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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 & Aim: Family-centered care, which has become the cornerstone for pediatric nursing practice, supports the integrity of child and family health. It brings families a unique care and improves child and family health. Families are recognized as an essential part of a specialized child care during illness. They are expected to be skilful in child care both in and out of health care facilities. This study was carried out to determine health caregivers&apos attitude toward parent participation in the care of their hospitalized children at Madani pediatric hospital- Khoramabad in 2004.

Methods & Materials: This is a descriptive-analytical study. One hundred and sixty nine caregivers were selected through convenient sampling method. Data were gathered using a questionnaire including demographic and parents&apos attitude questions. The questionnaire had 36-item. The data were analyzed via SPSS computer software and using descriptive and analytical methods.

Results: Results indicated that the average of participants&apos attitude score was 92.28±12.55. Most of subjects had neutral attitudes toward parents&apos participation in their children&aposs care. Positive attitude were significantly related with marital status (P<0.04), having children (P<0.04) and being a nursing student (in comparison with medical students) (P=0.04).

Conclusion: The caregivers&apos attitudes toward parents&apos participation in the care of their hospitalized children were neutral. The students&apos and staffs&apos attitudes should be modified by taking part in continuous training programs.

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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 & Aim: Home care visits have unique advantages in many social problems and health complications such as psychologic complications and adverse birth outcomes. The aim of this study was to identify the effect of postpartum care at home on quality of life among low risk mothers.

Methods & Materials: This interventional study was conducted in Akbarabad health center of Tehran University of Medical Sciences in 2010. A total of 200 mothers were randomly allocated in two intervention and control groups. Mothers in the control group received two post partum visits in health care center and the intervention group received care at home. Data were collected through a questionnaire including demographic characteristics and the mothers&apos quality of life items along with a growth and development monitoring chart for newborns. For analyzing data, Mann-Withney U, Wilcoxon and Chi-square tests were used.

Results: Most of the mothers aged 20-29 years old. The number of visits were statistically different between the two groups (P=0.00, P=0.01). Dimensions of quality of life in the two groups were not statistically different: (Physical dimension: P=0.052), (Emotional dimension: P=0.775), (Public health dimension: P=0.068), (Social performance dimension: P=0.780) and (Total score: P=0.213).

Conclusion: the results of our study did not show no positive improvements in home postpartum care in comparison with the health care centers care. More studies are recommended.

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Background & Aim: Rapid changes experienced after child birth expose mothers to unpleasant experiences such as disturbances in sleep pattern. These experiences threaten health of mothers and infants. Some studies have shown that exercise can be an effective and non-pharmacologic method in improving sleep quality. The purpose of this study was to examine the effect of exercise on sleep quality among postpartum mothers.

Methods & Materials: This was a randomized clinical trial. Eighty primiparous women aged 18-35 years were recruited from health centers in Rafsanjan in 2009. The inclusion criteria were singleton pregnancy, lack of any acute and chronic physical and mental illnesses, having healthy and term babies, and having vaginal deliveries. Participants were randomly allocated to the intervention (n=40) and control (n=40) groups. Women in the intervention group received five 30-minutes sessions of Pilates weekly for eight weeks. The PSQI instrument was used to measure the related variables at baseline, forth and eighth weeks after the deliveries. Data were analyzed using the repeated measures ANOVA.

Results: Significant improvement was seen in the intervention group within eight weeks follow-up the interaction within time and group was significant (P=0.02). Comparison of mean sleep quality between the two groups has shown that the intervention was effective (P<0.001).

Conclusion: The Pilates exercise was effective in improving quality of sleep in postpartum period.

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  Background & Aim: Premature infants are the most admitted group to NICUs. Stabilization of cardio pulmonary parameters is a main goal in NICUs. Mechanical ventilation and endothracheal suctioning are the most common and effective procedures to stabilize cardio pulmonary parameters. The aim of present study was to compare the effects of two endothracheal suctioning methods (open and closed) on physiological stability in premature infants under mechanical ventilation .

  Methods & Materials: In this clinical trial, 90 preterm infants (GA: 27-34 weeks) hospitalized in the NICUs of Alzahra and Taleghani hospitals were selected and randomly assigned to two groups. In one group, infants were suctioned using open suctioning method and in the other group, infants were suctioned using closed suctioning method. The physiologic parameters (O2 sat, HR, mean BP variation) and stability (recovery time of HR, BP) were compared between the groups. Data were analyzed using descriptive and inferential statistical methods such as x², independent t-test and mixed model in the SPSS-21 . 

  Results: There was significant statistical difference between the two groups on mean BP (P=0.016). Recovery time of the BP and HR was shorter in the closed suctioning group. Physiologic stability was better in the closed suctioning group (P<0.05) .

