Journal of Hayat

Protecting women’s health during the COVID-19 pandemic

Ali Mohammad Mosadeghrad

The COVID-19 pandemic has damaged the lives of many people physically, psychologically, and socio-economically, and put a lot of pressure on the health system. COVID-19 infected 628.3 million people and killed 6.6 million people in the world until November 3, 2022 (1). The pandemic has exposed vast economic and social inequalities and widened the existing gap in providing services for the most vulnerable people, including women and girls. Preliminary studies show that COVID-19 disease affects men more than women. The death rate of men infected with COVID-19 is about 60 to 80% higher than that of women (2). However, as the prevalence and duration of the disease increases, its effects on women become increasingly severe. This disease undermined the fundamental rights of women and girls. They suffer disproportionately from discrimination, neglect and abuse. The World Economic Forum estimated in 2021 that the global gender gap would take about 36 years to close after the COVID-19 pandemic (3).
Women make up about 70% of healthcare workers (4). Therefore, they are at higher risk of contracting the COVID-19 infection. Also, quarantine measures have led to deficiencies in sexual, reproductive and maternal health care, increased domestic violence, the increased workload of girls and women at home and their withdrawal from schools, universities and the labor market. In other words, the secondary effects of COVID-19 threaten the health and lives of women and girls.

A comparison of the effect of multimedia and telephone education on illness perception in patients with myocardial infarction after discharge: A randomized clinical trial

Mahdi Basiri Moghadam

Background & Aim: Health-related behaviors of patients with myocardial infarction (MI) are highly affected by their illness perceptions, and education is one of the ways to enhance illness perception. Accordingly, the aim of this study was to compare the effect of multimedia and telephone education on illness perception in patients with MI after discharge.
Methods & Materials: A randomized clinical trial was conducted on 32 patients with MI who were discharged in 2019-2020 in Gonabad and Mashhad. The samples were selected by the convenience sampling method and randomly assigned to the multimedia or telephone groups. The educational content was similar for both groups, and was provided as a conversation for the telephone group, and as video, audio, and image for the multimedia group. The Brief Illness Perception Questionnaire (Brief. IPQ) was completed by the patients on the first day and the sixth week after discharge. Data were analyzed through the SPSS software version 20 using Kolmogorov-Smirnov test, chi-square test, Fisher's exact test, independent t-test, Paired t-test and Levene's test, at a significance level of P<0.05.
Results: The results showed that the average score for the components of illness perception after the intervention compared to before the intervention in the both groups had a significant increase (P<0.05), but no significant difference was observed in the comparison between the two groups (P>0.05).
Conclusion: Both multimedia and telephone training methods improve illness perception in the patients. Therefore, the trainer is suggested to choose the type of training according to individual differences and facilities of the recipient, and health managers should apply appropriate policies for patients with MI to benefit from telenursing care after discharge.
Clinical trial registry: IRCT20190607043834N1

Translation and psychometric properties of the Persian version of "Readiness for Hospital Discharge Scale in Elderly Patients"

Abbas Heydari

Background & Aim: Today, ageing is a challenge for health and care systems, and one of its main consequences is an increase in the readmission rates. Therefore, in all countries, efforts are being made to reduce the readmission rate. The Readiness for Hospital Discharge Scale was designed to understand patients' readiness levels for discharge. This study was conducted to translate and evaluate the psychometric properties of the Readiness for Hospital Discharge Scale.
Methods & Materials: In this methodological study, a convenience sample of 500 elderly patients admitted to hospitals affiliated with Mashhad University of Medical Sciences was selected in 2020-2021. The instrument was translated using the forward-backwards method. The psychometric properties of the final version of the instrument were assessed by employing exploratory and confirmatory factor analysis (validity) and Cronbach's alpha and the Guttman's split-half coefficient (reliability).
Results: In the factor analysis, all items had a factor loading above 0.3 and, all of them were retained. The goodness of fit indices confirmed the model and a good fit of the model. The Cronbach's alpha coefficient for the whole scale and the Guttman's split-half coefficient were 0.92 and 0.86, respectively.
Conclusion: The results of our study supported the four-dimensional structure of this instrument and indicated that this instrument has adequate validity and reliability. Therefore, nurses and doctors can use this tool as a suitable method to measure the elderly patients' readiness for discharge and to achieve a safe transfer from the hospital to home.

