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Introduction: Pregnancy is a natural phenomena and basis of birth but can induce various dangers to mother and fetus. Since mother is the central part of family, maternal mortality would be an irreparable damage to the community. On average 10100 live births and 12 maternal mortalities occur in Kurdestan province each year the maternal mortality rate is therefore 118/100000 live births which in comparison to similar figure in whole country (37/100000 live births) is three times higher.

Materials and Methods: This research is an analytic case-control study. Cases and controls were matched for place of residence and age at gestation. Cases (n=55) were chosen by census and controls (n=220) were chosen by random sampling. The tool used to collect data was questionnaire, validity and reliability of which was tested by content validity and test-retest method. The statistical testing used in this study were Chi square and odds ratio. Data were analyzed by SPSS .11 software.

Results: Most of maternal mortalities had occurred in women 18-35 years of age, illiterate and living in rural areas. Marivan had the highest maternal mortality compared to other surveyed cities (29.1%). Prenatal care (OR= 22.7), parturition agent (OR= 9.85), use of one of the method of family planning (OR= 2.5) and parturition method (OR= 2.3) had meaningful relationship with maternal mortality.

Conclusion: According to findings of this research, it is possible to decrease the maternal mortality by improving prenatal care and family planning and preventing parturition by uneducated midwives and avoiding unnecessary cesarian sections.

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Background & Aim: Some aspects of life style in adulthood have major preventive role from osteoporosis in adult ages. This research has been done in order to determining female teenager’s life style in relation with prevention of osteoporosis.

Methods & Materials: This research was a descriptive - analytical study. In this study, 760 person of female teenage students in high schools and pre-university centers of zone 17 in Tehran city were chosen by random classified cluster sampling method. In this study, the tool for data collection was written questionnaire, and method of it was answering to questionnaire. The questionnaire had 2 parts. First part included demographic characteristics, and second part included different dimensions of lifestyle in relation with prevention of osteoporosis, such as nutrition, exercise and physical activity, habits (smoking, using weight loss food regimen and weight loss drug). The life style categorized as 3 levels unfavorable, partially favorable, and favorable. The collected information was assessed by SPSS software and descriptive and analytical statistical methods were used to reaching study objects.

Results: Results Showed nutrition, phisycal activity and exercise the highest percent of cases (51.8%, 57.7%) had undesirable lifestyle. Also 50 percent of cases had undesirable lifestyle. About habits (Smoking, using weight loss food regimen and using weight loss drug) the highest percent of cases (74.9%) had desirable lifestyle. Also there was a significant statistical relationship between life style and variables of education level (p=0.004), economical status of family (p=0.043), the birth number in family (p=0.001) and educational level of mother (p=0.005).

Conclusion: According to the results of research, lifestyle of 50% of female teenagers was undesirable. Findings of this research are attentive and need more assessment and planning by responsible people in order to omitting noted problems in lifestyle.

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Background & Aim: Early diagnosis of breast lumps through breast self-examination (BSE) is important for early detection of breast cancer. The aim of this study was to evaluate factors predict the BSE behavior using Health Belief Model constructs in women referred to health centers in Bandar abbas, Iran.

Methods & Materials: In this cross-sectional study, 240 eligible women were randomly selected from eight health centers. Data were collected using a self-administered questionnaire including demographic characteristics and Champion&aposs Health Belief Model Scale (CHBMS). The CHBMS measures the HBM concepts of susceptibility (3 items), seriousness (6 items), benefits (4 items), barriers (8 items) and self-efficacy (10 items). All items were ranged in a Likert scale ranging from ‘‘strongly disagree (score: one)&apos&apos to ‘‘strongly agree (score: five)&apos&apos.

Results: A total of 240 women took part in the study. The mean age of participants was 37.2 (SD=6.1). Of all, 32.5% had high school education and 95.8% were married. The results showed that 31.7% of the women had performed the BSE however, only 7.1% had performed it regularly. Perceived BSE benefits, perceived BSE barriers and perceived BSE self-efficacy of the participants who performed the BSE were significantly higher than those who did not (P<0.03). The results from regression analysis indicated that the perceived BSE self-efficacy and perceived BSE barriers predicted breast self-examination behavior (P<0.001).

Conclusion: The findings of this study indicated that perceived BSE barriers and perceived BSE self-efficacy were influencing factors in predicting the BSE behavior. Therefore, in order to improve self-efficacy and decrease the barriers, BSE training programs are strongly recommended.

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Background & Aim: Pregnancy experience can be a kind of crisis in women&aposs lives. Different forms of anxiety can make problems in pregnant women. This study aimed to determine the effect of attachment education on anxiety and attachment behaviors of first-time mothers.

