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Introduction: Infertility and depression are major problems of today&aposs societies. Although depression is one of the most prevalent diseases in primary care practice, consult for receiving help is carried out much less than true prevalence of the disease. Therefore gathering information about prevalence and risk factors of depression is very valuable. Beck Depression Inventory (BDI) which is a screening tool for depression can be used in Iranian patients because of availability of a validated translation. The objective of this study was to estimate the prevalence of depression in infertile subjects in an infertility center.

Materials and Methods: In this study, 681 infertile women were evaluated in Shariati Hospital, Tehran. Demographic information’s including age, duration, type and cause of infertility, level of education, previous treatments and smoking habits were recorded. BDI was completed by patients and score was estimated. Score of 16 and higher was assumed positive.

Results: There was no relationship between age and prevalence of positive BDI score, but prevalence of positive BDI score was higher in infertilities of longer duration, infertilities caused by both male and female factors and in patients with low level of education and history of previous treatment or surgical therapy.

Conclusion: Infertile patients are at risk of depression. Rate of consulting with psychiatrists and getting help is low in our country due to cultural aspects, so screening of high risk subgroups in infertile patients and referring them to psychiatrist would be very helpful.

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Background & Aim: Recent studies suggest that patients&apos perceptions might be more important than objective clinical assessments in determining quality of life (QOL) in patients with End Stage Renal Disease (ESRD). The aim of this study was to determine QOL in patients experiencing ESRD and its related factors.

Methods & Materials: In this descriptive-correlational study, we recruited 202 hemodialysis patients from Iran University of medical sciences&apos hemodialysis units using convenience sampling method. Data were collected using "Ferrans and Powers quality of life Index- dialysis version" instrument and analyzed using SPSS-14.

Results: Findings showed that the patients had a high perceived QOL. Lowest satisfaction mean scores were for the items "your health" (M=3.80, SD=1.74), "being able to take care of your financial needs" (M=3.31, SD=1.85), "achieving your personal goals" (M=4.02, SD=1.63), and "your family&aposs happiness" (M=4.96, SD=1.27). It was reported that "probably you will get a kidney transplant" (M=4.22, SD=2.15), "neighborhood" (M=4.32, SD=2.09, "personal appearance" (M=5.67, SD=0.91), and "your spouse"(M=5.84, SD=0.61) also had lowest mean score for importance from patients point of view. Financial status, educational levels, marital status and number of children were all associated with the QOL (P≤0.05). There were no relationship between age, sex, occupational status, with duration of dialysis treatment (P>0.05).

Conclusion: This study denoted financial status, educational levels, marital status and number of children is related to QOL of hemodialysis patients. So, these factors that affect quality of life may promote health and wellbeing and may increase survival in hemodialysis patients. The findings of this study can assist providers in planning and implementing educational and support programs for patients and their family.

 

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Background & Aim: Spiritual well-being harmonizes several dimensions of human's life and is essential for coping with diseases. Chronic illnesses such as cancer cause crisis in physical, psychological, and spiritual dimensions of ones life. This study aimed to measure the spiritual well-being in cancer patients who undergo chemotherapy.

Methods & Materials: In this cross-sectional, descriptive-correlational study, Paloutzian & Ellison's Spiritual Well-being Self-report questionnaire was completed by 360 cancer patients. Patients were recruited using sequential sampling method. The inclusion criteria were being more than 20 years old, and being able to read and write. Data were analyzed using chi-square and Pearson tests in SPSS (version 11).

Results: The study findings revealed that the mean scores for spiritual well-being, religious well-being, and existential well-being were (98.35±14.36), (54.67±5.92), (43.67±10.01), respectively. Also, statistically significant relations were found between age, marital status, and educational levels with spiritual well-being (P<0.001).

Conclusion: Findings showed that the level of spiritual well-being was high in cancer patients. Moreover, as it is expected in Iranian culture, the level of religious well-being was more than existential well-being. There were significant relationships between spiritual well-being and personal characteristics. Hence, nurses should consider personal characteristics in their caring programs and choose a comprehensive and holistic approach toward their patients' care.

