Comparing the Efficacy of Foot Reflexology and Benson's Relaxation on Anxiety and Physiologic Parameters After Cesarean Surgery.

OBJECTIVE: To compare the efficacy of foot reflexology and Benson's relaxation on anxiety and physiologic parameters after cesarean surgery. DESIGN: Randomized controlled trial with three parallel arms. SETTING: Gynecologic ward of the Persian Gulf Martyrs Hospital in Bushehr, Iran, in 2020. PARTICIPANTS AND INTERVENTIONS: Women undergoing cesarean surgery (n = 135) were selected by convenience sampling and divided via block randomization into three groups of foot reflexology, Benson's relaxation interventions, and control group (n = 45 in each group). Interventions were performed 2 hours after cesarean surgery. MEASUREMENTS: Spielberger's State-Trait Anxiety Inventory, mercury sphygmomanometer, and pulse oximeter were used to collect the data. Anxiety was measured before and 30 minutes after the intervention. Physiologic parameters were measured before the intervention and immediately, 30 minutes, and 60 minutes after the intervention. Data were analyzed using inferential statistics. RESULTS: The mean score of situational anxiety after the intervention was significantly lower than before the intervention in the reflexology (t = 5.66, 11.14; 95% confidence interval [CI] [5.66, 11.14]) and Benson's relaxation groups (t = 7.362; 95% CI [5.91, 9.85]). However, changes in the control group were not significant (t = 1.674; 95% CI [-0.24, 2.55]). Decreases in anxiety scores were similar in the two intervention groups. After intervention, in most measurement times, respiratory rate and pulse rate decreased in the two intervention groups compared to the control group, and arterial oxygen saturation and systolic blood pressure increased. CONCLUSION: Considering the effect of both interventions on decreasing anxiety and improving most physiologic parameters, it seems that foot reflexology and Benson's relaxation can be recommended after cesarean surgery.

The predictive role of intimate partner violence in treatment adherence among women with chronic illness: A cross-sectional study.

OBJECTIVE: This study was an attempt to shed light on the predictive role of intimate partner violence in adhering to treatment regimens in women with chronic illnesses. METHOD: In a descriptive-analytical study, 400women with chronic illnesses in Bushehr were selected through convenience sampling. The data were collected by distributing a demographic information form and two questionnaires, including the intimate partner violence (IPV) questionnaire and the treatment adherence scale. RESULTS: According to the results, the 40 to 59 years age group (P = 0.046, ß = 0.104), the 60 to 79 years age group (P = 0.019, ß = 0.122), and the group receiving education about chronic illness (P = 0.031, ß = 0.106) showed a direct relationship with treatment adherence, while IPV (P < 0.001, ß = 0.284) had a significant inverse relationship with treatment adherence. CONCLUSION: The results of the study showed that predictors of treatment adherence are IPV in women aged 40 and older with chronic illnesses, and receiving education about chronic illnesses. It is necessary for healthcare providers to consider barriers such as intimate partner violence when providing education in order to increase treatment adherence. To avoid nonadherence, managers and health planners should implement policies to increase the level of awareness of healthcare staff on how to manage care of women with chronic illnesses who are abused by an intimate partner and refer them to counselors and family helpers.

Information-seeking process and clinical scenario solving: introduction of a new tool in nursing education.

BACKGROUND: Nursing education has recently undergone changes to improve care. These changes require innovative and transformative strategies in nursing education. Search as learning is one of the educational methods this study was conducted to determine the effect of the information searching process on scenario-based learning in nursing students. METHODS: This study is a single group semi-experimental study that was conducted on 38 nursing students in 2021. Students first drew a concept map according to their existing knowledge about two scenarios (diabetes and trauma). The students then searched the medical databases and drew another concept map after the search. Data were analyzed using descriptive statistics, paired mean tests and Pearson correlation coefficients. RESULTS: The results showed that the mean scores of the participants in the diabetes scenario before and after the search were 18.32 ± 5.50 and 19.13 ± 7.54, respectively, and those in the trauma scenario were 18.58 ± 7.69 and 29.61 ± 7, respectively (P < 0.01). The mean scores of the details of the conceptual map before and after the search in terms of themes, number of levels and relationships were statistically significant. In both scenarios, there was a positive correlation (p < 0.01) between learning and the number of correct webpages (r = 0.74 for trauma and r = 0.64 for diabetes), as well as between search time and the amount of learning (r = 0.77 for trauma and 0.64 for diabetes). CONCLUSIONS: The results showed that search as learning in nursing education scenarios led to student learning. It is recommended that nurse educators use this method as a tool in nursing education to increase students' awareness and develop their thinking skills. Further research is recommended to determine the effectiveness of this method with other educational methods.

Examining the impact of time management and resilience training on work-family conflict among Iranian female nurses: a randomized controlled trial.

