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Background & Objective: Labor potentially causes stress and anxiety, especially in nulliparous women. In Iran, many pregnant women undergo cesarean section electively due to fear of labor pain. The purpose of this study was to investigate the effect of reflexology on the anxiety level, blood pressure, and pulse in nulliparous women in Kerman.
Methods & Materials: In this clinical trial, 70 nulliparous women with gestational age more than 37 weeks and cervical dilatation of 3-4 cm were recruited for the study. The participants were randomly allocated to two equal reflexology and control groups. The reflexology group received the intervention for 20 minutes (each foot: 10 minutes) on their feet and the control group received massage for 20 minutes on their legs. Anxiety level, blood pressure and pulse rate were measured at baseline and immediately after the intervention using Spielberger questionnaire.
Results: Anxiety level did not differ between the two groups at baseline (P=0.85). After the intervention, the mean of anxiety level was significantly lower in the reflexology group than in the control one (P<0.001). The pulse rate (P=0.44) and blood pressure (P=0.59) did not differ significantly in two study groups after the intervention.
Conclusion: Reflexology reduced anxiety level in labor.

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Background & Objective: Poor physical and psychological health status in chemical warfare victims could result in decreasing quality of sleep. This study was conducted in order to evaluate the effect of using Continuous Care Model on sleep quality in chemical warfare victims with bronchiolitis obliterans.

Methods & Materials: A total of 62 chemical warfare victims with bronchiolitis obliterans were recruited to the study. The participants were randomly allocated to experimental and control groups. The Continuous Care Model was used to experimental group for a period of two months. The quality of sleep was measured using Pittsburgh Sleep Quality Index (PSQI) before and after the intervention in both study groups. Data were analyzed using independent sample t-test, and paired t-test in the SPSS-version 15.

Results: There were significant differences between experimental and control groups in the means of Subjective Sleep Quality, Sleep Disturbances, Use of Medications, and global scores after the intervention (P<0.05).

Conclusion: Using Continuous Care Model had positive effect on sleep quality in chemical warfare victims suffering from bronchiolitis obliterans.

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  Background & Aim: Falling is common among elderly due to changes in sensory–motor function. Falling causes physical, emotional and financial problems and decreases the quality of life in elderly. Since the causes of falling are multifactorial, multi-dimensional approaches should be considered to prevent it. This study aimed to investigate the effect of a multidimensional fall prevention program on the incidence of falling and quality of life among old people living in nursing homes.

  Methods & Materials: This before-after quasi-experimental study was conducted on 60 old people living in nursing homes who met the inclusion criteria. Multidimensional fall prevention program was focused on: 1- exercise (stretching, balance, and strength) 2-training classes for caregivers and elderly and 3-environmental modification. Data were collected before and six months after the intervention using demographic and illness form, fall frequency form and the LEIPAD questionnaire. Collected data were analyzed using the paired t-test, one-way ANOVA, Mann-Whitney and Wilcoxon tests in the SPSS-16 . 

  Results: Before and six months after the intervention, the mean frequencies of falling were 2.00 (±0.70) and 0.20 (±0.55), respectively. The mean scores of quality of life before and six months after the intervention w ere 56.48 (±10.45) and 77.43 (±10.45), respectively. Results indicated that there were statistically significant difference between the study participants before and six months after the intervention regarding falling frequency (P<0.001) and quality of life score (P<0.001).

  Conclusion: The multi-dimensional fall prevention program decreased the fall frequency and increased quality of life of participants. Health care providers, particularly nurses can use the prevention program to diminish falling incidence among elderly and improve their quality of life.

  

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Background & Aim: Chronic diseases are one of the most prevalent health problems affecting the quality of an adolescent's interaction with others. Social support can be important particularly during adolescence due to the many internal and external changes that happen to a person. This study aimed to determine the levels of perceived social support and its correlated factors in adolescents with chronic disease.

Methods & Materials: In this cross-sectional study, 172 adolescents 11-16 years with a chronic disease referred to Tehran’s selected hospitals, were included using purposive sampling during three months in 2014. Data were collected through “children and adolescents social support questionnaire”. Data were analyzed by independent t-tests, one-way ANOVA, Pearson correlation coefficient and multiple linear regression on SPSS software v.22.

Results: The total score of perceived social support (45.46±5.88) was at a high level. Among the demographic factors, gender (P<0.01), ethnicity, parental education, family income, number of children, birth order, and having insurance (P<0.001) showed a significant correlation with perceived social support. Among the factors related to illness, the type of chronic disease (P<0.01), the number of hospitalizations (P<0.001), the lack of participation in group activities due to illness (P=0.04), school absenteeism rates (P=0.002) and academic failure (P<0.001) were significantly associated with perceived social support.

Conclusion: According to the findings of this study, given the level of perceived social support and its related factors, it is recommended to pay more attention to caring for adolescents with chronic disease at the community level.

