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Background & Aim: Breastfeeding is the most cost-effective, health-promoting, and disease-preventing activity that new mothers can perform. Many researches have focused on identifying factors that influence breastfeeding initiation and duration. An important and modifiable factor is the perceived self-efficacy of mothers for breast feedings. It refers to a mother&aposs perceived ability to breastfeed her newborn and is a dominant variable in the duration of breastfeeding. The purpose of this study was to assess the relationship between self-efficacy and breastfeeding.

Methods & Materials: A descriptive, longitudinal, analytic approach was used in this study. The three-part questionnaire was administered to the eligible pregnant women (437 pregnant women) who were at least in 37 weeks of gestation and intended to breastfeed. They were then contacted again at one and four months postpartum to determine their infants&apos feeding level and method. The questionnaire was re-administered to the participants at that time.

Results: The results showed that 80.4 percent of participants had exclusive breastfeeding during one month. There was no significant relationship between antenatal breastfeeding self-efficacy and the breastfeeding. The self-efficacy was significantly related to breastfeeding outcomes at one month. Mothers with high self-efficacy were significantly more likely to breastfed their babies exclusively at one and four months postpartum than the mothers with low self-efficacy.

Conclusion: Maternal breastfeeding self-efficacy is significantly related to breastfeeding duration and level. Measuring breastfeeding self-efficacy not only identifies high risk mothers, but also provides important information to health care providers in providing support to new mothers.

 

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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: Caregivers of elderly with Alzheimer&aposs disease, particularly females, encounter challenges. Their different roles in giving care to the patients could result in physical and mental disorders. The self-efficacy seems to be an essential factor in empowering individuals coping with stressful situations and challenging tasks. The aim of this study was to investigate general self-efficacy among women as family caregivers of elderly with Alzheimer&aposs disease.

Methods & Materials: In this cross-sectional descriptive study, 112 women reffered to the Iran Alzheimer Association, Tehran were selected through convenience sampling method. The General Self-Efficacy Scale (GSE-10) was used to collect data. Data were entered into the SPSS-16 and then processed using descriptive statistics and independent t-test, ANOVA and Scheffe.

Results: The mean score of the general self-efficacy was 28.24±6.34 indicating that considerable percentage of the participants had unsatisfactory level of self-efficacy (65.2%). In addition, there were significant relationships between the women&aposs general self-efficacy with educational and economic statuses (P<0.05). There were no significant relationships between general self-efficacy with age, marital status, occupational status and duration of caring.

Conclusion: According to the findings, a considerable percentage of the participants had unsatisfactory level of self-efficacy. Therefore, it is essential to promote the caregivers self-efficacy in order to give them the ability of better adaptation with the life&aposs challenges. In particular, the self-efficacy promotive programs should be implemented among caregivers with lower educational and economic status.

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Background & Aim: The challenges that patients face after intestinal ostomy surgery can lead to impaired adjustment and self-efficacy. There is evidence suggesting these variables have reciprocal effects on each other. Therefore, the present study aimed to determine the correlation between adjustment and self-efficacy in patients with intestinal ostomy.

Methods & Materials: This descriptive correlational study was conducted on 76 patients with intestinal ostomy hospitalized in hospitals affiliated to Mashhad University of Medical Sciences using convenience sampling method in 2015. Research instruments were comprised of the demographic and disease information questionnaire, the Stoma Self-efficacy Scale, and the Ostomy Adjustment Inventory. The SPSS software v.19 using descriptive and inferential statistics was used to analyze the data.

Results: The results of Pearson correlation test showed a significant and positive linear correlation between the mean score of self-efficacy and the dimensions of adjustment: acceptance (P<0.001, r=0.518), anxious preoccupation (P<0.001, r=0.438), social engagement (p<0.001, r=0.488), and anger (P<0.001, r=0.384). Moreover, multiple regression analysis indicated that the dimensions of social engagement and acceptance have a significant and positive linear correlation with self-efficacy in patients with intestinal ostomy.