Comparison of the effect of breast milk odor and Rosa damascena aroma on pain and duration of crying due to blood sampling in neonates: A cross-over clinical trial

Tabandeh Sadeghi

Background & Aim: Considering the use of aromatherapy as a non-pharmacological method of pain control and a scarcity of studies in this area, the aim of the study was to compare the effect of breast milk odor and Rosa damascena aroma on pain and crying due to blood sampling in neonates.
Methods & Materials: In this cross over clinical trial study, 40 neonates hospitalized in the NICU of Ali Ibn Abitalib hospital in Rafsanjan were divided into two groups (breast milk odor and Rosa damascena aroma). In the first step, tree minutes before blood sampling until its completion, cotton soaked in 2 cc of breast milk was placed at a distance of three centimeters from the neonate’s nose. In the next step, cotton soaked with two drops of rose essential oil was used, similar to the method of breast milk. For the second sample, the order of interventions was changed. The pain was calculated with the NIPS instrument and crying with a stopwatch by a person who was blinded to the groups. The data were analyzed by STATA software version 14.
Results: The mean score of pain for two periods in two groups were 3.75±2.33 and 4.30±1.70 respectively, and there was no significant difference between the two groups (P=0.415). The mean score of crying for two periods in two groups were 16.98±16.21 and 15.03±9.99 respectively, and there was no significant difference between the two groups (P=0.650).
Conclusion: The breast milk odor and rose damascena aroma have a similar effect in reducing the pain of neonates. Thus, according to the conditions, each of these methods can be used.
Clinical trial registry: IRCT20150713023190N11

Acceptance of illness and social, individual factors as the predictors of quality of life in hypertensive patients

Leila Mirhadyan

Background & Aim: Many factors affect the hypertensive patients’ quality of life. Identifying the factors related to the quality of life can help to promote the quality of life in hypertensive patients. This study aimed to determine the predictive role of illness acceptance and social, individual factors in the hypertensive patients’ quality of life.
Methods & Materials: This correlational, cross-section study was conducted in 2020-2021 on 245 hypertensive patients referred to a hypertension clinic in Lahijan selected by the convenience sampling method. Data were collected by a questionnaire, including demographic information, Acceptance of Illness Scale and the WHO's Quality of Life-Brief questionnaire. Data were analyzed by multiple linear regression at a 95% confidence level using the SPSS software version 23.
Results: The mean score for the quality of life was 65.32±12.18 (0-100) and for the acceptance of illness was 31.83±4.98 (8-40). Age, sex, employment status, marital status, monthly income, family arrangement and the acceptance of illness were identified as the predictors of quality of life in hypertensive patients (P<0.001). According to the coefficient of determination (R²=0.401), the variables of the final regression model explained about 40% of the quality-of-life changes among hypertensive patients.
Conclusion: Given that the acceptance of illness and some social, individual factors can affect the hypertensive patients’ quality of life, focus on the strategies to promote the acceptance of illness and paying attention to social, individual factors can help improve the quality of life among hypertensive patients.

Effect of topical heat therapy on clinical symptoms of peripheral neuropathy in patients with type II diabetes: A clinical trial

