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Background & Aim: Labor refers to a chain of physiologic events that allows a fetus to undertake its journey from the uterus to the outside. Friedman (1954) described a sigmoid pattern for labor. This study was carried out to compare the pattern of labor progression in nullipara women of Fasa with the Friedman&aposs labor curve.

Methods & Materials: This cross-sectional study was conducted among 619 nulliparous women aged 18-35 who had term delivery and had no serious disease. In order to data analysis, we used one way ANOVA for comparing the means, and fixed effect of regression models in reverse method for curves drawings.

Results: In all of the subgroups, effacement rate increased by increasing the cervical dilatation. Mean of dilatation rate was significantly higher in induced group than the other groups. Duration of the active phase was longer in the group that had sedation than the other two groups. Means of the duration of active phase and second stage were significantly lower in our study than the durations in the Freidman&aposs study (P<0.001) (3.87 hours vs. 4.9 hours and 52 minutes vs. 57 minutes, respectively). We did not observe the deceleration phase in our study.

Conclusion: The pattern of labor progression differed from the Freidman&aposs curve and had not sigmoid shape. The most important factor in latent phase was the time of admission to the labor ward.

 

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Background & Objective: Research utilization is an important way to extent the knowledge in nursing practice. It empowers the nursing profession. Research utilization is a new paradigm in Iran&aposs nursing care. This study aimed to assess the extent of research utilization in nursing clinical practice in Tehran, Iran.

Methods & Materials: This is a cross-sectional study. The clinical nurses with at least one year of work experience were selected through a multistage stratified sampling method. They completed a five-sectioned self-report questionnaire. The scores were categorized into high, intermediate, and low. Data were analyzed using descriptive statistics and Chi-Square test in SPSS.

Results: Findings revealed that the research utilization in 66.9% of the nurses was low. There was significant relationships between the extent of research utilization and the level of education, professional condition, clinical setting, research activities, work shift, job satisfaction, and English language skills.

Conclusion: The majority of nurses&apos practice is not according to the research findings. We need to find appropriate strategies to enable us to utilize the research findings.

 

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Background & Objective: Conflict occurs more frequently in health care organizations than the other settings due to complexity, frequent interaction between personnel, variations in specialties, roles, and hierarchy. Although conflict is not harmful and destructive in its nature and some degrees of conflict can help to improve health care services, high levels of conflict or its continuity may be harmful. Therefore, it is necessary to manage and control conflict. This study was carried out to assess the relationship between components of the conflict control model.

Methods & Materials: In this cross-sectional study, we developed a questionnaire that probed the relationships between components of conflict control model. A total of 290 nurses were recruited to the study using multi-stage sampling procedure from general educational hospitals in Tehran. Data were gathered using a questionnaire. Content validity of the questionnaire was examined by the expert panel. The internal consistency of the questionnaire was 0.81. Data were analyzed in the SPSS using descriptive statistics and spearman statistical test.

Results: The range of age was 22-53 (34.5±8.2). The majority of the respondents (88.6%) were female, 57.6% were married and 84.8% were staff nurses. From the majority of nurses&apos perspective, the meaning of conflict was discoordination, disagreement and disparity. However, some of the nurses meant it as violence, and difficult issues. About 41.4% of the respondents used negotiation, when they faced up to conflict. Other strategies were aggression, disagreement, avoidance, forgiveness, ignorance, and imposing own ideas to the others. From the respondents&apos point of view, factors that might cause or control the conflict were "mutual understanding and interaction" (32.4%), personality of nurses and their individual characteristics (26.6%), and conditions of the job (21.7%). Interaction was recognized to be the core strategy in conflict control model. Interaction had also significant associations with the five main variables in this study.

Conclusion: Lack of appropriate and efficient communication was an important factor in occurrence of conflict from the nurses&apos point of view. It is essential to improve nurses&apos and managers&apos communication channels by helping personnel to use effective communication skills. This measurement can be helpful for staff in understanding each other and reducing misconceptions. In addition, recognizing additional factors and variables that increases the occurrence of conflict can help to modify effective approaches.

