Journal of Hayat

The effectiveness of cognitive-behavioral therapy in alleviating COVID-19-related anxiety, fear of negative evaluation, and depression among women diagnosed with anorexia nervosa

Farzin Bagheri Sheykhangafshe

Background & Aim: Eating disorders manifest numerous psychological and social consequences for both individuals and society. The present study was conducted to investigate the effectiveness of cognitive-behavioral therapy in alleviating COVID-19-related anxiety, fear of negative evaluation, and depression among women diagnosed with Anorexia Nervosa.
Methods & Materials: This study employed a quasi-experimental pre-test-post-test design with a control group. The research population consisted of women diagnosed with anorexia nervosa in Tehran in 2022. Thirty participants were selected through convenience sampling from psychological clinics in the 6th and 8th districts of Tehran, and were randomly assigned to either the intervention group (n=15) or the control group (n=15). Questionnaires assessing eating attitudes, COVID-19-related anxiety, fear of negative evaluation, and depression were administered to both groups. The intervention group received a total of eight 90-minute sessions of cognitive-behavioral therapy, while the control group did not receive any intervention. The collected data were subsequently analyzed using multivariate analysis of covariance through the SPSS software version 24.
Results: The results of the study showed that cognitive-behavioral therapy led to a significant reduction in mental anxiety related to COVID-19 (P<0.001, F=36.41), physical anxiety related to COVID-19 (P<0.001, F=39.15), fear of negative evaluation (P<0.001, F=41.92), and depression (P<0.001, F=47.48) in women diagnosed with anorexia nervosa (P<0.001).
Conclusion: Cognitive-behavioral therapy demonstrated efficacy in alleviating psychological disorders among women diagnosed with anorexia nervosa. Given the potentially severe impairment of mental health experienced by numerous individuals with anorexia nervosa, it is imperative to implement measures for identifying and providing psychological interventions to vulnerable groups.

Comparison of the effect of EMLA ointment and lidocaine spray, along with the use of rhythmic breathing on the intensity of pain caused by the insertion of needles in the arteriovenous fistula among hemodialysis patients: A clinical trial

Ali Mohammadpour

Background & Aim: Patients undergoing hemodialysis commonly experience discomfort due to the insertion of needles into their arteriovenous fistula. The aim of the study was to compare the effect of EMLA ointment and lidocaine spray, along with the use of rhythmic breathing on the intensity of pain caused by the insertion of needles in the arteriovenous fistula among hemodialysis patients.
Methods & Materials: This study was a randomized clinical trial conducted on a total of 80 patients who were referred to Imam Khomeini and Golestan hospitals in Ahvaz in 2022. The numerical pain measurement scale was used as the data collection tool. The participants were selected using the convenience sampling method and then randomly allocated into two groups. In the EMLA ointment group (n=39), a total of 2 grams of EMLA ointment was applied to the target area 60 minutes before the hemodialysis procedure. In the lidocaine spray group with rhythmic breathing (n=41), 2 puffs of lidocaine spray were administered along with rhythmic breathing 5 minutes prior to needle insertion. The pain intensity was then measured and recorded. The collected data was analyzed using descriptive and inferential statistics in SPSS version 20, with a significance level set at 0.05.
Results: The group receiving EMLA ointment and the group receiving lidocaine spray, with rhythmic breathing had mean pain scores of 1.95±1.09 and 2.12±1.10, respectively. Although the mean pain score in the EMLA ointment group was lower than that in the lidocaine spray group with rhythmic breathing, the difference was not statistically significant (P=0.479).
Conclusion: The findings of this study indicate that both EMLA ointment and lidocaine spray, along with the use of rhythmic breathing, have comparable efficacy in reducing pain among hemodialysis patients. Therefore, considering the patient's condition, the utilization of either of these methods is recommended.
Clinical trial registry: IRCT20220512054826N1

Comparison of the effectiveness of emotional expression through writing and narration in reducing post-traumatic stress and postpartum depression among women undergoing emergency cesarean section

