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Introduction: Maintenance of the body temperature reduces mortality in low birth weight infants and adequate environmental warmth is essential for maintenance of the body temperature of newborns. However, neonatal hypothermia continues to be a significant issue in the developing countries. This study was performed to describe the incidence and severity of hypothermia after delivery.

Materials and Methods: We measured body temperature of 898 consecutive newborn infants by a low-reading thermometer. Body temperature less than 36.5°C was designated as &aposhypothermia&apos. In such cases, the infants were re-warmed according to the WHO recommendations, their body temperature was recorded every hour and their final outcome was noted.

Results: The overall incidence of hypothermia was 53.2%. A total of 456 (50.2%) infants had mild hypothermia (35°C > T > 36.5° C) while 22 (2.5%) had moderate to sever hypothermia (T < 35°C). The incidence and severity of hypothermia was found to be significantly associated with birth weight (p=0.000) and gestational age (p=0.000). The duration of re-warming was also correlated with birth weight (p=0.000). Logistic regression analysis showed that the mortality rate of hypothermic neonates was 3.64 times that of the normothermic infants. The risk of death was higher in the moderate to severe hypothermic groups than in the mild hypothermic infants.

Conclusion: The incidence of hypothermia was found to be high with both the incidence and severity to be significantly associated with birth weight and gestational age. The risk of death was recognized to be higher in the hypothermic newborns than non-hypothermic ones. These results show the importance of maintenance of the body temperature of newborns.

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Background & Aim: Shoulder pain is a consequence of hemiplegia among patients with stroke. It makes patient to be dependent to others in their daily living activities. This study aimed to determine the effect of the slow stroke back massage (SSBM) on shoulder pain and hand function among patients with stroke.

Methods & Materials: In this semi-experimental study, 34 patients were recruited among from 70 patients who reffered to rehabilitation center in 2010, according to the inclusion criteria. Participants were randomly allocated into two groups of control and experiment. In the intervention group, the SSBM was implemented for 10 minutes through seven consecutive sessions. Shoulder pain and hand function were measured using the visual pain scale (Visual Analog Scale), and the researcher-made "affected hand function in ADL" instrument, respectively. The measurement was done before and 24 hours after the last session of the intervention. Data were analyzed using descriptive and inferential statistical tests (independent t-test and paired t-test).

Results: At baseline, the mean scores of shoulder pain were 8.4 in both experimental and control groups (P=0.999). After the intervention, the mean scores of shoulder pain were 1.13 and 8.40 in experimental and control groups, respectively (P<0.001). At baseline, the mean scores of hand function were 7.46 and 8.93 in the experimental and control groups, respectively (P=0.752). After the intervention, the mean scores of hand function reached 9.13 and 8.6 in the experimental and control groups, respectively (P=0.918).

Conclusion: According to the results of the study, applying the SSBM as a treatment procedure and care plan by health care providers can be considered as an effective intervention to prevent or reduce shoulder pain and consequently to improve motor function of affected hand in patients with hemiplegia after stroke.

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Background & Aim: Fertility is the most important factors affecting population fluctuations. Reproductive behaviors of a community can be studied through different methods. One of the methods is the evaluation of the interval between marriage and the birth of the first child. The aim of this study was to investigate the factors influencing the interval between marriage and first birth using the Cox regression model.

Methods & Materials: In this study, 1230 first-time mothers referred to urban and rural health centers of the city of Bandar Abbas were selected and studied in 2012-2013. The Cox regression model (proportional hazard) was performed to investigate the interval between marriage and first birth and the factors influencing this interval. Descriptive analysis of data was performed using SPSS software version 22 and data modeling was performed by R software version 3.2.1.

Results: In this study, the mean interval between marriage and first birth was 27.63 (±24.35) months. Based on the Cox model, mother’s age at marriage with HR(Hazard-Ratio)=1.13 (1.01–1.25) and place of residence with HR=1.28 (1.12–1.46) had significant effects on the interval between marriage and first birth.

Conclusion: The results of the current study compared to previous studies show that the interval between marriage and first birth has decreased, and some changes are observed in the factors influencing this interval.