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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: Transition from studentship to working life is a stressful and challenging event. The concept of transition is important in nursing education, management, and practice issues. However, despite its supreme importance, there are certain ambiguities about the concept of transition in nursing. The aim of this study was to analyze the concept of transition in the context of nursing in Iran.

  Methods & Materials: We used the three-phase hybrid concept analysis model including the theoretical phase, the fieldwork phase, and the final analytic phase in this study. In the theoretical phase, we conducted an online literature search to find relevant articles published prior to 2012. In the fieldwork phase, five novice nurses, two experienced nurses, and one head-nurse were interviewed. Interviews were transcribed verbatim and analyzed using thematic analysis approach. During the final analytic phase, we compared the findings of the first two phases to provide a clear and comprehensive definition of the concept of transition . 

  Results: The findings of the theoretical phase revealed that transition was a process phenomenon having defined attributes such as detachment, individual perception, awareness, and human response patterns. According to the findings of the fieldwork phase, transition was an interactive, evolutionary, and time-bound phenomenon that embodies attributes such as socialization, unavoidability, and competence and ability development. In the final analytic phase, a comprehensive definition was provided for the concept of transition in the context of nursing in Iran .

  Conclusion: This study provided a comprehensive understanding of the concept of transition from nursing studentship to working life in Iran. The findings of this study can be used to develop theories, instruments, and criteria for evaluation of novice nurses’ transition to experienced nurses .

  

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  Background & Aim: Nurses’ m ental health is an important dimension of quality of life and health care delivery. Job instability can be threatening for mental health of nurses. This study was conducted to assess the relationship between minor psychiatric disorders (MPD) among nurses with their job stability .

  Methods & Materials: This was a cross-sectional-analytical study. A total of 771 nurses working in Bushehr and Fars provinces were recruited to the study through multi stage sampling. Mental health status was evaluated using the GHQ-12 questionnaire. The employment type -contractual, apprenticeship, permanent, and fixed term- were used as items to measure job stability. Data were analysed using latent class regression . 

  Results: About 27.48% of nurses suffered from MPDs. There was no significant relationship between the types of employment with MPD . There was a significant relationship between MPD with gender (P=0.049). Females were 20% more likely to have MPD .

  Conclusion: Prevalence of MPD among nurses was in the moderate level. High prevalence of MPD among female nurses shows necessity of providing appropriate strategies to control MPDs such as anxiety and stress among nurses .

  

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  The results of several studies show the relationship between the ratio of nurses/patients with quality of care and patient outcomes (1-3). This means that less the ratio, more expected adverse outcomes for patients. These findings have led some institutions to establish mandated nurse-patient ratios (4). Establishing standard ratios could potentially improve patients' outcomes such as patients' safety (5, 6), decrease length of stay (3) and readmission rates (7), and improve recruitment and retention of nurses in the system and reduce their burnouts (8).

  According to Mohammad Aqajani, Deputy of the Iran Ministry of Health and Medical Education (MOHME), the country is facing a serious nursing shortage as about 80 thousand nurses serve 80 thousand beds in public hospitals, i.e. one nurse per hospital bed. However, the national standards suggest at least two nurses per bed. Now each year there are nine thousand graduates of nursing baccalaureate program thus, even if no nurse is retired or leave the system and all graduates could be recruited to work in the nursing field, still at least nine years will be needed to provide adequate nurses. In fact, a significant number of nurses leave their job due to retirement, early retirement, turnover and migration so achieving the standard of nursing staffing in a ten-year timeframe seems impossible. ...

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Background & Aim: In the view of the importance of evidence-based clinical practice in recent years, clinical disciplines such as nursing and midwifery have found a special need to systematic review and meta-analysis. However, systematic reviews and meta-analysises like any other studies may be poorly designed and implemented. Therefore, certain guidelines have been considered for reporting of such studies. The PRISMA statement is one of the most recent developments to improve the reporting quality of systematic reviews. The present study aimed to assess the reporting quality of systematic reviews and meta-analysises in the Iranian journals of Nursing and Midwifery, based on the PRISMA statement.