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Background & Aim: Brain injury is one of the most common traumas and the most important cause of death in traumatic events. Ventilated patients are susceptible to pressure ulcers caused by endotracheal tube fixation (ETF). The aim of the present study is to compare three methods of ETF (band, adhesive and holder) on the incidence of pressure ulcers in patients with head injury.
Methods & Materials: This randomized clinical trial was performed in a hospital in Mashhad in 2017. A total of 108 hospitalized patients with head trauma were included in the study by convenience sampling. The patients were randomly divided into three groups of ETF using holder, band and adhesive. In three groups, the incidence of pressure ulcers caused by fixation method was assessed at 6, 12, 18, and 24 hours after the intervention. The grade of ulcer was measured by pressure grading scale (EPUAP/NPUAP). The data were analyzed using the SPSS software version 16.
Results: The incidence of pressure ulcers at 6, 12, 18, and 24 hours after the intervention was significantly different in the three groups (P<0.05). At six and 12 hours after the intervention, the three groups had a grade one ulcer. However, after 18 hours, 10% in the adhesive group and band group and 24 hours after the intervention, 25% in the band group and 12.1% in the adhesive group had a grade 2 pressure ulcer, but this amount was 0% in the holder group.
Conclusion: Use of holder rather than adhesive and band for ETF in mechanically ventilated patients causes less pressure ulcers.
Clinical trial registry: IRCT20171015036800N1
 

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Background & Aim: Tokophobia was introduced as a psychiatric disorder for the first time in 2000. The purpose of this study is to answer four questions: What is tokophobia and how does it occur? What is the global prevalence of tokophobia? What are the symptoms of tokophobia? and what are the strategies for the control and treatment of tokophobia?
Methods & Materials: This systematic review was conducted by searching articles in English and Persian published between January 2000 and January 2018 on international databases; PubMed, Scopus, Web of Science, Google Scholar, Science Direct, and domestic databases; Magiran and SID, along with a manual search in resources.
Results: After reviewing 151 articles, finally 16 were included in the study. The results indicate that tokophobia is a severe and pathological fear of childbirth. In the categorization of psychiatric disorders, it is classified as a specific phobia based on the Diagnostic and Statistical Manual of Mental Disorders, 4^th edition (DSM-IV). The etiology of tokophobia is multifactorial, and its prevalence in pregnant women was reported around 14 percent among 18 countries. The signs and symptoms of the disorder are insomnia, crying, restlessness, depression, anxiety and severe worry about childbirth. Psychological strategies, cognitive behavior therapy and medication have been proposed to reduce the fear of childbirth in women in different studies.
Conclusion: As a guide, these results can assist the healthcare team members to recognize and screen at-risk women as well as to perform nursing interventions and psychotherapy in the prenatal and delivery stages.
 

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Background & Aim: The healthy nutrition education is one of the most important priorities in all life periods, especially in childhood. The teaching method is also considered one of the important factors for the effectiveness of education. Therefore, the aim of this study was to compare the effect of lecture and role-playing methods on awareness of healthy nutrition in school-age children.
Methods & Materials: This quasi-experimental study was conducted on 60 primary school students in Gonabad city in 2017. Participants were selected by multistage random sampling and allocated into two groups of role-playing and lecture. Students' awareness was measured by a self-structured questionnaire before, immediately and one month after education. Data were analyzed using the SPSS software version 16 by descriptive and inferential statistics. A P-value less than 0.05 was considered significant.
Results: The mean score of awareness for the role-playing group before, immediately and one month after the intervention respectively was 10.77±2.55, 14.1±55.15 and 14.50±1.10 and for the lecture group respectively was 11.07±1.85, 13.72±1.43 and 11.47±2.84 (the score range: 0-16). There was a significant difference in the mean score of awareness before, immediately and one month after the intervention between the two groups (P<0.001), and in the role-playing group, the increase in awareness score was more than in the lecture group.
Conclusion: Considering the greater effect of role-playing method than lecture on healthy nutrition education in school-age children, it is suggested that more attractive, dynamic and effective methods such as role-playing, in accordance with educational behavioral goals, be used in school nutrition education programs. In addition to enhancing educational efficiency, this will make the effects of education and learning more sustainable for students.
 

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Background & Aim: Each conceptual model in nursing seeks to explain the fundamental concepts of the discipline based on the culture and values of societies in order to be used more effectively, as a scientific and practical framework. The aim of this study was to design a conceptual model of care during infancy from Islam perspective.
Methods & Materials: The conceptual model used in this study was designed based on the model synthesis process developed by Walker and Avant (2011) in three steps in 2017: Concept development and specifying focal concept, statement synthesis and identifying connections between concepts, systematic organization of connections and building an integrated representation. Qur’an and its interpretation books and Shiite Hadith books were of the resources.
Results: As a result of developing the concept of “care during infancy in terms of Islam”, six concepts were synthesized. “Infant as a person with dignity and potential for excellence” was as the focal concept. Other concepts included “basic principles of nurturing”, “parents as the representatives of God in nurturing infants”, “mother as the symbol of creativity and divinity of God”, “healthy and competent child”, and “God as the merciful nurturer”. After defining connections between the concepts, the structure of conceptual model was presented.
Conclusion: Infant care is nurturing a human being who has dignity, rights and potential for excellence from the time of conception. From Islam perspective, God is the eternal nurturer who nurtures the infant with kindness and dignity, and mother is the manifestation of the creativity and divinity of God. The infant is entrusted to the parents by God, and parents are the agents of God who lay the groundwork for nurturing the infant. In order to have a healthy and competent child, observing the principles of nurturing is important. “Care during infancy from Islam perspective” model is a conceptual model that can be used for the development of applied theories, clinical practice, research, and education of nursing students and the community.