Iranian journal of nursing and midwifery research (Iran J Nurs Midwifery Res)

Publisher: Medknow Publications

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ISSN 2228-5504

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Medknow Publications

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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: The number of women who select cesarean section due to fear of childbirth has increased. Role play education seems to be a helpful method to remove or reduce the fear of childbirth. Therefore, this study aimed to investigate the effect of role play education on primiparous women's fear of natural delivery and their decision on the mode of delivery. In this blind clinical trial, 67 primiparous women with natural pregnancy at 34-36 weeks of gestational age and with no indication of cesarean section were selected from the health care centers in Mashhad. They were randomly assigned to two groups who underwent pre-test and post-test with the help of delivery attitude questionnaire to investigate their fear of childbirth and a researcher-made pregnant women's decision investigation questionnaire. Education through role play was conducted in the form of three scenarios during seven stages. The findings were analyzed by Fisher's exact test and independent t-test through SPSS. The two groups were significantly different concerning the fear of childbirth after the intervention (P = 0.007), and the fear score showed a higher reduction in the role play group compared to the lecture group. There was a significant difference between the two groups concerning the reduction of elective cesarean section and the decision on the mode of delivery at the time of admission in the labor room (P = 0.000). About 75% in the lecture group and 100% in the role play group selected natural delivery. In the present study, the effect of role play was more in making a decision on natural delivery, reducing the fear of childbirth, and reducing the rate of elective cesarean section. It is suggested to use role play method to educate pregnant women to reduce the rate of cesarean sections.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):40-6.
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    ABSTRACT: Presently, using complementary therapy such as lavender oil has specific application in medicine. The purpose of this study was to investigate the effect of aromatherapy massage on the severity of primary dysmenorrhea in nursing and midwifery students of Islamic Azad University of Arsanjan, Iran. This study was performed using clinical trial method on 80 eligible students whose level of pain was measured by visual analogue scale (VAS) before the intervention. Each participant, in the first days of menstruation, randomly received two types of massage with lavender and placebo oil in two consecutive cycles of menstruation. Their level of pain was measured before and 30 min after the intervention. In this study, each group was considered as their self-control group in the next cycle. The data were analyzed by SPSS software. A significant decrease in VAS score after lavender massage was detected in comparison with placebo massage. There was a statistically significant difference between VAS scores after and before placebo massage. In addition, statistically the effect of lavender massage on the severity of primary dysmenorrhea was higher than that of placebo massage (P < 0.001). Findings of this study showed that lavender oil massage decreases primary dysmenorrhea and it can be used as an effective herbal drug.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):156-60.
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    ABSTRACT: Musculoskeletal disorders (MSDs) are a serious problem among the nursing staff. Mental workload is the major cause of MSDs among nursing staff. The aim of this study was to investigate the mental workload dimensions and their association with MSDs among nurses of Alzahra Hospital, affiliated to Isfahan University of Medical Sciences. This descriptive cross-sectional study was conducted on 247 randomly selected nurses who worked in the Alzahra Hospital in Isfahan, Iran in the summer of 2013. The Persian version of National Aeronautics and Space Administration Task Load Index (NASA-TLX) (measuring mental load) specialized questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used for data collection. Data were collected and analyzed by Pearson correlation coefficient and Spearman correlation coefficient tests in SPSS 20. Pearson and Spearman correlation tests showed a significant association between the nurses' MSDs and the dimensions of workload frustration, total workload, temporal demand, effort, and physical demand (r = 0.304, 0.277, 0.277, 0.216, and 0.211, respectively). However, there was no significant association between the nurses' MSDs and the dimensions of workload performance and mental demand (P > 0.05). The nurses' frustration had a direct correlation with MSDs. This shows that stress is an inseparable component in hospital workplace. Thus, reduction of stress in nursing workplace should be one of the main priorities of hospital managers.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):1-6.