Methods & Materials: In this study, we conducted a comprehensive search on the Iranian journals of Nursing and Midwifery (Persian and English), indexed by the SID, Magiran, Irandoc, Iranmedex and Google Scholar databases during 2010 to 2015 years. The search was implemented using the key words such as systematic review and meta-analysis. Of the 44 articles found, after considering the inclusion criteria, 16 articles remained that were investigated using the PRISMA statement. Data were analyzed through the descriptive statistics and chi-square test using SPSS software version 16.

Results: The compliance rate of studies on the basis of PRISMA statement was estimated to be about 63%. The most common deficiency in the reporting quality was related to methodology estimated to be about 57%. The most visible deficiencies in the reporting of systematic reviews and meta-analysises were related to bias in the primary studies and bias in combining the results of these studies and lack of reporting these biases.

Conclusion: In this study, the reporting quality of systematic reviews and meta-analysises in the Iranian journals of nursing and midwifery was in the moderate level. The most probable reason for this may be the lack of enough attention of researchers to the PRISMA statement or not using this statement in reviewing articles. Therefore, it is recommended that an appropriate share of the educational programs on research methodology be allocated to systematic reviews and familiarizing with valid criteria such as PRISMA statement.

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Background & Aim: Increasing understanding of death anxiety among different cultures and patient populations is critical to provide quality patient care. Researchers who investigate death anxiety, are looking for a reliable and valid instrument compatible with culture in order to achieve this goal. The aim of the study was to evaluate the psychometric properties of the Templer’s Death Anxiety Scale-Extended (TDAS-E) among a sample of chemical veterans of Iran–Iraq warfare.

Methods & Materials: In this methodological study, 300 veterans completed the Persian version of the 51-item TDAS-E in 2015. The face, content and construct validity (convergent and discriminant validity) of the TDAS-E were assessed. Also, its reliability was measured using Cronbach’s alpha coefficient, construct reliability and intra correlation coefficient.

Results: Results of exploratory and confirmatory factor analyses extracted four stable distinct factors including fear of the hereafter, fear of facing death, fear of the shortness of life, fear of dying following an incident and mishap. The fitness of the four-factor model of the Templer’s death anxiety construct was approved based on standard indices (c²/df=2.832, GFI=.915, AGFI=.873, PCFI=.657, PNFI=.612, RMSEA=.078). Discriminant and convergent validity of all factors were acceptable. Also, scale reliability was confirmed using Cronbach’s alpha coefficient (0.88), construct reliability (higher than 0.70) and intra correlation coefficient (0.87).

Conclusion: The results of the current study revealed that the four-factor construct of TDAS-E had suitable validity and reliability among Iranian chemical warfare veterans. Given the proper psychometric properties, this scale can be used in future research to evaluate death anxiety in this population.

Background & Aim: Increasing understanding of death anxiety among different cultures and illness populations is critical to provide quality patient care. Researchers who investigate death anxiety, are looking for a reliable and valid instrument compatible with culture in order to achieve this goal. The aim of the study was to evaluate the psychometric properties of the Templer’s Death Anxiety Scale-Extended (TDAS-E) among a sample of chemical veterans of Iran–Iraq warfare.

Methods & Materials: In this methodological study, 300 veterans completed the Persian version of the 51-item TDAS-E in 2015. The face, content and construct validity (convergent and discriminant validity) of the TDAS-E were assessed. Also, its reliability was measured using Cronbach’s alpha coefficient, construct reliability and intra correlation coefficient.

Results: Results of exploratory and confirmatory factor analyses extracted four stable distinct factors including fear of the hereafter, fear of facing death, fear of the shortness of life, fear of dying following an incident and mishap. The fitness of the four-factor model of the Templer’s death anxiety construct was approved based on standard indices (c²/df=2.832, GFI=.915, AGFI=.873, PCFI=.657, PNFI=.612, RMSEA=.078). Discriminant and convergent validity of all factors were acceptable. Also, scale reliability was confirmed using Cronbach’s alpha coefficient (0.88), construct reliability (higher than 0.70) and intra correlation coefficient (0.87).

