OTHERS_CITABLE The Quality of Obtaining Surgical Informed Consent for Cesarean Section in Public Hospitals of Iran Abstract: Introduction: Nowadays, about 50-65% of births in Iran occur by Cesarean Section (CS). Informed consent (IC) is one of the most important ethical, legal and professional requirements of a surgical procedure. Objectives: This study aims to assess the quality of obtaining surgical IC from women underwent CS in public hospitals of Iran. Materials and Methods: In this analytical study with cross-sectional design, 300 postpartum women who had CS referred to two public hospitals in Rasht, Iran were participated through stratified random sampling method in 2016. Data were collected using a two-part researcher-made questionnaire. Collected data were analyzed by using descriptive statistics, Kruskal-Wallis test, Mann-Whitney U test, and Spearman’s correlation test. Results: The mean age of participants was 29.84 ± 5.9 years. The majority of them (45.3%) had education lower than high school. The overall mean score for the quality of obtained IC was 62.23±23.38, out of 150 points. Regarding its dimensions, quality of acquiring IC form (20.21±7.12, out of 40 points), provision of CS-related information (15.67±11.10, out of 45 points), voluntariness (7.53±6.95, out of 25), and the physician–patient relationship (18.81±8.87, out of 40 points) were perceived poor. Women’s educational level had a significant correlation with the IC quality dimensions of voluntariness (P=0.0001) and physician–patient relationship (P=0.043). The number of deliveries (P=0.008), live births (P=0.031), and stillbirth (P=0.0001) had a significant correlation with acquiring the IC form. The voluntariness was significantly associated with the number of live births (P=0.023) and stillbirth (P=0.001). The physician-patient relationship dimension was significantly associated with the number of pregnancies (P=0.023) and abortions (P=0.0001). The overall quality of obtained IC was significantly correlated with the women’ age (r= 0.162, P= 0.005). Conclusion: Most of women in Iran are not informed enough about the CS and its consequences. Health care providers should pay more attention to the women’s characteristics when obtaining IC for the CS.  We recommend essential changes in the process of obtaining surgical IC for the CS in public hospitals of Iran. Obtaining IC during pregnancy may reduce unnecessary CSs. http://hnmj.gums.ac.ir/article-1-1527-en.pdf 2020-12-20 1 8 10.32598/jhnm.31.1.2044 Informed consent Cesarean section patient rights Shadi Sabetghadam 1 Midwifery (MSc), Reproductive Health Research center, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0001-9018-4541 Sedighe Rezaie-Chamani sedigherezaie65@yahoo.com 2 Instructor, School of nursing and midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0003-4171-5857 Zahra Amirkhanzadeh Barandouzi 3 Ph.D. Candidate, School of Nursing, University of Connecticut, CT, USA AUTHOR https://orcid.org/0000-0002-8537-4751 Sedigheh Sedigh Mobarakabadi 4 Instructor, School of nursing and midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-6776-7770 Yalda Donyaei Mobarrez 5 Midwifery (MSc), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-8783-4934
OTHERS_CITABLE A Comparative Study on Adverse Pregnancy Outcomes in Pregnant Women with Different Age Abstract Introduction: Delayed childbearing is increasing. Increased maternal age has been associated with increased risk of pregnancy complications. On the other hand, the adolescent pregnancy has traditionally been considered high-risk, especially in developing countries. Objective: This study aimed to compare the adverse pregnancy outcomes in different age groups of pregnant women. Materials and Methods: The analytical study with cross-sectional design was conducted on 345 pregnant women referred to one of the maternity hospitals in Rasht, Iran in 2018 who were selected by sequential sampling method. They were followed from gestational age >37 weeks until delivery in 3 groups: <19 years, 19-35 years and >35 years. The data collection tool was a two-part researcher-made questionnaire which surveys demographic, fertility, and socioeconomic information and adverse maternal and neonatal outcomes. The collected data were analyzed using descriptive and inferential statistics (Chi-square test, Fisher’s exact test, Kruskal-Wallis test, ANOVA, Bonfrroni test, Spearman correlation test, and multiple linear regression analysis). Results: The highest prevalence of maternal diabetes mellitus (29.7%) and cesarean section (72.46%) were reported in the age group >35 