Conclusion: The results revealed that the dimensions of social engagement and acceptance of ostomy were the most important factors in relation to self-efficacy. Therefore, in order to care for patients with intestinal ostomy especially in the early months after surgery, it was recommended to help patients adjust themselves to the physical appearance of ostomy and maintain their social engagement, by designing and implementing appropriate educational and supportive interventions.

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Background & Aim: Diabetes is the most common metabolic disease that needs self-management. The aim of this study was to compare the effects of loss- and gain-framed messages on knowledge, self-efficacy and self-management in diabetic patients.
Methods & Materials: In this randomized clinical trial (IRCT2016122931653N1), 112 patients with type 2 diabetes referred to the 17th Shahrivar Diabetes clinic in Borazjan in 2017, were divided into three groups including loss-framed message, gain-framed message, and control. The data were collected by questionnaires in three steps; before, one week and three months after intervention. Chi-square test, one way analysis of variance and repeated measures analysis of variance were used to analyze the data on the SPSS software version 22.
Results: Before the intervention, mean scores for knowledge, self-efficacy and self-management in loss-framed messages group and gain-framed messages group were lower than control. One week and three months after the intervention, mean scores for knowledge, self-efficacy and self-management in both the loss-framed messages and gain-framed messages groups showed a significant increase compared to the control group (P<0.001). One week after the education, self-management score in the gain-framed messages group was 102.26±11.20, in the loss-framed messages group was 111.53±13.73 and in the control was 88.75±11.41. Three months after the education, self-management score in the mentioned groups were 105.58±11.80, 108.72±15.39 and 88.49±13.51, respectively.
Conclusion: The results of this study showed that designing and implementing educational programs based on loss-framed messages and especially gain-framed messages can improve knowledge, self-efficacy and self-management behavior in diabetic patients.
 
 

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Background & Aim: Waterpipe smoking during pregnancy is a health problem, and interventions must be designed for its cessation. The present study was conducted to examine the effect of motivational interviewing (MI) on self-efficacy to quit hookah smoking in pregnant women.
Methods & Materials: The randomized clinical trial was conducted on 140 pregnant women who smoked hookah and lived in the marginal settlements in Zahedan in 2017. The convenience samples were randomly assigned to intervention and control groups. Data were collected using demographic characteristics and self-efficacy to quit hookah smoking questionnaires. Participants in the intervention received four group sessions of MI, while those in the control only received usual recommendations for quitting hookah smoking. The post-test was performed eight weeks after the completion of the intervention. Independent t-test, paired t-test, Chi-square, and Analysis of Covariance (ANCOVA) were used for data analysis through the SPSS software version 21.
Results: The demographic characteristics and gestational age of women were comparable between two groups, but the duration of hookah consumption in the intervention was more than the control (P=0.008). While the mean score of self-efficacy of two groups in pre-test was alike, in the post-test the score of self-efficacy in the intervention (60.85±7.25) was higher than the control (22.77±3.79) (P<0.001).
Conclusion: Given that MI approach has a positive effect on self-efficacy to quit hookah smoking, it is suggested that this counseling strategy is integrated into health care programs for pregnant women smoking hookah.
Clinical trial registry: IRCT201609240299954N5
 

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Background & Aim: Maintaining and improving the health of the elderly through effective interventions requires the recognition of their lifestyle, including exercise using a valid and appropriate culture-specific tool. The aim of this study was to design and evaluate the psychometric properties of a tool for measuring exercise self-efficacy in the elderly.
Methods & Materials: A sequential exploratory mixed method study was performed in the form of a questionnaire with two qualitative and quantitative sections in 2019. The qualitative section consisted of item generation including three stages: theoretical stage (targeted search of existing literature), field work (semi-structured interviews with the elderly) and final analysis (integration of the results from the two previous stages). In the quantitative section, the psychometric properties of the questionnaire was evaluated using face, content and construct validity as well as the reliability through internal consistency and stability.
Results: Out of 37 initial items, four items were removed after calculating the item impact score.  Seven items were removed after assessing the content validity ratio and content validity index. Also, five items were omitted due to having a load factor less than 0.03. The result of exploratory factor analysis consisted of three factors “recognition”, “situational compatibility” and “self-control” which all together could explain 90.180% of the variance. The Cronbach’s alpha and the Intraclass correlation coefficient were found to be 0.957 and 0.949 respectively.
Conclusion: The data analysis approved that the designed tool can be used for measuring exercise self-efficacy among the elderly due to having acceptable reliability and validity, simplicity and a short completion time.
 

