors affecting the quality of life in postmenopausal women, and designing educational interventions in this area. It is recommended promoting self-efficacy (to perform behaviors related to the control of menopause complications) and improving attitude toward menopause to be integrated into all educational interventions designed and implemented to improve the quality of life in postmenopausal women.

The effect of foot reflexology massage on overt anxiety and physiological parameters of patients undergoing tibia plaque surgery

Fatemeh Imani

Background & Aim: Anxiety and hemodynamic changes are common complications of surgeries. The aim of this study is to investigate the effect of foot reflexology massage on overt anxiety and physiological parameters of patients undergoing tibia plaque surgery.
Methods & Materials: In this clinical trial study, 96 eligible patients who were candidates for Tibia plaque surgery, referred to Imam Ali (AS) Teaching Hospital in Bojnourd in the spring of 2016, were selected by the convenience sampling method. Then, they were randomly divided into two groups of 48 people: experiment and control. For the experiment group, one hour before the operation, the foot reflexology massage was performed for 10 minutes. For the control group, the foot was touched for 2 minutes. Patients’ anxiety was measured using the Spielberger Manifest Anxiety Questionnaire before and one hour after the intervention, and patients’ physiological parameters were measured before and after the intervention and at 2, 4, 6, 12 and 24 hours after the surgery. To compare and analyze the data, chi-square tests for qualitative variables and t-test, Mann-Whitney test and Repeated Measure ANOVA for quantitative variables were used on the SPSS software version 21.
Results: This study showed that the average score of anxiety after the intervention was significantly different in both the control and experiment groups (P=0.038). Also, Foot reflexology massage significantly reduced systolic blood pressure after the intervention (P=0.039) and 4 hours after the surgery (P=0.007), and also reduced diastolic blood pressure immediately after the intervention (P=0.001). Heart rate decreased significantly at all measured times after the intervention (P<0.05).
Conclusion: Foot reflexology massage can reduce overt anxiety and improve physiological parameters of patients undergoing tibia plaque surgery. Therefore, this method can be used for reducing anxiety in the patients candidate for orthopedic surgery.
Clinical trial registry: IRCT20200502047265N1

Spiritual health in pregnant women with domestic violence experience in the south of Iran in 2020: A descriptive study

Foozieh Rafati

Background & Aim: Domestic violence has many negative consequences on the physical, mental and well-being of pregnant women. Today, spiritual health is recognized as one of the most important factors in protecting individuals against physical and mental problems. The aim of the study was to investigate spiritual health and its relationship with demographic characteristics of pregnant women with domestic violence in the south of Iran.
Methods & Materials: This descriptive study was conducted in 2020 on 305 pregnant mothers with domestic violence experience, referred to comprehensive health centers in Jiroft. Subjects were selected by the convenience sampling method, and data were collected using the Spiritual Health Scale and the short form of the Domestic Violence Screening Scale. The data were analyzed using the SPSS software version 24 and independent t-test, analysis of variance and linear regression.
Results: The mean (and standard deviation) score of spiritual health was 79.89(18.98). Spiritual health score has a statistically significant inverse relationship with the women’s age (P<0.001, r_s=-0.18), duration of marriage (P<0.001 and r_s=-0.32), number of children (P<0.001, r_s=-0.26) and domestic violence (P<0.001, r_s=-0.65). The results of regression analysis showed that the duration of marriage, spouse occupation, and domestic violence were the predictors of participants’ spiritual health score (R²=0.45).
Conclusion: The findings of the study can help medical staff and social workers who are in contact with pregnant women experiencing domestic violence to identify and devise strategies to promote spirituality as a way leading these women towards health.

Effect of guided imagery on anxiety of the children candidate for tonsillectomy

Sharareh Khosravi

Background & Aim: Tonsillectomy is one of the most common pediatric surgeries. Preoperative anxiety in children is one of the concerns of caregivers, and its management is an important part of nursing care. The aim of this study was to investigate the effect of guided imagery on anxiety in children candidate for tonsillectomy.
Methods & Materials: In this clinical trial, 70 children aged 7 to 12 years, candidates for tonsillectomy in the ENT ward of Amirkabir hospital in Arak in 2021 were divided into experimental or control groups. A demographic information form and the face anxiety scale were used to collect the data. In the control group, anxiety was assessed one hour before and 15 minutes before the surgery. In the experimental group, one hour before the operation and after completing the questionnaire, the child was asked to listen to an audio file with the hands-free for 15 minutes and visualize it in his mind. Then, the anxiety scale was completed again.
Results: The mean score of anxiety before the intervention was 4.31±0.79 in the experimental group and 4.06±0.87 in the control group, which had no statistically significant difference. The mean score of anxiety after the intervention was 3.83±0.89 in the experimental group and 4.89 ± 0.90 in the control group, which showed the mean score of anxiety of children after the intervention had a statistically significant difference between the two groups (P<0.001).
Conclusion: The preoperative intervention reduced preoperative anxiety in the children candidate for tonsillectomy. This intervention is an easy and safe process and can be used as an effective method.
Clinical trial registry: IRCT20211008052701N1