Methods & Materials: In this clinical trial, 84 primigravida women were selected from two hospitals in Shirazi using convenience sampling. The participants were randomly allocated to the test and control groups. Data were collected using a personal data form, the Anxiety Inventory Spielberger, and the maternal infant attachment tab view. The intervention group received four two-hour sessions during one month training course on attachment behavior. Maternal attachment behaviors were shaped Weekly on the forms. The control group received usual care of pregnancy. At the first day after the delivery, the researchers observed mothers attachment behavior during breastfeeding in all groups using Avant sheet without informing the mothers. Data were analyzed using statistical tests such as Chi-square, T-test, and paired t-test.

Results: The mean of the anxiety score was no significantly different before the intervention between the groups (P=0.59). The average anxiety scores was statistically significant after the intervention in the two groups (P=0.003). Also, average scores on the attachment of mothers with the breastfeeding infants was statistically different (P<0.001) in the intervention group.

Conclusion: Attachment behavior training reduces anxiety and increases maternal attachment.

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Background & Aim: Multiple structural factors preside over burn units influence nurses&apos quality of care and their activities. The complexity and multy-dimensional nature of nursing care in these units, creates many challenges. Understanding the perspectives of people&aposs involved is recommended. This study, with a theory-to-research approach, was conducted to assess the frequency of confronting intra and extra organizational factors preside over burn units, the intensity of its related pressure, and correlations among these variables from nurses&apos perspectives.

Methods & Materials: In this cross-sectional, correlational study, 98 nurses working in the Shahid Mottahari burn center were recruited by census. Data was collected using the intra and extra organizational factors instrument, provided based on the previous grounded theory study of the researchers. Intra-organizational factors questionnaire consisted of 58 Likert type statements in eight subscales and two dimensions of frequency (α=0.94) and intensity (α=0.96). Extra-organizational factors questionnaire consisted of eight Likert type statements (α=0.74). Data were analyzed using the SPSS version 14.

Results: The results revealed that the frequency of nurses&apos confrontation with factors related to environment and patients as well as its intensity were more than other factors. Moreover, the intensity of the whole factors was more than its frequency. All the extra- organizational factors were significantly correlated with all intra-organizational factors except for the "absence of employment permission" (P<0.05).

Conclusion: This study explained the importance of intra-organizational factors of a burn center in inducing stress on nurses. In addition to verification of some relationships in the previous mid-range theory, the results of this study also modified some of its aspects. Therefore it added to the existing body of knowledge about organizational factors and job stress in burn units. Moreover, it produced some evidences to use in nursing administration and service, and finally it resulted in some directions to control stress in nurses&apos job.

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Background & Aim: Premature infants undergo painful and stressful procedures during care and treatment. Nurses can help to reduce short- and long-term effects of pain caused by diagnostic and therapeutic procedures using various methods including music therapy. The aim of this study was to assess the effect of music therapy on physiological pain responses of premature infants during and after blood sampling.

Methods & Materials: This was an experimental study with crossover design conducted on 20 premature infants hospitalized in the intensive care unit of a hospital affiliated to the Tehran University of Medical Sciences for a five months period in 2010-11. Infants were randomly allocated in two groups of experiment and/or control. Each infant was considered as its own control. We assessed the physiological pain responses caused by blood sampling such as heart rate and oxygen saturation level. Infants in the experiment group listened to the Transitions music five minutes before until 10 minutes after the blood sampling. The responses were recorded and reviewed ten minutes before until ten minutes after the blood sampling in both groups and physiological changes were detected. Data were analyzed using ANOVA and Chi-square tests in the SAS and SPSS.

Results: Results showed significant difference in heart rate between the experiment and control groups during needle exit (P=0.022). There was also significant difference in heart rate between experiment and control group in the first 5 minutes of blood sampling (P=0.005).

Conclusion: Results showed that music therapy could reduce some physiological responses of pain during and after blood sampling. Music therapy can be used as a beneficial intervention following painful procedures such as blood sampling in the NICU.

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  Background & Aim: Reducing maternal anxiety has a critical role in maternal and fetal mental and physical health. This study aimed to assess the effect of two anxiety reducing techniques including relaxation and maternal-fetal attachment training on anxiety in third trimester and postpartum depression among primipara women.

  Methods & Materials: In this clinical trial, 126 pregnant women were randomly selected and divided into three groups including relaxation training, maternal-fetal attachment skills training, and control group. The participants completed a demographic questionnaire, the Spillberger and Beck questionnaires and written consents at baseline. The participants completed the questionnaires after the intervention too. The one way ANOVA and paired t-test were used to analyze the data. 

