@article{ author = {Sharma, Maneesh and Lakhara, Pooja and KumarSharma, Suresh and Jelly, Prasuna and Sharma, Rakesh}, title = {The Burden of Caregivers of Patients Undergoing Hemodialysis}, abstract ={Introduction: There is a scarcity of literature about the burden of hemodialysis patients’ caregivers. Caregivers often receive little attention, and the primary focus is always on the patients. Frequent hospitalizations and factors associated with the disease can lead to depression and reduce the caregiver’s quality of life. Objective: The study aimed to determine the burden of caregivers of patients undergoing hemodialysis at a tertiary care hospital. Materials and Methods: This cross-sectional analytical study was conducted in a tertiary care hospital in northern India. A total of 110 caregivers who were providing care to their patients for more than 3 months were selected by purposive sampling method. The study data were collected by self-prepared demographic questionnaire to collect basic information regarding patients and caregivers, and the level of burden was assessed by a revised Zarit Burden Interview (ZBI) standardized on a 5-point scale. Descriptive and inferential (the Chi-square and Fisher exact test, 1-way ANOVA test) statistics were used for data analysis. Results: The mean±SD age of caregivers was 37±13 years. Nearly half of caregivers, 50 (45.46%), reported mild to moderately burdened, while 15 (13.63%) caregivers had moderate to severely burdened. The caregivers were mild to moderately burdened as the mean burden score was 25±12. There was no significant association between the levels of burden scores and selected sociodemographic variables of the participants. Conclusion: It was found that caregivers of hemodialysis patients experienced moderate burden while caring and being with the patient, which may alter their health and quality of life.}, Keywords = {Caregiver, Hemodialysis, Burden}, volume = {31}, Number = {2}, pages = {69-75}, publisher = {}, doi = {10.32598/jhnm.31.2.2089}, url = {http://hnmj.gums.ac.ir/article-1-1589-en.html}, eprint = {http://hnmj.gums.ac.ir/article-1-1589-en.pdf}, journal = {Journal of Holistic Nursing And Midwifery}, issn = {2588-3712}, eissn = {}, year = {2021} } @article{ author = {Yosefi, Zahra and Afshar, Mohammad and MirbagherAjorpaz, Neda and Sadat, Zohre}, title = {The Effect of Training Based on James Brown Model on Self-efficacy in Adolescents with Type 1 Diabetes Mellitus}, abstract ={Introduction: Type 1 Diabetes Mellitus (T1DM) is one of the most frequent chronic diseases among children and adolescents. Educational strategies underscore patient’s roles in the management of diseases and enhance self-efficacy behaviors. Objective: The purpose of this study was to investigate the effects of an educational intervention based on James Brown’s model on self-efficacy in adolescents with T1DM. Materials and Methods: In this randomized clinical trial, 70 participants were selected and assigned to the control and intervention groups by random block. The two groups received routine care for T1DM. The intervention group was also provided with educational sessions, 60 minutes twice a week for 4 weeks, based on the educational model. The participants completed the diabetes management self-efficacy instrument at the beginning, at the end, and a month after the end of the study. Data analysis was performed using the Chi-square, Independent samples t-test, Covariance (ANCOVA), and repeated measures ANOVA. Results: The mean±SD age of the intervention and control groups was 14.81±2.05 and 15.18±2.11 years, respectively. Before the intervention, the two groups were not different statistically in terms of demographic variables (age, sex, duration of diabetes, insulin intake, etc.) and self-efficacy. The results showed that immediately after the intervention and also in the follow-up stage, the mean scores of self-efficacies and its subscales (nutrition, blood glucose monitoring, physical activity, and medical treatment) in the intervention group were significantly higher than the control group (P<0.05). The mean scores of self-efficacies at the beginning, at the end, and a month after the end of the study were 27.97±5.08, 41.46±4.41, and 44.55±4.38, respectively. In the control group, however, these differences were not significant. Conclusion: The education based on James Brown’s model can improve self-efficacy among adolescents with T1DM. It is recommended that nurses use this method to increase self-efficacy in adolescents with T1DM.