Somayyeh Khazaeian

Background & Aim: The utilization of emotional expression methods, including narrative counseling and written emotional expression, has been shown to be efficacious in mitigating the intensity of diverse psychological issues such as depression and acute stress, particularly following traumatic events. Additionally, emergency cesarean section is commonly acknowledged as a traumatic event that may lead to psychological challenges for the mother. The purpose of this research was to compare the effectiveness of emotional expression through writing and narration in reducing post-traumatic stress and postpartum depression among women undergoing emergency cesarean section.
Methods & Materials: This quasi-experimental study was conducted in Zahedan, involving a total of 120 women who underwent emergency cesarean section and were admitted to Ali Ibn Abi Talib (AS) hospital during the period of 2021-2022. The participants were selected using convenience sampling and were randomly divided into three groups: written emotional expression, narration and control, with each group consisting of 40 participants. The intervention consisted of one face-to-face session and two non-face-to-face sessions. Data collection involved the use of the Edinburgh Depression Questionnaire and PTSD assessments, administered before and six weeks after the intervention across all three groups. The data were analyzed using SPSS version 24, employing descriptive and inferential tests such as ANOVA and Tukey's post hoc analysis.
Results: The results showed a significant decrease in the average scores of post-traumatic stress and postpartum depression in the written emotional expression and narration groups, compared to the control group, after the intervention (P<0.05). However, before the intervention, there were no significant differences observed among the three groups (P>0.05). Furthermore, a higher mean difference was observed in both post-traumatic stress and postpartum depression scores before and after the intervention in the written emotional expression group, compared to the narration group, indicating a greater effect of written emotional expression (P<0.001).
Conclusion: Based on the research findings, highlighting the positive effect of both narration and written emotional expression, it is recommended to incorporate these techniques as supplementary components within comprehensive educational and care programs for women experiencing traumatic childbirth.

Exploring the determinants of childbearing decision-making among women and men of reproductive age: A qualitative study

Mina Hashemiparast

Background & Aim: In recent years, significant changes have occurred in the dynamics of childbearing within familial context. Notably, Iranian families have witnessed a noticeable decline in the desire for childbearing and having additional children. The aim of this study was to explore the determinants of childbearing decision-making among women and men of reproductive age.
Methods & Materials: This study adopts a qualitative research design using the conventional content analysis approach in 2023. The participants comprised 19 married women and men of reproductive age living in Zanjan, who were purposively selected to ensure maximum variation. After obtaining informed consent, the participants were invited to participate in individual, semi-structured interviews. Data collection continued until data saturation was reached, with concurrent analysis conducted throughout the process. The textual data were managed using MAXQDA software, version 2020.
Results: Throughout the inductive data analysis process, seven main categories emerged as determinants of decision-making about childbearing. These categories included social role modeling, reflection within family structure, social and economic requirements, contemporary concerns in parenting, avoidance of responsibility and comfort-seeking, unpleasant past experiences and age-related challenges. Among these categories, social and economic requirements emerged as the most prevalent concept across all interviews, with a total of 505 open codes associated with this category.
Conclusion: The normalization of reduced childbearing rates within the society, accompanied by shifting values and attitudes towards the significance of children, as well as economic and social problems have contributed to an increasing preference for smaller families. Furthermore, the desire for fewer children can be viewed as a response to the individualistic tendencies of women and men, as well as a means of avoiding parenting concerns.

Developing code of ethics in midwifery counseling: A modified Delphi study

Razieh Lotfi

Background & Aim: The interdisciplinary nature of the profession of counseling in midwifery underscores the need for the establishment of an ethical framework to guide the provision of counseling services in various areas of midwifery and women's health. Consequently, the present study has been conducted with the objective of formulating code of ethics in midwifery counseling.
Methods & Materials: The present study is a developmental study using the Delphi method, which was conducted in three stages in 2020. The first stage involved qualitative content analysis to review the texts, and the development of an initial draft of ethical codes. In the second stage, expert opinions were sought from professionals specializing in medical and midwifery ethics to evaluate and make revisions to the initial draft. The third stage involved validation of the draft codes and their finalization.
Results: According to the results of the qualitative content analysis, a total of 182 codes were obtained from the texts and classified into eight categories. However, through the Delphi rounds, the number of categories was subsequently reduced to six, resulting in a decrease in the number of codes to 121. The identified categories included; "Professional competence", "Professional communication", "Management of client data", "Ethical considerations in tele-counseling", "Ethical considerations in midwifery counseling education”, and "Ethical considerations in research". These categories were established with a consensus level of 92.4%.
Conclusion: In this research, a set of ethical codes was obtained from the experts’ opinions in relevant disciplines from various universities across the country, with appropriate validity and consensus levels. These codes can be used in providing counseling services in midwifery, promoting safety and adhering to ethical principles and values.