  Results: At baseline, the mean total anxiety, state and trait anxiety and depression scores were not significantly different between the groups. The ANOVA showed differences in the mean score of anxiety after the intervention (P=0.03) in the intervention groups. There were statistically significant differences between the attachment and control groups (P=0.01) and the relaxation and control groups (P<0.001) in terms of the mean score of state anxiety. The ANOVA showed a reduction in the mean score of state anxiety after intervention in the attachment (P=0.02) and relaxation groups (P=0.01). There was significant difference after the intervention in the mean score of maternal depression (P=0.002) between the attachment and relaxation groups with the control group (P=0.01, P=0.01 respectively). 

  Conclusion: A ttachment and relaxation trainings can reduce maternal anxiety and post-partum depression. Pregnancy visit is an important opportunity to screen maternal anxiety and prevent post-partum depression using simple and non-expensive training programs.

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  Background & Aim: Oral health is one of the most important components of personal health. Understanding current status of oral health is necessary to provide future oral health interventions. The aim of this study was to determine factors influencing tooth brushing behavior based on the health belief model (HBM) among 5- and 6-grader students.

  Methods & Materials : : In this cross-sectional study, 370 primary school students were selected using the stratified cluster sampling method. Data were collected using a questionnaires based on the HBM. The obtained data were analyzed in the SPSS-20.

  Results: The results showed that 95.7% of the students brushed their teeth once or more daily. Mean and standard deviation of the brushing frequency in one week was 8.66±3.54. There was a significant correlation between the perceived barriers (P=0.00, r=-0.14) and self-efficacy (P=0.04, r=0.10) with the brushing behavior.

  Conclusion : According to the results, educating students and decreasing different barriers seems to be necessary to improve brushing behavior.

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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: Adherence to the principles of appropriate nutrition and diet therapy is one of the most important aspects of diabetes management. The present study aimed to assess the effect of nutrition education based on "MyPlate" Food Guidance on the anthropometric indices and blood profiles in people with type 2 diabetes.

Methods & Materials: In this randomized clinical trial study conducted in 2014, 44 people with type 2 diabetes were randomly allocated either into the control group or the intervention group. Anthropometric measurements, blood profiles, energy intake and physical activity data were collected before and three months after the 2 hours face-to-face “MyPlate” nutrition education session for the intervention group or the usual educational sessions for the control group. Paired t-test, independent sample t-test, ANCOVA, and nonparametric tests were utilized to analyze the data.

Results: At the beginning of the study, the two groups were similar in terms of the anthropometric indices, glycosylated hemoglobin, blood sugar and physical activity. After intervention, except for physical activity which was higher in the nutrition education group based on "MyPlate" Food Guidance, the other above cases were lower than the control group (P<0.05), but no significant differences were seen in the changes of blood pressure (systolic and diastolic) and energy intake between two groups of education and control.

Conclusion: Nutrition education based on "MyPlate" Food Guidance for three months decreases the anthropometric indices and blood profiles in people with type 2 diabetes.

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Background & Aim: Females’ quality of sexual life is one of the key issues of sexual and reproductive health. This is a subjective concept and defined as individual’s perception of sexual aspect of life. The aim of this study was to explore the factors affecting Iranian women’s quality of sexual life.

Methods & Materials: This qualitative study was conducted by conventional content analysis. Data were collected by 17 in-depth, unstructured interviews and 14 sexual life narratives through purposeful sampling among married and reproductive aged women from five university-affiliated health centers in Tehran and Shiraz. Constant comparative method was used to analyze data.

Results: According to the participants’ experiences, 3 themes emerged as direct factors affecting the quality of sexual life including ‘preparation before sexual relationship’, ‘couple’s interaction and harmony in sexual relationship’ and ‘previous sexual relationship outcomes’. ‘Marital life status’ and ‘passive sexual socialization’ were explored as the factors which can conceptualize the context of females’ quality of sexual life.

Conclusion: In this study, factors affecting females’ quality of sexual life were identified. Attention to these factors is suggested to design appropriate interventions by health care system in Iran.

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Background & Aim: Ultraviolet (UV) keratitis is an inflammation of the corneal epithelium and conjunctiva caused by UV radiation and is associated with the symptoms including severe eye pain, decreased visual acuity, severe tearing and red eye. The use of primary patching in the patients is doubtful. Therefore, this study aimed to determine the effect of eye patching on the improvement of clinical symptoms in patients with UV keratitis.

Methods & Materials: In this clinical trial, 120 patients with UV keratitis referred to the emergency department of Khatam Al Anbia center affiliated to Mashhad University of medical sciences, were randomly assigned into two groups (each group contains 60 patients) with patching and non-patching in 2015 (IRCT2015092124124N1). In one group, both eyes were patched and the other group was not patched. All other care was similar in both groups. Clinical symptoms were checked and compared between two groups before and after 12 hours. Data were analyzed by descriptive statistics, independent t-test, paired t-test, Chi-square and Wilcoxon using SPSS software version 23. A p-value less than 0.05 was considered significant.