years. The highest frequency of premature rupture of membranes (18.8%) and abnormal fetal presentation (13.8 %) were reported in age groups <19 years and 19-35 years, respectively. Among maternal outcomes, maternal diabetes, abnormal fetal presentation, premature rupture of membranes and delivery by cesarean section were significantly different between three groups (P<0.05). There was a significant difference between maternal age and neonatal outcomes in ages groups <19 years and 19-35 years (P<0.05). Multiple linear regression model showed that the maternal age <19 years was a predictor of adverse neonatal outcomes. The group <19 years reported more adverse outcomes than the age group 19-35 years (β=0.282, 95% CL: 0.002-0.561, P=0.049). Conclusion: All age groups of pregnant women faced some pregnancy outcomes. Due to Iran’s new plan to encourage childbearing, prenatal screening, and receiving more prenatal care, we recommend pregnant women to participate in childbirth preparation training courses.     http://hnmj.gums.ac.ir/article-1-1529-en.pdf 2021-12-29 9 16 10.32598/jhnm.31.1.2017 Pregnancy outcome maternal age Reproduction Adolescent Soudabe Ebrahimi 1 Midwifery (MSN), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-2440-9607 Maryam Niknami niknamym@gmail.com 2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-4684-030x Fateme Rafat 3 Instructor, Department of Midwifery, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0001-5944-2901 Ehsan Kazemnezhad Leili 4 Associate Professor, Social Determinants of Health Research Center (SDHRC), Biostatistics, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-9195-9094
OTHERS_CITABLE Patient Satisfaction With the Quality of Health Services Provided by Public Hospitals in Rasht, Iran Introduction: Service quality is a distinguishing and most powerful competitive factor. By improving the quality of service delivery, it is possible to increase productivity, reduce costs, and, as a result, increase patient satisfaction. Objective: The present study aims to determine the level of patient satisfaction with the quality of health services provided by public hospitals based on the SERQUAL-KANO model. Materials and Methods: This is an analytical study with cross-sectional design. The study population consists of all patients admitted to the emergency department, and male & female medical wards of public hospitals in Rasht, Iran. This, 250 patients were selected by a two-stage stratified sampling method. Data collection tools were two questionnaires of SERVQUAL and Kano with acceptable reliability (α=0.77 and 0.72). Kolmogorov-Smirnov and Wilcoxon tests were used to analyze data. Results: The majority of patients were male (53%) with a bachelor’s degree (32%) aged 40-59 years (38%). In all hospitals, according to the Wilcoxon test results, the highest and lowest mean quality scores were related to assurance and tangibility dimensions (P<0.05). The highest level of patient satisfaction was reported in Hospital no. 2 with a quality gap of +0.41, while the lowest level was related to Hospital no. 5 with a gap of -0.23. According to Importance-Performance Analysis matrix, tangibility was in the “Concentrate Here” quadrant; the dimensions of reliability and responsiveness were in the “Low Priority” quadrant; the dimension of assurance was in the “Possible Overkill” quadrant; and the dimension of empathy was in the “Keep Up the Good Work” quadrant. According to the Kano model, 13 attributes were classified as “Attractive”, 11 as “One-dimensional”, and only 1 property as “Reverse”; no attribute was classified as “Indifferent”. Conclusion: It seems necessary to make more improvements in facilities and equipment, appearance of staff, communication tools, and cleanness of hospital environment to increase patient satisfaction in public hospitals. http://hnmj.gums.ac.ir/article-1-1531-en.pdf 2021-12-29 17 25 10.32598/jhnm.31.1.2022 Patient satisfaction Patients Health Fardin Mehrabian 1 Professor, Department of Health Education and Promotion, Health and Environment Research Center, School of Health, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/orcid.org/0000-0002-9613-2395 Mahnaz Hemmati Nodoust Gilani mahtty41@yahoo.com 2 Assistant Professor, Department of Public Administration, School of Management, Payame Noor University, Tehran, Iran AUTHOR https://orcid.org/0000-0002-8415-7456 Alireza Almaee 3 Graduate, public administration, Payame Noor University of Iran, Rasht, Iran AUTHOR https://orcid.org/0000-0002-5942-7717