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Background & Aim: Physical and psychosocial problems along with the changes in life style, put hemodialysis patients under pressure. It seems that social support decreases psychological stresses and improves quality of life. This study aimed to describe hemodialysis patients&apos perceptions on their social supports and related factors.

Methods & Materials: This descriptive-correlational study is a part of a larger study. All patients (n=202) referred to the hemodialysis units of Iran University of Medical Sciences were recruited to the study during a four-months period. Data were collected using "Personal Resources Questionnaire" (PRQ 85-PART 2) and analyzed using SPSS v.14.

Results: Findings revealed that the most patients (64.9%) had perceived social support at high levels. There were significant relationships between social support with economic status, gender and marital status (P<0.05). Findings also indicated that the statements of "I enjoy doing little extra things that make another person&aposs life more pleasant" and, "I belong to a group in which I feel important" had the highest and lowest scores respectively.

Conclusion: Regarding the variety of perceptions in hemodialysis patients on social support and its related factors, nurses can prevent social isolation of these patients through identification of high risk groups and can also reduce their stresses and help them to improve their quality of life by providing adequate supportive interventions.

 

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Background & Objective: Labor pain is usually the most severe pain women experience in their lives. Most women suffer from low back pain during first stage of labor. The pain can produce adverse effects on delivery procedure. Because of potential side effects of medications used in labor, alternative methods for pain relief have received more attention nowadays. The aim of this study was to evaluate the effect of subcutaneous injection of sterile water on labor pain, type of labor, and satisfaction with pain management in nulliparous women.
Methods & Materials: This was a randomized single-blind study. Samples were consisted of 80 women who were randomly allocated to two intervention and control groups. In the intervention group (40 women) sterile water was injected subcutaneously in four sacral regions during first stage of labor. In the control group, we just inserted a needle in the same area. Low back pain intensity was assessed before and 10, 45, and 90 minutes after the injections using visual scales in both groups. Data were analyzed using descriptive (relative & absolute frequencies, mean and standard deviation) and inferential statistics (t-test, paired t-test and c²) in the SPSS.
Results: There was no significant difference between two groups at baseline. The mean of pain intensity in 10 and 45 minutes after the injection was decreased significantly in the intervention group (P=0.00). There was no significant difference between two groups in the 90^th minute. There was no difference in the type of labor between two groups. The mean of the satisfaction score was higher in the intervention group than in the control one.
Conclusion: It seems that subcutaneous sacral injection of sterile water might be an effective and safe method to alleviate labor pain in women

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Background & Aim: Violence in workplaces threatens safety of personnel. Among health care personnel, nurses are more exposed to verbal and physical violence. The aim of this study was to assess confrontation of nurses with verbal and physical violence in hospitals of Babol University of Medical Sciences.

Methods & Materials: In this field study, all of nurses employed in hospitals of Babol University of Medical Sciences (n=302) were recruited to the study. Data were gathered using standardized questionnaire including four parts. Data were analyzed using descriptive and analytic (Chi square and Fisher&aposs exact test) statistics.

Results: More that 70% of the nurses had an experience of violence during their work period. Male nurses were more exposed to violence than the female nurses. Most of the violence was done by patients&apos relatives (40.4%).

Conclusion: The results showed that most of the participants had the experience of violence done by patients&apos relatives. In order to minimize violence in hospitals, preventive strategies including proper management, proper protection, and public education should be considered.

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Background & Aim: Infants are very sensitive and special attention is needed to take care of their physical and mental health. Some studies showed that massage by parents can improve infants&apos sleep quality. The aim of this study was to compare the effect of massage with sunflower oil or sesame oil on infants&apos crying and sleep times.