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    ABSTRACT: Stressors in the intensive care unit (ICU) impair patients' comfort, excite the stress response, and increase oxygen consumption in their body. Non-medical interventions are recommended by several studies as a treatment to improve comfort in the ICU patients. Sensory stimulation is one of the most important interventions. Since arterial blood oxygen saturation is an important index of patients' clinical and respiratory condition, this study aimed to investigate the effect of sensory stimulation provided by family on arterial blood oxygen saturation in critical care patients. This study is a clinical trial conducted on 64 patients hospitalized in the ICU wards of Al-Zahra and Kashani hospitals in Isfahan, Iran in 2012 and 2013. The patients were selected by simple sampling method and were randomly assigned to two groups (study and control). Patients' arterial blood oxygen saturations were measured 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group, and simultaneously in the control group without any intervention. Repeated measures analysis of variance (ANOVA) showed a significant difference in the mean of arterial blood oxygen saturation levels 10 min before, immediately after, 10 min and 30 min after sensory stimulation in the study group (P < 0.001), but in the control group, the difference was not significant (P = 0.8). Pair wise comparison of the mean arterial blood oxygen saturation levels at different time points by Fisher's Least Significant Difference (LSD) showed that there was a significant difference in the intervention group (P < 0.022). But in the control group, there was no significant difference between pairs of time points (P > 0.18). Application of sensory stimulations as a nursing and non-medical intervention by the family members improves comfort and increases the level of blood oxygen saturation in critical care patients.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):63-8.
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    ABSTRACT: Few attempts were made for alleviating the physical/psychological problems among the cardiac valve-replaced patients and no comprehensive study was done based on the experiences of such patients. This study was undertaken to describe the stressful experiences of the heart valve-replaced patients. In this qualitative study performed during 2012-2013 with a content analysis approach, 13 patients from Tehran and Kashan therapeutic centers participated. The study sampling was accomplished with purposeful sampling using a semi-structured interview that continued until data saturat ion. All interviews were recorded, and were immediately handwritten word by word and finally typewritten. Description and analysis of the data were done by Graneheim and Lundman content analysis. One hundred and seventy-five primary codes were derived among the 680 codes taken from the participants interviewed. Using abstract and deep perception of the categories, 14 subcategories and 5 themes were derived. The themes are as follows: worry of care conditions, worry of life with the ongoing condition of having prosthetic cardiac valve, worry regarding the instability in life, fear of hospital, and fear of unknown factors. Each theme consisted of special subsidiary themes with specific functions. The main themes of fear and worry about on losing the valve were identified and introduced in the cardiac valve-replaced patients. As the nature and function of these themes are different in different societies, recognition and discrete definition of them are necessary for care planning and promotion.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):121-8.
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    ABSTRACT: Literature shows that interprofessional collaboration (IPC) is a challenging phenomenon both in theory and practice, and it is affected by socio-cultural contexts in which the health professionals (HPs) play their roles. Considering some evidences on the similarities and differences between eastern and western socio-cultural contexts, this study aims to explore and describe the socio-cultural factors influencing IPC in these two contexts. This was a pilot qualitative descriptive study that was conducted in 2012-2013. Data were collected through conducting one-to-one and group interviews as face-to-face and written in terviews (narratives) with purposeful samples of HPs from various disciplines including nurses, medical doctors (MDs) from variety of specialities, social workers, and psychologists from health system in Iran and Germany. Other methods of data collection were taking field notes and reviewing related literature. The qualitative content analyses method was employed to derive the common categories and themes. Totally 22 participants took part in the study. Moreover, researchers had a 10-day period of field observation in Germany (health systems affiliated with Albert Ludwigs University of Freiburg). Qualitative data analysis revealed three themes and related subthemes. The themes were: (1) Interaction beyond boundaries, (2) motivation to engage in IPC, and (3) readiness to approaching toward IPC. The results of the study emphasized that in both eastern and western contexts, organizational, professional, and community socio-cultural textures, mainly in terms of attitudes toward other people, other professions, and IPC, play their role as important factors. We suggest future researches about each of the emerged themes.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):99-104.
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    ABSTRACT: Self-esteem is a determinant factor of mental health. Individuals with low self-esteem have depression, and low self-esteem is one of main symptoms of depression. Aim of this study is to compare the effects of problem-solving skills and relaxation on the score of self-esteem in women with postpartum depression. This clinical trial was performed on 80 women. Sampling was done in Mashhad healthy centers from December 2009 to June 2010. Women were randomly divided and assigned to problem-solving skills (n = 26), relaxation (n = 26), and control groups (n = 28). Interventions were implemented for 6 weeks and the subjects again completed Eysenck self-esteem scale 9 weeks after delivery. Data analysis was done by descriptive statistics, Kruskal-Wallis test, and analysis of variance (ANOVA) test by SPSS software. The findings showed that the mean of self-esteem scale scores was 117.9 ± 9.7 after intervention in the problem-solving group, 117.0 ± 11.8 in the relaxation group, and 113.5 ± 10.4 in the control group and there was significant difference between the groups of relaxation and problem solving, and also between intervention groups and control group. According to the results, problem-solving skills and relaxation can be used to prevent and recover from postpartum depression.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):105-12.