Results: The results showed that redness (P<0.001) and tearing (P<0.001) were more improved in the non-patched group but there was no statistically significant difference between the two groups in visual acuity (P>0.05).

Conclusion: Eye patch does not have effect on the improvement of clinical symptoms such as tearing and redness, and these symptoms are more improved without patching.

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Background & Aim: Assessment of sexual health literacy requires an appropriate tool. The purpose of this study was to develop and validate a questionnaire to evaluate the level of sexual health literacy among Iranian adults.
Methods & Materials: This study was designed in two phases in Tehran during 2017-2018. In the first step, the questionnaire was developed by item generation through expert panel and literature review. In the second step, the assessment of psychometric properties of the questionnaire including face, content, and structure validity (exploratory factor analysis) and convergence criterion (using general health literacy questionnaire) were done. Reliability of the questionnaire was assessed by internal consistency (Cronbach’s alpha) and intraclass correlation coefficient (ICC). Data were analyzed using the SPSS software version 21.
Results: The content validity indices (CVI and CVR) for all items were 0.84 and 0.81, respectively. Exploratory factor analysis identified four factors including skills of access, reading and understanding, evaluation and analysis, and application of information that explained %68.1 of the variance. Convergent validity of the questionnaire showed a correlation between the questionnaire’s dimensions and general health literacy questionnaire in the range of 0.31 to 0.70. The SHELA showed a high internal consistency reliability with Cronbach’s alpha, ranging from 0.84 to 0.94 and intraclass correlation coefficient (ICC), ranging from 0.90 to 0.97.
Conclusion: The psychometric assessment of the 40-item questionnaire (SHELA) indicates desirable validity and reliability. This questionnaire is suggested for assessing the level of sexual health literacy of adults in future studies.
 

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Background & Aim: Efforts to improve self-care in patients with heart failure provide better treatment outcomes and longer life expectancy. The purpose of this study was to determine the effect of a caring program based on Pender model on health-promoting self-care behaviors in patients with heart failure.
Methods & Materials: In this single-blind randomized controlled trial, 48 patients with class II or III heart failure, referred to Golestan hospital in Tehran in 2017-2018, were recruited by the purposive sampling method and were randomly assigned to an intervention or a control group. For the intervention group, a caring program based on the Pender Health Promotion Model was conducted in six sessions. Data were collected by the Health Promoting Lifestyle Profile and the Self-Care Heart Failure Index, before and after the intervention. Descriptive and inferential statistical tests were used to analyze the data by the SPSS software version 16.
Results: The mean scores of the dimensions (except self-actualization) and the total score of health-promoting behaviors and self-care in the intervention group were higher than in the control group after the intervention (P<0.05). In addition, after the intervention, the mean scores of the dimensions and the total score of health-promoting behaviors and self-care significantly increased in the intervention group (P<0.05).
Conclusion: Implementing a caring program based on Pender model increases the self-care and health-promoting behaviors of patients with heart failure. Therefore, application of this caring program is recommended for this group of patients.
Clinical trial registry: IRCT20150801023446N17
 

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Background & Aim: Cardiovascular diseases, especially coronary artery disease, are one of the most common causes of death worldwide. Recently, coronary intervention through the skin has been used for treatment, which has significantly reduced mortality rates. Nursing care behavior is of special importance in reducing the complications of angioplasty. The purpose of this study was to determine the effect of primary nursing care on the patients’ perception of nursing care behavior after coronary angioplasty.
Methods & Materials: In this randomized controlled clinical trial, 60 patients admitted from February 2018 to April 2018, to the CCU of Razi hospital in Birjand were selected by the convenience sampling method and assigned into two groups of 30, using a simple random allocation method. For the patients in the control group, routine care was delivered case by case, and for the patients in the primary nursing care group, care was provided based on the nursing process. At the time of discharge, the Caring Behaviors Inventory (CBI) was completed for the patients via interviews. Data were analyzed using the independent t-test and the significance levels of 0.05.
Results: The results showed that the mean scores of perception of care behavior and dimensions "respect" and "assurance of humanistic presence" in the intervention group were significantly higher than those of in the control group (P<0.05). However, no significant differences were observed between the two groups in the dimensions "positive attitude and relationship", "knowledge and professional skill" and "attention to other experiences" (P>0.05).
Conclusion: Provision of primary nursing care leads to improving the patient’s perception of nursing care behavior, increasing sense of respect, and assurance of humanistic presence of the nurse. Therefore, it is recommended to use this caring method in the cardiac intensive care unit.