Mahnaz Parimoo

Background & Aim: Diabetic neuropathy is found in 50% of people with diabetes and refers to a group of diseases that affect all nerves such as peripheral, autonomic and spinal nerves. This study aimed to investigate the effect of topical heat therapy on clinical symptoms of peripheral neuropathy in patients with type 2 diabetes.
Methods & Materials: The present study was a randomized controlled clinical trial conducted on 52 patients with type 2 diabetes with peripheral neuropathy referred to the clinic of Allameh Behlool Gonabadi Hospital in 2018. The participants were randomly divided into two groups of intervention and placebo. The intervention group received heat therapy using a hot pack at 40 ° C twice a day for 20 minutes for a week. The control group received all routine care similar to the intervention group. A demographic information form and NSS questionnaire were used to collect the data through interview. Data were analyzed using the SPSS software version 23 at a significance level of less than 0.05.
Results: The mean scores of neuropathy symptoms before and after the intervention were 5.46±1.90 and 4.12±1.55 respectively for the intervention group, and 4.88±1.53 and 5.08±1.52 for the control group that no significant difference was observed between the both groups before the intervention (P=0.23), but there was a statistically significant difference after the intervention (P=0.03). Also, the comparison of the mean scores of two groups after the intervention showed a significant difference (P<0.001).
Conclusion: The findings showed that topical heat therapy can improve the clinical symptoms of peripheral neuropathy. Since this technique is easy to learn and inexpensive, it can be used to reduce treatment costs and drug side effects, as well as to improve patient self-care.
Clinical trial registry: IRCT20181015041354N1

Domestic violence during pregnancy and its predictive factors during the COVID-19 epidemic among primiparous women in Isfahan

Fatemeh Torabi

Background & Aim: COVID-19 is one of the crises that seriously threatens the individuals’ mental health, especially pregnant women. On the other hand, the COVID-19 quarantine can affect the occurrence of domestic violence in pregnant women. The aim of the current study was to investigate the prevalence of domestic violence in pregnancy and the factors affecting it during the COVID-19 pandemic.
Methods & Materials: This was a descriptive-correlational study conducted on 308 primiparous mothers referred to health centers in Isfahan in 2021. The participants were selected using the multi-stage sampling method. Data was collected using a demographic characteristics form and the domestic violence questionnaire. Data analysis was done through the SPSS software version 22 using the Spearman's correlation coefficient, Mann-Whitney and Kruskal-Wallis tests.
Results: A total of 59 mothers (19.2%) experienced domestic violence during their pregnancy (a score of 60 and above from the domestic violence questionnaire). The most prevalent type of violence (including perceived) was psychological violence with 74.4% (229 people), followed by economic, sexual, and physical violence with 35.1% (108 people), 17.2% (53 people), and 14.9% (46 people) respectively. A significant relationship was found between domestic violence during pregnancy and the number of siblings, birth order, the educational level of mother and her husband, and husband’s occupation (P<0.05).
Conclusion: The COVID-19 pandemic has made pregnant women more vulnerable to domestic violence. There are many individual and cultural factors contributing to domestic violence. Some factors were identified as the predictors of violent behavior such as the educational level of woman and her husband, and occupation. Identifying these factors and screening of domestic violence during pregnancy can prevent the occurrence of violent behavior by the spouse and the negative consequences of domestic violence on the mother and her fetus.

The quality of nursing care in nurses working in the intensive care unit of COVID-19 in Arak medical training centers in 2021-2022

Ezzat Jafarjalal

Background & Aim: Attempting to improve the quality is an important issue in the nursing service and care system. The COVID-19 pandemic has created great challenges for healthcare systems, especially for the intensive care units, which can affect the quality of nursing care provided to these patients. The aim of this study was to determine the quality of nursing care in nurses working in the intensive care unit of COVID-19.
Methods & Materials: In this descriptive-cross-sectional conducted in 2021-22, 142 nurses from Valiasr, Amir Kabir, Amir al-Momenin and Khansari hospitals affiliated to Arak University of Medical Sciences were selected by the census method. The Martins’ nursing care quality questionnaire (including 25 items in 7 domains) was completed by the participants. The SPSS software version 16 and independent t-tests, analysis of variance and the Pearson's correlation coefficient were used for the data analysis.
Results: The result showed that the mean score of the nursing care quality was 83.83±7.74, which was considered favorable due to being higher than the median score of the tool (62.5). Among the individual characteristics of nurses, the nursing care quality had a statistically significant relationship with the type of employment (P=0.003), age, work experience and work experience in the intensive care unit (P<0.001).
Conclusion: Considering the significant relationship of the nursing care quality with the type of employment, age and work experience, it is recommended that health managers take an effective step in formulating the necessary policies to improve the quality of nursing care by taking into account the experience of skilled nurses in intensive care units.