Methods & Materials: This triple-blinded clinical trial was conducted on 120 infants who were 10-15 days old, full-term, single, exclusively breastfed and with no history of hospitalization. The infants were assigned randomly into three groups of sunflower oil massage, sesame oil massage and massage with no oils. Mothers administered 15 minutes of massage to their infants twice per day (morning and afternoon) for 28 days. Times of crying and sleep were measured by a parents&apos information form at baseline, and at the end of the first, second, third, and fourth weeks of the study. Data were analyzed using the repeated measures ANOVA.

Result: Within four weeks of following, decreasing pattern of infants crying time was not significant (P=0.18) however, the mean of crying time between the three groups was significant (P=0.007). The interaction effect of crying time and groups was not significant (P=0.18). Increasing pattern of infant sleep time was statistically significant in the fourth weeks of the following (P<0.001) however, the mean of sleep time between three groups was not significant (P<0.56). The interaction effect of sleeping time and groups was not significant (P<0.10).

Conclusion: Since there were not statistical significant differences between the infants&apos crying and sleep times between the three groups, and despite the fact that increasing pattern of infants sleep time is a normal pattern, it is not possible to have a proper conclusion.

 

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Background & Aim: Postoperative nausea is a common problem after general anesthesia, especially in ambulatory surgery. In ocular surgeries including strabismus surgery, intraocular pressure increase may lead to eye damage. Drug therapy has various side effects. The purpose of this study was to evaluate acupressure on nausea in patients undergoing strabismus surgery.

Methods & Materials: In this double-blinded clinical trial, 60 patients undergoing strabismus surgery were allocated into intervention and control groups. In the intervention group, a sea-band was placed on the P6 point of patients&apos wrists 30 minutes before induction of anesthesia. In the control group, the sea-band was placed in the opposite position of the patients&apos wrists. Data were collected during six hours after surgery in the recovery room. Data were analyzed using Chi square, t-test, and Mann-Whitney tests.

Results: There were no differences in demographic and surgical characteristics between the two groups at baseline. The intensity of nausea in the recovery room (P=0.002) and six hours after surgery (P<0.001) were significantly less in the intervention group than the control group.

Conclusion: Based on the findings of this study, acupressure decreases post operative nausea. Acupressure is a simple, noninvasive and cost- effective intervention which can be applied by nurses to prevent post operative nausea.

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Background & Aim: Pain can detrimentally affect physical functioning, psychological well-being and social interaction. Various attitudinal factors may be associated with inadequate pain control. Hence, studies should be undertaken to gain a better understanding of association between pain control attitudes and use of analgesics and cancer pain intensity. This study aimed to determine relationship between pain control attitudes and use of analgesics and pain intensity in cancer patients with pain.

Methods & Materials: A descriptive cross-sectional study was conducted with 200 cancer patients who underwent chemotherapy or radiotherapy and experienced pain in previous 24 hours. The pain control attitudes, use of analgesics, worrisome about using analgesics and physical and psychological impacts of pain were measured using questionnaires. The cancer pain intensity was measured using the visual analogue scale. Validity and reliability of the instruments were evaluated. Data were analyzed using independent t-test and ANOVA.

Results: About 58% of patients agreed that they would wait before asking for help. Beside, the findings indicated that willing to tolerate pain and perceived control over pain were associated with the time and frequency of taking analgesic and pain intensity in previous 24 hours and last week. Also concerns about addiction to pain-relieving medications were related to the analgesic type and pain intensity within last week (P=0.03), and fear of injection was related to analgesic use and pain intensity within last week (P<0.001).

Conclusion: Many cancer patients had attitudes which could interfere with pain relieving. Suggestions are made for developing patient education programs, accessing effective cancer pain controls and decision making for cancer pain relief.

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Background & Aim: Endotracheal suctioning (ETS) is a common invasive nursing procedure. Hemodynamic parameters changes during and after the procedure. If appropriate strategies do not be applied during the ETS, hemodynamic changes can be significant and life threatening in critically ill patients. The purpose of this study was to assess the effect of education of endotracheal suctioning on patients&apos hemodynamic parameters.