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Background & Aim: Caring for children with chronic illness is associated with the care burden of families and affects their self-efficacy. In addition, family-centered care can have positive outcomes. The aim of this study was to determine the relationship of the perception of family-centered care, burden of care and self-efficacy in the mothers of children with chronic illness.
Methods & Materials: This descriptive-analytical study was conducted in 2019 on 220 mothers of children with chronic illness, admitted to pediatric hospitals in Tehran and were selected using the convenience sampling method. Data were collected using the Perception of Family-Centered Care-Parent, Perceived Maternal Parenting Self-Efficacy, and the Impact-on-Family Scale. Data were analyzed by SPSS software version18 using descriptive and inferential statistics such as Pearson correlation and regression tests at the significance level of 0.05.
Results: Results showed that perception of family-centered care is directly associated with self-efficacy and inversely associated with the burden of care (respectively P<0.001 and P=0.022), so that for each 1-unit increase in the score of perception of family-centered care, self-efficacy of mothers increased by 0.25 and the burden of care decreased by 0.23. No significant association was found between self-efficacy and the burden of care (P=0.962).
Conclusion: Given that family-centered care can lead to an increase in self-efficacy and a reduction in the burden of care, nurses can improve mothers’ self-efficacy and reduce their burden of care by improving family-centered care.
 

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Background & Aim: Pre-hospital emergency staff, as the first responder group at the scene of emergencies and disasters, should be able to cope with, and maintain their physical and mental health. The aim of this study was to investigate the relationship between resilience and self-efficacy of pre-hospital emergency staff with their professional quality of life.
Methods & Materials: The present study is a cross-sectional, descriptive study that was conducted in 2019. A total of 200 pre-hospital emergency operational staff from Alborz province participated in the study using proportional and convenience sampling. Data collection tools were a demographic form and three standardized questionnaires including the emergency medical services resilience scale, the Schwartz and Jerusalem self-efficacy scale, and the Stamm professional quality of life scale. Data were analyzed through the SPSS software version 20 using descriptive statistics (mean and standard deviation) and analytical statistics (Spearman correlation, one-way ANOVA and linear regression) at the significance level of P less than 0.05.
Results: The mean and standard deviation of self-efficacy (29.67±5.82), resilience (123.14±17.07), compassion satisfaction (39.81±8.09), burnout (12.06±4.76), and secondary traumatic stress (23.61±7.27). There was a significant correlation between self-efficacy and three components of professional quality of life (P<0.05). Self-efficacy was positively related to compassion satisfaction and negatively related to burnout and secondary traumatic stress. Self-efficacy and resilience were also predictors of compassion satisfaction and burnout (P<0.05). The effect of self-efficacy and resilience on compassion satisfaction was positive. The results of stepwise multiple linear regression analysis showed that five components of resilience including self-management, stress outcomes, communication challenges, maintaining peace of mind and job motivation had an effect on compassion satisfaction (P<0.05). The effect of all resilience components on compassion satisfaction was positive.
Conclusion: Alborz pre-hospital emergency operational staff were at an acceptable level in terms of resilience, self-efficacy and professional quality of life.
 