Conclusion: The results of the current study revealed that the four-factor construct of TDAS-E had suitable validity and reliability among Iranian chemical warfare veterans. Given the proper psychometric properties, this scale can be used in future research to evaluate death anxiety in this population.

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Background & Aim: Needlestick injuries (NSIs) are a serious occupational hazard for health care providers and nurses that are often not reported for various reasons. Several studies have reported a different rate of this great challenge. The aim of this systematic review and meta-analysis was to estimate the prevalence of under-reporting of NSIs in healthcare providers in Iran.
Methods & Materials: By searching national and international databases including SID, Magiran, Google Scholar, IranMedex, Science Direct, PubMed and Scopus, 19 published articles were extracted. Data analysis was carried out through the random-effects model, and heterogeneity was investigated by I² index. The data were analyzed using the Stata software version 12.0.
Results: The rate of non-reporting of NSIs in 19 relevant articles in Iran with the sample size of 9274 was 59% (95% CI: 49-69). The rate of under-reporting of NSIs in the healthcare providers (64%) was higher than in nurses (55%). Based on the meta-regression results, there was no significant relationship between the prevalence of under-reporting of NSIs and the year of publication (P=0.138), sample size (P=0.390) and age (P=0.918).
Conclusion: The results of the study showed that more than half of health care providers did not report NSIs. Notifying health care providers about the risks of NSIs and properly dealing with the injured cases is necessary in order to increase the reporting of NSIs.
 

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The World Health Organization (WHO) has introduced palliative care as a way to improve the quality of life of patients with incurable diseases and their families. This care begins with the diagnosis of the disease, and continues throughout the illness (1). Palliative care improves the quality of life of patients with life-threatening diseases and their families. Its purpose is to relieve suffering through the identification, evaluation, and relief of pain and other physical, psychosocial and spiritual problems (2).
Palliative care is required for many diseases. According to reports, every year about 40 million people in the world need palliative care, but only 14% of them receive it, of whom 78% live in low-income or middle-income countries. According to the World Health Organization, patients who require palliative care services, suffer from cardiovascular diseases (38.5%), cancer (34%), chronic pulmonary diseases (10.3%), AIDS (5.7%), and diabetes (4.6%). Other patients with diseases, such as dementia, kidney failure, multiple sclerosis, Parkinson’s disease, rheumatoid arthritis, neurological diseases, congenital anomalies, and resistant tuberculosis may also need palliative care services (1). Palliative care can be offered to patients through various models, including hospital-based palliative care, hospice-based palliative care and home-based palliative care (3). Studies have shown that home-based palliative care has a very beneficial effect on the physical, mental, psychological, social and economic dimensions of patient’s life, and reduces the cost of health system, shortens the length of hospitalization, reduces hospital complications and prevents hospital readmission (4-6). This type of care also facilitates the continuity of post-discharge care and helps patient to easily benefit from the facilities of different centers (7). On the other hand, most people prefer to receive care at their homes with their families (8). Studies have shown that home-based palliative care is clinically and economically effective and leads to the satisfaction of patients and their families. Also, the World Health Organization in 2014 has introduced home-based palliative care as one of the main elements of the health systems all around the world (1). However, reports indicate that many countries in the world do not have palliative care programs in their health care system (7), and the lack of government support for palliative care services, lack of prepared professional staff to provide palliative services, limitation in access to narcotic analgesics, resource constraints, lack of policy-makers’ familiarity with palliative medicine, the negative attitude of society towards palliative care and socio-cultural issues have been mentioned as barriers to palliative care in the world (1, 9,10).
Iran’s health system is faced with increasing number of chronic patients and shortages of manpower and ICU beds in health centers. Most patients with life-threatening diseases in Iran are frequently admitted to hospital during the last days of their lives. Despite the shortage of hospital beds, especially in the critical care units, these patients occupy these beds and receive specialized medications until the end of their lives and eventually many of these patients die on ICU beds in hospital (11). While in many cases, hospitalization of incurable patients in critical care units does not have any positive effects on patients’ recovery, and is considered a futile care (12), which increases the costs of health system, poses financial burden on patient’s family, and leads to dissatisfaction and work burnout in healthcare staff (13). On the other hand, many of these patients prefer to spend the last days of their lives at home with their family and be in close contact with their relatives. Evidence suggests that palliative care in Iran is only offered in isolated and limited centers. Most patients are deprived of this kind of care, and home-based palliative care does not have any place in Iran’s health system (14). Patients with incurable conditions who require palliative care services are lost in the system, and in most cases do not receive proper and timely services they need (15). Also, the traditional attitude of healthcare staff towards the management of incurable conditions, the lack of transparency in the protection of healthcare staff against discontinuation of unnecessary treatments or unreasonable expectations of patients and their families, as well as social and cultural differences are barriers to the promotion of palliative care in Iranian society. Another problem in providing home-based palliative care services is the defect in the payment process and insurance coverage of end-of-life patients (16,17). Therefore, given the high prevalence of chronic and incurable illnesses, the increasing number of elderly population, limited critical care beds, shortages of human resources, limited financial resources and equipment in health centers, and taking into account the benefits of home-based palliative care, healthcare system authorities should consider this care method to be one of the important priorities of the health system so that patients can maintain their quality of life and also experience peace during the last days of their lives. Considering the limited research in this field, further research is required on the management of various dimensions of home-based palliative care in order to provide suitable models for the provision of home-based palliative care services in Iran.
 

