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The present research is a descriptive - analytic study about the rate of use, reasons of use or refusal of Hormone Replacement Therapy in menopausal women referred to gynecology clinics in selected hospitals of Tehran University of Medical Sciences in the year 2001. Samples of research included 400 women age between 40-65 years which selected on accidental basis and collected means was questionnaire which contain demographic characteristics (age, job and education), receiving information, information source, the reasons for use or refusal of Hormon Replacement Therapy. Research findings showed that 8.75% of menopausal women used Hormone Replacement Therapy. Their reasons are as follow: 28.57% due to physician recommendation. 26.37% due to improvement of hot flash. 23.08% for prevention of osteoporosis 16.48% due to hysterectomy. 3.3% due to prevention of cardiovascular diseases. 2.2% because of improvement of sexual activities. The reasons for non-useres are as follows: 46.96% having no information about such a method, 16.4% thinking about menopuae as a natural phenomenon and no need for treatment, 10.53% not-suffering from menopausal effects, 7.08% medical recommendation, 5.6% fear of hazardous effect leading to cancer. In the present research, there is no significant relationship between age, job and the method of Hormone Replacement Therapy but have significant relationship between education rate and receiving information about the method of use.

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The present study is a descriptive one made for the purpose of quality assessment of family planning counseling in health and treatment centers affiliated to Tehran University of Medical Sciences in year 2000. 410 client of the Family Planning Social Services who had attended 25 health and treatment centers affiliated to Tehran University of Medical Sciences were participated in this research study. A checklist was completed through the observation of family planning counseling sessions. The finding and results of this study showed that personnel&aposs behaviour and the quality of family planning counseling for the majority of samples in the first section have been suitable. In the section of the history taking from clients helping them to select suitable method and to determine next appointment, data for the majority of samples in this study have been in an average level. In the section of need understanding of clients introductory methods providing information the audiovisual training equipments used during family planning counseling, explanation of way of utilizing the selected method, and finally the environment for family planning counseling have not been suitable for majority of the samples. The findings of this study can be beneficial for public health planning in order to improve the quality of the family planning services.

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Childbirth is one of the most stressful situations in a woman's life. In order for a woman to adjust to the stress of delivery and to make it a happy experience for her, she should be supported with adequate information as well as emotionally and physically. This research was undertaken to analyze the opinion of mothers concerning the importance of and their satisfaction with information, physical and emotional support received in the labor and delivery rooms. In this descriptive-analytic study 400 post-partum mothers from 10 various training hospitals in city of Tehran in the year 2000 were randomly selected and interviewed by questionnaire in the post-delivery ward. Results showed that most of the mothers placed great importance on physical, informational, and emotional support, respectively. They had received inadequate physical and informational support and relatively adequate emotional support. But most of them were satisfied with the informational, emotional and physical support, respectively. There was no significant association between the level of satisfaction of the mothers with these three types of support and their importance but there was a significant association with the way that support was received. (P<0.05). Complete satisfaction with the support offered, despite their inadequacy or limitations, may be due to the fact that mothers are unaware of their rights and have few expectations or may be due to the time of conducting the interview (just before discharge). The lack of any relation between the demographic variables and the value of importance in the different areas of support shows that these are basic needs and all should be equally provided. In order to increase satisfaction, support and care should be provided to mothers in the best possible fashion. Finally, regarding the presence of midwifery students and their teachers in teaching hospitals, they should be made directly responsible for the reformation of the hospital system, preparation of hospital charts and their organization.

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Introduction: Nurses as the main members of treatment-and-care team play an important role in improvement and promotion of health in society. Job stress is a recognized and integral part of modern nursing which has destructive effects on both nurses and patients.