Methods & Materials: This was a non-equivalent quasi-experimental study conducted in two critical care units in Hazarat Rasool hospital. All nurses working in these two units participated in the study in a period of two weeks. Systolic blood pressure, diastolic blood pressure and mean blood pressure of all patients who needed suctioning were measured before and after the endotracheal suctioning. We analyzed the data using the SPSS.

Results: At baseline, the systolic, diastolic and mean arterial blood pressures increased significantly (P=0.02) in the first and third minutes post-suctioning. In post-education phase, diastolic and mean arterial blood pressure increased significantly (P<0.001) in the first minute post-suctioning. In the third minute post-suctioning, systolic, diastolic and mean arterial blood pressure decreased (P=0.43).

Conclusion: The study findings showed significant changes in hemodynamic parameters after post-endotracheal suctioning. In this study, conducting endotracheal suctioning education improved the outcomes of hemodynamic parameters in patients. Educational programs can improve nursing care outcomes by preventing and minimizing hemodynamic changes during and after the suctioning in critically ill patients.

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Background & Objective: Nursing students usually experience various types of stress. Lack of stress coping strategies result in more stress, incompatibility, manifestation of disorders, and mental health problems. This study carried out to assess the methods of coping with stress among nursing students.

Methods & Materials: In this cross-sectional study, 358 male and female bachelor of nursing students studying at Tehran University of Medical Sciences during the first semester of 2011-2012 were selected. Data were collected using the Coping Inventory for Stressful Situation and a demographic questionnaire. The data was analyzed using descriptive and inferential statistics in the SPSS-14.

Results: There were 66.2% female and 33.8% male students in the study. The age of the students ranged 17-29 years. Most of the students aged 20-22 years (45%), were single (90.8%), were habitants of Tehran (53.1%), had an average economic status (72.1%), and were employed (20.9%). Of all, 19.3% had experienced stressful events in the last three months. A small number of the students (4.7%) suffered from chronic diseases. The nursing students mostly used problem-oriented coping style (56%). The emotion-oriented method was used among 45.99% of the students and the avoidance-oriented style was used among 39.34% of the students. There were no statistically significant relationship between the coping styles and the demographic characteristics.

Conclusion: The problem-oriented, emotion-oriented, and avoidance-oriented styles were the most frequent styles used by the students, respectively. The mental health, particularly among nursing students who deal with patients and have important role in the health system, is important and requires special attention. The stress coping styles should be inserted in the educational curriculum of the nursing schools.

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Background & Aim: Stress is a main problem among nurses which affects their professional performance and personal life resulting in conflict between work and life. The aim of this study was to determine the effect of stress management on work-family conflicts.

Methods & Materials: In a quasi-experimental two-group study, 64 medical nurses were selected randomly to the study from Shahid lavasani hospital in Tehran. Data were gathered using a questionnaire including demographic characteristics, work-family conflict items, and nursing stress scale. Then, the experimental group participated in a 2-day stress management course. The questionnaire was completed by the participants one month later. Data were analyzed in the SPSS v.18.

Results: The mean work-family conflict score was 3.97 in the experimental group at baseline. It declined after the intervention to 3.357 (P<0.001). There was statistically significant difference between the two groups on work-family conflict after the intervention (P=0.007). There was a significant decrease in the job stress from baseline (46.52) to the post-intervention measurement (35.61) in the experimental group (P<0.001). There was a statistically significant difference between the two groups in the mean of job stress after the intervention (P=0.014).

Conclusion: Stress management education declined work-family conflict and job stress among nurses. This education should be used in nursing clinical and educational training programs.

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  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.

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  Background & Aim: Technology advancement has increased the survival rates of premature infants. Preterm newborns frequently experience oral feeding difficulties due to lack of coordination in sucking, swallowing and respiration. This may negatively affect attainment of independent oral feeding skill and leads to longer hospital stays. This study aimed to examine the effects of non-nutritive sucking vs. oral massage therapy on attainment of independent oral feeding and length of stay in the NICU .