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Background & Aim: The most common complication of peripheral intravenous catheter use is phlebitis. This study aimed to determine the effect of Arnebia Euchroma on the prevention of peripheral intravenous catheter-related phlebitis.
Methods & Materials: A double-blind randomized clinical trial done on 120 patients hospitalized in CCU and heart wards of Shariaty hospital in Tehran in 2017. The convenience samples were allocated into the two groups of control and intervention. After the insertion of an IV catheter (by sterile technique, in the site of upper limb without any signs of phlebitis), Arnebia Euchroma poultice for the intervention group and placebo poultice for the control group, was applied to the skin in the distal portion of IV catheter at 3×3 cm from the catheter insertion site. Then, this site was covered by sterile dressing. The patient was monitored every 12 hours by removing the dressing, and the poultice was applied again. Data were analyzed by descriptive and inferential statistics using the SPSS software.
Results: The two groups were homogeneous in terms of age and sex, but were different in the number of hospitalization days. While no phlebitis was observed in the baseline, there was a significant difference between the two groups (42.37% for intervention group vs 0% for control group) at the hour of 12. By adjusting the effect of hospitalization days, the difference was still significant (P<0.001).
Conclusion: Arnebia Euchroma poultice was effective in the prevention of phlebitis. Thus, this poultice can be used when inserting a peripheral intravenous catheter.
Clinical trial registry: IRCT2017012432147N1
 

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Background & Aim: Anxiety is one of the most common psychiatric disorders in the family of patients with traumatic brain injury. This study aimed to determine the effect of providing information about the patient’s condition on the anxiety level of the family members of hospitalized patients with traumatic brain injury.
Methods & Materials: This quasi-experimental study was conducted on 90 family members of traumatic brain injury patients admitted to Shahid Bahonar hospital in Kerman in 2016. The participants were selected by the consecutive sampling method and were assigned to intervention and control groups. In the intervention, the participants were informed by the nurse about changes in the patient’s condition during the first three days of admission to intensive care unit. During this period, the control received routine care. Data collection tool was the Spielberger anxiety inventory. Independent and paired t-test were used to compare the mean scores of anxiety using the SPSS software version 16.
Results: There was no statistically significant difference in the mean scores of overt, covert and general anxiety between the two groups before the intervention (P>0.05). However, after the intervention in the experimental group, the mean scores of overt anxiety (45.51±7.26), covert anxiety (45.42±6.51) and general anxiety (90.93±12.72) decreased (P<0.05) compared to the mean scores of overt anxiety (49.22±9.42), covert anxiety (49.02±9.15) and general anxiety (98.24±17.67) in the control group.
Conclusion: Providing planned information on changes in the condition of hospitalized patients with traumatic brain injury can reduce the anxiety of family members of these patients.
Clinical trial registry: IRCT20180206038642N2
 

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Background & Aim: Providing self-care education to patients and their family leads to improvement in the quality of life and increase in participation in self-care programs. The aim of this study was to compare the effect of education by peer and nurse on self-care in hemodialysis patients.
Methods & Materials: In this quasi-experimental study, 105 hemodialysis patients from three selected hospitals in three cities of Isfahan province (Zarinshahr, Falavarjan and Mobarakeh) were selected by the simple random sampling method from February 2016 to September 2016. Three centers were randomly assigned to three groups including education by peer, education by nurse and control. The individual face-to-face education was provided by the peer or the nurse to hemodialysis patients, and the control group only received routine education. Data gathering tool was the hemodialysis patients’ self-care questionnaire which was completed for three groups before and one month after education. The data were analyzed using the SPSS software version 18 through Chi-square test, paired t test, the analysis of variance and Tukey’s post-hoc test at the significance level of P<0.05.
Results: There were no significant differences between the three groups in age, duration of dialysis, gender, and level of education (P>0.05). The Tukey’s multiple comparisons tests showed that the effect of nurse intervention on self-care improvement was significantly more than peer intervention and the control group (P<0.001) and also the effect of peer intervention on self-care improvement was significantly more than the control group (P<0.001).
Conclusion: Education by a nurse is effective in the self-care behaviors of hemodialysis patients and will improve these behaviors. Also, using peer experiences has advantages for hemodialysis patients such as easy, low-cost and effective education, based on life experiences and lack of need for special equipment.
 