Materials and Methods: The present descriptive and analytical study aims to determine the level of nurses&apos job stress in Tehran in 2004. It also tries to identify factors affecting job stress from nurses&apos point of view. A total of 111 nurses working in two educational and non-educational hospitals in Tehran were studied. The sampling was simple, i.e. the subjects volunteered to participate in the study. A questionnaire with 2 sections was developed. In the first section we asked about personal and professional characteristics and the second section was designed to evaluate job stress in following 5 categories: management, economy and welfare, mentality and social affairs, occupational health and ergonomics. There was also an open-ended question asking about nurses&apos attitude toward job stress. The questionnaire items were to be answered on a scale ranging from 0 to 4. We used descriptive statistics and Chi square statistical test to analyze the collected data.

Results: The results showed that 44.1% of samples had high levels of job stress while 54.1% suffered from medium and 1.8% from low levels of job stress. There was a significant relationship between hospital type and job stress job stress in the educational hospital was higher compared to the noneducational hospital. There was also an inverse relationship between years of experience and job stress.

Conclusion: Due to high percentage of the subjects with high to medium levels of job stress, employment of preventive and precautionary procedures regarding job stress is recommended.

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Pregnancy and delivery are special events in women’s and their family’s life. Although pregnancy is a natural phenomenon and not a disease, sometimes it can be associated with several dangers to the mother and her fetus. Maternal death is a global finding and its five most important causes are bleeding, infection, hypertension, prolonged labor and abortion in unsanitary condition. Early diagnosis of abnormal labor progression and prevention of prolonged labor can reduce the risk of postpartum bleeding and infection. The chart of labor called “Partograph” has been introduced and applied since 1970 to help diagnosis of the abnormal labor and cephalopelvic disproportion. Partograph is an early alerting system which can prevent probable difficulties in different stages of labor through recording of all of the observations and examinations on one chart, so that mother can be referred as soon as possible to higher levels of health services.

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Background & Aim: Sleep is an important physiological process that has deep effects on psychological and physical health. This study carried out to investigate the association between quality of sleep and health-related quality of life in nurses.

Methods & Materials: In this cross sectional and descriptive-analytic study, 127 nurses in Imam Hossein Hospital of Shahroud, Iran, during February and March 2006 were chosen enumeration and then their sleep quality and their quality of life in eight dimensions were measured with using Pittsburgh sleep quality index (PSQI) and 12-item short form health survey (SF-12) questionnaire and were compared. The data were analyzed using SPSS 11.5 software.

Results: Upon to the results of this study, 25.2%, 70.9% and 3.9% of cases were working on morning shift, circulator shift and afternoon/night shifts respectively. Mean of time that they spend in bed were estimated 30.2 minute and 2.1% of subjects declare they get to sleep more than 30 minutes after going to bed. Mean of gotten up time in the morning in was at 6 and 58% of them described that they wakeup 1 hour earlier to anticipation time. According to the results, 35.5% of subjects have taken medicine (prescribed or "over the counter") to help them sleep. Spearman correlation coefficient test revealed a significant correlation (p<0.05) between the mean of Sleep Quality score and the mean of quality of life score in all dimensions in subjects.

Conclusion: According to the results, quality of sleep is poor in majority of nurses and significantly has decreased their quality of life in different aspects, especially in general health, mental health and physical pain.

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Background & Objective: According to Iranian national statistics, every year 400 to 500 thousand unwanted pregnancies occur in Iran. The emergency contraceptive methods are easily accessible and affordable for the women of this region. Regarding the important role of health care providers in representing these methods, this study is to determine the knowledge and attitudes of these staff toward required contraceptive methods.

Methods & Materials: In this semi-experimental study, 216 health personnel working in south of Tehran health centers were randomly selected. Two 30- minute educational sessions were presented to the staff. The methods of education included face to face, and group discussion. At the end of each session a pamphlet was given to the staff. Data were gathered using a questionnaire before and 2-6 weeks after the education. Statistical analysis was carried out using statistical package for social sciences (SPSS).

Results: The results showed that there were significant statistical differences between the knowledge and attitudes (P<0.001) of personnel about the emergency contraceptive methods before and after education. There was no significant relationship between demographic characteristics and attitudes of personnel. There was a significant relationship between sex (P<0.001), educational level (P<0.003), educational major (P<0.001), with knowledge after intervention.