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    ABSTRACT: Infertility is a serious problem in a couple's life that affects their marriage relationships. So, dissatisfaction with sexual function resulting from interpersonal problems is common among these couples. This qualitative study aimed to explore the experiences of infertile women in their sexual life. This is a qualitative study with a phenomenological approach. The participants were 20 infertile women referring to the health care centers and infertility clinics of Isfahan and were selected through purposive sampling. Data were collected by tape recording of deep interviews and analyzed by Colaizzi's method. Analysis of the participants' experiences led to five main concepts: "Disturbed in femininity-body image," "discouragement of sexual relations," "sacrifice of sexual pleasure for the sake of getting pregnant," "confusion in sexual relation during infertility treatment," and "striving to protect their marriage." Findings revealed that infertility affects women's different aspects of sexual life, especially disturbance in femininity-body image and sexual reluctance. With regard to women's willingness to protect their matrimonial life and prevent sexual trauma as a destroying factor for their family's mental health, it seems sexual counseling is necessary for infertile couples.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):34-9.
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    ABSTRACT: Most of the studies about parenting stress among parents of children with autistic spectrum disorder (ASD) have been conducted in western societies. The objective of this research, conducted in Iran, is to evaluate the parenting stress among fathers and mothers of children with ASD and find the correlation between severity of the disorder in children and the level of parental stress. Participants included 42 couples having children aged between 2 and 12 diagnosed with ASD based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The diagnosis was made by two child and adolescent psychiatrists. Demographic information of the participants was collected using a questionnaire. The severity of pervasive developmental disorder in children was determined based on Childhood Autism Rating Scale (CARS); stress of parents was measured using Parenting Stress Index (PSI). Collected information was analyzed by the SPSS (version 16) software. Evaluation of subscales in participants' data showed a positive correlation coefficient between the PSI-parent domain and Childhood Autism Rating Scale-Parent form CARS-P rating (r = 0.339, P =0 0.028) and also between the total stress index and CARS-P rating (r = 0.333, P = 0.031) for fathers. It is thus suggested that fathers of children with more severe developmental disorders experience more stress. The results showed significant differences between fathers and mothers in the three PSI subscales including PSI-child domain score (P < 0.005), PSI-parent domain score (P < 0.005), and the total stress index (P < 0.005). Mothers had significantly more stress than fathers. These findings show that parents with ASD children have many emotional needs which should be considered in planning the effective treatment strategies for their children.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):93-8.
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    ABSTRACT: Nowadays, depression is one of the most prevalent mental diseases to which some individuals like mothers of mentally retarded children are more vulnerable due to their (children's) special condition. Therefore, the present study aimed to investigate the level of depression and its related factors in these mothers. This cross-sectional study was conducted on 120 qualified mothers with mentally retarded children who were from exceptional children girls' schools in Isfahan. The subjects filled personal characteristics and Beck depression inventory assessment, and their level of depression and its association with some baseline factors were analyzed through descriptive statistics in SPSS. Results showed that 75% of the mothers experienced various levels of depression, of whom 25.8% suffered from minor depression, 24.2% from moderate depression, and 25% suffered from major depression. The results obtained showed that there was a significant direct association between the intensity of depression and students' age, mothers' age, fathers' age, the number of children, and the length of parents' marriage and a reverse association between the intensity of depression and subjects', fathers', and mothers' education (P = 0.004). No association was observed between mothers' occupation and the intensity of depression. Meanwhile, there was a negative significant association between fathers' occupation and mothers' depression (P = 0.02). About 33.3% of the mothers did not believe that their spouses' and families' psychological and mental support was adequate. The present study showed that mothers of mentally retarded children are predisposed to depression. With regard to the important role of mothers in the family and, consequently, the risk of impaired health of the family members, especially these children's health, prevention and diagnosis of depression and treatment of these mothers seem to be essential. Adequate support to these mothers plays a key role in reduction of the risk of their depression.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):69-74.