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Background & Aim: Needlestick injury is an occupational risk. Medical university students are more likely to prone to this kind of injury in comparison to other students due to their limited knowledge, skills and clinical experiences. The present systematic review and meta-analysis aimed to estimate the prevalence of needlestick injury in medical university students in Iran.
Methods & Materials: In the present systematic review and meta-analysis, 22 papers written by Iranian researchers published in Persian and English, were included without time limitations. The articles were found by searching Iranian (Magiran, Scientific Information Databases (SID) and IranMedex) and international (Google Scholar, Web of Science, PubMed and Scopus) databases. Data were analyzed using meta-analysis method and the random effects model.
Results: The overall prevalence of needlestick injury among medical university students was 47% (95% CI: 39-55). There was no relationship between vaccine coverage, age of samples, and sample size with the prevalence of needlestick injury. The prevalence of needlestick injuries significantly decreased with increase in the publication years of articles (P=0.03), and significantly increased (P=0.049) with lack of reporting.
Conclusion: Considering the high prevalence of needlestick injury in the students of medical sciences universities, it is of great necessity to design educational programs focusing on the proper use of sharp and cutting instruments as well as the importance of reporting and modifying professional behavior such as avoiding the reinsertion of needles in order to reduce the incidence rate of needlestick injuries.
 

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Background & Aim: Female genital cancers are the third most common type of malignancy among women. Considering the importance of these cancers, the present study was conducted to determine the age-standardized rate (ASR) of female genital cancers in Iran.
Methods & Materials: In this systematic review, six international databases (Medline/PubMed, ProQuest, Scopus, Embase, ScienceDirect, and Google Scholar), and four national databases (Scientific Information Database, MagIran, IranMedex, and IranDoc) were searched in 2017. Thereafter, Persian and English papers referring to the ASR of female genital cancers in Iran were included. The Joanna Briggs checklist was used to evaluate the quality of studies. Data were independently extracted by two reviewers.
Results: A total of 264 papers were found in the initial search of the databases, and 27 papers were included for final analysis. Based on the random-effect model, the ASR was 2.07 (95% CI, 1.83-2.31) for cervical cancer, 3.15 (95% CI, 2.75-3.54) for ovarian cancer, and 1.52 (95% CI, 1.32-1.73) per 100,000 for uterine cancer.
Conclusion: The ASR of female genital cancers in Iran was lower than other countries of the world. It should be noted that the results of this review must be judged with caution because of the high heterogeneity of the studies.
 