BACKGROUND: Female nurses confronting work-family conflict may endure adverse consequences for themselves and their families, leading to a decline in job performance and intentions to quit. Investigating the effects of interventions based on factors contributing to work-family conflict can aid in identifying optimal strategies for conflict reduction and mitigating its negative repercussions. This study aimed to examine the impact of time management and resilience training on work-family conflict among Iranian female Nurses in 2022. METHODS: In this randomized controlled trial employing pre, post, and follow-up measures, 132 female nurses employed in the hospitals of Bushehr University of Medical Sciences (Bushehr, Iran) were selected and subsequently categorized into three groups-time management, resilience training, and control groups-using simple random sampling method. 10 online training sessions were conducted for each intervention group. A demographic form and a work-family conflict questionnaire were used for data collection. Repeated measures ANOVA, one-way ANOVA and multivariate general linear model were used to examine the hypotheses. RESULTS: Regarding total work-family conflict, posttest mean scores were significantly lower than the pretest in both time management (p < 0.001) and resilience (p < 0.001) training groups, but follow-up mean scores were significantly higher than posttests in both time management (p < 0.001) and resilience (p < 0.001) training groups. In the control group, the mean scores at three time points were not statistically different (P = 0.058). The post-test mean score of work-family conflict was comparable in the two intervention groups (P > 0.05) and lower than the control group (P < 0.001) The follow-up mean score was comparable in the two intervention groups (P > 0.05) and lower than the control group (P < 0.001). CONCLUSION: Time management and resilience training effectively reduced the work-family conflict experienced by female nurses. Therefore, it is recommended that training programs such as time management and resilience training be incorporated into the ongoing education of nurses to alleviate their work-family conflict. Considering the diminishing impact of these interventions over time, training should be reiterated based on the evolving needs of the nurses. TRIAL REGISTRATION: Number (IRCT20190122042453N2),01/27/2022.

Investigating the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease: A cross-sectional study from Iran.

INTRODUCTION: Despite the effect of coronary artery disease on sexual function and the relation between sexual function and marital satisfaction, few studies have investigated the effect of treatment adherence on marital satisfaction. The present study aims to investigate the role of treatment adherence in predicting marital satisfaction among women with coronary artery disease. METHODOLOGY: In this cross-sectional study, 385 women with coronary artery disease in Bushehr-Iran, 2021, were selected using a convenient sampling method. The data were collected using the demographic form, Seyed Fatemi medication adherence scale, female sexual function index, and evaluation and nurturing relationship issues, communication, and happiness marital satisfaction scale. The data was analyzed using univariate and multivariate logistic regression tests. RESULTS: The mean (± standard deviation) age of the participants was 52.19 ± 12.15 years old. Considering the effect of demographic variables, treatment adherence (ß = 0.164, P = 0.001) and sexual function (ß = 0.156, P = 0.001) were positive predictors of marital satisfaction. CONCLUSION: Treatment adherence was a positive predictor of marital satisfaction. Healthcare providers should pay attention to the family consequences of non-adherence to treatment. Moreover, when counseling patients to adhere to the treatment, they should mention the physical benefits as well as psychological and family outcomes in order to motivate patients to follow their treatment.

Effect of teaching health-promoting behaviors on the care burden of family caregivers of hemodialysis patients: a four-group clinical trial.

INTRODUCTION: Chronic kidney disease could have a profound effect on the life of patients and family caregivers. The caregivers' care burden increases as the disease progresses. Interventions reducing care burden should be investigated. Educational interventions could affect family caregivers' care burden among hemodialysis patients. However, most studies and interventions have focused on caregivers. Therefore, this study aims to compare the effect of teaching Health-promoting behaviors on the care burden of family caregivers of hemodialysis patients. MATERIALS AND METHODS: This trial was conducted using a pretest-posttest design and follow-up after one month. Hemodialysis patients and their family caregivers were selected using convenience sampling method. In total, 124 patient-caregiver pairs were divided into four groups of patient-centered education, caregiver-centered education, Patient and caregiver education and control by block randomization (15 blocks of 8 members and 1 block of 4 members) (n = 31 pairs per group). The intervention (teaching health-promoting behaviors) was performed in 8 sessions using the teach-back method, except for the control. The data were collected by patient and caregiver demographic forms and Novak and Guest care burden inventory as well as following the treatment regimen in three stages (before, immediately after and one month after the intervention). Demographic variables were compared among the four groups using ANOVA, Kruskal-Wallis and Chi-square test. The intragroup comparison of the main variables was made using the repeated measures ANOVA with modified LSD post hoc test. The intergroup comparison was made by one-way ANOVA with LSD post hoc test. RESULTS: Out of 124 caregivers participating in the study, 68 (54.8%) were female. Also, out of 124 patients participating in the study, 86 (69.4%) were male. The mean age of the caregivers and patients was 39.2 ± 11.31 and 54.23 ± 14.20 years old, respectively. There was a statistically significant difference in the mean total care burden scores of the pre-test and post-test between the four groups (p < 0.001). The total care burden decreased in patient-centered, caregiver-centered and Patient and caregiver education groups. However, this reduction in the caregiver-centered and Patient and caregiver education groups was significantly higher than the patient-centered education group (p < 0.001). CONCLUSION: The results revealed teaching health-promoting behaviors reduced care burden. Moreover, caregiver-centered approach could reduce care burden more than patient-centered approach. Therefore, this could be used as a supportive method to improve the health of patients and caregivers. TRIAL REGISTRATION NUMBER (TRN): IRCT20090522001930N4. DATE OF REGISTRATION: 2021-11-12.