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    ABSTRACT: Midwifery cares take place in diverse communities with different ethnics groups. Therefore, midwifery cares could be planned wisely and principally based on women's and their families' changeable demands which focus on social and cultural issues. This qualitative study explored the midwives' experiences of care in the community. This qualitative study was conducted by descriptive phenomenological approach. The subjects, selected by purposive sampling, comprised 13 midwives employed in Isfahan, Iran. Semi-structured interviews were audio-taped, transcribed, and simultaneously analyzed through Colaizzi's method. With descriptive analysis of participants' experiences, three main themes were explored (personal characteristics of the community midwife, social determinants of women's health, and achieving community-based midwifery skills). Knowledge of women's social status, gender inequality in health, and existence of social health risk factors for women in their community helps midwives to provide reproductive health care based on clients' needs and demands. Therefore, midwives should enhance the quality of their care through integrating professional skills with a full understanding of the social context.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):113-20.
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    ABSTRACT: Hypertension is very common in patients with end-stage renal disease and accelerates cardiovascular morbidity and mortality. The most important factor in achieving normal blood pressure in these patients is reaching dry weight. Sodium and extracellular fluid balance play a vital role in this regard. Considering the lack of consensus about the efficacy of stepwise sodium profile and individualized dialysate sodium, this study aimed to determine the superior method for blood pressure control in hemodialysis patients. In a quasi-experimental study, patients satisfying the inclusion criteria were enrolled through convenience sampling. The patients were randomly assigned to two groups of stepwise sodium profile and individualized dialysate sodium. Information record form was used for data collection. Data were analyzed with paired and independent t-test and descriptive statistics using SPSS for Windows 20.0. Patients in the two groups were similar in qualitative and quantitative background variables. While systolic blood pressure significantly decreased following hemodialysis with individualized dialysate sodium (P < 0.001), there was no significant difference between pre- and post-dialysis systolic blood pressure values using stepwise sodium profile (P = 0.060). Individualized dialysate sodium caused greater change in the mean systolic blood pressure than stepwise sodium profile did (P = 0.040). Pre- and post-dialysis diastolic blood pressure values showed significant differences in both groups (P < 0.001 using individualized dialysate sodium and P = 0.009 using stepwise sodium profile). However, the mean changes in diastolic blood pressure of the two groups were not significantly different (P = 0.295). We found no significant difference in interdialytic weight gain and blood pressure control by the two methods. The change in systolic blood pressure was lower in the stepwise profile method than in the individualized dialysate sodium method, and this method did not cause interdialytic hypertension. So, by adjusting the dialysis solution with regard to plasma sodium levels, lead to more blood pressure control. Meanwhile, the two groups were not significantly different in the mean changes of diastolic blood pressure.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):12-6.
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    ABSTRACT: The World Health Organization emphasizes on integration of sexual health into primary health care services, educating people and health care workers about sexuality, and promoting optimal sexual health. Despite the high prevalence of sexual problems, these problems are poorly managed in primary health care services. This study was conducted to evaluate the efficacy and feasibility of the first two steps of PLISSIT (Permission, Limited Information, Specific Suggestions, Intensive Treatment) model for handling of women sexual problems in a primary health care setting. This was a quasi-experimental study that was carried out in Zanjan, northwest of Iran. Eighty women who had got married in the past 5 years and had sexual problem were randomly assigned to control and intervention groups. The intervention group received consultation based on PLISSIT model by a trained midwife and the control group received routine services. Female Sexual Function Index (FSFI) questionnaire was used for assessing and tracking any changes in sexual function. Data were collected at three points: Before consultation and 2 and 4 weeks after consultation. Paired t-test and repeated measures analysis of variance (ANOVA) test were used for comparison of scores within groups. Significant improvement was found in FSFI sub-domain scores, including sexual desire (P < 0.0001), arousal (P < 0.0001), lubrication (P < 0.0001), orgasm (P = 0.005), satisfaction (P = 0.005), pain (P < 0.0001), and FSFI total score (P < 0.0001) in the intervention group compared to the control group. This study showed that PLISSIT model can meet the sexual health needs of clients in a primary health care setting and it can be used easily by health workers in this setting for addressing sexual complaints and dysfunctions.
    Iranian journal of nursing and midwifery research 01/2015; 20(1):139-46.