Exploring health behaviors of pregnant women during the COVID-19 pandemic: A qualitative content analysis

Anvar-Sadat Nayebinia

Background & Aim: Infectious diseases represent a significant health concern within human communities. Considering the importance of pregnancy, the present study was conducted with the aim of exploring the health behaviors exhibited by pregnant women during the COVID-19 pandemic.
Methods & Materials: This qualitative study employed the conventional content analysis approach to examine a cohort of 16 pregnant women in 2021. The research was conducted within the health centers of Ilam, employing the purposeful sampling technique and unstructured interviews to collect the data. Simultaneous to the data collection, conventional content analysis was employed to analyze the data. MAXQDA version 10 software was utilized for data management purposes.
Results: The participants had a mean age of 30 years, while the average gestational age was 30.38 weeks. Through analysis, three main themes and eight categories were derived from the collected data. The main themes identified were as follows: 1- self-care practices for disease prevention, 2- the adverse effects of the pandemic on pregnancy, and 3- changes in the healthcare system.
Conclusion: The results of the present study highlight the emergence of a novel form of self-care among pregnant women as a consequence of the COVID-19 pandemic. The adverse effects of the pandemic, such as quarantine measures, were associated with the development of negative ruminations within pregnant women. Following the quarantine restrictions, significant modifications were observed in the ways through which women sought health-related information and engaged in daily activities. Moreover, alterations were made to care policies. Paying attention to the comprehensive health needs of pregnant women, including both physical and mental health, is imperative within the context of pandemic-related health services.

Effect of tele-rehabilitation nursing on health locus of control in patients with knee osteoarthritis: A randomized clinical trial

Narges Arsalani

Background & Aim: Knee osteoarthritis as a common chronic illness leading to disability, imposes numerous challenges on individuals in terms of daily living and self-care. Therefore, the implementation of tele-rehabilitation nursing interventions that foster patients' internal health locus of control and enhance the development of self-care behaviors may be useful. This study aimed to determine the effect of tele-nursing rehabilitation on the health locus of control in patients with knee osteoarthritis.
Methods & Materials: In this randomized clinical trial study, a total of 34 patients with knee osteoarthritis referred to the rehabilitation clinics affiliated with Shiraz University of Medical Sciences in 2022 were enrolled. The intervention group participated in an 8-session tele-rehabilitation nursing program, while the control group received standard routine care. The Multidimensional Health Locus of Control scale was administered to both groups on three separate occasions. The data were subjected to descriptive and inferential statistical analyses using SPSS software version 26.
Results: According to the results from a two-way repeated measures analysis of variance (ANOVA), a statistically significant difference was observed solely in the trend of changes in the mean score of internal belief between the two groups and over the study time period (P<0.001). Specifically, the scores of the intervention group exhibited a significant increase over time, surpassing those of the control group.
Conclusion: The implementation of tele-rehabilitation nursing care, which emphasizes patient responsibility for their internal health locus of control can improve self-care. Therefore, it is recommended that nurses employ this approach in managing additional chronic conditions.
Clinical trial registry: IRCT20220216054038N1

Incidence rate of pressure ulcers and associated factors among children and newborn hospitalized in teaching hospitals

Seyedeh Fatemeh Ghasemi

Background & Aim: Pressure ulcers pose a serious and anticipated challenge within the health system. The present study aimed to determine the incidence of pressure ulcer and associated factors among children and newborns.
Methods & Materials: In this cohort study a sample size of 1025 children aged 0 to 14 years hospitalized in two medical training centers affiliated with Kermanshah University of Medical Sciences, were included. The sampling method employed was convenience sampling, conducted between March and July 2022. The data collection tools utilized in this study included a demographic information questionnaire, the Glasgow Coma Scale, National Pressure Ulcer Counseling Association classification, and Braden Q Scale. The data was analyzed using both univariate and multivariate logistic regression analyses.
Results: The incidence rate of pressure ulcers was found to be 4.97% (51 people). In terms of severity, the majority of pressure ulcers were categorized as first grade, accounting for 82.14% (46 people), with the hand area being the most frequently affected site of ulceration, representing 35.71% (20 people). The factors exhibited a significantly higher relative risk of pressure ulcers in children and infants included consciousness level of less than 14 (RR=6.07, 2.90-12.73: 95%CI), hospitalization duration of more than five days (RR=1.08, 1.05-1.12: 95%CI), presence of respiratory problems (RR=2.17, 1.19-3.94: 95%CI), immobility (RR=6.46, 3.44-12.13: 95% CI), utilization of NCPAP mask (RR=1.11, 1.05-1.18: 95% CI), and pulse oximeter (RR=6.07, 1.03-1.10: 95% CI). In the multivariate analysis, hospitalization duration of more than five days (RR=4.89, 2.29-10.40: 95% CI, P<0.001) and immobility (RR=2.49, 1.29-6.29: 95% CI, P=0.01) were found to be significantly associated with an increased risk of pressure ulcers.
Conclusion: The incidence rate of pressure ulcers observed in the present study was relatively low, measuring below 5%. Notably, prolonged hospitalization duration and immobility were identified as the most important risk factors contributing to the development of pressure ulcers among children and infants. Moreover, the utilization of specific medical devices, especially angiocaths and NCPAP masks, as well as the presence of respiratory diseases emerged as additional significant factors associated with the occurrence of pressure ulcers.