  Methods & Materials: This clinical trial was conducted on 72 premature infants (28-32 week gestational age) hospitalized in the NICU of Alzahra Hospital in Tabriz in 2013. The eligible infants were randomly allocated to one of the three groups: oral massage, non-nutritive sucking, and control groups. Newborn infants in the oral massage group received pre- and intraoral massage therapy (before gavage) for at least 10 days. The newborn infants in the non-nutritive sucking group were encouraged to suck on a finger of mother or the researcher before gavage. The control group received usual care. The time to attain independent oral feeding and length of stay in the hospital were compared in the groups . 

  Results: Compared to the control group, the time to oral intake was significantly shorter in both experimental groups (P<0.001). There was no significant difference between the duration to achieve independent oral feeding status among the groups (P=0.915). Length of stay in the hospital did not significantly differ among the three study groups (P=0.342) .

  Conclusion: Findings indicated that both oral massage and non-nutritive sucking therapy groups could accelerate attainment of independent oral feeding in premature newborn infants .

  

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  Background & Aim: Virtual education can be delivered via different routes. The purpose of this study was to investigate the effectiveness of interactive and non-interactive virtual educations about brain death and organ transplantation on knowledge and satisfaction of education among intensive care nurses .

  Methods & Materials: This quasi-experimental study was conducted on intensive care nurses of hospitals affiliated to Tehran University of Medical Sciences in 2014 . Participants were selected through a convenient sampling method and were assigned into two groups with 32 participants in each. The first group participated in an interactive electronic education while the second group received a non-interactive education about brain death and organ transplantation . Knowledge of both groups was measured before and after the education. The satisfaction of participants with the course was measured using a questionnaire. The scores were compared within and between groups using the paired and independent t-test, respectively . 

  Results: The knowledge of both groups increased significantly after the intervention (P<0.001) however, there was no significant difference between the mean scores of the two groups after the education (P<0.05). The s atisfaction with the course was significantly higher in the interactive education group (P=0.04) .

  Conclusion: B oth interactive and non-interactive electronic educations increased the knowledge of nurses. The nurses were more satisfied with the interactive education. Further studies are recommended .

  

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Background & Aim: Pap smear test is an effective screening method for early detection of cervical cancer. This study aimed to determine the effect of education based on the health belief model on women’s belief and practice regarding Pap smear test.

Methods & Materials: In this quasi experimental study, 100 married women under coverage of Bushehr health centers participated in the study in 2014-2015. The data collection instrument was a questionnaire consisted of demographic information, the questions concerning knowledge and the HBM constructs regarding Pap smear. The training program was performed in two group sessions. Three months after the intervention, women’s practice about Pap smear test was evaluated in both groups. After data collection, data were analyzed by descriptive statistics, repeated measure analysis of variance, independent t-test and Chi square on SPSS software v.20.

Results: Before the study, both groups had not any significant differences in all variables and constructs. After the intervention, the mean scores of knowledge (P<0.001), perceived seriousness (P=0.015) and perceived barriers (P<0.001) were significantly different between two groups. Three months after the intervention, 42 (85.7%) in the intervention group and 4 (8.2%) in the control group had performed Pap smear test (P<0.001).

Conclusion: Designing and implementing educational program based on health belief model can promote women’s awareness and reduce their perceived barriers and as well as enhance their practice regarding Pap smear test.

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Background & Aim: Restless legs syndrome (RLS) is a sensorimotor disorder that is frequently observed in patients with multiple sclerosis. This study aimed to determine the effect of stretching exercises on the severity of restless legs syndrome symptoms in patients with multiple sclerosis.

Methods & Materials: This quasi-experimental study with control group (IRCT2016041627427N1) was conducted on 60 patients with multiple sclerosis (30 in the intervention group and 30 in the control group) referred to the multiple sclerosis society of Kermanshah in 2015. “The demographic questionnaire”, “the symptoms of restless legs syndrome and their severity”, and “exercise recording form” were used to collect the data. The intervention group was taught the correct way to exercise during four half-hour sessions. The severity of RLS symptoms was measured before the intervention and the end of the fourth and eighth weeks. Data were analyzed by descriptive and inferential statistics using SPSS software version 20.