  Conclusion: Variation of the mean BP and recovery time was more in the open suctioning group compared with the closed suctioning group. Considering better physiologic effects of closed suctioning, it is recommended to assess the combined effect of closed suctioning with weight on physiologic parameters of premature infants .

  

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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: Although compassionate care is recognized as a core component of nursing care, there is not still a precise definition about this complex and challenging concept. This study aimed to analyze the concept of compassionate care in nursing using a hybrid model.

Methods & Materials: A three-phase hybrid model (theoretical, field work, and final analysis) was used in this study. In the theoretical phase, the concept of compassionate care was searched in main databases from 2000 to 2016. In the field work phase, in-depth, face to face interviews were done with 11 nurses. The content analysis method was used to analyze the data. Final analysis was done in the last phase.

Results: The results of the final analysis showed that compassionate care is a process in which nurses interactively communicate with patients, try to explore patients’ concerns by putting themselves in their positions and understanding their situations, and do their utmost to eliminate these concerns.

Conclusion: According to this concept analysis, the constructive interaction between nurse and patient is one of the most important features of compassionate care that has not been mentioned in previous definitions. Also in this study, the nurses emphasized that they did their best to resolve the patients’ concerns. Therefore, the current study could be the basis for future studies in the area of compassionate care.

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Background & Aim: Culturally sensitive care is an essential component of professional development process and one of the predictive factors of nurses’ cultural competency. This care is the most important approach to improve the quality of nursing care in culturally diverse groups. The current study aimed to explore the consequences of culturally sensitive care in pediatric nursing.

Methods & Materials: This study is a qualitative study using conventional content analysis. 25 nurses and 9 parents were purposefully selected with maximum variation sampling from the pediatric wards of three referral teaching hospitals in Tabriz and Tehran in 2015-2016. Data were collected through in-depth interviews and field notes and simultaneously analyzed using MAXQDA software version 10.

Results: The consequences of culturally sensitive care in pediatric nursing emerged in two categories: justice-based care (with three subcategories: the lack of cultural bias, culture-based communication and effective participation) and cultural satisfaction (with two subcategories: reduced cultural stress and safe care). Culturally sensitive care prevents misunderstandings and improves nurse-child/parents communication and leads to parents’ honesty to share information and express cultural needs. The expression of cultural needs decreases stress levels in parents and children and results in safe care by reducing intractable traditional treatment.

Conclusion: According to the findings of this study, it is suggested that effective culturally sensitive interventions in pediatric wards should be included in in-service courses and nursing curriculum.

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Background & Aim: Patient participation is an important component of the patient-centered care approach and part of patients’ rights, with positive outcomes for the health care system. The aim of this study was to explore the nurses' experiences of patient participation in nursing care and its related factors.
Methods & Materials: This qualitative study was carried out with the participation of 18 nurses working in educational hospitals of Tabriz in 2019. The purposeful sampling through semi-structured interviews and focus group sessions was used to collect the data. Data analysis was performed using conventional content analysis. To achieve the accuracy of the data, the Lincoln and Guba criteria were used.
Results: Analysis of the data resulted in four main categories "giving information, decision-making, collaboration and respect". The patient’s participation from the nurses’ perspectives was: an interactive process of decision-making and collaboration between the nurse and the patient with the exchange of information, respect, and permission from the patient. The results also included the prerequisites, domains, outcomes, barriers, and solutions for patient participation in nursing care.
Conclusion: Patient participation today is considered the legal right of the patient and also the gold standard of international health care systems. So nurses, health system policy makers, patients and academic centers can use these results to improve patient participation in the care.
 

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Background & Aim: Structured description of pediatric medical emergencies requires the assessment and classification of underlying factors. The aim of study was to investigate frequency of predisposing factors for the entry of foreign bodies (FB) in the ear, ingestion and aspiration in children under five years in Tabriz.
Methods & Materials: This is a descriptive, cross-sectional study conducted through convenience sampling (n=245) in the ENT and emergency departments and the clinic of children's hospital in Tabriz, from March 2019 to June 2019. A researcher-made tool including the demographic characteristics form and questionnaire on predisposing factors was used to collect the data. Data was analyzed using the SPSS software version 21 through descriptive statistics.
Results: There were 137 (55.9%) cases of  FB aspiration into the airways (upper and lower), and the highest was related to nose. FB in ear was 19.6% and in stomach was 19.2%. Clinical manifestations were pain (50.2%), no clinical signs (29.4%), and the rest were bleeding with pain, cough, shortness of breath, suffocation, wheezing, nausea, and vomiting. The place of event was at home (in living room) and in the evening and night time. FB types included objects, food stuff/snacks/nuts, beans and fruit cores, and toy pieces, and it is most likely to be seed, toy pieces, nuts, shirt buttons, and rosary beads.
Conclusion: Parental, child-related, and environmental predisposing factors were reported. Therefore, future studies are suggested to evaluate the contribution of each of three factors and to implement necessary educational, notification, and interventional measures.
 