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Background & Aim: Perimenopause is associated with severe changes in reproduction and hormones. The aim of this study was to determine the effect of group counseling on the severity of menopausal symptoms in the transition to menopause.
Methods & Materials: This clinical trial study was performed on ninety perimenopausal women in Javanrood city in 2019. Women were randomly assigned into the intervention or control groups using the block randomization method. Counseling was conducted for the intervention group in groups of 11 to 12 people in four 60-minute sessions for four consecutive weeks. After 8 weeks, the severity of menopausal symptoms was measured using the Menopause Symptoms Scale. Data were analyzed using the SPSS software version 21.
Results: There was no statistically significant difference between the two groups in terms of menopausal symptoms scores before the intervention (P=0.86). After the group counseling, the median (Q1, Q3) of menopausal symptoms, physical, mental and genitourinary symptoms in the intervention and control groups were 17.0 (15.0, 21.5) and 21.0 (17.0, 30.5) (P<0.001), 6.0 (5.0, 8.0) and 9.0 (6.5, 11.0) (P<0.001), 6.0 (5.0, 8.0) and 8.0 (5.0, 10.0) (P=0.004), and 5.0 (4.0, 6.0) and 6.0 (5.0, 8.5) (P<0.001), respectively. These values for the intervention group were significantly lower than those in the control group.
Conclusion: Providing group counseling for four sessions was effective in reducing the severity of menopausal symptoms in perimenopausal women. Therefore, it is suggested that this strategy be used to promote women's health in the premenopausal period.
Clinical trial registry: IRCT20120215009014N320
 

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Background & Aim: Designing healthcare spaces and physical facilities requires the identification of the patient's family needs, and it is considered an important component of nursing theories. The aim of this study was to explain the needs of family caregivers of patients undergoing gynecological surgery for physical facilities and equipment in hospital.
Methods & Materials: This study is based on the results of the qualitative part of a large hybrid study on the development and implementation of a need-based service delivery program for the caregivers of patients undergoing gynecological surgery in 2017. The selection of participants was purposefully done with maximum variation. The study data were collected using 31 (16 caregivers, 6 nurses, 4 doctors, 3 patients and 2 service workers) in-depth interviews and observations and analyzed by the conventional qualitative content analysis using the Zhang and Wildemuth approach.
Results: Data analysis led to the development of the theme "need for physical facilities", which fell into two categories "need for proper physical structure in the hospital" with the following subcategories: "need for care facilities behind the operating room door", "need to provide welfare facilities in the hospital for caregivers", "need for welfare facilities in the surgical ward", "necessity of allocating rooms to the similar patients", and category "need for appropriate hospital facilities and equipment" with subcategories "caregiver’s need for facilities and amenities", and "caregiver’s need for facilities and amenities for the comfort of the patient".
Conclusion: The results show the importance of having a physical structure tailored to the needs of family caregivers as well as the availability of appropriate facilities and equipment in hospital. One of the limitations of the study was preventing men from visiting patients in the women’s hospital. It is recommended that the needs of male companions and the necessity of their presence according to the cultural context be studied. Also, a new architectural design is suggested to create a suitable therapeutic environment and positive effect on patients’ improvement and increase patient and family satisfaction.
 

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Background & Aim: Reducing pain after surgery, especially cesarean section is one of the most important factors for maternal and infant health. Choosing the way of reducing pain with fewer complications has drawn the attention of researchers. The aim of this study was to compare the effect of Hugo point pressure and auricular seed acupressure on pain after cesarean section.
Methods & Materials: In this clinical trial, 168 pregnant women who were candidates for cesarean section, referred to the educational and medical centers of Rafsanjan University of Medical Sciences in 2020, were selected through purposive sampling and randomly divided into three groups: Hugo point pressure, auriculotherapy, and control. In the Hugo group, massage was applied on the li4 point (between the thumb and forefinger) for 10 minutes. 24 hours later, the intervention was repeated. Before and after the intervention, pain intensity was measured using the Visual Analogue Scale (VAS). In the auriculotherapy group, earrings were placed on the Shenmen point located in the earlobe. Pain was assessed by the VAS 20 minutes after the intervention and 24 hours later. No intervention was performed for the control group and only the researcher was present next to the studied subjects for 10 minutes. Data were analyzed by the SPSS software version 20 using paired t-test and one-way analysis of variance (ANOVA). P<0.05 was considered significant.
Results: The average pain score in the Hugo group was 6.70±1.55 before the intervention and 6.20±1.78 after the intervention (P=0.026). In the auriculotherapy group, the average pain score before the intervention was 5.99±1.75 and after the intervention was 4.66±2.01 (P<0.001). No significant difference was observed in the average score of pain intensity on the first day between the two groups, before the intervention (P=0.062). But the average score of pain intensity on the first day after the intervention was lower in the auriculotherapy group compared to the other two groups (P<0.001). On the second day, there was a significant difference in the average pain score between the three groups after the intervention (P=0.009).
Conclusion: The results of this study showed that both auriculotherapy and the Hugo method are effective for reducing pain after cesarean section; but the continuance of pain reduction after auriculotherapy was more than Hugo point pressure. These methods can be used along with other pharmaceutical methods to reduce pain after cesarean section.
Clinical trial registry: IRCT20131228015965N17

 

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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.