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Background & Aim: Reduced quality of life and self-efficacy are among problems of mothers of children with chronic diseases. This study aimed to determine the effect of empowerment based on the Gibson model on self-efficacy and quality of life in the mothers of children with thalassemia.
Methods & Materials: In this quasi-experimental study, the study population were the mothers of children with thalassemia referred to rare disease clinics in Rafsanjan and Kerman in 2020. The sample size was 25. Mothers were selected by the convenience sampling method and divided into two groups. In the intervention group, mothers participated in five training sessions based on the Gibson model, and in the control group, mothers received routine care. Data collection tools included the Zhang’s self-efficacy questionnaire and the SF-36 which were completed before the intervention and six weeks after the intervention. Data were analyzed using chi-square test, independent and paired t-test via the SPSS software version 18.
Results: Before the intervention, the mean score of self-efficacy (P=0.31) and quality of life (P=0.47) were not statistically significant between the groups, but after the intervention, the mean score of self-efficacy in the intervention group (68.81±9.36) was significantly higher than that of in the control group (44.69±6.87) (P<0.001). But there was no significant difference in the mean score of quality of life between the intervention (60.64±10.08) and control (56.19±11.41) groups after the intervention (P=0.19).
Conclusion: According to the results, empowerment based on the Gibson model is an appropriate method for improving self-efficacy in the mothers of children with thalassemia. However, further studies are recommended about its effect on quality of life.

 

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Background & Aim: The average growth indicators in babies from unwanted pregnancy are lower than other babies. Perceived stress in these mothers can have a double effect on the reduction of milk. Considering the importance of breastfeeding in the health of mother and child, the present study aimed to determine the effect of couples counseling on perceived stress and the improvement of breastfeeding self-efficacy in women with an unwanted pregnancy.
Methods & Materials: In this randomized controlled trial study, 60 women with an unwanted pregnancy referred to comprehensive health centers of Khodabandeh city in 2021 were selected using the convenience sampling method and randomly allocated into two intervention and control groups in blocks of four. The control group received routine care, and the intervention group received six sessions of couples counseling based on spousal support twice a week. The data were collected using the Dennis Breastfeeding Self-efficacy Questionnaire, and the Cohen's Perceived Stress Questionnaire in three stages; before, immediately after the intervention and six weeks after delivery. The data were analyzed using the SPSS software version 16 by descriptive statistics, chi-square test, Fisher’s exact test, independent t-test and repeated measures ANOVA at a 95% confidence level.
Results: In the counseling group, the mean score of breastfeeding self-efficacy increased immediately after the intervention and six weeks after delivery compared to before the intervention, and decreased in the control group (P<0.001). In the counseling group, the mean score of perceived stress decreased immediately after the intervention and six weeks after delivery compared to before the intervention, and increased significantly in the control group (P<0.001).
Conclusion: Couples counseling based on spousal support was effective in improving breastfeeding self-efficacy and reducing perceived postpartum stress in women with an unwanted pregnancy. The presence of spouses in the breastfeeding counseling program appears to be a suitable measure that can be taken into consideration by planners in this field.
Clinical trial registry: IRCT20150731023423N18

 

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Background & Aim: Self-efficacy disruption poses a significant challenge for patients with a stoma, affecting their ability to engage in community life and carry out daily activities. Utilizing remote training methods for patients presents an opportunity to maximize the use of these resources. This study aims to determine the effect of a telenursing-based training program on the self-efficacy of patients with a stoma.
Methods & Materials: This quasi-experimental study involved a convenient sample of 80 patients with a stoma in Zahedan in 2023, who were randomly assigned to two groups: intervention and control, each comprising 40 participants. The intervention group received the telenursing-based program application. Self-efficacy was assessed using the self-efficacy of stoma patients questionnaire before the intervention, as well as one and three months after the intervention. Data were analyzed using Chi-square test and a two-way repeated measures analysis of variance through SPSS software version 26.
Results: The intervention group exhibited a mean (SD) age of 42.84±12.98 years, while the control group had a mean (SD) age of 46.26±11.89 years (P=0.320). The self-efficacy total scores in the intervention group showed values of 69.75±8.05 before the intervention, 77.28±7.57 at one month, and 92.72±6.43 at three months post-intervention, suggesting a significant effect of the telenursing-based training on self-efficacy levels (P<0.001).
Conclusion: The results of the present study show the effect of the telenursing training program on improving self-efficacy levels in patients with stoma. Therefore, it is recommended to implement such programs to support this patient population.