Conclusion: Knowledge and attitudes toward emergency contraceptive methods increased significantly after education. This finding reveals the importance of continuous education for health care staff such as midwives and physicians to facilitate successful guidance of their patients towards effective family planning.

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Background & Objective: Osteoporosis is a metabolic disease which results from gradual destruction of bone mass. Prevention of osteoporosis should be started from childhood by getting adequate calcium and doing weight-bearing exercises. Participating of mothers in health education interventions is likely to promote longer-lasting health behaviors in their daughters. The aim of this study was to investigate the effect of simultaneous education of mothers and daughters on osteoporosis preventive behavior among high school female students.

Methods & Materials: In this interventional study, 400 female students were randomly selected via a two-phased sampling method. At first stage, four schools were selected randomly. At the second stage, 400 students were divided randomly into two groups. Their osteoporosis preventive behaviors were measured using a two-sectioned questionnaire: demographic section, and osteoporosis preventive behaviors assessment section. The first group participated in the educational programs with their mothers and the other group participated without their mothers. The educational program had two sessions, each one lasted 45 minutes. The second stage of the study was performed three months later. Data analysis was carried out using t-test and chi squared test.

Results: Results showed that in both groups, osteoporosis preventive behaviors scores increased significantly after intervention. It was higher in case group (P<0.001). Eating behavior was significantly different in two groups (P=0.003).

Conclusion: Results showed that simultaneous educational program for mothers and daughters promotes eating behavior in the girls.

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Background & Objective: High rates of cesarean delivery have worried health policy makers. One of the main reasons for cesarean section in Iran is cesarean election. Health Belief Model (HBM) is one of the most powerful models used in health education programs. The objective of this study was to determine the effect of education designed based on HBM on choosing delivery mode among pregnant women.

Methods & Materials: In this experimental study, 128 nulliparous women were recruited from Shahrood health care centers and private gynecologists' offices. Samples were randomly allocated into two equal groups. Women in the experimental group participated in two 40-minutes educational classes which were designed based on HBM. Data were gathered both before and after the classes, and then were analyzed using SPSS.     

Results: The results indicated that there were no significant differences between two groups in demographic characteristics, infertility history, disease history, perceived susceptibility, and perceived benefits and barriers. After the intervention, significant differences were found between perceived  susceptibility (P<0.001), perceived severity (P<0.001), perceived barriers (P=0.004), with practice (choosing the delivery mode) (P<0.001).

Conclusion: The results showed that using HBM in program designing was effective in the pregnant women's decision-making toward delivery mode.

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Background & Aim: Childbearing is a potentially traumatic event in the lives of women and can lead to post traumatic stress disorder in some women. This study aimed to determine the prevalence and predisposing factors of post traumatic stress disorder after childbearing in women in Bushehr.

Methods & Materials: In this cross-sectional study, 400 women who attended the medical centers 6-8 weeks after delivery were recruited to the study. Participants with traumatic delivery were included in the study. They completed the posttraumatic symptoms scale-I (PSS-I), and predisposing factors questionnaire. Data were analyzed in two groups of women with the PTSD and without PTSD using Chi-square and Fisher&aposs exact test with P=0.05.

Results: The results of this study showed that 54.4% of women had experienced a traumatic delivery and one-third of the women were affected to PTSD after childbearing. There were significant differences between obstetrical factors including complications of pregnancy, wanted pregnancy, post-partum complications, interval of the last two pregnancies less than two years neonatal factors including type of feeding, issues of child care, birth weight and psychological factors including stressful life events, and maternity social support with the PTSD (P<0.05). Income had statistically significant association with the PTSD (P<0.05).

Conclusion: Some of obstetrical, neonatal and psychological factors are associated with occurrence of the PTSD after delivery

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Background & Aim: Patients adherence to medical recommendations requires new and effective strategies. Promoting self-efficacy is considered as an important measurement to help patients to participate in their own treatment protocol. This study was conducted to determine the effect of a nursing intervention on improving self-efficacy and reducing cardiovascular risk factors in patients with cardiovascular diseases in a public hospital in Urmia.