Association between depression and blood pressure in community-dwelling older adults: focus on Bushehr elderly health (BEH) program.

INTRODUCTION: Depression and increased blood pressure are significant burdens in elderly care. This study was conducted to discover the association between hypertension (HTN) and depression based on data obtained from the Bushehr Elderly Health (BEH) program in a large population of Iranian elderly in Bushehr, southern Iran. METHODS: This study was carried out based on data obtained from the Bushehr Elderly Health (BEH) program in a large population of Iranian elderly in Bushehr, a southern city in Iran. 2419 old adults were included in the study through multi-stage random sampling. Depression was assessed using Patient Health Questionnaire-9 (PHQ-9), and blood pressure was measured using a standard mercury sphygmomanometer. Statistical analysis was conducted via chai-square, analysis of variance (ANOVA), and univariate and multivariate linear regression tests. RESULTS: The mean age of participants was 69.95 ± 6.95 years. The prevalence of depression was 23.8%. Diastolic blood pressure (DBP) decreased with increasing PHQ score (B=-0.001; 95%CI: -0.00 to -0.00, P-value = 0.011). In the final model adjusted for confounding variables, no significant association was found between depression score and DBP (B=-0.00; 95%CI: -0.00 to 0.00, P = 0.13). Conversely, in the final model, which included the confounding variable, SBP was significantly associated with depression. It was deduced that a variable acted as a negative confounder in this association; in a way that with increased depression score, SBP significantly decreased (B=-0.00; 95% CI: -0.00 to -0.00, P = 0.04). CONCLUSION: Depression and its related medications could be significantly associated with controlled SBP. Health practitioners in primary health care centers must monitor the elderly inflicted with HTN for early symptoms of depression to help maintain blood pressure levels using medicinal and non-medicinal interventions.

Effect of Foot Reflexology and Benson Relaxation on Pain, Breastfeeding and Weight of Neonates of Women Undergoing a Cesarean Section.

BACKGROUND: Given the negative effect of postoperative pharmacological pain control on breastfeeding, the present study aimed to compare the effects of reflexology and Benson relaxation methods on pain, breastfeeding, and infant weight gain in women undergoing a cesarean section (C/S). METHODS: This randomized clinical trial was conducted on 135 women undergoing a C/S in the Gynecology Ward of Bushehr Persian Gulf Martyrs Hospital in Bushehr, Iran, in 2020. The participants were selected using convenience sampling, and randomly divided into three groups of foot reflexology, Benson relaxation, and control. The interventions were performed two hours post-operation and six hours after the first intervention. The pain score was measured and recorded immediately, and 30 and 60 minutes after each intervention. Breastfeeding frequency and duration were also assessed in the first 18 hours of birth. The infants' weight was assessed at birth and 10 days later. Data analysis was performed using inferential statistics, chi-square or Fisher's exact test, Kruskal-Wallis test, Mann-Whitney U or one-way ANOVA, Wilcoxon test and logistic regression analysis. RESULTS: There was a larger decrease in the pain score of the reflexology and Benson relaxation (P<0.01) groups after the first and second interventions, compared to the control group. The breastfeeding frequency was higher in the two intervention groups, compared to the control group (P<0.001). Furthermore, the rate of return to the birth weight in ten days of birth was higher in the reflexology (P<0.01) and Benson groups (P<0.05) than the control group. CONCLUSION: Both the reflexology and the Benson relaxation methods effectively decreased pain and increased breastfeeding frequency and the infant's weight gain.

Effects of mindfulness-based stress reduction training on rumination in patients with breast cancer.