OTHERS_CITABLE A Comparative Study on Psychosocial Factors between Mothers of Infants with and without Physical Abnormalities Abstract Introduction: Congenital anomalies are one of the most important causes of disability and mortality in childhood seen in developing and developed countries. Mothers with physically-abnormal newborns have unfavorable lifestyle compared to mothers with healthy infants. Objective: The aim of this study was to determine the difference between mothers of infants with and without physical abnormalities in terms of psychosocial factors. Materials and Methods: This is a case-control study with two study groups; the case group (n=133) consists of mothers who had babies with birth defects referred to health centers in Amol city, Iran for postnatal care in 2018. The control group (n=133) included mothers with healthy infants in this city. They were selected using a convenience sampling method. Measurement tools included a Socio-demographic form, Health-Promoting Lifestyle Profile (HPLP), Multidimensional Perceived Social Support Scale (MPSSS), Coping Strategies Scale - Short Form (CSS-SF), Prenatal Distress Questionnaire (PDQ), and General Health Questionnaire - Short Form (GHQ-SF). Data were analyzed using descriptive statistics, chi-square test, and t-test. Results: A total of 266 mothers with a mean age of 31.9±5.6 years were examined. There was a significant difference between the two groups of mothers in terms of overall HPLP score (P=0.01), and its dimensions of spiritual growth (P<0.05), physical activity, nutrition (P=0.01), and stress management (P<0.05). Moreover, a significant difference was reported between them in terms of MPSSS and its dimensions of social support from friends, family, and significant others (P=0.01). Furthermore, There was a significant difference between them with respect to GHQ dimensions of anxiety/insomnia, and depression (P<0.01); CSS dimensions of escape avoidance and emotion-focused coping strategies (P=0.01); and PDQ and its dimensions of concerns about the delivery and the health of the baby, and about the body weight/image (P=0.01). Conclusion: Mothers of infants with and without birth defects are significantly different from each other in terms of psychosocial factors. It seems that poor psychosocial variables in mothers during pregnancy can act as a risk factor for congenital anomalies.       http://hnmj.gums.ac.ir/article-1-1532-en.pdf 2021-12-29 26 34 10.32598/jhnm.31.1.2027 Congenital anomalies psychosocial variables Mothers Mahtab Ranjbar 1 Sociology (MSA), School of Literature & Humanity, University of Guilan, Rasht, Iran AUTHOR https://orcid.org/0000-0002-4498-1440 Ebrahim Masoudnia masoudnia@guilan.ac.ir 2 Associate Professor, Department of Social Sciences, School of Literature & Humanity, University of Guilan, Rasht, Iran AUTHOR https://orcid.org/0000-0003-4310-8647 Mohsen Haghshenas Mojaver 3 Assistant Professor, Babol University of Medical Sciences, Babol, Iran AUTHOR https://orcid.org/0000-0001-7427-2576
OTHERS_CITABLE Comparing the Effect of Face-To-Face Education and E-learning on the Physical Activity of the Elderly Abstract Introduction: Regular physical activity is very effective in preventing or delaying chronic diseases and premature death in the elderly. Objective: This study aimed to compare the effect of face-to-face education and e-learning methods on the physical activity of the elderly. Materials and Methods: This is a quasi-experimental study conducted in Karaj, Iran in 2018. The participants were 88 elderly people referred to a senior rehab center and then were assigned into three groups of face-to-face education (n=30), e-learning (n=28), and control (n=30).The study data were collected by a demographic form and the 41-item community healthy activities program for seniors questionnaire (CHAMPS) before the intervention, 1 month after the intervention, and 3-month follow-up. Face-to-face education and e-learning were presented to the two educational groups’ during eight 20-minute sessions. The obtained data were analyzed using ANOVA, Bonferroni post hoc test, the Chi-square test, and repeated measures ANOVA. The significance level was set at0.05. Results: Between the two educational groups, a significant difference was observed in the mean score of physical activity at three measurement phases (P = 0.001).The effect size was 0.61 for face-to-face education and 0.64 for e-learning. Based on the results of the Bonferroni post hoc test, there was no significant difference between e-learning and face-to-face education groups. Conclusion: Both face-to-face and e-learning methods were effective in promoting the physical activity behavior of the elderly. E-learning method can be used as one of the complementary methods of traditional education for improving the physical activity of the elderly.   