Methods & Materials: In this single group before/after study, 81 patients with at least two cardiovascular adjustable risk factors were recruited. The self-efficacy intervention was presented to the patients and one of their family members. The self-efficacy was scored before, immediately and one month after the intervention. The Cardiovascular risk factors were measured before and one year after the intervention. Descriptive statistics, ANOVA with repeated measures, paired t-tests, and McNemar test were used to analyze data.

Results: Overall self-efficacy scores and its sub-groups were significantly improved after one month. There were significant differences in the mean BMI, HDL, LDL, systolic and diastolic blood pressures, and weight before and one year after the intervention. The number of smokers and patients with hyperlipidemia were significantly decreased one year after the intervention. However, there were not significant differences in the number of overweight patients and patients with hypertension before and after the intervention.

Conclusion: Results showed that our intervention to improve self-efficacy had positive effect on the overall self-efficacy score and the scores of its subgroups. Our intervention was also effective in controlling cardiovascular risk factors and in reducing the frequency of smokers and patients with hyperlipidemia. It seems that combination of medical orders with self-efficacy improving interventions on patients and their families are influential in controlling cardiovascular risk factors.

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Background & Aim: The Non Stress Test (NST) is a main assessment tool for fetal wellbeing however, it has a high rate of false-positive results. External stimulation with halogen light has been recommended to aid in provoking fetal response, decreasing false-positive results and promoting the test. This study aimed to assess the effect of halogen light stimulation on nonreactive pattern of NST.

Methods & Materials: From 850 women who underwent NSTs, 50 women with singleton and cephalic fetuses who had nonreactive NSTs were allocated to receive halogen light stimulation through a halogen light source of 1,000,000 candle power. The light was applied to the lower abdomen above symphysis pubis over fetal head for 10 seconds. Results were compared to BPP scores as a backup test. We used mean± SD, chi-square Test and Fisher&aposs Exact Test. The >α0.05 was considered as significant level.

Results: Following stimulation, 68% of nonreactive results changed to reactive patterns. In half of the cases, first acceleration occurred in less than two minutes. Almost 90% of fetuses had reactive pattern within nine minutes.

Conclusion: Halogen light stimulation decreased the incidence of non reactive tests and testing time. Halogen light stimulation is safe and efficient in fetal well being assessment.

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Background & Aim: Motivated faculty promotes nursing students&apos educational level which leads to community health promotion. Attempts should be made to recognize and analyze motivating factors including expectations. This qualitative study attempted to clarify expectations of faculty of Tehran nursing schools on management system.

Methods & Materials: This was a qualitative study. The participants were 14 nursing faculty members of Tehran, Shahid Beheshti, Artesh, Shahed, and Baghiatallah Universities located in Tehran. Purposive sampling was used to recruit the participants. Data were collected using semi-structured interviews with the participants. Qualitative content analysis was used to analyze the data.

Results: Expectations of nursing faculty were explained in eight categories: empowerment of the faculty, organizational support, fairness, appropriate performance evaluation, providing appropriate working conditions, applying appropriate management strategies, attention to welfare and financial problems and promoting quality of education and research.

Conclusion: Understanding the expectations of the nursing faculty and trying to meet them can improve performance of the faculty. Meeting these expectations can enhance motivation and job satisfaction among the faculty.

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Background & Aim: Most of the psychological turmoil of marital conflicts is related to sexual dissatisfaction. Sexual satisfaction is influenced by physical and mental illnesses. Pelvic floor muscle relaxation is a major health problem in which prolapsed pelvic floor muscles causes paralysis, pelvic organs&apos prolpases, pelvic organs&apos dysfunction, dyspareunia, and back pain. The aim of this study was to assess the effect of pelvic floor muscle exercise on sexual satisfaction in primiparous women.