Knowledge and attitude of mothers with teenage daughters towards early marriage, its causes and consequences

Mojgan Mirghafourvand

Background & Aim: Child marriage is a violation of human rights and children's rights. Since most of these marriages take place without the informed consent of children, and parents are the final decision makers. Therefore, the mothers’ attitude towards the marriage of girls can have an undeniable effect on the early marriage of their daughters. The aim of the present study was to determine the knowledge and attitude of mothers with teenage daughters towards early marriage, its causes and consequences.
Methods & Materials: This descriptive-analytical, cross-sectional study was conducted on 270 mothers with teenage daughters in Tabriz in 2020-2021. Data were collected using a researcher-made questionnaire, and were analyzed using descriptive statistics, one-way analysis of variance, Chi-square test and Fisher's exact test through the SPSS software version 21.
Results: More than half (55.2%) of the mothers had a good level of knowledge about early marriage. The majority of mothers (87.0%) were against marriage before the age of 18. There was a statistically significant relationship between mothers' knowledge and attitude towards early marriage (P<0.001). The emotional, social, intellectual and economic maturity of girls were the most important reasons for the decrease in early marriage, and one of the most important reasons for the increase in early marriage was not reaching intellectual-psychological maturity. The most important consequence of early marriage from the mothers' points of view was the high possibility of family involvement in married life and decision-making.
Conclusion: Despite the negative attitude of mothers towards early marriage, nearly half of them had poor and moderate levels of knowledge regarding early marriage. Therefore, raising the level of knowledge of mothers with teenage daughters about the consequences of early marriage, creating a culture to correct social misconceptions, passing appropriate laws to prevent child marriage, can reduce the severity of this harm.

Comfort status of the hospitalized patients with mental disorders in the psychiatric wards of Lavasani social security hospital in Tehran in 2020

Zahra Kashaninia

Background & Aim: Comfort is the ultimate goal in all the nursing processes. The aim of the study is to examine the comfort status of the hospitalized patients with mental disorders.
Methods & Materials: This study is a descriptive, cross-sectional study that was conducted on 275 patients hospitalized in the psychiatric wards of Lavasani hospital in Tehran in 2020. The study subjects were selected using the convenience sampling method. The patients completed a demographic form and the comfort questionnaire of psychiatric patients. Data were analyzed using descriptive and inferential statistics, independent t-test, analysis of variance, and the Scheffe test through the SPSS software version 24 at a significance level of 0.05.
Results: A total of 184 patients (66.9%) were male. The overall comfort score was 128.76, which was more than median based on the score from 38 to 190.
The highest scores in the dimensions of comfort, were respectively sociocultural domain (65.20±91.55), psychospiritual domain (64.19±31.50), physical domain (58.22±37.06), and environmental domain (49.19±22.39). The Scheffe test showed that the comfort score for the patients with sufficient income was significantly higher (P<0.001). Also, the patients who were employees had a higher comfort score compared to others (P=0.017).
Conclusion: The patients gained the least comfort score in the environmental domain, and the most comfort score in the sociocultural domain. Therefore, devising and implementing all nursing interventions are recommended with the aim of maintaining and improving comfort in the environment of psychiatric departments.

Severity and frequency of moral distress among nurses in clinical settings at teaching hospitals during the outbreak of COVID-19

Ebrahim Aliafsari Mamaghani

Background & Aim: The Covid‐19 pandemic has posed numerous ethical challenges to nurses and has exacerbated moral distress in clinical settings. Hence, due to the important role of nurses in pandemics, this study was conducted to investigate the severity and frequency of moral distress among nurses working in clinical settings at Maragheh teaching hospitals during the outbreak of COVID-19.
Methods & Materials: This was a cross-sectional study conducted on 174 nurses working in surgical-medical, intensive care, pediatric and emergency wards of Maragheh hospitals in 2020-2021. Data were collected using a demographic form and the Corley’s Moral Distress Scale.
Results: The median (Interquartile Range (IQR) = Q3 − Q1) of the severity and frequency of moral distress experienced were 54 (44-59) and 52 (43-58), respectively. The median of moral distress experienced in the intensive care and emergency wards were 56 (51-59) and 46 (43-51), which was more severe than that of in other wards. The median of frequency and severity of moral distress in men were 48 (41-59) and in women 50 (43-59), respectively, which was significantly higher than that of in women (P<0.001). The severity and frequency of moral distress had a statistically significant relationship with age, and work experience (P>0.05) so that with increasing age and work experience, the severity and frequency of moral distress decreased.
Conclusion: Given the high frequency of moral distress among nurses during the COVID-19 pandemic in specific clinical settings, the use of management strategies in order to improve working conditions and create a positive setting can be helpful. It seems that holding courses on coping with moral distress in nurses in the context of the COVID-19 pandemic is an appropriate practical solution.