http://hnmj.gums.ac.ir/article-1-1533-en.pdf 2021-12-29 35 43 10.32598/jhnm.31.1.2037 Elderly Education Physical activity E-learning Face-To-Face education Shahab Papi 1 PhD Candidate in Gerontology, Department of Public Health, Faculty of Health, Social Determinant of Health Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran AUTHOR https://orcid.org/0000-0001-9917-7364 Yadollah Abolfathi Momtaz yabolfathi@gmail.com 2 Associate Professor, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. Malaysian Research Institute on Ageing (My Ageing), University Putra Malaysia AUTHOR https://orcid.org/0000-0003-1939-1470 Mahshid Foroughan 3 Professor, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0002-8801-4946 Farahnaz Mohammadi Shahboulaghi 4 Professor, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0001-8357-0882 Marzieh Araban 5 Associate Professor, Department of Health Education and Promotion, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AUTHOR https://orcid.org/0000-0001-9920-0261 Tahereh Ramezani 6 PhD. Candidate in Gerontology, Iranian Research Center of Ageing, University of Social Welfare and Rehabilitation, Tehran, Iran AUTHOR https://orcid.org/0000-0003-2020-3764
OTHERS_CITABLE Internet Addiction and Its Relationship with Family Functioning in High School Students Abstract Introduction: Family-related factors play an important role in adolescent’s addiction to the Internet. Objective: The aim of this study was to examine the relationship between Internet addiction and family functioning in high school students. Materials and Methods: This is an analytical  study with a cross-sectional design conducted on 796 high school students in Rasht city, Iran who were selected using multi-stage cluster random sampling method. Data collection tools were a demographic form, the Young’s Internet Addiction Test, and the Family Assessment Device. Chi-Square test and rank-ordered logistic regression analysis were used for data analysis. Results:The response rate of of students was 86.81%; 85.7% had at least two family members who were using the Internet; 71.2% of students had no addiction, 27.5% were exposed to Internet addiction and 1.3% had Internet addiction. The majority (65.0%) of studnets had unhealthy family functioning. The relationship between Internet addiction and family functioning was statistically significant (P=0,001). There was a significant statistical relationship between Internet addiction and family income (P= 0.003), father's job (P=0.001), and duartion of internet usage per day (P=0.001). Logistic regression model showed that the family functioning score (OR=1.02, 95% CI;1.01-1.04, P=0.001), duration of Internet usage per day (OR=1.02, 95% CI;1.11-1.20, P=0.0001), and gender (male) (OR=1.02, 95% CI;1.26-2.58, P=0.001) significantly affected Internet addiction. Conclusion:Due to the direct statistical relationship between Internet addiction and family functioning, it is necessary to pay serious attention to the phenomenon of Internet addiction and make appropriate plans for adolescents and their families to use the Internet properly.     http://hnmj.gums.ac.ir/article-1-1535-en.pdf 2021-12-29 44 52 10.32598/jhnm.31.1.2025 Internet addiction Family functioning High school students Zahra Harsej 1 Nursing (MSN), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR Nasrin Mokhtari Lakeh lakeh.nasrin@gmail.com 2 Instructor, Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-9529-0914 Farzaneh Sheikholeslami 3 Instructor, Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-1723-0748 Ehsan KazemnezhadLeili 4 Associate Professor, Biostatistics,Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran AUTHOR https://orcid.org/0000-0002-9195-9094
OTHERS_CITABLE Relationship between Social Support and Parents\' Satisfaction with Medical Care Provided to their Premature Infants Abstract: Introduction: Premature birth is highly stressful for parents. Nursing support is crucial for premature infants. Parental satisfaction is a vital indicator of the quality of care provided by nurses. Therefore, determining the factors related to parental satisfaction is important in nursing care. Objective: This study aims to investigate the relationship between social support and parents' satisfaction with the medical care provided to their premature infants in the Neonatal Intensive Care Units (NICUs). Materials and Methods: This is an analytical/correlational study. Participants were 