Methods & Materials: This clinical trial was conducted among 100 primiparous women selected through cluster randomized sampling from five clinics of Tehran University of Medical Sciences. Samples were randomly divided into two equal groups. The intervention group received pelvic floor exercises (Kegel) for 16 weeks. The control group did not receive any intervention. Data were collected using the Linda Berg questionnaire before the intervention and 16 weeks after the intervention in both groups. Data were analyzed using descriptive statistics and chi-square, t-test in the SPSS v.18.

Results: After 16 weeks, significant differences were reported in the levels of sexual satisfaction in the intervention and control groups (P<0.001).

Conclusion: The Kegel exercises are easy and non-expensive methods that should be offered by health professionals to increase sexual satisfaction in women after childbirth.

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Background & Aim: Pregnancy can conflict with sexual function that can be affected by physical and psychological changes during pregnancy. The aim of this study was to compare sexual functions between nulliparous and multiparous pregnant women referred to health centers in Eastern district of Guilan.

Methods & Materials: This cross-sectional study was carried out in Guilan during 2009-2010. We used convenient sampling method to select 554 pregnant women. Data were gathered using a questionnaire including demographic characteristics, sexual function and fear of harm to fetus. The SPSS-16 was used to analyze the data by the Mann-Whitney U and Generalized linear models. The level of significance was set at 5%.

Results: There was no significant difference between nulliparous and multiparous pregnant women regarding sexual function in the first and second trimesters of pregnancy (P=0.353, P=0.251). There were significant differences between nulliparous and multiparous pregnant women regarding sexual desire (P=0.002), arousal (P=0.01), orgasm (P=0.01), pain (P=0.02) and sexual function total score (P=0.016). There was significant difference between nulliparous and multiparous pregnant women regarding sexual function (P=0.008).

Conclusion: Sexual counseling and rehabilitation programs should be compiled as part of the comprehensive care of prenatal care especially for multiparous pregnant women.

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  Background & Aim: Hysterectomy is a common gynecologic surgery leading to great concerns in women. This study aimed to determine the effect of foot massage on anxiety level after hysterectomy.

  Methods & Materials: In this double-group randomized clinical trial, 60 women undergone hysterectomy were selected using convenience sampling method and were randomly allocated into two intervention or control groups. Patients in the intervention group received foot massage three sessions during three consecutive days (every session lasted 20 minutes). In the control group, the researcher was only beside the women for 20 minutes. The Spilberger anxiety questionnaire was used to measure the anxiety level. Data were analyzed using repeated measures ANOVA and independent t-test.

  Results: The mean of the anxiety score was not significantly different between the two groups before the intervention (P=0.21). After the intervention, there was significant difference between the two groups in the anxiety scores (P<0.001). There was also significant difference between the two groups in the anxiety scores one week after the surgery (P<0.001).

  Conclusion: Foot massage can reduce anxiety in patients who underwent hysterectomy.

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  Background & Aim: Hysterectomy is the second most common major surgery among women of reproductive age. Studies have suggested that women do not usually receive adequate information regarding hysterectomy before the surgery. Depression is a common psychiatric condition diagnosed after hysterectomy. The aim of this study was to assess the impact of pre-hysterectomy counseling on depression among women.

  Methods & Materials : In this clinical trial, 100 women who had undergone hysterectomy for non-malignant conditionswere selected from two hospitals (women’s’ hospital and Imam Khomeini hospital) and completed the informed consent forms. Participants were randomly divided into two intervention and control groups. In the intervention group, we implemented the supportive counseling within two sessions. Depression was assessed 1-2 weeks before the surgery and two monthsafter the surgery. Data were gathered using the 30-item SAMA questionnaire (modified BECK questionnaire in Iran)for depression and a demographic questionnaire. The two groups were assessed using the Wilcoxon rank-sum test, Mann Whitney U test and paired-t test. Data were analyzed in the SPSS-14.0. The p-value less than 0.05 was considered significant forall tests.

  Results: Mann Whitney U test showed no significant difference between the control and intervention groups in the mean score of depression (p<0.001). In the intervention group, the mean score of depression was 44.46 ± 6.7 at baseline and 20.86 ± 5.9 after the intervention.