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Background & Aim: Iranian elderly population is increasing, and a high percentage of this population suffers from diabetes. Considering that the concept of active aging has not been developed in the context of chronic diseases that are common in aging (such as diabetes), the purpose of this study was to analyze the concept of active aging in diabetic elderly patients based on a hybrid model.
Methods & Materials: Three stages of hybrid model (theoretical, field work and final analysis) were used in this study. In the theoretical phase, 35 articles (published in 1990-2016) from scientific databases were analyzed. In the field work phase, 10 participants were interviewed and then a qualitative content analysis was performed. In the final phase, the findings of the two previous stages were merged and analyzed.
Results: The definition of active aging for the diabetic elderly is a comprehensive, dynamic, multidimensional and culturally dependent process that requires a sense of satisfaction, happiness, well-being, security, and physical and mental health, that is achieved through social participation, providence of appropriate health and employment services, awareness of diabetes, and financial, emotional, family, and governmental support that brings subjective and objective benefits to the international, national and individual levels (such as adaptation to illness, a sense of worth and self-esteem). In order to achieve this, paying attention to the whole life span from childhood to old age is needed.
Conclusion: The results of this study suggest that health, security, satisfaction, participation, access to health services, support and knowledge of diabetes play an important role in activating elderly people with diabetes in Iran.
 

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

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Background & Aim: Anxiety is one of the most important psychological problems during the menopausal period. Anxiety can affect the health and quality of life of postmenopausal women. The purpose of this study was to investigate the effect of viola odorata syrup on anxiety among postmenopausal women.
Methods & Materials: This study is a triple blind clinical trial that was performed on 84 postmenopausal women referred to health centers in Mashhad in 2019. In both groups, postmenopausal women received 5 ml of viola odorata or placebo syrup twice a day for one month. Before and after the intervention, anxiety was assessed using the Depression, Anxiety and Stress scale-21. Data was analyzed using the SPSS software version 25 and Mann-Whitney, Chi-square and Fisher's exact tests.
Results: Before the intervention, there was no significant difference in women’s anxiety levels between viola odorata group and placebo group, and the two groups were homogeneous (P=0.084). After the intervention, there was a significant difference between the two groups (P=0.004). The corrected average was 3.61±3.02 (2.9-4.2, CI95%) for the violet group and 7.63±3.60 (6.9-8.3, CI95%) for the placebo group. Also, after the intervention the anxiety score decreased in the viola odorata group, and increased in the placebo group. The Mann-Whitney U test showed a significant difference (P<0.001).
Conclusion: According to the results of the present study, viola odorata syrup decreased anxiety in postmenopausal women. Therefore, it can be used as a complementary treatment along with chemical therapies to reduce anxiety in postmenopausal women.
Clinical trial registry: IRCT20180514039660N1
 

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Background & Aim: The health of newborns and infants as the future makers of the country is of special importance. Today, the main benefits of breastfeeding for children, mothers and society have widely been recognized. Given the importance of self-efficacy in initiating and continuing breastfeeding, the present study was conducted to determine the effect of breastfeeding counseling with a spiritual approach on breastfeeding self-efficacy in primiparous women.
Methods & Materials: In this randomized controlled trial study, 60 primiparous women referring to the childbirth preparation classes at Alavi Hospital, Azadegan Comprehensive Health Service Centers, Sina and Dr. Hazrati in Ardabil in 2019 were selected through the convenience sampling method and assigned to intervention or control groups using quadruple block method. The control group received routine care and the intervention group received eight sessions of breastfeeding counseling with a spiritual approach. Data was collected using the Dennis Lactation Self-efficacy Questionnaire and analyzed through the SPSS software version 16 using descriptive statistics, chi-square test and independent t-test at 95% confidence level.
Results: The mean scores of breastfeeding self-efficacy for the intervention and control groups were 27.48±5.83 and 28.23±4.44 (P=0.575) before the intervention, 39.83±10.14 and 25.33±3.62 (P<0.001) immediately after the intervention, 42.45±13.00 and 23.43±6.23 (P<0.001) one month after the intervention. There was a significant difference between the two groups after the intervention.
Conclusion: Employing spiritual approach in breastfeeding counseling was effective in improving the breastfeeding self-efficacy of primiparous women. The integration of spiritual content into the package of postpartum services with a focus on breastfeeding appears to be an appropriate measure that can be considered by planners in this area.
Clinical trial registry: IRCT20150731023423N14