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Background & Aim: Cancer is a disease that affects the quality of life of the patient, and palliative care is a solution that can improve it. However, home palliative care program has not developed in most countries of the world. The aim of this study is to improve a home palliative care program for cancer patients.
Methods & Materials: This research is an action research study that was conducted through quantitative and qualitative approaches in Tabriz over 2018-2020. Eighteen home care nurses were selected for interviews using purposive sampling in order to identify the care needs of cancer patients and the barriers to palliative care at home. In addition, a questionnaire to determine the attitude and knowledge was distributed among 60 home care nurses before and after the action stage. The qualitative data were analyzed using conventional content analysis method, and the SPSS software version 14 was used to analyze the quantitative data.
Results: The care needs of cancer patients were determined in five categories and barriers to palliative care in three categories. Cancer patients have physical, psychological, educational, financial and spiritual needs, and barriers to palliative care include poor instruction, families' desperation, and unprofessional caregivers. In the quantitative phase, nurses had average knowledge and negative attitude towards palliative care. Training through virtual space improved the knowledge and attitude of nurses, and the paired t-test showed that the mean score of nurses' knowledge after the action stage was significant.
Conclusion: according to the findings, to improve palliative care at home, the physical, psychological, educational, financial and spiritual needs of cancer patients should be considered. Removing barriers to palliative care including developing guidelines, supporting the families of cancer patients and training special nurses for palliative care at home can improve care in these patients.

 

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

 

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Background & Aim: Intramuscular injections represent a painful procedure for premature infants. This study aimed to compare the effects of pressure massage at Hegu point versus Kunlun–Taixi pressure points on pulse rate, arterial oxygen saturation, and crying duration following intramuscular injection of vitamin K in premature infants.
Methods & Materials: A randomized, single-blind clinical trial was conducted on 100 premature infants admitted to the neonatal intensive care unit between 2020 and 2021. Participants were selected through convenience sampling and then randomly assigned into four groups of 25 individuals each: Hegu point massage, Kunlun–Taixi points simultaneous massage, placebo and control. Prior to the vitamin K injection, the intervention groups received targeted pressure point massage, the placebo group received nasal tip massages, and the control group received standard care. Pulse rate, arterial oxygen saturation, and crying duration were recorded before, during and after the intramuscular injection using a pulse oximeter and chronometer. Data were analyzed using two-way repeated measures analysis of variance in SPSS software version 24.
Results: Significant differences were observed in average pulse rate (P=0.013) and average arterial oxygen saturation (P=0.028). The group receiving simultaneous massage at Kunlun–Taixi points exhibited the lowest mean pulse rates during (149.24±7.78) and after (144.16±8.64) the injection, as well as the highest mean arterial oxygen saturation percentages during (88.36±9.37) and after (88.04±8.33) the injection.
Conclusion: Simultaneous massage of Kunlun–Taixi pressure points reduced changes in pulse rate and arterial oxygen saturation induced by intramuscular injection in premature infants. It is recommended to use this simple and low-priced method to reduce the physiological responses to injection-related pain in premature newborns.
Clinical trial registry: IRCT20210630051743N1

 

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Background & Aim: Although chemotherapy is effective in treating leukemia, it is associated with multiple adverse effects. Mothers, as key members of the healthcare team, need adequate information regarding these side effects to provide optimal care. This study aimed to investigate the side effects of chemotherapy in pediatric and adolescent leukemia patients and examine their relationship with maternal treatment knowledge.
Methods & Materials: This descriptive, cross-sectional study was conducted in 2023 and involved 110 mothers and their children aged 6-18 years hospitalized for leukemia at educational hospitals in Tabriz. A convenience sampling method was employed. Data collection instruments included the American Cancer Society's chemotherapy side effects checklist and an information questionnaire for parents of children with cancer, developed by Motlagh et al. The data were analyzed using SPSS version 24, applying chi-square tests, one-way ANOVA, paired t-tests, Pearson correlation coefficients, and repeated measures ANOVA.
Results: The mean age of mothers was 37 years, and that of the children was 11.61 years. The majority of diagnoses were Acute Lymphoblastic Leukemia (ALL). The severity of complications—such as fever, nausea, vomiting, mouth mucositis, diarrhea, anorexia, and bleeding—showed a significant increasing trend over the four-week observation period (P<0.001). Additionally, a significant difference was observed in mothers' treatment knowledge between the first and fourth weeks (P<0.001). There was a significant relationship between chemotherapy complications and mothers' treatment knowledge (P<0.05).
Conclusion: Mothers actively seek and obtain information regarding their children’s chemotherapy treatment, with their knowledge increasing as complication severity rises. Awareness of side effects and their management strategies enables parents to provide appropriate care and empowers caregivers to offer the best advice and support to patients and their families throughout the treatment course.