  Conclusion : Pre-hysterectomy counseling should be provided for women in order to reduce negative psychological consequences.

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  Background & Aim : Childhood cancer discloses family, and mother in particular, to a number of challenges. It consumes a lot of time, energy, and money of parents to fulfill their caring responsibilities. In some cases and along with increase of caring pressure, mental health of parents deteriorates. The vesting consequences of such events may alter the process of children caring and their quality of life (QoL). The purpose of this study was to examine the relationship between mother’s general health status with the QoL of the child diagnosed with cancer.

  Methods & Materials : In this descriptive cross-sectional study, 124 mothers of children diagnosed with cancer and aged 6-14 years old, referred to Imam Reza and Amir Hospitals in Shiraz during a four month period (from early November to late February) were selected to the study. Data were gathered using the following instruments: 1) the questionnaire of factors related to QoL in children 2) mother's general health status form 3) TNO_AZL Children Quality of Life (TACQOL) and 4) Ped QL Cancer Module. Data were collected through interviewing with mothers and reviewing the medical records of the hospitals. Data were analyzed using the Kruskal–Wallis, Spearman correlation coefficient, Mann-whiteny test and logistic regression in the SPSS-19.

  Results: : A few number of mothers (7.3%) reported good general health status and a large number described their general health status as moderate (55.6%) and poor (37.1%). The mean of health related QoL score and the specific QoL score for children were 78.45±10.05 and 65.51±17.54, respectively. According to the multi-factorial logistic regression, demographic and social factors such as child’s age and treatment-related factors including the period of radiotherapy, along with the duration of disease were more correlated with health and specific QoL scores in children, compared to the mothers’ general health status score.

  Conclusion : Results from this study suggested that emotional support is as important as financial empowerment. The QoL in these patients and their families may improve by identifying the families who are at risk of mental problems.

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  Background & Aim: The present study aimed to investigate the spiritual health among nursing and midwifery students at Kerman University of Medical Sciences in 2012 .

  Methods & Materials: This was a cross-sectional study in which all 222 nursing and midwifery students studying at Kerman University of Medical Sciences were recruited to study. Data were gathered using t he Palutzian & Ellison questionnaire of spiritual well-being. The obtained data were then analyzed in the SPSS-20 using parametric statistical tests such as independent t-test and Anova . 

  Results: Results showed that spiritual well-being of nursing and midwifery students was in the good range. Except gender, no statistically significant relationships were observed between the mean of spiritual well-being and parameters such as age, marital status, academic year, and field of study .

  Conclusion: According to the findings , spiritual health among nursing and midwifery students was moderate. It is necessary to promote spirituality among nursing and midwifery students .

  

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  Background & Aim: Insertion of chest tubes is a necessary measurement in chest trauma. The trauma patients need specific skills for self-care. This study aimed to determine the effect of using supportive-educative system on self-care skills in trauma patients with chest drainage system .

  Methods & Materials: In this quasi-experimental study, 62 trauma patients with chest-tube were selected from three surgery wards of Besat hospital in Hamadan from December 2012 to May 2013. Two wards were randomly allocated into the experiment group (n=31) and one ward was allocated into the control group (n=31). Participants were selected using convenience sampling. The supportive-educative system was designed based on the patients’ needs and was implemented to the experimental group in three consecutive days. The study instruments included self-care needs assessment form and self-care skills checklist. Measurements were completed once the patients were admitted to the wards and three days later by an external observer. Data were analyzed using t-test, Chi-squared test, Mann-Whitney and Wilcoxon tests with a 95% confidence level in the SPSS-16 . 

  Results: There were no significant differences between the two groups in the study variables at baseline (P>0.05). Although self-care skills in both control (P<0.01) and experiment (P<0.001) groups were improved, using educative-supportive system led to better self-care skills in the intervention group in compare to the control group (P<0.001) .

  Conclusion: In general, self-care skills of patients with chest drainage system could be improved by supportive-educative system. The improvement in the control group can be attributed to self-care trainings conducted routinely by doctors and nurses .