}, Keywords = {Self-efficacy, Adolescents, Diabetes mellitus}, volume = {31}, Number = {2}, pages = {76-84}, publisher = {}, doi = {10.32598/jhnm.31.2.2048}, url = {http://hnmj.gums.ac.ir/article-1-1590-en.html}, eprint = {http://hnmj.gums.ac.ir/article-1-1590-en.pdf}, journal = {Journal of Holistic Nursing And Midwifery}, issn = {2588-3712}, eissn = {}, year = {2021} } @article{ author = {Moaddaby, Somayeh and Adib, Masoomeh and Ashrafi, Sadra and KazemnezhadLeili, Ehs}, title = {Perception of the Futile Care and its Relationship With Moral Distress in Nurses of Intensive Care Units}, abstract ={Introduction: The development of science and technology has provided more opportunities for patients to live and even receiving futile medical care or treatment with no hope of recovery. This process leads to awkward experiences and moral distress in nurses who frequently deliver with such care. Objective: This study aimed to determine the perception of futile care and its relationship with moral distress in nurses working in intensive care units Materials and Methods: This is a cross-sectional study conducted on 155 nurses working in Intensive Care Units (ICUs) employed in educational-therapeutic centers and hospitals of Guilan Province, Iran. They were selected by convenience sampling method. The study data were collected using the researcher-made questionnaire and Corley moral distress questionnaire. The obtained data were analyzed using descriptive statistics and inferential statistics the Kolmogorov-Smirnov test, nonparametric Mann-Whitney U, Kruskal-Wallis, Fisher exact and Backward logistic regression model. Results: The mean±SD age of the samples was 34.71±6.68 years; their mean±SD work experience was 10.24±5.63 years, and the mean±SD work experience in the ICU was 6.76±4.64 years. The results indicated that their mean±SD perception of futile care was 63±7, and their mean±SD moral distress was 92±54. The score of moral distress showed a low but significant and positive correlation with the legal and organizational aspects of futile care (r=0. 279, P=0.001) and the total score of perception futile care (r=0.2, P=0.012). In the multivariate analysis based on the logistic regression model of futile care, only the relationship between the legal and organizational score in care had a significant relationship with moral distress. So that by increasing one unit in the legal and organizational aspect of care, the chances of scoring above the mean of moral distress increases 1.2 times (P=0.0001, 95% CI; 1.077-1.324).  Conclusion: Perhaps by familiarizing nurses with the legal and organizational nature of patient’s care, the moral distress of caring can be reduced.}, Keywords = {Futile care, Moral distress, Intensive care units, Nurses}, volume = {31}, Number = {2}, pages = {85-92}, publisher = {}, doi = {10.32598/jhnm.31.2.2119}, url = {http://hnmj.gums.ac.ir/article-1-1592-en.html}, eprint = {http://hnmj.gums.ac.ir/article-1-1592-en.pdf}, journal = {Journal of Holistic Nursing And Midwifery}, issn = {2588-3712}, eissn = {}, year = {2021} } @article{ author = {Hajipoor, Sayareh and Pakseresht, Sedigheh and Niknami, Maryam and AtrkarRoshan, Zahra and Nikandish, Sim}, title = {The Relationship Between Social Support and Postpartum Depression}, abstract ={Introduction: Postpartum depression is a common and severe problem that has adverse effects on maternal and family health. Social support is one of the determinants of health, and in recent years has received increasing attention, and its overlook is a significant risk factor for postpartum depression. Objective: This study aimed to determine the relationship between social support and postpartum depression in women referring to comprehensive health centers in Rasht City, Iran. Materials and Methods: The present study is a cross-sectional, analytical study performed on 300 mothers referred to the comprehensive health service centers in Rasht 2-4 weeks after their deliveries. They were selected by cluster sampling method, which was done systematically within each cluster. The study data were collected using a three-part questionnaire of demographic characteristics, Edinburgh Postpartum Depression Scale (EPDS), and Hopkins social support. The obtained data were analyzed using descriptive and inferential statistics (t-test, Friedman, Mann-Whitney, Kruskal-Wallis, Spearman correlation coefficient, and rank logistic regression). Results: The results showed that the mean±SD age of the study mothers was 29±5.3 years. About 63.7% of mothers had low postpartum depression, and their mean±SD total score of social support was 64.03±16.92. The most support received from the spauses and parents. There was a statistically significant relationship between social support received by mothers after childbirth with education level (P=0.003), job (P=0.001), spauses’ job (P=0.001), income (P=0.001), residence status (P=0.043), number of deliveries (P=0.05) and pregnancy desire (P=0.047) and there was a significant inverse correlation between depression score and social support score by spauses (P=0.004, r=-0.167), parents (P=0.002, r=-0.176) and total social support score (P=0.024, r =-0.130). After adjusting for individual social variables, the effect of social support score on the part of the spauses (P=0.001), parents (P=0.006), friends, and relatives (P=0.033) continued to be associated with the severity of depression. Also, the number of deliveries (P=0.05) and h spauses’ jobs (self-employed) were significant compared to the unemployed ones (P=0.049). Conclusion: The results showed a significant and inverse relationship between social support and symptoms of postpartum depression. Although these results show the most support from spauses and parents, the amount of support received in the area of spauses’ ​​parents, friends, and relatives were low. It is necessary to draw the attention of midwives and health care providers to mothers and inform them about the importance of social support and its prominent role in reducing postpartum depression.}, Keywords = {Depression, Postpartum depression, Social support, Women}, volume = {31}, Number = {2}, pages = {93-103}, publisher = {}, doi = {10.32598/jhnm.31.2.1099}, url = {http://hnmj.gums.ac.ir/article-1-1600-en.html}, eprint = {http://hnmj.gums.ac.ir/article-1-1600-en.pdf}, journal = {Journal of Holistic Nursing And Midwifery}, issn = {2588-3712}, eissn = {}, year = {2021} } @article{ author = {TohidiNoroodi, Homa and Mirhadyan, Leila and MosaffaKhomami, Homa and KazemnezhadLeili, Ehs}, title = {Risk of Child Abuse and Its Predictors in Mothers with Children Under 5 Years Old}, abstract ={Introduction: Child abuse as a public health problem has adverse consequences for children’s physical and mental health. Even mothers may be responsible for child abuse, so it is essential to identify high-risk cases and take preventive measures. Objective: This study aimed to determine the potential risk of child abuse and its predictors of risk among mothers with children under 5 years old referred to comprehensive health service centers in Rasht City, Iran, in 2019. Materials and Methods: This is a cross-sectional study conducted on 450 mothers of children under 5 years old referred to the comprehensive health service centers in Rasht. The study data were collected by Adult-Adolescent Parenting Inventory form (AAPI-2 form A). The obtained data were analyzed using descriptive statistics, stepwise multiple linear regression, and the Friedman test to investigate the relationship between subscales. Results: The samples were mothers with a mean±SD age of 30.6±5.2 years. Mostly had diploma (41.78%), were housewife (79.33%) and all of them were married. The total mean±SD of score obtained for the child abuse risk was 3.18±0.56. Most mothers (87.31%) had moderate to severe level of child abuse risk. Based on multiple linear regression test, education (β=0.161, 95%CI; 0.076-0.247, P =0.001), being an employee (β=0.223, 95%CI; 0.059-0.387, P=0.008), family income (β=0.092, 95% CI; 0.006-0.179, P=0.037), spouse’s education (β=0.128, 95% CI; 0.046-0.209, P=0.002), and addiction status of spouse (β=0.236, 95% CI; 0.006-0.466, P=0.044) were predictors of child abuse risk among the studied variables, respectively.  Conclusion: The results showed that most samples had a moderate risk of child abuse. It reveals the necessity to assess the attitudes of mothers about parenting, which predicts the potential of child abuse to some extent and can provide a basis of educational interventions for mothers to prevent child abuse.}, Keywords = {Child abuse, Risk factors, Mothers, Preschool children}, volume = {31}, Number = {2}, pages = {104-113}, publisher = {}, doi = {10.32598/jhnm.31.2.1050}, url = {http://hnmj.gums.ac.ir/article-1-1596-en.html}, eprint = {http://hnmj.gums.ac.ir/article-1-1596-en.pdf}, journal = {Journal of Holistic Nursing And Midwifery}, issn = {2588-3712}, eissn = {}, year = {2021} } @article{ author = {Mirpour, Zinatsadat and Rahmani, Mohammadali and Ghorbanshiroodi, Shohreh}, title = {Explaining the Concept of Re-experiencing Abusive Relationships}, abstract ={Introduction: Choosing an emotional partner is an important occasion that profoundly affects various aspects of life; however, many relationships fail, and people face a vicious cycle of unhealthy and harmful relationships. Objective: This study aimed to explain the concept of re-experiencing harmful relationships. Materials and Methods: This research is a qualitative study done with the Grounded Theory (GT) approach done using the purposive sampling method until data saturation. Data collection methods included semi-structured interviews, observations, and field notes. In this study, 8 victims of harmful relationships and 8 psychologists were interviewed. Each interview lasted 25 to 55 minutes and was digitally recorded. Data analysis was performed along with data collection by Strauss and Corbin’s constant comparative analysis. Using Lincoln and Guba criteria, the accuracy and strength of this research were confirmed. Results: The open coding results indicated that 47 concepts could effectively frame the pattern of re-experiencing unhealthy relationships. In the axial coding stage, the concepts were classified into 8 general categories. Finally, in the selective coding stage, the phenomenon of “harmful relationships” was extracted as a significant category. The central coding paradigm consisted of 8 key features: perceived violence, psychological symptoms, unhealthy relationship strategies, dark personality traits, emotion regulation problems, retention factors, family harms, self-breaking behaviors. Each includes subclasses with specific characteristics. Conclusion: The results showed that harmful relationships are complex, dynamic, continuous, and intervened with the contextual conditions, retention factors, causal conditions, and intervening conditions. So it is necessary to develop and present psychological programs and interventions based on these problems.}, Keywords = {Abusive relationships, Re-experience, Grounded theory}, volume = {31}, Number = {2}, pages = {124-134}, publisher = {}, doi = {10.32598/jhnm.31.2.2094}, url = {http://hnmj.gums.ac.ir/article-1-1599-en.html}, eprint = {http://hnmj.gums.ac.ir/article-1-1599-en.pdf}, journal = {Journal of Holistic Nursing And Midwifery}, issn = {2588-3712}, eissn = {}, year = {2021} } @article{ author = {AkbarianMoghaddam, Yasaman and Moradi, Maryam and VahedianShahroodi, Mohammad and Ghavami, Vahi}, title = {Effectiveness of the Education Based on the Theory of Planned Behavior on Childbearing Intention in Single-child Women}, abstract ={Introduction: Rapid decline of the total fertility rate in Iran in recent decades has caused serious demographic challenges to the country. One important reason for this decrease is single-child behavior adopted by Iranian families. Objective: The present study was conducted to assess the effectiveness of education based on the Theory of Planned Behavior (TPB) on childbearing intention in single-child women. Materials and Methods: This randomized field trial with the pretest-posttest design was done on 72 single-child women presenting to health centers in Mashhad City, Iran, in the intervention (37 persons) and control (35 persons) groups from August 2019 to February 2020. Research tools included a demographic and obstetric questionnaire and a researcher-made childbearing intention questionnaire based on TPB. The intervention group received three 110-min sessions of education, which was based on TPB. The control group received routine health center care. The study data were analyzed by using the Kolmogorov-Smirnov, Shapiro-Wilk, Independent t-test, Mann-Whitney U test, repeated measures Analysis of Variance (ANOVA), Freidman test, post hoc tests of Bonferroni and Dunn, the Spearman rank correlation coefficient, and the Generalized Estimating Equation (GEE) model. Results: The mean±SD age of the participants were 32.6±4.7 and 32.9±4.7 years in the intervention and control groups, respectively, and most of the women had university-level education in both groups. Changes in childbearing intention from the pre-intervention stage were significantly higher in the intervention group than the control group immediately (P=0.001) and then one month after the intervention (P=0.001). The results of the GEE model showed that the childbearing intention was significantly higher in the intervention group (β=0.68, 95% CI; 0.449-0.911, P=0.001,), and there was a significant positive relationship between attitude and childbearing (β=0.023, 95% CI; 0.013-0.033, P=0.001). Conclusion: Education based on the theory of planned behavior increased childbearing intention in single-child women in this study, so this educational program is advised for promoting childbearing.}, Keywords = {Childbearing, Education, Intention, Single-child women, Theory of planned behavior}, volume = {31}, Number = {2}, pages = {135-145}, publisher = {}, doi = {10.32598/jhnm.31.2.2135}, url = {http://hnmj.gums.ac.ir/article-1-1598-en.html}, eprint = {http://hnmj.gums.ac.ir/article-1-1598-en.pdf}, journal = {Journal of Holistic Nursing And Midwifery}, issn = {2588-3712}, eissn = {}, year = {2021} }