BACKGROUND: Breast cancer has been a serious public health dilemma for women worldwide, with not only physical and social impairments but also psychological stress responses such as rumination. Rumination is a constant preoccupation with thoughts. The present study aimed to investigate the effectiveness of mindfulness-based stress reduction training in lowering rumination among women diagnosed with breast cancer. METHOD: This randomized controlled trial with a pretest, posttest, control group, and one-month follow-up design included 46 female breast cancer survivors, recruited from the clinics and hematology wards of Bushehr, Iran. The inclusion criterion was that at least three months should have passed since the last chemotherapy/radiotherapy. The participants were randomly assigned to two experimental and control groups. The experimental group received eight sessions of mindfulness-based stress reduction training. A demographic information form and a rumination questionnaire were used for data collection, and the participants completed the questionnaire in the pretest, posttest, and follow-up stages. Chi-square, Mann-Whitney U, and repeated-measures ANOVA were used to analyze the data. P < 0.05 was considered statistically significant. RESULTS: There was no significant difference in the rumination scores of the experimental group at three measurement stages. For the control group, the mean rumination scores on the posttest and follow-up were both significantly higher than on the pre-test (P < 0.001). The control group's mean follow-up rumination score was significantly higher than that of the post-test (P = 0.02). A comparison of the two groups adjusted for the baseline showed a significant difference between them in terms of the mean rumination score on the post-test (P = 0.01) and follow-up (P < 0.001). CONCLUSION: The experimental group was more successful in avoiding increased rumination than the control group, an ability that can be attributed to the effect of mindfulness training. The use of this method is recommended because it is non-invasive, non-pharmacological, free from complications, and can be easily performed by women. However, future studies should consider larger samples and long-term follow-ups.

The effect of Flipped Classroom through Near Peer Education (FC through NPE) on patient safety knowledge retention in nursing and midwifery students: a solomon four-group design.

INTRODUCTION: Selecting an appropriate teaching methodology is one of the key stages in education. This study is an attempt to delve into the effect of FC through NPE on patient safety knowledge retention in nursing and midwifery students. METHODS: A randomized controlled trial, using the Solomon design, was conducted in 2019 on 82 nursing and midwifery students enrolled from Bushehr nursing and midwifery school. The Subjects were then allocated to four groups via block randomization. The Subjects in both intervention groups studied the educational content online for 2 weeks and subsequently attended the FC through NPE. Both control groups merely received education based on conventional method. The post-test was once administered to the four study groups immediately after completing the program and once again 2 months after it. RESULTS: The posttest mean scores of knowledge retention in both intervention groups remained the same (P = 0.1), while they were higher in the control groups (P < 0.05). The changes in the mean scores of the post-test in the intervention and follow-up groups did not demonstrate a statistically significant difference between the four study groups (P = 0.130, F = 1.941). CONCLUSION: The use of the FC through NPE increased the knowledge mean scores; however, it failed to affect knowledge retention. Given the infancy of this pedagogical approach, further studies are needed to investigate its effects on various learning outcomes.

The Actor-Partner Effects of Parenting Stress on Quality of Life Among Parents of Children with ASD: The Mediating Role of Mental Quality of Life.

The present study investigated the actor-partner effects of parenting stress (PS) on quality of life (QoL) among parents (96 couples) of children with autism spectrum disorder (ASD). Data were collected using the QoL Scale and the PS Index. Structural equation modeling was also utilized to test the hypothesis. The results revealed the effects of PS in each parent on mental QoL of that parent. Maternal PS further shaped physical QoL in mothers. However, PS in one parent did not influence QoL of his or her partner. Accordingly, mental QoL had a mediating role between PS and physical QoL. It was ultimately suggested to take account of QoL among parents in addition to the treatment of children with ASD.

Renal artery stenosis and its predictors in hypertensive patients undergoing coronary artery angiography.

BACKGROUND: Renal artery stenosis (RAS) has been increasingly recognized in the recent years, especially in patients with coronary artery disease (CAD). RAS affects the patients with hypertension (HTN), but the exact prevalence is not known. OBJECTIVES: This study was performed to determine the prevalence and to identify the predictors of RAS in hypertensive patients undergoing coronary artery angiography. PATIENTS AND METHODS: In a cross-sectional study from August 2008 to August 2009, 481 patients with HTN and suspected CAD underwent selective coronary and renal angiography for screening and predicting RAS. RAS was defined as a higher than 50% stenosis in the renal artery lumen. Multivariate analysis of factors associated with the presence of RAS were examined using a logistic regression model. RESULTS: The mean ± standard deviation of age was 59.25 ± 10.81 years and 50.3% were men. According to angiographic data, 425 patients (88.4%) had CAD, while 56 (11.6%) had normal coronary arteries. RAS was seen in 94 (22%) patients with CAD. The multivariate logistic regression analysis identified only age (P < 0.001) and the number of significant coronary lesions (P < 0.001) as independent predictors of RAS. Gender, smoking, congestive heart failure, diabetes mellitus (DM), hyperlipidemia (HLP) and body mass index (BMI) were not independent predictors. CONCLUSIONS: This study suggests that in the management of patients with RAS, risk factors should most likely be considered as beneficial. In addition, the clinical and angiographic features are helpful in predicting its presence in elderly patients with CAD.