130 parents of premature infants admitted to the NICUs in three hospitals affiliated to Tehran University of Medical Sciences in Iran. They were selected based on a convenience sampling method. Tarkka’s Social Support Questionnaires and the Neonatal Index of Parent Satisfaction were used for collecting data. Data were analyzed by using descriptive statistics and T-test, Chi-square test, ANOVA and Pearson correlation test. Results: It was reported that 55.38% of the infants were females, with a mean birth weight of 1880.97± 544.85 gr and a mean gestational age of 32.07±2.41 weeks. The mean age of their mothers and fathers was 31.25±5.12 and 35.03±5.66 years, respectively. The highest level of social support in mothers and fathers was related to emotional support (3.65±0.69 in mothers and 3.29±0.57 in fathers), while the lowest level of social support was related to concrete support (3.32±0.80 in mothers and 3.16±0.65 in fathers). Mothers perceived higher social support than fathers. They also had more satisfaction with medical care (3.88±0.81 in mothers and 3.63±0.69 in fathers). There was a significant relationship between social support and parental satisfaction (r=0.791, P<0.05). Conclusion: Parents of premature infants need more social support, especially concrete aid. Therefore, planning to promote social support of parents, especially fathers, by nurses in the NICUs seems necessary.     http://hnmj.gums.ac.ir/article-1-1534-en.pdf 2021-12-29 53 60 10.32598/jhnm.31.1.2042 Premature infants Social support Parental satisfaction Mona Mohtashami mohtashami@shmu.ac.ir 1 Instructor, Department of Anesthesiology, School of Allied Medicine, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR https://orcid.org/0000-0002-1559-787X Zahra Ahmadi 2 Instructor, Department of Community Health Education, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran AUTHOR https://orcid.org/0000-0001-5082-6343 Malihe Imeni 3 Instructor, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR https://orcid.org/0000-0003-0240-1433 Malihe Amerian 4 Instructor, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR https://orcid.org/0000-0002-8753-486X Marzieh Faghani Aghoozi 5 Instructor, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran AUTHOR https://orcid.org/0000-0001-7916-5884
OTHERS_CITABLE Effect of a Quality of Life Education Program on Psychological Well-Being and Adherence to Treatment of Diabetic Patients Abstract Introduction: Diabetes is a chronic disease with fatal health complications. Identifying the psychological factors that control this disease is very important, one of which is quality of life (QOL). Objective: This study aimed to investigate the effect of a QOL education program on psychological well-being (PWB) and adherence to treatment of patients with type 2 diabetes. Materials and Methods: This is a pilot study with a quasi-experimental design based on pretest and posttest phases. The statistical population consists of all diabetic patients referred to health centers in Semnan City, Iran during the 6months from March to September 2018.Of them,30 type 2 diabetes, aged 30-60 years (male and female) were selected based on the inclusion criteria and randomly assigned to the intervention and control groups. They were first assessed by using Hayes’s general adherence scale (GAS) and Ryff’s psychological well-being scale the short form (PWBS-SF).Then, the intervention group received QOL education in 12 sessions, once per week each for 90 min. Then, posttest assessments were carried out. The collected data were analyzed using MANCOVA. Results: The QOL education program significantly increased adherence to treatment (P= 0.005) and PWV and all its dimensions (autonomy, environmental mastery, personal growth, positive relations with others, be purposeful in life, self-acceptance) in patients (P = 0.005). Conclusion: Since diabetes is one of the chronic diseases that need constant care and there is no definitive and immediate treatment for it, increasing PWB and adherence to treatment in patients to control this disease by QOL education can be very effective.     http://hnmj.gums.ac.ir/article-1-1528-en.pdf 2021-12-29 61 67 10.32598/jhnm.31.1.2034 Quality of Life Adherence Psychological well-being Diabetes mellitus type 2 Faezeh jahan Faeze.jahan@gmail.com 1 Assistant Professor, Department of Psychology, Semnan Branch, Islamic Azad University, Semnan, Iran AUTHOR https://orcid.org/0000-0002-2501-3583 Saeed Nematolahi 2 Master of Clinical Psychology, Semnan Branch, Islamic Azad University, Semnan, Iran AUTHOR https://orcid.org/0000-0002-1784-9233