Results: Before the intervention, the mean score for the severity of RLS symptoms was respectively 19.08±8.12 and 17.42±5.24 in the intervention and control groups (P=0.569). One month (P=0.002) and two months after the intervention (P<0.001), the score was changed to 9.70±5.24 and 7.08±4.08 in the intervention group and 17.61±5.31 and 17.92±5.52 in the control group.

Conclusion: Stretching exercises can improve the severity of RLS symptoms in patients with multiple sclerosis. Therefore, the stretching exercises program is recommended for this group of patients.

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Harlequin ichthyosis is the most severe form of autosomal-recessive congenital ichthyoses with a high mortality rate. In affected infants, mutations occur in the ABCA12 gene. The ABCA12 gene produces the proteins that are essential for the natural development of skin cells. In this disease, disruption in keratinization of epidermis results in the impaired barrier function and susceptibility of the neonate to dehydration and infection. Recent advances in neonatal care and early administration of treatment have increased the chances of child survival. In this article, we introduced a term female neonate with harlequin ichthyosis, born of a 26-year-old mother, significantly recovered by early treatment using an ointment (composed of Eucerin 88 g, sodium chloride 6 g, and urea 6 g).
 

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Background & Aim: Health promoting behaviors have been recognized as an important strategy for maintaining and improving the independence, health and quality of life of people with chronic diseases. The aim of the present study was to compare the health promoting behaviors of patients with MS with those of healthy people.
Methods & Materials: This cross-sectional, comparative study was conducted on MS patients and healthy people in Guilan province in 2018. For this purpose, 120 MS patients (from the MS association of Guilan province and other health centers) and 120 healthy people were selected by the convenience sampling method. The Health-Promoting Lifestyle Profile (HPLP-II) was used to collect the data. The data were analyzed using the SPSS software version 22.
Results: The results showed that health promoting behaviors of MS patients were significantly lower than those of healthy people (t=-3.127, df=238, P<0.001). The results of the components analysis indicated that the mean ranks of self-actualization (U=4948.500, Z=-4.191, P<0.001), interpersonal relationships (U=12874.000, Z=-2.957, P<0.003), stress management (U=5787.000, Z=-2.644, P<0.008) and physical activity (U=5506.500, Z=-3.156, P<0.002) in MS patients were significantly lower than those in healthy people. However, there was no significant difference between MS patients and healthy people in the components of health responsibility and nutrition.
Conclusion: In general, it can be concluded that chronic conditions are associated with a decrease in health promoting behaviors in MS patients, and the patients should be educated in this area using appropriate nursing and psychological interventions.
 

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Background & Aim: Improving clinical decision-making is one of the challenges of the pre-hospital emergency system. Therefore, the aim of this study was to determine the effect of pre-hospital trauma management training program on the capability of clinical decision- making in emergency medical technicians.
Methods & Materials: In a randomized controlled field trial study, 64 pre-hospital emergency technicians from Gonabad University of Medical Sciences, were randomly assigned to either intervention or control groups by the stratified sampling method in 2018. For the intervention group, a pre-hospital trauma management training program was administered based on existing domestic and global standards in a two-day crash course with a combination of learning techniques including lecture and simulation. The research instruments were a demographic questionnaire and a researcher-made questionnaire on clinical decision-making, completed before the course, immediately and one month after the completion of the course. Data were analyzed by the SPSS software version 19 using independent t-test, the repeated analysis of variance and Bonferroni's post-test.
Results: The mean changes in clinical decision-making scores before and immediately after the intervention (9.31 vs. 0.3), before and one month after the intervention (7.86 vs. 1.1) and immediately after the intervention and follow-up one month after the intervention (1.62 in. vs. 1.39) were significantly higher in the intervention group than in the control group (P<0.001).
Conclusion: The pre-hospital trauma management training program can improve clinical decision-making in pre-hospital emergency medical technicians. Therefore, this program can be integrated into the technicians’ training programs.
Clinical trial registry: IRCT20180802040677N1